Meeting contemporary expectations for physical therapists: Imperatives, challenges, and proposed solutions for professional education

BACKGROUND AND PURPOSEThe intimate relationship between practice and education in any profession demands an integrated view of the pressures of the work environment and the social culture in which that work lies. The mission of health care always has been to improve health-first of individuals-and then of populations as science evolved and a more global view of human health emerged.1 Advances in science and shifts in the structure of health care brought new expectations that shaped how the realities of practice must fit the changing demographics of health, illness, and disability. Currently emerging changes in health care policy and regulation have required physical therapists (PTs) to respond to many new expectations.2 These changes are catalysts to lead the evolution of practice and capture opportunities to promote the health of our patients via new delivery models. This position paper proposes changes in professional education to allow PTs to respond to the complexities of health and health care, and be full partners in what must become an integrated and interdisciplinary service industry.POSITION AND RATIONALEWe address 3 focal areas to drive change in physical therapist didactic and clinical education. First, achieving true interdisciplinary practice demands that physical therapist educators create learning experiences that result in interprofessional competence. This expectation must apply initially and across the entire continuum of professional development. Second, while responding to new accountabilities of the federal Affordable Care Act (ACA) may be stressful for practitioners, there is opportunity to create new approaches to address current stresses in clinical education. We advocate expanding the breadth of clinical education to include experiences in accountable care organizations (ACOs) or patient-centered medical homes (PCMHs) as a strategy for building practice options for care across the lifespan of patients. Finally, providing focused and in-depth education in the care of patients with highly prevalent conditions may prepare graduates to implement new care models and pathways that transform how contemporary health conditions are managed. Low back pain, obesity, and cancer survivorship are used as examples of conditions that are common in the adult health profile of the United States (US) and about which PTs must be especially well-educated. Effectively managing these conditions requires more than a single episode of care and demands an interdisciplinary approach inclusive of both treatment and prevention. We propose to develop new paradigms of clinical practice by tailoring professional education to achieve an integrated, interdisciplinary approach to health and health care that will meet contemporary needs.The Interdisciplinary EnvironmentInterprofessional education (IPE) is not a new concept, but it is now an imperative. The US was recognized as a leader in IPE in the 1970s3 and is experiencing a resurgence as health care providers acknowledge the need to be truly interdisciplinary. IPE gained global attention when the World Health Organization (WHO) established its Expert Committee on Medical Education.4 Additional impetus for formalizing IPE arose in 2002 when the Institute of Medicine (IOM) requested that educators focus on IPE as a core essential.5 By 2008, the IOM had restated this request as an imperative. The Association for Prevention Teaching and Research (APTR) fueled interest in IPE by creating the Healthy People Curriculum Task Force (HPCTF) in 2002, and then convening the first Institute for IPE Prevention Education in 2007. In this Institute, interdisciplinary team members from the same institution proposed IPE projects.6 Then, in 2009, the IPE Collaborative (IPEC), comprised of 6 different professional associations, collaborated to publish a report on core competencies for IPE in the health professions.7 Although not a part of the IPEC, the American Physical Therapy Association (APTA) supports having core competencies in IPE and has embraced the work of defining and promoting interprofessional expectations for physical therapy. …