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People with disabilities (PWD) are considered a historically marginalized population that experiences significant health disparities resulting from the unequal distribution of resources as evidenced in the social determinants of health. Health professions education presents an opportunity to explore the policy, systems, and environmental (PSE) changes that are needed to improve social conditions and address known disparities for PWD. Evidence suggests that inclusion of learners with diverse lived experiences, including students with disabilities (SWD), strengthens our understanding of the influence of social determinants on health and our ability to address known barriers. Unfortunately, PWD and other minoritized individuals are grossly underrepresented in physical therapy. It is imperative that Doctor of Physical Therapy (DPT) education more intentionally promotes the full inclusion of SWD to improve representation and to better support the complex needs of this population. In this perspective we describe key social determinants of health for PWD, offer strategies for increasing representation and inclusion of SWD in DPT education, and summarize how the inclusion of SWD in DPT education can enhance our understanding of and ability to address social barriers for this population.

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Healthcare is experiencing a transformative phase, with artificial intelligence (AI) and machine learning (ML). Physical therapists (PTs) stand on the brink of a paradigm shift in education, practice, and research. Rather than visualizing AI as a threat, it presents an opportunity to revolutionize. This paper examines how large language models (LLMs), such as ChatGPT and BioMedLM, driven by deep ML can offer human-like performance but face challenges in accuracy due to vast data in PT and rehabilitation practice. PTs can benefit by developing and training an LLM specifically for streamlining administrative tasks, connecting globally, and customizing treatments using LLMs. However, human touch and creativity remain invaluable. This paper urges PTs to engage in learning and shaping AI models by highlighting the need for ethical use and human supervision to address potential biases. Embracing AI as a contributor, and not just a user, is crucial by integrating AI, fostering collaboration for a future in which AI enriches the PT field provided data accuracy, and the challenges associated with feeding the AI model are sensitively addressed.

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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.

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BACKGROUND: The development of procedural skills is essential in health sciences education. Rubrics can be useful for learning and assessing these skills. To this end, a set of rubrics were developed in case of neurophysiotherapy maneuvers for undergraduates. Although students found the rubrics to be valid and useful in previous courses, the analysis of the practical exam results showed the need to change them in order to improve their validity and reliability, especially when used for summative purposes. After reviewing the rubrics, this paper analyzes their validity and reliability for promoting the learning of neurophysiotherapy maneuvers and assessing the acquisition of the procedural skills they involve. METHODS: In this cross-sectional and psychometric study, six experts and 142 undergraduate students of a neurophysiotherapy subject from a Spanish university participated. The rubrics' validity (content and structural) and reliability (inter-rater and internal consistency) were analyzed. The students' scores in the subject practical exam derived from the application of the rubrics, as well as the rubrics' criteria difficulty and discrimination indices were also determined. RESULTS: The rubrics´ content validity was found to be adequate (Content Validity Index > 0.90). These showed a unidimensional structure, and an acceptable internal consistency (α = 0.71) and inter-rater reliability (Fleiss' ƙ=0.44, ICC = 0.94). The scores of the subject practical exam practically covered the entire range of possible theoretical scores, showing all the criterion medium-low to medium difficulty indices - except for the one related to the physical therapist position-. All the criterion exhibited adequate discrimination indices (rpbis > 0.39), as did the rubric as a whole (Ferguson's δ = 0.86). Students highlighted the rubrics´ usefulness for learning the maneuvers, as well as their validity and reliability for formative and summative assessment. CONCLUSIONS: The changed rubrics constitute a valid and reliable instrument for evaluating the execution quality of neurophysiotherapy maneuvers from a summative evaluation viewpoint. This study facilitates the development of rubrics aimed at promoting different practical skills in health-science education.

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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.

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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.

