The impact of simulation-based learning on the knowledge, attitude and performance of physiotherapy students on practice placement.

BACKGROUND: Practice placement is a crucial part of pre-registration physiotherapy education worldwide. However, educators face challenges in finding practice sites for students to undertake placement. The use of simulation-based (SBL) learning has the potential to replace some traditional placement, thereby increasing placement capacity, but the benefits have not been fully explored. This study aimed to assess the impact of SBL placement on students' knowledge, attitude, and performance during practice placements with external providers. METHODS: This study utilised an exploratory qualitative research design using a semi-structured interview to collect data from Year 2 students of a 2-year MSc pre-registration physiotherapy programme in the UK. To be eligible to be included in the study, students must have participated in the 4-week simulation placement and have completed all their practice placements with external providers. All the interviews were conducted virtually in a 1:1 setting and recorded. The interviews lasted an average of 45 min. An inductive thematic analysis based on Braun and Clarke's approach was utilised in this study. RESULTS: Twelve students consented to participate in this study. The 56 codes generated from the data were categorised into 5 themes; [1] Working together, [2] Working with Service Users, [3] Professionalism, [4] Profession-specific practical skills and [5] Generic practical skills. Participants unanimously expressed a positive view on working in groups, and they believe that engaging with service users who acted as patients enhanced the authenticity of the simulation placement. Subjective and objective assessments were considered important profession-specific skills gained during the simulation. Despite the benefits derived from the simulation placement, some participants felt that the learning experience would have been enriched by periodically changing the groups they were working in and having the opportunity for more 1:1 feedback throughout the four weeks. CONCLUSIONS: SBL has the potential to be a valuable educational experience for physiotherapy students. It may assist in better preparing students for successful integration into the dynamic healthcare environment. To enhance and improve the authenticity of this type of placementour recommendations include recruiting more service users, incorporating and encouraging more intervention-based elements, and increasing the practice educators' and students' contact time.

Lesbian, gay, bisexual, and transgender clinical competence of physiotherapy students in Israel.

BACKGROUND: Clinical competence encompasses attitudes, skills, and knowledge regarding diverse client groups. Appropriate clinical competence requires an understanding of the cultural context in which healthcare is delivered. In conservative countries such as Israel, there is a noticeable scarcity of information regarding the clinical competency of physiotherapy students (PTSs) in effectively treating lesbian, gay, bisexual and transgender (LGBT) individuals. The objective of this study was to assess the level of LGBT clinical competence among PTSs in Israel. METHODS: Conducted through an anonymous online self-report survey, this study gathered personal and academic background information and self-reported data on previous LGBT education during undergraduate studies of PTSs. It utilized the Hebrew version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS) questionnaire. Descriptive statistics were computed for all outcome measures. The internal reliability of the LGBT-DOCSS was assessed. Total scores of the LGBT-DOCSS, along with scores in each of the three subscales (clinical preparedness, knowledge, and attitudes), were compared across different levels of religiosity and gender. RESULTS: The sample comprised of 251 PTSs, with an average age of 25.57 ± 3.07 years (34.7% men, 65.3% women). All students reported a lack of LGBT community-related courses during their undergraduate studies. The translated Hebrew version demonstrated good internal consistency, with Cronbach's alpha ranging from 0.65 to 0.83. The LGBT-DOCSS total score was 4.55 ± 0.61 out of 7, indicating a low level of clinical competency. The highest mean score was in the attitudes subscale (6.55 ± 0.87), which was significantly higher than the scores for the knowledge subscale (3.14 ± 1.46) and clinical preparedness subscale (3.36 ± 0.86). Religiousness was significantly associated with clinical preparedness and attitudes. Men exhibited higher self-reported levels of knowledge and clinical preparedness, albeit with more negative attitudes compare to women. Sexual orientation was significantly associated with clinical competency, with PTSs who identified as heterosexual demonstrating a lower level of clinical competency compared to participants who identified as non-heterosexual. CONCLUSIONS: In Israel, PTSs demonstrated a low level of clinical competency in terms of self-reported knowledge and self-reported clinical preparedness but contrasting positive attitudes toward the LGBT community. Religiousness, gender and sexual orientation had a significant influence on competency levels.These preliminary findings highlight the urgent necessity to enhance the knowledge of PTSs regarding the LGBT community to improve their clinical competence. TRIAL REGISTRATION NR: Not applicable.

