Back to #physicaltherapy Education: Clinical Practice Guidelines
After dealing with insurance issues the past few weeks, let’s return to #physicaltherapy education-amongs the things that has to be fixed for long term flourishing of our profession.
A few weeks ago, this newsletter posted #physicaltherapy Education-The Problem and a Solution, which brought forth a possible solution for the high cost and student debt of physical therapy students and how various factors have contributed to a sharp decline in applications to PT schools. A suggestion was that halfway through the PT curriculum, students would sit for their boards and become temporarily licensed subject to final licensing, which would be dependent on the completion of their internships and full DPT education. Several have reached out and asked what the content would be on those boards. While I would leave that to the academics and Commission on Accreditation in Physical Therapy Education (CAPTE), it would definitely include evidence-based and consensus-driven clinical practice guidelines (CPGs).
I consulted with Dr. Joe Godges, Clinical Professor of Physical Therapy at the University of California, who coordinates the CPG integration for The Academy of Orthopaedic Physical Therapy (AOPT) and is part of a great group bringing attention to a more profound adoption of them in orthopaedic clinical practice to better detail CPGs for our newsletter readers.
In recent decades, physical therapy researchers have contributed substantially to the scientific literature by describing the strategies for classifying and managing common musculoskeletal conditions. The AOPT has sponsored teams of clinical experts for each common musculoskeletal condition to systematically review the quality and clinical relevance of this literature on an ongoing basis and provide guidance to clinicians on the best, evidence-based practice for managing a specific group of patients. In essence, these clinical practice guidelines summarize the information available in medical libraries for clinicians to guide the health care they provide for their clients.
CPGs can also guide what clinical educators should teach clinicians in entry-level and post-professional programs. These programs can train clinicians to gain knowledge competency of practice guidelines that can be assessed using standardized exams and skill proficiency with implementing guidelines-based evaluation and treatment procedures that can be evaluated during supervised clinical education programs.
The AOPT has developed an examination process to assess for and a public-facing directory to recognize physical therapy students and physical therapists with knowledge competency and skill proficiency with guidelines-based prevention and management of common musculoskeletal conditions.
Most healthcare settings where the staff, including PTs, could be exposed to individuals experiencing an emergency cardiac event require the staff to be certified in knowledge competency and skill proficiency with administering the clinical practice guidelines of the American Heart Association. The AHA’s “Get with the Guidelines” program includes training and certification in Basic Life Support, Automated External Defibrillator, and Advanced Cardiac Life Support. In contrast, most healthcare settings where the staff is exposed to individuals with common musculoskeletal conditions have no such requirements to know the AOPT clinical practice guidelines — even though there are numerous high-quality scientific publications validating the value of guidelines-based care for common musculoskeletal conditions, such as low back pain, versus the routinely provided non-guidelines-based care. Thus, the AOPT strongly promotes that their CPGs be integrated into the training of practitioners at all levels of care — beginning with DPT students for the essential knowledge and skill components and progressing to advanced skill proficiency training for managing more complex cases within clinical residency and fellowship education.
The AOPT, of course, focuses its development and dissemination efforts on CPGs for therapy for individuals with musculoskeletal conditions. However, parallel CPG efforts are underway by APTA’s Physical Therapy Academies in Neurology, Geriatrics, and Pediatrics — developing and disseminating CPGs for clinicians working with individuals with common neurological, geriatric, and pediatric conditions, which can also be integrated into DPT student and clinical residency and fellowship training.
To further drive these guidelines, what could be a better way than completing their integration into the DPT Curricula and testing them as part of the physical therapist student’s journey? Variability decreases and more importantly quality and outcomes go up, patient care enhanced.
Thoughts? Please weigh in.
larry
@physicaltherapy
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Lastly, 100% of all proceeds from my book Called to Care: A Medical Provider’s Guide for Humanizing Healthcare goes to The Foundation for Physical Therapy Research
