scholarly journals Want to Engage More Physical Therapy Students in Geriatrics? Teach the 4Ms

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 14-15
Author(s):  
Tiffany Shubert ◽  
Cristine Henage
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
Physical Therapists ◽  
The United States ◽  
Health Programs ◽  
Evidence Based ◽  
Physical Therapy Students ◽  
Demographic Shift ◽  
The Impact ◽  
What Matters

Abstract In 2019, 1.2% of the 209,000 licensed physical therapists in the United States had completed sufficient training to be Geriatric Certified Specialists. The dramatic demographic shift in the population will require all physical therapists to have foundational knowledge of evidence-based management of older adults. Our purpose was to pilot the impact of an 8-week curriculum for physical therapy students that integrated key concepts of rehabilitation for older adults with the Age-Friendly Health System’s 4Ms (Mentation, Mobility, Medications, What Matters). The curriculum included guest speakers from medicine, social work, nutrition, pharmacy, community providers (YMCA) and older adults. Every class modeled how to assess the Ms and integrate information into a plan aligned with what matters to the client. Students completed a pre-post survey to evaluate their understanding of the 4Ms, and self-assess confidence in applying concepts to practice. Results supported the value of integrating the 4Ms into the curriculum. Over 89% of respondents reported assessing medications and mentation was very important to patient care compared to 11% and 33% pre-course, and 78% of students reporting they were highly-likely to advocate for the 4Ms as part of their practice. The 4Ms provided a framework that made geriatric care more appealing. Several students commented they had no interest in geriatrics prior to the course, but were more confident in their abilities and more interested in caring for older adults. Findings from this pilot support the value of the 4Ms as a framework for graduate-level allied health programs curriculum development.

We Don’t Know our Own Strength: A Survey of Strength Training Attitudes, Behaviors and Knowledge in Physical Therapists and Physical Therapist Students

2021 ◽  
Author(s):  
Reed Handlery ◽  
Emma Shover ◽  
Thavi Chhoun ◽  
Lauren Durant ◽  
Kaci Handlery ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Strength Training ◽  
Professional Education ◽  
Physical Therapists ◽  
Physical Therapist ◽  
The United States ◽  
Physical Therapy Students ◽  
Physical Therapy Education ◽  
Education Participation ◽  
Therapy Education

Abstract Objective Strength training is frequently utilized by physical therapists; however, there has been discussion about whether physical therapists utilize strength training adequately. The purpose of this study was to describe and compare the strength training attitudes, behaviors, and knowledge of physical therapists and physical therapy students and to determine how participant characteristics influenced knowledge scores. Methods An anonymous survey was created in 3 rounds. For round 1, researchers used textbooks to create items assessing demographics, attitudes, behaviors, and knowledge regarding strength training. Rounds 2 and 3 consisted of feedback from 7 content experts until 80% consensus was reached; items were added, removed, or edited based on feedback. The final survey was distributed through social media, list servs, and email, targeting physical therapists and students based in the United States. Response frequencies for all items were reported. Overall knowledge scores were calculated by summing correct responses for each item, with a maximum score of 13; scores <70% were considered low. Binomial logistic regression determined which characteristics (demographics, attitudes, or behaviors) influenced whether participants adequately utilized strength training principles (scored ≥70% on knowledge items). Results There were 777 physical therapist and 648 student participants. Nearly 90% of therapists and students reported frequently prescribing strength training. Over 48% of therapists felt their professional education did not prepare them to apply strength training (compared with 24% of students), and 68% believed that strength training is inadequately applied in physical therapy (compared with 40% of students). Sixty-two percent of therapists and 55% of students scored ≥70% for knowledge items. Additional strength training education and regular participation in strength training increased the odds of scoring ≥70% on knowledge items. Conclusions Physical therapists and physical therapy students frequently prescribe strength training, despite similarly low knowledge scores. To increase knowledge, greater emphasis on strength training in professional education, continuing education, participation in strength training, or all 3 is warranted. Impact Strength training is an important intervention used in physical therapy and must be used appropriately to improve the health of patients. According to these findings, strength training education may not currently be optimal, as demonstrated by low knowledge scores by both therapists and students. Further work is needed to determine how knowledge of strength training relates to patient outcomes and also how best to implement strength training in physical therapy education and practice.

scholarly journals Physical Therapy Clinical Instructor Self-Reported Evidence-Based Practice Use

