Defining Core Faculty for Physical Therapist Education

Abstract

Background and Purpose. 

With the rapid transition in professional (entrylevel) educational preparation from the master's degree to the doctoral degree in physical therapist education, the need for doctorally trained faculty is likely to increase substantially. Several different doctoral degrees that may meet the academic qualifications expected of core faculty members currently are offered; however, these doctoral degrees vary widely in their educational focus, rigor, and philosophy. Such differences in doctoral preparation, combined with faculty shortages, have increased the debate over the necessary academic qualifications for people who serve as core faculty members in physical therapist education programs. The purpose of this article is to suggest that the ideal faculty team in professional physical therapist education should include a balance of people possessing terminal academic degrees in physical therapy or a closely related field, people possessing terminal professional clinical degrees with documented clinical specialization, and people possessing terminal academic degrees in foundational sciences with or without physical therapy degrees.

Position and Rationale. 

A diverse core faculty with a balance of academic training in complementary fields will benefit an education program in many ways, such as providing breadth of expertise, serving to maintain academic standards in doctoral education, and meeting requirements established by accrediting agencies and home institutions.

Discussion and Conclusion. 

For programs providing professional physical therapist education, a variety of doctorally prepared people should be actively recruited for core faculty positions. Once hired, these faculty members should be vigorously supported and mentored so as to ensure their success in meeting the faculty expectations established by their academic institutions and pertinent accrediting bodies.

BACKGROUND AND PURPOSE

At present, there are shortages of faculty in physical therapist education.¹ This problem may be compounded by the transition to the Doctor of Physical Therapy (DPT) as the accepted professional credential. With such a transition, the need for core faculty members to be doctorally trained is likely to be substantially increased because of the need to satisfy both institutional and accreditation standards requiring that recipients of doctoral degrees be trained by doctorally prepared faculty. Determining how best to meet this need for doctorally prepared faculty has been complicated by several questions and is likely to be clouded by credentialing debates.

Is it suitable for a core faculty member to hold any doctoral degree, or is a particular doctoral degree more appropriate? Does clinical expertise substitute for a doctoral degree, or can it be combined with a professional degree or a clinical doctoral degree to meet the expectations for core faculty members? One may begin answering these questions by considering the requirements necessary to be a core faculty member in physical therapist education. These are questions that must be viewed from several perspectives, including accreditation standards, meeting institutional tenure and promotion criteria, and educational and clinical perspectives.

POSITION

With regard to the qualifications expected of core faculty members in a DPT program, we consider the following notions: optimal matching of doctoral training with the chosen type of scholarly pursuits increases the likelihood of success for both the academic program and core faculty members, the ideal faculty team should include a balance of people possessing earned terminal academic degrees and terminal professional degrees with demonstrated clinical expertise, and the faculty should include a small number of members who possess a terminal academic degree in a foundational science and who may or may not possess a physical therapy degree. In an effort to justify our position, the specific aims of this article are to describe the various doctoral degrees that would best meet the requirements for doctoral preparation in the context of physical therapist education and to discuss how diverse doctoral preparation could best meet the goals of an education program.

RATIONALE

Faculty Shortage

Statistics recently released by the American Physical Therapy Association (APTA)¹ indicated that 1,921 graduates of professional physical therapist education programs received a DPT in 2004. This number is projected to increase to over 5,000 doctoral graduates by 2008 on the basis of current trends.¹ Physical therapist education has been strained further because approximately 10,000 physical therapists have successfully completed transitional DPT programs.¹ Against this background of increasing student numbers, APTA has reported that 130 core faculty positions currently are unfilled and that 62 additional positions are expected to be created. Given that there are 1,883 total full-time core faculty positions in all currently accredited physical therapist education programs, these data equate to a current vacancy rate of nearly 7%, and the rate is projected to climb to as high as 14% with the anticipated expansion of DPT programs.¹ This situation may worsen because 41% of current core faculty members are presently 50 years of age or older.¹ Collectively, these data suggest that finding new faculty and replacing retiring faculty with doctorally trained people may be difficult.

