Preparing for the Future: A Practice-Based Approach for Entrepreneurship Education in Health Professions.

In a dynamic healthcare landscape, graduates in healthcare enter a field that is filled with change and uncertainty. Educators, seeking to prepare students to meet the demands of this change from a clinical perspective, must prepare students for adapting to the healthcare market. Entrepreneurship education prepares the student to adapt to such changes. This paper describes an interactive practice-based approach to teach entrepreneurship incorporating practices of play, empathy, creativity, experimentation, and reflection. Focusing on active learning, students participated in games, competitions, and group work that convey the habits of entrepreneurs. To determine the relationship of these activities in a physical therapy course with students' mindset and intentions of becoming entrepreneurs, data were collected measuring the entrepreneurial orientation (EO) and entrepreneurial intention (EI) of the students at the beginning and end of the course over three cohorts. EO consists of three behaviors: innovativeness, risk-taking, and proactiveness. With 234 students completing the outcome measures at both timepoints, a significant increase in proactiveness was found, but no change was found in other behaviors of EO or EI. Lower scores were found in females with risk-taking and EI. Healthcare professions education programs should consider including entrepreneurship education in their curricula using a participative, practice-based approach.

The Relationship Between Professionalism and Leadership: Parent-Child or Sibling?

Professionalism has been the foundation of physical therapy's contract with society, with the American Physical Therapy Association's (APTA) Core Values and Code of Ethics serving as its building blocks. Professional formation has focused on professionalism and has been taught in a manner that is more implicit than explicit in doctor of physical therapy (DPT) curricula. As a domain of competence, professionalism alone has not been broad enough to meet societal needs. In reaching our centennial year, many have reflected on what competencies are needed to move forward. The need for leadership competencies is not new and has been espoused by our leaders over the past 100 years. Some advocate for the adoption of leadership as a unique domain of competence, separate from the domain of professionalism, whereas others propose that either professionalism or leadership is one domain of competence that subsumes the other. The purpose of this Perspective is twofold: to compare and contrast the concepts of professionalism and leadership, and to make recommendations regarding what constitutes domains of competence within the professional formation of physical therapists. This Perspective offers recommendations addressing professional formation and the adoption of leadership and professionalism as 2 distinct domains of competence and discusses educational and clinical implications of the recommendations. This Perspective asserts that these recommendations must be adopted to move the profession forward into the next century so that physical therapists are recognized as adding value to the health care system and the evolving needs of society.

Self-Leadership Is Critical for All Physical Therapists.

Evidence that supports the explicit need to develop leadership skills at all levels of clinical practice is prevalent,1-8 yet intentional development of "self-leadership" within health care, and particularly within physical therapy, remains slow, fragmented, and inconsistent. Delineation and standardization of the definition of leadership, and the approach to developing leadership skills in individuals practicing within health care continues to be debated, producing several key dilemmas. Moreover, there is a lingering misperception that developing leadership capacity is reserved for physical therapists who assume positional or formal roles as "leaders" within communities, health care organizations, practices, or teams. This misperception focuses leadership development on "leading others" rather than "leading self." Similarly, challenges exist between balancing the leadership development needs of the leader as a positional role and the act of "leading" as physical therapists practice and engage within all levels of care and within different communities-as individuals and within teams. This tension further complicates when and how best to prepare physical therapists to meet this essential skill set in clinical practice. The purpose of this perspective is to describe nonpositional self-leadership and its importance to physical therapy practice, to propose common or contemporary leadership-related terminology, and to suggest a framework for leadership development. Through accomplishing these purposes, readers may be encouraged to change and adopt recommendations.

Exploring the Concept of Leadership from the Perspective of Physical Therapists in the United States.

Purpose: The purpose of this study was to examine the perceptions of physical therapists practising in the United States of the importance of leadership characteristics and of demographic traits and other factors that might be associated with perceptions of leadership in three contexts: workplace, health care system, and society. Method: An online questionnaire was distributed through snowball sampling to physical therapists practising in the United States over an 8-week period between October and November 2019. A total of 15 leadership characteristics were rated on a 5-point scale of importance. Results: A total of 278 physical therapists responded to the questionnaire. They rated communication and professionalism as the top two leadership characteristics across all settings. Self-awareness and business acumen were not perceived as important for leadership. No relationship was found between gender and self-declaration as a leader or between a participant's practice setting and their rating of the importance of leadership characteristics. Conclusions: Our results further the discussion of leadership in the physical therapy profession. They highlight a comprehensive acceptance of leadership characteristics as important regardless of context. Further work will be necessary to transition this declaration of the importance of leadership skills to identifying the essential leadership skills for physical therapist education and clinical practice.

Objectif : examiner les perceptions des physiothérapeutes des États-Unis à l'égard de l'importance des caractéristiques de leadership, des caractéristiques démographiques et d'autres facteurs susceptibles d'être associés aux perceptions de leadership dans trois contextes : le milieu de travail, le système de santé et la société. Méthodologie : distribution en ligne d'un questionnaire par échantillonnage en boule de neige aux physiothérapeutes qui exercent aux États-Unis, sur une période de huit semaines entre octobre et novembre 2019. Au total, les chercheurs ont évalué 15 caractéristiques de leadership sur une échelle de cinq points. Résultats : au total, 278 physiothérapeutes ont répondu au questionnaire. Ils ont classé la communication et le professionnalisme au sommet des caractéristiques du leadership dans tous les contextes. Ils n'ont pas perçu la conscience de soi ni le sens des affaires comme des éléments importants du leadership. Ils n'ont constaté aucun lien entre le genre et l'autodéclaration de leader ou entre le milieu de pratique d'un participant et son classement de l'importance des caractéristiques de leadership. Conclusion : les résultats font évoluer les échanges sur le leadership dans la profession de la physiothérapie. Ils font ressortir l'acceptation complète de l'importance des caractéristiques du leadership, quel que soit le contexte. D'autres travaux s'imposent pour faire transiter cette déclaration sur l'importance des capacités de leadership vers la détermination des compétences de leadership essentielles pour l'enseignement de la physiothérapie et la pratique clinique.

