Assessing the benefits of an online prematriculation anatomy workshop on knowledge acquisition and anatomy competency in a Doctor of Physical Therapy program

Preparing students for the transition to graduate-level education with greater learning demands in a condensed time frame is a challenging process for health professions educators and incoming students. Prematriculation programs offer a solution for exposing students to the foundational sciences in preparation for the academic rigor of a doctoral program. This retrospective study assessed whether incoming students enrolled across 3 yr of a 2-day online anatomy workshop, offered in July and August before the start of their first semester resulted in improved anatomy knowledge. Whether this acquired knowledge translated to improved anatomy outcomes in the first semester of a Doctor of Physical Therapy program was also assessed, while also accounting for variables of gender, ethnicity, and grade-point average. Knowledge acquired during both days of the workshop resulted in statistically significant improvements in anatomy postquiz scores compared to the baseline prequiz (P < 0.001). Multivariate regression analyses demonstrated statistically significant relationships between the first-semester anatomy practical score and workshop participation (P = 0.04) as well as a predictive value of gender (P = 0.01). Evaluating a timing effect on the predictive value of the online anatomy workshop demonstrated statistically significant effects of the prematriculation workshop on both first-semester anatomy practicals for August (P = 0.03 for practical 1; P = 0.04 for practical 2) but not July workshop participants. Findings from this study support the utility of an online prematriculation anatomy workshop to prepare students for graduate-level anatomy learning expectations in a doctoral allied health program.NEW & NOTEWORTHY This paper presents the findings of a retrospective study examining the effectiveness of an online prematriculation anatomy workshop on knowledge acquisition and first-semester anatomy competency following the success of a previously offered peer-led onsite workshop. To our knowledge, this is the first report of an online prematriculation program that successfully introduces graduate-level learning expectations and access to anatomical resources leading to improved anatomy competency in an allied health professional program.

The effect of pre-body donor quizzes on student performance in a hybrid anatomy course

Learning human anatomy is essential for Doctor of Physical Therapy (DPT) education. Body donors are traditionally utilized to understand content, but in a hybrid learning environment, students have limited time to use body donors. To improve body donor access and learning, we created online synchronous pre-body donor activities. The impact of these online strategies on students' subsequent exams and final grade were investigated in a non-randomized, observational study. These activities were hypothesized to positively influence students' anatomy performance. In a 16-week semester, DPT students (case [n = 91], control [n = 22]) participated in a hybrid program of asynchronous/synchronous online learning and two in-person immersions. Measures included student course grades and teaching surveys. Spearman's rho correlations analyzed the relationship between four pre-body donor quizzes to body donor exams, written exams, and final course grade. Mann-Whitney U tests assessed differences in grades between cohorts. A linear regression model examined the influence of pre-body donor quizzing on exams/final grades. Correlation tests revealed a strong relationship between the average pre-body donor quiz score and both the first written exam and final course grade (p = 0.0001). The case group achieved significantly higher scores than the control group on the first in-person body donor exam (p = 0.011), the second written exam (p = 0.0001), and the final grade (p = 0.004). The pre-body donor quizzes predicted performance on the subsequent in-person body donor exams, written exams, and the final grade. Implementation of online pre-body donor learning activities was associated with increased academic performance among hybrid DPT students and may aid in learning anatomy concepts for clinical practice.

The current state of anatomy education in United States doctor of physical therapy programs

Physical therapy education has significantly evolved over the past few decades. While gross anatomy is integral to physical therapy education curricula, the current state of anatomy education within these programs is not well understood. The primary purpose of this report was to provide an update on the current state of anatomy education across United States (US) Doctor of Physical Therapy (DPT) programs. A survey was disseminated to all 261 accredited US physical therapy programs. The survey was deployed in November 2020 with a deadline to respond by January 15, 2021. The response rate was 32.6% (85/261). When teaching anatomy, 90.5% of the responding programs used dissection, 71.4% used didactic lectures, 60.7% used computer-assisted technology, 58% used prosections, 23.8% used plastinated models, and 31% reported using other methods. DPT programs have experienced declines in PhD faculty (15.7%) and Master of Physical Therapy faculty (15.3%) and notable increases in DPT (16.5%) and physician faculty (8.2%) teaching anatomy within DPT programs. Despite greater use of computer-assisted technologies, these technologies have not replaced donor-based dissection in DPT programs.

The Development and Evaluation of a Pediatric Interprofessional Education (IPE) Experience for Occupational and Physical Therapy Graduate Students

Interprofessional competence is needed to improve health care outcomes. The aim of this paper is to describe the development of theoretically grounded interprofessional education (IPE) experiences to advance interprofessional competencies for occupational and physical therapy doctoral students. In addition, a pretest/postest survey was designed to determine the participants' perceptions of knowledge attainment, roles, and attitudes. Two cohorts of students (N = 115) completed surveys pre and post IPE experiences. Statistically significant changes were found on perception of roles and knowledge attainment. Additional studies are needed to determine if IPE leads to behavioral changes in practice and improves patient outcomes.

Physical therapy students' application of an imaging decision rule for acute knee pain

BACKGROUND

Evidence supports direct referral for imaging by physical therapists. Accuracy and self-efficacy for imaging decisions have not been investigated in entry-level doctor of physical therapy (DPT) students.

