The Debt Burden of Entry-Level Physical Therapists

2019 ◽  
Vol 100 (4) ◽  
pp. 591-599 ◽  
Author(s):  
Steven B Ambler
Keyword(s):  
Clinical Practice ◽  
Physical Therapy ◽  
Physical Therapists ◽  
Small Sample Size ◽  
Small Sample ◽  
Student Debt ◽  
Practice Setting ◽  
Entry Level ◽  
Debt Burden ◽  
Educational Debt

Abstract Background The growing student debt of physical therapists entering the workforce, coupled with the growth in projected need, raises concerns about where and how entry-level physical therapists will practice and if these choices will be affected by their debt burden. Objective The purpose of this study was to identify the debt profile of entry-level physical therapists and explore relationships between student debt and clinical practice setting choices. Methods This study utilized a cross-sectional survey design to identify debt profiles and explore relationships between student debt and the clinical practice choices of entry-level physical therapists. Results The mean debt-to-income ratio based on the total reported educational debt was 197% (93%). The most frequently reported debt range for doctor of physical therapy (DPT) debt and total educational debt was $100,000 to $124,999. Despite the setting itself being rated as the most important factor (83%), 28% of participants reported debt as a barrier to their desired practice setting. In addition, when considering job choice overall, 57% of the participants reported that their student debt has had an effect on their decision. Limitations This study is limited by its small sample size, originating from 1 state, and being taken by convenience from a special interest group. Data were collected via an anonymous survey, which increases the risk of selection bias. In addition, there are further personal, family, and institutional characteristics that were not collected in this study, which may influence the interaction between student debt and clinical practice choices. Conclusion The results of this study suggest that practice setting choice may be affected by physical therapist student debt, and student debt may be a barrier overall to practice and career choices in physical therapy.

scholarly journals Self-Reported Measurement of Heart Rate and Blood Pressure in Patients by Physical Therapy Clinical Instructors

2002 ◽  
Vol 82 (12) ◽  
pp. 1192-1200 ◽  
Author(s):  
Ethel M Frese ◽  
Randy R Richter ◽  
Tamara V Burlis
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Clinical Education ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Practice Setting ◽  
Clinical Instructors ◽  
Strongly Agree

Abstract Background and Purpose. The Guide to Physical Therapist Practice (Guide) recommends that heart rate (HR) and blood pressure (BP) measurement be included in the examination of new patients. The purpose of this study was to survey physical therapy clinical instructors to determine the frequency of HR and BP measurement in new patients and in patients already on the physical therapists' caseload. The use of information obtained from HR and BP measures in decision making for patient care and the effects of practice setting and academic preparation on the measurement and use of HR and BP also were examined. Subjects and Methods. A sample of 597 subjects was selected from a list of 2,663 clinical instructors at the clinical education sites of the 2 participating universities. Clinical instructors from a variety of practice settings were surveyed. A 26-item survey questionnaire was mailed to the clinical instructors. Results. Usable survey questionnaires were received from 387 respondents (64.8%); 43.4% reported working in an outpatient facility. The majority of the respondents strongly agreed or agreed (59.5%) that measurement of HR and BP should be included in physical therapy screening. When asked if routinely measuring HR and BP during clinical practice is essential, opinions were nearly split (strongly agree or agree=45.0%, strongly disagree or disagree=43.7%, no opinion=11.3%). More than one third (38.0%) of the respondents reported never measuring HR in the week before the survey as part of their examination of new patients. A slightly larger percentage (43.0%) reported never measuring BP of new patients in the week before the survey. Conversely, 6.0% and 4.4% of the respondents reported always measuring HR and BP, respectively, of new patients in the week before the survey. When given a list of reasons why HR and BP were not routinely measured in their clinical practice, respondents most frequently chose “not important for my patient population” (52.3%). Relationships were found between practice setting and frequency of HR and BP measurement in new patients. Discussion and Conclusion. Practices related to HR and BP measurement reported by this sample of clinical instructors do not meet the recommendations for physical therapy care described in the Guide.