Clinical learning evaluation among undergraduate physical therapy students during rotations in teaching hospitals of Sialkot and Lahore.

OBJECTIVE: To evaluate the clinical learning environment among undergraduate physical therapy students. METHODS: The descriptive, cross-sectional study was conducted from Januar y 23 to May 25, 2023, after approval from the ethics revie w committe e of Imran Id rees Ins titute of Rehabilitation Sciences, Sial kot, Pak istan, an d comprised undergraduate physical therapy students of either gender aged 19-26 years in their 3rd to 5th academic year studying in different institutions in Lahore and Sialkot. Data was collected using the clinical learning evaluation questionnaire. Data was analysed using SPSS 22. RESULTS: Of the 295 students, 269(91.2%) were females and 26(8.8%) were males. The overall mean age was 22.03±1.14 years. There were 210(71.2%) stude nts enrol led in the semester system , w hile 85(28.8%) we re part of the an nual system. The overall mean score was 71.05±10.20. Super vision (76.02±11.80) and motivation (80.21±11.71) were the most satisfying part of clinical learning identified by the students. CONCLUSIONS: The clinical learning environment demonstrated high satisfac tion levels in supervision and motivation domains, while im provements were nee ded in the areas of cas es, authenticity and organisation of doctor-patient encounters.

Brazilian classification of physical therapy diagnosis.

BACKGROUND: The Brazilian Classification of Physical Therapy Diagnosis, developed by the Federal Council of Physiotherapy and Occupational Therapy (COFFITO), has the constitutional objectives of standardizing ethical, scientific and social aspects of the Physical Therapy profession. OBJECTIVE: To describe the work process, rationale and proposal for standardization of a physical therapy diagnosis classification system in Brazil. METHODS: A working group was created to propose a standardized classification for the description and codification of physical therapy diagnoses. Some terminologies common to the International Classification of Functioning (ICF) were used to make the nomenclature of diagnoses compatible with the outcomes inherent in the field of physical therapy. RESULTS: The Brazilian Classification of Physical Therapy Diagnosis project culminated in a physical therapy diagnosis model consisting of terms grouped by organic systems and identifying codes. In addition, an application was developed to allow professionals to use the standardized diagnostic classification in an online system. CONCLUSION: The diagnostic classification system is expected to advance the Physical Therapy profession allowing the identification of structural and/or functional alterations in a simplified and standardised manner. From a physical therapy perspective, this classification may help to consolidate the autonomy of the Brazilian physical therapists by establishing a clearer pathway between the diagnosis and interventions.

Position statement on genuine physiotherapy research at German university hospitals.

In addition to patient care, physiotherapy is increasingly important in research at university hospitals. Genuine physiotherapy research plays a decisive role in this. This position statement describes the opportunities, benefits, framework conditions, challenges, and research priorities of genuine physiotherapy research at German university hospitals.

Systematic Development and Validity Evidence for a Checklist to Assess Bed Mobility Skills Among Physical Therapy Students.

INTRODUCTION: Assessments with strong validity evidence are necessary to accurately assess health professions students' performance of clinical skills. The aim of this study was to develop and validate a checklist assessment of physical therapy students' performance of bed mobility skills. METHODS: A checklist was developed using a 4-step process: 1) evidence review and preliminary checklist development, 2) Delphi review to reach consensus on content, 3) pilot testing and checklist editing, 4) final round of Delphi review. Consensus during Delphi review was defined as 100% of participants rating an item "keep as is" and zero comments in Round 1, and >50% of participants rating each item agree/strongly agree in subsequent Delphi rounds. Interrater reliability (IRR) was measured by two raters scoring 32 recorded exam simulations. RESULTS: All 48 items of the checklist reached consensus after three rounds of Delphi review (12 participants in Round 1, 11 participants in Rounds 2-3). IRR was substantial with 88.5% agreement, Cohen's kappa coefficient=0.61, p<0.001, 95% CI [0.56, 0.66]. DISCUSSION: This checklist has potential to be used to assess student readiness to evaluate and train patients in bed mobility tasks for first-time clinical experiences and to serve as a methodological template for future checklist development.