OBJECTIVE

The purpose of this study was to understand the relationship between entry-level DPT instruction and accuracy and self-efficacy for imaging referral due to acute knee trauma. A second purpose was to identify relationships between accuracy and self-efficacy.

METHODS

An online survey was sent via e-mail to program directors in accredited DPT programs in the United States with an invitation to forward the survey to DPT students. The survey captured demographic information and included five questions that assessed the respondent's ability to apply the Ottawa Knee Rules (OKR). Self-efficacy was assessed using the Physiotherapist Student Self-Efficacy (PSE) questionnaire, a self-rated 5-point Likert scaled tool.

RESULTS

Of 240 surveys, DPT students who completed imaging coursework had greater accuracy and higher self-efficacy (68.0% correct (95% CI, 63.6-72.5), PSE = 3.67, P < .001) compared to students who had not (45.8% correct (95% CI, 40.8-50.7), PSE = 2.67, P < .001). Conclusion: Accuracy by DPT students who completed imaging coursework was significantly improved and comparable to values from autonomous providers.

Predictive factors of academic success in neuromusculoskeletal anatomy among doctor of physical therapy students

Predictors of academic success in anatomy have been studied, but not in Doctor of Physical Therapy (DPT) students. The objectives of this study were to (1) explore predictors of academic success in a DPT anatomy course, (2) evaluate sex-based differences in the predictors of academic success and their influence on anatomy course grade, and (3) investigate the influence of the DPT anatomy course on visual-spatial ability. Forty-nine DPT students completed a demographic questionnaire, Learning and Study Strategies Inventory (LASSI), and Mental Rotations Test (MRT) before the ten-week anatomy course (MRT-1) and repeated the MRT at the end of the course (MRT-2). Anatomy course grade was determined based on quizzes and written and practical examinations. Multiple regression analysis showed significant associations between the predictor variables age (p = 0.010) and the LASSI anxiety subscale (p = 0.017), which measures anxiety coping, with the anatomy course grade. On the MRT-1, male DPT students attempted and correctly answered more questions than females (both, p < 0.0001). Female students had higher LASSI self-regulation and use of academic resources subscale scores (both, p < 0.05). In the 44 DPT students that completed the MRT-2, the number of correct and attempted responses increased following the anatomy course (p < 0.0001). Age and anxiety coping, but not sex, are predictors of anatomy course grades in DPT students. Mental rotations test scores improved following the anatomy course. The LASSI should be used in other cohorts to identify students with low anxiety subscale scores in order to provide targeted support.

Effect of self-regulated learning and technology-enhanced activities on anatomy learning, engagement, and course outcomes in a problem-based learning program

Problem-based learning (PBL) offers advantages for teaching anatomy and physiology for physical therapy students as clinical cases provide a scaffold for a comprehensive review of body systems. Although the utilization of interactive anatomy software greatly contributes to an active learning environment and efficient use of time, simply providing textbook readings, access to anatomy software, and models is not enough to engage students to become active in reaching their learning goals. Time constraints, meaningful technology implementation, resource abundance, and unfamiliarity are challenges that decrease the effectiveness of both facilitating and learning anatomy. The present study investigated the use of three supplemental learning tools to support anatomy instruction in a self-regulated manner. Friedman test results demonstrated significant differences for perceived engagement [χ²(2) = 15.74, P < 0.001, W = 0.23] but not for perceived learning. Survey responses demonstrated that perceived engagement was greatest with the nondigital supplemental learning tool compared with the two technology-enhanced learning tools (iBooks Author + SoftChalk and SoftChalk alone). Multivariate regression analyses demonstrated statistically significant relationships between the nondigital supplemental learning tool and anatomy practical scores (P < 0.001). The technology-enhanced supplemental learning tools did not further increase learning outcomes as measured by practical scores compared with nondigital learning tools. Incorporation of instructor-created instructional materials independent of technology is an efficient method to drive self-regulated learning, enhance engagement, and improve anatomy course outcomes and may overcome barriers associated with a purely self-directed PBL model.

Development and implementation of a three-dimensional (3D) printing elective course for health science students

Three-dimensional (3D) printing technology has become more affordable, accessible, and relevant in healthcare, however, the knowledge of transforming medical images to physical prints still requires some level of training. Anatomy educators can play a pivotal role in introducing learners to 3D printing due to the spatial context inherent to learning anatomy. To bridge this knowledge gap and decrease the intimidation associated with learning 3D printing technology, an elective was developed through a collaboration between the Department of Anatomy and the Makers Lab at the University of California, San Francisco. A self-directed digital resource was created for the elective to guide learners through the 3D printing workflow, which begins with a patient's computed tomography digital imaging and communication in medicine (DICOM) file to a physical 3D printed model. In addition to practicing the 3D printing workflow during the elective, a series of guest speakers presented on 3D printing applications they utilize in their clinical practice and/or research laboratories. Student evaluations indicated that their intimidation associated with 3D printing decreased, the clinical and research topics were directly applicable to their intended careers, and they enjoyed the autonomy associated with the elective format. The elective and the associated digital resource provided students with the foundational knowledge of 3D printing, including the ability to extract, edit, manipulate, and 3D print from DICOM files, making 3D printing more accessible. The aim of disseminating this work is to help other anatomy educators adopt this curriculum at their institution.