Focal Seizures in Patients With SCN1A Mutations

2016 ◽  
Vol 32 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Christopher L. McDonald ◽  
Russell P. Saneto ◽  
Lionel Carmant ◽  
Márcio A. Sotero de Menezes
Keyword(s):  
Clinical Practice ◽  
Time Course ◽  
Pediatric Patients ◽  
Small Sample Size ◽  
Genetic Mutation ◽  
Small Sample ◽  
Focal Seizures ◽  
Clinical Considerations ◽  
New Research ◽  
Scn1a Gene

The SCN1A gene has been implicated in the etiology of various forms of epilepsy. New research has linked this gene to specific types of epilepsy, all of which present in infancy or early childhood. This study examines the time course and pathology of pediatric patients who have a mutation in the SCN1A gene in order to open a discussion regarding the key trends of this form of epilepsy as well as important clinical considerations in management for patients who present with symptoms relating to the SCN1A mutations. We retrospectively examined 20 patients who presented to the clinic with focal seizures, as well as were positive for an SCN1A genetic mutation. Despite the small sample size, we were able to find important trends in the time course of the disorder as well as important areas of clinical practice that must be taken into consideration for these patients.

scholarly journals Acupuncture in Subacute Stroke: No Benefits Detected

2013 ◽  
Vol 93 (11) ◽  
pp. 1447-1455 ◽  
Author(s):  
Yi Zhu ◽  
Lixia Zhang ◽  
Gang Ouyang ◽  
Dianhuai Meng ◽  
Kailin Qian ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Motor Function ◽  
Small Sample Size ◽  
Randomized Study ◽  
Theoretical Background ◽  
Scalp Acupuncture ◽  
Small Sample ◽  
Acupuncture Group ◽  
Rehabilitation Centers ◽  
Subacute Stroke

Background There is debate concerning the effect of acupuncture on rehabilitation following stroke, with key reviews unable to find evidence of benefit. This lack of evidence may be due to poor study design, small sample size, and insufficient theoretical background. Objective The present study was designed to determine whether acupuncture combined with conventional physical therapy improves motor function and activities of daily living in patients with subacute stroke compared with conventional physical therapy alone. Design A multicenter, single-blinded, randomized study was conducted. Setting Four rehabilitation centers in the Jiangsu province of China participated in this study. Patients One hundred eighty-eight patients with subacute stroke admitted to the hospital were randomized into an acupuncture group and a conventional rehabilitation group. Interventions A combination of body and scalp acupuncture was used for 3 months in the acupuncture group. All patients underwent conventional stroke rehabilitation. Measurements The Fugl-Meyer Assessment (FMA) and Barthel Index (BI) were performed at baseline and at 1, 3, and 6 months after inclusion in the study. Results No statistically significant differences were found at baseline between the groups. No statistically significant differences were found between the groups using the FMA motor scores and the BI scores at baseline or at 1, 3, or 6 months. Significant improvements were found in each group following treatment. Conclusions In patients with subacute stroke, the addition of body and scalp acupuncture to a regimen of conventional physical therapy does not result in further improvement in either motor function or ADL beyond the effect of conventional physical therapy alone.

scholarly journals Internal and External Focus of Attention During Gait Re-Education: An Observational Study of Physical Therapist Practice in Stroke Rehabilitation

2013 ◽  
Vol 93 (7) ◽  
pp. 957-966 ◽  
Author(s):  
Louise Johnson ◽  
Jane H. Burridge ◽  
Sara H. Demain
Keyword(s):  
Physical Therapy ◽  
Stroke Rehabilitation ◽  
Physical Therapists ◽  
Focus Of Attention ◽  
Small Sample ◽  
Gait Rehabilitation ◽  
External Focus ◽  
Physical Therapy Treatment ◽  
The Impact ◽  
Therapy Treatment

BackgroundFocus of attention is known to play an important role in motor skill learning, yet little is known about how attention is directed within the context of stroke rehabilitation.ObjectiveThe aims of this study were: (1) to identify physical therapists' use of internal and external focus of attention during gait rehabilitation for individuals with hemiplegia following stroke and (2) to use the findings to design an experimental study examining the impact of focus of attention on learning poststroke.DesignThe study design involved direct nonparticipation observation of physical therapy treatment sessions.MethodsEight physical therapy treatment sessions, in which gait rehabilitation was taking place, were video recorded. Patients were aged between 36 and 85 years, and ranged from 7 to 216 days poststroke; physical therapists had between 3 and 12 years of experience in stroke rehabilitation. Data analysis took 2 forms: (1) clear definitions of internal and external focus of attention were agreed on via a consensus group and used to develop an analysis matrix through which incidences of instruction and feedback were identified, categorized, and counted; and (2) verbal dialogue was transcribed verbatim and transcripts were thematically analyzed to provide a detailed description of how instructions and feedback were used, illustrated by examples.ResultsThe use of instructions and feedback (internal and external focus) was high; an average of one verbal instruction or feedback statement was delivered every 14 seconds. Sixty-seven percent of the statements were internally focused, 22% were externally focused, and 11% were of mixed focus. Unfocused statements (eg, “good”) also were used regularly. Patients were frequently encouraged to “think about” their performance.LimitationsObservational data collection methods may result in changes in the behavior of those observed, which is a potential source of bias. The small sample size also was a limitation of the study.ConclusionPhysical therapists frequently encouraged patients to be aware of their movements and their performance (internal focus). This approach may reduce automaticity and hinder learning and retention.

