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Center for the Future of the Health Professions Jan. 2022 digest

This month, The Center for the Future of the Health Professions is posting its first monthly op-ed column for 2022. Our columns represent strong, informed, and focused opinions on issues that affect the future of the health professions. As mentioned in the past, the center was developed to provide state, local, and national policymakers and health system stakeholders with accurate, reliable, and comprehensive data and research about the healthcare workforce, so they can effectively plan for a sustainable future and make the best use of available resources.

This month features a discussion around the future of the education of physical therapists (PTs), in the U.S. and, in particular, their education at A.T. Still University (ATSU). This month’s feature is authored by Lori M. Bordenave, PT, DPT, PhD, chair and associate professor of physical therapy in the Department of Physical Therapy in ATSU’s Arizona School of Health Sciences (ATSU-ASHS). She is a fellow of the Education Leadership Institute of the American Physical Therapy Association (APTA) and long-time faculty of ATSU.

Physical therapy in the U.S.

In 2021, APTA celebrated its centennial year. However, the practice of physical therapy began much earlier with the formation of schools to train reconstruction aides (the initial title given to physical therapists) shortly before the first World War in 1914.1 Since that time, physical therapy has grown and emerged as an essential part of the healthcare system with physical therapists working with individuals across the lifespan in a wide range of settings.

Physical therapists’ work focuses on improving movement and quality of life through exercise, hands-on treatment, and patient education.2 This will look different depending on each individual’s needs. For example, the interventions used for a child with cerebral palsy will be different from those used for someone with Parkinson’s Disease or someone with chronic pain. However, working with a physical therapist can help all of these individuals improve their function to participate in the things they love. Over the past year, physical therapists have proven their importance to the overall healthcare system, serving as the entry point for many musculoskeletal injuries. Patients have been unable to access other healthcare providers because of the barrier created by the pandemic.3 Additionally, many physical therapists have served an essential role in treating patients with COVID-19 in the hospital setting and afterward to support their recovery and return to function.4

While the importance of physical therapists in hospitals has become apparent due to the pandemic, most (32%) work in out-patient clinics.5 The job outlook is very positive for physical therapists with a projected increase demand of 26% by 2030.6 With this projected increase, it is anticipated that most graduates will have ample job opportunities into the future.2 In particular, there will be a need for physical therapy care in rural communities and for increased diversity of physical therapists to serve the needs of all members of our communities.4

Physical therapy at ATSU

The physical therapy program at ATSU’s Mesa campus graduated its first class in 1998. Since that time, the program has transitioned to a Doctor of Physical Therapy (DPT) degree and added three other programs to the department. The postprofessional DPT is designed to allow practicing physical therapists to receive their doctorate, and the two residencies support specialization in the areas of orthopedic or neurologic physical therapy. The addition of these programs demonstrates the department’s commitment to advancing the practice of physical therapy. Importantly, these programs encourage students in the entry-level DPT program to see the value of lifelong learning and clinical specialization as they begin their education in physical therapy.

Students in the three-year entry-level program spend the first two years primarily in classrooms, learning the foundational skills of practice. In 2017, a new curriculum led to the addition of integrated clinical education (ICE) experiences during these first two years. These ICE experiences allow students to apply the skills learned in the classroom immediately under the supervision of one of the many excellent clinical instructors who work with them in clinics throughout the Phoenix metropolitan area. Then during the third year of curriculum, students complete their terminal clinical experiences in clinical sites throughout the U.S.

While there was initially a shift to online learning for the classroom part of the curriculum early in the pandemic, the program was able to modify the learning environment to resume lab and hands-on learning by the summer of 2020. Similarly, there were some challenges with ICE and terminal clinical experiences early in the pandemic. As the importance of physical therapists in providing care to patients who might otherwise not be seen and their role in treating patients with, and post-COVID-19 became clearer, most clinical sites resumed taking students for clinical experiences. Long-term, with the burnout currently being reported by many healthcare providers and the addition of new physical therapy programs in the Phoenix metropolitan area, there may be a shortage of clinical experiences.  

ATSU’s Center for Occupational and Physical Therapy, a new addition to the university in 2019 may alleviate some of this shortage. This student-run, pro bono clinic allows students the opportunity to provide direct care under faculty supervision. Because of the faculty’s wide range of practice expertise, the clinic can provide free care to patients with a variety of conditions. Additionally, students who choose to serve on the board that oversees the clinic learn valuable management and leadership skills. Unfortunately, the center closed during the pandemic until July 2021. However, with the reopening and expanded hours, it is hoped that in the future, most ICE experiences will be able to be offered through the center.

Physical therapy is a growing profession with a wide range of opportunities into the future. The ATSU-ASHS Physical Therapy Department aims to not only provide high-quality, entry-level education for students beginning their journey as physical therapists, but also to support the continuing development of practicing physical therapists through the postprofessional DPT and the orthopedic and neurologic physical therapy residencies. It will be exciting to see how the alumnus of the ATSU-ASHS Physical Therapy Department contribute to the next 100 years of APTA and physical therapy.

We would love to hear your comments about this month’s feature.

1.         Moffat M. The History of Physical Therapy Practice in the United States. Journal of Physical Therapy Education. 2003;17(3):15-25.

2.         Becoming a PT. American Physical Therapy Association. Accessed December 28, 2021. https://www.apta.org/your-career/careers-in-physical-therapy/becoming-a-pt

3.         Tepper DE. Opportunities exist in projected workforce demand. APTA Magazine. American Physical Therapy Association; 2021. https://www.apta.org/apta-magazine/2021/04/01/opportunities-exist-in-projected-workforce-demand

4.         American Physical Therapy Association. Impact of COVID-19 on the physical therapy profession over one year. 2021. https://www.apta.org/apta-and-you/news-publications/2021/impact-of-covid-19-on-the-physical-therapy-profession

5.         Bureau of Labor Statistics U.S. Department of Labor. Occupational outlook handbook, Physical therapist. Accessed December 28, 2021. https://www.bls.gov/ooh/healthcare/physical-therapists.htm

6.         Department of Health and Human Resources Health Resources and Services Administration. Health Workforce Projections. Accessed December 28, 2021. https://data.hrsa.gov/topics/health-workforce/workforce-projections

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