2021 Academy of Acute Care Physical Therapy Annual Lecture Award: Preparing a Future in Acute Care: Strategies for Success : Journal of Acute Care Physical Therapy

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ACUTE CARE LECTURE

2021 Academy of Acute Care Physical Therapy Annual Lecture Award

Preparing a Future in Acute Care: Strategies for Success

Ohtake, Patricia J. PT, PhD, FNAP

Author Information
Journal of Acute Care Physical Therapy: October 2021 - Volume 12 - Issue 4 - p 143-149
doi: 10.1097/JAT.0000000000000175
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Good evening. I'm deeply honored to have been selected as the 2021 APTA Acute Care lecturer. I would like to express my sincere gratitude to APTA Acute Care for the remarkable opportunity to deliver this prestigious lecture, an opportunity made even more distinctive by occurring in the centennial of our wonderful profession. I'm grateful for my exceptional colleague and friend, Dr Jim Smith, who led the nomination resulting in this award, and for my many colleagues—it is a privilege to know you, work with you, and learn from each of you. There are 2 remarkable young women who I would like to acknowledge this evening—my daughters Miyoko and Midori. They have always respected my passion for the profession of physical therapy and know how important my commitment to advancing the profession through education, research, and service is to me. Thank you for your love and support throughout my professional journey.

When I first learned about being the recipient of this lecture award in January 2020, the coronavirus disease-2019 (COVID-19) outbreak was just beginning. Now 1 year later, the full impact of the coronavirus is being felt around the world. COVID-19 has impacted us all, both personally and professionally. While this pandemic has delivered significant challenges to physical therapist practice in every setting, these challenges have been intensely felt in the acute and critical practice environments. In the face of COVID-19, acute care physical therapists (PTs) and physical therapist assistants (PTAs) have all been called upon to be continuously learning about this new virus and how it affects the health and functioning of the people we provide services for. We were resilient and used our knowledge and experience to develop new treatment strategies to optimize the outcomes of these patients. We have learned new ways to practice, how to work behind masks and face shields, and how to effectively use virtual communication strategies. All of the acute care PTs and PTAs who have been educating us, especially through the APTA Acute Care Saturday morning webinars, and those who have been treating patients with COVID-19 are nothing short of remarkable! Here is my virtual applause to you all.

Tonight, as I address you virtually, we will consider strategies to successfully prepare a future in acute care physical therapy. Currently, approximately 11% of all PTs practice in acute and critical care settings.1 With the increase in the number of acute and critically ill patients due to COVID-19, it is essential that we increase the pipeline of PTs and PTAs to provide rehabilitation in acute care settings. Even though all PT and PTA programs are required to provide acute care content, I encourage us to ask ourselves 2 questions. First, are we providing high-quality acute care education for our students? Second, are our students being provided the opportunities to become excited about acute care practice?

I hope to convince you that to optimally develop our future acute care providers we must provide our PT and PTA students with exposure to high-quality acute care education and because acute care education is a complex, multifaceted endeavor, we must engage our collective wisdom. Collective wisdom refers to the knowledge, insight, and extraordinary creative potential gained through group and community interaction.2 As we gather here this evening, we have the opportunity to benefit from our collective wisdom and to start this conversation. In addition to sharing my own thoughts, I will be incorporating the wisdom of the previous Acute Care Lecture Award recipients. These esteemed professional leaders challenged our thinking with their provocative thoughts and inspired us on our paths of personal and professional development. Furthermore, our Academy is brimming with exceptional clinicians, educators, and scientists. To further engage our collective wisdom, I've asked a few of our extraordinary members to share their ideas about the characteristics of academic and clinical educators that contribute to fueling students' enthusiasm for practice in the acute care setting. It is a privilege to be able to share their insight and wisdom with you this evening.

To illustrate the power and influence of exposure in deciding one's career choices, I'd like to share my path to physical therapy. It's likely similar to your own story—after being exposed to the profession either personally following an injury or illness, or through a family member or friend who required physical therapy—we were hooked!