A Pilot Study of a Physical Therapy Cadaveric Anatomy Course: Assessing the Impact of Examination Format on the Learning Environment

Anatomy education continues to evolve in health professional programs as curricula shift to competency-based models and contact hours decrease. These changes in curricula may significantly alter the learning environment for students. Importantly, changes in learning environment have been shown to impact student learning strategies and well-being. It follows, then, that an investigation of students' perceptions of the learning environment is key to understand the impact of modern anatomy curriculum alterations. The current pilot study evaluated the impact of modifying examination format on the learning environment of physical therapy students participating in a human cadaveric anatomy course. Two study cohorts of first year (entry-level) physical therapy students were invited to complete a preliminary learning environment questionnaire with 13 visual analog scale items and four short answer items. One study cohort was tested with a viva (oral) practical examination, and the other, with a bell-ringer practical examination. Analysis of quantitative items revealed two significant findings: physical therapy students in the bell-ringer cohort found it was more difficult to prepare for their examination, and that they had inadequate time to respond to questions compared to the viva cohort. Analysis of qualitative items revealed distinct themes that concerned physical therapy student learning environment specific to cadaveric anatomy. These results demonstrate that examination format can influence the learning environment of physical therapy students studying cadaveric anatomy. As a result, care needs to be taken to ensure that modernized curricula align the examination format to the method of instruction and the future application of students' knowledge in clinical practice.

Regarding the Dead: A Model for Anatomical Gifting Outside the Traditional Medical School Setting

In 2017, Elon University became one of very few universities in the United States without a medical school to have an in-house Anatomical Gift Program (AGP). The program accepts first-person-consenting individuals only and within 2.5 years has become self-sufficient, supporting anatomy curricular needs of its physical therapy, physician assistant, and undergraduate biology and anthropology programs (n = 21 donors annually). This paper describes the timeline, costs, and benefits of developing an in-house AGP at a university without a medical school. Policy development, public outreach, equipment needs, and cost benefits are discussed. Within 2.5 years of program opening, the AGP Director delivered 161 educational outreach presentations at 86 different venues across the state providing information on anatomical gifting. The program registered 320 individuals (60% female, 40% male) and enrolled 41 deceased donors (69% female, 31% male; average age of 74.6 at time of registration and 74.8 at donation). During the first seven months of the program, donor preparation costs (with outsourcing for transport/donor preparation/document filing/serology testing/cremation) averaged US$ 2,100 per donor. Over the past 23 months, donor preparation has been completed on site, lowering the cost per donor to US$ 1,260. Other costs include personnel salaries, legal fees, and outfitting of the anatomy laboratory and preparatory room. Program benefits include support of anatomy education on campus, assurance that all donors have given first-person consent, and faculty/student access to donor-determined health, social, and occupational information. Faculty, staff, and students contribute to the daily operations of the AGP.

Physical therapists' evidence-based practice profile and perspectives of entry-level EBP education: a mixed methods study in the Philippines

Background and Purpose. Inclusion of evidence-based practice (EBP) in entry-level physical therapy (PT) curricula is meant to develop the necessary competencies for better EBP uptake in clinical practice. This study aimed to: 1) determine the practice, knowledge, and values for EBP of the graduates of an entry-level PT curriculum with EBP education; 2) compare graduates' EBP practice profile to their EBP knowledge and values; and 3) explore their views on their EBP education and how EBP education influenced their practice. Methods.A convergent parallel design was used to gather quantitative and qualitative data. The Evidence-based Practice Profile - 2 (EBP²) questionnaire was used for quantitative data. Focus group discussions and open-ended questions in the EBP² were sources for qualitative data. Results.Seventy-seven completed the questionnaire and eight participated in focus group discussions. Participants scored highest for Relevance domain (standardized mean = 75.3) and lowest for Practice (standardized mean = 45.5). Three themes, 'Positive impact of EBP education,' 'Realities of PT clinical practice, and 'Strategies to improve EBP education' were derived. Data integration confirmed findings that graduates have good knowledge, value for, and confidence in doing EBP. Discussion and Conclusion.Findings suggest that early EBP education led to adequate knowledge, confidence, and positive attitudes, but practice barriers hinder EBP uptake. The medical model of service delivery was identified as a factor that influences EBP use. There is a need to revisit the EBP education program to complement real-world demands.

