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Background and Expertise of Faculty Teaching Cardiovascular and Pulmonary Content in Entry-Level DPT Programs

Bartlo, Pamela PT, DPT, CCS; Lefebvre, Kristin PT, PhD, CCS; Wellmon, Robert PT, PhD, NCS

Cardiopulmonary Physical Therapy Journal: April 2017 - Volume 28 - Issue 2 - p 53–62
doi: 10.1097/CPT.0000000000000046
Research Report
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Purpose: The purposes of this study were (1) to examine the qualifications and expertise of individuals teaching cardiovascular and pulmonary physical therapy (CVP-PT) content at entry-level DPT education programs and (2) to determine the amount of time devoted to the content and method of delivery.

Methods: A survey sent through email to 206 program directors of accredited DPT programs assessed institutional demographics, the faculty teaching the CVP-PT content, and the method of delivery. The responses were examined descriptively using frequency counts and percentages.

Results: There was a 49.5% response rate with 102 completed surveys. Among faculty teaching CVP-PT content, 54% had a PhD/EdD, 32% a DPT, and 19% had other degrees. Only 43% teaching the CVP-PT content had a Cardiovascular and Pulmonary Clinical Specialist (CCS) certification. Approximately, 83% of the institutions employed a full-time faculty member to teach the CVP-PT content. Most programs used a single course to deliver the CVP-PT content and 84% reported the use of simulation for CVP-PT content delivery.

Conclusions: These results demonstrated that entry-level DPT programs responding to the survey had qualified faculty with CVP-PT expertise and that there is a need to encourage further professional development of faculty with CCS credentials.

1Department of Physical Therapy, D'Youville College, Buffalo, NY

2Institute for Physical Therapy Education, Widener University, Chester, PA

Correspondence: Pamela Bartlo, PT, DPT, CCS, Department of Physical Therapy, D'Youville College, Buffalo, NY (bartlop@dyc.edu).

The authors declare no conflicts of interest.

IRB approval was from D'Youville College, Buffalo, NY and Widener University, Chester, PA.

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INTRODUCTION

The Commission on the Accreditation of Physical Therapy Education (CAPTE) requires that students in entry-level Doctor of Physical Therapy (DPT) education programs have access to faculty with adequate expertise in the areas in which they teach.1 This requirement ensures that the faculty member, whether adjunct, part-time, or full-time, is able to deliver content that allows students to become competent entry-level physical therapy (PT) clinicians on graduation and successfully pass the Federation of State Boards of Physical Therapy licensure examination. Value is placed on the credentials and expertise of the individuals delivering the educational content in all areas of practice in PT programs throughout the United States.

In the literature on pedagogy in higher education, teaching effectiveness and excellence have been linked to a number of factors, which include the following: (1) the delivery of content by faculty members who have an active research agenda and expertise in the field in which they teach; (2) the ability of the faculty member to bring innovation to the classroom through professional development; (3) the participation of the faculty member in the scholarship of teaching; and (4) the employment status of the individual teaching the curricular content.2-5

The primary variable in the literature that consistently links to teaching effectiveness is the expertise of the individual delivering the course content. Expertise is not necessarily a reflection of the years of teaching experience. Evidence supports that student evaluations of faculty tend to worsen over time, or as a faculty member ages. However, regardless of age and tenure status, outstanding university teachers are also researchers in their field.6 Wolff and Tobin supported the notion of teacher as expert through their observations of teachers who worked to improve their knowledge base.7 These researchers concluded that when a teacher's knowledge of their field increased, student engagement and achievement also improved.