QUALIFICATIONS EXPECTED OF FACULTY

In an effort to fill core faculty vacancies, it seems reasonable to ask, “What qualifications are expected of faculty?” A review of advertisements for available core faculty positions suggests that a very broad spectrum of experience, scholarship, and academic credentialing is being sought. When viewing list-serves announcing available core faculty positions in doctoral programs, one is likely to see qualification descriptors such as “doctorally prepared,” “possessing an earned terminal degree,” and “recognized specialization in the area of expertise.” These broad descriptors suggest that nonspecific advertisement language may be necessary to attract an adequate applicant pool in the hope that a specific criterion for the position may be met by a particular applicant.

The need for faculty with doctoral training was recognized as early as 1989 by Soderburg,² who suggested that clinicians desiring a career in physical therapist education should pursue terminal degrees at the level of the Doctor of Philosophy (PhD), the Doctor of Education (EdD), or the Doctor of Science (DSc or ScD). The impending complete transition to a doctoral degree at entry into the profession brings more urgency to Soderburg's proposal. The immediacy of discussion involving approaching faculty shortage issues is further supported by 2 specific goals of the APTA Education Strategic Plan (2006-2020): “Develop strategies to address physical therapy faculty supply and demand,”³ and “Develop leaders in physical therapy academic and clinical education and research with established roles and influence in prominent national and international agencies.”³

Despite Soderburg's suggestion regarding doctoral preparation, such an absolute requirement does not exist. The Commission on Accreditation in Physical Therapy Education (CAPTE) recognizes that each physical therapist education program must have a core faculty to meet accreditation requirements but does not explicitly define a core faculty member as one who has doctoral training.⁴ However, CAPTE standards do require that core faculty members demonstrate “contemporary expertise in assigned teaching areas.”⁴ Such expertise can be demonstrated by educational endeavors, including formal academic work, residency, and continuing education, by scholarship, including presentations and publications, and by consultation and service related to teaching areas.⁴ This requirement suggests that the possession of a doctorate may be an implicit expectation of accreditation.

Supporting this notion is the professional education model, first proposed for medicine by the Flexner Report but consistently applied to a variety of professions, including physical therapy.⁵ This report defines education expertise as involving academic knowledge, analytical reasoning, and research.⁵ In physical therapist education, these characteristics of expertise are perhaps best represented by the foundational and clinical sciences. Because this model emphasizes academic knowledge and research activities, it can be argued that expertise is best represented by a recognized terminal academic degree that focuses on both academic training and research training, such as the PhD. Skill-based learning (psychomotor and intellectual), the second component of this model, allows for the application of foundational knowledge to the treatment of patients. The third component focuses on affective traits related to ethical behavior and to social roles and responsibilities that define the profession to the public. These latter 2 components would appear to demand clinical experience on the part of the faculty member, lending credibility to clinical expertise being a highly desired trait.

Although accreditation standards are not explicit regarding the need for doctoral training within the core faculty, 2 arguments can be made suggesting that such a requirement may be advantageous to faculty members and to the program. First, CAPTE standards require that core faculty members actively engage in scholarly activities and have a scholarly agenda.⁴ Participation in these activities requires specialized training, like that in doctoral training, as demonstrated by the amount of curriculum time dealing with statistics and experimental design. Dissertations and other research-oriented projects reflect the practical applications of these skills. It can be argued that developing the intellectual thought processes and research skills required to participate in scholarly activities can be self-taught and implemented without formal doctoral training. However, we contend that people within the physical therapy profession or other professions who have successfully accomplished this feat are the exception to the rule. This presumption has been validated by authors in the academic environment for medicine^6,7 describing the reduced likelihood of faculty development, particularly in the arena of scholarly productivity, while people are attending to clinical and faculty demands. The mere possession of a doctoral degree strongly suggests that an individual has acquired at least some research skills and can meet CAPTE standards.

