EDGE-ucation 2.0: Moving forward the value of physical therapy
Purpose
The purpose of this session is to move forward clinical practice by advancing the role of stroke outcome measures in physical therapy education.
Methods and/or Description of Project
In 2009, the Academy of Neurologic Physical Therapy recognized that an essential method of defining the value of physical therapy was through the use of standardized outcome measures. A task force was convened to critically examine the literature and come to a consensus on stroke-related outcome measures for use in physical therapy education, clinical practice, and research.[1] After numerous presentations, articles published[2-5], and government mandates, use of outcome measures is still not standard of care.[6, 7]
From 2015-2016 a revision task force of eight diverse physical therapy experts in stroke rehabilitation convened and updated the stroke Evidence Database to Guide Effectiveness (StrokEDGE) recommendations in conjunction with the Rehabilitation Measures Database. Articles published related to the psychometric properties of the original StrokEDGE measures, from 2010-2015, were examined using a modified Delphi consensus process. In addition, a thorough literature search was then completed to find any new stroke outcome measures, and subsequent articles were reviewed. Any new evidence or updated recommendations were made to the outcome measure worksheets and provided back to the Rehabilitation Measures Database.
Results/Outcomes
A total of 38 measures were reviewed. Updates have been submitted to the Rehabilitation Measures Database for posting on the webpage.
Conclusions/Relevance to the conference theme: Through the Looking Glass: Transforming Physical Therapy Education
Given the current paucity of outcome measure use in everyday stroke rehabilitation, the updated guidelines present a new opportunity for dissemination. Education of the next generation of providers is the foundational step in improving the use of outcome measures in clinical practice and efforts must be refocused on education to provide clinicians with the tools to succeed in the evolving healthcare system.
References
1. Sullivan, J.E., et al., Outcome measures for individuals with stroke: process and recommendations from the American Physical Therapy Association neurology section task force. Phys Ther, 2013. 93(10): p. 1383-96.
2. Lang, C.E., et al., The Brain Recovery Core: Building a System of Organized Stroke Rehabilitation and Outcomes Assessment Across the Continuum of Care. Journal of neurologic physical therapy : JNPT, 2011. 35(4): p. 194-201.
3. Jette, D.U., et al., Use of standardized outcome measures in physical therapist practice: perceptions and applications. Phys Ther, 2009. 89(2): p. 125-35.
4. Field-Fote, E.E., Measuring up to our full potential: physical therapy at the EDGE of best clinical practice. J Neurol Phys Ther, 2012. 36(3): p. 113-4.
5. Potter, K., et al., Outcome measures in neurological physical therapy practice: part I. Making sound decisions. J Neurol Phys Ther, 2011. 35(2): p. 57-64.
6. Bland, M.D., et al., Clinician adherence to a standardized assessment battery across settings and disciplines in a poststroke rehabilitation population. Arch Phys Med Rehabil, 2013. 94(6): p. 1048-53 e1.
7. Anderson, H.D. and J.E. Sullivan, Outcome measures for persons with acute stroke: a survey of physical therapists practicing in acute care and acute rehabilitation settings. J Acute Care Phys Ther, 2015. 7(2): p. 76-83.
Course Objectives
Using the STROKEDGE recommendations as a framework, we will: 1) briefly revisit the EDGE process and updated guidelines by the STROKEDGE Revision task-force, 2) breakdown current barriers to standardized measurement usage in the classroom and during clinical internships, 3) explore innovative strategies to better incorporate outcome measures into physical therapy curriculum, and 4) incorporate clinical research into models for outcome measure use for students.
Upon completion of this course, learners will be able to:
1. Describe strategies to educate and prepare students to effectively and efficiently use outcome measures within the evolving healthcare system;
2. Provide clinical case examples of how assessments can be efficiently incorporated into physical therapy education, practice, and research;
3. Critically examine outcome measure utilization and barriers from the educator, clinician, patient, and payer perspective, using the STROKEDGE Revision recommendations as model;
4. Explore the role physical therapists play in implementation of outcome measures, as student to expert clinician, as educators, and as researchers.
Instructional Methods
Multiple Level: Indicates that a single level cannot be determined. The instructional level may vary and will be through powerpoint presentation and audience discussion.
Tentative Outline/Schedule
0:00-0:30 Brief Review of the StrokeEDGE 2.0 process
Presentation of revised recommendations
Success and failure
0:30-1:20 Barriers to outcome measure use in the classroom
Examining the DPT curriculum
Integration strategies and assessment for outcome measures
1:20-1:30 Question and Answer