Perceptions of Incivility Among Students and Faculty in Entry-Level Health Professional Programs

Purpose: Online education is growing in popularity but has the potential to result in cyber incivility leading to disruptions in the learning environment. There is little known about the differences in attitudes between students and faculty in the online learning experience regarding cyber civility. The purpose of this study was to analytically measure student and faculty perceptions and attitudes of cyber incivility. Methods: A convenience sample of 180 (34 faculty and 146 students) participants from a health care university were recruited. A 27-item survey was given to record the perceptions of students and faculty on issues of cyber civility. An exploratory factor analysis was completed to validate the survey tool and determine the factors that made up the survey. A Mann Whitney U test was conducted to determine significant differences between student and faculty perceptions on the survey items. Results: Four factors were identified of the retained 19 items after the exploratory factor analysis: attitudes, presentation, appearance, and multitasking. There was a significant difference on 10 of the remaining survey items between students and faculty. Conclusions: Faculty perceived unprofessional dress, multitasking, and active display of complaints in the virtual environment more uncivil and disruptive than students. The themes show the differences between students and faculty perceptions in online platforms in healthcare educational programs. These differences highlight the need for healthcare educational programs to focus on strategies that align student and faculty expectations to positively impact the dynamics of the class and enhance learning in the virtual environment

Self-Efficacy with Telehealth Examination: the Doctor of Physical Therapy Student Perspective

Introduction: The shift to telehealth exposed gaps in our understanding of how physical therapy students perceive patient assessment in a remote situation using the examination component of the patient/client management (PCM) model. The purpose of the study was to compare Doctor of Physical Therapy (DPT) students’ self-efficacy performing patient assessment using the examination component of the PCM model using telehealth compared with conventional examination. To achieve the purpose of this study, the Physical Therapist Self-Efficacy (PTSE) scale was used. More specifically, self-efficacy in clinical reasoning was measured using the following items: (1) PTSE total score (2) performance of tests and measures, (3) determining when to refer to another practitioner, and (4) screening for primary medical disease. Methods: A survey-based descriptive and exploratory repeated measures design was used, with surveys distributed to entry-level DPT students during their clinical experiences in the United States during the Fall 2020 semester. A convenience sample of 35 second- and third-year entry-level DPT students who reported provided both telehealth and traditional examinations during clinical experiences was used. Descriptive and inferential statistics were used to evaluate within group differences comparing student self-efficacy using telehealth and conventional examination. Results: Wilcoxon sign ranks revealed statistically significant differences in self-efficacy scores of students conducting patient assessment using telehealth compared to conventional examination. More specifically, scores for telehealth were lower (P \u3c 0.001) compared to conventional examination in PTSE total score, performance of tests and measures, determining when to refer to another practitioner, and medical screening for primary disease. Discussion: Doctor of Physical Therapy students’ self-efficacy was lower when providing telehealth across all PTSE questions pertaining to the examination component of the PCM model. Exploring telehealth content and sequence in entry-level physical therapy curriculum may help students feel more prepared to perform telehealth examination. Key words: Examination, Physical therapy, Self-efficacy, Students, Telehealth

Doctor of Physical Therapy students’ clinical reasoning readiness and confidence treating with telehealth: a United States survey

Purpose: Telehealth has an emerging footprint on entry-level physical therapy programs. Students’ readiness for clinical reasoning with virtual versus traditional face-to-face treatment remains unknown. The purpose of this study was to evaluate Doctor of Physical Therapy (DPT) students’ preparedness for clinical experiences with and without telehealth. Methods: A descriptive and exploratory cross-sectional survey was employed, with a voluntary convenience sample of 211 second- and third-year university DPT students during Fall 2020 clinical experiences. Descriptive and inferential statistics evaluated differences in DPT students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences with and without telehealth. Results: Telehealth availability was 40.3%, with 16.6% of DPT students reporting participation. Most students reported being comfortable (39.3%) or neutral (32.2%) using telehealth. DPT students’ confidence level using telehealth to treat was 74% on initial and 97% on subsequent same-patient visits. Mean PTSE scores were significantly lower during clinical experiences with telehealth (13.1) compared to traditional experiences (15.1) (PP Conclusion: While entry-level DPT programs continue to establish best practice for telehealth education, current trends in academic curriculum seem to prepare students’ clinical reasoning readiness for clinical experiences. The PTSE could be used to identify outlier students requiring additional mentoring during traditional and telehealth clinical experiences

Comparison of Flex vs. residential clinical education program outcomes: physical therapy students’ self-efficacy, confidence, and clinical competence