It is important to note that core faculty in a tenure-track position also must meet institutional standards of scholarship in order to remain in their academic positions. These requirements may not be the same as those defined by CAPTE or other accrediting agencies. However, CAPTE recognizes that a strong record of scholarly accomplishments increases the likelihood that a core faculty member will be successful in maintaining institutional standards of scholarship and ultimately achieving tenure⁴ and recognizes that senior tenured faculty members contribute significantly to the stability and ongoing successes of physical therapist education programs.⁴ Faculty members who enter a core faculty position with a doctorate may be better positioned to achieve tenure than faculty members who must acquire research skills while fulfilling other faculty duties. The concept of “on-the-job training” in scholarship is unlikely to prepare one for success in meeting current scholarly expectations, amiably christened the “publish or perish” ethic.⁸

Many academic institutions have recognized that clinical teaching and scholarly endeavors are independent undertakings requiring different skill sets.⁹ For this reason, clinical faculty members at the instructor or assistant professor level often are placed in non-tenure-track positions. This practice insulates them from the scholarship requirements of the tenure process but denies them the inherent protections of tenure. However, if they are core faculty members, they still must meet the scholarship requirements established by CAPTE.

An understanding of scholarship seems to be necessary and useful in order to link doctoral education with scholarship and CAPTE expectations for successful core faculty.⁴ We agree with Jules Rothstein, who stated clearly that scholarship is not synonymous with research.¹⁰ Rather, as he explained, “scholarship is far more encompassing” than research and therefore is better described as being able to add to the profession's body of knowledge. Importantly, he argued that all academic physical therapists, including clinical faculty members, should be expected to generate scholarship. He separated scholarship from research because, like CAPTE, he embraced the broad definition of scholarship proposed by Boyer in 1990.¹¹ Specifically, this definition recognizes that scholarship has 4 separate but overlapping components: discovery, integration, application, and teaching. This broad definition recognizes that scholarship involves more than simply the generation of new knowledge. It recognizes that new knowledge must be integrated, applied, and taught to be fully brought into the body of knowledge.¹⁰

The scholarship of discovery involves the addition of new knowledge and understanding to the body of knowledge, the classic definition of research. Such scholarship involves a rigorous process of discovery through accurate observations, testable hypotheses, well-designed and carefully controlled experiments, and conclusions drawn from reasonable data analysis. Work by Woollacott et al¹² on basic mechanisms that contribute to postural responses in older adults and work by Nashner et al,¹³ who identified defects in the ability of children with cerebral palsy to maintain stance, exemplify the scholarship of discovery. Both groups developed mechanistic knowledge of basic physiological processes that contributed to the understanding of how physical therapy interventions work clinically.

Given the proliferation of medical information over the past 2 decades, Boyer¹¹ argued that scholarship can involve critical analysis and review of already existing knowledge drawn from within a discipline or can involve the synthesis of information drawn from a variety of disciplines. Such information often is presented in the form of literature reviews and meta-analyses. The scholarship of integration is well represented by the December 1993 themed issue of Physical Therapy, particularly in the interesting work of Lieber and Bodine-Fowler,¹⁴ which focused on the properties of basic skeletal muscle and how these properties influence and explain the principles and practice of rehabilitation.

As a service-oriented, practical science, much of physical therapy research is focused appropriately on the scholarship of application rather than discovery or integration. The purposes of application research are to connect theoretical constructs and new information to clinical practice and to facilitate the transfer of new information (discovery) or new theory (integration) to the clinic, where such scholarly endeavors can benefit patients directly. Shaffer and Harrison¹⁵ provided an example of this type of scholarship with the application of compensatory strategies during functional activities.

