Transforming Physical Therapist Clinical Education for 21st Century Practice: Findings of the APTA Best Practice in Clinical Education Task Force
Purpose
To share findings of the Best Practice in Clinical Education Task Force and promote discussion regarding opportunities to eliminate unwarranted variations in clinical education and practice
Methods and/or Description of Project
In 2014, the House of Delegates approved 2 motions specific to investigating the future of physical therapy education: RC 12-14: Promoting Excellence in Physical Therapist Professional Education, and RC 13-14: Best Practice for Physical Therapist Clinical Education.
RC 13-14 charged:
That the APTA, in collaboration with relevant stakeholders, identify best practice for physical therapist clinical education, from professional level through postgraduate clinical training, and propose potential courses of action for a doctoring profession to move toward practice that best meets the evolving needs of society with a report to the 2017 House of Delegates.
This effort shall include, but not be limited to, the examination of:
Current models of physical therapist clinical education from professional level through postgraduate clinical training;
Mandatory postgraduate clinical training;
Stages of licensure;
Findings from related studies and conferences; and
Models and studies of clinical education in other health care professions.
In response to RC 12-14, the Board of Directors established the Excellence in Physical Therapy Education Task Force (EETF) that presented 8 recommendations to the Board that were approved at its November 2015 meeting. This included the formation of the Education Leadership Partnership (ELP) (a collaboration of the American Council of Academic Physical Therapy [ACAPT], American Physical Therapy Association [APTA], and Education Section of the APTA) as the vehicle to address the EETF recommendations. Similarly, in response to RC 13-14 the Board of Directors created the Best Practice for Physical Therapist Clinical Education Task Force (BPCETF), with the work of that group occuring between January 2016 and January 2017.
The Board of Director’s charge to the BPCETF was to consider strategies and provide a recommendation(s) to the Board of Directors to identify best practice for physical therapist clinical education, from professional level through postprofessional clinical training, and propose potential courses of action for a doctoring profession to move toward practice that best meets the evolving needs of society.
After engaging in a year-long information-gathering process, the BPCETF submitted 5 content recommendations, and 1 dissemination recommendation to the Board of Directors for their January 2017 meeting. After reviewing the scope of the task force’s work and recommendations, the Board of Directors adopted a revised Recommendation 6: “That APTA design a plan for dissemination of the Best Practice in Physical Therapist Clinical Education Task Force (BPCETF) report for receiving widespread stakeholder input. Upon receipt of the input the APTA Board of Directors will consider adoption of the recommendations at their November 2017 meeting .” The rationale for this recommendation was based on understanding the importance and value of engaging all relevant stakeholders and allowing the collective community bring its thoughts and suggestions forward. The Board of Directors recommended that the ELP be charged with leading this stakeholder review and reporting process. The BPCETF Board of Directors Report to the House of Delegates was posted in April 2017.
Results/Outcomes
After engaging in a year-long information-gathering process, the BPCETF submitted 5 content recommendations, and 1 dissemination recommendation to the Board of Directors
Since 1975, multiple professional work groups and task forces have been formed with subsequent consensus conferences or summits to specifically address issues facing physical therapist student clinical education.
Despite an extensive list of recommendations, innovations, and potential solutions that resulted from these collective works, physical therapist student clinical education training has changed little over the past several decades. The status quo persists because by some measures the current models have been effective, in that the educational community continues to produce graduates who successfully become licensed. Additionally, significant changes to academic and clinical education models will require a degree of consensus and cooperation among multiple stakeholders with competing priorities and varied perspectives that could, or might, result in uncharted disruptions to practice and education.
Based on its work and feedback from multiple stakeholders, the BPCETF concluded that current clinical education models are unsustainable, suboptimal, and not designed to produce practitioners required by the health care system of the future, nor will they help the profession achieve our vision. The BPCETF took a global approach when forming its recommendations, not wanting to be prescriptive but to provide a framework for future consideration. The task force recognized that the details of any formative plan for the future of clinical education will come from the collective involvement of multiple stakeholders, and that the transition process could take decades.
Conclusions/Relevance to the conference theme: Through the Looking Glass: Transforming Physical Therapy Education
In the 2012 APTA McMillan Lecture, Alan M. Jette (2012) described 3 major societal storms: lack of access to health care, the age wave, and costs of health care. Jette proposed that to meet societal needs, “physical therapists must possess and use critical systems skills” including “… universal standardized measurement and data collection, widespread quality and improvement and implementation techniques, interprofessional coordination and care management, diffusion of practice innovations and standardized practice models, and health policy leadership for widespread change” (Jette, 2012). Physical therapist education must continue to evolve as physical therapists increasingly position themselves to function as points-of-entry in the complex and evolving health care system focused on outcomes, value, and efficiency. Physical therapist professional education programs should build capacity to increase emphasis related to didactic content and clinical practice experiences in chronic care management, interprofessional collaboration, primary care practice, and population health and wellness.
The physical therapy profession continues to evolve and now includes: all graduates earning the DPT degree, all licensure jurisdictions having some form of direct access and practitioners assuming varying degrees of primary care responsibilities highlighted by long-established models in the uniformed services divisions of the United States military and Public Health Service. Additionally, postprofessional residency and fellowship programs continue to grow at an exponential rate. Considering these examples of growth and the escalation of higher education costs, corresponding student debt, decreased payment for provision of clinical services, increased productivity demands on clinicians serving as clinical instructors, and the current variation in student readiness—there is a need for an alternative clinical education model.
References
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Course Objectives
Identify the multiple stakeholders engaged in physical therapist clinical education
Consider options for changes in clinical education that address contemporary and future physical therapist practice
Discuss the relationships and opportunities between clinical education, postgraduate professional development and quality of physical therapist practice.
Recognize the impact of significant variability in the quality of physical therapist clinical education in structure, process, and outcomes
Identify factors related to limited overall capacity for clinical education placements
Analyze multiple economic factors that significantly impact clinical education
Compare and contrast physical therapist clinical education models with those of other health professions
Instructional Methods
Panel presentation, small group discussion, Question & Answer/Comment Session
Tentative Outline/Schedule
45 Minutes:
Overview of Task Force Report Findings and Recommendations
History, background
Preparing physical therapy students for contemporary and future practice
Relationship of entry-level education and post-graduate professional training
Rationale for task force recommendations
Next steps
15 minute small group – What are opportunities for and barriers to implementing recommendations?
30 minute Q&A/comments