My exposure to physical therapy happened when I was 16 years old. I'm the first born in my family and was my father's son until my brothers were old enough to assume that role. I was helping my dad work on the car when he severed all of the tendons on the back of his hand. Following reconstructive surgery, he worked with a PT for months to regain the mobility and function in his hand. By attending many of his appointments with him, I became fascinated and decided physical therapy was the career for me. I was going to be a hand PT.

I grew up in a suburb of Montreal and embarked on my physical therapy education at McGill University. Our program was housed in the historic Hosmer House. It was nothing short of spectacular! I was able to find a photograph of the main floor staircase—it truly was this magnificent when I was a student there. I can't count the number of times my classmates and I were traipsing up and down this impressive staircase in our shorts and T-shirts on our way to either class or laboratory.

My passion for acute care physical therapy also was born out of exposure. On my first day of my clinical rotation at the Royal Victoria Hospital, a very large tertiary care hospital, I discovered I was going to be working in the intensive care unit (ICU). After a few days, I completely forgot about being a hand therapist. Acute care practice was where I knew I wanted to be!

I started my clinical career as a physiotherapist at Toronto General Hospital (TGH) during an exceptional period. At that time, TGH was a 1500-bed tertiary care hospital with 8 ICUs and 108 ICU beds. I gained so much experience rotating through these ICUs as well as working in cardiovascular, thoracic, and other surgery units. Magnetic resonance imaging became available, allowing for a view inside our patients that led to faster, more accurate diagnoses. Coronary artery stents were developed permitting our patients to undergo a percutaneous procedure to reestablish coronary artery blood flow instead of requiring the considerably more invasive approach of coronary artery bypass surgery and a much longer period of functional impairment. AIDS was identified and we learned to safely and effectively care for our patients with Pneumocystis carinii and Kaposi's sarcoma in ways we hadn't experienced before. Digit replantation surgery was emerging as a viable procedure and I had the opportunity to treat these patients. But perhaps my most memorable experience was when I had the privilege to be 1 of 2 PTs who provided care for the first single lung transplant recipient to survive for more than a few weeks. Our patient lived an additional 6 years with a wonderful quality of life, years he would not have had without this innovative surgery and the pioneering approach to pre- and postoperative rehabilitation we provided. As you can see from these examples from my career, and I have no doubt you all have had exposure to exceptional experiences in your careers, exposure is important in professional development.

Let's return to the question I asked earlier, are our students being provided opportunities to become excited about acute care practice? I believe the answer lies in exposure to high-quality acute care education (see Table 1). It is essential that we expose our students to:

  1. Robust acute care content that is well taught and integrated into the curriculum,
  2. Academic and clinical learning experiences that align with learners' preferences,
  3. Exceptional role models,
  4. Interprofessional education (IPE), and
  5. APTA Acute Care
TABLE 1. - Educational Exposure Opportunities for Acute Care Physical Therapist and Physical Therapist Assistant Students
To enhance the future of acute care physical therapist and physical therapist assistant practice, we must expose our students to the following:
  • Robust acute care content that is well taught and integrated into the curriculum

  • Academic and clinical learning experiences that align with learners' preferences

  • Exceptional role models

  • Interprofessional education

  • APTA Acute Care


Let's examine the collective wisdom as it relates to these 5 areas.

EXPOSE STUDENTS TO ROBUST ACUTE CARE EDUCATION CONTENT

To prepare future PTs and PTAs for practice in acute care environments, academic and clinical educators are tasked with educating students to efficiently make complex decisions for all patients. To assist educators in identifying the relevant content for acute care practice courses, in 2015, the Academy's Minimum Skills Task Force published the Core Competencies for Entry-Level Practice in Acute Care Physical Therapy.3 This document identifies the necessary knowledge, actions, and behaviors that are required of an entry-level PT clinician to practice in the acute care environment. This document was followed in 2017 with the Core Competencies for Entry-Level Physical Therapy Assistants in the Acute Care Setting.4 This subsequent document clarifies the necessary skills required for an entry-level PTA to treat patients in the acute care environment. Implementing the guidance in these 2 important documents is a key step to ensuring our acute care course content is of the highest quality and aligned with evidence-based recommendations.

