A multisite cross-sectional study of intercultural competencies in doctor of physical therapy students.

BACKGROUND: Physical therapists (PTs) work in diverse communities with individuals whose identities and beliefs may differ significantly from their own. Academic institutions must include intentional curriculum aimed at graduating PTs who can skillfully navigate intercultural encounters. Being prepared to engage with difference and demonstrate skills related to intercultural competencies (ICC) will prepare entry-level PTs to provide individualized, high-quality care. Intercultural competencies are essential skills that can reduce healthcare disparities, and promote equitable and inclusive healthcare delivery. This study examined the impact of PT curricula, student demographics, and participation in intercultural learning experiences (ILEs) on students' development of ICC. METHODS: A cross-sectional study of 8 Doctor of Physical Therapy (DPT) programs in the United States (US) compared ICC in first-year (F) and third-year students (T), and T who participated in an ILE (T + ILE) to those who did not (T-only). Subjects included 1,038 students. Outcome measures included The Inventory for Assessing the Process of Cultural Competence-among healthcare professionals-Student Version© (IAPCC-SV), and a demographic survey. RESULTS: Independent t-tests showed that group T (mean = 64.34 ± 5.95, 95% CI: 63.78-64.90) had significantly higher IAPCC-SV total scores than group F (mean = 60.8 ± 5.54, 95% CI = 60.33-61.27, p < 0.05). Group T + ILE (mean = 65.81 ± 5.71, 95% CI = 64.91-66.71) demonstrated significantly higher IAPCC-SV total scores than group T-only (mean = 63.35 ± 5.8, 95% CI = 62.6-64.1, p = 0.039). A one-way ANOVA and post hoc comparisons showed that the 25 to 34-year age group (mean = 63.80 ± 6.04, 95% CI = 63.25-64.35, p < 0.001) and the ≥ 35-year age group (mean = 64.21 ± 5.88, 95% CI = 62.20-66.22, p < .024) had significantly higher IAPCC-SV total scores, than the 18 to 24-year age group (mean = 60.60 ± 5.41, 95% CI = 60.09-61.11). Students who identified in US census minority ethnic or racial categories (US-Mn) (mean = 63.55 ± 5.78, 95% CI = 62.75-64.35) had significantly higher IAPCC-SV total scores than students who identified in US majority ethnic or racial categories (US-Mj) (mean = 61.98 ± 5.97, 95% CI = 61.55-62.413, p = .0001). CONCLUSIONS: Results of the study support the hypothesis that DPT programs can promote the development of intercultural skills in students. The ultimate objective of this academic preparation is to improve the student's ability to deliver equitable, person-centered healthcare upon entry into practice. Specific ICC for entry-level DPT students are not clearly defined by US physical therapy professional organizations, academic institutions, or accrediting body. Students who participated in an ILE exhibited higher levels of ICC when compared to those who did not. Findings from this study can guide curriculum development, utilization of resources, and outcomes assessment. More research is needed to examine characteristics of an ILE that could inform best practice.

Assessing cultural competence: a comparison of two measures and their utility in global learning experiences within healthcare education.

OBJECTIVES: The purpose of this study was to investigate the relationship between two measures of cultural competence (CC), one more widely used, the other designed for healthcare students. It was hypothesized that there would be strong correlations allowing educators to forgo one measure for the other based on utility, resources, and sustainability. DESIGN: Exploratory, cross sectional design SETTING: One US Doctor of Physical Therapy (DPT) academic program. PARTICIPANTS: 145 DPT students. MAIN OUTCOME MEASURES: Intercultural Development Inventory® (IDI) and Inventory for Assessing the Process of Cultural Competence-among healthcare professionals-Student Version© (IAPCC-SV). RESULTS: There were significant (negligible to low, rho = 0.16-0.28; p < 0.05) relationships between the IAPCC-SV total and three constructs with IDI Perceived Orientation scores, and the IAPCCSV total and two constructs with the IDI Developmental Orientation scores. There were significant (negligible to low, rho = 0.18-0.35; p < 0.05) relationships between IAPCC-SV total and construct scores with the IDI Acceptance and Adaptation orientation scores. Students with scores in an IDI DO of Acceptance or Adaptation were significantly more likely to have an IAPCC-SV score in the category of Culturally Competent (X2 = 3.70, p = 0.05). CONCLUSIONS: The discordance of the two measures suggests that the instruments measure unrelated constructs (worldviews, attributes or skills) of cultural competence that are exclusive to each measure and context dependent. Context specific measures may not be generalized to a greater worldview, and visa versa. Multimodal assessment that triangulates data and supports student learning outcomes may be the most effective strategy to capture the impact of curriculum and/or a global learning experience on students' development of cultural competence. CONTRIBUTION OF THE PAPER.

The Changing Landscape of Intercultural Mindset in 616 Doctor of Physical Therapy Students Over the Past 7 Years and the Implications for Doctor of Physical Therapy Cultural Competence Education.

INTRODUCTION: This prospective longitudinal study will report the results of a quantitative analysis of the change in Intercultural Development Inventory (IDI) scores and the distribution of students in 5 orientations along the Intercultural Developmental Continuum (IDC) in 8 cohorts of Doctor of Physical Therapy (DPT) students during their academic preparation. REVIEW OF LITERATURE: The expanding interest in developing intercultural sensitivity in an increasingly more complex and diverse health care environment calls for the dissemination of research on the effectiveness of innovative curricular models that include psychometrically strong outcome measures. Research suggests that health care providers can develop intercultural sensitivity when provided with didactic knowledge, experiential learning, self-reflection, mentoring, and a systematic individualized development plan. SUBJECTS: The participants were from a sample of convenience of 616 DPT students from the graduating classes of 2015-2022. METHODS: The study is a repeated-measure design. The IDI was selected to guide targeted intervention and assessment of intercultural sensitivity at an individual level and group level and was administered in semesters 3 and 8 as part of the DPT program course requirements. RESULTS: There was significant improvement in the IDI Perceived and Developmental Orientation (DO; P < .001) scores between semesters 3 and 8. There was a significant change (P = .0001) in the distribution of students along the 5 DOs of the IDC with 10% of students regressing 1 orientation, 51.7% of students remaining the same, 33.3% of students advancing 1 orientation, and 5% of students advancing 2 orientations along the IDC. Nearly 40% of participants had a positive shift along the IDC. DISCUSSION AND CONCLUSION: The results of this study suggest that intercultural sensitivity or mindset, as measured by the IDI, can be developed in DPT students who participate in a targeted intercultural development curriculum based on the Process Model of Cultural Competence by Deardorff and the Developmental Model of Intercultural Sensitivity by Bennett.

A longitudinal study of outcome measures for children receiving early intervention services.

PURPOSE: The purpose of this study was to compare the Pediatric Evaluation of Disability Inventory (PEDI) and the Mullen Scales of Early Learning (MSEL) as measures of change in children who received early intervention services. METHODS: Thirty-four children were stratified into 2 groups according to the presence of gross motor delay. The PEDI and MSEL were administered 3 times: at an average age of 18, 31, and 53 months of age. Data were analyzed using a repeated-measures multivariate analysis of variance. RESULTS: The findings suggest that PEDI Functional Skills Scaled Scores were capable of measuring change in both groups of children. The standard scores on the PEDI Functional Skills Social Scale were found to be more sensitive to change than the MSEL Receptive and Expressive Language scores for children with motor delays. CONCLUSION: Using PEDI scaled scores may be an effective strategy for measuring change in children receiving early intervention services.