• Benefits and Challenges in the Development and Implementation of a Doctor of Physical Therapy Consortium

      Keskula, Douglas R; Mishoe, SC; Wark, ET; Department of Physical Therapy (Georgia Regents University, 2013-05-23)
      Educational consortiums provide an opportunity to improve the quality of the educational programs involved through an increase in resources, collaboration, and expertise, both administrative and faculty. This paper addresses the benefits along with the major challenges encountered in the development and implementation of a consortium involving multiple universities within a state system of higher education. The Board of Regents of the University System of Georgia approved the Doctor of Physical Therapy Consortium in 2005. The consortium created a partnership between three existing and successful physical therapy programs. One program was housed in a research university, and two were located in state universities. The primary goal of the consortium was to create an educational alliance within Georgia, which enabled the two state university physical therapy programs to offer doctoral level education to their students. The state university programs were unable to award the doctoral degree due to their institutional missions at that point in time. Forming a collaborative relationship between the state programs built on the excellence of the existing programs, helped to meet the demands of incoming students seeking a degree in physical therapy, produced a steady number of physical therapy graduates, and helped to meet the increasing expectations for practice into the future. The consortium was created to allow each partner to retain their unique mission, curriculum and identity while offering a doctoral degree in physical therapy to all students. Although there were several successful outcomes directly related to the consortium, there were also a variety of challenges that we believe limited the sustainability of the partnership. These challenges included costs relative to benefits, managing ambiguity, the perceived lack of faculty control, and issues related to effective and assertive conflict management.
    • Witchcraft and Physical Therapy Management: Application of the Inquiry-Based Model to Physical Therapy Education

      Keskula, Douglas R; Wark, ET; Department of Physical Therapy; Department of Physical Therapy (Georgia Health Sciences University, 2013-01-08)
      The purpose of this case report is to describe the inquiry-based model of instruction and its use in an entry-level physical therapy educational setting. Educators facilitate the acquisition of critical thinking skills through their choice and application of various instructional strategies and methodologies. The inquiry model is designed to help students problem solve by facilitating the acquisition of both analytical and process skills. Practice and mastery of these skills are beneficial to students in the health professions, as they will need to transfer these abilities to the complex clinical setting. This is particularly true of physical therapists, who practice in an increasingly autonomous manner. The use of the inquiry model as an instructional method complements a learner centered environment. The learning activity described below is used as a bridge to the examination, evaluation and diagnostic process the physical therapy students will need to master in subsequent didactic and clinical educational experiences. The selection of the problem used in the inquiry process is a key consideration to the success of the activity. The problem chosen must be interesting, intriguing and hold the attention of the students. A general problem such as the witchcraft example discussed in this paper is suitable for most disciplines, as specific clinical skills or content knowledge is not necessary for students to participate and be successful in this activity. The key element of the inquiry method is the debriefing session that concludes the activity. In the debriefing, faculty lead a guided discussion regarding the processes used by the learners to reach a viable solution to the problem. Areas examined include why certain hypotheses were formed, what information was sought and utilized by the learners to try to prove or disprove the hypotheses, and how the learners classified or grouped information together. The debriefing discussion highlights not the outcome of the problem but rather the critical reasoning process utilized by the learners to reach a conclusion, which is the primary goal of this learning activity. Students consistently respond favorably to this activity as evidenced by their active participation and positive course feedback. The faculty and students of the entry-level physical therapy program have found this activity to be a very pertinent precursor to the critical reasoning required for the clinical diagnostic process. Practical guidelines for the organization and implementation of the inquiry model as a type of instructional strategy are presented.
    • The National Physical Therapist Assistant Examination's First Time Pass Rates and Their Relationships to Education Program Faculty Attributes

      Novak, MK; Brown-Cross, Dawn; Echternach, John; Department of Physical Therapy (Nova Southeastern University, 2011-10)
      Background and Purpose. There is a paucity of published literature regarding the correlation between faculty attributes and education program pass rates on the National Physical Therapy Examination (NPTE) particularly regarding the physical therapist assistant (PTA). The purpose of this study was to 1) determine if there is a relationship between faculty attributes in PTA educational programs and program outcomes on the NPTE for Physical Therapist Assistants (NPTE-PTA) and 2) construct a prediction model for PTA program outcomes based on faculty attributes. Subjects. The 233 United States’ PTA programs accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) in 2006 were studied. Methods. Using a retrospective design, data were obtained regarding the PTA programs from the dataset of CAPTE’s PTA annual accreditation report and the Federation of State Boards of Physical Therapy’s pass rate database. Selected faculty attributes (designation of highest degree conferred, years of teaching experience, employment status, license designation [physical therapist or physical therapist assistant] and clinical specialization) were correlated to first time program pass rates. Backward deletion regression was used to predict the first time pass rate on the NPTE-PTA. Results. Based on data from 190/233 PTA programs, seven attributes had a statistically significant relationship to the outcomes on the NPTE-PTA. They were the number of: 1) full-time faculty; 2) adjunct faculty with an associate’s degree; 3) full-time faculty with a terminal degree; 4) core faculty with a terminal degree; 5) all faculty with a terminal degree 6) years of teaching experience of the full-time faculty; 7) years of teaching experience of the core faculty. Backward deletion regression analyses demonstrated an overall model of two combined predictor factors (full-time faculty years of teaching and full-time faculty terminal degree) that significantly predicted the first time pass rate on the NPTE-PTA accounting for 6.5% of the variance. Discussion and Conclusion. Faculty attributes of the institutions providing PTA programs are associated with first time pass rates of their graduates. This study provides a foundation for future studies by identifying some of the faculty attributes that relate to NPTE-PTA outcomes.
    • Adjuvant Chemotherapy for Patients with Stage III Colon Cancer: Results from a CDC-NPCR Patterns of Care Study.