EXPOSE STUDENTS TO CORE FACULTY WITH ACUTE CARE EXPERTISE

PT and PTA education programs need core faculty with acute care expertise to serve as acute care educators. As Dr Ellen Wruble shared with us in her 2016 Acute Care Lecture, Survival Is Not Enough,5 we must insist that acute care content not be the stepchild of the curriculum, but rather be a highly valued content area led by full-time faculty with acute care expertise. Acute care physical therapy content is often outsourced to expert clinicians, who no doubt add enormous value to these courses. However, these clinicians are often not trained as academic educators, and as adjunct faculty, the opportunities to integrate the acute care content into the larger program curriculum, as would occur with full-time faculty, are lost.

EXPOSE STUDENTS TO FACULTY WHO ARE EXCELLENT EDUCATORS

While it is a significant step to ensure PT and PTA education programs have full-time faculty with acute care expertise, these faculty must also be exceptional educators and role models. High-quality active learning experiences require much more time to develop and much more skill to implement successfully. Despite completing a master's degree, PhD degree, and a 3-year post-doctoral fellowship, or grade 26 as my daughters would fondly say, when I started my first academic position, I had no idea how to teach! It is essential that graduate and academic education programs provide formal faculty development opportunities in teaching and learning for all of their postprofessional students and faculty. Formal education in the area of simulation is especially important for faculty teaching acute care content. Simulation is a powerful instructional design strategy, whose potential is further optimized when led by faculty with a rigorous understanding of simulation and the use of structured debriefing.

ALIGN ACADEMIC AND CLINICAL LEARNING EXPERIENCE INSTRUCTIONAL DESIGN STRATEGIES WITH LEARNER PREFERENCES

When selecting instructional design strategies, it is critical to know the general characteristics and learning preferences of the students we are educating. The majority of our current PT and PTA students are members of Generation Z. Generation Z are the first students that have always had access to the Internet and social networking.6 They are the most diverse generation in history in terms of race, gender, and sexual orientation.7 In general, Generation Z are active problem solvers, enjoy learning independently, and are committed to advocating for equity and social justice.6 They are motivated by a desire to please others and they get ahead through hard work.8

In contrast to millennials who were raised by “helicopter” parents, parents of Generation Z assumed a coaching role, providing both positive and negative feedback.8 This has led to Generation Z valuing and seeking out close mentoring relationships and performing well when these relationships are based on honesty, mutual respect, and provide engagement.6

With respect to education, Generation Z places considerable value on academic achievement and they optimally engage in their education when the learning experiences have relevance and the rationale for the learning experiences is made clear to them.9 Generation Z highly values authentic learning experiences and in-person interaction. They are independent learners and prefer to work at their own pace. They favor working alone prior to contributing to group work. When considering instructional design strategies, we must remember these learners are very tech savvy and are able to locate and synthesize information quickly.10 These learners have short attention spans and educational material should aim to accommodate this. Generation Z embraces active learning that incorporates problem-solving, creativity, hands-on participation, and discussion.11 Taken together, Generation Z demonstrates a unique combination of a strong work ethic, technologic capability, and a willingness to learn that will serve them well in their careers.12

