Gail M. Jensen

Describing Expert Practice in Physical Therapy

In this article, the authors demonstrate how grounded theory may be used to develop models for understanding clinical practice. Through a series of research studies involving novice, experienced, and expert physical therapy practitioners, conceptual frameworks were continually revised based on data obtained from returning to the field and relevant literature available at the time. As concepts and relationships moved to larger themes, a theoretical framework for expertise in clinical practice was proposed. Current work on verifying the theoretical framework continues. Grounded theory is an excellent research approach to bound and help guide a multistage research program involving multiple researchers working in multiple settings.

Understanding the lived experiences of patients: application of a phenomenological approach to ethics.

This perspective article provides a justification, with an overview, of the use of phenomenological inquiry and the interpretation into the everyday ethical concerns of patients with disabilities. Disability is explored as a transformative process that involves physical, cognitive, and moral changes. This perspective article discusses the advantages of phenomenology to supplement and enhance the principlist process of ethical decision making that guides much of contemporary medical practice, including physical therapy. A phenomenological approach provides a more contextual approach to ethical decision making through probing, uncovering, and interpreting the meanings of “stories” of patients. This approach, in turn, provides for a more coherent and genuine application of ethical principles within the “textured life-world” of patients and their evolving values as they grapple with disability to make ethical and clinical decisions. The article begins with an in-depth discussion of the current literature about the phenomenology of people with disability. This literature review is followed by a discussion of the traditional principlist approach to making ethical decisions, which, in turn, is followed by a discussion of phenomenology and its tools for use in clinical inquiry and interpretation of the experiences of patients with disabilities. A specific case is presented that illustrates specific tools of phenomenology to uncover the moral context of disability from the perspective of patients. The article concludes with a discussion of clinical, educational, and research implications of a phenomenological approach to ethics and clinical decision making.

Closing the Gap Between Ethics Knowledge and Practice Through Active Engagement: An Applied Model of Physical Therapy Ethics

Physical therapist practice has a distinct focus that is holistic (ie, patient centered) and at the same time connected to a range of other providers within health care systems. Although there is a growing body of literature in physical therapy ethics knowledge, including clinical obligations and underlying philosophical principles, less is known about the unique ethical issues that physical therapists encounter, and how and why they make ethical decisions. As moral agents, physical therapists are required to make autonomous clinical and ethical decisions based on connections and relationships with their patients, other health care team members, and health institutions and policies. This article identifies specific ethical dimensions of physical therapist practice and highlights the development and focus of ethics knowledge in physical therapy over the last several decades. An applied ethics model, called the “active engagement model,” is proposed to integrate clinical and ethical dimensions of practice with the theoretical knowledge and literature about ethics. The active engagement model has 3 practical steps: to listen actively, to think reflexively, and to reason critically. The model focuses on the underlying skills, attitudes, and actions that are required to build a sense of moral agency and purpose within physical therapist practice and to decrease gaps between the ethical dimensions of physical therapist practice and physical therapy ethics knowledge and scholarship. A clinical case study is provided to illustrate how the ethics engagement model might be used to analyze and provide insight into the ethical dimensions of physical therapist practice.

Portfolios and professional development in the health professions

Increasing concern in professional education has focused on the gap between thought and action, theory and practice, the academy and the everyday world. Reflection, a process of reviewing, reenacting, and analyzing ones performance, has been proposed as a process in which a professional can learn from experience. The purpose of this article is to report the results of a project that piloted the use of portfolios as a vehicle for professional development and reflection in two health professions, nursing and physical therapy. Evaluation results obtained through a qualitative content analysis of student portfolios and studentfeedback data suggest that student reflection on professional development was promoted, although the portfolios varied in their structure and complexity. Identified portfolio components and implementation benefits and barriers are relevant findings for educators wishing tofacilitate reflection.

Learning: What Matters Most

Dr Jensen is a leader known nationally and internationally for her scholarly contributions related to expert practice, clinical reasoning, professional ethics, and educational theory and application. Although her vision and work often center on physical therapy, she reaches beyond the profession to have an impact on health professions and higher education more broadly. She has served on several editorial boards, including Physical Therapy and the Journal of Physical Therapy Education , and is currently deputy editor for Physiotherapy Research International and Associate Editor for Physiotherapy Theory and Practice and is on the editorial board of Qualitative Health Research . Dr Jensen is author or coauthor of more than 60 publications in peer-reviewed journals and has coauthored 9 books, most recently Leadership in Interprofessional Health Education and Practice , Expertise in Physical Therapy Practice (2nd edition), Educating for Moral Action: A Sourcebook in Health and Rehabilitation Ethics , and the forthcoming third edition of Handbook of Teaching for Physical Therapists . Dr Jensen has received funding from federal, state, and foundation grants totaling more than