In some cases, content expertise can come from a faculty member having a robust research agenda, in addition to classroom teaching responsibilities. Halse et al6 found that most winners of teaching excellence awards were also esteemed researchers in their field. In an analysis of the relationship between teaching effectiveness and research expertise, Coate et al8 found that teaching and research were often integrated into the classroom. The investigators reported that research expertise assisted in information being translated to students in innovative and cutting-edge ways and interviews with students supported the increased effectiveness of the research-active faculty.8 When the research agenda of the faculty member focuses on the scholarship of teaching, the symbiotic relationship between teaching effectiveness and research expertise grows even further. The scholarship of teaching is imperative not only to the attainment of the institutional educational mission, but also is linked to teaching effectiveness through faculty self-reflection on teaching practice and commitment to using objective measures of student success.9

Alternatively, the content expertise of the faculty member may stem from clinical practice and experience. The achievement of a board-certified clinical specialization ensures that the faculty member has the knowledge needed to teach the cardiovascular and pulmonary PT course content. To obtain clinical specialization, the individual must demonstrate depth and breadth of knowledge in a specialty area, as well as advanced clinical expertise and skills.10 Neither an active research agenda nor a clinical specialization can ensure that an individual will be a highly effective educator, but they do verify the individual's knowledge level, which has been shown to be linked with effective teaching.7

The ability of the instructor to implement innovative teaching activities can be linked with teaching excellence and effectiveness. Innovation in teaching often is linked to the instructor having access to professional development opportunities. Honkimaki et al11 studied the success and learning experiences of students who participated in planned pedagogical innovations on the part of the course instructors. In this study, course instructors had the opportunity to participate in specific professional development activities that supported the design of innovative teaching activities. Outcomes of the study found teaching effectiveness to improve in the form of increased student motivation and decreased mutual competition and reproductive learning strategies.11 Desimone et al12 also found professional development to have an impact on student learning, especially when professors adopted active learning strategies. Adjunct and part-time faculty may have fewer opportunities to access professional development opportunities and campus resources,13,14 thus lending to lower perceptions of teaching effectiveness by students.2

Teaching effectiveness in higher education is also significantly associated with the employment status and rank of the individual teaching the content. As it is much more likely that full-time faculty members would be actively engaged in the research process and have opportunity for professional development or attempt innovative teaching practices, it is not surprising to see a relationship between employment status and teaching effectiveness in the literature. Bianchini et al3 measured teacher quality by evaluating the results from standardized surveys of student satisfaction with teacher effectiveness in a higher education engineering program. The relationship between teaching effectiveness and variables such as teacher personal characteristics, academic rank, and disciplinary affiliation was investigated. The use of nonfaculty instructors to deliver course content was significantly and negatively correlated with all variables of student satisfaction, including variables such as organization, clarity, and raising student interest.3 In a cohort of nurse educators (n = 44) and nursing students (n = 538), Allison-Jones and Hirt2 looked at the teaching effectiveness of part-time and full-time instructors in higher education. Similar to the Bianchini study,3 the findings showed that part-time, clinical nursing instructors were significantly less effective than full-time instructors.2 Even when the course is delivered using an online format, there is evidence for increased teaching effectiveness among full-time faculty. Mueller et al5 found significantly improved successful completion rate, decreased failure and withdrawal rates, less grade variance, and improved satisfaction in courses taught by full-time faculty versus part-time adjunct faculty.

For those specifically teaching cardiovascular and pulmonary physical therapy (CVP-PT) curricular content, the CAPTE requirement that faculty have the necessary clinical and/or academic preparation fits with the literature on teaching effectiveness and expertise. This content expertise is demonstrated in several different ways. At minimum, a full-time faculty member should have a Doctorate of Physical Therapy (DPT) and a clinical specialization, such as a Cardiovascular and Pulmonary–Certified Specialist (CCS), or a terminal degree, such as a PhD or EdD, with clear research or clinical experience in the content area of the curriculum taught. A clinical specialization in a content area other than cardiovascular and pulmonary care is not sufficient. In that case, the faculty member must still show clinical and/or research experience in cardiovascular and pulmonary PT to meet the criteria of content expert according to CAPTE.

