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Full Story

Roundtable Discussion Follow-Up

May 21, 2019

The ACAPT Board of Directors held its annual Roundtable Liaison Meeting at CSM in Washington, DC.  Gathered together were members of the board and members of the various PT programs around the country, engaging on ideas, challenges, and solutions.  The board collected the notes from the discussions and wanted to respond to several themes that have emerged.  Those responses appear below:
Nancy Reese represented ACAPT on a CAPTE Task Force to discuss 1) how graduation rates are calculated and 2) the "10%" rule (CAPTE Rule 9.8a).  The task force also included multiple stakeholders from PT and PTA education.  Recommendations from the task force to CAPTE included 1) return to the calculation of graduation rates based on students who graduate within 150% of the total length of the program, and 2) continue to allow programs a 10% flexibility in CAPTE set class size prior to requiring an ASC, counting only new students (and not decelerating or repeating students) in the cohort size.  CAPTE voted on these changes at their spring meeting.  Official changes and wording will be released in the next "What's New" document.
ACAPT appreciated the opportunity to be part of this task force and the open and thoughtful discussions that occurred during the meetings.


New program development with limited available resources including clinical sites:

We continue to facilitate discussions regarding resources. CAPTE needs to be more prescriptive in the minimum requirements for resources (fiscal, faculty, staff, administrative structure within the school/college [i.e., direct access of Program Directors/Chair to institution’s decision makers], etc.) that are necessary for all physical therapists education programs, including new and developing programs. ACAPT is partnering with APTA and the Academy of Physical Therapy Education through the Education Leadership Partnership to address these issues.


Clinical Education Summit follow-up:

The work following the clinical education summit is ongoing and the recommendations from summit continue to serve as a relevant foundational framework to guide current and future initiatives. Completed work thus far includes creating:
  1. A common terminology glossary for physical therapist clinical education
  2. A common definition of and baseline expectation parameters for integrated clinical experiences
  3. A resource summarizing the recommended minimal level of knowledge, skills, abilities and professional behaviors (KSAs) necessary for students to demonstrate prior to their first full-time clinical experience
A panel exploring the role of simulation in clinical education is expected to offer its recommendations to the ACAPT Board in fall 2019.


A panel to address awards and recognition of clinical sites and clinical educators was initiated in January 2019.

ACAPT’s National Consortium of Clinical Educators (NCCE) has also taken the lead on coordinating panels looking at the payment for clinical experience issue (initiated January 2018, report expected by ELC 2019) and the clinical education placement process (initiated in January 2019), which will have implications on capacity for clinical education. The NCCE has also reconvened the panel that developed the common terminology glossary to disseminate and facilitate integration of terminology profession-wide (initiated January 2019, and will occur in stages).     

Finally, ACAPT has also partnered with the APTA and APTE to form a Clinical Education Strategy Group, which developed a series of recommendations regarding best practices in clinical education. This partnership between the APTA, ACAPT and APTE, known as the Education Leadership Partnership (ELP), will be taking action on the strategy group recommendations in 2019-20.  


Addressing issues of Resilience for PT Students: 

A taskforce was created in 2017 and will be launching a survey for program directors, faculty, and clinical faculty to determine the scope of the problem and current strategies being used to address mental health and resiliency in both the academy and clinical sites. Based on the results of this survey, the Taskforce hopes to create both resources and educational programming to better equip programs, faculty, students, and clinical instructors.


Faculty Shortage:  

ACAPT, through the RIPPT consortium, has published a list of PhD programs suitable for research training for future PT faculty.  Many of these programs are in the same academic unit as the PT program.  Some are in closely affiliated departments at their institution such as Anatomy, Kinesiology, Neuroscience, Biomedical Engineering, etc., where PhD PT faculty serve as advisors and PT program graduates are eligible for admission.
The link for this list is here:
A task force formed by ACAPT is also working on this problem to find ways to increase the number of PhD trained PT faculty for the future.  This group is planning to make recommendations by Fall of 2019.


Helping Clinicians Join the Academic World: 

Clinicians will discover that many of these programs allow for a part-time option where the therapist can work in the clinic during coursework.  Typically, when it is time for the dissertation work, a year of full time effort will be required.  Most programs offer tuition remission plus a stipend for full time PhD students, and many allow limited clinical practice to supplement income even for full time PhD students.  Additional scholarships are available from the Foundation for Physical Therapy, NIH, and other funding agencies for PhD training.
Clinicians interested in implementation science may also want to explore the Masters in Public Health, especially those with the DPT entry level PT degree.  Universities affiliated with medical schools typically recognize the MD plus an MS or MPH as adequate research training, so regular faculty appointments may be possible at such places without a PhD; the DPT counts as a terminal doctorate, and the MS or MPH counts as additional research training.  Programs are still required to have at least 50% with a PhD or equivalent, but title such as clinical assistant professor are often appropriate.  In addition, the MPH programs are typically designed for working professionals and focus on health sciences research approaches.  This can be a very useful and feasible option for a working professional.