Purpose: Alternative flexible (Flex) path Doctor of Physical Therapy (DPT) programs may have an emerging footprint. The differences between Flex and traditional residential DPT program clinical experience outcomes remain unknown. The purpose of this study was to evaluate Flex and residential DPT students’ clinical reasoning self-efficacy, confidence with treating, and Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences. Methods: A descriptive and exploratory cross-sectional survey was used with a voluntary convenience sample of 211 university DPT students during Fall 2020 full-time clinical experiences. Descriptive and inferential statistics evaluated differences in Flex and residential DPT program students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final CPI clinical reasoning and summative scores during clinical experiences. Results: Mean PTSE scores were significantly lower for Flex (x̄ = 14.2) compared to residential DPT students (x̄ = 15.2) (P \u3c 0.05). No significant student differences were found in (1) Flex (x̄ = 2.1) and residential (x̄ = 2.2) confidence with treating at the initial visit (P = 0.59), (2) Flex (x̄ = 2.8) and residential (x̄ = 3.0) confidence with treating subsequent same-patient visits (P = 0.15), and (3) Flex (x̄ = 15.8) and residential (x̄ = 16.5) CPI clinical reasoning (P = 0.17), and (4) Flex (x̄ = 16.1) and residential (x̄ = 16.7) CPI summative scores (P = 0.21). Conclusion: Clinical reasoning self-efficacy among Flex DPT students was lower, but there was no difference in CPI clinical reasoning or summative results between Flex and residential DPT students. In the university investigated, the Flex distance learning DPT program curriculum appeared effective in preparing students’ clinical reasoning readiness for the available full-time clinical experiences. We recommend academic institutions consider expanding Flex entry-level DPT program availability options because the outcomes were comparable. Additional flex entry programs may help address the underrepresentation of nontraditional students in entry-level DPT programs and societal demands for physical therapy services

Ethnicity Does Not Impact Physical Therapy Students’ Clinical Readiness and Performance, a United States Exploratory Study

Purpose: To explore the impact of ethnicity on clinical readiness and performance among Doctor of Physical Therapy (DPT) students, as determined by 1) Physical Therapist Self-Efficacy (PTSE) score, 2) self-confidence treating patients, and 3) final American Physical Therapy Association (APTA) Clinical Performance Instrument (CPI) clinical reasoning and summative ratings during clinical experiences. Methods: This study is a survey-based, descriptive, and exploratory cross-sectional research design involving sample of 211 DPT students evaluated for differences across ethnic students’ groups 1) PTSE score during student clinical experiences, 2) confidence with treating initial and subsequent same-patient visits, and 3) final CPI clinical reasoning and summative scores during clinical experiences. Results: Kruskal-Wallis test showed no difference across ethnic groups (American Indian or Alaskan Native, Asian/Pacific Islander, Black or African American, Hispanic, White or Caucasian, prefer not to answer, and multiple ethnicity) in 1) clinical reasoning self-efficacy (PTSE), n=211, p=.438; 2) confidence treating at initial visit n=211, p=.088 and subsequent patient visits n=211, p=.584; and 3) clinical performance on the CPI for clinical reasoning n=211, p=.273 and summative n=211, p=.189 scores. Conclusions and Recommendations: All ethnic groups demonstrated strong clinical readiness and performance during each clinical experience level. Ethnic groups did not differ on clinical reasoning self-efficacy or confidence treating patients. Although the gap appears to be closing, there continues to be underrepresentation of ethnic groups in DPT programs. We recommend investigating factors impacting underrepresentation of ethnic groups in DPT academic programs to explore initiatives to close the diversity gap and best match societal representation

Is Vision Essential to Physical Therapist Practice? Perceptions of Interested Parties in DPT Education

Introduction: The perceptions of students, faculty, staff, and clinicians regarding blindness or visual impairment (BVI) and physical therapist practice were explored before, during, and after interactions with a Doctor of Physical Therapy (DPT) student with BVI. Review of Literature: Information is sparse about the prevalence of students with disabilities in DPT programs in the United States. Medical school programs that welcome students with disabilities report positive interactions with faculty and student peers. Subjects: 36 (20 students, 11 faculty, 2 staff, and 3 clinical instructors) Methods: A recent DPT graduate (pseudonym JM) with BVI classified as “near total blindness”, is now a licensed, full-time employee at an outpatient orthopedic clinic. We surveyed students, faculty, staff, and clinicians who interacted with JM as a DPT student, asking for perceptions about the education, clinical skills, and employment potential of a DPT student with BVI. Results: An increase toward more favorable perceptions of individuals with BVI was exhibited for all 10 of the Likert scale questions, X2(2)=38.00 to 59.42, p\u3c 0.001. Post hoc analysis demonstrated an increase between perceptions before and during interactions with JM for all questions, Z=-4.02 to -4.95, p\u3c 0.001. Six of 10 questions exhibited an increase between perceptions during and after interacting with JM, Z=-2.53 to -3.50 p≤ 0.011. Qualitative analysis revealed three themes: accommodations, personal qualities, and setting with an overarching theme of an approbative shift in perceptions. Discussion and Conclusion: The shift in perceptions about vision as essential for physical therapist practice is important and suggests that “essential functions” should be considered within the context of the individual’s characteristics and lived experiences. Reevaluation of DPT program applicant qualifications regarding vision may be warranted. Further, for clinical instructors, the benefits may outweigh the challenges of mentoring a student with accommodations for BVI

An Exploratory Study of Healing Circles as a Strategy to Facilitate Resilience in an Undocumented Community