Clinical Education Data Management: Current Landscape in Entry-Level Physical Therapist Education.

BACKGROUND: Data management (DM) systems represent an opportunity for innovation in education and data-driven decision-making (DDDM) in allied health education. Understanding clinical education (CE) DM systems in entry-level physical therapy (PT) education programs could provide valuable insight into structure and operation and may represent opportunities to address CE challenges. The purpose of this study is to describe how PT programs are using CE DM systems to inform recommendations for CE DM and support knowledge sharing and DDDM. SUBJECTS: CE faculty and administrators were recruited from entry-level PT education programs to participate in a cross-sectional survey. METHODS: The authors designed a novel survey which included demographics and use of CE DM systems. Descriptive statistics and content analysis of narrative data were used to examine responses. RESULTS: The survey was distributed to 220 academic PT programs in June 2021 with 111 respondents (50% response rate). Respondents use multiple systems to complete CE tasks (e.g., placement process, on-boarding, agreement tracking, as a CE site database). Forty-three percent (n=47) use one system, 76% (n=35) of those use the same Software as a Service vendor. Eighty-six percent (n=96) are satisfied with their current CE DM system. Respondents enter data related to CE site information, CE environment, length of the CE experience, and accreditation-required clinical instructor information. Ninety-four percent (n=93) and 70% (n=70) extract data to make decisions about the placement process and curriculum, respectively. CONCLUSION: While variability across CE DM systems presents a challenge, survey respondents indicated common practices related to functionality, data entry, and extraction. Clinical education DM systems house critical data to address challenges in CE. Strategies to improve accessibility and use of this data to support DDDM should be explored.

Best Practices in Clinical Education: A Site Visit Decision-Making Model in Physical Therapist Education.

Stakeholders in health science education engage in site visits during student clinical education experiences, which may occur in person or remotely via videoconference, telephone, or email. Significant variability in practice highlights the need for a more consistent approach to conducting site visits based on evidence-based best practices. Site visits can be burdensome to both clinical and academic stakeholders considering the significant time and resources needed to conduct them effectively. Despite these obstacles, site visits have been shown to add value to the clinical experience for all parties involved. This paper presents the available literature in health science education regarding clinical site visits and describes how it was used to develop and implement a model of best practice for conducting clinical site visits in physical therapist education. The Site Visit Decision-Making Model is based upon findings from contemporary research exploring the interests of each stakeholder, as well as the multifaceted and purposeful decision-making process that takes place when conducting site visits in physical therapist clinical education. Implementation of this model may assist academic stakeholders in health science education in prioritizing which methods of communication for conducting site visits are most effective and efficient.

Taking Action to Promote Diversity and Inclusion: One Program's Efforts Through Pathway Opportunities, Holistic Admissions, and Curricular Changes.

AIMS: Concerted, effective, and sustainable change in healthcare education programs is a critical step towards creating more diverse, inclusive, and equitable professions. This commentary demonstrates how one entry-level physical therapist education program, through a process of reflection, prioritization, and action, is taking steps to increase diversity, equity, and inclusivity within their program. RATIONALE: This article highlights initiatives that are leveraging existing partnerships and creating new ones to reach and mentor students from diverse communities, steps taken towards a more holistic and equitable admissions process, implementation of curricular changes to intentionally discuss the social determinants of health, and engagement of faculty and students to foster personal and professional development on diversity, equity, and inclusion topics. Outcomes to track the effectiveness of the strategies being used by each initiative are shared. CONCLUSION: To create active agents of change, education programs must create a diverse and equitable space for students and guide them to become leaders who can transform society. Steps taken by an entry-level physical therapist education program to implement strategies to promote diversity, equity and inclusion can serve as a road map for other healthcare professional programs.

Scientific approach, attitudes, and perspectives on research among Swedish physiotherapy students-a cross-sectional study.