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Purpose

To date, there is no available literature reporting on the qualifications of faculty teaching CVP-PT content in CAPTE-accredited programs, in what way that content is being delivered, or how many credit hours or how much time is being devoted to the content across entry-level DPT programs. The purpose of this study was to collect data from CAPTE-accredited DPT programs in the United States to examine the qualifications and expertise of individuals teaching CVP-PT content and the amount of time devoted to and method of delivery of CVP-PT content. These data were used to determine whether there were any patterns between the variables of interest including the employment status, academic credentials, and level of expertise of the individuals delivering the CVP-PT content, as well as the size, type, or geographic location of the institution and its DPT program. Identification of the faculty delivering the content and the methods by which the material is being presented can assist in optimizing the quality of the CVP-PT content being delivered to entry-level DPT students.

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METHODS

Data Collection

This study was approved by the Institutional Review Boards of D'Youville College in Buffalo, NY and Widener University in Chester, PA. In early summer 2014, the researchers accessed the list of accredited DPT programs in the United States through the CAPTE website. There were 211 accredited DPT programs in the United States at the time of the survey administration. Of the 211 programs, 206 surveys were sent to the email address of the DPT program director provided on the CAPTE website or, if not listed, was obtained by contacting the program directly through the phone number provided on the CAPTE website. There were 5 institutions with inadequate contact information to send initial emails and phone calls were not returned; they were not included in data collection. Surveys were sent electronically through SurveyMonkey. There were additional emails sent at 2 other intervals to solicit responses from those program directors who did not respond to the first call for participation.

The 12-question survey developed collected demographic data on the faculty teaching CVP-PT content in US DPT programs (See Appendix 1). This survey was developed by the authors, and then reviewed by a colleague. After review, the survey was adjusted slightly to ensure ease in understanding and that information collected would be meaningful.

The survey had 4 sections. The first section collected demographic information about the academic institution and included questions ascertaining whether the institution was public or private, the region of the DPT program, the total number of students enrolled at the institution, and enrollment in the DPT program. The second section of the survey collected data about how the CVP-PT content was delivered in the DPT program and whether or not simulation was incorporated in the CVP-PT content. The third section of the survey attempted to ascertain information regarding the number of faculty teaching the CVP-PT content and their educational credentials, including whether or not they were CCS credentialed. The final section of the survey was an area for open-ended comments from the program directors to provide additional information that could not be ascertained from the 12-questions survey.

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Participants

Surveys were sent to 206 DPT program directors of CAPTE-accredited programs. The DPT Program Directors were asked to complete the survey based on the DPT program at their institution.

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Data Analysis

The survey responses were analyzed descriptively focusing on frequency and percentages of responses using SPSS version 20.0 (IBM Corp, Armonk, NY). Each of the 12 survey questions was analyzed for overall frequency of response to observe specific relationships between the variables related to faculty expertise and training and institutional variables such as geographic location, institution size, program size, and public versus private institutional status.

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RESULTS

Institutional Demographics

Of the 206 surveys emailed electronically, 102 completed responses were received for a participation rate of 49.5%. Public institutions made up 53% of the respondents with private institutions comprising 47% (Table 1). The Northeast, Southeast, and Midwest regions of the United States had the most respondents at 31.4%, 21.6%, and 27.5%, respectively. The Southwest and West regions had a response rate equal to 10.8% and 8.8%, respectively (Table 1).

TABLE 1

TABLE 1

Among public institutions, most of the responses were from the Southeast (15.7%) followed by the Midwest (14.7%), Northeast (9.8%), Southwest (6.9%), and West (5.9%). The largest percentage of responses for private institutions were from the Northeast (21.6%), followed by the Midwest (12.7%), Southeast (5.9%), Southwest (3.9%), and West (2.9%) (Table 1).