To be successful educating Generation Z, it is essential to keep these characteristics in mind and to develop learning experiences that align with these students' values and skills. Instructional design strategies that are effective and well received include a hybrid of online and in-person education with clear communication of relevance and expectations.13 Given that these students are very tech savvy, we can leverage this skill to optimize the delivery of our educational content. These learners are more open to accessing information through podcasts, websites, interactive videos, and Internet-based educational games, and other gamified learning experiences.14 A flipped classroom strategy works well with these students especially when the asynchronous, independent learning involves short faculty-developed lecture video or audio presentations supplemented with podcasts and websites that prepare students for the in-person sessions that should employ active learning approaches such as case discussions and journal clubs that promote clinical decision-making and problem-solving.15 Dr Barbara Smith, assistant professor at the University of Florida and seasoned acute care educator, clinician, and scientist, emphasizes the importance of engaging our students through problem-solving when she stated, “As an educator, I take advantage of PT students' innate intellectual curiosity through case studies, clinician guest instructors, and lab exercises” (Barbara Smith, personal communication).

EXPOSE STUDENTS TO AUTHENTIC LEARNING EXPERIENCES—INCLUDING SIMULATION

Since authentic learning experiences are highly valued by Generation Z, simulation-based learning is an ideal instructional strategy, especially for acute care education. To be effective, simulation scenarios must be realistic, which for physical therapy often means the use of standardized patients instead of mannequins. The simulation scenarios must be followed by a robust, structured debriefing session—debriefing is where the real learning occurs.16 In the 2013 Acute Care Lecture, Leveraging Technology to Advance Acute Care Practice,17 Dr Sharon Gorman, professor at Samuel Merritt University and President of APTA Acute Care, endorsed the importance of the authenticity of simulation when she stated that “if scenarios are not realistic, students will continue to struggle in acute care placements, will continue to feel ill prepared for work with acutely ill patients, and remain confused when ultimately exposed to actual acute care practice.”17 Dr Gorman continued to emphasize the importance of using “best practices, evidence-based principles, and realistic clinical scenarios if we are to maximize the educational potential of simulation.”17

EXPOSE STUDENTS TO SIMULATION TO INCREASE INTEREST IN ACUTE CARE PRACTICE

Educating our students using simulation provides them with important exposure to acute care practice. In Australia, simulation is so highly valued that students may spend up to 25% of acute care clinical rotations in simulation.18 Furthermore, the value of simulation cannot be overstated, as exposure to a practice area has been shown to be very powerful in developing interest in that area of practice. For example, the University of North Carolina implemented an optional half-day simulation course in which pairs of first- and second-year medical students, wearing scrubs, received mentored instruction by cardiothoracic surgeons on 4 high-fidelity simulators allowing the students to experience surgical skills.19 This course resulted in twice the number of students selecting the cardiothoracic surgical clerkship. Quite a nice return on investment.

Research from my laboratory has corroborated these findings. We investigated the impact of a brief simulation-based learning experience on 121 PT and occupational therapist (OT) students' interest in pursuing a career in acute care practice (Patricia J. Ohtake, unpublished work). PT and OT student dyads participated in a high-fidelity simulation in which they evaluated and performed a cotreatment for a standardized patient recovering from a total hip replacement. Before the simulation, 21% of students were not interested pursuing a career in acute care practice, 57% were possibly interested, and 21% were very interested. Following the simulation experience, only 4% of students were no longer interested in a career in acute care! This was astounding. Students possibly interested in acute care practice increased to 63% and there were twice as many students who expressed being very interested in acute care practice as a career. This brief acute care simulation-based learning experience led to an overall increase from 21% to 33% of our students being very interested in acute care practice as a career and nearly all of the remaining students being possibly interested. This demonstrates the impact of simulation on career interest and emphasizes how imperative it is that we provide our students with high-quality acute care simulation opportunities to allow them to experience acute care practice in realistic, safe environments.

EXPOSE STUDENTS TO ADVANCED ACUTE CARE ELECTIVE COURSES

For the past 5 years, Emory University has led an advanced acute care practice course that includes simulation and clinical experiences.20 A recent graduate survey revealed that 71% of the acute care course graduates who were working had jobs in acute care practice and 16% of students were pursuing acute and critical care residencies. All of the students felt prepared for their first job, regardless of the setting, and the majority of students felt confident in the acute and critical care practice areas.