BACKGROUND: Scientific evidence is important to evidence-based practice. Hence, the application of evidence-based practice requires relevant skills and an understanding of science, which therefore need to be learned and trained during the undergraduate program in physiotherapy. The aim of this study was to investigate attitudes, perceived competence, and conditions for a scientific approach among physiotherapy students in Sweden, and to compare attitudes and perceived competence between students in different program years. METHODS: Physiotherapy students from six universities (n = 1499) were invited to respond to a digital survey. The survey contained questions regarding attitudes toward science, perceived competence in research interpretations and open comments regarding requirements for a strengthened scientific approach during education. Comparisons between education years were performed with ANOVA/Kruskal‒Wallis test (scale outcomes) and logistic regression (binary outcomes). RESULTS: A total of 466 students responded to the survey. In total, 57% (n = 266) of the students had a high interest in science. No significant difference in interest in science was found between students in the three program years, but 75% (n = 347) reported increased interest during the program. A perceived high ability to understand the structure and performance of scientific studies was reported by 31% (n = 144), to evaluate the methodology by 16% (n = 72) and to interpret statistical results from scientific studies by 12% (n = 55). The lowest perceived competence was reported among students in their second year (p < 0.05). A majority of the students (88%; n = 410) reported a perceived personal need for strengthened conditions for a scientific approach, with suggested prerequisites during education via increased theoretical and applied understanding of the research. CONCLUSION: Even though this study does not fully cover physiotherapy students at all undergraduate programmes in Sweden, the results support that a scientific approach and training should be strengthened during education to enable physiotherapists to understand and interpret science and to fully apply an evidence-based approach in upcoming clinical practice. Both theoretical and applied knowledge and understanding are needed.

A Comparison of Physical Therapist Educational Outcomes Before and During the COVID-19 Pandemic: A Multicenter Study.

INTRODUCTION: The purpose of this study was to analyze and compare educational outcomes of Doctor of Physical Therapy (DPT) graduates before and during the COVID-19 pandemic. REVIEW OF LITERATURE: Reports show increased stress, anxiety, and burnout during the COVID-19 pandemic, which may have negatively affected academic performance. Historically, academic performance is predictive of National Physical Therapy Examination (NPTE) scores. Yet, there is little evidence analyzing student outcomes during the pandemic. SUBJECTS: Doctor of Physical Therapy graduate records (N = 1,897) were retrospectively collected from a multicenter convenience sample consisting of 5 blended programs. Records were sampled from existing "prepandemic" graduates of Fall 2018-2019 (n = 988) and "pandemic" graduates of Fall 2021-2022 (n = 909). METHODS: A causal comparative and correlational study design was used. Grade point average (GPA) and NPTE scores were collected. A general linear model examined differences between groups, and a multiple linear regression examined predictors of NPTE performance. RESULTS: Grade point average was a significant predictor of NPTE score (r2 = 0.56; P < .01) for the overall sample and for the prepandemic and pandemic cohorts (r2 = 0.38, P < .01; r2 = 0.45, P < .01, respectively). Grade point average was not significantly different between the groups (P = .09), nor did it significantly influence differences in NPTE scores (P = .13). Pandemic graduates displayed a significantly lower NPTE pass rate (85.1%) compared with prepandemic graduates (89.7%; P < .01). Pandemic graduates experienced higher rates of academic difficulty (20%; P < .01) and had a approximately 5 times higher likelihood of not passing the NPTE. DISCUSSION AND CONCLUSION: This is the first study to report on DPT graduate outcomes spanning the COVID-19 pandemic. Similar to previous studies, GPA remained the most significant predictor of NPTE scores. Pandemic graduates demonstrated significantly lower NPTE scores and higher rates of academic difficulty (GPA < 3.0). Continued monitoring of NPTE performance is warranted between prepandemic, pandemic, and postpandemic cohorts across modes of program delivery.

A Comparative Analysis of Physical Therapy Anatomical Knowledge and Retention: Human Donor Dissection Versus Virtual Laboratory.

