Secondary Logo

Journal Logo

RESEARCH REPORT

Physical Therapy Education Program Faculty Challenges, Concerns, and Priorities During the COVID-19 Pandemic: Looking Back and Moving Forward

Majsak, Michael J. PT, EdD; Hall, Cheryl A. PT, DHSc, PCS, MBA; Kirsch, Nancy R. PT, DPT, PhD, FAPTA; Krencicki, Dennise B. PT, DPT, MA; Locke, Elizabeth PT, PhD; Hyland, Nannette PT, PhD

Author Information
Journal of Physical Therapy Education: June 2022 - Volume 36 - Issue 2 - p 97-106
doi: 10.1097/JTE.0000000000000228

Abstract

INTRODUCTION

As reported by the American Council of Academic Physical Therapy (ACAPT),1 the COVID-19 pandemic had a profound impact on physical therapy programs across the United States. Discussions among administrative and clinical faculty in the New York (NY) and New Jersey (NJ) programs revealed that many faculty shared similar experiences. In-person lectures were suspended, and clinical skills laboratories were carried out under stringent policies of screening, social distancing, and use of personal protective equipment. In some cases, clinical education experiences were delayed, suspended, or cancelled, resulting in delays in academic progression and graduation.

In response to the challenges and concerns of the 29 physical therapist programs and 18 physical therapist assistant programs across NY and NJ, the New York Physical Therapy Association Academic Administrators Special Interest Group (NYPTA AASIG) created the NPTA AASIG COVID-19 Response Team, a communication network for program directors (PDs) and faculty, and members of the NY/NJ Clinical Education Consortium to collect and share information on COVID-19 and strategies to benefit all programs and students. Weekly online meetings were held, and online surveys distributed to collect, share, and analyze data collected.

REVIEW OF LITERATURE

Each physical therapy education program is responsible for creating and adhering to an education model that meets the standards and required elements of the Commission on Accreditation in Physical Therapy Education (CAPTE).2 Program models are diverse, heavily contextualized by the program mission and goals, andragogy, and institutional resources. Differences exist in faculty and student class sizes, teaching methodology, research activity, degrees of in-person and distance-based education, and clinical education structure. Models also differ between physical therapist and physical therapist assistant education programs. Thus, programs experienced different challenges and concerns in response to the pandemic. Programs not using distance-based learning or clinical simulation pre-COVID created these spontaneously, whereas others merely adapted their methodology. Many challenges and concerns were common across programs, such as how to conduct on-campus activities, promote student and faculty interactions, and complete clinical education experiences without delaying student academic progress or graduation. Contributing to these challenges was a lack of knowledge of COVID-19 transmission, how long the disruption would continue, and lack of experience in managing an infectious disease pandemic.

Similar challenges were previously experienced by medical schools in Hong Kong and Toronto in response to the severe acute respiratory syndrome epidemic in 2003.3,4 Response strategies included greater integration of information technology, educating students in smaller groups, and developing prerecorded and distance-based learning activities. Many of these, found to be beneficial to student learning, were retained postepidemic.4,5 Health professions faculty teaching under COVID-19 restrictions were similarly forced to adopt a hybrid teaching methodology, in some cases through “emergency remote teaching,”6 rather than a well-planned, intentional shift in program andragogy. This was the first exposure of many faculty to the “disruptive innovation” of online teaching technology already moving higher education from traditional on-campus education alone to hybrid and distance-based education.7,8 Recent published work report both the benefits and the concerns of the education model modifications made.8-14 Benefits include the use of educational technology to provide students access to instruction or alternatives to direct patient contact experiences.11,14 Concerns include a decrease in faculty-student engagement, inadequate depth of psychomotor learning, and issues of student anxiety and mental health.9,10,12,15

The purpose of this article was to share the major challenges and concerns reported by faculty teaching during the COVID-19 pandemic, and the priorities believed to be necessary for programs to be better prepared for future disruptive events. This study was designed as a companion study to that of Hyland et al,16 which reported physical therapy student perceptions of their education during the pandemic. The survey responses from faculty across the highly diverse physical therapy education programs in NY and NJ provide important insight to the elements to be considered as faculty consider program modifications after their own COVID-19 pandemic experiences.

METHODS

Faculty Survey

Similar to the process described by Hyland et al,16 a small workgroup of the NYPTA AAASIG COVID-19 Response Team constructed the draft of a faculty survey, based on the challenges and concerns expressed by PDs and directors of clinical education (DCEs) during 6 months of weekly meetings. The draft survey was posted online for comments and edits from the entire Response Team. After incorporating feedback, an internet-based survey using Research Electronic Data Capture17 was developed, comprising 5 questions on faculty demographics and 31 Likert scale questions for rating the magnitude (0–5) of challenges and concerns in 4 domains: Challenges to Online Learning; Challenges to Workload, Scholarship, Tenure, and Personal Finances; Concerns Related to Academic Issues; and Concerns Related to Returning Back to Campus. Also included were 4 open-ended questions for faculty to report their top 3 priorities for institutional support and any challenges or concerns not listed in the survey (Appendix, Supplementary Digital Content 1, https://links.lww.com/JOPTE/A161). This study was reviewed and designated as “exempt” status by the Mercy College Institutional Review Board.