Narrated Dissection Videos and Peer-Mentoring to Enhance Anatomy Performance of Underrepresented Minority Students in Physical Therapy Education

Three-dimensional virtual technology (3DVT) educational tools and peer-tutoring have proven to be effective teaching strategies in improving student learning outcomes. The purpose of this study was threefold: (1) compare the anatomy academic performance between underrepresented minority (URM) and non-minority (non-URM) students, (2) compare the voluntary use of 3DVT dissection videos and peer-mentoring between these two cohorts, and (3) estimate the association between the use of these teaching strategies on anatomy examinations and course grades at a school of physical therapy. Three-dimensional virtual technology narrated dissection videos and peer-mentoring were made available to all students. Time accessing the video and attending peer-mentoring sessions was measured throughout the course for all students. Three practical and four written examinations and the final course grade were calculated. Numerous one-way ANOVAs were used to compare examination/course grades between student cohorts (URM and non-URM) and usage of the two educational strategies (3DVT and peer-mentoring). Multiple linear regressions were performed with teaching strategies as predictors and grades as outcomes. Underrepresented minority students demonstrated significantly lower practical examination scores (P = 0.04), lower final course grades (P = 0.01), and a greater use of mentorship hours (P = 0.001) compared to non-URM. The regression models with both predictors (3DVT and peer-mentoring) combined demonstrated the greatest association with grades for both URM and non-URM. For both groups of students, the association between predictors and practical examination scores, although fair, was not statistically significant. Peer-mentoring seems to be the most effective teaching strategy in helping URM students succeed in anatomy.

An Alternative Method for Anatomy Training: Immersive Virtual Reality

The aim of this study was to investigate the effect of immersive three-dimensional (3D) interactive virtual reality (VR) on anatomy training in undergraduate physical therapy students. A total of 72 students were included in the study. The students were randomized into control (n = 36) and VR (n = 36) group according to the Kolb Learning Style Inventory, sex, and Purdue Spatial Visualization Test Rotations (PSVT-R). Each student completed a pre-intervention and post-intervention test, consisting of 15 multiple-choice questions. There was no significant difference between the two groups in terms of age, sex, Kolb Learning Style Inventory distribution, and the PSVT-R (P > 0.05). The post-test scores were significantly higher compared to pre-test scores in both the VR group (P < 0.001) and the control group (P < 0.001). The difference between the pre-test and post-test results was found to be significantly higher in favor of the VR group (P < 0.001). In this study, anatomy training with a 3D immersive VR system was found to be beneficial. These results suggest that VR systems can be used as an alternative method to the conventional anatomy training approach for health students.

An anatomy workshop for improving anatomy self-efficacy and competency when transitioning into a problem-based learning, Doctor of Physical Therapy program

First-year Doctor of Physical Therapy (DPT) students entering a problem-based learning (PBL) program are faced with a number of pedagogical challenges, including the development of self-directed learning skills, resource unfamiliarity, and group dynamics. These challenges can make learning anatomy in a self-directed manner less efficient. Prematriculation introduction of strategies to improve anatomy learning may help prepare students for a rigorous DPT program and improve anatomy learning efficiency. The present study describes a 2-day anatomy workshop offered to incoming students before a DPT program was initiated. Knowledge acquired during both days of the workshop resulted in statistically significant improvements in anatomy postquiz scores for each corresponding prequiz (P < 0.001 for lower and upper limb quizzes). Workshop participants survey responses demonstrated that anatomy confidence and PBL preparedness increased at distinct intervals following the workshop and was significantly higher than controls after the first semester (P < 0.01 for anatomy confidence and PBL preparedness). Multivariate regression analyses demonstrated statistically significant relationships between semester anatomy practical scores and workshop participation (P = 0.03 for practical 1 and P = 0.049 for practical 2) and undergraduate grade point average (P < 0.001 for practical 1 and P = 0.03 for practical 2). First-year DPT students reported the anatomy workshop to be a valuable experience for learning strategies to improve anatomy self-efficacy. An introductory anatomy workshop is an effective strategy to improve self-directed anatomy learning efficiency before the start of a rigorous DPT program.

Qualitative and quantitative evaluation of an interprofessional workshop between physical therapy and medical students

Interprofessional education (IPE) is an important component of medical education, preparing students for the collaboration necessary for high-quality patient care. This study aimed to compare IPE readiness in pre-qualification physical therapy (PT) and medical (MD) students before and after an interprofessional workshop and identify factors influencing the workshop's perceived educational value. In two consecutive years, students were surveyed with the Readiness for Interprofessional Learning Scale (RIPLS) following a four-hour, case-based workshop. During the second year, students were also surveyed before the workshop and answered open-ended questions about its educational value. PT and MD students had similar mean pre-workshop RIPLS scores (83.0, SD 5.3 vs. 80.7, SD 7.9; p = .27), but post-workshop scores were higher among PT students (86.3, SD 6.5 vs. 80.3, SD 8.8; p < .001). Qualitative thematic analysis of responses to open-ended questions revealed students valued IPE within the workshop. However, MD students in particular identified improvement opportunities in workshop delivery, timing, and content. These factors undermined the perceived educational value for MD students and may have contributed to their lower post-workshop RIPLS scores. This study suggests that a brief workshop can improve readiness for IPE among pre-professional students and highlights the importance of content, delivery, and timing to IPE success.

Naming the Dead: What information do Physical Therapy and Physician Assistant Anatomy Faculty Share With Students?

