Excellence in Pediatric Physical Therapy Education: Recommendations and Action Items.

PURPOSE: This special communication identifies evidence-based recommendations and offers action items to facilitate the uptake of new knowledge from the National Study of Excellence in Pediatric Physical Therapy Education (NSE-Peds). SUMMARY OF KEY POINTS: The NSE-Peds identified a conceptual framework consisting of 4 key dimensions and associated elements that dynamically interact to prepare future physical therapists to meet the needs of society. The conceptual framework serves as the Knowledge Creation component of the knowledge to action (KTA) framework, but translation into practice requires the Action Cycle, the second component of the KTA framework. Recommendations and action items provide tangible products derived from the NSE-Peds conceptual framework for application in the Action Cycle. CONCLUSIONS: Using the KTA framework, implementation of the recommendations at the level of the individual, program, and organization should enhance pediatric physical therapy education and ultimately physical therapy care provided to children and families.

Physical Literacy in Elementary Physical Education: A Survey of Fundamental Movement Skill Practice Patterns.

PURPOSE: To describe fundamental movement skill (FMS) practice patterns in the elementary physical education (PE) curriculum. METHODS: A cross-sectional survey was sent to PE teachers of grades 1 through 6. Sixty-eight responses were included for analysis. RESULTS: Only 38.2% of teachers taught all 12 FMS components. Compared with PE teachers for grades 4 to 6, a significantly higher proportion of PE teachers for grades 1 to 3 taught all 12 FMS and used direct instruction methods. For children falling behind, only 8.8% reported referring to an exercise program and no PE teacher sought a health care referral. A video abstract can be found in Supplemental Digital Content 1 (available at: http://links.lww.com/PPT/A342).

Sternal Precautions and Prone Positioning of Infants Following Median Sternotomy: A Nationwide Survey.

PURPOSE: To describe current practice of pediatric sternal precautions (PSPs) and prone positioning restrictions (PPRs) in infants after median sternotomy. METHODS: A Web-based survey with 21 questions was developed on the basis of a review of current literature and expert consultation. Snowball sampling resulted in 68 participants well represented by profession throughout the United States. RESULTS: Approximately 80% of participants reported having institutional protocols for PSPs. Most common reported PSPs were no lifting at the axillae and no pulling of arms to achieve sitting. PSPs also included PPRs. The opinions of participants supported no PPRs or modified PPRs compared with strict PPRs. CONCLUSIONS: Types of PPRs varied across participants, with the majority of participants in favor of modified PPRs while PSPs were less varied. Research is needed to examine the effects of PSPs and PPRs in infants post-median sternotomy.

Contemporary Practice as a Board-Certified Pediatric Clinical Specialist: A Practice Analysis.

PURPOSE: The purpose of the 2019 practice analysis was to identify the elements of contemporary practice as a board-certified pediatric clinical specialist. METHODS: Consistent with the processes of the American Board of Physical Therapy Specialties (ABPTS), a subject matter expert panel used consensus-based processes to develop a survey to gather information concerning the knowledge areas, professional roles and responsibilities, practice expectations, and practice demographics of board-certified pediatric clinical specialists. The web-based survey was divided into 3 parts and administered to 3 separate groups of board-certified pediatric clinical specialists. RESULTS: Survey responses from 323 clinical specialists provided data to support confirmation and revision of the Description of Specialty Practice (DSP) for pediatrics. CONCLUSIONS: The revised DSP will provide contemporary practice information to inform the ABPTS specialist examination blueprint and the curricula of credentialed residency programs in pediatric physical therapy.

Moving Toward Excellence in Pediatric Physical Therapy Education: A Scoping Review.

PURPOSE: The purpose of this scoping review was to identify and map current evidence that underpins excellence in pediatric physical therapy education. METHODS: An extensive review was conducted of literature published over a 27-year period regarding pediatric physical therapy/medical/allied health education. RESULTS: Thirty articles were reviewed and analyzed. Articles were classified as levels of evidence 4 to 7. Three major overarching concepts emerged: faculty characteristics, curriculum, and pedagogy. CONCLUSIONS: Few published studies with methodological rigor exist on this topic. More research and higher quality studies are needed to identify exemplar programs, curriculum, and pedagogy. The key concepts identified in this review will help inform the definition of excellence, as it is perceived through the lens of pediatric physical therapy educators, clinicians, and students.

Comparative Effect of Power Training and High-Speed Yoga on Motor Function in Older Patients With Parkinson Disease.

OBJECTIVES: To compare the effects of power training (PWT) and a high-speed yoga program on physical performances in older patients with Parkinson disease (PD), and to test the hypothesis that both training interventions would attenuate PD symptoms and improve physical performance. DESIGN: Randomized controlled trial. SETTING: A laboratory of neuromuscular research and active aging. PARTICIPANTS: Patients with PD (N=41; mean age ± SD, 72.2 ± 6.5y). INTERVENTIONS: Two high-speed exercise interventions (specifically designed yoga program and PWT) were given for 12 weeks (twice a week), and 1 nonexercise control group. MAIN OUTCOME MEASURES: Unified Parkinson Disease Rating Scale motor score (UPDRSMS), Berg Balance Scale (BBS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go, functional reach, single leg stance (SLS), postural sway test, 10-m usual and maximal walking speed tests, 1 repetition maximum (RM), and peak power (PPW) for leg press. RESULTS: For the posttests, both training groups showed significant improvements (P<.05) in all physical measurements except functional reach on the more affected side, SLS, and postural sway compared with the pretests, and significantly better scores for UPDRSMS, BBS, Mini-BESTest, Timed Up and Go, functional reach on the less affected side, 10-m usual and maximal walking speed tests, 1RM, and PPW than controls, with no differences detected between the yoga program and PWT. CONCLUSIONS: Both the specially designed yoga program and PWT programs can significantly improve physical performance in older persons with PD.