Data Collection and Analysis

The survey was sent by email to each DPT and PTA education program in NY and NJ for distribution to program faculty. No specifications or restrictions were made on the number of program faculty to respond to the survey. Faculty response data were categorized by program type and location and by faculty rank, tenure, and employment status.

Quantitative Data Analysis

Faculty and program demographic data were coded and saved into Excel version 2012 data files, along with faculty Likert scale ratings on the magnitude of their challenges and concerns. Descriptive analysis of faculty demographics and quantitative analysis of the Likert scale data were carried out using IBM SPSS 27 software. Mean Likert scale ratings of the challenges and concerns were calculated. A mean rating ≥2.5/5.0 was set as the minimal criterion defining a major challenge or concern. Differences in faculty ratings between program location and academic rank were analyzed with Kruskal–Wallis 1-way analysis of variance on ranks, followed by paired comparison tests. Differences by program type were analyzed with a Mann–Whitney U test. Statistical significance for all tests was P < .05.

Qualitative Data Analysis

To preclude data analysis bias, qualitative data analysis was conducted by a team of 3 investigators separate from the team analyzing the quantitative data. Faculty responses to the open-ended questions were documented verbatim in an Excel table for thematic analysis. Because of the purposive sampling used in this study and the focus on interpretation of responses rather the confirmation of a priori hypotheses, principals of inductive thematic analysis were used.18

Trustworthiness of the Qualitative Data

Trustworthiness of the data was assured by meeting the 4 criteria advocated by Lincoln and Guba.19-21Credibility: A team of 3 investigators carried out a triangulated analysis of the data; each was either a PD or DCE who had been working and experiencing the effects of the COVID-19 pandemic for over 6 months. Transferability: The investigators were a PD from a NY private university and a PD and DCE from a NJ public university; responses were received from the diverse programs and faculty across NY and NJ. Dependability: The data analysis was logical, traceable, and well documented; an internal audit of the thematic analysis process was carried out by 2 investigators not involved in the analysis. Confirmability: The presence of 6 investigators working in 2 teams and data collected from numerous diverse programs and faculty provided multiple opportunities for methodological, data source, and analyst triangulation, and reflexivity in the data analysis.

Thematic Analysis Procedures

Data familiarity was begun by 2 investigators reading through the entire list of faculty comments and taking notes on ideas for open coding. The 2 investigators next generated a hierarchical template of initial codes and subcodes. Once saturation of codes was achieved, axial coding was performed to identify preliminary themes. The third team investigator then came in to triangulate the codes and themes, and join the team in reviewing, revising, defining, and naming the themes.

RESULTS

Subjects

Completed surveys were received from 137 faculty across the 47 NY and NJ programs. The geographical location of programs, initially specified by the 10 NYPTA Districts and NJ, were collapsed into 4 major regions: Western, Central, Downstate, and New Jersey. Part-time and full-time faculty were collapsed into rank and tenure status. Table 1 provides faculty demographics and Table 2 provides the characteristics of the diversity of the NY and NJ programs.

Table 1. - Faculty Demographics by Geographical Region
No. of Faculty by Geographical Regionsa
Program Faculty Rank Tenure Status Central Western Downstate New Jersey Total Faculty % Program Type % All
DPT Lecturer Nontenure 1 1 9 4 15 12.9% 1.1%
Tenure 0 0 0 0 0 0 0.0% 0.0%
Assistant professor Nontenure 8 6 16 6 36 31.0% 26.3%
Tenure 1 2 8 2 13 11.2% 9.5%
Associate professor Nontenure 0 4 8 7 19 16.4% 13.9%
Tenure 3 3 9 0 15 13.0% 10.9%
Professor Nontenure 0 1 5 1 7 6.0% 5.1%
Tenure 4 1 4 2 11 9.5% 8.0%
Total DPT faculty 17 18 59 22 116 84.7%
PTA Lecturer Nontenure 5 0 1 0 6 28.6% 4.4%
Tenure 0 0 0 0 0 0.0% 0.0%
Assistant professor Nontenure 0 0 1 0 1 4.8% 0.7%
Tenure 0 0 0 0 0 0.0% 0.0%
Associate professor Nontenure 0 1 0 0 1 4.8% 0.7%
Tenure 1 0 3 0 4 19.0% 2.9%
Professor Nontenure 0 1 2 0 3 14.2% 2.2%
Tenure 3 2 1 0 6 28.6% 4.4%
Total DPT faculty 9 4 8 0 21 15.3%
Total DPT and PTA faculty 26 22 67 22 137
Abbreviation: NY = New York.
aBased on the collapsing of the New York Physical Therapy Association Districts and New Jersey Central: Central, Eastern, and Southern Tier NY Districts.
Western: Western and Finger Lakes, NY Districts.
Downstate: Greater NY, Brooklyn-Staten Island, Long Island, and Hudson Valley Districts.
New Jersey: NJ programs.