The size of the institution responding to the survey is reported in Figure 1. The participating institutions with the smallest size, or number of enrolled students (<5000) made up 39.2% of the respondents. Institutions with between 5000 and 14,999 students made up 30.4% of the respondents. Institutions that were greater than 15,000 students in size made up 30.4% of the response. The respondents were evenly distributed based on institution size (small, medium, or large).

Fig. 1

Fig. 1

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Curricular Characteristics

DPT program enrollment was evenly distributed between small- (0–39 students) and medium-sized (40–59 students) programs. Programs with 0 to 39 students made up 43.7% of the respondents with only 1 program reporting a class size of <20 students. Programs with 40 to 59 students made up 40.8% of the respondents. Finally, larger programs with greater than 60 students made up the smallest group of respondents at 15.5% (Fig. 2).

Fig. 2

Fig. 2

A majority of the program directors responding reported that a single course was devoted exclusively to covering CVP-PT content. These institutions made up 58.8% of the respondents, whereas 18.6% of the respondents indicated that their institution had 2 or more courses dedicated exclusively to CVP-PT content. All other institutions indicated that the CVP-PT content was interspersed among the courses in the curriculum, rather than having exclusive courses dedicated to the delivery of CVP-PT content.

Regarding credit hours, a small number (3.0%) of the responding programs reported 2 or less credit hours of CVP-PT content. Most common across the programs were 3 to 5 credit hours (Fig. 3). Although most programs were offering 3 to 5 credit hours of CVP-PT content, a higher number of credit hours (6+) of CVP-PT content were found more often in DPT programs housed within private institutions (29.8%) when compared with public institutions (11.1%) (Fig. 3).

Fig. 3

Fig. 3

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Faculty Characteristics

Table 1 contains the demographic information related to the DPT program directors report that 53.5% of the primary CVP-PT faculty had a PhD or EdD degree, 32.7% had a DPT, and 13.9% had other degrees. Larger (52.5%) and medium-sized (49.1%) universities had a greater percentage of faculty with the PhD/EdD or terminal doctoral degree as compared with small (43.6%) universities teaching CVP-PT content. Larger universities had the smallest percentage of faculty with the DPT (31.1%). Of those faculty teaching CVP-PT content, the greatest representation of PhD/EdD faculty was found in the Midwest (27.8%), followed by the Southeast (22.2%) and Northeast (22.2%), which had similar representations (Table 1). The Southwest (16.7%) region and West (11.1%) had the lowest representation of faculty with the postprofessional doctoral degree. Faculty with the DPT credential delivering CVP-PT content were most often located in the Northeast (36.4%), followed by the Southeast (30.3%), Midwest (21.2%), West (6.1%), and Southwest (6.1%) (Table 1). Most faculty teaching CVP-PT content in CAPTE-accredited institutions were full-time employees of the DPT programs or other departments within the institution (84.2%). Full-time faculty teaching CVP-PT content, compared with either part-time or adjunct, were most often located in the Northeast (32.9%) followed by the Midwest (27.2%) and Southeast (20.0%). The greatest underrepresentation of full-time faculty delivering CVP-PT content was seen in the Southwest (11.8%) and West (8.2%) (Table 1). Of note, only 4 institutions reported having part-time faculty and 10 institutions reported having adjunct faculty teaching their CVP-PT content as compared with 73 institutions reporting full-time faculty teaching that content. Therefore, the results presented in tables and graphs were compared for full-time faculty versus the combination of part-time faculty and adjunct faculty.

Within this group of full-time faculty, approximately 40% had attained the CCS. Of the part-time faculty teaching the CVP-PT content, approximately 75% had attained their CCS. This may be reflective of the involvement by part-time faculty in clinical practice when compared with full-time faculty because CCS certification does require continued evidence of clinical practice. Faculty teaching CVP-PT content with PhD or EdD degrees (32.7%) were much less likely to have a CCS when compared with faculty with DPT (54.5%) or Master's degree level (63.6%) of education (Fig. 4).

