The Blind Men, the Elephant, and the Continuing Education Course: Why Higher Standards Are Needed in Physical Therapist Professional Development

Exploring the personal and professional outcomes of pursuing fellowship training in orthopedic manual physical therapy: a mixed-methods analysis

OBJECTIVE

Post-professional education in orthopedic manual physical therapy (OMPT) provides a unique pathway for clinicians to refine clinical skills and reasoning in pursuit of professional excellence. Despite these benefits, fellowship training demands significant personal and financial investment. Therefore, understanding whether fellowship education promotes professional growth, job satisfaction, and return on investment is essential. The aim of this study was to explore fellowship-trained OMPTs' self-reported perceptions of pursuing fellowship education in the United States (US), while identifying predictors that may be associated with career success following fellowship education.

METHODS

A convergent parallel mixed-methods design via online survey and one-on-one semi-structured interviews was used. A thematic coding process was implemented for qualitative analysis. Descriptive statistics were calculated for demographic data. Binary logistic regression models assessed relationships between demographic variables and the personal and professional impact of fellowship training.

RESULTS

One hundred and nine participants completed the survey, and 23 underwent focused interviews, meeting data saturation. Merging of analyses revealed five themes related to personal and professional impacts of fellowship including clinical outcomes, job satisfaction, barriers, clinical excellence, and professional opportunities. Board-certified clinicians had greater odds (OR = 4.47, 95% CI 1.17-15.93, p = .03) of reporting fellowship training enhancing their application of current research. Those with a doctorate degree reported greater odds (OR = 9.18, 95% CI 2.31-36.56, p = .002) of establishing impactful mentors through fellowship. PTs with < 10 years of practice were more likely to report fellowship training positively affecting their salary (OR = 4.28, 95% CI 1.50-12.24, p = .01) and self-perception as expert clinicians (OR = 7.29, 95% CI 1.65-32.22, p = .01).

DISCUSSION/CONCLUSION

This study is the first to examine personal and professional outcomes among US fellowship-trained clinicians, highlighting the positive impact on clinical reasoning, mentorship, and compensation - especially among novice clinicians. Fellowship enhances job satisfaction, career growth, and clinical excellence, offering insights for prospective fellows and future research directions.

The educational pathway to Advanced Practice for the physiotherapist: A systematic mixed studies review

BACKGROUND

Advanced Practice Physiotherapy (APP) is a higher level of practice grounded in 4 pillars: clinical practice, leadership, education and research. A critical step toward successful integration and sustainability of APP in healthcare systems is understanding the educational pathway to APP.

OBJECTIVES

1) To describe the post-licensure educational pathways that physiotherapists engage in to advance their level of practice. 2) To evaluate demonstration of the pillars of APP by the physiotherapist after traversing a post-licensure educational pathway.

METHODS

This systematic mixed studies review is reported in accordance with PRISMA and pre-registered (PROSPERO: CRD42024499563). 8 databases plus the grey literature were searched. 2 independent reviewers determined eligibility, extracted data, assessed quality (QuADS) and determined the overall confidence in the cumulative evidence (GRADE-CERQual).

RESULTS

81 studies (18 qualitative, 17 mixed methods, 46 quantitative) were included in a data based convergent qualitative synthesis. 6 distinct post-licensure educational pathways were described and evaluated: Masters level education, residency and fellowship programs, accredited area of practice education, mentorship, multiple encounter courses and single encounter courses.

CONCLUSION

There is a high level of confidence (GRADE-CERQual) in the finding that Masters level education consistently resulted in all 4 pillars demonstrated by the physiotherapist. Masters level education appears to be the optimal pathway to APP.

Is there a correlation between length of employment and receiving a post-professional certification or residency in physical therapy? A pilot study

BackgroundVarious factors in recent years have been shown to negatively impact the physical therapy (PT) workforce in the United States, including decreased reimbursement, burnout, student debt, work-life balance, and more.ObjectiveTo determine if there is a correlation between length of employment and receiving a post-professional certification or residency training in PTMethodsA convenience sample of 121 PTs completing a post-professional certification or residency program, or none, was obtained from a large multi-clinic PT group with an accompanying educational department. Data for each of the employed PTs in the cohort was obtained regarding the hire date, duration of employment before certification/residency, since certification/residency, and overall.ResultsOnly one certification, the pain certification, was correlated to longer employment versus no formal post-professional certification/residency training (p = 0.02). Results show that the mean duration of employment before the start of a pain certification (3.67 years) was significantly longer than sports physical therapy residency (0.52 years; p = 0.001), orthopedic physical therapy residency (1.13 years; p = 0.006)) and manual therapy certification (0.81 years; (p = 0.001). Following training, employment duration produced a less pronounced difference.ConclusionEnrollment in a post-professional pain certification occurs later in the employment tenure compared to other certifications and residencies. Additional research is needed to explore the correlation between post-professional education and longevity of employment and other confounding variables.

National Study Examining Excellence and Value in Physical Therapist Residency Education: Part 1-Design, Methods, and Results

OBJECTIVE

A challenge in health professions is training practitioners to navigate health care complexities, promote health, optimize outcomes, and advance their field. Physical therapist residency education offers a pathway to meet these needs in ways that "entry-level" (professional) education may not. Identifying key aspects of excellence in residency education and understanding its value in developing adaptive expertise will help devise strategies to enhance program, resident, and patient outcomes. The objective of this study was to examine current physical therapist residency education practices to identify and describe examples of excellence and value.