Workplace model for physical therapists and occupational therapists

2014 ◽  
Vol 28 (3) ◽  
pp. 290-314 ◽  
Author(s):  
Joan I.J. Wagner ◽  
Sharon Warren ◽  
Greta Cummings ◽  
Donna L. Smith ◽  
Joanne K. Olson
Keyword(s):  
Job Satisfaction ◽  
Organizational Commitment ◽  
Physical Therapists ◽  
Small Sample Size ◽  
Specific Model ◽  
Research Literature ◽  
Small Sample ◽  
Exploratory Research ◽  
Content Type ◽  
Healthy Work Environments

Purpose – The purpose of this paper is to test a model linking physical therapy (PT) and occupational therapy (OT) practitioners’ perceptions of resonant leadership, structural empowerment and psychological empowerment to their experiences of spirit at work (SAW), job satisfaction and organizational commitment within the Canadian workplace. Design/methodology/approach – The authors tested the model using LISREL 8.80 and survey data from 101 OTs and 169 PTs, randomly selected by the Alberta professional licensing associations. Content analysis of responses to the open-ended comments section provided additional depth and insight. Findings – Analysis of results culminated in minor modifications to the original theoretical model, creating separate PT and OT models. Both models revealed a good fit with the observed data. Several SAW concepts accounted for moderate to large amounts of variance in both PT and OT models, indicating that SAW is a comprehensive workplace outcome. Research limitations/implications – Theory was derived from business and nursing research literature due to limited rehabilitation research literature. Discussion of OT results must consider the small sample size. This study is initial exploratory research. Practical implications – Each discipline-specific model provides professionals, health care leaders and policy makers with a rich body of information upon which to base beneficial workplace decisions. SAW will guide leaders in the holistic development and enrichment of the work environment. Originality/value – This research contributes to the substantive knowledge of the OT and PT disciplines, particularly in the areas of leadership, workplace structural organization and indicators of healthy work environments such as SAW, empowerment, job satisfaction and organizational commitment.

scholarly journals Ranking of the Generic Abilities among Baby Boomer, Generation X, and Millennial Physical Therapists and Physical Therapy Students

2019 ◽  
Author(s):  
Catherine Noonan ◽  
Jennifer Bunn ◽  
Heidi Shearin
Keyword(s):  
Physical Therapy ◽  
Stress Management ◽  
Generation X ◽  
Generational Differences ◽  
Physical Therapists ◽  
Physical Therapy Students ◽  
Practice Setting ◽  
Years Of Experience ◽  
Professional Behaviors ◽  
Significant Difference

Background: The events and social conditions experienced by a generational cohort are thought to shape values and behaviors. Numerous studies have correlated generational differences with unique professional behaviors and educational preferences. However, few studies have examined this theory in the practice of physical therapy. Purpose: The purpose of this study was to assess generational differences in ranking of the Generic Abilities, a tool for assessing professional behaviors, as used in physical therapy in the United States of America. Methods: An online survey including demographic information, region of residence, years of experience, and ranking of Generic Abilities was sent via email to clinical partners and diverse regional university physical therapy education programs. Comparisons of ranking between generations, sex, geographical region, years of experience, and practice setting were evaluated using a Kruskal-Wallis H Test. Results: Overall, all generations ranked professional behaviors similarly. Stress management was the only Generic Ability with a significant difference between generations (p = 0.001). Millennials ranked stress management higher than both Generation X (p = 0.010) and Baby Boomers (p = 0.023). There was a significant difference in rankings by years of experience for professionalism (p = 0.028) and stress management (p = 0.010). There was no statistical difference in rankings by sex, practice setting, race, educational and career status, or geographical region. Conclusion: With only one statistically significant exception, physical therapists and physical therapy students, regardless of generation, rank the Generic Abilities similarly, indicating that professional values may supersede those of a particular generation. Higher ranking of stress management among Millennials may indicate needs that impact career longevity. This knowledge can be utilized by educators and employers to implement strategies to improve success as younger generations progress through the work force.

