JOPTE

The Journal of Physical Therapy Education (JOPTE) is peer reviewed and published four times each year by theEducation Section of the American Physical Therapy Association. The Journal is indexed by Cumulative Index to Nursing & Allied Health Literature and in Physiotherapy Indexditor:

Editors:
Jan Gwyer, PT, PhD
Laurita M. Hack, PT, DPT, MBA, PhD 

2016 Volume 30 - Number 3

Editorial: Do What We Cannot Yet Do
by Jan Gwyer, PT, PhD, FAPTA, and Laurita M. Hack, PT, DPT, PhD, MBA, FAPTA
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As Picasso reminds us, and as we in physi-cal therapy know full well, simply learning about new things is not sufficient for mastery. We must practice them, of course! But that practice must also be under the guidance of experts who actually know how the task or skill should be done. This issue offers many opportunities to have several experts provide us some examples of things our students ben-efit from leaning how to do.
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Letter to the Editor: Thank You, Bell
by Martha (Marty) Rammel Hinman
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Our profession has lost another great lead-er and educator. Although Dr Bella May passed away last March, her influence lives on through the numerous contributions she made to our profession over the past 50 years. Bella devoted her entire academic career to the program she founded at the Medical Col-lege of Georgia (now Augusta University). The mere fact that she had the vision and courage to develop a nontraditional physi-cal therapy program without the benefit of prior academic experience was a feat in it-self, and one that could not be replicated in today’s academic environment. Throughout her career, Bella received numerous awards and accolades, published oft-cited articles and books, and inspired hundreds of PTs and PTAs whom she helped educate. Bella wore her passion (and opinions) on her sleeve and never missed an opportunity to share her point of view, particularly when it might in-fluence the future of physical therapy educa-tion. Yet beneath that determined, stalwart exterior was the Bella May I was fortunate to know on a personal level--a kind, intelligent woman, and trusted mentor who shared her heart and wisdom with those she cared about. Thank you, Bella, for caring about us and our profession.
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2016 Cerasoli Lecture: Unflattening
by Diane U. Jette, PT, DPT, DSc, FAPTA
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I am humbled and honored to be here be-fore you today, my esteemed colleagues, and I thank Polly’s family for helping to make this lectureship possible. It is a wonderful tradition and tribute to Polly and I hope my contribution is worthy. I doubt I would have taken the road here without parents who val-ued education, a husband and children who accepted my devotion to my profession, col-leagues who shaped my love for our profes-sion, and finally, my students who always inspired me to do better. I owe them many thanks. I also want to thank Leslie Portney for spearheading my nomination, those who wrote letters in support, and my colleagues who agreed to phone conversations with me as I prepared for this talk. They helped for-ward and deepen my thinking.
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A Systematic Review of Physical Therapist Clinical Instructor Demographics and Key Characteristics: Impact on Student Clinical Education Experiences
by Christine A. McCallum, PT, PhD, Rachel Reed, DPT, Stephanie Bachman, OTD, OTR/L, CHT, and Leigh Murray, PT, PhD
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Background. The clinical instructor (CI) plays a significant role in a physical therapist (PT) student’s clinical education (CE) experience. Authors have reported previous systematic reviews concerning effective teaching behaviors and com-munication styles across the allied health professions, but physical therapist CIs have not been closely analyzed. Purpose. To identify key CI demograph-ics/characteristics that impact PT stu-dents’ CE experiences. Data Sources. PubMed, PEDro, Pro-Quest, Google Scholar, CINAHL, and ERIC were searched up through Septem-ber 2015. Data Extraction. Quantitative data ex-tracted included CI demographics, CI teaching behaviors, and fundamental characteristics that have an effect on CI teaching effectiveness. Data Synthesis. Eight articles were se-lected. Three elements emerged from a qualitative descriptive thematic analy-sis: CI demographic data, CI credentialing status, and communication/teaching styles. The most effective communication skills exhibited by CIs included giving timely feedback to the student, using clear and concise communication, and clearly explaining responsibilities to the student. It is unclear from this review whether American Physical Therapy Association (APTA) credentialing influences CI effec-tiveness. Limitations. Publication bias and region-al bias may limit generalizability of results. Conclusions. The data from this review identified key CI demographic and per-sonal/environmental characteristics that positively impacted student outcomes. Higher level evidence and using reliable standard outcome measures is recom-mended to determine if CI effectiveness correlates with being an APTA-creden-tialed CI or any other demographic data. Innovative training programs could be designed to highlight the personal and environmental characteristics related to positive student outcomes. Key Words: Clinical instructor, Clinical education, Physical therapy education.
