Impact of Task-Fit Misalignment and the Director of Clinical Education: A Grounded Theory Study.

INTRODUCTION: The roles and responsibilities of the director of clinical education (DCE) are of interest in the academic physical therapist (PT) community. This study explored the impact of professional and positional task characteristics of the DCE position on task-fit misalignment within PT education programs. Task-fit explores how the tasks of a particular job align with the appropriately trained person who holds the position. REVIEW OF THE LITERATURE: A recently published DCE Matrix highlights 2 extremes of misalignment and nonoptimal task-fit between the position and the person. Misalignment was investigated rather than alignment because negative connotations often have greater impact on behavior, decision making, and relationships. The impact of misalignment is unknown. SUBJECTS: Program directors and DCEs among ACAPT member PT programs were surveyed. METHODS: A qualitative grounded theory design was used. Two rounds of surveys with focused questions about the impact of task-fit misalignment. Qualitative content data analysis through a constant comparative process was followed. Respondent descriptive statistics were collected. RESULTS: Three realms of impact were identified when misalignment of positional and professional characteristics exists. The realms include the 1) individual person holding the position; 2) academic program; or 3) physical therapy profession. There is a high level of agreement that task-fit misalignment affects each realm; variability exists about its prevalence. DISCUSSION: There seems to be an interconnectedness of impact among the person, the program, and the profession when misalignment exists between the fit of the DCE to the job or the work environment to the DCE. Findings indicate job crafting may be necessary to evolve the nature of the DCE work toward higher director-level tasks. This is the first study of its kind to explore the impact intersection of person-job fit and task-fit and the impact on a DCE's responsibilities. Nonrespondent or attrition bias may have limited sample size.

The implementation and evaluation of health professions students as health coaches within a diabetes self-management education program.

BACKGROUND AND PURPOSE: The purpose of this article is to describe how health professions students were trained and incorporated as health coaches into a group diabetes self-management education (DSME) program in an underserved, urban federally qualified health center. EDUCATIONAL ACTIVITY AND SETTING: Nursing, pharmacy, and physical therapy students from three local colleges were provided health coach training and then integrated into the DSME program with faculty assistance. The students connected with the assigned participants both in person and via weekly telephone calls over a three-month time period, applying concepts learned and providing patient-centered support. FINDINGS: Students noted self-reported improvement in their own perceived knowledge, skills, and attitudes related to health coaching from both qualitative (weekly and end of experience reflections) and quantitative (pre- and post-survey) measures. Participants were also engaged in assessing the program directly via survey responses and indirectly via attainment of personal health-related behavior change goals based on American Association of Diabetes Educators Seven Self-Care Behaviors. SUMMARY: With appropriate training and support from faculty, health professions students were successfully incorporated into an existing DSME program in the role of health coach, gaining knowledge, skills, and attitudes needed to help patients make behavior change.

Collaborations in Clinical Education: Coordinating Top-Down and Bottom-Up Efforts to Advance Best Practices in Physical Therapist Education.

BACKGROUND: Preparing students for today's healthcare environment requires visionary leadership and strategic implementation at the grassroots level. This paper describes the process used in physical therapy (PT) to gather information about regional clinical education consortia, enhance networking, and improve connectivity with national initiatives. PROCESS: Twenty consortia shared information about their structures, processes, and outcomes during small-group discussions using a mixed methods approach. Two additional consortia were later identified and interviewed. FINDINGS: Consortia structure varied, but an average lifespan of 27 yrs with limited turnover was noted. Most consortia included both academic/clinical educators and PT/PTA educators. Commonly reported processes included holding meetings, serving as peer network, mentoring new members, and collaborating on research. The most frequent outcome was education of stakeholders. Consortia supported national initiatives but voiced need for more engagement at the grassroots level. DISCUSSION: Regional consortia play a vital role in shaping the future of clinical education but increased coordination between top-down and bottom-up efforts is needed. Recommendations were developed to use technologies, develop systematic communications, facilitate regional and national networks, and promote inclusion of all stakeholders. CONCLUSION: A systematic process engaging grassroots organizations can prove valuable for coordinating top-down and bottom-up efforts in all health professions.

Effectiveness of pre-admission data and letters of recommendation to predict students who will need professional behavior intervention during clinical rotations in the United States.