INTRODUCTION: Despite a long history of using human donor dissection (HDD) for physical therapy (PT) anatomy education, there are no PT guidelines that require HDD. The purpose of this quantitative causal-comparative study was to determine if Doctor of Physical Therapy students who used HDD had different grades both within anatomy and within courses that require retention and application of anatomical knowledge (kinesiology and a foundational musculoskeletal course) compared with those who used virtual 3-dimensional anatomical software (VAS). REVIEW OF LITERATURE: Numerous factors affect the decision to use HDD within PT anatomy, and few PT studies have compared the effectiveness of VAS to HDD. SUBJECTS: All students who took anatomy in an entry-level PT program from 2018 to 2021 (232 total students, 115 who used HDD in 2018-2019 and 117 who used VAS in 2020-2021). METHODS: Mann-Whitney tests were used to compare anatomy grades (course, written examination, and practical examination) and future grades in kinesiology and a foundational musculoskeletal course for students who used HDD or VAS. RESULTS: Physical therapy students who used VAS had statistically significant higher anatomy course grades (VAS 93.81% ± 4.99% to HDD 92.20% ± 4.53%) and higher practical examination grades (VAS 97.43% ± 2.91% to HDD 93.55% ± 4.39%) compared with those who used HDD. However, there were no significant differences between groups on written anatomy examinations (VAS 89.42% ± 7.21% to HDD 90.40% ± 4.94%), kinesiology grades (VAS 91.86% ± 4.52% to HDD 92.80% ± 4.27%), or foundational musculoskeletal grades (VAS 89.50% ± 3.89% to HDD 89.77% ± 3.83%). DISCUSSION AND CONCLUSION: The causal-comparative study design prevents concluding that PT student grade differences were due exclusively to either anatomy laboratory method. It does provide preliminary evidence that the PT anatomy laboratory method did not practically affect anatomy performance or long-term application of anatomy knowledge in future coursework.

Clinical Site Visits: Perspectives of Clinical Instructors and Site Coordinators of Clinical Education.

INTRODUCTION: Site visits (SVs) are a common component of clinical education. The purpose of this paper was to explore clinicians' perspectives regarding SVs, including methods of communication used and their effectiveness, purposes of SVs, and the level of interaction between the stakeholders. REVIEW OF THE LITERATURE: Several communication methods are used to conduct SVs, with varying levels of "richness" and effectiveness. Previous studies have explored the perceptions of physical therapist (PT) students and Directors of Clinical Education regarding communication methods used during SVs, as well as reporting the purposes, effectiveness, and logistics. SUBJECTS: Clinicians, including clinical instructors (CIs) and Site Coordinators of Clinical Education, from across the United States, representing various geographical locations and settings were invited to participate. METHODS: An electronic survey was distributed to participants using information from 2 PT education programs and the Physical Therapist Clinical Performance Instrument database. RESULTS: A total of 273 responses were included in the analysis. Clinicians ranked in-person visits as their first choice of communication for future SVs (n = 157, 59.9%) and indicated that in-person communication was "very effective" (n = 143, 52.4%) when compared with videoconferencing (n = 55, 20.1%) and telephone (n = 49, 17.9%). Clinicians ranked verifying the competency level of the student and verifying site resources during the SV as "extremely important" or "important" (n = 257, 94.2% and n = 250, 91.5%, respectively). Answering CI's questions and providing support to the CI were also identified as "extremely important" or "important" (n = 262, 96% and n = 244, 89.4%, respectively). Analysis of open-ended responses revealed 5 themes: Communication is important, flexibility allows best fit for a situation, on-site visits offer a more complete picture, real-time dialog is preferred, and email can lead to misinterpretation. DISCUSSION AND CONCLUSION: Communication is a key component of the clinical-academic relationship. Although clinicians prefer in-person communication, flexibility is necessary when planning and conducting SVs. Future research recommendations include gathering student and clinician perceptions regarding faculty involvement in SVs, as well as gathering faculty perspectives regarding their participation in SVs. In addition, the impact of the pandemic on the future of SVs warrants further exploration.

Do Chosen Learning Strategies Predict Academic Performance in First-Year DPT Anatomy Students?