Fig. 4

Fig. 4

Faculty with CCS certification were more often located at private institutions (60.3%) when compared with public institutions (39.7%) and at medium-sized universities (51.6%). With respect to geographic location, regardless of employment status, faculty teaching with CCS certification was most frequently located in the Northeast (44.1%), followed by the Midwest (23.3%) and the Southeast (18.6%). The Southwest (4.7%) and West (9.3%) had the greatest underrepresentation of faculty with CCS teaching CVP-PT content (Table 1). Irrespective of the type of institution or geographic location of the institutions, 57% had faculty teaching CVP-PT content who had not attained the CCS certification.

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Use of Simulation

CVP-PT content delivered using some type of simulation experience directly related to the cardiovascular, pulmonary, or ICU care content was reported by 84% of the programs. Broadly defined, simulation can include role plays, paper case studies, as well as, the use of high-fidelity simulators. Program directors reported that 87.1% of full-time CVP-PT faculty were using simulation in their CVP-PT content delivery compared with 68.8% of part-time faculty. In addition, public institutions were more likely to be engaging in simulation to deliver CVP-PT content than private institutions. There was a small difference in the use of simulation based on the type of institution in which the DPT program was housed with 87.0% of public institutions reporting use of simulation to deliver CVP-PT content versus 80.9% of private institutions using simulation to deliver CVP-PT content.

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DISCUSSION

Although descriptive in nature, there is much that can be gleaned from the data. Program representation was not drastically different regarding type of institution, institutional size, or DPT cohort enrollment. Most respondents were public institutions, with <5000 students overall, and a DPT class cohort size of 21 to 59 students. When using these results to understand how CAPTE-accredited entry-level DPT programs are delivering CVP-PT content, it is important to remember these characteristics as they do not match all programs.

Also, it is important to keep in mind that most of the respondents were from the Northeast, Southeast, and Midwest, with a smaller response from the Southwest and West. There are slight differences in definitions as to which states fall in which regions of the country and the respondents self-selected the regions listed. Using the US Census Bureau's regional classification, the Northeast has most PT education programs (30.8%) followed by the Midwest (27.2%), Southeast (16.4%), West (15.4%), and lastly the Southwest (9.7%).15 Therefore, the only notable differences in this study's responses were that the Southeast was a bit overrepresented and the West was slightly underrepresented compared with the distribution of programs in those regions.

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CVP-PT Content Delivery

For this study, most respondents reported delivering CVP-PT content in a single course (58%). This content was delivered most often in 3, 4, or 5 credit hours (77.2%). The majority of these programs (57.8%) had 1 faculty member primarily responsible for the CVP-PT content with 1 or more other faculty acting in assistive roles (ie, laboratory or seminar instructor).

There are several sources that DPT education programs can use to ensure that they are delivering the necessary CVP-PT content to their students. CAPTE's curricular standards,1 the Normative Model of the American Physical Therapy Association (APTA),16 The APTA's Guide to Physical Therapist Practice17 and other professional sources are routinely used in initial PT education program development and subsequent curricular reviews to guide content development. However, these sources do not provide institutions with guidelines as to how this content should be delivered regarding the number of courses, credit hours, or level of education of the instructors. The information presented in this study gives the reader the characteristics of the DPT education programs that responded to this study. Although these findings cannot be completely generalized to all DPT education programs, the diverse nature of the sample may serve as a general model of what many institutions provide in their CVP-PT curriculum. There are no previous studies examining the best way to distribute CVP-PT content in a DPT program. Future studies may want to explore this line of investigation further.