      Cress, Rosemary D; Sabatino, Susan A; Wu, Xiao-Cheng; Schymura, Maria J; Rycroft, Randi; Stuckart, Erik; Fulton, John; Shen, Tiefu; Department of Health Management and Informatics (2010-08-06)
      OBJECTIVE: To evaluate adjuvant chemotherapy use for Stage III colon cancer. METHODS: This analysis included 973 patients with surgically treated stage III colon cancer. Socioeconomic information from the 2000 census was linked to patients' residential census tracts. Vital status through 12/31/02 was obtained from medical records and linkage to state vital statistics files and the National Death Index. RESULTS: Adjuvant chemotherapy was received by 67%. Treatment varied by state of residence, with Colorado, Rhode Island and New York residents more likely to receive chemotherapy than Louisiana residents. Older age, increasing comorbidities, divorced/widowed marital status, and residence in lower education areas or non-working class neighborhoods were associated with lower chemotherapy use. Survival varied by state but after adjustment for sex, sociodemographic and health factors, was significantly higher only for California and Rhode Island. Older age and lower educational attainment were associated with lower survival. Chemotherapy was protective for all comorbidity groups. CONCLUSION: Although adjuvant chemotherapy for Stage III colon cancer improves survival, some patients did not receive standard of care, demonstrating the need for cancer treatment surveillance. Interstate differences likely resulted from differences in local practice patterns, acceptance of treatment, and access.
    • Managing clinical knowledge for health care improvement

      Balas, E. Andrew; Boren, Suzanne A.; Office of the Dean of the College of Allied Health Sciences (2000)
      The authors assess the growth in clinical research studies coupled with a slow rate of adoption, often taking an average of 17 years for new evidence-based findings to reach clinical practice. Some issues discussed include the need for a more efficient information infrastructure to better connect front-line professionals with the research community, difficulties in translating research into practice, and an inadequate system to help health care clinicians evaluate the strength of new study findings.
    • Enabling Assessments to Better Inform Goal Setting and Treatment Planning for Patients with Elbow, Wrist, and Hand Impairments

      Hughes, Jason; Department of Occupational Therapy (11/7/2018)
      Musculoskeletal disorders, including elbow, wrist, and hand impairments, are the second most common disability worldwide and place a large burden on the health care system. Due to this prevalence and cost, accurate and precise assessment is critical to ensure that patient treatment is optimal (i.e. efficient and productive). Our first objective was to examine the item-level characteristics of the Elbow, Wrist, and Hand Computer Adaptive Test (EWH CAT) using Rasch analysis, including item difficulty measures, person ability measures, item fit, and item-person match. A unique feature of Rasch analysis is its ability to plot person ability and item difficulty on the same continuum. Awareness of this relationship helped us discern that while our items matched our sample relatively well (i.e. sample mean .13 logits above the item mean) there were slight ceiling and floor effects indicating that the addition of some harder and easier items might increase the breadth of abilities in our sample that could be accurately measured. After identifying the item-level properties of the EWH CAT, our second objective was to develop a data collection form to assist clinicians in goal setting and treatment planning. Using the Winsteps Rasch analysis program, a keyform was generated. Based on this keyform, a data collection form was created that could be used to illustrate how patient responses to specific items (i.e. difficulty indicated) differ from admission and discharge, thus helping to guide clinicians in goal setting and treatment planning. Our third objective was to identify factors that increase the probability of favorable outcomes for patients with elbow, wrist, and hand diagnoses. Seven variables were found to be associated with the likelihood of a poorer outcome: being female, having greater than three comorbidities, having a history of surgery, acuity of > 22 days, exercising less than 3 times a week, no medication use, and payer source. Four variables were significantly associated with a greater probability of a good outcome: no history of surgery, no medication use, shorter acuity, and payer source. This knowledge might indicate when a treatment approach different from traditional rehabilitation may be required and/or additional consults may be necessary.