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FORUM

ACAPT First Annual Geneva R. Johnson Innovations in Physical Therapy Education Forum: Doctor of Physical Therapy (DPT): So What? Now What? Educating DPTs as Leaders to Meet Future Societal Needs

Tschoepe, Barbara PT, PhD; Davis, Carol PT, DPT, EdD, MS, FAPTA

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Journal of Physical Therapy Education: Volume 29 - Issue 2 - p 84-87
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INTRODUCTION

The American Council of Academic Physical Therapy (ACAPT) is a component of the American Physical Therapy Association (APTA) and represents the institutions that provide physical therapist (PT) education. The purpose of ACAPT is to advance the enterprise of academic physical therapy by promoting the highest standards of excellence. For the purposes of ACAPT and its activities, academic physical therapy includes all aspects of PT education, including clinical education and post-professional education. ACAPT has a leadership role in establishing the direction of PT education and has the responsibility and accountability to duly reflect the interests and needs of the academic and clinical PT educational community.

Critical to advancing the ACAPT vision, the ACAPT Board of Directors explored opportunities in 2013 to develop a think tank of sorts, where we could bring together multiple stakeholders in a safe environment to incubate ideas, encourage dialogue and intellectual discourse, and set the stage for action to positively impact the future of PT education. The Forum idea, held in conjunction with the Educational Leadership Conference, was thus born. It was named in honor of Dr Geneva R. Johnson, who for over 60 years has served as an extraordinary leader in physical therapy education. As was stated at the Forum, Dr Johnson began her physical therapy career in the United States (US) Army. As she developed her clinical skills, she also developed a profound sense of the importance of education for practice. She used her skill and vision to found the first graduate program in physical therapy at Case Western Reserve University in 1960. In her subsequent years as a physical therapy educator, she has taken the lead in residency education, interprofessional education, interprofessional practice, advocacy, and mentorship. Figure 1 is a graphic representation of all the things that Dr Johnson has meant to her colleagues in physical therapy.

Figure 1. Graphic Representation of Geneva R. Johnson's Invaluable Characteristics That Propel the Profession of Physical Therapy
Figure 1. Graphic Representation of Geneva R. Johnson's Invaluable Characteristics That Propel the Profession of Physical Therapy

Thousands of students, faculty, and clinicians have benefited from Dr Johnson's insightful tutelage and her continual encouragement. She has tirelessly focused on educating and inspiring educational leaders who can clearly articulate a vision for our professional future and who are willing to take risks to achieve that vision. She continues to be a true visionary and inspires those around her to focus on the possibilities rather than on barriers. Dr Johnson has led the way with countless innovations in physical therapy education, including developing the first PT graduate program. She is a fitting namesake for the ongoing discussion of innovation in physical therapy education.

The Forum will be presented annually with the goals of:

  • Creating a safe environment for key stakeholders in physical therapy education to discuss the infinite possibilities of the future, rather than focusing on problems.
  • To encourage vision, innovation, creativity, and provocative new ideas that can positively influence the future of physical therapy education.
  • To challenge educators to proactively move physical therapy education forward instead of reacting to societal and professional needs.

FORUM ORGANIZATION AND STRUCTURE

After a presentation on Geneva R. Johnson, the Forum began with a keynote by a leading educator outside of physical therapy, followed by 3 short talks by PT educators designed to apply the keynote concepts to physical therapy. The last portion of the Forum consisted of development of new possibilities using the Appreciative Inquiry approach.1,2 Appreciative Inquiry is a way of thinking, seeing, and acting for powerful, purposeful change in organizations and has been found to be particularly useful in systems being overwhelmed by a constant demand for change, like that of physical therapy education. Appreciative Inquiry approaches change by assuming that whatever you want more of already exists in the organization, and that learning from best practices leads to new innovations.

FORUM HIGHLIGHTS

Keynote Speaker

Dr Lynn Gangone, PhD, began the Forum by offering a provocative keynote speech entitled, “The Zen of Higher Education.” A nationally known writer and speaker on gender equality, educational equity, and leadership development for women in higher education, Dr Gangone currently is the academic dean and clinical professor of the Colorado Women's College at the University of Denver. She is known in the physical therapy academic community for her role as a content expert faculty member in the Education Leadership Institute (ELI) fellowship program. Her experience leading an association representing private universities and colleges, her multiple successes in helping to save failing educational institutions, and her scholarly work exploring the indicators of decline and vulnerability in higher education set the stage for her keynote. As a higher education administrator, Dr Gangone shared her external perspectives on the future of higher education and its potential impact on physical therapy education.

