How Is Wound Care and Integumentary Education Being Taught in Professional-Level Physical Therapy Programs?
Authors: Lawson Daryl , Hettrick Heather , Vallabhajosula Srikant , Hale James Matthew 
Published: June 2018

Introduction:
The integumentary system is 1 of the 4 core systems along with musculoskeletal, neuromuscular, and cardiopulmonary systems that frame the curricular content for professional-level physical therapy programs. The purpose of this study was to investigate how the integumentary system curriculum is taught as 1 of the 4 core systems in professional-level physical therapy programs in the United States. A survey was sent to accredited and developing physical therapy programs within the United States to get a baseline on the following categories: (1) How is the integumentary content taught and delivered inclusive of contact hours? (2) Who teaches the content (full-time faculty, adjunct faculty, or guest lecturers, etc)? (3) What is the background, training, and expertise of the instructors? (4) Is the content part of a stand-alone course or bundled/threaded in other content areas?

Subjects:
A total of 232 professional (entry-level) physical therapy education programs at accredited or developing status by Commission on Accreditation in Physical Therapy Education were identified to complete the survey. An e-mail invitation requesting voluntary (and anonymous) survey participation was sent to all the programs in 2016. The survey was open to respondents for 2 months at a time with frequent e-mail reminders for participation. A total of 92 (40%) physical therapy education programs responded fully to the survey. Among these, 83 were accredited by Commission on Accreditation in Physical Therapy Education and 9 were developing programs on probationary status.

Methods:
A 41-question Internet survey to measure certain criteria related to wound management and integumentary education was developed to be answered by educators for this content. The categories included (1) institution demographics, (2) member demographic for person that is primary instructor for such material, (3) primary faculty member education/training related to wound care, and (4) primary faculty member clinical practice background. Question types that were formulated consisted of multiple choice, ranking, short answer, and comments.

Results:
Analysis of the survey led to several themes and disparities among programs. These included the duration of total time dedicated to didactic and laboratory hours. Student competency with integumentary and wound management was tested through written examination (69.9%) and practical examination (6.6%). Respondents reported that the most beneficial way to increase students' knowledge was clinical observations/affiliations (83%) and by increasing laboratory hours (28.4%). However, 95.8% of those who reported increasing the number of instructional hours reported a lack of time to be able to include further hours in the curriculum and that finding clinical wound/integumentary areas for observation is very challenging. Faculty qualifications were ongoing clinical practice (59.8%), continuing education without certification (49.4%), continuing education, and clinical practice leading to a certified wound specialist certification (50.6%).

Discussion and Conclusions:
This study provides data showing inconsistency regarding integumentary and wound management curricula in professional-level physical therapy programs compared with other core content areas in the United States. Furthermore, the study identified the core faculty demographics and challenges encountered to deliver this content. More physical therapy specialists with integumentary expertise are needed, as well as a need for more integumentary and wound management residencies.