Emory University | Woodruff Health Sciences Center
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'We're Ready for Any Task in Front of Us'

Unique curriculum approach creates complete physical therapists

By Kevin Bloye | Illustration By Jing Jing Tsong

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It didn’t take long for recent Emory Doctor of Physical Therapy (DPT) graduate Kara Arps to realize that Emory’s competency-based curriculum had prepared her for success in the field. While interviewing for a prestigious residency slot at the Monroe Carell Jr. Children’s Hospital at Vanderbilt, Arps, who graduated in May 2018, learned that several of the proficiencies that the hospital required—strong communications skills, advanced research capabilities and the ability to effectively consult and teach—were focal points of the division’s curriculum. Arps was selected and started her residency program in Nashville in August.

For the Emory DPT Program, the competency-based curriculum is nothing new—in fact, it’s been in place since the program’s inception in 1974. Dr. Pam Catlin, who was the director of the Emory Division of Physical Therapy from 1981 to 2004, led the faculty in the development of a competency-based curriculum and validated the competencies, component behaviors, and criteria using a series of Delphi surveys.

Dr. Catlin’s Delphi surveys found exceptional patient examination and intervention skills were not enough. Emory physical therapy students were expected to demonstrate competency in six distinct competency areas: Provision of Patient Care, Interpersonal Communications, Teaching and Learning, Research, Administration and Consultation. Revalidation studies in 1985 and 2013 continued to support the importance of these competencies and component behaviors for graduates of the Emory DPT program.

The Emory DPT faculty is laser focused on creating a fully integrated experience that requires students to demonstrate competency in these six behaviors. Combined with the various component behaviors that comprise each competency, these six competencies continue to make the Emory DPT Program one of the highest ranked physical therapy programs in the nation.

An Approach that Fosters Teamwork

For 2018 Emory DPT graduate Vinny Santucci, one word comes to mind when asked to identify a distinguishing characteristic of a graduate of the program: completeness. Early on in his graduate school journey, Santucci learned that with the competency-based approach, the program was not building “brainiacs,” but instead well-rounded, empathetic caregivers.

“It’s being able to talk to people. It’s being able to educate a patient. It’s being able to care,” Santucci, who recently started in Emory’s Neurologic Residency Program, explains. “When we graduated, I honestly felt like we were ready for the real world. We were ready for any task in front of us.”

According to Patricia Bridges, PT, EdD, associate professor and director of clinical education in Emory’s Division of Physical Therapy, that’s precisely the goal of the program. The six competencies are not taught in a single course. Instead, their components, which serve as measurable performance indicators, are carefully woven into every course.

“Everything is integrated and repeated throughout the curriculum, whether it’s in a lab or clinical setting.” says Bridges.

For example, in developing the teaching and learning competency, students may be assigned a project in which they are asked to create a video demonstrating all of the components of an effective therapist/patient teaching interaction. The Emory DPT curriculum calls for that new teaching knowledge to be integrated into every future exam, lab practicum or clinical experience.

“Students will not be tested just on providing PT skill intervention in the clinical setting,” explains Bridges. “They’ll be expected to educate the patient on functional tasks and home exercises.”

In the program’s first semester, faculty introduce the interpersonal communications competency as students are taught patient communications skills like active listening and motivational interviewing. From there, those skills are integrated into all subsequent clinical science courses.

“When you are demonstrating your proficiency in musculoskeletal care, it must include interpersonal communications,” said Emory DPT Professor and Interim Director Marie Johanson, PT, PhD. “So, when they perform their lab practicals, that’s a component of the practical even though the course is focused on the skills needed to treat a patient with a musculoskeletal problem. You can’t do that unless you can communicate effectively.”

For faculty members, Bridges explains, the competency approach simplifies the task of evaluating students.

“What really makes the difference in our curriculum is that it’s not just about whether the student taught the patient, but did he or she use the process that involves all the component behaviors that were applicable, and did he or she meet the criteria for those component behaviors?” Bridges explains.

According to Johanson, another distinguishing trait of the competency-based curriculum is the way that it reduces competition among students.

“If you’re working to achieve these competencies, and somebody else achieves them, it doesn’t make it any harder for you,” she says. “It’s the opposite of grading on a curve. It fosters teamwork where one student helping another student doesn’t put them lower on the curve.”

Arps agrees stating that when students in her class struggled in the classroom or with a certain clinical skill, others rallied around the student to provide help.

“The culture that has been created here recognizes that we’re all about to go into the workplace as clinicians, so not only are we not competing against each other, but we’re encouraged to challenge each other so that we all can be the best clinicians we can be,” Arps said. “It was a crucial part of not only our success, but also our quality of life in the program.”

Students in the Emory DPT Program must score at least 80 percent to be deemed competent in a particular component behavior. If they are unable to meet that mark, they may be offered remediation where specific weaknesses are identified and further instruction is provided to achieve mastery of the competency.

Santucci identifies this “no one left behind” approach as one of the strengths of the program and praises the physical therapy faculty for not just investing in the educational requirements of the students but their personal needs as well.

“The faculty care about students on a personal level,” he says. “They helped me out a couple of times with some personal issues and definitely, by the end of it, you develop that personal relationship that you didn’t think you’d have when you started. By the end of the third year, every single one of the faculty will say, ‘Now, we’re equals.’”

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