2015 ◽  
Author(s):  
Debra Bierwas ◽  
Joan Leafman ◽  
Lisa Wallace ◽  
Donald Shaw ◽  
Steven Fehrer
Keyword(s):  
Physical Therapy ◽  
Clinical Education ◽  
Evidence Based Practice ◽  
Physical Therapists ◽  
Physical Therapist ◽  
The United States ◽  
Clinical Instructor ◽  
Evidence Based ◽  
Clinical Instructors ◽  
Professional Characteristics

Introduction: Evidence-based practice is a required component of student physical therapist education. Practice applying the five steps of evidence-based practice to patient care (formulate question, retrieve evidence, appraise evidence, integrate evidence, evaluate outcomes), most effectively performed during clinical education, must occur for students to become proficient. Clinical instructor use of evidence-based practice is essential to assure that student physical therapist practice occurs during clinical education. Purpose: The purpose of this study was to assess self-reported evidence-based practice use by physical therapy clinical instructors and examine whether an association exists between professional characteristics and evidence-based practice use. Methods: This study was a cross-sectional, descriptive study using an electronic survey to collect data on clinical instructor professional characteristics and evidence-based practice use. Results: Respondents included 376 physical therapists who were clinical instructors in the United States. Participant responses for frequency evidence-based practice steps use ranged from never to frequently. Specifically, respondents reported integrating evidence into clinical instruction: never 2.1% (n = 8); rarely 6.4% (n = 24); occasionally 13.3% (n = 50); sometimes 28.7% (n = 108); and frequently 49.5% (n = 186). There was no difference in evidence-based practice use as the result of age or highest degree. Respondents who were American Physical Therapy Association members or held an American Board of Physical Therapy Specialties certification reported using some of the evidence-based practice steps more frequently than those who were not. Discussion and Conclusion: Although the majority of respondents in this study reported using evidence-based practice to some extent, there was great variability. Student physical therapists may be exposed to evidence-based practice during clinical education since the majority of respondents, considering their role as clinical instructors, reported evidence-based practice use. However, exposure cannot be guaranteed for every student because some respondents reported never using evidence-based practice. Educational program use of supplemental learning activities during clinical experiences may facilitate student practice of all five steps of evidence-based practice during clinical education.

scholarly journals Translating COVID-19 Evidence to Maximize Physical Therapists’ Impact and Public Health Response

2020 ◽  
Vol 100 (9) ◽  
pp. 1458-1464 ◽  
Author(s):  
Elizabeth Dean ◽  
Alice Jones ◽  
Homer Peng-Ming Yu ◽  
Rik Gosselink ◽  
Margot Skinner
Keyword(s):  
Public Health ◽  
Acute Respiratory Distress Syndrome ◽  
Health Education ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Physical Therapists ◽  
The United States ◽  
Evidence Based ◽  
The Impact

Abstract Coronavirus disease 2019 (COVID-19) has sounded alarm bells throughout global health systems. As of late May, 2020, over 100,000 COVID-19–related deaths were reported in the United States, which is the highest number of any country. This article describes COVID-19 as the next historical turning point in the physical therapy profession’s growth and development. The profession has had over a 100-year tradition of responding to epidemics, including poliomyelitis; 2 world wars and geographical regions experiencing conflicts and natural disasters; and, the epidemic of noncommunicable diseases (NCDs). The evidence-based role of noninvasive interventions (nonpharmacological/nonsurgical) that hallmark physical therapist practice has emerged as being highly relevant today in addressing COVID-19 in 2 primary ways. First, despite some unique features, COVID-19 presents as acute respiratory distress syndrome in its severe acute stage. Acute respiratory distress syndrome is very familiar to physical therapists in intensive care units. Body positioning and mobilization, prescribed based on comprehensive assessments/examinations, counter the negative sequelae of recumbency and bedrest; augment gas exchange and reduce airway closure, deconditioning, and critical illness complications; and maximize long-term functional outcomes. Physical therapists have an indisputable role across the contiuum of COVID-19 care. Second, over 90% of individuals who die from COVID-19 have comorbidities, most notably cardiovascular disease, hypertension, chronic lung disease, type 2 diabetes mellitus, and obesity. Physical therapists need to redouble their efforts to address NCDs by assessing patients for risk factors and manifestations and institute evidence-based health education (smoking cessation, whole-food plant-based nutrition, weight control, physical activity/exercise), and/or support patients’ efforts when these are managed by other professionals. Effective health education is a core competency for addressing risk of death by COVID-19 as well as NCDs. COVID-19 is a wake-up call to the profession, an opportunity to assert its role throughout the COVID-19 care continuum, and augment public health initiatives by reducing the impact of the current pandemic.

