Essential Requirements of Physical Therapy Education at East Carolina University, Department of Physical Therapy: Standards for Admission, Retention and Graduation
INTRODUCTION
The doctor of physical therapy degree (DPT) requires acquisition of general knowledge and basic skills in the practice of physical therapy. The practice of physical therapy involves examination, evaluation, and testing of individuals with mechanical, physiological, and developmental impairments, functional limitations, and disability or health and movement-related conditions in order to determine a diagnosis, prognosis, plan of therapeutic intervention, and to assess the ongoing effects of intervention. The education of entry-level physical therapist requires assimilation of knowledge, acquisition of skills and development of judgment through patient care experience in preparation for independent and appropriate decision making required to practice in a safe, legal and ethical manner.
POLICY
The East Carolina University Department of Physical Therapy endeavors to select applicants for admission who have the ability to become highly competent physical therapists. The Department of Physical Therapy at East Carolina University is an accredited graduate program in physical therapy and adheres to standards and guidelines of the Commission on Accreditation for Physical Therapy Education and the American Physical Therapy Association. Within these guidelines, the East Carolina University Department of Physical Therapy has the responsibility for selecting and evaluating students, designing, implementing and evaluating the curriculum, and awarding a degree. Admission and retention decisions are based on prior satisfactory academic achievement and on non-academic factors, which serve to insure that the candidate can complete the essential functions of the academic program, required for graduation. The Department has responsibility to the public to assure that graduates can become fully competent and caring professionals, capable of doing benefit and not harm. Therefore, it is critical that persons admitted possess compassion, integrity, intelligence, humanitarian concern, and physical and emotional capacity necessary to practice physical therapy. The Department of Physical Therapy, as a part of East Carolina University is committed to the principle of equal opportunity. The Department does not discriminate on the basis of race, color, creed, religion, national origin, gender, sexual orientation, age, marital status, disability, disabled veteran or Vietnam era veteran status. When requested, East Carolina University will provide reasonable accommodation to otherwise qualified students.
PROGRAM
Technical standards as distinguished from academic standards refer to physical, cognitive and behavioral abilities required for satisfactory completion of all aspects of the curriculum and the development of professional attributes required by the faculty of all students at graduation. Essential abilities required by the program include: motor, sensory, communication, intellectual (quantitative, integrative, and conceptual abilities for problem solving and integration of information from patient assessment) and the behavioral and social aspects of the performance of a physical therapist. The East Carolina University Department of Physical Therapy curriculum requires essential abilities in information acquisition. Students must possess the ability to master information presented in course work in the form of lectures, laboratory sessions, written material and projected images. Students must possess the cognitive ability necessary to master relevant content in basic science and clinical courses at a level deemed appropriate by the faculty and the graduate school. The ability to comprehend, memorize, analyze, and synthesize material are included in cognitive skills. Students must be able to discern and comprehend dimensional and spatial relationships of structures, and be able to develop reasoning and decision-making skills appropriate to physical therapy practice. Students must have the ability to take and document in the patient's record an appropriate history and perform a physical examination. The physical examination may include tests and measures of the following:
· aerobic capacity or endurance
· anthropometric characteristics
· arousal, mentation and cognition
· assistive and adaptive devices
· community or work (job/school/play) integration/reintegration
· cranial nerve integrity
· environmental, home and work (job/school/play) barriers
· ergonomics or body mechanics
· gait, locomotion and balance
· integumentary integrity
· joint integrity and mobility
· motor function
· muscle performance
· neuromotor development and sensory integration
· orthotic, protective and supportive devices
· pain
· posture
· prosthetic requirements
· range of motion
· reflex integrity
· self-care and home-management
· sensory integrity
· ventilation, respiration and circulation
The tests require that students observe and palpate body surfaces and obtain auditory information (patient voice and heart tones). The ability to communicate with the patient, family, physician, and other members of the health care team is required. The student must recognize the significance of non-verbal communication from the patient and possess openness, concern, and sensitivity to potential cultural differences. A major component of physical therapy practice is assessment and management of movement disorders. Physical therapy practice also involves alleviating impairment, functional limitation, and disability by designing, implementing and modifying therapeutic interventions that may include the following:
· coordination, communication and documentation
· patient-related instruction
· therapeutic exercises (including aerobic conditioning)
· functional training in self-care and home-management (including activities of daily living)
· functional training in community or work (job/school/play)
· integration/reintegration activities including work hardening and work conditioning
· manual therapy techniques including mobilization and manipulation
· wound management
· physical agents and mechanical modalities
· electrotherapeutic modalities
· prescription, application, and as appropriate, fabrication of assistive, adaptive, orthotic, protective, supportive and prosthetic devices and equipment
· airway clearance techniques
Students must have the ability, within reasonable limits to safely assist a patient in moving from a chair to a bed, from a wheelchair to a mat table, up and down a flight of stairs, ramp or curb. Students must also have to ability to move himself/herself and the patient in three-dimensional space in order to perform motor function tests and treatments, gait training, and joint mobilization while ensuring the physical safety of a patient at all times.