Within the United States, the COVID-19 pandemic highlighted critical inequalities affecting undocumented communities and resulting in particularly heightened stress for members of these communities. In addition to the stress associated with COVID-19, immigrants in the United States were more than ever subjected to a hostile antiimmigrant climate under Trump’s administration. Given this compounded stress, the impact of the pandemic on mental health is likely to be disproportionately experienced by undocumented immigrants. In response, a group of psychologists partnered with a leading immigrant rights advocacy organization and formed a reciprocal collaboration to support undocumented communities. A major focus of the collaboration is to foster learning, supporting members of the immigrant community to contribute to their own well-being and others in the community. Accordingly, the collaborative developed and delivered a web-based mental health education session to the immigrant community and to practitioners serving this population. The session presented the use of healing circles as a strength-based approach to building resilience and also sought feedback regarding specific features of healing circles that can enhance their effectiveness in managing distress. Survey data and qualitative findings from this study show that those who participated in the web-based program perceived the session as validating and informative. Findings also underscored the need for creating safe spaces for community members to be vulnerable about their lived experiences while promoting ownership of their narratives. We discuss practical implications pertaining to the development and facilitation of social support groups for immigrants led by nonspecialist community members trained for this role. Impact Statement We describe a reciprocal collaboration between psychologists and an immigrant-led advocacy organization for the purposes of supporting undocumented immigrants in tailoring culturally congruent therapeutic approaches for fostering resilience as they face multiple stressors due to interlocking crises, such as the COVID-19 pandemic and antiimmigrant policies. The collaboration led to the development and delivery of a web-based session that provided immigrant community members and practitioners with recommendations for facilitating healing circles as a strength-based and culturally responsive approach to fostering peer-led social support during stressful times. Findings highlight the need for creating such safe spaces for community members to be vulnerable about their lived experiences and feel validated

Utility network optimization in eco-industrial parks by a multi-leader follower game methodology

A multi-leader-follower game (MLFG) model for the design of the utility network in an eco-industrial park (EIP) is studied and implemented by introducing the concept of an environmental authority. The methodology also considers the flowsheet simulation of each enterprise involved in the EIP in order to obtain utility consumption of each enterprise operating by itself. The approach is validated on a case study of a potential Norwegian EIP. In the latter, multi-leader-single-follower and single-leader-multi-follower game models are studied. Each enterprise's objective is to minimize the total annualized cost, while the EIP authority objective is to minimize the equivalent CO2 consumption related to utility consumption within the ecopark. The MLFG is transformed into a MOPEC and solved using GAMS® as an NLP. The methodology proposed is proven to be reliable in multi-criteria scenarios compared to traditional multiobjective optimization approaches, providing numerical Nash/Stackelberg equilibrium solutions and specifically in EIP planning and optimization

“Global” graph problems tend to be intractable

AbstractA notion of “information-flow complexity” is used to formally measure the degree to which a graph problem is a “global” problem (in the sense of “global” vs. “local” optimization). Under this measure a number of intractable problems including VERTEX COVER, GRAPH 3-COLORABILITY, HAMILTONIAN CIRCUIT, and other NP-complete problems are exponentially more “global” than a number of tractable problems including EDGE COVER, GRAPH 2-COLORABILITY, EULERIAN CIRCUIT, and other problems in P

Doctor of Physical Therapy students’ clinical reasoning readiness and confidence treating with telehealth: a United States survey

Purpose: Telehealth has an emerging footprint on entry-level physical therapy programs. Students’ readiness for clinical reasoning with virtual versus traditional face-to-face treatment remains unknown. The purpose of this study was to evaluate Doctor of Physical Therapy (DPT) students’ preparedness for clinical experiences with and without telehealth. Methods: A descriptive and exploratory cross-sectional survey was employed, with a voluntary convenience sample of 211 second- and third-year university DPT students during Fall 2020 clinical experiences. Descriptive and inferential statistics evaluated differences in DPT students’ (1) Physical Therapist Self-Efficacy (PTSE) scale scores, (2) confidence with treating initial and subsequent same-patient visits, and (3) final Clinical Performance Instrument (CPI) clinical reasoning and summative scores during clinical experiences with and without telehealth. Results: Telehealth availability was 40.3%, with 16.6% of DPT students reporting participation. Most students reported being comfortable (39.3%) or neutral (32.2%) using telehealth. DPT students’ confidence level using telehealth to treat was 74% on initial and 97% on subsequent same-patient visits. Mean PTSE scores were significantly lower during clinical experiences with telehealth (13.1) compared to traditional experiences (15.1) (P <.001) and for integrated (second-year) (14.1) compared to terminal (third-year) clinical experiences (15.5) (P <.001). For traditional experiences, weak positive associations were demonstrated between PTSE and CPI scores. There were no significant differences for CPI scores between telehealth and traditional experiences. Conclusion: While entry-level DPT programs continue to establish best practice for telehealth education, current trends in academic curriculum seem to prepare students’ clinical reasoning readiness for clinical experiences. The PTSE could be used to identify outlier students requiring additional mentoring during traditional and telehealth clinical experiences