Table 2. - Diversity of Physical Therapy Education Programs Across New York and New Jersey
No. of Programs by Program Type
Descriptor DPT % of DPT Programs PTA % PTA Programs Total Programs % All
Institution type
 Public 11 23.4 15 31.9 26 55.3
 Private 18 38.3 3 6.4 21 44.7
Location
 Urban 12 25.5 8 17.0 20 42.5
 Suburban 17 36.2 10 21.3 27 57.5
Class size DPT programs PTA programs
 Median 37 24
 Range 12–85 9–32
Total programs
 DPT 29 61.7
 PTA 18 38.3

Quantitative Data

Major Challenges Related to Online Learning

Table 3 shows the mean Likert scale ratings of the faculty challenges and concerns in the 4 survey domains. In transitioning from classroom to online teaching, the greatest challenge was the lack of contact with students, with no differences shown between programs. Another major challenge was student internet connectivity, with the mean rating from PTA faculty greater than that of DPT faculty (U = 1,633.5, P = .004).

Table 3. - Faculty Ratings for Majora Challenges and Concerns
Mean Likert Scale Ratings
Challenges in online teaching
 Lack of contact with students 3.3 (±1.5)
 Student connectivity 2.5 (±1.3)
Challenges in workload, scholarship, tenure, and personal finances
 Increased workload 3.3 (±1.4)
 Learning online technology and teaching 2.9 (±1.5)
Concerns related to academic issues
 Experience with online teaching 2.5 (±1.3)
 Rigor of online learning experiences 2.9 (±1.5)
 Integrity of online testing 3.2 (±1.5)
 Administrating practical examinations 4.1 (±1.3)
 Quality and quantity of hands-on labs 4.1 (±1.1)
 Isolation of hands-on labs from lectures 2.9 (±1.5)
 Delay in clinical experiences 3.6 (±1.5)
 Delayed graduation 2.6 (±1.9)
 Program outcomes 3.0 (±1.5)
Concerns related to returning back to campus
 Student health and well-being 3.7 (±1.4)
 Faculty and staff health and well-being 3.6 (±1.5)
 Scheduling of labs and classrooms 2.9 (±1.6)
 Lab equipment and maintenance 3.3 (±1.5)
 Safety equipment and supplies 3.2 (±1.6)
 Coordination with college logistics 3.2 (±1.5)
aMean Likert scale scores ≥2.5/5

Major Challenges of Workload, Scholarship and Tenure, and Personal Finances

Increased workload was the greatest challenge reported by faculty in this domain. Second greatest was the challenge of faculty to learn online technology and teaching. Challenges in scholarship and tenure failed to reach the criterion for a major challenge across all faculty, but statistically significant rating differences existed between program type, faculty rank, and tenure status. Interruption of scholarly activity showed differences between faculty ranks (χ2(2) = 17.353, P = .001) with assistant and associate professors rating the challenge higher than lecturers (P = .014, P = .005) and professors (P = .002, P = .03). Statistically significant differences were noted between program type, with DPT faculty reporting a higher challenge than PTA faculty (U = 475, P = .000). Nearly similar differences were shown for tenure or promotion (χ2(2) = 19.048, P = .000). Assistant professors rated the challenge of tenure or promotion higher than lecturers (P = .026) and professors (P = .001) and associate professors higher than professors (P = .022). Statistically significant differences were also found for tenure type (χ2(2) = 9.774, P = .008) with faculty in a tenure process rating the challenge higher than faculty already tenured (P = .006). Differences existed between program type, with DPT faculty rating the challenge higher than PTA faculty (U = 883, P = .045).

Major Concerns Regarding Academic Issues

Many major concerns were reported in academic issues. The 2 greatest were limitations in physical contact during psychomotor laboratories and difficulty assessing student hands-on skills. The concern for quality and quantity of hands-on laboratories differed between faculty ranks (χ2(3) = 10.913, P = .012) with lecturers reporting a greater concern than assistant professors (P = .019) and associate professors (P = .046). Faculty concerns in the uncoupling of hands-on laboratories from lectures and in administering practical examinations were prevalent across all faculty.

Faculty reported major concerns regarding their own inexperience with online teaching methodology and in the rigor of online learning experiences. Lecturers had a higher level of concern for the rigors of online teaching than assistant professors (χ2(3) = 9.152, P = .027; paired comparison, P = .018), and PTA program faculty had a higher concern than DPT faculty (U = 1,558.5, P = .005). The integrity of online testing was also a major concern, greater for faculty from PTA programs than from DPT programs (U = 1,558.5, P = .005). Delays in clinical education experiences and graduation were a major concern and meeting program outcomes. Faculty of PTA education programs rated this concern higher than faculty of DPT programs (U = 1,634.5, P = .001), particularly for terminal clinical skill proficiency and readiness for the national license examination.