METHODS

A multi-site, multi-specialty qualitative case series was conducted, examining exemplary physical therapist residency programs and their contextual environments using a social constructivist theoretical lens. Six residency programs operating 20 individual residencies that were considered exemplar were selected for the study to participate in site visits. Qualitative case studies were generated from individual interviews, focus groups, review of artifacts, and field observations. The residencies were diverse in specialty area of practice, setting, and geographic location.

RESULTS

A conceptual framework was generated grounded in the domains of excellence and value. These domains were connected by 3 signature indicators: (1) atmosphere of practice-based learning, (2) embodiment of professional formation, and (3) elevated practice. These signature indicators represent the aggregate effects of the interchange between the excellence and value domains which sustain residency education.

CONCLUSION

This study builds upon the work of the Physical Therapist Education for the 21st Century (PTE-21) study and identifies key elements of excellence in residency education, the value of such education, and related outcomes. Findings from this study substantiate the need for a postprofessional phase of physical therapist education founded in practice-based learning encapsulated in residency education.

IMPACT

Results from this study could have compelling and powerful implications on the dialogue and strategic direction in physical therapist residency education.

Lesbian, gay, bisexual, and transgender clinical competence of physiotherapy students in Israel

BACKGROUND

Clinical competence encompasses attitudes, skills, and knowledge regarding diverse client groups. Appropriate clinical competence requires an understanding of the cultural context in which healthcare is delivered. In conservative countries such as Israel, there is a noticeable scarcity of information regarding the clinical competency of physiotherapy students (PTSs) in effectively treating lesbian, gay, bisexual and transgender (LGBT) individuals. The objective of this study was to assess the level of LGBT clinical competence among PTSs in Israel.

METHODS

Conducted through an anonymous online self-report survey, this study gathered personal and academic background information and self-reported data on previous LGBT education during undergraduate studies of PTSs. It utilized the Hebrew version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) questionnaire. Descriptive statistics were computed for all outcome measures. The internal reliability of the LGBT-DOCSS was assessed. Total scores of the LGBT-DOCSS, along with scores in each of the three subscales (clinical preparedness, knowledge, and attitudes), were compared across different levels of religiosity and gender.

RESULTS

The sample comprised of 251 PTSs, with an average age of 25.57 ± 3.07 years (34.7% men, 65.3% women). All students reported a lack of LGBT community-related courses during their undergraduate studies. The translated Hebrew version demonstrated good internal consistency, with Cronbach's alpha ranging from 0.65 to 0.83. The LGBT-DOCSS total score was 4.55 ± 0.61 out of 7, indicating a low level of clinical competency. The highest mean score was in the attitudes subscale (6.55 ± 0.87), which was significantly higher than the scores for the knowledge subscale (3.14 ± 1.46) and clinical preparedness subscale (3.36 ± 0.86). Religiousness was significantly associated with clinical preparedness and attitudes. Men exhibited higher self-reported levels of knowledge and clinical preparedness, albeit with more negative attitudes compare to women. Sexual orientation was significantly associated with clinical competency, with PTSs who identified as heterosexual demonstrating a lower level of clinical competency compared to participants who identified as non-heterosexual.

CONCLUSIONS

In Israel, PTSs demonstrated a low level of clinical competency in terms of self-reported knowledge and self-reported clinical preparedness but contrasting positive attitudes toward the LGBT community. Religiousness, gender and sexual orientation had a significant influence on competency levels.These preliminary findings highlight the urgent necessity to enhance the knowledge of PTSs regarding the LGBT community to improve their clinical competence.

TRIAL REGISTRATION NR

Not applicable.

The Impact of Training Time on Understanding the Treatment of Adolescent Idiopathic Scoliosis According to SOSORT International Guidelines: An Online Survey Study

The lack of knowledge by health professionals in the management of scoliosis can lead to an erroneous diagnosis. The aim of the current study was to understand the influence of length of professional experience on the knowledge of Brazilian physical therapists regarding international guidelines for the treatment of adolescent idiopathic scoliosis. The study was conducted using an online questionnaire consisting of 23 questions, divided into 8 questions on sociodemographic data and 15 questions based on information provided by the guidelines in the SOSORT 2016. In total, 506 physiotherapists were interviewed, and they comprised the study sample. The results showed that professionals who have been working for more than 6 years in the field have greater knowledge of AIS, seek to become more professional, and with that, have an understanding of AIS that is more aligned with the SOSORT. Length of experience made a difference when considering knowledge of the treatment of idiopathic scoliosis. The present study showed that a time since graduation of 6 years or more was satisfactory.

Investigation on the Distribution Characteristics of Chinese Continuing Education Based on the Community Detection Algorithm in Complex Networks

In order to closely fit the characteristics of continuing education, the development of continuing education teaching activities under the network background should not only be combined with the characteristics of professional adult education but also make reasonable use of modern teaching models in the actual teaching process. Based on the community detection algorithm in complex networks, this article makes thorough research and analysis on the complexity of Chinese continuing education by using complex network technology. By establishing the characteristics of vertex degree distribution, average path length, and clustering coefficient of complex networks, it is confirmed that Chinese continuing education has scale-free network characteristics and small-world network characteristics. The three aspects of relationship strength comprehensively analyze the information dissemination speed, scope, interpretation, and application; through the combination of the ant colony algorithm and complex network technology, multiple information dissemination paths are abstracted in Chinese continuing education. The research shows that the application of complex network algorithms can effectively improve the speed and quality of continuing education in China. It is found that the government should increase the number of adult education projects and improve the level of project categories, form key adult education research basis to promote the diversification of research subjects, expand the space for adult education projects to balance regional and provincial differences and attach importance to basic research on adult education, and integrate applied research.