The Interprofessional Standardized Patient Experience: An Effective Interprofessional Education Activity for Prelicensure Health Professional Students.

Introduction: For future success in the modern health care environment, health professions students require effective interprofessional education experiences to develop their perceptions of other professionals on the health care team. The Interprofessional Standardized Patient Experience (ISPE) is an interprofessional education activity for prelicensure health professional students in nursing, pharmacy, physical therapy, medicine, social work, and occupational therapy. Methods: The ISPE involved collaboration among students to conduct a subjective interview. Students from six health care professions individually interviewed a simulated patient while being observed by students from other professions. A structured faculty-guided debriefing session followed the comprehensive interview process. Students completed a voluntary pre- and post-ISPE survey with interprofessional questions and feedback on the activity. Descriptive statistics were used to analyze individual responses. Differences in student opinions by student profession and by the number of professions present were examined using chi-square tests. Results: Over 4 consecutive academic years, 1,265 students completed the ISPE, and 1,028 completed the pre- and post-ISPE surveys. Analysis of the survey responses indicated that the ISPE enhanced student awareness of the functions of an interprofessional team and increased student knowledge of the roles of different health care professions. Students rated the ISPE as a valuable experience. Differences were noted in some of the measures by profession and group size. Discussion: A single ISPE had a significant impact on prelicensure students' perceptions. The ISPE is a novel and effective approach to interprofessional education that students appreciate.

Developing Patient-Centered Preventative Care to Reduce Mobility Disability With Aging: Preferences From a Discrete Choice Experiment.

BACKGROUND AND PURPOSE: Mobility disability is the most prevalent form of disability for older adults in the United States. A physical therapy mobility checkup (MC) under development is a patient-centered preventative physical therapy visit. It includes physical performance testing and education on physical performance as a valuable and modifiable health indicator. The purpose of this study was to identify the proportion of older adults willing to participate in an MC, the age at which they would initiate care, their desired frequency of participation, and the characteristics, or attributes, of the MC they preferred. METHODS: In a cross-sectional study conducted at the Minnesota State Fair, adults older than 55 years answered survey questions about preventative health practices and completed a discrete choice experiment (DCE) to determine their preferences for the MC. Attributes studied in the DCE were visit duration, checkup content, education, and possible outcomes of participating in preventative care for mobility. Descriptive statistics characterized demographic information and survey responses. Conjoint choice modeling estimated the main effect for each DCE attribute. RESULTS AND DISCUSSION: One hundred sixty-six older adults participated in the study. Seventy-eight percent indicated that they would choose an MC if available. Most participants (66%) believed that MCs should occur before 60 years of age and at least annually (68%). A 30-minute visit duration, which accounted for 84% of attribute importance, was preferred. Balance, the preferred content of the MC, accounted for 12% of the attribute importance. Preferences for educational content and possible outcomes of participation with preventative care aimed at preventing mobility loss were not statistically significant. CONCLUSION: Older adults value preventative care for reducing mobility disability. They identified time efficiency and the inclusion of measures to assess balance as priorities for this preventative physical therapy visit.

A cross-sectional methodological study: evaluation of the examiner performance on the Dix-Hallpike test.

PURPOSE: The Dix-Hallpike test is recommended to diagnose Benign Paroxysmal Positional Vertigo (BPPV). This research aimed to quantify the movement of a healthy subject during the Dix-Hallpike test and determine what factors contribute to performance variation from the recommended head position with 20° cervical extension, 45° cervical rotation, and a brisk movement velocity. MATERIALS AND METHODS: Examiners performed the Dix-Hallpike test 10 times. The examinee's movement was recorded with Qualisys and processed with Visual3D. The proportion of variation in test performance within examiners, between examiners, and due to examiner position was calculated. RESULTS: Thirteen participants, 54% male and mean age 40, performed 50 cranial and 77 lateral Dix-Hallpike tests. Head position differed significantly from the recommendations with the cranial tests for extension (mean difference [MD] = 11.6°, p < 0.001) and rotation (MD = 4.8°, p < 0.001) and with lateral tests for extension (MD = 13.3°, p < 0.001). The largest proportion of variation was between examiners (60-91%), followed by within-examiners (3-16%). The examiner position contributed to 20% of the variation in the cervical rotation achieved. Tests lasted, on average, 1.80 s. CONCLUSIONS: Differences within and between examiners visually estimating the Dix-Hallpike test endpoints may impede BPPV diagnosis accuracy.

Vertigo diagnosis with the Dix-Hallpike may be improved by reducing inter-examiner differences with head positioning and velocity.With Dix-Hallpike testing, examiners should consider a cranial orientation relative to the examinee to better achieve the recommended head positioning.The cranial Dix-Hallpike and encouraging briskness as tolerated by the examinee should be emphasized with teaching the maneuver.

A Physical Therapy Mobility Checkup for Older Adults: Feasibility and Participant Preferences From a Discrete Choice Experiment.

PURPOSE: Physical performance measures, like walking speed, identify and predict preclinical mobility disability but are rarely used in routine medical care. A preventive model of care called Mobility Checkup is being designed to reduce mobility disability in older adults. This study had two purposes: 1) determine feasibility and outcomes of the Mobility Checkup, and 2) identify preferences of older adults regarding this model of care using a discrete choice experiment. METHODS: Adults over 55 years of age were recruited from the community. In the study's first phase, participants completed a Mobility Checkup, with feasibility evaluated using 6 criteria. In the second phase, a new sample of older adults (>55 years old) were educated about the Mobility Checkup and then completed a discrete choice experiment to determine their preferences regarding 4 attributes of this care model: cost, visit duration, desired education topic, and style of educational graphic. RESULTS: Each study phase was completed by 31 participants. Of the 6 feasibility criteria, 5 were met. Visit duration exceeded the 60-minute criteria for 13 of the 31 participants. Still, 91% of participants were very satisfied with the Mobility Checkup. Ability to transition positions identified preclinical mobility disability most frequently. A 30-minute visit with no out-of-pocket cost was deemed preferred. CONCLUSIONS: Older adults value knowing what physical performance measurements predict about their general health. Transitions should be evaluated as part of a Mobility Checkup for older adults. Clearly conveyed cost of health care service is important to older adult consumers.

Observational Study: Predictors of a Successful Functional Outcome in Persons Who Receive Physical Therapy for Knee Osteoarthritis.

A retrospective design was employed to determine what factors are predictive of achieving a successful outcome for individuals with knee osteoarthritis following an episode of physical therapy. Success was defined as achieving the minimum clinically important difference with the change in the lower extremity functional scale (LEFS). Receiving guideline adherent care was hypothesized to increase odds of success. Data for treatment interventions, health care utilization, patient characteristics, and LEFS scores were collected from electronic health records from 2014-2018 across 34 outpatient clinics. The sample (N = 706) was primarily female, White, and older adults. Receiving guideline adherent care did not predict odds of achieving success. Patient age, initial LEFS score, opioid prescription, number of visits, and Medicare/Medicaid insurance were predictive of the outcome. Increasing age after 65 years predicted decreased odds of success. Older adults showed improved odds with an opioid prescription and with increased number of visits from two through 18 therapy sessions. Opportunities exist for further health services research on optimal management of knee OA, including underutilization of physical therapy (only 6% in this study), measuring adherence to CPGs, determining recommended intensity for interventions, and the effects of non-physical therapy interventions such as opioid use on outcomes.