Gangone emphasized that change isn't coming, but that it is here, and she encouraged participants to be prepared to lead and navigate such change. She identified 6 themes impacting higher education today: (1) a volatile economic environment; (2) changing student demographics; (3) increased competition and global forces impacting higher education; (4) technological innovations making knowledge ubiquitous; (5) governmental policies lessening funding support for higher education; and (6) antiquated educational practices being held onto by programs and faculty. She encouraged the need for disruptive innovation to redefine core functions of higher education as they relate to education, research, and scholarship.

Dr Gangone challenged participants to take the initiative to chart our future path and to take advantage of new opportunities while being sensitive to barriers that may question sustainability of some of our current PT educational practices. She encouraged us to strengthen professional depth needed for a doctoring profession while focusing greater attention on the breadth of understanding of larger, unsettling times facing higher education. Doing so will help effectively navigate within a changing world of higher education and health care. She concluded that no program, school, college, institute, or university could remain status quo and survive.

Questions she posed included the following: Are we ready to innovate, to be tempered radicals, willing to take risks and make bold changes in professional education of the PT to stay ahead of the curve while successfully navigating within the university? How might we lead in facilitating needed changes to improve growth and viability of our educational institutions?

She then encouraged each of us to continue to pursue personal growth in leadership development to strategically move our education agendas forward. She was optimistic that our profession can lead the way to a new, more efficient, flexible, dynamic model of education delivery that produces graduates with outstanding outcomes while simultaneously promoting the viability of higher education into the future.

Ignite Speakers

The keynote was followed by 5-minute “Ignite” talks by 3 known leaders within the profession whose task was to present a personal perspective of an idea that could positively impact the future of PT education. Named purposely to ignite emotion, energy, and spirited conversation of the participants, the speakers were asked to challenge the traditional thought of how PT education should take place, and offer alternative innovative ideas that stretch our minds and foster creativity while simultaneously considering the evidence that illustrates best practices in teaching/learning.

First “Ignite” Talk. Dr Karen Abraham, PT, PhD, OCS, director and an associate professor of the Division of Physical Therapy at Shenandoah University, discussed competency-based education (CBE) as a new model for physical education. Competency-based models are being used in both undergraduate and graduate medical education in the US and abroad. CBE deemphasizes seat-time and allows students to progress as they demonstrate mastery of content/skills. The expected outcomes (competencies) of the graduate are clearly defined, with relevant learning opportunities provided that allow for competency achievement. Key to the success of a CBE model is regular and ongoing assessment of the competencies along with appropriate feedback to facilitate expected development. To move to a complete CBE model as a profession would require significant shifts in our educational models and likely take years to implement. However, there may be some initial steps that will encourage standardization that we need across professional preparation programs while allowing for the program flexibility that is desired by many. As we define best models/practices for clinical education, it would seem that defining the competencies necessary to achieve professional practice would a good place to start.

Second “Ignite” Talk. Dr Jennifer E. Green-Wilson, PT, EdD, MBA, the principal of the Institute for Business Literacy and Leadership, discussed the concept of leadership versus professionalism. She posed the possibility of redefining “professionalism” as “leadership.” Currently, we talk about professional roles, professional behaviors, professionalism, and professionalism issues. These are nouns and adjectives. Instead, to lead is a verb, indicating action. Our new vision for the profession of physical therapy calls for us to transform society. This requires action and for us to lead the transformational change. Are we preparing our graduates to fully achieve their roles as a doctoring professional or are we preparing them to merely be good clinicians? What if we integrate leadership, not professionalism, into our curricula so that we emphasize more non-clinical content skills? What would we achieve? We might develop strong professionals with a better balance of role identification, comfortable with collaboration, and capable of assuming multiple roles in the health care system, including leadership roles as appropriate in interprofessional health teams. We might develop PTs who have the broad mindset to actually help us as a profession, transforming society to improve the human experience. We would develop professionals who know how to implement change that is critical to our professional viability in the future. We need to make leadership development explicit and intentional in all professional education programs. Imagine the possibilities.

Third “Ignite” Talk. Dr Terry Nordstrom, PT, EdD, FNAP, assistant academic vice-president and associate professor at Samuel Merritt University, discussed the idea of adopting the movement system as our education foundation framework. In 2013, APTA's House of Delegates adopted a vision for the profession that reads, “Transforming society by optimizing movement to improve the human experience.” Subsequently, APTA adopted the following definition as a means to help guide the profession towards achieving its vision: “The human movement system comprises the anatomic structures and physiologic functions that interact to move the body or its component parts.” The vision and definition of the movement system provide the basis for what should be a universally accepted framework for professional physical therapy curricula. Adopting this framework has several important implications. It is essential that the curriculum prepare practitioners who are capable of an exquisite examination and analysis of human movement that is both specific (the parts) and holistic (the whole), and that integrates nonlinear approaches in the examination and management of movement system disorders. Given that the type of thinking required for practice is nonlinear, with the flexibility to integrate the parts with the whole, it follows that the approaches to teaching and learning ought to be founded on those same concepts. The faculty would limit linear, stepwise approaches to teaching and learning in favor of integrative, nonlinear, complexity learning.