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Faculty Characteristics

The results of this study showed that most of the DPT education programs had their CVP-PT content taught by a full-time faculty member who had a PhD/EdD or DPT as their highest level of education. When these 2 factors are combined, it shows that the DPT education programs in this study were striving to ensure delivery of CVP-PT content by a stable or dedicated faculty member with content expertise, and by virtue of being employed full-time, most likely had an understanding of how the content fit within the overall curriculum. This is in line with the research demonstrating that the study sample reported faculty characteristics leading to higher teaching effectiveness as rated by students.2,5 It is important for DPT education programs to have main clinical system courses taught by qualified faculty. The data showed that although those with postprofessional doctoral degrees were reported more frequently as delivering CVP-PT content in the Midwest, Southeast, and Northeast, DPTs were more frequently seen as the faculty delivering CVP-PT content in the Southeast and Northeast. This study did not attempt to quantify the “quality” of faculty teaching this content. It could be argued that the attainment of the CCS credential helps to enhance the quality of education the faculty member can provide with respect to the CVP-PT content due to their knowledge and clinical experience in the content area. This is by no means a comprehensive way to measure “teaching effectiveness” as it does not speak to the faculty member's ability to develop educational experiences that lead to entry-level competency. Likewise, the lack of CCS credentials does not necessarily mean that a faculty member does not have content knowledge. The CCS credential just speaks to the content knowledge area and clinical practice of the holder. The literature supports increased teaching effectiveness in full-time employed faculty members; therefore, those teaching on a part-time basis from the clinical environment may need more support and consideration for professional development to elevate their teaching effectiveness to be more on par with full-time faculty. The research suggests the potential for a link between increased academic excellence and teaching effectiveness.18

For this study, only 43% of the institutions (Fig. 4) reported having a faculty member with a CCS delivering the CVP-PT content. In the education arena, there has been some research showing the benefit of a specialist delivering the teaching material compared with a generalist.19 However, there was no research found in the health care or medical arenas analyzing the difference in teaching effectiveness or outcomes between education provided by a specialist or a generalist. Therefore, it is difficult to state that faculty with a CCS definitely would provide a better educational experience than someone without the CCS. As noted previously, the CCS does demonstrate specialist knowledge of CVP-PT content, which is a primary requirement for teaching effectiveness. Faculty with a CCS have this primary requirement of content knowledge and expertise, therefore are justifiably qualified as content experts for teaching the CVP-PT content in a DPT program. However, having a CCS is not the only way to demonstrate content knowledge and expertise. Faculty may have an extensive educational background, publications, and have conducted research in CVP-PT, but do not have the opportunity to participate in clinical practice and are therefore unable to maintain CCS certification. These results should be used to help initiate or enhance programs to further the training and quality of the faculty teaching CVP-PT content around the country. This preparation may be through further educational training such as attainment of a terminal postprofessional doctorate degree or through clinical specialist attainment. CAPTE criteria do state that evidence of the faculty member's contemporary expertise could be through education, clinical experience, consultation, scholarship, or development of course materials reflecting the expertise.1 The literature showed the more a faculty member was engaged in furthering their expertise in their field, the greater their teaching effectiveness in the content area.6,7,18 Therefore, it is important for institutions and other stake holders to assist faculty in furthering their expertise either through further education, research, or the attainment of clinical specialization. The fact that only 43% of faculty in this study had obtained the CCS may show one area of potential growth.

Faculty with CCS certification were more often located at private institutions (60.3%) when compared with public (39.7%) institutions. They were primarily at institutions in the Midwest, Southeast, and Northeast. The Southwest and especially the West had lower rates of faculty with CCS when compared with the other 3 regions.