In this novel study, the researchers quantify cadaver information provided to Physical Therapy (PT) and Physician Assistant (PA) anatomy faculty and ask what portion of that information is then shared with students. Descriptive statistics were used to the describe demographics of the study respondents and to report survey responses. The majority (60% or greater) of faculty who teach anatomy to PT and PA students have clinical degrees matching the student groups they teach. Chi-square analysis showed no appreciable difference (P < 0.001) between PT and PA anatomy faculty in the amount of cadaver information they receive or then share with students. There was a difference in the type of cadaver information (identifying vs. non-identifying) that is received and then shared by these faculty. Faculty are more likely to receive non-identifying cadaver information (93%) than identifying information (40%) (P < 0.0001) and share non-identifying information (83%) than identifying information (26%) with students (P < 0.0003). Interestingly, there is no consensus as to whether sharing cadaver information is respectful or disrespectful to those who donate their bodies for anatomy education and research. Further research is warranted into the reasons anatomy faculty withhold cadaver information from students and in the value, if any, for students knowing more about the cadavers they are learning from.

Effects of Alternating Dissection with Peer Teaching and Faculty Prosected Cadaver Demonstrations in a Physical Therapy and Occupational Therapy Gross Anatomy Course

The most effective method to teach gross anatomy is largely unknown. This study examined two teaching methods utilized in a physical therapy and occupational therapy gross anatomy course, (1) alternating dissection with peer teaching every other laboratory session and (2) faculty demonstrations during laboratory sessions. Student (n = 57) subgroup (A or B) academic performance was determined using written, laboratory practical, and palpation practical examinations. Subgroup A performed significantly better on laboratory practical examination questions pertaining to dissected, in comparison to peer-taught structures (67.1% vs. 60.2%, P = 0.008). Subgroup B performed significantly better on laboratory practical examination questions pertaining to peer-taught, in comparison to dissected structures (64.1% vs. 57.9%, P = 0.001). When Subgroup A was compared to Subgroup B, there were no statistically significant differences on laboratory practical examination question types, whether the subgroup learned the structure through dissection or peer teaching. Based on within and between subgroup comparisons, faculty demonstrations had no effect on written, laboratory practical, or palpation practical examination scores. Although limited, data suggest that the student roles when alternating dissection with peer teaching every other laboratory session appear to be equally effective for learning gross anatomy. The benefits of this method include decreased student/faculty ratio in laboratory sessions and increased time for independent study. Faculty demonstrations during laboratory sessions do not seem to improve student academic performance.

Examination of the short-term impact of a disability awareness training on attitudes toward people with disabilities: A community-based participatory evaluation approach

Background: Worldwide over a billion people live with a disability including 400,000 people in Ecuador. People with disabilities (PWD) face barriers to full participation in society. Barriers are generated by negative attitudes created through socio-cultural experiences. Awareness about disability can be facilitated through disability awareness training (DAT). Studies examining outcomes on DAT exist in high-resourced countries but are nonexistent in Ecuador. Study purposes:1) create a DAT using community input and conduct the training; 2) examine the impact of the DAT on attitudes toward and awareness of PWD; and 3) explore community perceptions regarding the impact of the DAT on action. Methods: Community-based participatory evaluation was employed to design and assess the impact of a DAT with 60 community members from Latacunga, Ecuador. The DAT incorporated a multi-modal approach (interactive discussion, problem-solving, hands-on activities) and was informed by the theory of planned behavior. Data sources were the Multidimensional Attitudes Scale (MAS) (Spanish version) administered pre- and post-DAT and interviews conducted with nine DAT participants. Results: Mann Whitney U revealed significant changes in two of four MAS constructs: emotion p = .005 and cognition p = .003. Five themes emerged from the interviews: 1) view of disability; 2) contact; 3) attitude; 4) training impact; and 5) action. Conclusion: In the short-term DAT may increase awareness of and decrease negative attitudes associated with disability. Effective strategies highlighted for raising awareness and improving attitudes were contact with PWD and education. Education leads to more positive perceptions of the barriers PWD face and their ability to participate in society.

Improving the Quality of Consumer Health Information on Wikipedia: Case Series

Background

Wikipedia is one of the most consulted health resources in the world. Since the public is using health information from Wikipedia to make health care decisions, improving the quality of that health information is in the public interest. The open editable content design of Wikipedia and quality control processes in place provide an opportunity to add high-value, evidence-based information and take an active role in improving the health care information infrastructure.

Objective

The aim of this project was to enhance Wikipedia health pages using high-quality, current research findings and track the persistence of those edits and number of page views after the changes to assess the reach of this initiative.

Methods

We conducted Wikipedia Editathons with 3 different cohorts of Physical Therapy (PT) students to add high-quality health information to existing Wikipedia pages. Students synthesized best evidence information and updated and/or corrected existing Wikipedia entries on specific health pages. To evaluate the impact of these contributions, we examined two factors: (1) response to our contributions from the Wikipedia editing community, including number and type of subsequent edits as well as persistence of the student contributions and (2) number of page views by the public from the time of the page edits.

Results

A total of 98 PT students in 3 different cohorts engaged in Editathons, editing 24 health pages. Of the 24 edits, 22 persisted at the end of the observation period (from time of entry to May 31, 2018) and received nearly 8 million page views. Each health page had an average of 354,724 page views.

Conclusions

The Wikipedia Editathon is an effective way to continuously enhance the quality of health information available on Wikipedia. It is also an excellent way of bridging health technology with best-evidence medical facts and disseminating accurate, useful information to the public.