Identifying Perspectives on Physical Therapist Residency Program Goals: Hallmarks of Success and Excellence.

OBJECTIVE: The purpose of this study was to describe common perspectives important to achieving excellence and success in physical therapist residency education programs. METHODS: Individuals with direct responsibility for creating and revising physical therapist residency program goals participated in a mixed-methods study using Q-methodology. They sorted 31 goal topics based on the level of importance for achieving excellence and success in physical therapist residency education. By-participant factor analysis identified dominant perspectives, which were interpreted based on emergent themes from the topics identified as the most important. Participants' rationale for selecting goal topics as the most important were extracted from the post-survey. RESULTS: Seventy-three individuals responded, representing 9 of the 11 clinical residency areas of practice. Three main perspectives emerged: resident behaviors, resident achievements, and program attributes. One shared perspective emerged across all 3 factors that emphasized the residents' ability to become self-regulated, lifelong learners who integrate learning into practice: preparation for future learning. CONCLUSIONS: Variability in weighting the importance of program goals associated with each perspective may include a program's organization and mission, individual beliefs and experiences related to program leadership, and resource availability. Although respondent emphasis placed importance of some items over others, the findings do not suggest that items ranked lower were unnecessary or unimportant in achieving program excellence. The relative importance of items was weighted differently based on the perspective of program leadership and the individual completing the sorting activity. IMPACT: The results of this study suggest that physical therapist residency programs should have at least 1 or 2 goals in each of the 3 distinct perspectives, as well as the 1 shared perspective identified in our findings. Some consistency in program goals based on the perspectives identified here may enable further research exploring excellence, value, and outcomes in physical therapist residency education.

Motor proficiency, strength, endurance, and physical activity among middle school children who are healthy, overweight, and obese.

PURPOSE: To compare motor proficiency, strength, endurance, and physical activity among children from minority backgrounds who were healthy weight (HW), overweight (OW), or obese (OB). METHODS: Eighty-six children, aged 10 to 15 years, of mostly Hispanic ethnicity, participated. Children were categorized according to body mass index-for-age percentile. Bruininks-Oseretsky Test of Motor Proficiency (BOT2) Short Form, Sit-to-Stand (STS), Timed Up and Down Stairs, and 6-Minute Walk Test (6MWT) were administered. Physical activity was measured by using activity monitors. RESULTS: Forty-five percent of children were classified as OW/OB. Children who were OB had lower mean BOT2, STS, and 6MWT performance than children of HW. Among children who were OW/OB, daily mean steps were lower and sedentary minutes higher than children of HW. In children who were OW/OB, body mass index was negatively correlated with BOT2, STS, and abdominal curls. CONCLUSION: Children who are OB demonstrate greater impairments in motor proficiency, strength, and endurance and participate in less physical activity than peers of HW.

The Use of Movement Scripts for Clinical Reasoning in Physical Therapist Education and Practice.

The purpose of this Perspective is to present an application of script-based reasoning to physical therapist education and practice. Illness script-based reasoning has been described as a cognitive strategy for medical practitioners to diagnose and manage health conditions. Analogous to this medical model of patient management, "movement scripts" can be used by physical therapists in clinical reasoning. Movement scripts use features of the human movement system to recognize, categorize, and substantiate clinical problems and can be used to facilitate the development of master adaptive learners across the spectrum of physical therapist education and practice. Movement scripts are also consistent with the concept of the "human body as teacher" as the signature pedagogy proposed by the National Study of Excellence and Innovation in Physical Therapy Education. Movement of the human body, as captured by the concept of the human movement system, is a vehicle for lifelong adaptive learning for the physical therapist. Script-based learning and practice are consistent with other elements of this model, including practice-based learning and the creation of adaptive expertise. As the role of the movement system as a guide to physical therapist practice continues to evolve, movement scripts can provide a structure to facilitate development of clinical reasoning skills for physical therapist practice and education.

National Study of Excellence in Pediatric Physical Therapy Education: Design, Methods, and Results.

OBJECTIVE: The purposes of this study were to identify and describe the attributes of excellence and innovation in professional pediatric physical therapy education and develop a conceptual framework identifying dimensions of excellence. METHODS: A multimethod case study design based on a grounded theory framework was used. Data collection included review of artifacts and field interviews (individual and focus group). A constant-comparative method for within case and across case was used for data analysis to verify and revise coding schemes, identify categories and subcategories, revise emerging themes, and develop a conceptual framework. RESULTS: Based on results of a predetermined grading rubric, 6 of 17 self-nominated academic sites were selected representing diverse institution types (public/private, Carnegie classification, size) and geographic locations. Pedagogical approaches and method of content delivery varied among programs; all used the essential core competencies. The core pediatric faculty member(s) were Board Certified Clinical Specialists. A conceptual framework was developed based on 4 key dimensions: Culture of Excellence, Exemplary Pediatric Faculty, Pedagogy, and Child and Family as Teacher (CFT), and 16 related elements. CONCLUSIONS: CFT is a unique and nonnegotiable dimension of excellence in pediatric physical therapy education, highlighting the partnership between the learner, child, family, and pediatric faculty member. CFT intersects with the other dimensions and integrates their elements (ie, faculty characteristics, contributions from the child and family, use of instructional strategies) to effectively prepare future pediatric physical therapists. Based on the pervasiveness of this dimension in teaching and learning across all programs, this may be the signature pedagogy of pediatric physical therapy education. IMPACT: Results of this study are important to professional physical therapist education administrators, pediatric academic faculty, and clinical educators because they represent an understanding of the attributes of excellence. The model can serve as a guide for best practice in pediatric physical therapy education.