Navigating postprofessional physical therapist education

  • Karen Westervelt

Student thesis: Doctoral Thesis


Postprofessional education for physical therapists (also known as physiotherapists) is vitally important. It enables the clinician to gain confidence and satisfaction at work, helps the profession obtain more autonomy with higher educated professionals, and allows for a high quality of care for the client. Despite the agreement that postprofessional education is necessary and important, many obstacles exist that limit access to high quality postprofessional education. Recent trends in Australia (AUS) and the United States of America (USA) are strikingly different and warrant a closer examination. AUS has seen a recent decline in academic postprofessional physical therapy programs, which needs to be better understood as it is detrimental to the profession. The USA has seen a recent surge in interest in residencies and fellowships which also must be examined, as the cost and location of many of these programs make them inaccessible to many. The authors believe that there is much to be learned from our colleagues in the opposite hemisphere. To our knowledge a thorough study and comparison of physical therapy postprofessional education in AUS and the USA has not been conducted. The aim of this thesis was to examine and compare postprofessional physical therapy education in AUS and the USA, identify the barriers and benefits to postprofessional education today, and propose and test models of postprofessional education that can help advance postprofessional education internationally. To begin, an in-depth review was conducted of physical therapy education around the globe. It was deemed important to understand current global entry-level programming before study of postprofessional programming could begin. Variations in duration of physical therapy educational programming, as well as number of programs in each country and region of the world, were demonstrated. Variation in number of physical therapy programs per million population was also demonstrated. Despite the variation, encouraging signs could be seen. For example, the World Confederation of Physical Therapist (WCPT) recommends all entry-level physical therapy programs involve four years of university-based education. Our research showed that this recommendation is being met in 64.2% of countries in the world. Striving towards standardization in entry-level education is important for the profession internationally, and allows for the international study and comparison of postprofessional physical therapist education. Understanding and centralizing information about entry-level education in the first study led to the second study, an in-depth review of postprofessional physical therapist education. This study narrowed the focus to AUS and the USA. Analysis of this data confirmed the general observation that academic postprofessional physical therapist education programs are on the decline in AUS; currently, they are only located in seven coastal cities, creating educational deserts for those located elsewhere. The USA data revealed that residencies and fellowships are on the rise, but, like AUS, there are also areas in the country that are without programs. Similarities in the two countries existed in regards to focus of areas of study, with interest being greatest in the Musculoskeletal and Sports specialty. However, both countries are perhaps missing an important population need by offering very few to no academic postprofessional programs in geriatrics. This in-depth comparison demonstrates the profound need for international collaboration. By learning from our international colleagues, we can help AUS restore postprofessional programming that is innovative and meets the needs of the professionals and the population, and can also help the USA learn a lesson in history from AUS. Current professionals in the USA who are seeking clinical specialization must get the greater recognition and compensation they need in order to maintain the profession’s forward momentum. These first two studies provided the foundation, i.e. existing educational programming, upon which three action based projects could build. The third study involved researching the providers themselves. Ten years of alumni in the USA and seven years of alumni in AUS from two schools were surveyed. A striking number of similarities were found, despite the fact that participants were being sampled from opposite sides of the world. Ten percent of participants from both schools had already completed a formal postprofessional education program. There was interest in obtaining postprofessional education among most clinicians, with the greatest interest in those with two years or less of clinical practice. Interestingly, both groups were interested in attending their alma mater to gain this additional education; however, both groups wanted a hybrid teaching style and were interested in collaborating internationally for this educational training in order to gain access to colleagues and experts around the world. They specifically were seeking clinical WESTERVELT, KAREN C. XXXIII mentoring. Barriers were also very similar for both groups, with cost and access to quality programming being the top two limiting factors for physical therapists seeking additional education. These findings lead to the formation of the final two studies to examine innovative models of delivery of postprofessional education. The fourth study was designed to examine a model of international collaboration in physical therapist education in order to better understand the effects on students and educators. A group of physical therapy students and professionals traveled from the University of Vermont to Bond University for a two-week international collaboration in manual physical therapy. Master classes, teaching labs, and social opportunities were held with the combined group. The themes that emerged from long answer survey questions and prompted journaling questions included experiencing the “other”, learning, and collaboration. The experience proved beneficial for the traveling students, the hosts, and the teaching faculty. The findings support this model of international collaboration in educational programming and show that benefits exist for all parties from collaborating internationally. Not surprisingly, cost was again determined to be a barrier for this model. Therefore, the final study was designed to address the need for postprofessional education that helps reduce the barriers of cost and access, both of which are known limitations of current models. The final study in this thesis involved the design and implementation of an online international clinical mentoring program. The model was specifically designed based on the findings of the first four studies. Small groups of novice clinicians from the USA and AUS were paired with clinical experts for online clinical mentoring sessions, which revolved around cases brought to the group by each novice. The video conferencing system allowed for a guided discussion of each case study and provided the novice with the support needed to improve confidence and critical thinking, two critical features of professional growth that are essential to develop during the transition from student to independent, confident, and competent practitioner. Participants found that confidence and critical thinking improved through participation. In addition, the model provided easy access to clinical mentors and to peers at a similar stage of professional development. Participants expressed a great appreciation for the structured design of the model. The experts were also in support of this innovative design, and felt that it was a viable model that will fill a real need within the profession for more accessible mentoring to support clinicians. In conclusion, this thesis provides information about physical therapist entry level education and postprofessional education at the programmatic level and at the user level. It clearly identifies concerns and barriers to postprofessional education, and provides practical, useful solutions to issues of cost, accessibility, and the need for greater international collaboration.
Date of Award7 Oct 2017
Original languageEnglish
SupervisorWayne Hing (Supervisor), Linda Crane (Supervisor) & Jeremy Sibold (Supervisor)

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