Getting on Board with Residency Education: Has the Ship Set Sail?
Purpose: As interest in residency education continues to grow, the number of accredited residency programs has not kept pace with the applicant demand in several specialties, and in others, there are fewer applicants than positions available. Perceived and actual barriers among potential participants (existing debt load, return on investment) and of potential programs (administrative and curricular challenges, lack of clinical sites, and financial considerations) may be partially to blame. As a profession, a commitment was made to the development of residencies as a postprofessional educational opportunity leading towards clinical specialization; but are we following through with this commitment? Several of our own leaders have consistently identified the need for continued development of residency education and interprofessional peer equivalence as an important component in maturation of the physical therapy profession. Postprofessional residency education was a major part of the core recommendations from the APTA’s Best Practices in Clinical Education Task Force in 2017, and was recommended as a requirement of demonstrating academic excellence in the National Study on Excellence in PT Education. Education leaders in our profession are asking hard questions in an effort to understand the level of commitment to residency education, the uneven pace of residency development, and the continued challenges programs face supporting residency programs. In addition, and the APTA Board of Directors’ 2019-20 strategic plan supports the long-term sustainability of the physical therapy profession, but it is unclear the extent to which this includes residency as formative part of the physical therapy education continuum. Whether postprofessional education is normalized or mandated adds to the conundrum of the return on investment with the growing costs of DPT education in general. The decision to pursue residency by DPT graduates is complicated further by dual paths for board certification (via ABPTS). Is the profession willing to normalize postprofessional education and training so that development of high-level clinical reasoning within a specialty (or subspecialty) area of practice is an expected path for all PT’s or all board-certified specialists? The purpose of this session is to engage our colleagues, academic and clinical, in a discussion about our collective commitment to the future of residency education as essential in advancing the profession to meet societal need.
Methods and/or Description of Project: The concept for this session germinated from a working group within the Academy of Physical Therapy Education (APTE) Residency and Fellowship SIG (RF-SIG) that has been meeting regularly since ELC 2018 to develop a collaborative research agenda for residency and fellowship education. There have been multiple discussions within this group on the future of residency education as we see it compared to what seems to be a lack of commitment from the profession. Thus, we began to explore how to bring the issues forward in a discussion with our colleagues.
In this session, panelists will each present short, topic focused presentations related to different viewpoints on real or perceived barriers to the adoption of residency education as an expected, rather than optional, part of physical therapists’ educational development. These presentations are intended to provide an overview of specific issues or challenges, possible solutions, and will set the stage for engaging the audience in a deliberative discussion focused on the current and future role of residency education as a postprofessional step within the education learning continuum of physical therapy. Small group discussions focused on the key topics introduced by the panel will be the initial phase of audience interaction. This will be followed by a larger group discussion summarizing the critical factors.
Tentative Outline/Schedule: • Welcome and introduction of session
• Identification of key topics: • Continuum of learning
• Master adaptive learner
• Models for residency education linked to DPT
• Financial considerations related to return on investment (ROI)
• Residency education expected outcomes/goals
• Strategies for advancing the process
• Small group breakouts (each group to discuss one of the topics above)
• Large group discussion with panel facilitation and response
Results/Outcomes: Recent studies have looked at residency program outcomes, patient outcomes, and core values. We continue to gain knowledge and understanding of professional formation, continuum of learning the adaptive learner, and the development of clinical reasoning. All of these concepts are extended to the value of residency beyond the level of patient outcomes. This presentation will incorporate those findings, and link what we know about value from residency education and what we still want to better understand. The desired outcome of this session is to build momentum in residency program growth, professional and postprofessional commitment to residency education, and identification of an ideal model for best practices in the full continuum of physical therapist education.
Conclusions/Relevance to the conference theme: This presentation is directly linked to the conference theme as we set sail on residencies within our profession over 20 years ago, however, in many ways we have yet to see the ships join the regatta in delivering multiple residency options for all DPT graduates. This is a conversation that needs to happen to get the entire sailing crew headed on the same course toward opportunity.