Café Style Table Discussions

Café style round table discussions led by 24 trained table facilitators guided over 250 participants to explore innovative ideas that can positively advance PT education in the future. Participants were able to join discussions on 2 different topics during this session and each table shared their ideas during large group reports. The principles of Appreciative Inquiry were followed throughout. Table facilitators played a key role in encouraging the group to embrace paradigm shifts and explore topics in greater detail. The topics discussed by the participants were:

  • Competency-based education (CBE) training versus education
  • Flipping educational priorities: educating for explicit and intentional leadership versus professionalism as we know it
  • Movement system: educating in a nonlinear manner
  • Educating community health PTs
  • Challenge of high cost of DPT education
  • Confident-centered presence of the PT in the presence of turmoil
  • Educating primary care PTs in unsettling times
  • How to cooperate for clinical education opportunities
  • Building bridges between academic and clinical education faculty
  • Turning competition into collaboration
  • The mile-high view for addressing unsettling times in health care
  • Welcoming the new demographic into PT education
  • The mile-high view for addressing unsettling times in higher education
  • Balancing professional identity with collaboration readiness
  • Experiencing leadership from wherever you are
  • Facilitating compassion of self that fosters interprofessional collaboration
  • Curriculum: how do we fill the jar differently?

Highlights of ideas and recommendations of the groups as they answered the question, ‘What if?” can be found at www.acapt.org.

CONCLUSION

Now our work begins, as ideas of the Forum have set the stage for subsequent action at institutional, consortia, or member levels. We hope that collaborations can be designed to further study the implications of such ideas and look forward to exploring how these creative ideas can be realized in our future to promote excellence in PT education

In summary, this Forum offered space to explore the mystery of infinite possibilities versus focusing on solving problems. It was a refreshing process that, in the spirit of Geneva R. Johnson, supported creativity and offered new excitement and energy. The Forum reinforced what we are doing well and our ideas enlightened us to develop potential future opportunities. Leading transformation of our education enterprise has endless potential, and as evident from our past, physical therapy educators can and will rise to the occasion! As Dr Gangone asked us, how are we going to step up into our greatness as PTs and “move higher education forward?”

The Second Annual Geneva R. Johnson Forum is well underway, and we look forward to everyone's engagement in the process as we strive for excellence in PT education. Plan on attending the next Education Leadership Conference, October 1–4, 2015, in Baltimore, Maryland.

NOTE

A more detailed report of the Forum, including a full description of Appreciative Inquiry, can be found at www.acapt.org.

ACKNOWLEDGEMENTS

To the members of the Physical Therapy Leadership Institute (PTLI), a think-tank spearheaded by Dr Geneva R. Johnson to use individual and collective spheres of influence to promote and support the positive movement toward excellence in physical therapy education. PTLI collaborated with ACAPT in presenting the Forum.

Beth Whitehead, PT, MBA, and the Whitehead Family Foundation for their financial support.

Dr Laurita Hack and Dr Gail Jensen for their contributions.

To the Table Facilitators: Drs Peter Altenberger, Mary Backinton, Janet Bezner, Jacklyn Brechter, Tammy Burlist, Catherine Certo, Gary Chleboun, Mary Dockter, Jody Frost, Carol Goulet, Laurita Hack, Amy Heath, Diane Jette, Stephanie Kelly, Merrill Landers, Pam Levangie, Tim Noteboom, Nancy Reese, Mark Reinking, Doreen Stiskal, Kimberly Topp, Linda Tsoumas, Tom Warner, and Kathryn Zalewski.

Dr Kathy Zaleswki and program planning committee members of the APTA Education Section for providing programming space within the Education Leadership Conference and for helping us make the Forum idea a reality.

REFERENCES

1. Cooperrider D, Srivastva S. Appreciative Inquiry in Organizational Life. Research in Organizational Change and Development. 1987;1;129-169.
2. Hammond SA. The Thin Book of Appreciative Inquiry. 3rd ed. Bend, OR. Thin Book Publishing; 2013
Copyright2015 (C) Academy of Physical Therapy Education, APTA