Major Concerns Regarding Returning Back to Campus

Major concerns in returning to campus were pervasive. The greatest were the health and well-being of students and of faculty. Coordinating with college logistics was another major concern. Scheduling of laboratories and classrooms, laboratory equipment, maintenance, and safety equipment and supplies were all major concerns for all programs.

Qualitative Data

Themes Emerging from Faculty Responses to Open-Ended Questions

The open-ended survey questions yielded 200 faculty comments on challenges, concerns, and priorities for institutional support in moving forward. Six themes were identified: challenges of online education, student and faculty safety, faculty personal needs, quality of student outcomes, communication, and administrative and institutional support. The themes, codes, and code descriptions are shown in Table 4. Table 5 provides representative phrases and comments.

Table 4. - Themes, Codes, and Description of Codes
Theme Codes Description of Code
Challenges of online education Technology Resources in hardware, educational media, and tech support to support online teaching
Teaching skills Instruction, training, and competency to teach online effectively
Connectivity Faculty/student internet access, bandwidth, and environment conducive for online learning
Student engagement Ability to keep students active and participatory during online sessions
Student and faculty safety Travel Students commuting between campus and home and two-way COVID-19 transmission
COVID protocols Detailed policies & plans for testing, social distancing, tracing, and managing positive cases
Campus teaching spaces Ensuring adequate space, ventilation, cleaning/disinfecting, maintenance support, and budget
Adherence to policies Policies and consequences for adherence and lack of adherence to COVID-19 policies
Faculty personal needs Competence in teaching online Time and training for personal development of online teaching skills, mentorship
Home needs/childcare Flexible work expectations to allow faculty to cover home and childcare needs
Time Reduction of nonessential program meetings and tasks to allow time for online teaching
Financial support Purchase of technology for distance-based teaching and online education training
Quality of student outcomes Hands-on skills Limited and compromised hands-on laboratories, difficulty assessing student hands-on skills
Integration Disconnection between lectures and laboratories, altered curricular sequencing
Clinical education Delays, modifications, and cancelations of experiences, lack of clinic predictability
Communication Student and faculty meetings Lack of personal connections between students, faculty, and community
Effective communication Volume, timeliness, clarity, transparency, and honesty of communication
Administration Detailed plans and guidelines, listening as well as informing, making a decision
Administration and Institutional support Professional development Support need for time and training for personal development
Flexible policies Allow flexibility in work locations, hours, days to allow personal needs to be addressed
Value Acknowledge increased faculty workload, respect faculty needs and input
Personnel Minimize staff furloughs, support hiring of additional faculty for on campus teaching
Compensation for workload Financial compensation or other forms of compensation for increased workload

Table 5. - Representative Faculty Comments in Open-Ended Questions by Themes
Theme Codes Representative Comments
Challenges of online education Technology “Provide necessary technology and technology support”
Teaching skills “Assistance with training of more advanced tools in online teaching”
Student engagement “Concerned with keeping students connected and engaged”
Student and faculty safety Travel “High concern of exposure and then bringing it home to older adults”
COVID protocols “Lack of a clear protocol and plan if there is a COVID outbreak on campus”
Campus teaching spaces “Provide better space and ventilation for in class lab experiences”
Adherence to policies “Concerned they will not observe CDC guidelines outside of the classroom”
Faculty personal needs Competence in teaching online “More individual tech support is needed”
Home needs/childcare “Caring for and teaching my own children while managing my students”
Time “The workload has increased exponentially; research and scholarly activity is decreased”
Financial support “Provide financial support for software”
Quality of student outcomes Hands-on skills “Better understanding that hands-on training is necessary for developing PTs”
Integration “Ensure classes with labs are able to schedule time for live lab sessions”
Clinical education “Failure to expediently support faculty teaching remotely AND implement distanced alternatives to full-time clinical education experiences directly threatened both the quality of the program AND the finite ability of faculty to shoulder extensive burdens”
Communication Student and faculty meetings “Communicate more clearly and consistently with faculty and students”
Effective communication “Improve communication and transparency across all constituencies”
Administration “Clear guidelines for who is allowed on campus and expectations for those individuals”
Administration and institutional support Professional development “Provide faculty hands-on help from someone who understands education, not just IT”
Valuing faculty “Listen to the boots on the ground”
Compensation for workload “Compensate or recognize the amount of work that goes into teaching virtually”

The theme of Challenges of Online Education emphasized the need for faculty to have the resources to teach effectively in a hybrid format. Issues of student connectivity were also shared. Faculty cited the need for personal development in online teaching skills and voiced concerns on the rigor and integrity of online teaching. A frequent statement was “concerned with keeping students connected and engaged.”

The theme of Student and Faculty Safety arose for returning to campus, with concerns on student travel and commuting between campus and home. Comments included the need for clear university protocols and procedures for COVID testing, social distancing, contact tracing, and managing positive cases were offered. Planning classroom space, ventilation, equipment, and cleaning protocols were also held to be important. Concern was not merely for knowledge of policies and procedures but adherence.