Finally, Boyer¹¹ recognized that investigations into teaching and learning also constitute scholarship. This type of scholarship involves constructs such as classroom assessment, current methods of teaching in the field, and inquiry and investigation centered on student learning. The primary focus of this type of scholarship may involve the classroom and is not confined to the research or clinical laboratory as the primary site of data collection. Warren and Pierson¹⁶ studied differences in the characteristics and attitudes of students in professional bachelor's and master's degree physical therapist education programs and then used these findings to modify the core curriculum. This work exemplifies the scholarship of teaching. Success in this area of scholarship implies a broad understanding of both content and optimal mechanisms for conveying this content to students so as to inspire independent exploration.

Types of Doctoral Degrees

At present, several different doctoral degrees are held by core faculty in physical therapist education programs; these include the PhD, the EdD, and the DSc or ScD. Each of these degrees has been viewed as being a terminal academic degree.¹⁷ The PhD is universally recognized as a terminal academic degree that is awarded after the completion of extensive academic work in a particular field of study involving extensive research activities.¹⁸ Although this degree is awarded primarily in purely academic programs, several physical therapist education programs offer a PhD in physical therapy, making such a degree a terminal academic research doctorate. We suggest that a PhD best prepares an individual to engage in the scholarship of discovery because this degree focuses on research.

The EdD is a professional doctorate that prepares students for specialized positions in the education sector.¹⁸ This degree, which is typically offered by schools of education, can be either research based or professionally based and tends to place less emphasis on research during training than does the PhD.¹⁸ The EdD is considered the equivalent of the PhD by the US Department of Education,¹⁹ but the National Science Foundation sometimes considers the EdD a nonresearch doctorate and sometimes considers it a research doctorate, depending on the situation.¹⁷ We suggest that an EdD best prepares an individual to engage in the scholarship of teaching because this degree is based in schools of education.

The DSc, ScD, or DSc in Physical Therapy is another doctoral degree sometimes held by core faculty members. This degree, which is rarer than the EdD and PhD, is earned with the approval of a committee on the basis of original research, publications, and extensive applied professional contributions.¹⁸ Although this degree is awarded predominantly in doctorate-level science and technology programs, such as engineering, information systems, and public health sciences, this degree recently began to be offered in physical therapy and occupational therapy. Like the EdD, this degree is not viewed consistently as a research doctorate,^17,19 but because the training focus typically is linked to clinical studies in medicine, physical therapy, and occupational therapy, we suggest that such a degree best prepares the holder to engage in investigations in the scholarship of application.

Finally, the physical therapy profession is moving toward the DPT, the professional degree increasingly being offered by physical therapist education programs.¹ The DPT is not considered a research doctorate; rather, it is viewed as a professional clinical doctorate or first professional degree. Other examples of a professional clinical doctorate or first professional degree include the Doctor of Pharmacy, the Doctor of Clinical Psychology, the Doctor of Chiropractic, and the Doctor of Podiatry.² Alone, the DPT does not suggest postprofessional training in either research or clinical practice and does not qualify the holder to be a core faculty member.⁴ This status requires that the holder of a DPT demonstrate evidence of additional clinical experience, specialty expertise, or advanced training in a specific content area. Given that the professional DPT is a relatively new degree, these additional requirements make it unlikely that most holders of a DPT can function and succeed as core faculty members as described by CAPTE.

The status of people who have earned a transitional DPT is a bit more ambiguous. The transitional DPT program is a degree program designed for licensed practitioners who have had a traditional physical therapist education below the doctoral level. This program builds on the skills, knowledge, and experience of practicing clinicians and bestows the DPT on its graduates. It does not signify advanced preparation or specialization and, as such, does not provide the qualifications expected of core faculty. As with the DPT, additional credentials, such as focused clinical experience or advanced certification, would be needed by a holder of a transitional DPT to serve as a core faculty member.

