The results of the qualitative analysis of the open-ended question, regarding how the program completion influenced overall practice, revealed 4 themes: relationships with clients and others, knowledge/expanded understanding, skill/outcomes, and perception of self/personal growth (Figure 2).
Relationships with Clients and Others
The comments within this theme emphasized an improved ability to communicate, enhanced relationships with clients, and increased respect and recognition from others. Examples of comments included the following:
- “My treatment has become more patient centered, addressing their specific goals.”
- “I feel confident acting as a mentor to others (student—post grads).”
- “It has given me the confidence to share my beliefs and findings with peers.”
- “I have received more professional respect from my peers.”
- “My patients constantly sing my praise.”
- “The program gave me more success in interaction with doctors and staff.”
- “It has enabled me to be recognized by my peers and patients as well as their families as expert of movement science and manual therapy.”
The comments within this theme included improvement in critical thinking, developing a deeper understanding of integrating knowledge and skill for overall patient management. Examples of comments included the following:
- “The higher level analysis and problem solving skills learned in the OMPT program have been vital to my success as an orthopedic specialist.”
- “I feel the OMPT program enhanced my technical skills and critical thinking.”
- “…raised my level of understanding orthopedic pathology and definitely about spine.”
- “The most valuable skills that I learned during the program were related to being a critical thinker.”
- “My treatments are very efficient and effective because of my ability to diagnose the correct cause of pain or movement impairments.”
The comments within this theme were specific to effective execution of the skills learned and ability to manage complex patients. Examples of comments included the following:
- “It has given me the confidence in myself because of my skills to treat many types of patients from simple to complex.”
- “I have been very comfortable with complex cases that may have not had prior success in PT [physical therapy].”
- “OMPT certification has helped me evaluate and treat patients more efficiently.”
- “Improved clinical examination skills and accuracy of delivery of treatment.”
Perception of Self/Personal Growth
The comments within this theme were directed at how the respondent felt regarding gratitude for the teaching, being committed to lifelong learning, overall confidence, being more fulfilled and satisfied, and experiencing overall personal growth. Examples of comments included the following:
- “I am very grateful for what the program gave me and the dedicated individuals that taught and mentored me.”
- “I would not be nearly as successful as a practitioner or as fulfilled in my career without the teachings and learnings of the OMPT program.”
- “I am more confident overall.”
- “Taking part in the OMPT Program has significantly increased my job satisfaction due to the gained ability to exercise better tools for better outcomes.”
- “I enjoy what I do more than I ever thought I would.”
- “The OMPT program has changed my life.”
- “OMPT has been essential in my development as a physical therapist and the continued evolution of the practice of OMPT continues to shape me as I am always learning new things and/or attempting to create new learning opportunities for myself.”
Quantitative and Qualitative Comparison
The comments and themes that emerged were consistent with the quantitative results. All the core values were represented except social responsibility (Table 9). The fourth theme of perception of self/personal growth stood out as being independent of the core values. These comments had to do with how the person felt and not observable behaviors. These comments centered around personal growth, increased confidence, and enhanced job satisfaction.
The purpose of this study was to examine the graduates' perceived effect of graduation from a university-based postprofessional certificate in OMPT on sample indicators representing the core values of accountability, altruism, compassion/caring, excellence, integrity, professional duty, and social responsibility as well as their perception of recognition by others as providing excellence in physical therapy. Respondents in this study primarily worked in outpatient settings, spent most of their time in patient care, and had a clinical focus in orthopedics. Quantitative results indicated an overall agreement that completion of the OMPT program led to an increase in the sample indicators representing the core values of accountability, altruism, compassion/caring, excellence, integrity, professional duty, and the additional construct of recognition by others as providing excellence in physical therapy. Within the construct of social responsibility, there was a neutral response. Qualitative analysis revealed 4 themes: relationships with clients and others, knowledge/expanded understanding, skill/outcomes, and perception of self/personal growth. Quantitative and qualitative comparison was consistent, except for social responsibility, which was only seen in the quantitative results, and perception of self/personal growth, which was only seen in the qualitative results.
The findings in this study are similar to the literature regarding participating in postprofessional education as a means to further develop professionalism. Like Smith et al, the current study found that graduates of a postprofessional OMPT program perceived that the program completion positively influenced clinical skills and expertise, critical thinking and clinical reasoning, communicating with patients and the medical community, and led to an increase in referrals from peers and other health professionals. Similar to Perry et al, in relation to core values, respondents in this study perceived that OMPT program completion had a positive influence on them professionally, related to examination and treatment skills, to clinical reasoning, to the ability to manage complex patients, and to enhanced recognition from others as providing excellence in physical therapy practice. The qualitative findings in this study within the theme “perception of self/personal growth” were perceived positive effects of completion of the OMPT postgraduate education that were in addition to the perceived enhancement of behaviors related to the core values of accountability, altruism, compassion/caring, excellence, integrity, and professional duty. Respondents indicated that completion of the program enhanced their personal growth, increased confidence, and enhanced job satisfaction, which included interest in continuing to invest in lifelong learning within the profession, increased enjoyment with work, and overall fulfillment in career, which were consistent with the findings of Perry et al. These perceptions could result in reduced practitioner burnout, retention of experienced therapists, and engaged employees, which can have a positive effect on the culture of the health care system and the community they are serving.