Database of Outcomes – Criteria for Excellence:  

ACAPT continues to focus on developing criteria and resources for excellence in PT programs as a principal focus of our mission.  We define excellence broadly, including student outcomes, faculty scholarship, leadership, and service, program facilities and recourses, and more.  As many are aware, an initial effort in this led to a carefully designed program outcomes survey (PT-MEPQ) that was administered on the ACAPT website.  Unfortunately, participation was low, so the board decided to pause data collection while we reexamined the issue.  A Criteria for Excellence meeting was held May 17-18 that brought together a variety of stakeholders including representatives of the original benchmarking effort, ACAPT board members, representatives from our educational leadership partnership group with the APTA and the Academy of Physical Therapy Education (APTE), clinicians, residency directors, managers who have close interactions with academic PT programs, and representatives from other professions with strong and successful outcomes assessment programs used across their profession.   Recommendations resulting from this meeting will be assessed by the ACAPT Board for feasibility, cost, and member benefit. The board hopes to provide options for member programs to submit for assessment of excellence reflecting the multi-faceted array of excellence related to areas such as community engagement, program/student/graduate/faculty outcomes, praxis of learning (pedagogical approaches to teaching/learning), and program characteristics.  The ACAPT Board will provide a summary of the Criteria for Excellence work at the Business Meeting at ELC.


Placement and national match:  

There is a Clinical Education Placement Process Task Force beginning work on this issue. Their process currently is doing a large literature review on placement processes and then likely an investigation related to these processes and the variability across the nation. Conversation has occurred about a national match - but through conversations at meetings clinical sites do not necessarily want things done in a random fashion - they still want best-fit selection/placement processes. Data to come out in publication before long. You can learn more about this Task Force, and others, here: https://acapt.org/about/our-leadership/task-forces


Reimbursement and Medicare supervision

This is a very large conversation from the Task Force for Payment for Clinical Experience - supervision, payer source, reimbursement. There is a need for the profession/leadership to continue to work hard in these areas.


Payment for clinical experiences: 

A report from the Payment for Clinical Experience Task Force is coming within 1-2 months at the latest. Details will be shared then.  You can learn more about this Task Force, and others, here: https://acapt.org/about/our-leadership/task-forces


Issues with SARA:  

This is an arduous and often tedious compliance effort for academic institutions.  Some universities have a specific staff member (commonly in the VPAA's office) assigned to SARA issues and compliance.  This appears to be an individual institution issue that needs direct attention by each institution's administration.


Implementation/Compliance with agreed upon policies 

A small group that originally worked on developing the admissions traffic rules has continued to monitor implementation with the goal of evaluating whether the rules are having the intended impact. In general, the majority of ACAPT member institutions are following the rules. In cases where the ACAPT Board becomes aware that a program may be experiencing challenges with following the rules, the ACAPT Board liaison contacts the institutional representative to explore whether the reported information is accurate and, if so, explores in more detail the specific issues at that institution. The ACAPT Board also receives a handful of questions from student applicants, and we have been responsive to these communications as well.  

The rules were approved by ACAPT member institutions with the understanding that we would hold ourselves mutually accountable with following the rules. Please note that specific questions about the admissions traffic rules are included in the annual PTCAS survey that all programs using PTCAS are asked to complete. If you have feedback to provide, please use this survey to have your voice heard. If you do not use PTCAS, we still want to hear from you. Please feel free to contact your ACAPT Board liaison about this matter.   

The ACAPT Board also acknowledges the ongoing turnover in program leadership positions and the fact that many new faculty serving on program-level admissions committees may not be familiar with the traffic rules. The work group referenced above plans to create a set of frequently asked questions and answers about the traffic rules and post these on the ACAPT webpage by August 2019.      


Recognize and represent institutional differences:

ACAPT is committed to ensuring that all member institutions are represented and that institutional diversity is considered in all discussions. This process starts with the ACAPT nominating committee that strives to ensure that slated candidates are both qualified and reflective of our member institutions.  Diversity of opinion and experience is a high priority for the Board when committees and workgroups are developed. The Board routinely considers factors such as geography, public/private, Carnegie classification, and program mission. The ACAPT Board also strives to identify a mix of individuals (e.g., gender, rank, tenure track vs. clinical track) that serve on committees and workgroups. Through Board liaison communication, electronic surveys, open forums, and roundtable discussions, the Board regularly seeks member feedback to inform strategic priorities and to drive discussion. We encourage institutional members to provide feedback to the Board to help us promote a diverse and representative organization that is responsive to the needs of all institutions.  


