The Experiences of Black Students in Physical Therapy Education in Texas: A Qualitative Study.

INTRODUCTION: Racial or ethnic minorities are underrepresented in many health care professions, including physical therapy. Understanding the experiences of minority students in graduate education provides insight into how physical therapy educational programs can promote diversity, equity, and inclusion, which are factors that have been shown to improve patient outcomes. The purpose of this study is to qualitatively analyze and describe the lived experiences of Black student physical therapists (PT) in Texas. REVIEW OF LITERATURE: Currently, there is a lack of qualitative research that investigates the experiences of Black students in physical therapy education in the United States. SUBJECTS: Nineteen Doctor of Physical Therapy students from 8 different physical therapy educational programs in Texas. METHODS: This qualitative study was conducted using a phenomenological approach. All participants took part in a focus group regarding their academic experiences. Students' dialogues were recorded and transcribed, and the researchers identified recurrent themes. RESULTS: After the analysis of focus group content, it was determined that the following 5 themes characterized the students' experiences: 1) Barriers to enrollment, 2) underrepresentation, 3) implicit and explicit racism, 4) code-switching, and 5) desired image. DISCUSSION AND CONCLUSION: There is evidence to suggest that Black or African American students are subject to unique pressures that negatively affect their experiences during their PT education. Efforts need to be made by higher education institutions and individuals to provide a more inclusive environment to best support those students. By gaining awareness of the results of this study, educators and students can begin dialogues on how to foster inclusivity and cultural understanding in physical therapy education. Ultimately, understanding the experiences of others can improve how individuals coexist in an increasingly diverse society, and how clinicians provide patient-centered, culturally aware care to patients and clients.

Women's Experience of Their First Sexual Encounter After Pelvic Reconstructive Surgery.

OBJECTIVE: To describe the timing, quality and patient concerns regarding the first sexual encounter after surgery for pelvic organ prolapse (POP) or urinary incontinence (UI). METHODS: Women scheduled to undergo POP or UI surgery who self-identified as sexually active were recruited to this qualitative study. Routine counseling regarding the return to sexual activity was provided 4-6 weeks postoperatively. Participants completed interviews 2-4 months after their surgery. Interviews were tape recorded, de-identified, and transcribed. Transcriptions were coded for major themes by two independent researchers; disagreements were arbitrated by the research team. Analysis was performed using Dedoose software. RESULTS: Twenty patients with an average age of 52.4 years participated. Most identified themselves as White (85%), one quarter had a history of hysterectomy, and 15% had previously undergone pelvic reconstructive surgery. Nineteen (95%) patients resumed intercourse 2-4 months after surgery. Thematic saturation was reached with major themes of Outside Influences, Conflicting Emotions, Uncertainty, Sexual Changes and Stability, Normalization, and Self-Image. First sexual encounter timing was strongly influenced by partners' desires and fears and physician counseling. Fear of damage to repairs affected patients' comfort with return to sexual activity. Although uncertain of how anatomical changes or presence of mesh would affect function, women hoped that changes would be positive, regardless of preoperative sexual function. Some women found their experience unchanged, whereas others reported need for change in sexual position, use of lubrication, and sensation of foreign body. Positive changes included increase in desire, pleasure, and improvement in orgasm. Self-image generally improved after surgery, which increased women's sexual confidence. CONCLUSION: The return to sexual activity after surgery for POP or UI represents a great unknown for many women. Reports of initial sexual activity after surgery are often positive, and physicians strongly influence initial postoperative sexual encounter timing. Frank counseling about patient and partners' fears regarding the effect of repair on sexual activity would likely improve patients' outcomes.