Strategies for Filling Vacancies

The ideal core faculty member would fulfill the requirements first proposed by the Flexner Report, as described by Sullivan.⁵ This faculty member would possess all 3 components of professional expertise: academic (foundational) knowledge, analytical reasoning, and research experience; skillbased learning, that is, the application of foundational knowledge to the practice of physical therapy; and professional behavioral traits consistent with the ethics and social roles of physical therapy. In terms of academic credentials, these components would imply the possession of an academic doctorate (PhD, EdD or, perhaps, ScD) in 1 or more of the foundational sciences or the possession of a first professional physical therapy degree (DPT or transitional DPT) combined with extensive clinical experience, specialization certification, research experience, or several of these. This ideal may be unrealistic, particularly given current and potential future faculty shortages. Therefore, we propose that the ideal faculty team should include a balance of people possessing earned terminal academic degrees in physical therapy or a closely related field, people possessing terminal professional degrees, and perhaps even a few people who do not possess physical therapy degrees but who possess terminal academic degrees in foundational sciences.

In an effort to bridge the ideal situation with the reality of education today, we suggest that a candidate's doctoral training be carefully matched to his or her anticipated scholarly pursuits and expectations. Faculty members whose responsibilities focus primarily on the discovery of new knowledge should possess a terminal academic degree related to their area of research. Typically, this degree would be a PhD, although a DSc or ScD with rigorous research requirements and an extensive publication record might be acceptable, as described by the National Science Foundation in the definition of earned research doctoral degree programs.¹⁷ However, it is important to note that faculty members possessing a PhD have enjoyed much greater success at generating funding through federal avenues than have those without this earned terminal academic degree.^20-22 This fact would lend credibility to the argument for recruiting people with a terminal academic degree to increase the likelihood that the educational institution could benefit from these types of funding opportunities.

The National Institutes of Health pathway of discovery²³ addresses the need for innovative research that integrates knowledge gained from various disciplines.

Physical therapist education programs with strong ties to basic science researchers are in an excellent position to benefit from federal grant funding opportunities. There are undoubtedly people without terminal degrees in the physical therapy profession who have successfully developed strong ties with the basic scientists at their institutions. However, the possession of a terminal academic degree, particularly a PhD, is arguably the easiest means for gaining respect among basic scientists. The possession of such a terminal degree ensures researchers from other disciplines that the physical therapist has developed the research skills and thought processes necessary to be a productive member of the team. Therefore, faculty members who engage in such collaborative affairs may be most successful at working in the scholarship of integration.

Conversely, a research scientist who holds a PhD may not be the best choice for the transfer of clinical information or theoretical constructs of patient care to students in physical therapist education programs. The scholarship of application occurs constantly in the clinical practice of physical therapy and in the educational realm of the professional therapist. In this situation, the research expertise and, particularly, the clinical expertise of the faculty member are demonstrated by clinically oriented scholarship and education. According to Bedard and Chi,²⁴ a prerequisite to expertise is a large, organized body of knowledge specific to the content area. One could argue that the successful completion of the academic rigors of a physical therapist education curriculum, successful performance on the state licensing examination, and attainment of a license to practice are adequate affirmations of content knowledge for becoming a core faculty member in a physical therapist education program. However, the DPT, which reflects these accomplishments, simply demonstrates the acquisition of professional preparation leading to independent practice. We suggest that an individual possessing a DPT must achieve a higher educational standard, such as the successful completion of American Board of Physical Therapy Specialties²⁵ specialization certification, as suggested by CAPTE.⁴ The eligibility requirement of 2,000 hours of clinical practice in the specialty area, with 500 hours within the preceding 3 years, enables the individual to acquire the clinical experience essential to achieving expertise, as suggested by Ericsson and Lehmann.²⁶ This tenet of expertise was further supported by Jensen et al,²⁷ who found clinical expertise to be an evolving skill requiring continued reflection on basic knowledge integrated through practice. Therefore, with the pursuit of focused course work, a research-oriented postprofessional degree, or both, an individual possessing a DPT could be viewed as an acceptable core faculty member, provided that the individual also meets the standards of expertise. This premise is supported wholly by CAPTE.⁴

