Nicole Christensen

An Interprofessional Consensus of Core Competencies for Prelicensure Education in Pain Management: Curriculum Application for Physical Therapy

Core competencies in pain management for prelicensure health professional education were recently established.1 These competencies represent the expectation of minimal capabilities for graduating health care students for pain management and include 4 domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain (Appendix 1). The purpose of this article is to advocate for and identify how core competencies for pain can be applied to the professional (entry-level) physical therapist curriculum. By ensuring that core competencies in pain management are embedded within the foundation of physical therapist education, physical therapists will have the core knowledge necessary for offering best care for patients, and the profession of physical therapy will continue to stand with all health professions engaged in comprehensive pain management. One hundred million adults in America have chronic pain.2 This statistic is greater than the number of individuals affected by diabetes, cancer, and heart disease combined.2,3 Chronic pain management costs the United States more than

Clinical Reasoning: Survey of Teaching Methods, Integration, and Assessment in Entry-Level Physical Therapist Academic Education

600 billion per year in health care costs and lost wages2 and creates major human and economic costs for patients, families, and society.1 Inadequate treatment or mismanagement of pain can cause delays in healing as well as long-lasting changes to the peripheral and central nervous systems.4 The Institute of Medicine published a report on pain in 2011 that highlighted it as a national challenge and recognized the need for a cultural transformation to effectively prevent, assess, treat, and understand pain of all types.2 This report addressed the deficit in pain education across all professions and promoted the inclusion of standardized information about pain within an “interprofessional setting.”2 Specific to physical therapy, a faculty survey of accredited physical therapist education programs in North America revealed 4 hours of pain education …

Physiotherapy Clinical Placements and Learning to Reason

Background Although clinical reasoning abilities are important learning outcomes of physical therapist entry-level education, best practice standards have not been established to guide clinical reasoning curricular design and learning assessment. Objective This research explored how clinical reasoning is currently defined, taught, and assessed in physical therapist entry-level education programs. Design A descriptive, cross-sectional survey was administered to physical therapist program representatives. Methods An electronic 24-question survey was distributed to the directors of 207 programs accredited by the Commission on Accreditation in Physical Therapy Education. Descriptive statistical analysis and qualitative content analysis were performed. Post hoc demographic and wave analyses revealed no evidence of nonresponse bias. Results A response rate of 46.4% (n=96) was achieved. All respondents reported that their programs incorporated clinical reasoning into their curricula. Only 25% of respondents reported a common definition of clinical reasoning in their programs. Most respondents (90.6%) reported that clinical reasoning was explicit in their curricula, and 94.8% indicated that multiple methods of curricular integration were used. Instructor-designed materials were most commonly used to teach clinical reasoning (83.3%). Assessment of clinical reasoning included practical examinations (99%), clinical coursework (94.8%), written examinations (87.5%), and written assignments (83.3%). Curricular integration of clinical reasoning-related self-reflection skills was reported by 91%. Limitations A large number of incomplete surveys affected the response rate, and the program directors to whom the survey was sent may not have consulted the faculty members who were most knowledgeable about clinical reasoning in their curricula. The survey construction limited some responses and application of the results. Conclusions Although clinical reasoning was explicitly integrated into program curricula, it was not consistently defined, taught, or assessed within or between the programs surveyed-resulting in significant variability in clinical reasoning education. These findings support the need for the development of best educational practices for clinical reasoning curricula and learning assessment.

Dimensions of clinical reasoning capability

Learning to reason should be experienced within a continuum of professional development, guided by curricula explicitly focused on the learning of and from clinical reasoning. We contend that this learning should be initiated during professional entry education, and intentionally built upon through post-entry-level continuing professional clinical education opportunities. While the focus and examples provided in this case are primarily from the authors’ entry-level education teaching and curriculum development experiences, we also extend our discussion to consideration of how learning to reason should and can be further facilitated within post-professional entry education contexts such as residency and fellowship programs.