Assessing the Reliability and Use of the Expository Scoring Scheme as a Measure of Developmental Change in Monolingual English and Bilingual French/English Children

2016 ◽  
Vol 47 (4) ◽  
pp. 297-312 ◽  
Author(s):  
Elizabeth Kay-Raining Bird ◽  
Nila Joshi ◽  
Patricia L. Cleave
Keyword(s):  
Clinical Practice ◽  
Elementary School Children ◽  
Developmental Change ◽  
Small Sample Size ◽  
Age Groups ◽  
Small Sample ◽  
Intrarater Reliability ◽  
Spoken Discourse ◽  
Language Groups ◽  
Expository Discourse

Purpose The Expository Scoring Scheme (ESS) is designed to analyze the macrostructure of descriptions of a favorite game or sport. This pilot study examined inter- and intrarater reliability of the ESS and use of the scale to capture developmental change in elementary school children. Method Twenty-four children in 2 language groups (monolingual English and bilingual French/English) and 2 age groups (7–8 years, 11–12 years) participated (6 in each subgroup). Participants orally explained how to play their favorite game or sport in English. Expository discourse samples were rated for 10 macrostructure components using the ESS. Ratings were summed for a total score. Results Inter- and intrarater reliability was high for the total ESS score and for some but not all ESS components. In addition, the total score and ratings for many ESS components increased with age. Few differences were found in use of macrostructure components across language groups. Conclusions The ESS captures developmental change in the use of expository macrostructure in spoken discourse samples. It may be beneficial to take into account the lower reliability found for ratings of some ESS components in clinical practice. Due to the small sample size, these results should be considered preliminary and interpreted with caution.

scholarly journals Opportunities and Challenges in The Use of an External Interprofessional Reviewing Body in a Curricular Review Process in a Doctor of Physical Therapy Curriculum

2016 ◽  
Author(s):  
Jill FitzGerald ◽  
Kelly Hawthorne
Keyword(s):  
Clinical Practice ◽  
Physical Therapy ◽  
Older Adult ◽  
Review Process ◽  
Faculty Members ◽  
Entry Level ◽  
Doctor Of Physical Therapy ◽  
Therapy Program ◽  
Physical Therapy Program ◽  
Curriculum Committee

Purpose: The purpose of this article is to describe the opportunities and challenges of a curricular review process in an entry-level doctor of physical therapy geriatric curriculum. The curricular review process utilized an external interprofessional reviewing body, in conjunction with an established internal curricular reviewing body, to determine inclusion of Essential Competencies in order to prepare students for best clinical practice in the care of the older adult. Method: The methodology of our curricular review process included both internal and external reviewing bodies but the intent of this article is to highlight how the review process was implemented including an external interprofessional reviewing body. The internal reviewing body involved two faculty members with expertise in geriatrics, the Program Curriculum Committee members, and the faculty members within the entry-level doctor of physical therapy program. The external reviewing body was comprised of the 2012-2014 members of the Faculty Development Collaborative Program in Geriatrics (FDCPG), a national interprofessional learning community representing multiple disciplines involved in the care of older adults. Results: The outcomes of including an external interprofessional reviewing body in the geriatric curricular review process were: the FDCPG justified the need for the review of the Essential Competencies, deemed their role as important in healthcare education, and reported a greater understanding of the role of physical therapists as part of an interprofessional healthcare team. The Program Curriculum Committee created a policy for consideration of other published competencies, including a recommendation for “other necessary consultation” based on our use of an external reviewing body, noting its value. The outcomes of the overall curricular review process included: 53/61 Essential Competencies were identified as already in the curriculum and the remaining 8/61 Essential Competencies were added. Conclusions and Recommendations: The addition of an external interprofessional reviewing body to an already established internal reviewing body within the geriatric curricular review process in an entry-level doctor of physical therapy program produced a curriculum that will hopefully prepare students for best clinical practice in the care of the older adult. This comprehensive curricular review process involved opportunities and challenges yet still can be used across multiple disciplines, across multiple curricular structures, and is in line with the current state of healthcare practice.

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