Leadership development of nursing professionals: Education and influences of self-efficacy.

BACKGROUND: According to Bandura's theory, understanding the relationship of traits and leader self-efficacy in the various roles of nursing can aid in leader development and the growth of the profession. PURPOSE: The purpose of this study was to explore the perceptions of leader self-efficacy of academic nursing professionals to determine if traits and participation in certain activities was predictive of leader self-efficacy. METHOD: A validated survey tool, the Leader Efficacy Questionnaire (LEQ) was administered to nursing professionals using snowball sampling from publicly available email addresses. FINDINGS: Statistical significance was found between the academic degrees and the 4 scores of the LEQ. Overall, the participants reported moderate to high leader self-efficacy with an LEQ overall score (LSME) of 70 or greater. DISCUSSION: The dynamic challenges of health care require an understanding of nursing professionals' leader self-efficacy in light of their academic preparation and activities to grow the profession.

Undergraduate students' perspectives of healthcare professionals' use of shared decision-making skills.

Essential for future healthcare professionals (HCPs) to delivering ethical and empathetic patient-centred care (PCC) as a team is the understanding of appropriate shared decision-making (SDM) responses when facilitating discussions with patients and family members. The purpose of this study was to evaluate undergraduate students' perspectives about HCPs' use of SDM as described in a case-study reflection assignment. An exploratory qualitative approach was used to analyse student-reflection assignments. The sample included 42 undergraduate students enrolled in an interprofessional education (IPE) course at a Midwest university based in the United States. Data consisted of student responses in a course reflection assignment that captured their perspectives about recommended SDM responses by HCPs. Student assignments were randomly selected using stratified sampling to provide representation of eight HCP roles. Analysis revealed two themes related to students' use of SDM responses. Results provide evidence supporting the tenet that through IPE, healthcare students can develop an understanding of SDM and ethical principles related to PCC.

The Quality of Reporting of Abstracts in Physical Therapy Literature is Suboptimal: Cross-Sectional, Bibliographic Analysis.

OBJECTIVE: The quality of abstract reporting in physical therapy literature is unknown. The purpose of this study was to provide baseline data for judging the future impact of the 2010 Consolidated Standards of Reporting Trials statement specifically referencing the 2008 Consolidated Standards of Reporting Trials statement for reporting of abstracts of randomized controlled trials across and between a broad sample and a core sample of physical therapy literature. DESIGN: A cross-sectional, bibliographic analysis was conducted. Abstracts of randomized controlled trials from 2009 were retrieved from PubMed, PEDro, and CENTRAL. Eligibility was determined using PEDro criteria. For outcomes measures, items from the Consolidated Standards of Reporting Trials statement for abstract reporting were used for assessment. Raters were not blinded to citation details. RESULTS: Using a computer-generated set of random numbers, 150 abstracts from 112 journals comprised the broad sample. A total of 53 abstracts comprised the core sample. Fourteen of 20 Consolidated Standards of Reporting Trials items for both samples were reported in less than 50% of the abstracts. Significantly more abstracts in the core sample reported (% difference core - broad; 95% confidence interval) title (28.4%; 12.9%-41.2%), blinding (15.2%; 1.6%-29.8%), setting (47.6%; 32.4%-59.4%), and confidence intervals (13.1%; 5.0%-25.1%). CONCLUSIONS: These findings provide baseline data for determining if continuing efforts to improve abstract reporting are heeded.

Introduction to the GRADE approach for guideline development: considerations for physical therapist practice.

BACKGROUND: Practice guidelines (guidelines) have an increasing role in health care delivery and are being published more frequently. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) is an approach for guideline development. The GRADE approach has been adopted by multiple national and international organizations producing guidelines related to physical therapist care. OBJECTIVE: The purpose of this article is to introduce physical therapists to the GRADE approach for guideline development. RESULTS: GRADE provides a consistent approach for guideline development and transparency in the communication of how the guidelines were developed and how the recommendations were reached, leading to informed choices by patients, clinicians, and policy makers in health care. GRADE leads to a clear distinction between the strength of the evidence and the recommendation. Both the direction (for or against) and the strength (weak or strong) of the recommendation are considered. For determining the strength of the recommendation, GRADE takes into account the quality of evidence, the balance of benefit and harm, uncertainty about or variability in patients' values and preferences, and uncertainty about whether the intervention is a wise use of resources. LIMITATIONS: The GRADE approach has been used primarily with interventions and clinical questions and less often with questions related to diagnosis and prognosis. CONCLUSIONS: The frequency of publication of guidelines is increasing. To make informed choices in the health care system, physical therapists should understand how guidelines are developed. The GRADE approach has been adopted by national and international organizations that produce guidelines relevant to physical therapist practice. Understanding the GRADE approach will enable physical therapists to make informed clinical choices.