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BACKGROUND: Evidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation. METHODS: One hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. Students completed the Evidence-Based Practice Confidence (EPIC) Scale and the Evidence-Based Practice Implementation Scale (EBPIS) at 6 timepoints: start of the program, prior to first clinical experience, after first clinical experience, at the end of classroom instruction, graduation, and one year post. Medians (Mdn) and 25th and 75th percentiles (P25, P75) were calculated for 42 (23.2%) students with complete data across all timepoints. Change between timepoints was assessed using Friedman's test and Wilcoxon signed rank test with a Bonferroni correction for post hoc analysis. RESULTS: There were significant changes in EPIC scores (p < 0.001) from enrollment (Mdn 50.0, P25, P75 35.5, 65.9) to prior to first clinical experience (Mdn 65.5, P25, P75 57.3, 72.5) and after the first clinical experience (Mdn 67.3, P25, P75, 58.9, 73.2) to the end of classroom instruction (Mdn 78.6, P25, P75, 72.0, 84.1). Significant increases on the EBPIS (p < 0.01) were only seen from after the first year of training (Mdn 15, P25, P75, 10.0, 22.5) to end of the first clinical experience (Mdn 21.5, P25, P75 12.0, 32.0). CONCLUSIONS: EBP confidence increased significantly after classroom instruction but remained the same after clinical experiences and at one year post graduation. EBP behavior significantly increased only after the first clinical experience and remained the same through graduation. Confidence and behavior scores were higher than were previously reported in practicing professionals. Ongoing assessment of EBP confidence and behavior may help instructors build appropriate curricula to achieve their outlined EBP objectives.

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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.

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BACKGROUND: Compared to other health professions, physiotherapy is a relatively new profession in Malawi and the United States, yet in both countries, past colonialism has influenced current physiotherapy education and research. The authors of this article are from Malawi and the United States, and they worked collaboratively to explore the impact of colonialization on physiotherapy education and research in their respective locations, and to discuss the similarities and contextual differences. Decolonializing physiotherapy education and research must begin by identifying how colonialization currently manifests within the profession. PURPOSE: The purpose of this article is to spark discussion about colonialization in physiotherapy education and research. DISCUSSION: Although decolonialization literature specific to physiotherapy is limited, the literature gathered about physiotherapy and other health professions prompted generative discussion and reflection among the authors. These discussions and reflections led to student-driven recommendations that are outlined in this article and could be included in the decolonialization efforts in physiotherapy. CONCLUSION: We propose that reflecting on how colonialism has influenced physiotherapy education and research could lead to international collaborations that support decolonialization in physiotherapy.

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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.

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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.

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BACKGROUND@#The Covid-19 pandemic caused educational institutions to shift from traditional to distance learning. Higher educational institutions offering bachelor’s degrees in Physical Therapy (PT) adapted to the situation by employing various strategies to facilitate learning online. One of the strategies employed is inviting family members as simulated patients in various performance-based assessments (PBA). In the Philippines, the PT department at the University of Santo Tomas made similar changes in the delivery of its courses. Given that family members are one of the primary stakeholders of PT education, it is important to know their experience, insights, and knowledge gained about the profession of PT after playing as a simulated patient (SP) during online performance-based assessments.@*OBJECTIVES@#This study aims to explore how family members describe their experiences playing the role of patients in PT PBAs.@*METHODS@#This study will utilize a phenomenological explorative research design. Family members, including parents, siblings, grandparents, cousins, and household helpers who played the role of a patient in any PT PBAs such as case presentation, case discussion, and practical examination, will be invited to participate. Semi-structured one-on-one interviews will be used for data gathering. Qualitative data from interview transcriptions will be analyzed using thematic analysis using NVivo 12 plus program.@*EXPECTED RESULTS@#Family Members will offer experiences in role-playing as patients in PBAs. Main themes and findings will be generated from their sharing that will provide insights regarding the improvement of remote PT PBAs.

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Case-based cadaver dissection offers students unique opportunities to blend traditional anatomic knowledge acquisition with clinical reasoning. Twelve physical therapy students completed surveys centered on case-based dissections. Case-based cadaver dissections were defined in this study as multiple clinical vignettes that required students to use the accessible cadavers to solve clinically based problems. The results of the study provide preliminary evidence that students perceive case-based cadaver dissections as beneficial to their anatomy education and beneficial to the development of their clinical reasoning skills. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01540-x.

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OBJECTIVE: The purpose of this study was to systematically review the literature regarding teaching quality improvement (QI) in physical therapist education based on the Institute of Medicine's 6-element definition of QI. Educational activities in QI methods in physical therapist professional education curricula, their developmental stage, and their level of evaluation were described. METHODS: Keywords related to physical therapist students and QI educational activities were used to search studies indexed in PubMed, CINAHL, and ERIC published from 2004 through November 2020. This search yielded 118 studies. After applying inclusion and exclusion criteria, 13 studies were retained for full-text review, which was conducted independently by 2 reviewers. The University of Toronto framework was used to assess developmental stage, and Kirkpatrick's taxonomy was used to assess the evaluation level of 4 retained studies. RESULTS: The scope of QI educational activities in the 4 retained studies was limited to 3 of the 6 elements of QI: identifying opportunities for improvement, designing and testing interventions, and identifying errors and hazards in care. None of the studies included educational activities to teach understanding and measuring quality of care. Three of the 4 studies spanned the first 2 stages of the University of Toronto framework (exposure and immersion); 1 study was limited to exposure. None of the studies assessed competence in QI methods. Evaluation of QI education was limited to Kirkpatrick levels 1 (reaction) or 2 (learning). None of the studies evaluated activities at level 3 (transfer of new behaviors) or level 4 (results). CONCLUSION: Education in QI methods in professional physical therapist curricula may be limited in scope due to constraints in physical therapist education and the strategic objective of the profession to differentiate itself from other professions. IMPACT: Entry-level physical therapists might not be educated to fully participate in interprofessional teams that use QI methods to continuously improve the quality of patient-centered care.