The study aimed at finding the value of letters of recommendation in predicting professional behavior problems in the clinical portion of a Doctor of Physical Therapy program learning cohorts from 2009-2014 in the United States. De-identified records of 137 Doctor of Physical Therapy graduates were examined by the descriptive statistics and comparison analysis. Thirty letters of recommendation were investigated based on grounded theory from 10 student applications with 5 randomly selected students of interest and 5 non-students of interest. Critical thinking, organizational skills, and judgement were statistically significant and quantitative differentiating characteristics. Qualitatively, significant characteristics of the student of interest included effective communication and cultural competency. Meanwhile, those of nonstudents of interest included conflicting personality descriptor, commitment to learning, balance, teamwork skills, potential future success, compatible learning skills, effective leadership skills, and emotional intelligence. Emerged significant characteristics did not consistently match common non-professional behavior issues encountered in clinic. Pre-admission data and letters of recommendation appear of limited value in predicting professional behavior performance in clinic.

The Relationship between the Supervision Role and Compassion Fatigue and Burnout in Genetic Counseling.

Many genetic counselors provide supervision to students during their career. Previous studies have shown genetic counselors, in general, are at increased risk for developing compassion fatigue. The purpose of this study was to determine if there was a difference in compassion fatigue and burnout levels in genetic counselors who currently supervise compared to genetic counselors who do not. Genetic counselors who currently practice in a clinical setting (N = 391) completed an online survey containing demographic questions, the Professional Quality of Life Scale, the State-Trait Anxiety Inventory, and questions specific to the genetic counselor's experiences with supervision. Overall, when controlling for trait-anxiety, the supervision role by itself was not independently associated with the risk for compassion fatigue and burnout among genetic counselors. Within supervisors, however, there were several factors which were associated with this risk. Those with less supervision experience reported more secondary traumatic stress. Those supervisors reporting less confidence had decreased compassion satisfaction. Those with less experience or less confidence in their supervision role were most likely to be at increased risk for developing compassion fatigue. Training in supervision and support for dealing with compassion fatigue and burnout may be beneficial to supervisors with less experience.

Selectivity of physiotherapist programs in the United States does not differ by institutional funding source or research activity level.

PURPOSE: This study aimed to compare selectivity characteristics among institution characteristics to determine differences by institutional funding source (public vs. private) or research activity level (research vs. non-research). METHODS: This study included information provided by the Commission on Accreditation in Physical Therapy Education (CAPTE) and the Federation of State Boards of Physical Therapy. Data were extracted from all students who graduated in 2011 from accredited physical therapy programs in the United States. The public and private designations of the institutions were extracted directly from the classifications from the 'CAPTE annual accreditation report,' and high and low research activity was determined based on Carnegie classifications. The institutions were classified into four groups: public/research intensive, public/non-research intensive, private/research intensive, and private/non-research intensive. Descriptive and comparison analyses with post hoc testing were performed to determine whether there were statistically significant differences among the four groups. RESULTS: Although there were statistically significant baseline grade point average differences among the four categorized groups, there were no significant differences in licensure pass rates or for any of the selectivity variables of interest. CONCLUSION: Selectivity characteristics did not differ by institutional funding source (public vs. private) or research activity level (research vs. non-research). This suggests that the concerns about reduced selectivity among physiotherapy programs, specifically the types that are experiencing the largest proliferation, appear less warranted.

Do Differences in Programmatic Resource Investments Result in Different 3-Year Pass Rates on the U.S. National Physical Therapy Examination?

PURPOSE: The rising cost of health professions education is well documented and a growing concern among educators; however, little is known about the implications of resource investment on student success. The objective of this study was to determine whether programs with higher National Physical Therapist Exam (NPTE) pass rates invested significantly more on programmatic resources. METHODS: This observational study used data from the Commission on Accreditation in Physical Therapy Education's (CAPTE) Annual Accreditation Report including all accredited physical therapist programs from the United States who graduated physical therapist students in 2011. Resource expenditures were recorded as both raw and as an index variable (resources per student). Descriptive statistics and comparisons (using chi-square and t-tests) among programs with <100% and 100% pass rates were analyzed from 2009-2011. An ANCOVA was used to determine differences in raw resource expenditures and resource expenditures per student. RESULTS: There were no differences in raw resource expenditures between programs with <100% and 100% pass rates. Programs with 100% pass rates were provided more resource expenditures per student for personnel, overall budget, and core faculty. CONCLUSIONS: The results of this study suggest programs with 100% pass rates invested significantly more per student for selected resources.