The theme of Faculty Personal Needs centered on the loss of usual personal and family time because of the dramatic increase in workload required to transform the curriculum to a hybrid format, learn to use online learning technology and platforms, and engage in numerous program meetings on COVID-19 issues. Self-identified DCEs reported that the time demands to communicate and coordinate changes in clinical education experiences was enormous. The impact of the pandemic on home life included numerous comments on issues of increased workload competing with childcare demands. Financial support for the purchase of education technology at home was cited as a necessity for distance-based education.

A theme of Quality of Student Outcomes was largely based on the concern of reduced time spent on the teaching, practice, and assessment of student psychomotor skills. In addition, the initial halt of hands-on learning activities early in the pandemic, the disconnection between the sequencing of lectures and laboratories, and delays in clinical education experiences were cited as compromising the integration of clinical skills.

Communication was a theme crossing over students, faculty, and institutional administration. The need for greater clarity and timeliness of information sharing was cited as well as the need for administration to acknowledge faculty concerns. Limited availability for faculty to meet with students and students to meet with each other was believed to compromise the ability to “create meaningful relationships with each other.” Faculty also reported a drop in program cohesion because of less shared time on campus.

The theme of Administrative and Institution Support arose from faculty comments regarding programmatic needs and resources not adequately acknowledged. These needs included approval of a flexible policy on off-campus work to allow faculty to manage personal needs in conjunction with a high workload. Financial compensation was cited, but a greater emphasis was providing faculty greater time and support to learn skills in online education and move traditional teaching materials to an online format. The hiring of additional personnel was suggested to support the demands of increased laboratory time with students in smaller, socially distanced groups.

DISCUSSION

Across the United States, physical therapy education programs are shifting from a reactive form of “emergency remote teaching”6 or “panicgogy”22 to a deliberate evolution in andragogy to “navigate a new normal.”8 The disruptive innovations of online education and nonpatient clinical learning experiences have gained greater acceptance after the COVID-19 pandemic. However, although the pandemic provided a catalyst for innovation and a shift toward hybrid models of education,10,11,13,14,23-25 a number of negative consequences and unresolved issues need to be addressed.9,10,15 Our findings provide important faculty perspectives on the challenges, concerns, and priorities of faculty from a group of physical therapy education programs highly diverse in community locations, faculty and student cohort sizes, and institutional structure. Interestingly, nonparametric analysis of the magnitude of faculty challenges and concerns between different geographical regions failed to show statistically significant patterns or differences. Hyland et al16 reported previously that student perceptions did differ by program region. Thus, the challenges, concerns, and priorities of faculty may be more universal than those of students. Interestingly, many of the challenges and concerns reported by faculty echoed those of students.16

Major Faculty Challenges

Retaining student contact and engagement was one of the greatest challenges faculty reported for transitioning to online teaching. Although student technology resources and internet connectivity may have contributed to this challenge, student adaptation to a change in teaching methodology26 and stress and decreased motivation to learn were reported.12 Our findings are consistent with Hyland et al16 and other reports of declines in student contact,27 engagement,28 and collaboration with one another and faculty29 in response to the COVID-19 pandemic. In addition to affecting cognitive learning, diminished contact might compromise student development in interpersonal skills, group dynamics, and professional behaviors.13,16

As in previous reports,13,30,31 the greatest personal challenges faculty reported was the increased workload to learn new technology, convert courses to an online format, and connect with students and colleagues, while fulfilling the roles of parents, scholars, and community members. A common perception was that the increased faculty workload was not recognized with changes in workload calculations, remuneration, or in changes of program staffing. Although the interruption of scholarly activity, promotion, and tenure was not rated as a major challenge across all faculty, the statistically significant differences between faculty of different ranks were not surprising. Faculty dependent on scholarly activity for promotion and tenure found the pandemic to be disruptive. Thus, assistant and associate professors were more affected than Lecturers or Professors. The statistically significant higher rating by DPT faculty than PTA faculty likely reflected the greater proportion of assistant and associate professors than professors and lectures in DPT programs or different institutional expectations and opportunities for faculty scholarship and tenure. Previous studies reported the negative impact of the pandemic on faculty research activity, especially for women overseeing domestic and childcare activities.30,32-35

Major Faculty Concerns

The 2 greatest concerns of faculty in adapting to COVID-19 restrictions were the reduced psychomotor learning experiences of students and the inability to conduct practical examinations to effectively assess student learning. These 2 concerns were within the top 3 challenges also reported by students.16 Because of social distancing, many programs split laboratories into multiple sections, requiring additional space, equipment and supplies, and teaching time. Several faculty perceived that their university administration did not support the hiring of additional part-time faculty to help cover the increased teaching time, instead expecting program faculty to cover those increased needs. In fact, across the higher education community, the demand for resources, PPE, personnel, space and supplies to meet instructional demands was reported to not be immediately recognized by administration.36 A major concern was how to provide students alternate ways to practice the hands-on learning for skill competency.37 The isolated laboratory experiences that the faculty were able to create were felt to be not as effective as the tradition of having course lectures and laboratories linked. Blended learning opportunities have been shown to provide the best options for teaching and assessing hands-on skills.38

Another major concern was the impact of the pandemic on clinical experiences. Concerns included the number of students experiences offered, the needs of clinical partners, meeting accreditation requirements and policies imposed by the University, and the need to develop alternate models of clinical education. The availability of clinical sites and experiences was previously reported as a major concern across multiple health professions.37 For all programs, the challenge was completing enough hours with sufficient patient types to meet the standards for entry-level practice. Faculty expressed a concern for meeting program outcomes resulting from changes in teaching methodology, limited student assessment, and the decrease in clinical experiences.

