Doctorate of Physical Therapy: Clinical and Academic Physical Therapists' Perception of Appropriate Curricular Changes, The

Journal of Physical Therapy Education, Spring 2007 by Brudvig, Tracy J, Colbeck, Carol L

Background and Purpose. The purposes of this study were (1) to examine what clinical and academic physical therapists (PTs) think should be added to physical therapist education curricula in order to produce autonomous professional (entry-level) physical therapist graduates, as physical therapist education programs make the transition from the entry-level Master of Physical Therapy (MPT) degree to the entry-level Doctor of Physical Therapy (DPT) degree, (2) to identify the changes physical therapist educators are making to curricula in order to meet the goal of producing autonomous professional physical therapist graduates, as programs transition from the entry-level MFF degree to the entry-level DPT degree, and (3) to analyze similarities and discrepancies between what clinical and academic PTs think should be added to the curriculum and the actual changes educators are implementing in their curricula as programs make this transition.

Subjects. The subjects consisted of randomly selected physical therapists who were members of the American Physical Therapy Association (762), randomly selected academic PTs (318), and program directors of physical therapist education programs (194).

Methods. A written questionnaire was distributed to 1,284 physical therapists, with a 54% return rate. One hundred ninety-four surveys were sent to program directors, with a 50% return rate. Data were statistically analyzed using descriptive statistics, cross tabulations, and chi-square tests.

Results. Academic and clinical PTs indicated that all 12 curricular content areas should be added to the curricula as programs make the transition from the MPT degree to the DPT degree. However, significant differences in the level of agreement were found between academic and clinical PTs for the areas of reimbursement, legal issues, ethics, and managed care, with clinical PTs indicating stronger agreement. A majority of program directors indicated they were adding significantly fewer content areas than both academic and clinical PTs think should be added.

Discussion and Conclusion. The results of this study indicate that both academic PTs and clinical PTs thought all 12 curricular content areas should be added to the curricula as programs make this transition. However, the results showed that there were significant differences in the level of agreement between these groups regarding the addition of reimbursement, legal issues, ethics, and managed care content to curricula. In all cases, clinical PTs indicated stronger agreement for the addition of these curricular content areas. These results are not consistent with what program directors are reporting they are adding to the curricula as programs make this transition.

Key Words: Curriculum, Doctor of Physical Therapy degree, Clinical physical therapists, Academic physical therapists.

INTRODUCTION

During the last 2 decades, the knowledge explosion in health care has led several health care professions to expand their academic standards by requiring a professional clinical doctorate as the entry-level degree.1,2 In 1 989, an American Physical Therapy Association (APTA) task force recommended that "the appropriate entry-level degree, based on the framework of practice and academic requirements, is the entry-level clinical doctorate."3 The Doctor of Physical Therapy (DPT) degree prepares physical therapists for clinical practice, clinical scholarship, and a professional career.4

The APTA House of Delegates in 2000 endorsed the Vision Statement for Physical Therapy 2020, which states, "By 2020, physical therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as the practitioner of choice to whom consumers have direct access for the diagnosis of, intervention for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health."5 Vision 2020 advocates that physical therapists "hold all privileges of autonomous practice," with autonomous practice defined as "independent, selfdetermined, professional judgment and action."5 A professionally autonomous person possesses skills and knowledge that enable him or her to function independently, without supervision. The autonomous practitioner is able to discover innovative solutions to problems and is accountable for his or her decisions.6�7 One of the major goals of the DPT degree is to produce an autonomous entry-level physical therapist graduate.

The Evaluative Criteria used by the Commission on Accreditation of Physical Therapy Education (CAPTE) are the same for both the professional (entry-level) master's and doctoral degrees.8 Physical therapist education programs are thus not required to make curricular changes as they make the transition to the DPT degree. Individual education programs make decisions about additions to the curriculum as they contemplate, envision, and plan this transition.

Physical therapist education programs are responsible for curricular changes being made as programs make this transition to the DPT. Academic physical therapists have a significant influence on the changes that are made due to their governance role in the academic setting. Clinical physical therapists' perspectives about what should be added to the curriculum also may be a vital link in this curricular transition. However, they are less accessible due to their off-site role in the program. Clinical physical therapists work with new graduates and may have valuable insight as to what additional knowledge or skills they should possess. Clinical physical therapists are in the clinic full-time and may have a better sense than academic physical therapists of the relationship between foundational knowledge and its application to unpredictable and unique clinical situations. Clinical physical therapists may understand the relationship between foundational knowledge, skills, and reflection and how to integrate them to solve complex patient cases. Clinicians' opinions, however, may not be considered by educators as programs revise their curricula. This was evident in a qualitative pilot study involving interviews of half of the program directors of physical therapist education programs in the state of Pennsylvania.8