The Impact of TimeSlips on Undergraduate Students in Service Learning With Older Adults

2020 ◽  
pp. 1-8
Author(s):  
Sabine Heuer
Keyword(s):  
Older Adults ◽  
Service Learning ◽  
Undergraduate Students ◽  
Attitude Scale ◽  
Evidence Based ◽  
Attitudes Toward Older Adults ◽  
Students Attitudes ◽  
Attitude Shift ◽  
The Impact ◽  
Journal Entries

Purpose Future speech-language pathologists are often unprepared in their academic training to serve the communicative and cognitive needs of older adults with dementia. While negative attitudes toward older adults are prevalent among undergraduate students, service learning has been shown to positively affect students' attitudes toward older adults. TimeSlips is an evidence-based approach that has been shown to improve health care students' attitudes toward older adults. The purpose of this study is to explore the change in attitudes in speech-language pathology students toward older adults using TimeSlips in service learning. Method Fifty-one students participated in TimeSlips service learning with older adults and completed the Dementia Attitude Scale (DAS) before and after service learning. In addition, students completed a reflection journal. The DAS data were analyzed using nonparametric statistics, and journal entries were analyzed using a qualitative analysis approach. Results The service learners exhibited a significant increase in positive attitude as indexed on the DAS. The reflective journal entries supported the positive change in attitudes. Conclusions A noticeable attitude shift was indexed in reflective journals and on the DAS. TimeSlips is an evidence-based, patient-centered approach well suited to address challenges in the preparation of Communication Sciences and Disorders students to work with the growing population of older adults.

Refining Evidence-Based Treatments for Late-Life Depression

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 67-76
Author(s):  
Grace C. Niu ◽  
Patricia A. Arean
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Brain Plasticity ◽  
Late Life ◽  
Aging Population ◽  
The United States ◽  
Future Research ◽  
Evidence Based ◽  
Late Life Depression ◽  
Evidence Based Treatments

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depressed older adults actually receive treatment. In this paper we review the research on refining treatments for LLD. We first identify evidence-based treatments (EBTs) for LLD and the problems associated with efficacy and dissemination, then review approaches to conceptualizing mental illness, specifically concepts related to brain plasticity and the Research Domain Criteria (RDoc). Finally, we introduce ENGAGE as a streamlined treatment for LLD and discuss implications for future research.

scholarly journals The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America

2021 ◽  
Vol 35 ◽  
pp. 100848
Author(s):  
Ganesh M. Babulal ◽  
Valeria L. Torres ◽  
Daisy Acosta ◽  
Cinthya Agüero ◽  
Sara Aguilar-Navarro ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Latin America ◽  
Well Being ◽  
The United States ◽  
The Impact

scholarly journals Food Insecurity in the United States: Identification, Treatment, and Implications

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 772-773
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Connie Bales ◽  
Julie Locher
Keyword(s):  
United States ◽  
Older Adults ◽  
At Risk ◽  
Food Insecurity ◽  
Well Being ◽  
The United States ◽  
Health Clinic ◽  
High Risk Population ◽  
Geriatric Syndrome ◽  
The Impact

Abstract Food insecurity is an under-recognized geriatric syndrome that has extensive implications in the overall health and well-being of older adults. Understanding the impact of food insecurity in older adults is a first step in identifying at-risk populations and provides a framework for potential interventions in both hospital and community-based settings. This symposium will provide an overview of current prevalence rates of food insecurity using large population-based datasets. We will present a summary indicator that expands measurement to include the functional and social support limitations (e.g., community disability, social isolation, frailty, and being homebound), which disproportionately impact older adults, and in turn their rate and experience of food insecurity and inadequate food access. We will illustrate using an example of at-risk seniors the association between sarcopenia, the age-related loss of muscle mass and function, with rates of food security in the United States. The translational aspect of the symposium will then focus on identification of psychosocial and environmental risk factors including food insecurity in older veterans preparing for surgery within the Veterans Affairs Perioperative Optimization of Senior Health clinic. Gaining insights into the importance of food insecurity will lay the foundation for an intervention for food insecurity in the deep south. Our discussant will provide an overview of the implications of these results from a public health standpoint. By highlighting the importance of food insecurity, such data can potentially become a framework to allow policy makers to expand nutritional programs as a line of defense against hunger in this high-risk population.