EXPOSE STUDENTS TO ACUTE CARE CLINICAL PRACTICE

The acute care clinical setting is another significant exposure opportunity for our students to develop an interest in acute care practice and be influenced by high-quality role models. Due to the decreased availability of acute care clinical experience sites, PT and PTA education programs are changing their requirements from an acute care experience to any inpatient experience. I encourage all acute care clinicians to be willing to take students on a regular basis. You may need to examine alternative strategies such as using 2:1 models,21 using an integrated faculty practice model,22 and using an interprofessional model.23 Dr Heidi Engel, ICU PT at University of California–San Francisco Hospital, described how exposure to the multifaceted learning that occurs for students in the ICU is formative and engaging when she stated, “In the ICU, this work is an extraordinary opportunity for students to learn complex medicine and to create or facilitate a collaborative culture that working with critically ill patients requires” (Heidi Engel, personal communication).

EXPOSE STUDENTS TO APPROPRIATE COMMUNICATION STRATEGIES

Communication and feedback are the other areas to pay close attention to in the education of Generation Z. While Generation Z has considerable experience engaging in electronic communication, they may lack robust in-person communication skills.14 These learners respect and seek immediate and frequent feedback and prefer that it is provided in the moment, and they lack tolerance for delays.9 And, as I'm sure many of you have noticed, Generation Z students are eager to provide feedback to faculty and clinical instructors.12

Generation Z is used to having information immediately available and they may struggle with boundaries regarding access to faculty and clinical instructors and in situations where they need to wait for a response. These students expect to be mentored and they expect faculty to be available 24/7.9,14 Dr Jennifer Sharp, assistant professor at Emory University, shared the importance of good communication skills and setting boundaries when she stated, “On the part of the Clinical Instructor, expectations need to be set at the start of the clinical experience, for both the students and the CI. These expectations should include engaging in open communication, understanding of learning style, and preferred feedback method” (Jennifer Sharp, personal communication). From these comments, one can appreciate that Generation Z performs best when they have a positive mentoring relationship with clearly delineated expectations and boundaries.

EXPOSE STUDENTS TO EXCEPTIONAL POSITIVE ROLE MODELS

The influence and characteristics of role models is the next exposure opportunity I'd like to discuss. The 2019 AAMC Graduation Questionnaire reported that 81% of medical students stated that a positive role model was a strong influence when selecting their residency practice area.24 Other evidence tells us that the 3 main outcomes of positive role modeling are development of professional behaviors, development of professional identity, and career choice.25 Yes, career choice!

What are the key characteristics of exceptional health professions role models? They are personality, clinical skills, and teaching ability.26 The personality attributes demonstrated by exceptional role models are positive attitudes toward students, compassion for patients and families, integrity and objectivity, and positive interactions with other health care providers. Clinical skill characteristics of exceptional role models include enthusiasm for their work and interactions with patients and families, proficiency as a diagnostician, and awareness of their strengths and weaknesses. The key characteristics valued in the teaching ability of role models are communications skills (especially listening), ability to make difficult topics understood, demonstrating that teaching is exciting and stimulating, and having patience. I'd like to share some of our APTA Acute Care collective wisdom that will amplify these important role model characteristics.

As academic and clinical educators, having thoughtful conversations with our students that demonstrate our compassion for our patients and their families likely resonates with Generation Z's commitment to social justice and equity. As so ardently stated by Dr Jim Smith, Professor at Utica College and Past President of APTA Acute Care, “Academic and clinical instructors who appreciate the magic that is practice in acute care, enlighten students about the dignity of helping a person regain the ability to get out of bed, to walk, to return home. Our characteristic is passion for the people who will benefit the most from physical therapy and our celebration is when we have inspired a student to pursue the honor of practice in acute care” (Jim Smith, personal communication). Clearly, we can see from Dr Smith's observations, we have the potential to inspire our students through each and every interaction we have with them.

