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Aims: The purpose of this study was to explore the changes in clinical reasoning, self-efficacy, and critical thinking of a group of Doctor of Physical (DPT) students who completed a high and low dose of pediatric experiential learning (EL) as a component of their semester-long pediatric course., Methods: A convenience sample of students at two DPT programs in the United States were recruited. A pre-test post-test comparison group design was used to examine the change in students' clinical reasoning, self-efficacy, and critical thinking following completion of a pediatric course that contained a high or low dose of EL. Students completed the Self-Assessment of Clinical Reflection and Reasoning, Physical Therapy Self-Efficacy Scale, and Health Science Reasoning Test during the first and last weeks of the semester. Students in the high-dose group reported a significant increase (p=0.000) over time in self-perceived clinical reasoning and self-efficacy. Overall critical thinking abilities significantly improved (p=0.044) over time in both groups., Conclusion: A high dose of pediatric EL seems to aid students in the development of self-perceived clinical reasoning and self-efficacy. Providing students with EL opportunities prior to pediatric rotations may help to bolster these important skills, leading to improved clinical performance.

Admission into Doctor of Physical Therapy (DPT) programs includes assessment of academic and non-academic metrics. Due to a lack of reliability of non-academic data, programs may base the admission decision solely on academic metrics. The Grit Scale score (GSs) has well-documented reliability associated with perseverance and passion in the context of long-term goals. The purpose of this study was to determine if a relationship exists between the GSs and final cumulative DPT grade point average (GPA) and between the GSs and final DPT class rank, and thus determine if the GSs is a useful non-academic metric in the admission process., Methods: This nonexperimental correlational cohort study examined data from 168 DPT students during the years of 2012-2016 from one eastern university. The 12-item Grit Scale was administered during the on-site DPT application interview as part of the overall application process. Final cumulative DPT GPA and final DPT class rank were obtained from the students' university records., Results: There was a moderate, positive, linear correlation between the students' GSs and class rank percentile (r=0.532, p<0.01) and a moderate, positive, linear correlation between the students' GSs and their final cumulative DPT GPA (r=0.553, p<0.01)., Conclusion: With this evidence, DPT admissions committees may choose to consider the GSs as a non-academic admission metric to aid the admission's process. Additional research is needed to discern the effectiveness of the GSs as a predictor of performance in the professional program and in other entry-level health care academic programs.

Background: A decline in empathy has been demonstrated in college students over a 30-year period. While higher empathy levels have been measured in healthcare students vs non-healthcare students, reports show a disheartening decrease in student empathy scores over the course of professional healthcare education., Objective: The purpose of this study was to assess self-reported empathy in students at two Doctor of Physical Therapy (DPT) programs, one of which used problem-based learning pedagogy while the other used a more traditional didactic teaching method., Methods: This was a cross-sectional study of cohorts of students enrolled at two DPT programs between June 2016 and January 2017. Empathy levels were measured using the Jefferson Scale of Empathy-Health Professions Student version (JSE-HPS) at the start of each year in their DPT education. Demographic factors of gender and age were also examined., Results: The majority of respondents were female (243/304) with an even distribution of respondents per year of educational experience. There was no significant difference in levels of empathy when comparing the cohorts of students from the two pedagogically different DPT programs. Females demonstrated higher levels of empathy than males. There was a greater level of empathy in third-year students than first-year students in both programs., Conclusion: No differences were found in empathy levels between students from two pedagogically different institutions. As empathy is correlated with improved patient outcomes and patient satisfaction, endeavors to understand, document, and increase students' empathy levels should be investigated.

Capstone courses in professional curricula provide opportunities for students to synthesize and integrate clinical and theoretical information from previous coursework. The purpose of this research was to ascertain the number and type of capstone projects utilized by Doctor of Physical Therapy (DPT) programs in the United States. Programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) that published web-accessible curricula were evaluated for the presence of the word capstone in the course title or description. Of the DPT program curricula analyzed (n=204 of 218 possible), 36% designated a capstone course. These capstone courses focused on research (49%), professional development (14%), evidence-based practice (12%), managing complex patients (7%), licensure preparation (4%), clinical education (3%), community service (1%), or a combination or choice between these categories (10%). Consensus regarding capstone courses may serve to promote best practice in entry-level professionals.