Preadmission predictors of graduation success from a physical therapy education program in the southwestern United States

PURPOSE

The field of physical therapy education is seeking an evidence-based approach to inform qualified applicant admission. A considerable amount of research exists; however, results represent an array of outcomes making practical application difficult. It aims to determine what preadmission criteria are predictors of graduation success.

METHODS

Data from the 2013-2016 graduating cohorts (n=149) were collected. Predictors included verbal, quantitative and analytical Graduate Record Examination rank percentile), admissions interview, precumulative science grade point average (SGPA), precumulative grade point average (UGPA), and reflective essay. Measures of graduation success were identified as the National Physical Therapy Examination (NPTE) and grade point average at the time of graduation (GGPA). Two separate mixed effects models determined associations between preadmission predictors and NPTE, and preadmission predictors and GGPA.

RESULTS

Overall, NPTE model fit comparison was significant (df=10; p=0.001) and within-cohort variance decreased 59.5%. The NPTE was associated with GGPA (β=125.21; p=0.001), and verbal Graduate Record Examination (VGRE) rank percentile interview, essay and GGPA (p≤0.001) impacted model fit. Overall, GGPA model fit comparison was not significant (df=8; p=0.56) and within-cohort variance was decreased by 16.4%. The GGPA was associated with interview (β=0.02; p=0.04) and UGPA (β=0.25; p=0.04). VGRE rank percentile, interview, UGPA, and essay (p≤0.02) impacted model fit.

CONCLUSION

Above findings suggest that GGPA predicts NPTE, and the interview and UGPA predict GGPA. The essay and VGRE rank percentile warrant attention because of their influence on model fit. It is recommended that admissions ranking matrices designate greater weight to the interview, UGPA, VGRE rank percentile, and essay.

Gross anatomy education for South African undergraduate physiotherapy students

Eight faculties in South Africa offer undergraduate physiotherapy training with gross anatomy included as a basis for clinical practice. Little information exists about anatomy education for this student body. A 42-question peer-reviewed survey was distributed to physiotherapy gross anatomy course coordinators in all the eight faculties. Seven coordinators from six (75%) of the universities responded. Two respondents' data from the same university were pooled. Collected data show that staff qualifications and experience varied widely and high to average staff to student ratios exist between faculties. Direct anatomy teaching duration was 12.3 (SD ±5.2) weeks per semester. Total number of weeks in courses per faculty was 27.6 (SD ±5.7) varying widely between institutions. Calculable direct contact anatomy hours ranged between 100 and 308 with a mean of 207.6 (SD ±78.1). Direct contact hours in lectures averaged 3.9 (SD ±1.6) per week and the average direct contact hours in practical sessions were 3.5 (SD ±1.8) per week. Dissection, prosection, plastinated models, surface anatomy, and e-learning were available across faculties. Ancillary modalities such as vertical integration and inter-professional learning were in use. All faculties had multiple-choice questions, spot tests, and short examination questions. Half had viva-voce examinations and one had additional long questions assessment. Students evaluated teaching performance in five faculties. Four faculties were reviewing anatomy programs to consider implementing changes to anatomy curriculum or pedagogy. The findings highlighted disparity between programs and also identified the need for specific guidelines to develop a unified South African gross anatomy course for physiotherapy students.

A gross anatomy flipped classroom effects performance, retention, and higher-level thinking in lower performing students

A flipped classroom is a growing pedagogy in higher education. Many research studies on the flipped classroom have focused on student outcomes, with the results being positive or inconclusive. A few studies have analyzed confounding variables, such as student's previous achievement, or the impact of a flipped classroom on long-term retention and knowledge transfer. In the present study, students in a Doctor of Physical Therapy program in a traditional style lecture of gross anatomy (n = 105) were compared to similar students in a flipped classroom (n = 112). Overall, students in the flipped anatomy classroom had an increase in semester average grades (P = 0.01) and performance on higher-level analytical questions (P < 0.001). Long-term retention and knowledge transfer was analyzed in a subsequent semester's sequenced kinesiology course, with students from the flipped anatomy classroom performing at a higher level in kinesiology (P < 0.05). Student's pre-matriculation grade point average was also considered. Previously lower performing students, when in a flipped anatomy class, outperformed their traditional anatomy class counterparts in anatomy semester grades (P < 0.05), accuracy on higher-level analytical anatomy multiple-choice questions (P < 0.05) and performance in subsequent course of kinesiology (P < 0.05). This study suggests that the flipped classroom may benefit lower performing student's knowledge acquisition and transfer to a greater degree than higher performing students. Future studies should explore the underlying reasons for improvement in lower performing students.