INTRODUCTION: The purpose of this study was to identify predictors of anatomy final course grades from first-year physical therapist students' characteristics and chosen learning strategies, as indicated on the Motivated Strategies for Learning Questionnaire (MSLQ). Identifying factors that contribute to success in content intensive classes may aid in coaching successful learning strategies as students transition from undergraduate coursework to Doctor of Physical Therapy (DPT) programs. REVIEW OF LITERATURE: Previous studies show that first-year graduate students use ineffective learning strategies that are insufficient for graduate-level study. The MSLQ correlates with academic performance at several educational levels. To date, only one study has examined the correlation of MSLQ with physical therapist students' academic performance for an anatomy course. SUBJECTS: Thirty-nine first-year physical therapist students participated in the study (27 from a hybrid program, 12 from a traditional program). METHODS: This study analyzed MSLQ scores for the total instrument, each domain, and each subscale using regression analyses to determine predictors of final anatomy grades. RESULTS: The subscales of Self-Efficacy and Test Anxiety had significant predictive value for anatomy grades (R2 = 0.455, F = 5.203, P = .029). Test Anxiety had an inverse relationship to anatomy grades, meaning lower test anxiety scores correlated with higher anatomy grades. The combination of Self-Efficacy, Test Anxiety, and Critical Thinking subscales resulted in a significant prediction of anatomy grades (R2 = 0.603, F = 6.659, P = .014). DISCUSSION AND CONCLUSION: This study found moderate correlations between MSLQ Motivation subscales and final grades in DPT anatomy classes. Self-Efficacy and Test Anxiety subscales had the strongest correlations and were significantly predictive of anatomy grades. Faculty may benefit from using inventories like the MSLQ for first-year physical therapist students to identify motivational characteristics associated with success and to remediate students' learning strategies to prevent academic failure.

Effectiveness of digital and analog learning methods for learning anatomical structures in physiotherapy education.

BACKGROUND: According to the German Physiotherapy Education and Qualification Regulations, teaching of anatomical structures is one of the fundamental subjects of physiotherapy education. Besides exhibits and models, anatomy atlases are usually used as teaching and learning tools. These are available in both analog form such as printed books or in digital form as a mobile application. Furthermore, the use of digital teaching and learning tools is steadily increasing within the education of health professionals. AIM: To assess the efficacy of a digital educational tool in contrast to an analog anatomical atlas in acquiring knowledge about anatomical structures. MATERIAL AND METHOD: The data collection took place in the context of an anatomy tutorial for students of the bachelor's degree program in physiotherapy. In a cross-over design, the students completed two learning assignments, each, with different learning materials provided, either with an anatomy app on a tablet or with an anatomy atlas as a book. The tests to assess the newly acquired knowledge immediately after the task, consisted of questions about the anatomical structures of the knee as well as the shoulder. In addition, the students' satisfaction with the learning materials provided was surveyed using a questionnaire. The survey assessed their satisfaction, their assessment of learning success, and their affinity to digital learning materials. This was done using a 5-point Likert scale and a free-text field. The data was analyzed descriptively, and group differences were calculated using a t-tests. RESULTS: Thirty students participated. The group comparison showed a significantly better outcome for the group that prepared with the analog anatomy atlas for the questions on the knee than the comparison group that used the anatomy app (t(28) = 2.6; p = 0.007). For the questions concerning the shoulder, there was no significant difference between the digital and analog groups (t(28) = 1.14; p = 0.26). The questionnaire revealed that satisfaction with the analog anatomy atlas was significantly higher than with the anatomy app. A total of 93.34% rated their experience with the analog learning tool at least "somewhat satisfied". In contrast, 72.67% of students partially or fully agreed that they "enjoyed learning with digital learning tools". DISCUSSION: Learning anatomical structures with the Human Anatomy Atlas 2023 + app did not show a clear advantage when compared to an anatomy book in these two cohorts of physiotherapy students. The results of the questionnaire also showed greater satisfaction with the analog anatomy atlas than with the anatomy app, whereas most students stated that they frequently use digital learning tools, including some for anatomical structures. Satisfaction with the learning tool seems to play a central role in their effectiveness. In addition, sufficient time must be provided for users to familiarize themselves with the user interface of digital applications to use them effectively. REGISTRATION: Diese klinische Studie wurde nicht in einem Studienregister registriert.

