Query: importance of professionalism in physical therapy

title: Leadership, administration, management, and professionalism (LAMP) in physical therapy: a Delphi study.
abstract: The knowledge and skills needed by physical therapists entering practice in the areas of leadership, administration, management, and professionalism (LAMP) are not known. Using the LAMP components identified by American Physical Therapy Association's Section on Administration, this study sought to define the range of LAMP content pertinent to physical therapy clinical management and to explore LAMP knowledge and skills required of physical therapists upon entry into the profession.  Thirty four physical therapist managers participated in a Delphi study to (1) create a comprehensive list of defined LAMP components, (2) determine the perceived importance of each component in the management of clinical practices, and (3) identify the level of knowledge and skill for each component believed to be necessary for a new physical therapist graduate.  Respondents agreed that 178 items should be on the LAMP component list. They perceived that almost all LAMP components are important in the management of a clinical practice, and they indicated that new graduates needed moderate to extensive knowledge in 44% of them. They believed that new graduates needed no skill in 29% of the components, whereas they needed at least intermediate skill for 22% of them. Top ranked component categories across the 3 scales (importance, knowledge, and skill) were communication, professional involvement and ethical practice, delegation and supervision, stress management, reimbursement sources, time management, and health care industry scanning.  This study provides a basis for further exploration of which LAMP components should be included in professional (entry level) physical therapist curricula and which components should be learned after graduation.

title: Association of importance of the doctoral degree with students' perceptions and anticipated activities reflecting professionalism.
abstract: has identified the Doctor of Physical Therapy (DPT) degree as 1 of 6 elements necessary to transition the physical therapy profession to a fully professionalized discipline. However, there have been no data to determine whether physical therapist students who place importance on the DPT degree perceive physical therapy to be more professionalized or anticipate participation in activities reflecting professionalism more than those who do not place importance on the DPT degree.  The subjects were 919 professional physical therapist students.  Faculty members at 34 physical therapist education programs distributed questionnaires to 1,172 professional physical therapist students and returned 919 questionnaires, for a response rate of 78.4% The data were statistically analyzed using chi square analysis and logistic regression.  There were few differences between students who place importance on the DPT degree (DPT I students) and those who do not place importance on the DPT degree (DPT NI students) regarding how professionalized they perceive physical therapy to be relative to other health care professions or regarding their anticipated participation in activities reflecting professionalism. The one potential distinction found when controlling for other variables was that DPT I students were more likely than DPT NI students to anticipate becoming faculty members.  When beginning their professional education, there are few differences between DPT I and DPT NI students' perceptions of the professionalization of physical therapy or anticipation of activities reflecting professionalism.

title: An interdisciplinary approach to introducing professionalism.
abstract: To provide interdisciplinary structured activities in academic and clinical settings for introducing the concept of professionalism to health professions students.  Undergraduate and graduate students from 8 health care disciplines including pharmacy, nursing, communication sciences and disorders, dietetics and nutrition science, genetic counseling, advanced medical imaging, medical technology, and physical therapy participated in an orientation program focusing on interdisciplinary health care and professionalism, as well as a field experience. ASSESSMENT Survey results from both components (orientation, n 284; field experience, n 123) indicated that the project was valuable in increasing students' awareness of (1) the importance of professionalism in the clinical setting and (2) the potential contributions of their profession to the health care team.  Health professions curricula should include interdisciplinary learning opportunities that enhance collaboration, collegiality, and professionalism among future members of the health care team.

title: INSTRUCTIONAL DESIGN AND ASSESSMENT An Interdisciplinary Approach to Introducing Professionalism
abstract: To provide interdisciplinary structured activities in academic and clinical settings for introducing the concept of professionalism to health professions students.  Undergraduate and graduate students from 8 health care disciplines including pharmacy, nursing, communication sciences and disorders, dietetics and nutrition science, genetic counseling, advanced medical imaging, medical technology, and physical therapy participated in an orientation program focusing on interdisciplinary health care and professionalism, as well as a field experience. Assessment. Survey results from both components (orientation, n 5 284; field experience, n 5 123) indicated that the project was valuable in increasing students' awareness of (1) the importance of professionalism in the clinical setting and (2) the potential contributions of their profession to the health care team.  Health professions curricula should include interdisciplinary learning opportunities that enhance collaboration, collegiality, and professionalism among future members of the health care team.