Background: Physical therapy workforce shortages are expected to increase for all 50 states through 2030. There is a recognized nationwide unprecedented shortage of well-prepared physical therapy instructors. One practical solution can be to share instructors among Doctor of Physical Therapy (DPT) programs using a blended teaching and learning model., Objective: The purpose of this project was to evaluate the effectiveness of a blended teaching and learning model for a neuroscience course in a DPT program., Methods: Faculty members from two DPT programs collaborated to develop, implement, and evaluate a blended teaching and learning model. The Blackboard Learning Management System (LMS) was available at both institutions and chosen as the learning platform. The design of this research study was retrospective nonexperimental observational., Results: The overall feedback from the students was positive. Most students (91.6%) strongly agreed or agreed that the content of the course was appropriate for learning neuroscience. The students taking this blended course performed slightly better than the students taking the traditional course, though there was no significant difference (p=0.06)., Conclusions: The results support the use of a blended teaching and learning model to meet faculty shortage challenges. Future research with a larger sample size is necessary.

Background: Physical therapist program level successes have been associated with cognitive and noncognitive predictors. To our knowledge, no studies in physical therapy have explored predictive criteria for positive professional performance (PPP) in one's career beyond an educational program. The two-fold purpose of this study was to analyze what traits were key indicators of PPP beyond one's academic preparation, with secondary goal to determine whether traits related to PPP could be mediated by academic preparation., Methods: A three-round Delphi survey targeted expert academicians with a specialization in programmatic performance and student success., Results: Twenty-one Delphi respondents completed all survey rounds; identifying and determining consensus on traits associated with PPP. Respondents determined whether the traits could be influenced by programmatic training. The majority of traits identified with PPP were noncognitive and over half were considered modifiable through academic training. Traits such as critical thinking, promoting and engaging in an active learning process, ethical practice, good communication skills, conveying professionalism, and responsibility for one's own actions scored the highest in the survey., Discussion: Findings may serve to benefit curricular designs of academic health professional programs to improve both programmatic and post-academic success.

It aimed to conduct a personality oriented job analysis to identify non-cognitive factors that may predict successful performance or performance difficulties in doctorate in physical therapy (DPT) students. The study employed focus groups and a survey with 9 DPT subject matter experts. Focus group participants including 3 DPT faculty members and 4 recent graduates of the DPT program identified 22 non-cognitive factors. Out of them, 15 factors were possibly associated with successful performance and 7 factors were possibly associated with performance difficulties. The questionnaire employing the Combination Job Analysis Method resulted in 12 factors which could be used in selection, and 10 which could be incorporated into training. The present study employed an established job analysis method using subject matter experts to identify a broad array of factors that go beyond what previous studies have examined, and which may predict success or difficulties in a DPT program.

Background: To meet the expanding need for physical therapists universities are under increasing pressure to enroll, educate, and train physical therapists. Poor academic performance can result in student dismissal from a physical therapy program. The purpose of this study is to determine if implementation of a retention program would improve student academic performance in the foundational science curriculum in a physical therapy program., Methods: A prospective observational cohort design was used. The retention program centered on three approaches: 1. Early identification of at-risk students. 2. Supplemental instruction in Human Anatomy. 3. Offering peer tutoring for the foundational science courses., Results: A significant association existed between the implementation of the retention program and the reduction of dismissals from the Fall Semester of 2012 to the fall 2013 semesters., Conclusion: Implementation of a retention program had a beneficial effect on decreasing student dismissals in a physical therapy program.