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Introduction: Practical examinations are necessary to demonstrate learning in the psychomotor, cognitive, and affective domains. Student perceptions of the organization and execution of practical examinations are an important consideration in the development of practical examinations. Review of the Literature: Multiple other health professions have investigated students' perceptions of objective structured clinical examinations (OSCE). There is little in the physical therapy literature with respect to student perception regarding proctor presence during practical examinations or OSCEs. Subjects: The participants were members of the classes of 2019-2021 in a Doctor of Physical Therapy (DPT) program at a New England University. Methods: A qualitative thematic approach was applied to de-identified transcripts of student focus group interviews. Independently coded themes were identified, discussed, and refined iteratively. Results and Discussion: Four themes emerged with multiple subthemes: impact of proctor being present; realistic, patient-focused experience; preparation for the practical; and stress. Students valued preparation that included clear expectations, utilization of formative assessments, and peer feedback prior to the practical. They also noted that a distractive-free testing space, having no proctor present in the room, recording the practical, and the format of OSCE's decreased stress and improved performance. Conclusions: These findings add to the body of knowledge in physical therapy and provide guidance to faculty as they plan and organize practical examinations.

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BACKGROUND:  The training of near-peer (NP) teachers and junior faculty instructors received major attention as a possible solution for the shortage of experienced anatomy instructors in faculties of medicine and health professions. Several studies described the training of NP teachers and junior instructors (≤ 2 years of teaching experience) using various methods. However, few publications include On the Job Training (OJT), which enables reflection and performance evaluation and encourages professionals to cope with their blind spots. Previous publications describing OJT did not include formal observation of the NP teacher or junior instructor. Therefore, this study aimed to present a novel approach to OJT inclusion during prosection laboratories based on the Lewinian experiential model. METHODS:  Eight physical therapy (PT) graduates were recruited as junior anatomy instructors into the prosection laboratories. All participated in a unique training program during two consecutive academic years (2017, 2018) and received OJT during the teaching sessions. Two questionnaires were filled out to evaluate the educational impact of the training program. Eighty-three first-year PT students participated in prosection laboratories in anatomy taught by junior instructors, and filled out a questionnaire evaluating the performance of both junior and senior instructors. In addition, we compared the final grades in anatomy obtained by students taught by senior instructors to the grades of those taught by junior instructors. RESULTS:  Each junior anatomy instructor participated in four OJT sessions. Based on self-reported measures, all professional and didactic aspects of the training program received a median score of 4.5 or higher on a five-point Likert scale. Students obtained similar grades in anatomy when taught by junior instructors compared with senior ones, and were similarly satisfied from the teaching performance of both senior and junior anatomy instructors. CONCLUSIONS:  OJT is applicable in a small-sized PT program facing a shortage of anatomy instructors. Including junior anatomy instructors in prosection laboratories for PT students is a viable solution to the shortage of experienced anatomy instructors. Further study, involving a larger cohort with a longer follow up will strengthen the preliminary results presented here.

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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.

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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.

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@#Objective To systematically summarize the effect of flipped classroom (FC) in physiotherapy teaching.Methods The following electronic bibliographic databases were searched from inception to June, 2021: CENTRAL, Medline, EMBASE, CINAHL plus, Academic Search Premier, Teacher Reference Center, ERIC, and Education Research. Original researches about FC for physiotherapy teaching were searched. The researches were screened, selected, extracted and assessed independently by two researchers, and, systematically reviewed.Results and Conclusion A total of 1 307 literatures were retrieved, and seven studies involving at least 770 student participants were finally included, which published mainly from 2013 to 2019. The subjects were students majored in physiotherapy, and the primary outcome index was exam results. FC teaching model generally can improve students' written test scores and enhance their high-level thinking ability. Students and teachers generally hold a positive attitude towards the FC teaching model.

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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.

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