Simulating the multi-disciplinary care team approach: Enhancing student understanding of anatomy through an ultrasound-anchored interprofessional session

Quality of healthcare delivery is dependent on collaboration between professional disciplines. Integrating opportunities for interprofessional learning in health science education programs prepares future clinicians to function as effective members of a multi-disciplinary care team. This study aimed to create a modified team-based learning (TBL) environment utilizing ultrasound technology during an interprofessional learning activity to enhance musculoskeletal anatomy knowledge of first year medical (MD) and physical therapy (PT) students. An ultrasound demonstration of structures of the upper limb was incorporated into the gross anatomy courses for first-year MD (n = 53) and PT (n = 28) students. Immediately before the learning experience, all students took an individual readiness assurance test (iRAT) based on clinical concepts regarding the assigned study material. Students observed while a physical medicine and rehabilitation physician demonstrated the use of ultrasound as a diagnostic and procedural tool for the shoulder and elbow. Following the demonstration, students worked within interprofessional teams (n = 14 teams, 5-6 students per team) to review the related anatomy on dissected specimens. At the end of the session, students worked within interprofessional teams to complete a collaborative clinical case-based multiple choice post-test. Team scores were compared to the mean individual score within each team with the Wilcoxon signed-rank test. Students scored higher on the collaborative post-test (95.2 ±10.2%) than on the iRAT (66.1 ± 13.9% for MD students and 76.2 ±14.2% for PT students, P < 0.0001). Results suggest that this interprofessional team activity facilitated an improved understanding and clinical application of anatomy. Anat Sci Educ 11: 94-99. © 2017 American Association of Anatomists.

Comparison of physical therapy anatomy performance and anxiety scores in timed and untimed practical tests

Students in health care professional programs face many stressful tests that determine successful completion of their program. Test anxiety during these high stakes examinations can affect working memory and lead to poor outcomes. Methods of decreasing test anxiety include lengthening the time available to complete examinations or evaluating students using untimed examinations. There is currently no consensus in the literature regarding whether untimed examinations provide a benefit to test performance in clinical anatomy. This study aimed to determine the impact of timed versus untimed practical tests on Master of Physical Therapy student anatomy performance and test anxiety. Test anxiety was measured using the State-Trait Anxiety Inventory (STAI). Differences in performance, anxiety scores, and time taken were compared using paired sample Student's t-tests. Eighty-one of the 84 students completed the study and provided feedback. Students performed significantly higher on the untimed test (P = 0.005), with a significant reduction in test anxiety (P < 0.001). Students who were unsuccessful on the timed test showed the greatest improvement on the untimed test ( x¯ = 20.4 ±10%). Eighty-three percent (n = 69) of students preferred the untimed test, 8.4% (n = 7) the timed test, and 8.4% (n = 7) had no preference. Students took on average eight minutes longer on the untimed test. This study found that physical therapy students perform better on untimed tests, which may be related to a reduction in test anxiety. If the intended goal of evaluating health care professional students is to determine fundamental competencies, these factors should be considered when designing future curricula.

Long-term effect of a short interprofessional education interaction between medical and physical therapy students

Medicine is increasingly focused on team-based practice as interprofessional cooperation leads to better patient care. Thus, it is necessary to teach teamwork and collaboration with other health care professionals in undergraduate medical education to ensure that trainees entering the workforce are prepared to work in teams. Gross anatomy provides an opportunity to expose students to interprofessional education (IPE) early in their training. The purpose of this study is to describe an IPE experience and report if the experience has lasting influence on the participating students. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was administered to first year medical (MD) and physical therapy (PT) students at Mayo Medical School and Mayo School of Health Sciences. Results demonstrated an openness on the part of the students to IPE. Interprofessional education experiences were incorporated into gross anatomy courses in both medical and PT curricula. The IPE experiences included a social event, peer-teaching, and collaborative clinical problem-solving sessions. These sessions enhanced gross anatomy education by reinforcing previous material and providing the opportunity to work on clinical cases from the perspective of two healthcare disciplines. After course completion, students again completed the RIPLS. Finally, one year after course completion, students were asked to provide feedback on their experience. The post-curricular RIPLS, similar to the pre-curricular RIPLS, illustrated openness to IPE from both MD and PT students. There were however, significant differences in MD and PT perceptions of roles and responsibilities. One-year follow-up indicated long-term retention of lessons learned during IPE.

Use of individual feedback during human gross anatomy course for enhancing professional behaviors in doctor of physical therapy students

Medical professionals and public consumers expect that new physical therapy graduates possess cognitive, technical, and behavioral skills required to provide safe and high-quality care to patients. The purpose of this study was to determine if a repertoire of ten professional behaviors assessed at the beginning of doctorate of physical therapy education and before the first significant clinical internship could be enhanced in a semester course in gross human anatomy using individual formative feedback. During the human anatomy course, 28 first-year physical therapy students completed six biweekly, anonymous self- and peer assessment surveys that targeted ten professional behaviors important to physical therapists. All professional behaviors were assessed using a five-point Likert scale. Feedback reports occurred at week eight (mid-semester) and week 16 (end-of-semester) and comprised the direct intervention components of this study. At the midpoint of the semester, professional behavior scores and narrative comments from weeks two, four, and six were compiled and shared with each student by one of three faculty members in a feedback session. Students then submitted biweekly self-and peer professional behavior assessments (weeks 10, 12, and 14) for the remainder of the human anatomy course. Differences between preintervention and postintervention scores for each of the ten professional behaviors were compared using the Wilcoxon signed-ranks test. Upon receiving mid-semester individual feedback, students demonstrated significant improvement in each of the ten professional behaviors. Results from this study indicated a gross anatomy laboratory dissection experience during the first academic semester provided an effective opportunity for teaching and assessing professional behaviors of doctoral students in physical therapy.