Students must be able to process and communicate information on the patient's status with accuracy in a timely manner to physical therapy colleagues and other members of the health care team.
Student must have the emotional stability to function effectively under stress and the ability to adapt to an environment which may change rapidly without warning or in unpredictable ways. It is the responsibility of the student with disabilities to request reasonable accommodations needed to execute the essential requirements and physical demands required of physical therapists.
References
Evaluative Criteria for the Accreditation of Education Programs for the Preparation of Physical Therapists. Commission on Accreditation in Physical Therapy Education (CAPTE) of the American Physical Therapy Association.
Hendrickson S, Lyden S, Tarter C, Banaitis D and Cicirello N. Implementation of the Americans with Disabilities Act into physical therapy programs. Journal of Physical Therapy Education. 1998;12:9-15.
Ingram D. Essential functions required of physical therapist assistant and physical therapy students. Journal of Physical Therapy Education. 1994;8:57-59.
Normative Model of Physical Therapist Professional Education: Version 97. APTA. Ward RS, Ingram D, and Mirone J. Accommodations for students with disabilities in physical therapist and physical therapist assistant education programs: a pilot study. Journal of Physical Therapy Education. 1998;12:16-21.
APPENDIX A
Clinical Performance Criteria
Students are evaluated using the Physical Therapist Clinical Performance Instrument developed by the American Physical Therapy Association. It is a central component of the assessment system and is used by the academic institution to ensure students' readiness for practice. Using visual analog scales for each of 24 performance criteria, grades for clinical affiliations are assigned and the clinical educator and academic faculty obtain a comprehensive perspective of students' progress from novice to competent to practice at entry-level.
The 24 performance criteria are:
1. Practices in a safe manner that minimizes risk to patient, self and others.
2. Presents self in a professional manner.
3. Demonstrates professional behavior during interactions with others.
4. Adheres to ethical practice standards.
5. Adheres to legal practice standards.
6. Communicates in ways that are congruent with situational needs.
7. Produces documentation to support the delivery of physical therapy services.
8. Adapts delivery of physical therapy care to reflect respect for and sensitivity to individual differences.
9. Applies the principles of logic and the scientific method to the practice of physical therapy.
10. Screens patients using procedures to determine the effectiveness of and need for physical therapy services.
11. Performs a physical therapy patient examination.
12. Evaluates clinical findings to determine physical therapy diagnoses and outcomes of care.
13. Designs a physical therapy plan of care that integrates goals, treatment, outcomes, and discharge plan.
14. Performs physical therapy interventions in a competent manner.
15. Educates others (patients, family, caregivers, staff, students, other health care providers) using relevant and effective teaching methods.
16. Participates in activities addressing quality of service delivery.
17. Provides consultation to individuals, businesses, schools, government agencies, or other organizations.
18. Addresses patient needs for services other than physical therapy as needed.
19. Manages resources (e.g. time, space, equipment) to achieve goals of the practice setting.
20. Incorporates an understanding of economic factors in the delivery of physical therapy services.
21. Uses support personnel according to legal standards and ethical guidelines.
22. Demonstrates that a physical therapist has professional/social responsibilities beyond those defined by work expectations and job description.
23. Implements a self-directed plan for professional development and lifelong learning.
24. Addresses primary and secondary prevention, wellness, and health promotion needs of individuals, groups, and communities.
Sample behaviors for each of the performance criteria are found in the document Physical Therapist Clinical Performance Instrument, APTA, 1997.
APPENDIX B
North Carolina Administrative Code
Title 21-Occupational Licensing Boards, Chapter 28 Board of Physical Therapy Examiners
Subchapter 48B-Types of Licenses and Scope of Physical Therapy Practice This document describes requirements for licensure to practice physical therapy including general requirements, licenses by endorsement and licenses by examination as well as scope of practice, including permitted practice, responsibilities, and prohibited practice.
APPENDIX C
G.S. 90-270.24-90-270.39
Physical Therapy Practice Act: North Carolina
Effective: December 30, 1985
Section 90-270.29. Qualifications of applicants for examination; application; fee.
APPENDIX D
Physical Demands Analysis-PCMH Physical Therapy Department
This document describes types of physical activities and the frequency of performance of the activity by physical therapy employees in this local practice setting. It includes: standing, walking, lifting (pounds), climbing, balancing, stooping, kneeling, crouching, crawling, twisting, bending, reaching, use of vision, tactile system, and hearing.
