The prevalence of wound management physical therapist practice in the state of Texas.

INTRODUCTION: Wound management has become one of the ten physical therapy (PT) certification specialty areas. With this advanced clinical designation opportunity, more PT specialists and residencies with integumentary and wound management expertise will be needed for the educational and practice training of future specialists. PURPOSE: The purpose of this study was to characterize wound management practice by licensed physical therapists in Texas. METHODS: A Qualtrics survey was distributed to 19,159 licensed physical therapists. The questionnaire contained 23 questions that inquired into the subject's professional background, clinical experience, and opinions of wound care practice. RESULTS: The response rate was 9.6% (n = 1,839) and 1,643 respondents indicated that they were currently practicing. Although 69.1% of active physical therapists (n = 1,136) stated that they had practiced wound care at some point of their career, most of them do not practice wound care anymore and their reasons were discussed. Of those active physical therapists, 41.3% (n = 679) of them reported wound care was being practiced in their facilities, but only 18.3% (n = 311) directly practiced wound care. The respondents felt that the prevalence of wound management physical therapists practice over the last five years has been decreasing. CONCLUSION: The current prevalence of wound management practice is low and a decreasing trend of PT practice in wound care was observed in Texas. A limitation of this study is the low response rate. Future studies across different regions of the country are warranted.

Justice in Educational Content: A Guide to Racial and Cultural Representation in Academic and Clinical Teaching and Assessment.

BACKGROUND AND PURPOSE: Case-based instruction is broadly used in health professions education, including physical therapy education. Case-based instruction can support achievement of higher-order, applied, learning objectives and clinical reasoning. Instructors strive to represent the diversity of the clinical population in case studies and may have explicit intercultural competency objectives. The inclusion of cultural, racial, and ethnic characteristics in cases or assessments can potentially reinforce stereotypes or inaccurately emphasize these characteristics as direct predictors of health profile. Furthermore, as most physical therapy faculty creating cases are from a White majority stance, there is a risk that inclusion of cultural elements risks inappropriate and biased representation. POSITION AND RATIONALE: Well-intentioned instructors risk substituting cultural, racial, and ethnic characteristics for social and structural determinants of health. Race is a social, not biologic construction and should not be confused. Informed instructors guided by evidence-based strategies can achieve rich case depictions that do not convey inaccurate risk or alienate learners. DISCUSSION AND CONCLUSION: A curriculum design strategy is offered for case development that brings explicit attention to representation of race and culture. This tool serves as a self-reflective and improvement tool. Continued community and student engagement is necessary to achieve high-quality and instructive case studies.

The Relationship Between Perceived Racism/Discrimination and Health Among Black American Women: a Review of the Literature from 2003 to 2013.

OBJECTIVES: The purpose of this paper was to systematically review the literature investigating the relationship between perceived racism/discrimination and health among black American women. METHODS: Searches for empirical studies published from January 2003 to December 2013 were conducted using PubMed and PsycInfo. Articles were assessed for possible inclusion using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 framework. In addition, the Agency for Healthcare Research and Quality (AHRQ) system for rating the strength of scientific evidence was used to assess the quality of studies included in the review. RESULTS: Nineteen studies met criteria for review. There was mixed evidence for general relationships between perceived racism/discrimination and health. Consistent evidence was found for the relationship between adverse birth outcomes, illness incidence, and cancer or tumor risk and perceived racism/discrimination. Inconsistent findings were found for the relationship between perceived racism/discrimination and heart disease risk factors. There was no evidence to support the relationship between perceived racism/discrimination and high blood pressure. CONCLUSIONS: There is mixed evidence to support the association between perceived racism/discrimination and overall objective health outcomes among black American women. The strongest relationship was seen between perceived racism/discrimination and adverse birth outcomes. Better understanding of the relationship between health and racism/discrimination can aid in identifying race-based risk factors developing primary prevention strategies. Future studies should aim to investigate the role of perceived racism/discrimination as a specific chronic stressor within discrete pathogenesis models.