title: Self assessment of professionalism in physical therapy education.
abstract: With the physical therapy (PT) professions' advancement to the clinical doctorate degree and the promotion of autonomous practice, exemplary professional conduct is an expectation of the PT profession. PT education programs are being challenged to develop methods to teach and assess professional behavior.  Forty three PT students (11 male and 32 female, ages 20 28 years) completed the APTA Professionalism in Physical Therapy: Core Values Self Assessment (PPTCVSA) after their first 3 week clinical experience and again after their final clinical experience.  A mixed design ANOVA compared participants' total scores and individual Core Value scores on the Professionalism in Physical Therapy: Core Values Self Assessment (PPTCVSA) after 3 and 33 weeks of clinical education. The effects of gender, age, and undergraduate area of study on growth in professionalism scores were also investigated.  Total PPTCVSA scores and individual Core Value scores on professionalism (accountability, altruism, compassion/caring, excellence, integrity, professional duty, and social responsibility) were higher after 33 weeks compared to scores after 3 weeks of clinical education. Female student's total professionalism scores were higher than male student's scores on both the first and second self assessments. In addition, female students scored themselves higher than their male peers on accountability, excellence, integrity, and professional duty.  Improved scores on the PPTCVSA indicate that physical therapy education is playing an important role in the development of professional behavior, knowledge, and application in practice.

title: A validation study of the APTA Professionalism in Physical Therapy Core Values Self Assessment
abstract: A VALIDATION STUDY OF THE APTA PROFESSIONALISM IN PHYSICAL THERAPY: CORE VALUES SELF ASSESSMENT Deborah K. Anderson, Ed.D. Department of Counseling, Adult and Higher Education Northern Illinois University, 2015 D. Eric Archer, Director Measures of student professionalism are being incorporated into both formative and summative assessments of students in medical and health professions education to heighten awareness of professionalism expectations, evaluate change over time, assess outcome of educational activities, and determine competency for progression. The Professionalism in Physical Therapy: Core Values Self Assessment (PCVSA) was developed to measure the frequency of behaviors that represent professionalism in both students and clinicians. However, psychometric analysis has not been conducted on this tool despite its use in physical therapist education. Using Messick's unified construct based conceptualization of validity, the investigator gathered evidence to evaluate the validity of PCVSA scores used to measure professionalism in physical therapist students. The investigator conducted multiple analyses that revealed many risks to the validity of scores from this assessment. The results indicated that the total PCVSA score had greater score consistency, stability, and reproducibility than did the seven subscale scores. However, issues regarding content, structure, and generalizability prevent this tool from having summative assessment utility in physical therapist education programs. Minimal detectable change scores were calculated and may be used for formative assessment to track development of professionalism behaviors over time. Limitations to this study include lack of sample diversity and small sample size for Part 3 of the investigation. Future research should explore content validity evidence for this tool and risks to validity using a more diverse sample. NORTHERN ILLINOIS UNIVERSITY DEKALB, ILLINOIS

title: Test Retest Reliability of the APTA Professionalism in Physical Therapy: Core Values Self Assessment Tool in DPT Students
abstract: Test retest reliability study.  Promoting professionalism is one of the key components of APTA's Vision 2020. The PTCVSA tool is used in PT educational programs as an assessment tool and to facilitate reflection. The tool is also in its initial use as a research tool with PTs. The psychometric properties of this tool have not been established.  Participants completed the PTCVSA tool on two occasions using a test retest design. A total of 96 PT students, including 50 first year and 46 second year students, completed both tests. Psychometric testing was undertaken, including internal consistency using Cronbach &agr; and test retest reliability.  Internal consistency (Cronbach &agr; of the individual core values ranged from .713 (accountability) to .934 (social responsibility) The test retest reliability intraclass correlation coefficient (ICC) for the entire tool was .753 overall. Test retest reliability was marginal .625) in first year students but was acceptable .798) in second year students. Intraclass correlation coefficient values for individual core values ranged from .538 (accountability) to .787 (social responsibility)  Although the PTCVSA may continue to be a valuable self reflection tool for all students in PT education programs, it was not a reliable measurement tool in the first year students participating in this study.  In this preliminary investigation, the PTCVSA demonstrated acceptable reliability as a measurement tool for self assessment of professional behaviors in second year students who have been in a clinical experience.