It is interesting to note that in the results of this study, there were a greater number of private institutions in the Northeast and Midwest and a greater number of faculty with CCS credentials in these regions as well. There are no specific criteria showing that private institutions that provide DPT education are either more research based or focused or have teaching as their primary mission. However, when this study's data are viewed collectively, the overall trend is institutions of small to mid-size, which in general tend to be more clinical or teaching based than primary research based. Therefore, the authors hypothesize that the institutions in this study trended toward a model of private, mid-sized schools having CVP-PT content delivered more often by faculty with DPT and CCS due to the clinical or education models in place. Likewise, the public, larger institutions trended toward the CVP-PT content being delivered by faculty with a PhD or EdD and without the CCS credential. For faculty tenure at a larger, public institution there may be a greater focus on research productivity and educational credentials that relate to having a terminal, postprofessional doctoral degree. These pursuits or requirements for faculty, potentially on a tenure track, typically take precedence over clinical practice. Therefore, one can expect to see higher numbers of faculty with terminal degrees compared with clinical degrees, and lower numbers of CCS credentials due to lack of time provided for clinical practice. For faculty tenure or renewal at mid-sized or smaller private institutions, the faculty have the ability to participate in clinical practice with more ease hence the higher rates of CCS. There is no current research examining these trends so it is an area of further examination needed to verify if this is truly the case as to why the subjects in this study tended toward those characteristics.

Previous research showed improved teaching effectiveness with increasing expertise in the field6,7,18 and with faculty performing research in their field.6,8,9,20 It is reassuring to see that such a high number of DPT programs in this study (81%) had their CVP-PT content delivered by doctorally prepared faculty. However, the authors cannot verify that all PhD or EdD faculty were engaged in research in CVP-PT content areas or that all DPT faculty had the CCS and were not specialists in another content area.

The rates of DPT faculty being highest in the Southeast, Northeast, and Midwest also match the numbers of individuals possessing the CCS certification. As stated, many faculty with PhD or EdD degrees may not have the ability to participate in clinical practice, which is integral to obtaining and maintaining the CCS credential. CAPTE stipulates that a full-time faculty member can have a DPT as their highest educational degree, but that they should also then possess some other, additional type of advanced credential or specialty training.1 Most small or mid-sized institutions also stipulate that faculty who are DPT prepared must also possess an advanced credential that speaks to their ability to teach in their respective area of content expertise. This helps explain the higher rates of faculty with DPT degrees having the CCS and higher rates of CCS faculty in the Midwest, Southeast, and Northeast. The greater number of faculty with PhD or EdD degrees in the Southwest and West also helps explain the lower numbers of CCS faculty in those regions. Lastly, faculty with Master's degrees had the highest comparative rates of CCS attainment (63.6%). This makes sense as most were clinicians serving as adjunct faculty. The study findings are important for DPT education programs to consider when recruiting faculty to teach CVP-PT content. Each institution will need to think about the overall structure at their institution. There were quite a few respondents having their CVP-PT content taught by part-time faculty without CCS credentials. Because this is not always ideal, the Education and Cardiovascular and Pulmonary Sections should look to bolster the number of part-time faculty with CCS credential teaching CVP-PT content. Mentoring programs, residencies, fellowships, and directed marketing are just some methods that could help improve the level of faculty teaching CVP-PT content across the country. Some of this may want to be targeted toward the Western region specifically as those areas had the lowest rates of full-time faculty and CCS credentialed faculty.

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Use of Simulation

A high number of respondents were using some type of simulation in the delivery of the CVP-PT content. This particular survey did not ask specifics as to which type of simulation, how much time students are engaged in simulation, what type of assessment was performed during or after simulation, or any other specifics regarding simulation. This study's question was simply looking to assess whether or not most institutions were using simulation for CVP-PT content. However, one institution did write a comment that the simulation used was a “fully equipped simulation lab with 4 vital sim mannequins.” The institutions also indicated that the students completed an “OSCE competence exam with real patients.” The results of this study were able to show that simulation for CVP-PT content was used more often by full-time faculty and at public institutions. This is important as teaching effectiveness improves with innovation in the classroom.11,12 Faculty teaching CVP-PT content may not always have the ability to expose students to actual patients with cardiopulmonary health conditions, so the use of simulation at any level may help to improve the effectiveness of the delivery of CVP-PT content. Regardless of employment status, educational degree, or specialization, most faculty were using simulation in the delivery of CVP-PT content.