Background: The purpose of this qualitative study was to assess the perceptions of Doctor of Physical Therapy (DPT) students in performing collegiate athletes' strength and conditioning training., Methods: Four DPT students with the Certified Strength and Conditioning Specialist (CSCS) credential voluntarily provided collegiate athletes strength and conditioning training. Students were interviewed to obtain their perceptions of how the experience impacted performance in DPT school and perceptions of anticipated future benefits., Results: Seven themes emerged from interviews: improved communication skills, movement analysis experience, improved time management/organization, increased understanding of exercises, attention to psychosocial aspects, interprofessional experience, and improved performance in coursework., Conclusion: DPT students with the CSCS credential perceived benefits from performing strength and conditioning training outside the standard DPT curriculum.

Demand for physical therapists in the United States (U.S.) is currently robust and expected to grow further. There are currently 228 physical therapy programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE), and 30 more are in development in the U.S.; 29,246 students are currently enrolled in these programs (2014-2015 data). A shortage of physical therapy faculty with an advanced doctoral degree (i.e., PhD, EdD, DSc) is a primary concern for these programs. Specialized residency and fellowship training in physical therapy continue to expand, preparing professionals to deliver advanced clinical care. The American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) reports that there are currently 179 accredited residency programs and 35 accredited fellowship programs in the U.S. A number of academic physical therapy programs also currently operate a clinical faculty practice. Currently, these aspects and trends in physical therapy education, advanced training, and clinical practice, for the most part, lack synergy and connectivity, in both planning and implementation amongst the various components. This professional theoretical article describes a novel model for academic physical therapy, with potential transformative implications for entry-level physical therapy education, advanced clinical training, and academic preparation.

Background: Clinical training in low-income countries has become increasingly popular among pre-licensure trainees from high-income countries. The Working Group on Ethics Guidelines for Global Health Training ("WEIGHT Guidelines") were designed to identify and inform the complex and contentious field of international clinical education. The purpose of this study was to use the WEIGHT Guidelines to evaluate an international clinical internship programme for Master's-level rehabilitation students at a Canadian university., Methods: In-depth, semi-structured interviews were conducted with eight Canadian rehabilitation researchers, educations and/or clinicians responsible for administering international internships across three clinical training programmes. Interview questions were informed by the WEIGHT Guidelines. Directed content analysis was used to identify priorities for policy, practice and research., Results: Five themes relating to strengthening international clinical education were identified: (1) from one-time internships to long-term partnerships, (2) starting a discussion about "costs", (3) a more informed approach to student selection, (4) expanding and harmonizing pre-departure training across disciplines, and (5) investing in post-internship debriefing., Conclusions: International clinical education is fraught with ethical, pedagogical and logistical issues that require recognition and ongoing management. This is the first study to use the WEIGHT Guidelines as a qualitative research tool for assessing an existing global health education programme. Results highlight new priorities for action at the Canadian "sending institution", including more explicit attention to the costs (broadly defined) borne by all parties. A crucial next step is deepened engagement with educational partners at the "receiving organizations" based in low-income countries to nurture dialogue regarding reciprocity, trust and sustainability of the partnership. Education research is also needed that evaluates models of pre-departure training and post-internship debriefing for trainees.

Background and Purpose: The American Physical Therapy Association (APTA) has identified the Doctor of Physical Therapy (DPT) degree as 1 of 6 elements necessary to transition the physical therapy profession to a fully professionalized discipline. However, there have been no data to determine whether physical therapist students who place importance on the DPT degree perceive physical therapy to be more professionalized or anticipate participation in activities reflecting professionalism more than those who do not place importance on the DPT degree., Subjects: The subjects were 919 professional physical therapist students., Methods: Faculty members at 34 physical therapist education programs distributed questionnaires to 1,172 professional physical therapist students and returned 919 questionnaires, for a response rate of 78.4%. The data were statistically analyzed using chi-square analysis and logistic regression., Results: There were few differences between students who place importance on the DPT degree (DPT-I students) and those who do not place importance on the DPT degree (DPT-NI students) regarding how professionalized they perceive physical therapy to be relative to other health care professions or regarding their anticipated participation in activities reflecting professionalism. The one potential distinction found when controlling for other variables was that DPT-I students were more likely than DPT-NI students to anticipate becoming faculty members., Discussion and Conclusion: When beginning their professional education, there are few differences between DPT-I and DPT-NI students' perceptions of the professionalization of physical therapy or anticipation of activities reflecting professionalism.