Feasibility of Goal Attainment Scaling in Chronic Low Back Pain: Protocol for Training & Implementation in an Outpatient Physical Therapy Setting (Preprint)

2021 ◽  
Author(s):  
Douglas Haladay ◽  
Rebecca Edgeworth Ditwiler ◽  
Aimee Klein ◽  
Rebecca Miro ◽  
Matthew Lazinski ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Clinical Setting ◽  
Goal Attainment ◽  
Physical Therapists ◽  
The United States ◽  
Goal Attainment Scaling ◽  
Low Back ◽  
Patient Centered ◽  
Patient Reported ◽  
Qualitative Phase

BACKGROUND Patient engagement in decisions regarding their healthcare may lead to improved outcomes and improved adherence to treatment plans. While there are several options for involving patients in their healthcare, goal setting is a readily accessible method for physical therapists to increase the involvement of patients in healthcare decisions. Physical therapy goals are often provider-generated and based on subjective information or standardized fixed-item patient-reported outcome measures. However, these outcome measures may provide a limited scope of activity and participation limitations which may not capture the needs of individual patients. Goal Attainment Scaling (GAS) is a patient-centered approach to involving patients in setting meaningful goals. While GAS has been shown to be reliable, valid, and sensitive to change in various population, there is limited evidence in the United States about utilizing GAS in the physical therapist management of patients with low back pain (LBP). OBJECTIVE The purpose of this report is to describe the protocol for a study to a) develop an application of GAS procedures to be used by physical therapists treating patients with chronic LBP in the United States and b) to test the feasibility of applying GAS procedures in chronic LBP in an outpatient physical therapy setting. METHODS This study will use a mixed-methods design with two (2) phases (Phase 1: Qualitative, Phase 2: Quantitative). The qualitative phase of the study will employ focus groups of patients with chronic LBP to identify an inventory of goals that are important and measurable. This inventory will be used to develop a series of leading questions that will allow physical therapists to assist patients in establishing goals in the clinical setting. The quantitative phase of the study will pilot-test the inventory developed in the qualitative arm in patients with chronic LBP to determine feasibility, reliability, validity, and responsiveness. We will also compare how well GAS captures change over time as compared to traditional fixed-item patient-reported measures. RESULTS We anticipate that this study will demonstrate that GAS can be implemented successfully by outpatient physical therapists, and it will demonstrate clinically important changes that are important to patients with chronic LBP. CONCLUSIONS GAS represents an opportunity for patient-centered care in the physical therapy management of chronic LBP. While GAS is not new, it has never been studied in a real-world clinical setting for the physical therapy management of chronic LBP which have unique time and productivity constraints. For GAS to be successfully implemented in this environment, we must demonstrate that clinicians can be trained efficiently and reliably, that GAS can be implemented in the clinical setting in under 15 minutes, and that GAS is able to detect clinically meaningful change in patient outcomes. CLINICALTRIAL N/A

scholarly journals Student Perceptions and Understanding of Client-Therapist Interactions Within the Inpatient Acute Care Environment: Qualitative Study

2015 ◽  
Vol 95 (2) ◽  
pp. 235-248 ◽  
Author(s):  
Lorna M. Hayward ◽  
Kristin C. Greenwood ◽  
Matthew Nippins ◽  
Alicia Canali
Keyword(s):  
Student Perceptions ◽  
Acute Care ◽  
Professional Competence ◽  
Physical Therapists ◽  
Sampling Technique ◽  
The United States ◽  
Doctor Of Physical Therapy ◽  
Inpatient Settings ◽  
Acute Care Settings ◽  
The Impact

BackgroundPhysical therapists practicing in inpatient acute care settings in the United States work in a 21st century health care system that requires professional competence in clinical reasoning and decision making. For doctor of physical therapy (DPT) students, the development of confidence in the patient evaluation and the professional skills necessary for managing the inpatient environment can be challenging.ObjectiveThe study's purpose was to understand whether the early exposure of students to inpatient settings informed their understanding of the thought processes and actions of experienced clinicians during client interactions.DesignA qualitative design was used.MethodsThirty-three DPT students working in inpatient settings were recruited from 15 unique inpatient hospital (acute care and rehabilitation) facilities with a convenience sampling technique. Reflective data were collected for 1 month with clinician-facilitated discussion boards.ResultsFour themes emerged: environment, communication, evaluation, and client-therapist interaction. The themes informed a conceptual model depicting the observation by DPT students of factors that influenced interactions between clients and experienced clinicians in inpatient settings. Reflection on the what, the how, and the why that informed clinical decisions enabled students to recognize the situated nature of evaluation and treatment approaches.LimitationsThe use of a sample from 1 year of a DPT program at one university reduced the generalizability of the results.ConclusionsLimited research has examined student perceptions of the interactions of experienced clinicians with clients in inpatient acute care settings. More research is needed to understand the impact of exposing students to the thoughts and actions of therapists working in such settings earlier within DPT curricula.

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