Creative Problem Solving and Social Cooperation of Effective Physical Therapy Practice: A Pioneer Study and Overview

Action research (AR) has an important role to play in educating physical therapists. Increasing efforts should be encouraged to instigate AR programs in physical therapy practice and clinical education. Such programs commonly require considerable effort and understanding by clinical instructors, and require adoption of new educational methods. AR programs can lead physical therapists and clinicians to be more questioning and reflective in evaluating practical questions regarding patient therapy and education. The purpose of this article is to educate the readers on the importance of AR and to provide a few relevant references on that topic. A specific study is described in this paper in which physical therapy clinical instructors participated in a structured workshop designed to demonstrate the values of AR and how such values can be incorporated in teaching their students. AR can lead to improved therapist-patient interaction and help solve specific practical problems arising during therapy sessions.

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Clinical Education and cultural diversity in physical therapy: clinical performance of minority student physical therapists and the expectations of clinical instructors.

Journal of Physical Therapy Education ◽

10.1097/00001416-200801000-00016 ◽

2008 ◽

Vol 22 (1) ◽

pp. 85

Author(s):

Patricia R Curatti

Keyword(s):

Physical Therapy ◽

Cultural Diversity ◽

Clinical Education ◽

Physical Therapists ◽

Clinical Performance ◽

Minority Student ◽

Clinical Instructors

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Clinical education and cultural diversity in physical therapy: Clinical performance of minority student physical therapists and the expectations of clinical instructors

Physiotherapy Theory and Practice ◽

10.1080/09593980500422404 ◽

2006 ◽

Vol 22 (1) ◽

pp. 1-15 ◽

Cited By ~ 16

Author(s):

Norene Clouten ◽

Midori Homma ◽

Norene Clouten ◽

Midori Homma ◽

Rie Shimada ◽

...

Keyword(s):

Physical Therapy ◽

Cultural Diversity ◽

Clinical Education ◽

Physical Therapists ◽

Clinical Performance ◽

Minority Student ◽

Clinical Instructors

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

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2015.1537 ◽

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.

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

Physical Therapy ◽

10.1093/ptj/82.12.1192 ◽

2002 ◽

Vol 82 (12) ◽

pp. 1192-1200 ◽

Cited By ~ 23

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.

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SAT0611-HPR LOW ADHERENCE TO RECOMMENDED PHYSICAL THERAPY IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS: A MIXED-METHOD CONTENT AND UTILIZATION ANALYSIS.

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4478 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1266.2-1266

Author(s):

E. Vanautgaerden ◽

M. Kaerts ◽

W. Dankaerts ◽

K. De Vlam ◽

T. Swinnen

Keyword(s):

Physical Therapy ◽

Disease Activity ◽

Mixed Method ◽

Axial Spondyloarthritis ◽

Physical Therapists ◽

Skills Training ◽

Treatment Modalities ◽

Patient Reported ◽

Global Disease Activity ◽

Therapy Sessions

Background:Patients with axial spondyloarthritis (axSpA) encounter limitations during daily activities and societal participation which seriously impart health-related quality of life. Optimal management of axSpA consists of combined pharmacological and non-pharmacological treatment modalities, including the encouragement of exercise and the consideration of physical therapy given the latter’s superior efficacy1. Few studies investigated the use of physical therapy and the alignment of treatment content with practice recommendations among patients with axSpA.Objectives:1) To estimate physical therapy use in patients with axSpA in a real life cohort; 2) to quantitatively and qualitatively describe the content of these physical therapy sessions; 3) explore possible determinants of physical therapy use and content.Methods:This cross-sectional study included 197 patients diagnosed with axSpA (Males/Females: 62.4/37.6%; mean±SD, age 42.6±12.0, BASDAI 3.7±2.1, BASFI 3.6±2.4, BASMI 3.1±1.8) and recruited during their routine consultation. The mixed-method approach included questionnaires (physical therapy use and content, medication, depression/anxiety (HADS), fear (TSK), physician global disease activity (PGDA)) and an in-depth qualitative interview (content of physical therapy). Interviews were analyzed using the Qualitative Analysis Guide of Leuven by two physical therapists. Spearman’s Rho correlations guided the exploration of determinants of physical therapy use and content.Results:Less than half (42.6%, n=84) of the axSpA of patients were in treatment with a physiotherapist. Most patients (40.0%) reported a physical therapy frequency of 1x/week. Session duration was typically 30 minutes (51.7% of the sample) and longer in fewer cases (30.0%). Exercise was in only 31.7% the cornerstone of their sessions. The majority of subjects (53.3%) were classified as receiving ‘passive therapy only’, with 10% of cases in the ‘exercise only’ and 36.7% in the ‘combination therapy’ groups. Interviews also revealed a lack of clear patient-centered treatment goals. We found moderate associations between physical therapy use/content parameters and medication, spinal mobility, fear, anxiety, depression, physician’s global disease activity versus (p<.05), but no relationship with patient-reported pain or disease activity.Conclusion:Despite the importance of exercise and the added value of physical therapy in axSpA, few patients engaged in physical therapy sessions that include exercise training of adequate dosage. Remarkably, physical therapy utilization seems to be predominantly guided by psychological factors. Professional education for physical therapists should therefore include skills training in the management of complex clinical presentations2. Last, future research should prepare the evidence-based implementation of state-of-the-art physical therapy guidelines in axSpA.References:[1]van der Heijde D, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017 Jun;76(6):978-991.[2]Swinnen TW, et al. Widespread pain in axial spondyloarthritis: clinical importance and gender differences. Arthritis Res Ther. 2018 Jul 27;20(1):156.Disclosure of Interests:Evelyne Vanautgaerden: None declared, Marlies Kaerts: None declared, Wim Dankaerts: None declared, Kurt de Vlam Grant/research support from: Celgene, Eli Lilly, Pfizer Inc, Consultant of: AbbVie, Eli Lilly, Galapagos, Johnson & Johnson, Novartis, Pfizer Inc, UCB, Thijs Swinnen: None declared