The concerns about the return to campus were extensive. The primary concerns for student, faculty, and staff health and well-being were consistent with other health care disciplines.39,40 Faculty were concerned about safely bringing students to campus for in-person instruction, preventing infection with appropriate PPE, and adhering to safety procedures. This suggests university administration needs to have contingency plans in place and availability of supplies, equipment, and space necessary to conduct concurrent smaller group laboratory activities to comply with social distancing. Many universities forced to make these changes recognize that some of these may become the norm in the future.41

Faculty Response Themes

The main themes identified from faculty comments highlight several elements that programs must consider in their post-COVID-19 transformations. Effective online educational technology, IT support, and faculty development in acquiring the skills to teach in a hybrid manner cannot be overemphasized. Kurz et al42 found that the discomfort in transitioning from traditional lecture format to nontraditional pedagogies while challenging for faculty offered advantages to students who found that recorded lectures provided the advantage of self-directed learning and material review. Technology issues were major factors in the challenges of student engagement and student–faculty interactions. Educators need to be aware that many students face significant learning hurdles, unrelated to technology. Many students find face-to-face communication more conducive to the learning process, presenting opportunities to engage with faculty and other students.43

The access and support of educational technology, the transfer of traditional teaching materials to online platforms, and learning to use online teaching technology was the largest contributing factor to the high workloads of faculty. Increased digitalization of education may become the standard after the pandemic altering the delivery of professional education in many domains including physical therapy. To continue this transition, institutions must commit to providing the resources to deliver education digitally.43

The themes of student, faculty, and staff safety were not surprising, and the issues of decreased student–faculty contact and interaction have been well reported.13,16,28,29,44 The themes of communication and administrative/institutional support were prevalent across all challenges and concerns, emphasizing the need for faulty to be well-informed in both university and program policies and procedures. In numerous comments, a lack of communication was associated with a lack of respect and support, and in some cases, a belief that faculty safety and health was being overlooked by university administration. Adnou et al45 recognized the importance of human resources practices that emphasized employee satisfaction and clear communication, which demonstrated trust between faculty and administration. Feelings of not being appreciated and valued existed at all levels of institutional personnel. Engaging in frequent communication between administration and staff was effective in keeping people informed with accurate information in a changing environment.

An interesting finding not commonly reported with the challenges of teaching during the pandemic was the theme of childcare. Previous studies have addressed the challenges experienced by women balancing professional and domestic activities.32-35 However, the complexity of parents having to deal with the loss of childcare services and react to the variable school schedules, education technology demands, and hybrid education formats of their children were particularly challenging and stressful. Flexibility in faculty expectations and availability for program activities such as staff and committee meetings, and tasks outside of teaching obligations are necessary for faculty to meet both their program and childcare needs. Petts et al46 reported that mothers of young children reduced their hours voluntarily while at home during the pandemic, and fathers were relatively unaffected by the changes in childcare needs during the pandemic. Our respondents did not identify their gender, so it is not clear whether the impact of childcare demands was different between faculty.

A number of limitations did exist within this study. Although the diversity of the NY and NJ programs is wide, the data collected reflect a circumscribed region of the United States, and the data reported are limited to a sample of campus-based programs, with no online/hybrid programs included. Thus, the transferability of these findings cannot be assumed on a national level. Another limitation is that the number of faculty responding was not specified or restricted by program, so an unequal representation of programs may exist.

In aggregate, the data collected are rich and provide insight to aspects of faculty challenges, concerns, and priorities commonly discussed at professional meetings and tied to the standards, elements, and more recently the COVID-19 exceptions put forth by CAPTE.47 These data are important for faculty to consider in the ongoing evolution of their programs.

CONCLUSION

The purpose of this study was to analyze the major challenges and concerns faculty reported during the COVID-19 pandemic, and priorities for moving forward. The quantitative and qualitative data analyzed offer a rich data set from which to offer recommendations to move forward. However, faculty comments also provide insight to the sizable investment of time and resources institutions must make to help faculty with high workloads acquire the skills to use a hybrid learning format effectively in what has been called a “new normal.”8

The impact on faculty included work–life balance, career growth, and financial security. Faculty with young children attending school virtually or caring for family members who were ill experienced types of stress different from faculty concerned about disruption in their scholarly productivity, promotion, and tenure. Across all faculty, the increased workload required to meet previous and new program obligations was a major concern.