Habits of Mind: Student Transition toward Virtuous Practice

2 million, always with a strong commitment to collaborative, community-based work both within and across disciplines. Dr Jensen received her PhD in educational evaluation with a minor in sociology from Stanford University. She holds a masters degree in physical therapy from Stanford University and a bachelors degree in education from the University of Minnesota. During her career, she has held faculty appointments at Stanford University, Temple University, the University of Alabama at Birmingham, Samuel Merritt University, and Creighton University. Dr Jensen is Dean of the Graduate School, Associate Vice President for Research, Academic Affairs, Professor of Physical Therapy, and Faculty Associate, Center for Health Policy and Ethics, Creighton University. Her clinical practice has centered on orthopedic practice, and she has served as a member of the …

Reflections from an interprofessional education experience: evidence for the core competencies for interprofessional collaborative practice.

ABSTRACT: How does one get to be a “good therapist,” one who subscribes to high ethical and professional standards? Current theory and research are used to examine and discuss work with physical therapist students and expert clinicians. The importance of multidimensional knowledge and a collaborative, patient‐centered focus in the clinical reasoning process are analyzed as the foundation for developing deliberative clinical judgment. From this analysis, we propose educational strategies and learning experiences designed to facilitate developing skills and habits of mind that will contribute to virtuous practice. A model for growth through transformative learning is used to reflect on the analysis of student moral development. We propose that critical self‐reflection is a key component for the continued evolution of physical therapy education.

A Vision for Society: Physical Therapy as Partners in the National Health Agenda

The Core Competencies for Collaborative Practice identify the skills needed by every health care provider to be successful in implementing interprofessional practice. Health professions students need to build skills for interprofessional practice as emerging professionals. Reflection is a core skill needed for successful interprofessional practices. This study identifies themes from an interprofessional education research project and discusses their congruency with the Competencies.

Group Work and Reflective Practicums in Physical Therapy Education: Models for Professional Behavior Development

The American Physical Therapy Associations (APTAs) Vision 2020 statement1 provided the stimulus our profession needed to develop a stronger self-awareness and broader public perception of physical therapy as a doctoring profession. Health service delivery in the United States is being refined and shaped by current sociopolitical events. In addition, changes in the demographics of our society, technological advances in medicine that continue to decrease mortality yet increase morbidity, and the critical need for more affordable health care will have an impact on the demand for physical therapy services. In 2001, the Institutes of Medicine (IOM) recognized the urgent need for fundamental change in the American health care delivery system due to the existing “chasm” between the care delivered and the health of the children and adults who reside in the United States today,2 especially for those with developmental or acquired disability.3 On March 23, 2010, US President Barack Obama signed into law the Patient Protection and Affordable Care Act (Public Law 111–148) (PPACA).4 The PPACA focuses on the initial steps needed to reform a health care delivery and reimbursement system that is not consistently meeting the health needs of children and adults across the US population. Healthy People 2020 (HP2020) is the science-based, 10-year national public health agenda for improving the health of all Americans as determined by the US Department of Health and Human Services.5 Healthy People 2020 is the road map between the PPACA (the law that mandates health care reform) and the reform needed in both health services delivery and the national health-science research agenda. There are unique opportunities for physical therapists to participate in the process of health care reform, which includes the stewardship of health care dollars. Through advances in the science and practice of physical therapy, physical therapists have …

Ethics education: developing habits of mind through the use of pedagogical content knowledge

ABSTRACT: As the professional role of the physical therapist continues to evolve, physical therapy educators are faced with the task of preparing professionals who can solve problems and make decisions in an often ambiguous, complex health care setting. They also, however, are faced with curriculums that are already content rich and that leave little room for new additions. The authors suggest alternative teaching methods that focus on active learning strategies applied in small group process and reflective activities. Small group process can facilitate development of professional behaviors through the use of collaboration, collegiality, goal setting, decision making, divergent thinking, peer evaluation and self‐evaluation, and creative problem solving. Reflective activities can be used to help bridge theory with practice. Reflection allows time for analyzing, synthesizing, and integrating complex information and examining alternative strategies and their consequences. Examples of specific classroom activities of these two teaching methods include group expert techniques, game activities, provocative issues, student‐designed evaluations, and reflective practicums.