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Clinical Site Directors’ Perspectives on Clinical Education
by Carol Recker-Hughes, PT, PhD, Carolyn Padial, PT, Elaine Becker, PT, DPT, PCS, and Maureen Becker, PT, DHSc
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Background and Purpose. A 2-way part-nership between academic programs and clinical sites is required to achieve an adequate quantity of high quality clini-cal education (CE) experiences. Until re-cently, the perspectives of the directors of clinical sites, who are responsible for de-cision-making with respect to important CE issues, have not been adequately rep-resented in physical therapy professional literature. The input of directors at clinical sites, who participate in decisions such as resource allocation and participation of staff in CE, are critical to inform ongoing strategic planning. Participants. The study surveyed 293 di-rectors of clinical sites in New York and in New Jersey who were affiliated with 3 academic physical therapy programs. Methods. A comprehensive online sur-vey was developed to capture directors’ perspectives on CE. The questionnaire in-cluded the following sections: (1) respon-dent demographics and decision-making roles, (2) reasons for and challenges of providing a CE program, (3) perspectives on the impact of CE on the quality of patient care and on productivity, and (4) supports desired and provided by academic programs. Descriptive statistics consisted of percentages and frequency distributions. Results. In all, 147 surveys were com-pleted for a return rate of 53%. A vast ma-jority of respondents actively participated in CE decision-making process. The ma-jority of respondents identified multiple reasons for having a physical therapist (PT) student program, including 90.4% who said that CE programs contribute the professional development of staff. Nearly 50% of directors reported that academic programs have limited awareness of their challenges, with staffing issues most fre-quently identified. A strong majority of directors reported that the PT student program had a neutral or overall positive effect on productivity (77.6%) and quality of care delivered (93.6%). Many supports and benefits for CE are not perceived as being offered by academic programs and all of the respondents were interested in having academic programs provide ad-ditional supports. Few directors (16.1%) anticipated growth of their student pro-grams. Conclusions. Directors’ responses indi-cate that they are key stakeholders in CE and involved in critical decisions that im-pact the sustainability and quality of CE experiences. The findings of this survey are valuable to complement the recom-mendations of the 2014 Clinical Educa-tion Summit and to inform next steps in strategic planning at local, regional, and national professional levels. Key Words: Clinical education, Direc-tors’ perceptions, Survey study, Physical therapy.
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Changes in Physical Therapist Students’ Self-Efficacy for Physical Activity Counseling Following a Motivational Interviewing Learning Module
by Beth Black, PT, DSc, Jennifer Lucarelli, PhD, MarySue Ingman, PT, DSc, and Courtney Briskey, PT, DPT
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Background and Purpose. Healthy Peo-ple 2020 articulates the need for health professionals to incorporate health pro-motion counseling into their treatment programs to address personal behaviors that contribute to morbidity and prema-ture mortality, such as smoking, insuf-ficient physical activity, and poor diet. Physical therapists (PTs) have a unique opportunity to discuss health behav-iors with their patients during treatment sessions. However, PTs have shown re-luctance to engage in health promotion counseling due to a lack of confidence and inadequate training in counseling skills. Motivational interviewing (MI) is a pa-tient-centered counseling approach that has been shown to be both efficient and effective in supporting behavior change. The purpose of this case report was to determine if a 4-hour MI learning mod-ule increased PT student self-efficacy for counseling patients to increase their level of physical activity. Case Description. Twenty-eight third-year doctor of physical therapy students received 4 hours of instruction in MI. The learning module included lecture, video demonstrations, class discussions, student role-playing, and practice with standard-ized patients. Prior to and following the module, students completed a self-efficacy questionnaire that measured their level of confidence in counseling patients in the area of physical activity. The students also completed an evaluation of the module. Outcomes. Students had increased lev-els of self-efficacy for counseling patients to increase their level of physical activity following the learning module (P < .001). Furthermore, the majority of students (93%) reported they were more likely to discuss physical activity with their pa-tients. Discussion and Conclusion. A 4-hour MI learning module increased PT stu-dents’ self-efficacy for counseling patients in the area of physical activity. Future re-search should examine the students’ com-petence in the technique and whether PT students engage in more health behavior counseling in the clinical setting as a re-sult of this training. Key Words: Health promotion and pre-vention, Teaching methods, Patient edu-cation.