Update on Faculty Development

ACAPT, as an organization that serves institutional members, supports faculty development of its members through rich programming in conjunction with the Academy of Physical Therapy Education (APTE) at the Educational Research Conference each October. The ACAPT Leadership Academy provides faculty development related to leadership for faculty, clinical instructors/educators, and program administrators. At ELC 2019, they are providing a pre-conference on “Crucial ConversationsTM” by the authors of the book Crucial ConversationsTM. The Education Research Network has also provided faculty development sessions related to educational research such as the MERC educational research sessions and GAMER workshops. Lastly, the National Interprofessional Education Consortium (NIPEC) regularly shares links for ongoing faculty development in the area of interprofessional education. 


Curriculum Standardization: 

The work of the Clinical Education Panels resulted in the publication in standardized terminology related to clinical education. Further work on standardization has not been done but continues to be on the radar of the ACAPT BOD.  


Resources for difficult topics such as academic dishonesty, workload formulas, and/or templates for activities:

The upcoming Pre-conference at ELC on Crucial ConversationsTM  will hopefully provide a resource for difficult conversations related to PT Education. There is also a standing workshop at each ELC designed for new administrators. Currently, the National Interprofessional Education Consortium (NIPEC) has a wealth of resources related to interprofessional practice on the ACAPT websites. The BOD is planning on building a repository of resources online over time. 


Holistic Admissions: 

ACAPT continues to support the implementation of holistic admissions processes in professional physical therapy education programs by programming annually at ELC.  In the past two years, there have been a number of presentations that have related to holistic admissions.  Most recently at ELC there was a panel presentation by several programs that described how they approached the process.  We are continuing to look at how to be a resource on holistic admissions.  


Diversity initiatives: 

ACAPT Board approved the formation of a DEI Consortium at the January CSM meeting.  In addition, when we are making appointments to committees, task forces, work groups, etc. we look at the broad concept of diversity in appointments.  


Workforce data:

There are no specific efforts directed toward this yet other than to continue discussions and encourage further research and discussions on workforce.  PTCAS data should be available soon for the most recent application cycle for further review and discussion.  

Like many other large health professions with a centralized application service, the Physical Therapist Centralized Application Service (PTCAS) has seen a 3.7% decrease in the number of applicants to DPT programs, and a 12.5% decrease in the number of applications submitted in a year-over-year comparison of May 1. These changes have resulted in the average number of programs being applied to by applicants via the CAS being reduced from 6.01 in the 2018 cycle to 5.46 in the 2019 cycle. These downward shifts come despite continued growth in the number of CAS participating programs over the past 2 years. Several factors are likely contributing to these decreases, including:

  • A change in the application platform in the previous application cycle that altered the process by which designations are chosen.
  • A significant increase in the number of programs utilizing (40% of participating programs in 2019) and applicants applying via (65.2% year-over-year increase in 2019) the Early Decision process, thus significantly reducing the number of programs to which those applicants are applying.
  • A spike in the number of programs filling their class via the Early Decision process, thus not accepting additional applications during the regular application period.
  • A shift to earlier deadline dates by programs, thus reducing the number of programs applicants have to apply to later on in the application cycle should they not receive offers from their initially chosen programs.
  • A reduction in the total population of students interested in and applying to health profession education programs as a whole.
  • An expansion of marketing and awareness of alternate health professions careers, resulting in more competition among professions for the same pool of applicants.
To help address this dip in applicant numbers while working to ensure that our profession is as diverse as the society it serves, APTA expanded its outreach to K-12 students to encourage PT and PTA career paths. To assist with this endeavor, APTA has hired an additional staff member, Mya Shackleford, who will serve as the Program Manager for PTA-CAS and Applicant Pipeline Initiatives under Ryan Bannister, Director of CAS and Student Recruitment. In 2018, APTA participated in 7 career fairs for students interested in science, technology, engineering, and math, and in the health professions. Additionally, APTA began a partnership with HOSA: Future Health Professionals, a 240,000 member student group for high school and college students interested in careers in the health professions. Through these engagements, APTA reached more than 10,000 students, parents, educators, school counselors, and career advisors. Continuing with this initiative, APTA has already participated in 8 student recruitment activities this year, with an additional 15+ events designed for K-12 and college students scheduled throughout the remainder of 2019.

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