This article explores major considerations for analysis and discussion of the role of the clinical doctorate as the first professional degree in physical therapist education (DPT). A process for this analysis is posed based on a conceptual framework developed by Stark, Lowther, Hagerty, and Orczyk through grounded theory research on professional education. External influences from society and the profession, institutional and programmatic influences, and articulation of critical dimensions of professional competence and professional attitudes as major categories are discussed in relation to the DPT. A series of questions generated from the application of the model are put forth for continued discussion and deliberation concerning the DPT. We conclude that the DPT provides the best pathway to serve society, the patient, and the profession.

Clinical doctorates are emerging in occupational therapy. By examining the development of clinical doctorates in medicine, dentistry, psychology, pharmacy, nursing, and physical therapy, implications can be drawn for the future of occupational therapy education. These histories offer us a sense of the distinct purpose and curricular structure of the professional doctorate, its successes and problems, its general sequence of unfolding, the political dynamics surrounding it, and the potential it holds for supporting the profession's capacity for service to patients.

In response to the rural health initiative established in 1991, the University of Kentucky has developed an innovative distance learning program of physical therapy instruction that combines classroom lecture and discussion via compressed video technology with laboratory experiences. The authors describe the process of planning, implementing, and evaluating a specific distance learning course in pathomechanics for the professional-level master's-degree physical therapy students at the University of Kentucky. This presentation may serve as a model for teaching distance learning. Descriptions of optimal approaches to preclass preparation, scheduling, course delivery, use of audiovisual aids, use of handout material, and video production are given. Special activities that may enhance or deter the achievement of the learning objectives are outlined, and a problem-solving approach to common problems encountered is presented. An approach to evaluating and comparing course outcomes for the distance learnere is presented. For this particular course, there was no statistically significant difference in the outcome measures utilized to compare the distance learners with the on-site learners.

Purpose: The purpose of this research was twofold. The first purpose was to assess the predictive validity of the interview process in student completion of entry level Masters of Physical Therapy programs on the conventional schedule for the university. The second was to provide a descriptive study of interview formats currently used by these institutions and the cost to the institution, estimated by hours of labor used exclusively for the interview process., Method: A questionnaire was mailed to the Director of Admissions of 63 accredited Masters of Physical Therapy programs in the United States. Forty-three responded to the questionnaire for a response rate of 68.3%. Twenty-eight programs (65.1%) performed interviews and fifteen (34.9%) programs did not., Results: A two-tailed t-test revealed that no significant difference existed between programs that interview and those that did not with regards to the attrition rate of students. There was great diversity between the programs in interview content and structure. The cost to the institutions in terms of hours averaged 261 hours per school for faculty and support staff combined., Conclusion: The schools of physical therapy that award the Masters of Physical Therapy degree vary markedly in the interview content and format both between schools and with recommendations known to enhance validity and reliability. Since, no difference exists in attrition of students between schools that interview and those that do not, the expense and time invested by both the institution and the students are important considerations. The findings of this study indicate the need for continued investigation of the effectiveness of the interview process and alternative methods of valid and reliable student selection.

This study examined the intrateam reliability of a structured interview process used to help select students to a professional education program in physical therapy. Two hundred and twenty academically qualified applicants were interviewed by one of six two-member teams using a standardized format. Each member of a team independently rated the applicant on each of four performance skills using a 5-point ordinal scale; the maximal total score possible was 16 points. A weighted kappa (Kw) statistic was used to estimate intrateam agreement for both 1993 and 1994 on each performance skill and overall interview score. We observed wide variation in intrateam Kw scores for each of the four performance skills between the 1993 and 1994 admission cycles. According to Kw values for overall score agreement, five of the six interview teams either remained the same or increased at least one level between 1993 and 1994. Intrateam variability may be reduced by having team members review specific criteria used to rate a skill before the interview process commences each year.

