Cross Cohort Variation in Comprehension of PTA Supervision Requirements in a Dpt Program
Background and Purpose: Currently, the guidelines for physical therapist direction and supervision of the physical therapist assistant varies at the state and national level. The purpose of this study was to examine the impact of a focused educational intervention on Doctor of Physical Therapy Student comprehension of direction and supervision of the physical therapist assistant.
Case Description: 52-1st year and 54-2nd year Doctor of Physical Therapy students volunteered to participate in the study. Students received one lecture focused on current direction and supervision requirements utilizing the APTA’s PT/PTA Teamwork: Models in Delivering Patient Care documents and the state’s Physical Therapy Practice Act.
Method: The study participants were one of convenience. The students who agreed to participate completed an anonymous web-based Pre-Test and Post-Test with four multiple choice questions: Q1- supervision required for an inpatient facility, Q2- direction to perform examination activities, Q3 - direction to perform mobilization, and Q4 - supervision required for Medicare patients. DPT program faculty provided a 30-minute educational lecture including case studies after the Pre-Test. The Post-Test was available for students to complete for a 10-minute time period after the educational intervention. Pre-Test and Post-Test responses were analyzed for differences in cohort responses as well as any change in comprehension after the intervention.
Outcomes: Pre-Test combined means for correct responses = 46%. Post-Test combined means for correct responses = 65%. 1st Year: Pre-Test score = 1.81 (SD .79) and Post-Test score = 2.63 (SD 1.01). There was statistical gain on Q3 (p< 0.001) and Q4 (p<.007) for 1st year students. 2nd Year: Pre-Test score = 1.85 (SD .96) and Post-Test score = 2.59 (SD .99). There was statistical gain on Q3(p< 0.003) for 2nd year students. Comparison of the cohorts Pre-Test and Post-Test scores revealed a statistical difference in score for Q1 (p<0.011) with less correct responses by 2nd year students, there was no significant difference in score for Q2-Q4 or the total score.
Discussion: Students appeared to have benefited from the intervention as demonstrated by improved Post-Test scores. 1st year students demonstrated significant improvement in comprehension for both direction and supervision, while 2nd year students only demonstrated significant improvement for direction of the PTA. This study indicates that students experience some improvement following an educational intervention. However, students from both cohorts still had difficulty correctly identifying appropriate requirements for the supervision of the PTA, which may cause issues in the clinical setting. Students may benefit from additional opportunities to interact with PTA students to allow better integration of direction and supervision concepts. Future studies could examine if post intervention students have any change in the CPI rating as it relates to supervision of the PTA.