Comparison of Financial Literacy between Graduate Physical Therapy and Physician Assistant Students
Purpose/Hypothesis: Physical Therapy (PT) and Physician Assistant (PA) students commonly accumulate debt in pursuit of their post-graduate educational aspirations. Consequently, healthcare students have become critical consumers of education and evaluate the post-graduation return on investment when making choices about their training options. Despite these truths, the summary of the current literature suggests that future healthcare providers are inadequately prepared to engage in healthy financial habits and lack the business acumen to assure personal and business pecuniary success upon graduation. The initial purpose of this multi-phase project is to develop and pilot a survey that identifies PT and PA students’ financial literacy. This baseline needs assessment will be used to develop educational modules that focus on improving students’ personal financial knowledge and heightening awareness of its impact on healthcare practice. Number of Subjects: 109 Materials and Methods: After reviewing the existing literature on financial literacy assessments, we developed a 43-item survey that assessed financial lifestyle and habits (8 questions), savings knowledge (9 questions), credit and borrowing strategies (10 questions), and investment knowledge (16 questions). The four sub-sections were scored both individually and as whole to provide an overall financial literacy score. Survey items were primarily derived from previously vetted financial literacy surveys, including the National Financial Educators Council, the Financial Industry Regulatory Authority, the 2018 Harris Poll on Financial Literacy commissioned by the National Foundation for Credit Counselling, and Ohio State University’s National Student Financial Wellness Study. The survey assessed financial self-efficacy through six additional items rated on a four-point Likert scale. Participants also provided information regarding socioeconomic background, debt status, and future salary expectations. 111 PA and 76 PT graduate students in the School of Health Professions at UT Southwestern Medical Center were invited to complete the online survey. The email invitation assured students that their candid opinions, reflections, and answers were valued. We analyzed continuous data using independent t-tests, and we used Mann-Whitney U tests for categorical data. A sample size of 99 respondents was necessary to reach a 5% margin of error at a 90% confidence level. Results: 109 students completed the survey (58% response rate). The response rate for PT students was 68%, and was 51% for the PA students. PT students were younger (24.6 + 3.0; p = 0.035) and reported higher parental income (median combined parental income = $100-124,999.00; p = 0.025). There was no difference between groups in regards to race/ethnicity, marital status, dependent support, parental education level, or number of previous careers. Both groups had a similar percentage of students (68-69%) with tuition-based debt, but PT students had a higher, non-significant (p =0.17) median total loan amount ($80-99,999.00). PA students had a significantly higher starting and future salary expectation (p <0.001). Collectively, students correctly answered 37% of the financial literacy questions (15.9 of 43 questions). Financial lifestyle and credit and borrowing were the areas that students scored the best at 49% and 50%, respectively. Students scored the lowest on savings and investment knowledge with an average of 38% and 24% correct responses, respectively. PT students’ scores were not statistically significantly different from PA students for any category of financial literacy. Regarding financial self-efficacy, the overall mean score was 15.4 + 3.6 with no statistically significant difference between PT and PA students. Conclusions: Both PT and PA students have very low financial literacy especially in the areas of savings and investments. To complicate matters, both groups of students have low self-efficacy regarding their confidence to manage financial problems, cope with financial setbacks, and plan for a lifetime financial security. Clinical Relevance: These conclusions are particularly worrisome when a majority of students are borrowing at the maximal recommended level of debt to income ratio to fund their career training. Educational programs to address these deficits should be developed and implemented.