Teaching the PT-PTA Relationship: “Teaming” with Possibilities!
Purpose: Physical therapists and physical therapist assistants have worked together for decades to deliver services to patients. However, health professionals need to understand the high level of coordination and cooperation required to achieve excellence, safety, and continuity of care for their patients.1 Interprofessional team-based care is defined as care delivered by intentionally created, usually relatively small work groups in health care who have a collective identity and shared responsibility for a patient or group of patients.2 In 2011, the Interprofessional Education Collaborative (IPEC) developed core competencies to facilitate a coordinated effort across various health professions to embed essential interprofessional education content in all health professions education curricula. The IPEC competencies describe behaviors necessary for optimal collaboration between health care professionals in clinical practice, and are particularly applicable to the PT-PTA team.3 These four competencies include: • Understanding roles and responsibilities • Providing client-centered care that embodies values and ethics • Developing insight into how to collaborate with the interdisciplinary health care team using effective communication that is respectful and assertive • Ways to develop leadership skills and take accountability for behaviors The APTA describes values-based behaviors for the PTA in terms of duty, integrity, and collaboration with the PT. The collaboration is defined as working together within their respective roles to optimize care and enhance service delivery. This requires education of the student PT on proper delegation to, utilization of, and promoting a positive team relationship with the PTA. Current CAPTE standards require DPT and PTA curricula to teach interprofessional education (IPE) and the IPEC competencies.4 Students often view their own group more highly than other groups as part of stereotypic views; these views may or may not be accurate and may impact future relationships. While there is some IPE research on student PTs with other health care professionals (OT, Psychology, social work),5,6 there is limited literature on IPE experiences with student PTs and PTAs.7,8 Our study sought to examine our students' views toward the PT-PTA team. As compared to a study of collaborative education by Plack,9 the students we studied were in the 2nd year of their respective programs and had more academic experience of their professions.Our DPT and PTA Education programs have worked together for a decade to provide an interactive classroom experience for students using a case-based learning approach. Several years ago, we began to teach our students team skills using a common team curriculum. Due to the lack of evidence about the PT-PTA team relationship and educational methods, we completed a multi-year study to obtain information from our students about their knowledge, perceptions, and attitudes toward team training as an outcome of using this team skills curriculum and practicing these skills to interact on a case together. Therefore, the purpose of this scholarly project was to: • Identify DPT and PTA students’ knowledge, attitudes and perceptions of the use of interprofessional team skills in the context of the PT-PTA relationship • Use data to drive quality improvement of a shared learning activity for PT and PTA student team interactions. Methods and/or Description of Project: Eighty-one DPT year-2 students from a DPT program (academic health sciences center) and 37 PTA year-2 students from a PTA program (private non-profit college) participated in a survey to collect information about attitudes and perceptions toward interdisciplinary education and team training. The surveys were conducted prior to any team skill training in either curriculum (year 1 pretest team knowledge) and these students were resurveyed following team training curricula and a collaborative learning experience together (year 2 post-test of team knowledge and using a retrospective approach to assess changes in student attitudes toward teamwork and interdisciplinary education). Two validated instruments were used (Interdisciplinary Education Perception Scale and Teamwork Attitudes Questionnaire). Data was collected from students in 3 cohorts from each institution. Data were analyzed using nonparametric statistics. Using Wilcoxon Signed Ranks tests, we established that all three cohorts showed a shift in attitudes in the intended direction that supported teamwork and interprofessional collaboration. Chi-square tests demonstrated that all three groups improved on the proportion of questions answered correctly Results/Outcomes: While team training and the learning experience were found to be overwhelmingly effective by the students, the results of our study identified a gap between the perception of PTAs and PTs about the strength and value of their relationship. The data indicated that the PTA students were less confident about the perception of PTs toward their role on the team. PT students thought highly of PTAs but there was a gap between PTAs and PTs who strongly agreed that they need to depend upon or cooperate with PTAs. Overall, students’ perceptions and attitudes from pre- to post-tests improved in a positive direction. Similar to the literature on other health care professions and IPE, our study showed that 105 out of 108 students were in agreement that the team training learning experience from the team skills curriculum and the collaborative learning experience was effective. The open-ended comments also gave us input for improving the quality of the experience which we have begun to implement. A follow up survey is planned to assess the changes to this experience in the future. Conclusions/Relevance to the conference theme: Physical Therapy Education curricula need to reflect changes in healthcare and be active proponents of PT-PTA team-based care to optimize patient safety and quality outcomes. Team skills are developed through modeling and practice, including collaborative experiences and educational role play opportunities. The student PT must learn to delegate, lead, support, and communicate with the PTA. The student PTA must learn to be a situational leader, support, and communicate with the PT. DPT and PTA Education curricula should intentionally educate students in the IPEC core competencies of understanding team roles, values, communication, and teamwork to meet CAPTE requirements. Our presentation is designed to facilitate program faculty to build effective PT-PTA team education through curricular innovation, using an evidence based approach.