Equivalence of students' scores on timed and untimed anatomy practical examinations

Untimed examinations are popular with students because there is a perception that first impressions may be incorrect, and that difficult questions require more time for reflection. In this report, we tested the hypothesis that timed anatomy practical examinations are inherently more difficult than untimed examinations. Students in the Doctor of Physical Therapy program at Thomas Jefferson University were assessed on their understanding of anatomic relationships using multiple-choice questions. For the class of 2012 (n = 46), students were allowed to circulate freely among 40 testing stations during the 40-minute testing session. For the class of 2013 (n = 46), students were required to move sequentially through the 40 testing stations (one minute per item). Students in both years were given three practical examinations covering the back/upper limb, lower limb, and trunk. An identical set of questions was used for both groups of students (untimed and timed examinations). Our results indicate that there is no significant difference between student performance on untimed and timed examinations (final percent scores of 87.3 and 88.9, respectively). This result also held true for students in the top and bottom 20th percentiles of the class. Moreover, time limits did not lead to errors on even the most difficult, higher-order questions (i.e., items with P-values < 0.70). Thus, limiting time at testing stations during an anatomy practical examination does not adversely affect student performance.

Oral anatomy laboratory examinations in a physical therapy program

The process of creating and administering traditional tagged anatomy laboratory examinations is time consuming for instructors and limits laboratory access for students. Depending on class size and the number of class, sections, creating, administering, and breaking down a tagged laboratory examination may involve one to two eight-hour days. During the time that a tagged examination is being created, student productivity may be reduced as the anatomy laboratory is inaccessible to students. Further, the type of questions that can be asked in a tagged laboratory examination may limit student assessment to lower level cognitive abilities and may limit the instructors' ability to assess the students' understanding of anatomical and clinical concepts. Anatomy is a foundational science in the Physical Therapy curriculum and a thorough understanding of anatomy is necessary to progress through the subsequent clinical courses. Physical therapy curricula have evolved to reflect the changing role of physical therapists to primary caregivers by introducing a greater scope of clinical courses earlier in the curriculum. Physical therapy students must have a thorough understanding of clinical anatomy early in the education process. However, traditional anatomy examination methods may not be reflective of the clinical thought processes required of physical therapy students. Traditional laboratory examination methods also reduce student productivity by limiting access during examination set-up and breakdown. To provide a greater complexity of questions and reduced overall laboratory time required for examinations, the Physical Therapy Program at Mercer University has introduced oral laboratory examinations for the gross anatomy course series.

A Cardiopulmonary Instructor's Perspective on a Standardized Patient Experience: Implications for Cardiopulmonary Physical Therapy Education

PURPOSE

Standardized patients (SP) in Doctor of Physical Therapy (DPT) curricula are increasingly used for students to practice developing clinical reasoning, communication, and professional skills in an authentic learning environment. The purposes of this article are to: (1) describe an instructional model that synthesized SPs, Internet-based communities of practice, and reflection to teach clinical reasoning in DPT students; and (2) a cardiovascular and pulmonary physical therapy (CPPT) instructor's perspective on the educational process and student clinical skill development.

SUMMARY OF KEY POINTS

The model, employed in a course: "Integrative Physical Therapy Practice," enabled the instructor to document student clinical performance and reasoning during an SP interaction. For students, clinical reasoning was illuminated through the model's assessment process. Data collected through the assessment process provided important feedback to the instructor on classroom instructional effectiveness.

CONCLUSIONS

Examination of student learning experiences enabled the instructor to consider: (1) key aspects of examination and management for persons with cardiovascular or pulmonary disorders, (2) methods for visualizing clinical reasoning, (3) the impact of teaching on student learning, and (4) strategies for teaching CPPT. More research is indicated to investigate pedagogy for the development of clinical reasoning in DPT students.

Scoring of the physical therapist clinical performance instrument (PT-CPI): analysis of 7 years of use

PURPOSE

The aims of this study were to (1) describe the completion rates of the 24 performance criteria (PCs) from the Physical Therapist Clinical Performance Instrument (PT-CPI) by clinical instructors; (2) evaluate change in PC visual analogue scores (VAS) with students' clinical experience; and (3) evaluate scoring patterns over time.

METHODS

Final VAS scores for 208 physiotherapy (PT) students (seven cohorts) from 1,039 clinical placements between 2001 and 2008 were analyzed. Completion rates were calculated for each PC. Kruskal-Wallis tests evaluated differences in VAS scores between cohorts. Friedman's tests were used to compare VAS scores for each PC over time.

RESULTS

Completion rates were above 90% for 18 PCs. Data from the seven cohorts were combined. All PC scores showed significant change from 10 to 15 weeks and from 15 to 20 weeks of clinical experience (p≤0.001). Although differences in scores decreased over time, 19 PCs showed significant differences between 20 and 25 weeks, and 11 PCs showed significant differences between 25 and 31 weeks of clinical experience (p<0.01).

CONCLUSIONS

Certain PCs had lower completion rates. The PT-CPI was used consistently by clinical instructors to evaluate student performance over time. A continual progression in acquisition of clinical competencies was illustrated by PT-CPI scoring patterns as students advanced through their PT education programme.