When asked to share some thoughts about expert clinical instructors, Dr Daniel Malone, Associate Professor at the University of Colorado and Past-President of the Academy of Cardiovascular and Pulmonary Physical Therapy, corroborated the importance of role models being aware of one's strengths and weaknesses. He stated, “Don't be afraid to say three little words: “I don't know” and “I need help”. These words should be an important part of everyone's clinical practice” (Daniel Malone, personal communication).

Dr Kathy Lee Bishop, Assistant Professor of Physical Therapy at Emory University and coauthor of Acute Care Physical Therapy: A Clinician's Guide27 with Dr Malone, demonstrates her enthusiasm for teaching when she states, “My job is not just to teach, but share my passion why this setting is an exciting, emotional, draining, thought provoking setting in which to practice” (Kathy Lee Bishop, personal communication). Dr Bishop encourages her students to be better clinicians, to integrate and apply their knowledge, and to take an active role as part of a patient-centered care team.

Dr Hallie Zeleznik, Director at University of Pittsburgh Medical Center, Centers for Rehabilitation Services, highlights the importance of teaching self-reflection as a role model. Dr Zeleznik advocates for all clinicians to grow through their own self-reflection and actively teaches this important skill to her students. Dr Zeleznik states, “It's not enough to quietly self-reflect when we are working with students in the clinical setting. Instead, we need to be vocal as we self-reflect – not only so that the students begin to learn and understand our critical thinking process, but also so that they learn the value of reflecting on clinical practice as a way to continually improve our expertise as physical therapists” (Hallie Zeleznik, personal communication).

Role models have the ability to make difficult topics easily understood and to demonstrate that teaching is exciting and stimulating. Christiane Perme, ICU PT at Houston Methodist Hospital, enthusiastically encouraged the members of the Academy to establish the role of physical therapy in the ICU in her 2015 Acute Care Lecture, Solidifying the Future of the Physical Therapy Profession in ICU: The Time Is Now!28 In this lecture, she eloquently assisted us to understand the challenges for clinical practice in the ICU, to recognize the importance of using outcome measures for patients receiving physical therapy, and discussed ways to advance the profession and improve quality of care and functional outcomes.

I'd like to offer one additional example of the power of exposure to a positive role model to pique the interest of our students for acute care practice. A few weeks ago, I received an email from a recent graduate from our program who shared, “I am applying for a position in an inpatient setting because I was really inspired by your work for APTA Acute Care and specifically the lunch we were able to have with Dr. Ellen Hillegass during her visit to UB.” One lunch! That's all it took, and of course exposure to a leader in this practice area, Dr Ellen Hillegass. We need to inspire our students, even if it is one at a time, through our own actions and by exposing them to local and national professional leaders.

As you can appreciate, our collective wisdom shows us that exposure to academic and clinical role models has a significant impact on our students, especially when they are selecting a practice area. I truly believe everyone here tonight has the characteristics of role models and I encourage you to use them at every opportunity.

EXPOSE STUDENTS TO ROBUST INTERPROFESSIONAL EDUCATION

Interprofessional collaboration has been an integral part of acute care practice since its inception. With the formalization of the core competencies for interprofessional collaborative practice set forth by the Interprofessional Education Collaborative (IPEC) in 201129 and updated in 2016,30 IPE is now included in the majority of health professions education programs' accreditation requirements. IPE programs are being established; however, many of these programs lack the rigor to adequately prepare PTs and PTAs for collaborative practice. The majority of interprofessional learning experiences are often limited to on-campus case discussions, with few required interprofessional simulations, and even fewer required interprofessional experiences in clinical settings—the very place where our students will be applying these skills.31

In her 2012 Acute Care Lecture Acuity, Autonomy and the Intelligent Conversation,32 Dr Mary Sinnott highlighted the importance of interprofessional communication and teamwork, 2 of the 4 IPEC core competencies. Dr Sinnott emphasized that “in order to successfully meet the needs of our patients and our organizations, we must establish and maintain – on a daily basis—professional relationships with a myriad of individuals at all levels of the organization ... .” Dr Sinnott emphasized the importance of the PT on the interprofessional team by citing evidence that PT involvement in discharge planning significantly reduces readmission. She went on to underscore the importance of being able “to speak the ‘language' of other professions so that they value our input because it advises their thought process.” These are skills learned through IPE, especially in the clinical setting.