Scholarly research productivity is not related to higher three-year licensure pass rates for physical therapy academic programs.

BACKGROUND: In the domain of academia, the scholarship of research may include, but not limited to, peer-reviewed publications, presentations, or grant submissions. Programmatic research productivity is one of many measures of academic program reputation and ranking. Another measure or tool for quantifying learning success among physical therapists education programs in the USA is 100 % three year pass rates of graduates on the standardized National Physical Therapy Examination (NPTE). In this study, we endeavored to determine if there was an association between research productivity through artifacts and 100 % three year pass rates on the NPTE. METHODS: This observational study involved using pre-approved database exploration representing all accredited programs in the USA who graduated physical therapists during 2009, 2010 and 2011. Descriptive variables captured included raw research productivity artifacts such as peer reviewed publications and books, number of professional presentations, number of scholarly submissions, total grant dollars, and numbers of grants submitted. Descriptive statistics and comparisons (using chi square and t-tests) among program characteristics and research artifacts were calculated. Univariate logistic regression analyses, with appropriate control variables were used to determine associations between research artifacts and 100 % pass rates. RESULTS: Number of scholarly artifacts submitted, faculty with grants, and grant proposals submitted were significantly higher in programs with 100 % three year pass rates. However, after controlling for program characteristics such as grade point average, diversity percentage of cohort, public/private institution, and number of faculty, there were no significant associations between scholarly artifacts and 100 % three year pass rates. CONCLUSIONS: Factors outside of research artifacts are likely better predictors for passing the NPTE.

Modifiable variables in physical therapy education programs associated with first-time and three-year National Physical Therapy Examination pass rates in the United States.

PURPOSE: This study aimed to examine the modifiable programmatic characteristics reflected in the Commission on Accreditation in Physical Therapy Education (CAPTE) Annual Accreditation Report for all accredited programs that reported pass rates on the National Physical Therapist Examination, and to build a predictive model for first-time and three-year ultimate pass rates. METHODS: This observational study analyzed programmatic information from the 185 CAPTE-accredited physical therapy programs in the United States and Puerto Rico out of a total of 193 programs that provided the first-time and three-year ultimate pass rates in 2011. Fourteen predictive variables representing student selection and composition, clinical education length and design, and general program length and design were analyzed against first-time pass rates and ultimate pass rates on the NPTE. Univariate and multivariate multinomial regression analysis for first-time pass rates and logistic regression analysis for three-year ultimate pass rates were performed. RESULTS: The variables associated with the first-time pass rate in the multivariate analysis were the mean undergraduate grade point average (GPA) and the average age of the cohort. Multivariate analysis showed that mean undergraduate GPA was associated with the three-year ultimate pass rate. CONCLUSIONS: Mean undergraduate GPA was found to be the only modifiable predictor for both first-time and three-year pass rates among CAPTE-accredited physical therapy programs.

Assessing the effectiveness of a clinical instructor online training module as measured by student perception and sustained best practices.

Due to current scrutiny of physical therapy (PT) clinical education, clinical education models require revisions with close examination of current practice, including best practices in clinical instructor (CI) education. Unfortunately, depth of research currently available to support these revisions is minimal, particularly in areas of research that investigate maintaining recently taught skills in CI training and students' perceived CI effectiveness following training. This study's purpose was to explore these areas. CIs (n=21) were assigned to either a control or treatment group. Treatment group-CIs completed an online module prior to supervising a Doctor of Physical Therapy (DPT) student during a 9-week clinical rotation and then participated in data collection activities following the rotation. Data from control group-CIs established a baseline. Data from students' assessments of their CIs' performances yielded qualitative themes demonstrating differentiated learning environments and module-taught best practices for treatment group-students. Quantitative findings did not make a distinction between the two student groups. Lastly, treatment group-CIs maintained best practices after an inactive period. This study suggests CIs were able to maintain best practices using just-in-time education, distributed clinical practice, and reflection. By continuing examination of online CI education, PT clinical education can move toward new models through evidence-based CI best practices.