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Self-Reported Characteristics of Physical Therapy Clinical Instructors: A Comparison to the American Physical Therapy Associationʼs Guidelines and Self-Assessments for Clinical Education

Journal of Physical Therapy Education ◽

10.1097/00001416-200601000-00006 ◽

2006 ◽

Vol 20 (1) ◽

pp. 47-55 ◽

Cited By ~ 20

Author(s):

Kathleen M Buccieri ◽

Kathleen Schultze ◽

Jill Dungey ◽

Theresa Kolodziej ◽

Shauna Malta ◽

...

Keyword(s):

Physical Therapy ◽

Clinical Education ◽

Clinical Instructors ◽

Self Assessments ◽

American Physical

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Exploring the experiences of novice clinical instructors in physical therapy clinical education: a phenomenological study

Physiotherapy ◽

10.1016/j.physio.2013.10.005 ◽

2014 ◽

Vol 100 (4) ◽

pp. 349-355 ◽

Cited By ~ 13

Author(s):

B.H. Greenfield ◽

P.H. Bridges ◽

T.A. Phillips ◽

A.N. Drill ◽

C.D. Gaydosik ◽

...

Keyword(s):

Physical Therapy ◽

Clinical Education ◽

Phenomenological Study ◽

Clinical Instructors

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Physical Therapy Faculty, Clinical Instructors, and Employer Expectations for New DPT Graduates in the Acute Care Setting

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2019.1790 ◽

2019 ◽

Author(s):

Leah Nof ◽

Claudia Gazsi ◽

Shari Rone-Adams ◽

Debra Stern

Keyword(s):

Physical Therapy ◽

Acute Care ◽

Delphi Study ◽

Physical Therapists ◽

Problem Solver ◽

Clinical Instructors ◽

Entry Level ◽

New Graduates ◽

New Graduate ◽

Physical Therapy Faculty

Purpose: The purpose of this study was to determine how the expectations of new graduate physical therapists held by physical therapy faculty (PTF), clinical instructors (CIs), and employers (PTE) compared in the acute care (AC) setting, and determine if graduates are meeting the entry-level expectations of the three stakeholders in acute care. Methods: This mixed method study used Survey Monkey to gather data from participants. Faculty, CIs and PTEs were recruited from CAPTE accredited DPT programs. The current survey used the top 25 characteristics developed by the Delphi study by Gazsi to determine level of agreement of importance among the three participant groups for entry-level performance in acute care. Results: The study had 399 participants. Of the 25 characteristics, 7 were ranked most important by more than 75% of all participant groups combined. Two characteristics – safe and reliable – were consistently ranked highest by all 3 participant groups. Four significant differences among groups were for the characteristics of recognition of red flags, critical thinker, problem solver, and team player. A majority (82.4%) reported that new graduates were meeting expectations. Conclusions: Although the majority of participants reported that new graduates were meeting expectations, the implication of differences in expectations among some of the participants is that these differences should be considered in curricula development.

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Influence that Service in a Pro Bono Clinic has on a First Full-Time Physical Therapy Clinical Education Experience

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2017.1624 ◽

2017 ◽

Author(s):

Daria Porretta ◽

Jill Black ◽

Kerstin Palombaro ◽

Ellen Erdman

Keyword(s):

Physical Therapy ◽

Focus Group ◽

Clinical Experience ◽

Clinical Education ◽

Full Time ◽

Clinical Instructors ◽

Clinical Experiences ◽

Education Experience ◽

Pro Bono ◽

The Impact

Purpose: Physical therapist education programs strive to prepare their students for full-time clinical experiences in a variety of ways. Experiential and service learning in authentic contexts reportedly help students make connections between the classroom and the clinic. The purpose of this study was to explore the influences that service in a physical therapy pro bono clinic has on a first full-time clinical education experience. Methods: Participants were all third year doctoral physical therapy students at Widener University who were entering their first full-time clinical education experience. Sixteen participants kept journals throughout their first full-time clinical experience regarding the impact of their previous pro bono experience. Upon completion of the 10-week full-time clinical experience, the sixteen participants answered a Likert-scale survey to further delineate the influence of the pro bono experience, and fifteen of the participants participated in focus group discussions to further explore themes that emerged from the journal and survey data. Data from the focus group and journals were analyzed qualitatively. The responses from the surveys provided quantitative data. In addition, the researchers looked at the Clinical Instructors (CI) midterm comments on the APTA’s Clinical Performance Instrument (APTA PT CPI WEB) to further corroborate or disconfirm the findings. Results: Triangulation of the data points revealed 9 categories of positive impact that the pro bono experience had on their first full-time clinical experience. The strongest three categories in order were client interaction, clinical instructor interaction, and professional communication. The next five categories were of relative equal strength and related to specifics areas of competency. They were competency in documentation, evaluation, intervention, clinical reasoning and cultural competency. A final overarching category was increased confidence. CI comments on the midterm CPI corroborated these findings. Participants also shared ways in which the pro bono experience could have better prepared them for their full-time clinical experience. Conclusions: Regular participation in a pro bono clinic throughout the didactic portion of the physical therapy curriculum contributed to student confidence and competence in their first full-time clinical experience. Future research should include interviews with the clinical instructors to further corroborate the student perceptions. The findings of this study also serve to inform how the pro bono clinical experience can be enhanced to further contribute positively to the students’ first full-time clinical experiences.

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