From Take-off to Landing: Developing future practitioners for the area of integumentary physical therapy practice through collaborative academic and clinical leadership.
Purpose: The purpose of this session is to describe the collaborative leadership activities of Doctor of Physical Therapy (DPT) Program faculty and physical therapist wound care specialists from a local hospital to increase student exposure to and competence in the underrepresented area of integumentary physical therapy (PT) practice.Methods and/or Description of Project: The DPT Program consists of an eight-semester, guide-based curriculum. The clinical education curriculum includes three service-learning courses, two five-day integrated clinical education (ICE) experiences, and three full-time, twelve-week clinical education experiences. The didactic curriculum includes physical therapy sciences and practice courses dedicated to the four primary practice areas. The dedicated three-credit course in wound management is offered in the third semester of the didactic curriculum. The course coordinator is a core faculty member, who is a PhD trained physical therapist with extensive wound management and skin research experience. Course faculty, including other full-time faculty with wound management experience, and community wound care clinicians conduct didactic sessions, structured labs, and integrated special experiences (SEs). Local clinical instructors participate in both didactic and structured lab content. Among the clinicians participating, Certified Wound Specialists from a local hospital assist with addressing focal topics including biophysical modalities related to wound management and hands-on skill application. Two SEs occur within the course. The first is a “lived experience” where students wear a multi-layer compression dressing for a week. Students also engage in a patient lab for diabetes foot screening and education. An additional volunteer opportunity exists for students to participate in a diabetes foot clinic at a local medical provider for underserved individuals. This opportunity is available throughout the curriculum. In order to support mastery of integumentary didactic knowledge and application of practice skills, ICE opportunities were expanded to include an integumentary experience (2015). The awareness of the need for this experience evolved through discussions between integumentary core faculty and clinical partners (2014). This integumentary ICE was designed to occur in the semester immediately following the didactic integumentary course and required collaborative leadership of both faculty and hospital wound care physical therapists. This experience occurs in a dedicated wound treatment and hyperbaric center that provides the student exposure to both inpatient and outpatient interprofessional wound-based practice. Students are selected for this experience based on an expressed interest in this practice area and recommendation of the course coordinator. Since its inception, fifty students (44% of all eligible students) have participated in a total of 800 hours of integumentary ICE. Student openness to wound care and resilience to sensory factors in this environment are developed in this model of education. This experience allows students an opportunity to explore this area of physical therapy practice, and to consider a full-time clinical experience in the center. It enables students to recognize integumentary care practice within non-“wound care” environments. This integrated experience has led to full-time integumentary clinical education experiences with this clinical partner. In fact, two students have participated in full-time clinical education experiences and one more is scheduled. Future plans for an integumentary residency are being considered and discussed.Results/Outcomes: The session will describe the process of development of the didactic and clinical education curriculum, emphasizing the components relevant to integumentary practice. Through lecture and a panel discussion, involved stakeholders (a former student, course faculty, clinical faculty, and administration) will present shared goals, challenges experienced, and the plan for future development, including a wound care residency. As wound care is an underrepresented specialty area within physical therapy practice, this process provides an innovative opportunity to cultivate interest and experience among students and new professionals.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: Physical therapists contribute a unique skill set and movement system knowledge to integumentary management. However, less than 5% of physical therapists practice in an integumentary management setting. Regardless of the percentage of physical therapists specifically practicing in this area, patients who require these services deserve competent, qualified physical therapist care. Without student exposure to experiences that foster understanding of the physical therapist role or contribution to the wound care team, students may be challenged to attain entry-level competency for physical therapy practice in this practice area. Collaborative leadership between academic and clinical faculty foster the engagement of students in didactic coursework with clinical specialists and expanded clinical education opportunities for the program. Patients require access to competent healthcare providers. Those integumentary providers include physical therapists who can bring the unique knowledge of movement to patients who have a compromised integumentary system that inherently affects movement. This approach to physical therapy integumentary education addresses that patient and practice need.References: Gibbs KA, Bachman T, Spivey S. Physical therapist student practice: where are wound management clinical experiences occurring? JACPT. 2016;7(3):87-92. Hicks R, Cook P, Dulas T, Clem J. Demographics of physical therapy practice: implications for education. JoPTE. 2004;18(2):80-86. Irion G. Knowledge expectations of wound management specialist in physical therapy. JACPT. 2015;6(3):116-127. Kloth LC. The role of physical therapy in wound management. J Am Col Certif Wound Spec. 2009;1:4–5. Kloth LC. The roles of physical therapy in wound management, part II: Patient and wound evaluation. J Am Col Certif Wound Spec. 2009;1(2):49-50. Kloth LC. Roles of physical therapists in wound management, part III: Select biophysical technologies and management of patients with diabetic foot ulceration. 2009;1(3):80-3. Kloth LC. The roles of physical therapy in wound management, part IV. J Am Col Certif Wound Spec. 2009;1(4):106-8.Course Objectives: 1. Briefly describe the history of integumentary practice in physical therapy and associated educational opportunities. 2. Describe a DPT curriculum that includes integrated and full-time integumentary/wound care management clinical experiences. 3. Share the experiences and roles of each of the stakeholders in the design: a. Academic faculty (Chair, DCE, and course coordinator for integumentary course) b. Clinical faculty (Guest lecturers and clinical instructors for student experiences) c. Graduate who participated in integrated and full-time clinical experience in the wound care center. 4. Identify turbulent and smooth moments in the design and delivery of the model. 5. Describe thoughts related to next steps in entry-level integumentary education and wound care residencies.Instructional Methods: Lecture Panel for questionsTentative Outline/Schedule: 0 -10 minutes: Introduction of session 10-20 minutes: History of wound care practice and education 20-40 minutes: Curriculum design overview and specifics regarding wound management 40-55 minutes: Example of student in the model 55-65 minutes: Turbulence and moments of smooth air 65-75 minutes: Planning and integrating the next step (residency) 75-90 minutes: Panel discussion for Q&A