Medical Screening in Physical Therapy Clinical Education - a Survey of DPT Students and CIs
Purpose: With direct access now available in all 50 states, it is increasingly important that physical therapists (PTs) follow best practice standards for medical screening. Best practice standards include gathering information about imaging, laboratory, medications, and vital signs during the examination. Prior investigators report actual utilization of some medical screening tests by clinical instructors (CIs) and PTs ranging from <10% up to 75%. The purpose of this study was to assess how often Doctor of Physical Therapy (DPT) students and CIs incorporate components of medical screening into their examinations and to evaluate differences in medical screening utilization among clinical settings. Methods/Description: All graduating DPT students (N=37) and their CIs (N=42) were invited to participate in an anonymous survey (Qualtrics, Inc.) during the final clinical internship. 37 DPT students (100%) and 22 CIs (52%) responded to the survey. Respondents were asked to indicate their clinical practice setting and rate their utilization of each of the following medical screening tests: imaging tests (RAD), laboratory tests (LABS), medication usage (MEDS), pulse rate (PR), respiration rate (RR), temperature (TEMP), blood pressure (BP), and pain rating during the initial examination of patients. Response options for frequency of utilization included: never, rarely, sometimes, often, and very often. For each medical screening test, percentage of respondents was calculated for each response option. Chi-square tests were conducted to assess for differences in frequency of utilization between DPT students and CIs, and between IP and OP settings. Results/Outcomes: Responses were obtained from the following clinical settings: 19 inpatient (IP), 34 outpatient (OP), 4 pediatric, and 2 skilled nursing/post-acute care. There were no differences in frequency of utilization of any screening tests between DPT students and CIs (p>.05). Tests screened most frequently (often or very often) by OP DPT students and CIs were RAD (97.6%), pain (94%), and MEDS (70.6%). Tests screened least frequently by OP practitioners (never or rarely), were TEMP (3%), RR (9.9%), PR (26.5%), LABS (29.6%), and BP (38.2%). IP DPT students and CIs reported frequently screening for pain (100%), PR and BP (84.2%), LABS (76.7%), MEDS (68%), and RAD (57.9%). There was no significant difference in frequency of screening for RAD, MEDS, RR, TEMP, or pain between IP and OP respondents (p>0.05). Respondents from IP settings screened for LABS, PR, and BP more frequently than OP respondents (p<0.05). Conclusions/Relevance to the conference theme: The utilization of medical screening by CIs and DPT students, not previously reported, is consistent with CI and physical therapist utilization rates in past studies. Some medical screening components (LABS, PR, and BP), were performed infrequently by outpatient CIs and DPT students. This poses an area for development in education to improve medical screening across IP and OP physical therapy settings.