To facilitate the development of robust IPE programs, the Commission on Accreditation in Physical Therapy Education (CAPTE) has endorsed the 2019 Guidance on Developing Quality Interprofessional Education for the Health Professions document developed by the Health Professions Accreditors Collaborative and the National Center for Interprofessional Practice and Education.33 This document provides PT and PTA education programs direction when developing, implementing, and assessing their IPE programs. I encourage all of you to read this document and share it with your IPE leadership.

Although our PT and PTA students likely participate in our institutional IPE programs, we have a responsibility within our acute care academic and clinical education to prepare our students to represent themselves professionally and to advocate for their role on the health care team. As Dr Jennifer Ryan, Assistant Professor at Northwestern University, so clearly stated in her 2014 Acute Care Lecture, Do You Own Your Practice? Owning Your Decisions and Actions,34 “It is the responsibility of the therapist to inform the team of the rationale that drives her decisions and to support her decisions with evidence.” I'm hopeful that all acute care PT and PTA clinicians expose their students to opportunities to gain experience as active members of the interprofessional team.

EXPOSE STUDENTS TO APTA ACUTE CARE

This is the last exposure opportunity I'd like to share with you this evening. I'd be remiss if I did not first acknowledge the great work of James Dunleavy, first President of APTA Acute Care, who gave the first Acute Care Lecture, Acute Care: Our Profession's Foundation and Its Future.35 Jim led the formation of the Academy to ensure PTs and PTAs in acute care practice have a defined place in our professional association and to feel they are valued by their colleagues. The Academy gives acute care practice a defined voice in the APTA and a mechanism to advance our clinical practice.

As we have seen throughout this evening, exposure creates interest. I encourage the APTA Acute Care Board of Directors to consider developing more opportunities for students for participation and prominence in our organization. These opportunities could potentially include having student representation on all of our committees and developing a student focus group. As we have seen tonight, the power of positive role models is significant, and I encourage those of us in leadership positions to be role models to both our students and our membership. In his 2019 Acute Care Lecture, The Praxis of Physical Therapy,36 Dr Jim Smith promoted the importance of a career in which we advocate the value of physical therapy to our patients, physical therapy colleagues, institutions, state legislators, and society. Engagement with the Academy can provide our PT and PTA students with the knowledge, skills, and role models to grow in advocacy, professional service, and association governance.

In conclusion, I'm hopeful that, by sharing a sampling of APTA Acute Care's collective wisdom with you this evening, I have been able to convince you of the incredible influence of exposure and have inspired you to expose your PT and PTA students to high-quality course content and effective, enthusiastic academic and clinical instructors and learning experiences that align with our Generation Z learners' preferences. These will all serve to excite our students to choose acute care physical therapy practice.

Our collective wisdom was also emphatic about the importance of positive role models—these are the superheroes residing in us—and I encourage all of you to unleash your power to be a positive role model for all your students to see.

As we move forward in these endeavors, we need all of our APTA Acute Care members to share their wisdom so we can capitalize on our collective wisdom to prepare a future for acute care physical therapy practice.

I'm grateful for my colleagues who embrace acute care physical therapy and for the physical therapy students at the University at Buffalo who inspire me to expose them to the best education I can provide and to be a positive role model for them. Thank you all for the opportunity to share these thoughts with you this evening.

Patricia J. Ohtake, PT, PhD, FNAP
Assistant Vice President for Interprofessional Education,
Associate Professor, Physical Therapy Program,
University at Buffalo, Buffalo, New York

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