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Opportunities for Future Research

These results were meant to be a descriptive analysis of the level of faculty teaching within DPT education programs in the United States. These results can be used to help target specific areas of the country or types/sizes of institutions to help enhance the effectiveness of faculty teaching the CVP-PT content. Additional research should be performed to further analyze the use of simulation in CVP-PT education. One area of simulation, high-fidelity patient simulation, represents an emerging technology that has been shown to be effective in enhancing student learning, clinical decision-making, and psychomotor skill application.21-24

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Opportunities for Faculty Development

The results of this study will allow interested parties, such as CAPTE, the American Physical Therapy Association (APTA), the Section on Cardiovascular and Pulmonary Physical Therapy (CV&P Section) and the American Board of Physical Therapy Specialists (ABPTS) to determine the need for mentoring or to support programs to assist adjunct and nonspecialist professors to enhance their level of expertise. Individual DPT institutions could also use this information to assist with faculty recruitment and development. One program director commented that the state in which the university is located has one person with a CCS and there is one faculty member that teaches CVP-PT content in 4 different institutions because of a lack of qualified faculty for this content area. Increase opportunities for faculty development could result in improved content expertise for those teaching in the area of CVP-PT. For example, as the Cardiovascular and Pulmonary Section is attempting to begin a mentor/mentee program for physical therapists looking to go into this area of practice, the results of this study may be helpful in determining if the mentor/mentee program needs to be extended to educators in certain geographic locations or types of institutions to improve the overall quality of CVP-PT education. The results of this study may also help DPT programs in other countries to assess the similarities or differences of their faculty compared with those of the institutions in this study.

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Study Limitations

Although there was a good response rate, increasing the number of institutions providing responses would help improve the generalizability of these results. Also, there was a lower representation of programs in the Southwest and West regions. Increasing the response rates from institutions in those regions would only help to strengthen the results of this study. There was also the possibility of sampling bias meaning that those programs that responded did so due to confidence in their programs having qualified faculty teaching the CVP-PT content. There was the possibility that those programs that did not respond had lesser qualified faculty. CAPTE standards require that all programs have qualified applicants, but this study did not verify the credentials of faculty at programs that did not reply. The survey did not ask specific questions regarding the use of simulation and that may limit the use of the simulation results found in this article.

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Conclusion

Most respondents of this study were smaller to mid-sized institutions with DPT cohort sizes of 21 to 59 students. Typically, a primary faculty member taught CVP-PT content in one course of 3 to 4 credits with the assistance of other adjunct faculty members. Most were full-time faculty with a PhD or EdD and did not possess the CCS credentials. The Southwest and West had the greatest underrepresentation of faculty with CCS credentials. Faculty with a PhD or EdD had a lower rate of CCS credentials compared with those with a DPT or Master's Degree. The results of this study showed that there may be a need to encourage development of faculty with their CCS credentials as one method of justification of content expertise for clinical doctorate prepared faculty, but that overall the DPT programs represented here did have their CVP-PT content taught by qualified faculty with expertise in this content area.

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Survey to Assess the Background of Faculty Teaching in Cardiovascular and Pulmonary Courses in DPT Programs

We are conducting this survey to assess the level and background of faculty teaching the Cardiovascular and Pulmonary PT (CVPT) content in PT programs across the country. The purpose is to be able to identify what is the typical staffing level of CVPT education in PT programs. This may be used to then encourage and/or mentor cardiovascular and pulmonary PTs who are interested in entering education. Please fill out the following survey based on the institution at which you are currently employed.

By initiating this survey, you give consent for the researchers to use this survey information in data analysis. Surveys will be kept confidential and no information will be used that may identify an institution. You may withdraw from the study at any time by ceasing to fill out the survey.

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REFERENCES

1. American Physical Therapy Association. Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapist. 2014. http://http://www.capteonline.org. Accessed February 5, 2016.
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Keywords:

faculty; cardiovascular; pulmonary

© 2017 Cardiovascular and Pulmonary Section, APTA