Findings from this study revealed new aspects of the perceived influence of graduate program completion that were not reflected in other studies. These aspects support the perception that completion of the postprofessional program positively influenced participants to maintain ethical employment, retain responsibility for skills, recognize limits of expertise and efficiently refer, and adhere to ethical billing practices. These items directly capture aspects of the core values within the PCV document of accountability, integrity, professional duty, and excellence. Graduates, who purposefully choose to be employed in environments that strive for high ethical standards, could influence the elevation of overall professionalism. The positive influence, on retaining responsibility for delivery of the clinical skills learned within the OMPT program, could lead to consumers receiving the most skilled care. Recognizing the limits of expertise, efficiently identifying a need for further medical management, and referring to the most appropriate provider could result in less time and resources expended by the provider, the third-party payer, and the medical institution. The combined results of being perceived by others as experts in providing physical therapy, with the overall perception of an increase in behaviors related to core values could result in increased opportunities for respondents to be influential within a peer group, an institution, the profession, the health care team, and society.
The construct of social responsibility that included 4 items related to community education, membership and participation in professional organizations, promoting legislature, and increasing the appreciation and respect for the uniqueness of each individual patient and professional encounter yielded a neutral response overall. Although Guenther et al, investigated self-assessed core values of PTs unrelated to postgraduate education, the findings of this study are analogous, with the construct of social responsibility yielding an overall lower score and the constructs of compassion/caring, accountability, and integrity yielding higher scores. The specific items within the social responsibility construct most analogous to political activism (which scored low in the study of Guenther et al) was promoting legislature regarding physical therapy. The item most analogous with volunteerism (which scored low in the study of Guenther et al) was related to participation in community education. Similar to the results of Guenther et al, in the current study, these 2 items scored lower and pulled the overall construct score down. Perhaps, the finding of lower scoring items related to social responsibility in the current study is not representative of the perceived influence of completion of the OMPT program. This finding is consistent with the interpretation of Guenther et al and Dutton et al regarding their findings that social responsibility is not consistently identified by PTs as part of their professional role and not fully integrated into the profession of physical therapy. Strategies to further integrate behaviors related to social responsibility could include curricular changes that explicitly state related goals include service learning activities and provide positive role modeling of social responsibility; integrating social responsibility into the mission statements of medical institutions and physical therapy departments; providing support for participation in political activism; and identifying and providing community volunteer activities. Dutton et al provided evidence for facilitating factors to volunteerism that include, among others, creating volunteer opportunities that provide socialization and identifying causes that participants can personally identify with. Barriers to volunteering included restricted time and difficulty identifying appropriate opportunities.11 These facilitating factors and barriers could be addressed within the work place and within entry-level education curriculum to integrate social responsibility within the profession of physical therapy.
When comparing OMPT program goals to the results of this study, there was compatibility in both individual items and constructs that related to all OMPT program goals. Although the construct mean of social responsibility was neutral, the individual survey item related to appreciating and respecting the uniqueness of each individual patient and professional encounter (which was within the social responsibility construct) yielded agreement, indicating that the specific OMPT goal is being met. This finding also shows that respondents perceived that this specific behavior related to social responsibility was enhanced by the completion of OMPT.
Limitations and Future Research
One limitation of this study was that the survey items were framed with positive wording, which may have biased respondents. The respondents may have had a positive bias toward the OMPT program. There is lack of validity and reliability testing of the OMPT Graduate Survey used in this study. The orthopedic focus, the graduate certificate structure, and the use of a single program limits the generalizability of the findings.
The development of a valid and reliable instrument to measure professionalism is needed and could include validity and reliability testing of the existing CVSA or the OMPT Graduate Survey used in this study. Validating an instrument could have extensive application within the field of physical therapy and enhance the understanding of the domain of professionalism within many settings: doctoral level physical therapy education, postprofessional education, and clinical settings within all specialties. Further exploration of the domain of professionalism is imperative to further develop strategies within these settings to promote and further integrate all aspects of professionalism.
The further development of professionalism within health care is critical to improve the quality of care and meet the needs of society.1 To continue to enhance the impact of PTs on society as a profession, methods to increase and enhance professionalism must be identified.
The results of this study suggest that completion of a postprofessional program may contribute to the development of the core values. The results also suggest that there is an increased recognition by others of providing excellence in physical therapy. In addition, there appears to be an added value that includes enhanced job satisfaction, confidence, and personal growth. The core value of social responsibility does not appear to be influenced by the completion of the OMPT program. The findings lend support that, in addition to developing skills and increasing knowledge, a postprofessional OMPT program can contribute to the further development of professionalism.
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Professionalism; Core values; Postprofessional education; Orthopedic manual physical therapy
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