Feasibility of Improving Global Health in Underserved Populations by Utilizing Service-Learning and Pro Bono Physical Therapy: A Systematic Review.

PURPOSE: Restrictions in access and affordability of health care across the world limits global health. Pro bono physical therapy through service-learning in Doctor of Physical Therapy (DPT) curricula has been proposed to address these limitations. However, there is a lack of research regarding best practice. This study aims to evaluate the feasibility of improving global health in underserved populations by utilizing service-learning and pro bono PT through a systematic literature review. METHODS: Peer-reviewed articles were selected based on the following criteria: the study evaluated a service-learning and/or pro bono program utilizing PT students, the program included service to underserved populations and focused on global health, and the study included defined student and/or patient outcomes. RESULTS: The original search yielded 397 articles, of which 10 were selected for the final analysis. The strength of evidence for these 10 qualitative studies was determined. Service-learning and/or pro bono PT models varied across studies. Outcomes assessed focused on individual changes in the APTA Core Values Self-Assessment, student development, and community satisfaction. CONCLUSION: Service-learning and pro bono models may improve global health in underserved populations. However, there is limited research between these models and improvement of global health. Service-learning and pro bono models should incorporate the use of the APTA's Core Values, address mentorship, and sustainability for all stakeholders.

Front-loading of anatomy content has no effect on long-term anatomy knowledge retention among physical therapy students: a prospective cohort study.

BACKGROUND: Information learned over a longer period of time has been shown to result in better long-term knowledge retention than information learned over a shorter period of time. In order to address multiple curricular goals, the timing and spacing of anatomy content within the Doctor of Physical Therapy (DPT) program at our institution recently changed from a very spaced to a very compressed format. The purpose of the present study was to assess differences in anatomy knowledge retention that might have been impacted by this change. The research hypothesis was that students receiving spaced instruction would have significantly better anatomy knowledge retention than students receiving massed instruction. METHODS: Participants consisted of two cohorts of DPT students that both received 45 contact hours of anatomy lecture and 90 contact hours of anatomy lab. The LONG cohort experienced anatomy through a lecture and lab taught over a 30-week, 2 semester period as separate courses. In contrast, the SHORT cohort took their anatomy lecture and lab concurrently over one 10-week semester. A pre-test was administered on the first day of their anatomy lecture course, and a post-test was administered to each cohort 18 months after completion of their last anatomy exam. RESULTS: After controlling for age-related differences in the two groups, no significant differences in mean pre-test, post-test, or percentage improvement were found between cohorts (p = 0.516; 0.203; and 0.152, respectively). CONCLUSION: These findings refute the hypothesis and show that both spaced and massed instruction in these cohorts resulted in the same level of long-term anatomy knowledge retention.

Understanding the Changing Health Care Needs of Individuals Aging With Spinal Cord Injury.

Background: Individuals over age 65 are projected to account for over 20% of the general population by 2030. This trend is reflected in an increase in the age of individuals sustaining traumatic spinal cord injury (SCI). Based on current evidence, there is concern regarding the needs of older individuals aging with SCI and current health care services. Research is limited regarding factors that contribute to health status and treatment outcomes associated with aging 5 or more years post SCI. Objective: The purpose of this qualitative study was to explore changing health care needs of individuals aging with SCI and their caregivers and to identify the environmental supports and barriers to achieving long-term health and treatment outcomes. Methods: This was a phenomenological study utilizing semi-structured interviews. Inclusion criteria were age greater than 60 years old and 5 years post SCI. Between October 2014 and January 2016, 41 individuals with SCI and eight caregivers participated in the semi-structured interviews. Emergent themes and quotations were noted and analyzed using established methods. Triangulation was used to establish rigor and trustworthiness. Results: Data analysis of the interviews revealed four themes (health literacy, health services, changes with age, and environment) and 10 subthemes. Conclusion: Rehabilitation programs should consider the health literacy of older individuals with SCI and their caregivers. Similarly, these programs should be designed to allow them to identify and utilize resources in solving barriers to everyday participation. Further investigation is required to examine the macro-environmental influences (systems and policies) on the changing health care needs of individuals aging with SCI.