As clinicians extrapolate and apply information gained from the literature or from attending continuing education courses, the effectiveness of new interventions must be evaluated through controlled trials, when feasible. Publishing the results of clinical trials and even publishing peer-reviewed case studies meet the definition of the scholarship of application according to CAPTE.⁴ It is clear that a terminal academic degree with a strong research component would be useful in clinical research but probably not necessary. Current professional doctoral degree physical therapist education content for scientific inquiry appears to be minimally adequate to prepare an individual with a DPT to complete clinical research or to produce a case study description, if the individual has the above-described additional credentials. It would be particularly helpful in ensuring success for such a faculty member to be mentored by an experienced faculty member.⁶

Expertise in pedagogical methods is essential if one is to teach effectively,²⁸ but subject content expertise is equally important.^24,26 It is often difficult for an inexperienced, junior faculty member to achieve content expertise. It is obvious that the large, organized body of knowledge specific to the content area will vary according to the subject considered. For junior faculty members tasked to teach foundational sciences, such as anatomy or physiology, mastery of content area is probably best represented by the completion of a terminal academic degree in or related to the content area. To increase the likelihood of success for these faculty members in the teaching arena, mentoring by faculty members with teaching experience and demonstrated expertise would be beneficial. For junior faculty members tasked to teach clinical sciences, such as neuromuscular or musculoskeletal sciences, or patient and client management, such as screening or examination, mastery of content area may be better represented through the rewarding of American Board of Physical Therapy Specialties specialization certification if a certification related to the content area is provided. These faculty members also could benefit from mentoring by senior faculty members in pedagogical methods.

We suggest that all parties involved in the institutional process of physical therapist education also could benefit from the diversity of a faculty member whose expertise involves the science of teaching and learning. This very specialized skill of pedagogy could be represented by a core faculty member or adjunct possessing a terminal academic degree (PhD, EdD, or ScD) in a field such as cognitive psychology, educational psychology, or education.

Concerns Associated With Multiagency Accreditation

When reviewing potential candidates for any core faculty vacancy, one also must be cognizant that institutions often seek accreditation from more than 1 accrediting agency. These accrediting agencies may have somewhat different requirements for core faculty members. An example of such a situation is an institution that is accredited by a regional agency, such as the Southern Association of Colleges and Schools, and by another accrediting agency. For example, the Southern Association of Colleges and Schools requires that any core faculty member teaching at the graduate or postbaccalaureate level must hold an earned doctorate or terminal degree in that teaching discipline or a closely related discipline.²⁹ In contrast, CAPTE does not require such a link between the focus of doctoral education and the faculty member's teaching discipline. These contrasting standards may cause conflict when accreditation is sought from more than 1 accrediting agency. The mention of the in-depth issue of accreditation is provided only to allow the reader the opportunity to recognize the many complexities involved in assembling a core faculty that meets all applicable accreditation standards.

CONCLUSION

The ideal core physical therapy faculty should not be entirely academically minded or entirely clinically focused and should not be entirely composed of people with professional degrees at entry into the profession, or people who are novices in terms of clinical experience. Rather, the ideal faculty team should include a balance of people possessing earned terminal academic degrees in physical therapy or a closely related field, people possessing terminal professional degrees, and perhaps even a few people who do not possess physical therapy degrees but who possess terminal academic degrees in foundational sciences. Programs providing professional physical therapist education should actively recruit a variety of doctorally prepared people for core faculty positions. Once hired, these members should be vigorously supported and mentored so as to ensure their success in meeting the faculty expectations established by their academic institutions and pertinent accrediting bodies. Success may be further ensured if the anticipated or expected type of faculty scholarship is best matched to an individual's particular doctoral preparation.

ACKNOWLEDGEMENTS

We thank Annette Richardson and Joel Williamson Jr for their contributions in the editing of this manuscript.