Background and Purpose: The purpose of this study was to investigate processes used by students in developing conceptual knowledge in physical therapy., Subjects: The subjects were 10 first-year physical therapist students enrolled in a professional Master of Physical Therapy degree program., Methods: Qualitative methods were used to collect data during a 15-week kinesiology course. Data were collected using open-ended interviews, observation, and journals kept by the students throughout the course., Results: Several major themes emerged, including use of discussion, use of visualization, and use of experience by the students as they learned concepts in kinesiology., Conclusion and Discussion: The type of learning processes used by students in this study may be enhanced by educational methods such as collaboration and group learning, situated cognition and use of authentic contexts, cognitive apprenticeship, and whole-part-whole learning. Further research is needed to explore the relationship between student learning processes and teaching methods used in physical therapy education.

This paper presents a clinical reasoning course for postgraduate physiotherapy students, conducted at the University of Sydney. The course was designed to foster the development of students' clinical reasoning skills and clinical knowledge. The rationale and nature of the course are discussed, along with evaluation findings. Results indicate that the course has succeeded in stimulating students' interest and enjoyment in clinical reasoning and promoting students' understanding of and competence in this complex ability.

Background and Purpose: The aim of this study was to evaluate whether postgraduate physical therapy students studying manipulation could learn to accurately produce specific forces during palpation of an intervertebral joint., Subjects: The 12 subjects (7 female, 5 male), aged 26 to 36 years (X = 29.5, SD = 2.9), had each completed a 4-year degree course in physical therapy and had worked between 3 and 10 years in clinical practice. All subjects were enrolled in a 12-month postgraduate manipulative therapy diploma course., Methods: Subjects in the experimental group (n = 6) trained to apply specific forces of 1, 5, 10, 15, 20, and 25 kiloponds using bathroom scales. They practiced for 10 minutes per day for 30 days. Their ability to produce these forces on command was measured using a force platform as they applied posteroanterior passive accessory intervertebral joint movements to the lumbar spine of the healthy subjects. This testing was done prior to training (pretest), immediately after training (posttest), and 1 month following cessation of training (retention test). The control group subjects (n = 6) had no training with scales but were also students of the postgraduate manipulative physical therapy course., Results: In comparison with the control group, the experimentally trained group showed reduced error in force production both immediately after training and 1 month later. This improvement was significant for the retention test. For the retention test, the experimental group subjects were also tested on the trained task (ie, their ability to apply specific forces to the scales). They developed higher levels of accuracy than did the control group., Conclusion and Discussion: Experimental training, therefore, was an effective addition to normal training, suggesting that therapists can learn to quantify applied forces, with significant implications for communication and evaluation of joint behavior.

Previous research has demonstrated that practitioners within the same profession share a common approach to knowledge acquisition and transmission. A search for the identification of this common approach to knowledge in physiotherapy was undertaken using the Epistemic Orientation Model. The research reported was premised on the assumption that students admitted to physiotherapy programs in Canada possess an epistemic orientation that is similar to the epistemological structure of the knowledge base considered important to the program. Using a standardized instrument known as the Knowledge Accessing Modes Inventory (KAMI) to measure epistemic orientation, data were collected from a sample (N = 59) of first- and third-year students registered in a physiotherapy program in a central Canadian university. The data indicated that a high degree of association exists between the epistemological structure subsumed in the knowledge base deemed essential to gain admission to the program and the dominant rational epistemic mode of the practitioners-to-be. Based on the results, the article examines the usefulness of the epistemic orientation concept on activities within the profession. Implications for professional development are noted and avenues for further research are suggested.