The quantitative data on faculty challenges and concerns and the themes emerging from the thematic analysis provide strategies to consider for strengthening programs in moving forward to be more resilient to future disruptions. The stress on faculty to adapt to new learning methodology should be evaluated, based on optimal utilization of the strengths and talents of the spectrum of university personnel. Faculty cited the need for strong IT support and instructional technology training through personnel competent in those areas, permitting faculty to focus on their expertise the delivery of physical therapy content. Communication pathways should be assessed to capitalize on what can be easily put in place to reduce gaps in communication across the education community. Conduits should be established for peer mentorship to help faculty meet their scholarly goals, encourage their service aspirations, and enhance their teaching expertise. Current expectations for how content is delivered and where and when faculty prepare to teach and engage in scholarship should be assessed. The focus on education excellence should incorporate the COVID-19 lessons learned, as well as information provided through ACAPT and CAPTE that model flexibility and creativity to meet and exceed accreditation standards, faculty development goals, and program outcome expectations.

The results of this study indicate many challenges, concerns, and priorities need to be addressed if programs are to deliver their curricula in a manner consistent with their mission, goals, and educational model. Because future disruptions can reasonably be expected to occur, there is a need to use the knowledge gained to pre-emptively develop strategic plans to support flexible modes of education. The important lessons learned from the COVID-19 disruption are important for not only preparing for the next disruptive event but also for strengthening the infrastructure of physical therapy education now, to incorporate the best of the changes we made in reacting to the pandemic and establishing a strong foundation to keep our educational programs contemporary and relevant.

FUNDING

Nil.