Evaluation and students' perception of a health equity education program in physical therapy: a mixed methods pilot study.

BACKGROUND: Health equity is a common theme discussed in health professions education, yet only some researchers have addressed it in entry-level education. PURPOSE: The purpose of this study is to serve as an educational intervention pilot to 1) evaluate students' perception of the effectiveness of the DPT program in providing a foundation for health equity education, with or without the benefit of a supplemental resource and 2) establishing priorities for the program related to educating students on health inequities in physical therapy clinical practice. A mixed method design with a focus-group interview was utilized to explore students' perceptions of the DPT program's commitment to advancing health equity. METHODS: A three-staged sequential mixed methods study was conducted. Stage 1 began with quantitative data collection after completing the DEI Bundle utilizing the Tripod DEI survey. Stage 2 involved identifying themes from the Tripod Survey data and creating semi-structured interview questions. Stage 3 consisted of a focus group interview process. RESULTS: A total of 78 students completed the Tripod DEI survey upon completing 70% of the curriculum. Thirty-five students, eight core faculty, 13 associated faculty, and four clinical instructors completed the APTA DEI Bundle Course Series. According to the Tripod DEI Survey results, program stakeholders found the program's commitment to DEI and overall climate to be inclusive, fair, caring, safe, welcoming, and understanding of individuals from different backgrounds, including a sense of student belonging where students feel valued and respected. Three themes emerged from the qualitative focus group interviews, including the value of inclusivity, health equity curricular foundations, and DEI in entry-level DPT education. CONCLUSIONS: This study highlights the value of incorporating health equity and DEI topics into curricula while fostering an incluse program culture.

Use of the International IFOMPT Cervical Framework to inform clinical reasoning in postgraduate level physiotherapy students: a qualitative study using think aloud methodology.

BACKGROUND: Vascular pathologies of the head and neck are rare but can present as musculoskeletal problems. The International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) Cervical Framework (Framework) aims to assist evidence-based clinical reasoning for safe assessment and management of the cervical spine considering potential for vascular pathology. Clinical reasoning is critical to physiotherapy, and developing high-level clinical reasoning is a priority for postgraduate (post-licensure) educational programs. OBJECTIVE: To explore the influence of the Framework on clinical reasoning processes in postgraduate physiotherapy students. METHODS: Qualitative case study design using think aloud methodology and interpretive description, informed by COnsolidated criteria for REporting Qualitative research. Participants were postgraduate musculoskeletal physiotherapy students who learned about the Framework through standardized delivery. Two cervical spine cases explored clinical reasoning processes. Coding and analysis of transcripts were guided by Elstein's diagnostic reasoning components and the Postgraduate Musculoskeletal Physiotherapy Practice model. Data were analyzed using thematic analysis (inductive and deductive) for individuals and then across participants, enabling analysis of key steps in clinical reasoning processes and use of the Framework. Trustworthiness was enhanced with multiple strategies (e.g., second researcher challenged codes). RESULTS: For all participants (n = 8), the Framework supported clinical reasoning using primarily hypothetico-deductive processes. It informed vascular hypothesis generation in the patient history and testing the vascular hypothesis through patient history questions and selection of physical examination tests, to inform clarity and support for diagnosis and management. Most participant's clinical reasoning processes were characterized by high-level features (e.g., prioritization), however there was a continuum of proficiency. Clinical reasoning processes were informed by deep knowledge of the Framework integrated with a breadth of wider knowledge and supported by a range of personal characteristics (e.g., reflection). CONCLUSIONS: Findings support use of the Framework as an educational resource in postgraduate physiotherapy programs to inform clinical reasoning processes for safe and effective assessment and management of cervical spine presentations considering potential for vascular pathology. Individualized approaches may be required to support students, owing to a continuum of clinical reasoning proficiency. Future research is required to explore use of the Framework to inform clinical reasoning processes in learners at different levels.