title: Facilitating Professionalism in Physical Therapy: Theoretical Foundations for The Facilitation Process
abstract: As doctors of physical therapy achieve increased autonomy and take greater leadership in the provision of health care, a correspondingly higher level of professionalism will be expected. APTA's 2006 Education Strategic Plan, Goal 7, states, "Identify and use strategies to effect behavioral change in physical therapists and student physical therapists to: Integrate professionalism core values into physical therapy practice." The purpose of this article is to describe how recognized behavioral theory supports The Facilitation Process described by May et al as an effective approach to the development of professionalism in both the academic and practice settings.  This article presents a case study demonstrating the development of professional behavior in Jordan, a physical therapist student, as she progressed through her academic and clinical education. Using a conceptual model that shows the relationship between Prochaska and DiClemente's11 Transtheoretical Model of Change, Bandura's12 Social Cognitive Theory, and The Facilitation Process, Jordan's case is analyzed to demonstrate how the application of the conceptual model and adult learning theory contributed to her developing professionalism. The role of academic faculty is contrasted with the role of clinical supervisors in promoting professional behavior.  The Facilitation Process provides guidance in organizing activities and interactions that are generally present in the academic or practice setting and enhances their effectiveness in promoting behavioral change without adding responsibilities to the academic advisor or clinical supervisor.  The conceptual model presented in this article demonstrates that the elements of The Facilitation Process are consistent with 2 accepted theories of behavioral change. The case analysis demonstrates how adult learning theory can enhance the effectiveness of The Facilitation Process in effecting behavior change in adult learners.

title: Professionalism in Physical Therapy: A Reflection on Ways of Being in Physical Therapy Education
abstract: Lately, I've been thinking a lot about professionalism in physical therapy, more precisely, about professionalism in physical therapy education. So, too, have many others, judging from the numerous presentations and conversations about this topic at the 2004 Combined sections Meeting of the American Physical Therapy Association (APIA) this past February. Driven by APIA'S Vision 2020 statement and the vision of a doctoring profession, the recently developed and adopted document, Professionalism in Physical Therapy: Core Values,1,2 provides a valuable blueprint for physical therapy educators as they consider how to promote student learning and development as future health care professionals who will embrace and enact these core values in their everyday practice. The result of an APTA sponsored consensus conference, the document identifies and defines seven core values that are essential to professionalism in physical therapy: accountability, altruism, compassion and caring, excellence, integrity, professional duty, and social responsibility.1 As I read through the definitions and indicators put forth in this document, 1 couldn't help but think that teaching and learning about these values and dimensions of professionalism is not so much about what is being taught and learned as it is about how we are teaching, and, perhaps most importantly, who we are as teachers in relation to our students. Furthermore, I believe these values urge us to attend to and critically examine how we teach and who we are as faculty both individually and collectively in physical therapy education. Professing and owning these values is obviously not the stuff of rote memorization and recitation of some oath or pledge it is living them; it is about "ways of being" with our students as they make the journey toward professionalism. Sam Feitelberg, in his recent Pauline Cerasoli address to physical therapy educators, "The Influence of Leaders,"3 echoed my thoughts, and I hope those of many others, on this matter: We should never forget that a student is a learner and should be respected. .and is not a lower form of person on the road to becoming a professional. If we go forward to adopt a pledge or oath, then we have committed ourselves to behaving in a way that will bring meaning and life to the words as students recite them. Many authors have written about the Importance of who we are In relation to our students (Ie, our relational stance or ways of being with students in educational endeavors) and the influence of such presence on learning.4 10 This presence can have both positive and negative influences on learning. Social constructivist theories of teaming remind us that teaching and learning are extraordinarily relational, contextual, and reciprocal endeavors. As such, they also remind us that learning does not just occur in one's head but through active and authentic engagement with academic content through and with other individuals. Thus, our presence as faculty (both academic and clinical) is critical. Students, educational researchers, and educational philosophers have all helped us to identify and understand characteristics, attributes, and behaviors that contribute to positive presence and that enable and enhance learning. In one recent study of physical therapist students and their approaches to learning, Sellheim9 reported positive presence factors as faculty enthusiasm, respectful and positive attitudes toward students, and accessibility. Alternatively, negative presence factors were reported as intimidation, egotistical attitudes, and mistrust. Other influential authors have urged teachers to explore and develop positive presence as a means for facilitating learning through "thoughtful teaching,"6 "mindful practice,"11,12 and, last but not least, "pedagogical sensitivity and tact."7 The latter of these concepts, described in van Manen's7 treatise on the moral dimensions of teaching, The Tact of Teaching: TheMeaning of Pedagogical Thoughtfulness, should be required reading for physical therapy educators, in my opinion.

title: 'Professionalism in Physical Therapy' To the Editor