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Effects of Meditation on Stress Levels of Physical Therapist Students
by Joshua Chambers, PT, DPT, Beth Phillips, PT, DPA, Michael Burr, PT, DPT, and Danny Xiao, PT, DPT
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Background and Purpose. Due to the arduous nature of the professional (entry-level) physical therapist (PT) education program, PT students often experience higher levels of stress than their age and gender-matched peers, which can nega-tively affect their academic performance and wellbeing. Therefore, finding meth-ods to manage stress is important for stu-dents’ wellbeing and academic success. The purpose of this study was to inves-tigate the effect of meditation on stress levels of students in a doctor of physical therapy program. Participants. Twenty-four PT students in their first and second year of an entry-lev-el doctoral degree program participated in this study. Methods. This study examined the stress levels of 24 subjects via blood pressure, morning and evening salivary cortisol lev-els, and 3 different stress questionnaires (Perceived Stress Scale, General Anxiety Disorder 7, Stress Visual Analog Scale) us-ing a quasi-experimental pretest-posttest design. The intervention was a twice-daily 20-minute beeja mantra-based medita-tion performed for 8 weeks. Results. All 24 students completed the study with average compliance of 91.6% ± 8.7% (mean ± SD) meditating at least once per day, and 77.3% ± 19.8% meditating twice per day. A paired t test was used to analyze the blood pressure readings, with systolic blood pressure decreasing by 2.9 ± 2.3 (standard error of the mean: SEM) mmHg (P = .022), and diastolic blood pressure decreasing by 4.6 ± 2.9 (SEM) mmHg (P = .005). Four subjects with pre-hypertensive systolic blood pressure read-ings prior to the meditation intervention moved into healthy normal range by the conclusion of the study. The Wilcoxon signed rank test was used to evaluate the questionnaires, which showed signifi-cantly decreased subjective stress levels (P < .05). No significant changes in mean morning (AM) or night (PM) salivary cortisol levels were found (P > .05). How-ever, 9 of the 14 (64%) subjects who had at least 1 cortisol measurement outside of the normal range (established by ZRT Labs) at the start of the study had both AM and PM cortisol levels in the normal range following the intervention. Discussion and Conclusion. The results of this study show that an 8-week mantra-based meditation program significantly reduces blood pressure, significantly re-duces perception of stress based on the subjective questionnaires, and that a 1-day AM/PM cortisol sample may not be sufficient to accurately analyze a subject’s true daily cortisol level to show statistical change. Key Words: Student stress levels, Beeja mantra meditation, Blood pressure, Cor-tisol.
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Group Peer Teaching: A Strategy for Building Confidence in Communication and Teamwork Skills in Physical Therapy Students
by Christopher Seenan, PT, PhD, FHEA, Sivaramkumar Shanmugam, PT, PhD, FHEA, and Jennie Stewart, PT, MSc, FHEA
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Background. First-year entry-level stu-dents are faced with a number of challeng-es including social and cultural changes when enrolling in a university. Building confidence in their skills of academic study can help minimize the impact of this transition and prepare students to maximize learning. Aim. To embed reciprocal peer teaching (RPT) within the physical therapy cur-riculum and explore its effects on student confidence in communication and team-working skills. Methods. Fifty-seven first-year entry-level physical therapist (PT) students completed group peer teaching embed-ded in a core first-year anatomy module. Questionnaire, focus groups, and semis-tructured interviews were used to evalu-ate the outcome of this novel learning and teaching strategy. Results. Students reported satisfaction with the experience of the group peer teaching. The key themes were group work, peer teaching, and peer feedback. Students also reported increased confi-dence in skills, especially in communica-tion and teamwork. Faculty felt that the group peer teaching was beneficial for students, and an effective learning and teaching strategy. Conclusion. This study found that RPT embedded within a first-year course helped increase skills and confidence in communication and teamwork. Peer teaching appears to be an effective method in aiding the development of important skills within the first year of a PT educa-tion program. Key Words: Peer teaching, Collaborative learning, Transitioning, Skill develop-ment.
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Interprofessional Education Workshop Outcomes: Learning and Understanding Professional Roles in Stroke Care
by Sarah E. Wallace, PhD, CCC-SLP, Paula Sammarone Turocy, EdD, Leesa M. DiBartola, EdD, Elizabeth D. DeIuliis, OTD, Janet Astle, EdD, Shirley Cousino, MBA, Alison Morgan, MPA, Christine O’Neil, PharmD, Lynn Coletta Simko, PhD, and Yvonne Weideman, DNP
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Background and Purpose. If patient out-comes are to be optimized, students from every health care discipline should be pre-pared to work in interprofessional teams. The purpose of this paper was to describe a novel interprofessional education (IPE) stroke workshop for health care studies across 8 disciplines. An additional pur-pose was to examine changes in student learning outcomes and understanding of the roles of other disciplines in stroke care following an interprofessional stroke workshop. Description and Evaluation. Participants completed a multistaged interprofessional workshop that included collaborative his-tory taking with a real patient and devel-opment of a comprehensive plan of care. Of the 413 students from 8 health care disciplines who participated in the work-shop, 334 participants completed pre and posttests and permitted use of their data to measure outcomes. Study participants included 29 physical therapist (PT) stu-dents, as well as students from athletic training, health management systems, physician assistant studies, occupational therapy, pharmacy, nursing, and speech-language pathology. Outcomes. Analysis of pre and posttest results demonstrated significant changes in some but not all aspects of the stu-dents’ understanding of stroke, as well as each discipline’s role and responsibility in stroke prevention, diagnosis, and treat-ment. The results for the PT students were similar to the results demonstrated by the entire group. Discussion and Conclusion. Although examination of pre and posttest scores demonstrated that IPE involving collab-orative practice activities can help pre-pare students to work in interprofessional teams, less learning related to professional roles and responsibilities occurred than expected. The workshop faculty plan to use the results of the current study to de-velop, refine, and examine future IPE ac-tivities. Key Words: Interprofessional education, Stroke care, Roles and responsibilities.
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