REFERENCES

1. American Council on Academic Physical Therapy. COVID19 Response; 2021. https://acapt.org/elc-event/covid19-response. Accessed February 1, 2021.
2. Commission on the Accreditation in Physical Therapy Education. Commission on Accreditation in Physical Therapy Education Rules of Practice and Procedure, Version 21.0.01. Alexandria, VA: American Physical Therapy Association; 2022.
3. Clark J. Fear of SARS thwarts medical education in Toronto. Bmj. 2003;326:784.
4. Patil NG, Chan Y, Yan H. SARS and its effect on medical education in Hong Kong. Med Educ. 2003;37:1127-1128.
5. Lim EC, Oh VM, Koh DR, Seet RC. The challenges of “continuing medical education” in a pandemic era. Ann Acad Med Singap. 2009;38:724-726.
6. Hodges C, Moore S, Lockee B, Trust T, Bond A. The Difference Between Emergency Remote Teaching and Online Learning. Educause Review; 2020. https://er.educause.edu/articles/2020/3/the-difference-between-emergency-remote-teaching-and-online-learning. Accessed June 16, 2021.
7. Christensen C, Eyring H. The Innovative University: Changing the DNA of Higher Education. New York, NY: John Wiley & Sons; 2011.
8. Gagnon K, Young B, Bachman T, Longbottom T, Severin R, Walker MJ. Doctor of physical therapy education in a hybrid learning environment: Reimagining the possibilities and navigating a “new normal”. Phys Ther. 2020;100:1268-1277.
9. Foo CC, Cheung B, Chu KM. A comparative study regarding distance learning and the conventional face-to-face approach conducted problem-based learning tutorial during the COVID-19 pandemic. BMC Med Educ. 2021;21:141.
10. Gaur U, Majumder MAA, Sa B, Sarkar S, Williams A, Singh K. Challenges and opportunities of preclinical medical education: COVID-19 crisis and beyond. SN Compr Clin Med. 2020;2:1992-1997.
11. McCullough LB, Coverdale J, Chervenak FA. Teaching professional formation in response to the COVID-19 pandemic. Acad Med. 2020;95:1488-1491.
12. Ng L, Seow KC, MacDonald L, et al. eLearning in physical therapy: Lessons learned from transitioning a professional education program to full eLearning during the COVID-19 pandemic. Phys Ther. 2021;101:pzab082.
13. Plummer L, Belgen Kaygısız B, Pessoa Kuehner C, et al. Teaching online during the COVID-19 pandemic: A phenomenological study of physical therapist faculty in Brazil, Cyprus, and the United States. Educ Sci. 2021;11:130.
14. Sklar DP. COVID-19: Lessons from the disaster that can improve health professions education. Acad Med. 2020;95:1631-1633.
15. Berger R, Mallow A, Tabag K, et al. Teaching and learning in a time of corona: A social work experience. Clin Soc Work J. 2022;50:43-54.
16. Hyland N, Vore ME, Chan C, Katz J, Rivers L, Hewson K. COVID-19 impact on students in physical therapist and physical therapist assistant education programs in New York and New Jersey: Key issues and recommended responses. J Phys Ther Educ. 2021;35:279-285.
17. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377-381.
18. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77-101.
19. Lincoln YS, Egon G. Naturalistic Inquiry. Newbury Park, CA: Sage Publications, Inc; 1985.
20. Forero R, Nahidi S, De Costa J, et al. Application of four-dimension criteria to assess rigour of qualitative research in emergency medicine. BMC Health Serv Res. 2018;18:120.
21. Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: Striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16:1-13.
22. Dhawan S. Online learning: A panacea in the time of COVID-19 crisis. J Educ Tech Syst. 2020;49:5-22.
23. Liang ZC, Ooi SBS, Wang W. Pandemics and their impact on medical training: Lessons from Singapore. Acad Med. 2020;95:1359-1361.
24. McMaster D, Veremu M, Santucci C. COVID-19: Opportunities for professional development and disruptive innovation. Clin Teach. 2020;17:238-240.
25. Savage DJ. The COVID-19 pandemic as a catalyst for medical education innovation: a learner's perspective. FASEB Bioadv. 2021;3:449-455.
26. Morrison ES, Naro-Maciel E, Bonney KM. Innovation in a time of crisis: Adapting active learning approaches for remote biology courses. J Microbiol Biol Educ. 2021;22:1-6.
27. Rieck S, Crouch L. Connectiveness and civility in online learning. Nurse Educ Pract. 2007;7:425-432.
28. Tsai C-L, Ku H-Y, Campbell A. Impacts of course activities on student perceptions of engagement and learning online. Distance Educ. 2021;42:106-125.
29. Ramlo S. COVID-19 response: student views about emergency remote instruction. College Teaching. 2021;70:65-73.
30. VanLeeuwen C, Veletsianos G, Johnson N, Belikov O. Never-ending repetitiveness sadness. Loss and “Juggling with a blindfold on:” lived Experiences of Canadian College and faculty members During the COVID-19 pandemic. Br J Educ Tech. 2021;52:1306-1322.
31. Minello A. The pandemic and the female academic. Nature. 2020. doi: 10.1038/d41586-020-01135-9. Epub ahead of print.
32. Pereira MDM. Researching gender inequalities in academic labor during the COVID-19 pandemic: avoiding common problems and asking different questions. Gend Work Organ. 2021;28:498-509.
33. Viglione G. Are women publishing less during the pandemic? Here's what the data say. Nature. 2020;581:365-366.
34. Uddin M. Addressing work-life balance challenges of working women during COVID-19 in Bangladesh. Int Soc Sci J. 2021;71:7-20.
35. Cardel MI, Dean N, Montoya-Williams D. Preventing a secondary epidemic of lost early career scientists. Effects of COVID-19 pandemic on women with children. Ann Am Thorac Soc. 2020;17:1366-1370.
36. Currie G, Hewis J, Nelson T, et al. COVID-19 impact on undergraduate teaching: Medical radiation science teaching team experience. J Med Imaging Radiat Sci. 2020;51:518-527.
37. Moreau C, Maravent S, Hale GM, Joseph T. Strategies for managing pharmacy experiential education during COVID-19. J Pharm Pract. 2021;34:7-10.
38. McCutcheon K, Lohan M, Traynor M, Martin D. A systematic review evaluating the impact of online or blended learning vs. face-to-face learning of clinical skills in undergraduate nurse education. J Adv Nurs. 2015;71:255-270.
39. Schlesselman LS, Cain J, DiVall M. Improving and restoring the well-being and resilience of pharmacy students during a pandemic. Am J Pharm Educ. 2020;84:ajpe8144.
40. Baloren E. Knowledge, attitudes, anxiety and coping strategies of students during COVID-19 pandemic. J Loss Trauma. 2020;25:635-642.
41. Romanelli F, Rhoney DH, Black EP, Conway J, Kennedy DR. Pharmacy education crosses the rubicon. Am J Pharm Educ. 2020;84:ajpe8131.
42. Kurz L, Metzler ET, Ryan KC. Teaching in the time of COVID-19: Reconceptualizing faculty identities in a global pandemic. J Teach Learn Tech. 2021;10:172-184.
43. Rashid S, Singh Yadav J. Impact of Covid-19 pandemic on higher education and research. Indian J Hum Dev. 2020;14:340-343.
44. Kaufmann R, Vallade JI. Exploring connections in the online learning environment: student perceptions of rapport, climate, and loneliness. Interactive Learning Environments 2020. Published online. doi:10.1080/10494820.2020.1749670.
45. Adonu D, Opuni YA, Dorkenoo CB. Implications of COVID-19 on human resource practices: A case of the Ghanaian formal sector. J Hum Resour Manag. 2020;8:209-214.
46. Petts RJ, Carlson DL, Pepin JR. A gendered pandemic: childcare, homeschooling, and parents' employment during COVID-19. Gend Work Organ. 2021;28:515-534.
47. Commission on the Accreditation in Physical Therapy Education. CAPTE 2020 Town Hall Meetings. https://www.capteonline.org/globalassets/capte-docs/whats-new/capte2020townhallmeetingsummaryquestionsandanswers.pdf. Accessed November 1, 2020.
Keywords:

COVID-19; Pandemic; Hybrid learning; Faculty; Curriculum

Supplemental Digital Content

© 2022 Academy of Physical Therapy Education, APTA