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Abstract Background Although clinical reasoning abilities are important learning outcomes of physical therapist entry-level education, best practice standards have not been established to guide clinical reasoning curricular design and learning assessment. Objective This research explored how clinical reasoning is currently defined, taught, and assessed in physical therapist entry-level education programs. Design A descriptive, cross-sectional survey was administered to physical therapist program representatives. Methods An electronic 24-question survey was distributed to the directors of 207 programs accredited by the Commission on Accreditation in Physical Therapy Education. Descriptive statistical analysis and qualitative content analysis were performed. Post hoc demographic and wave analyses revealed no evidence of nonresponse bias. Results A response rate of 46.4% (n=96) was achieved. All respondents reported that their programs incorporated clinical reasoning into their curricula. Only 25% of respondents reported a common definition of clinical reasoning in their programs. Most respondents (90.6%) reported that clinical reasoning was explicit in their curricula, and 94.8% indicated that multiple methods of curricular integration were used. Instructor-designed materials were most commonly used to teach clinical reasoning (83.3%). Assessment of clinical reasoning included practical examinations (99%), clinical coursework (94.8%), written examinations (87.5%), and written assignments (83.3%). Curricular integration of clinical reasoning–related self-reflection skills was reported by 91%. Limitations A large number of incomplete surveys affected the response rate, and the program directors to whom the survey was sent may not have consulted the faculty members who were most knowledgeable about clinical reasoning in their curricula. The survey construction limited some responses and application of the results. Conclusions Although clinical reasoning was explicitly integrated into program curricula, it was not consistently defined, taught, or assessed within or between the programs surveyed—resulting in significant variability in clinical reasoning education. These findings support the need for the development of best educational practices for clinical reasoning curricula and learning assessment.

Financial stress is implicated in poor health and decreased Quality of Life (QOL). The purpose of this project was to assess the 2-year effect of a financial education program on the health of single, low-income women. A total of 30 women were enrolled and 20 continued through follow-up. Two years following intervention, women demonstrated a $8,026 increase in mean annual income and significant improvements in health-related QOL and hopefulness. Half of the participants lost weight, and while not statistically significant, mean weight decreased by 2.2 pounds. Trends in decreased fast food consumption were observed. The results suggest that financial education has a significant, sustained effect on the health and health-related QOL of single, women of low income.

The physical therapy profession continues to respond to the complex and changing landscape of health care to meet the needs of patients and the demands of patient care. Consistent with this evolution is the rapid development and expansion of residency and fellowship postprofessional programs. With the interested number of applicants exceeding the number of residency and fellowship slots available, a “critical period” in the educational process is emerging. The purposes of this perspective article are: (1) to analyze the state of residency and fellowship education within the profession, (2) to identify best practice elements from other health professions that are applicable to physical therapy residency and fellowship education, and (3) to propose a working framework grounded in common domains of competence to be used as a platform for dialogue, consistency, and quality across all residency and fellowship programs. Seven domains of competence are proposed to theoretically ground residency and fellowship programs and facilitate a more consistent approach to curricular development and assessment. Although the recent proliferation of residency and fellowship programs attempts to meet the demand of physical therapists seeking advanced educational opportunities, it is imperative that these programs are consistently delivering high-quality education with a common focus on delivering health care in the context of societal needs.

The authoritative clinical handbook promoting excellence and best practice Cardiovascular Prevention and Rehabilitation in Practice is a comprehensive, practitioner-focused clinical handbook which provides internationally applicable evidence-based standards of good practice. Edited and written by a multidisciplinary team of experts from the British Association for Cardiovascular Prevention and Rehabilitation (BACPR), this book is invaluable for practitioners helping people with heart disease return to health. The text provides an overview of research findings, examines the core components of cardiac rehabilitation, and discusses how to support healthier lifestyles and reduce the risks of recurrence. Now in its second edition, this textbook has been fully revised to incorporate recent clinical evidence and align with current national and international guidelines. Increased emphasis is placed on an integrated approach to cardiac rehabilitation programmes, whilst six specified standards and six core components are presented to promote sustainable health outcomes. * Describes how cardiovascular prevention and rehabilitation programmes can be delivered to meet standards of good practice * Covers a broad range of topics including: promoting health behaviour change to improve lifestyle risk factors, supporting psycho-social health, managing medical risk factors, and how to develop long-term health strategies * Emphasises the importance of early programme commencement with assessment and reassessment of patient goals and outcomes, and gives examples of strategies to achieve these * Discusses the role of programme audit and certification of meeting minimum standards of practice * Looks to the future and how delivery of cardiovascular prevention and rehabilitation programmes internationally will need to meet common challenges Cardiovascular Prevention and Rehabilitation in Practice is an indispensable resource for all health professionals involved in cardiac rehabilitation and cardiovascular disease prevention.

The purpose of this special series, as stated in the initial call for proposals in 2014, is \"to focus on identifying the curricular elements and instructional changes that will be necessary to ensure the provision of high quality physical therapy services for pediatric patients and adults with lifelong developmental disabilities.\" While the literature on the scholarship of teaching and learning (SoTL) in physical therapy education continues to expand in both breadth and depth, the variability of educational practices relative to the education of pediatric physical therapy knowledge, skills, and abilities is highly variable across professional physical therapy curriculum. [...]many of the concerns first identified in 1993 by Cherry and Knutson1 and by Martin2 regarding the limited amount of time spent and the variability in teaching pediatric content as part of the entry-level physical therapy curriculum are still unresolved. [...]perhaps more notable, has been the encouragement of the coeditors, through editorials and their own contributions to the literature, acknowledging that research of physical therapy education needs to be supported by evidence and sound methodology.3-4 In her 2011 McMillan lecture, Dr Jensen spoke directly to the need for educational research that will provide evidence on best practices in physical therapist education.5 And more recently, Jensen et al proposed \"a compelling rationale for building a much needed foundation for education research in physical therapy\"6 The foundations for our work on this series began around the same time. [...]these first manuscripts span the 4 topic areas requested in our call and broadly represent the...

Caring for older adults has become increasingly complex due to multiple health and societal factors. The purpose of this study was to evaluate the impact of an interprofessional community-based educational project on students' attitudes toward other health care professions and older adults. A pretest and posttest quasi-experimental research design was implemented with 64 participating students from four health care professions (nursing, occupational therapy, physical therapy, and pharmacy). These students completed the Interdisciplinary Education Perception Scale (IEPS) and Survey of Attitudes on Aging Scale (SAAS) before and following an educational experience with older adults. Qualitative data were collected through student reflection journals and focus groups with participating students. The results of the study showed that interprofessional community-based learning had a significant impact on some students' attitudes toward older adults. The difference between pretest and posttest reached a statistically significant level on the SAAS in occupational therapy (p = 0.013) and physical therapy students (p = 0.044). No significant differences, however, were found between the pretest and posttest in pharmacy (p = 0.097) or nursing students (p = 0.144). Similarly, the experience also had a positive impact on some students' perceptions of other health care professions as measured by the IEPS. A significant difference was found between the pretest and posttest in occupational therapy (p = 0.000) and physical therapy students (p = 0.028). This study indicates that interprofessional community-based learning can be an effective method for some students to increase their understanding and respect toward other health professionals and older adults.

Financial stress is a condition that occurs commonly in the United States, especially in single-mothers and their children. This stress can be a barrier to optimal health and wellness. In an effort to reduce financial stress and improve money management skills in low income, single mother families, the Financial Success Program (FSP) was created. This novel program provides education and support to an underserved population and may also improve the health and well-being of the women and children enrolled. Through a unique interprofessional collaboration, a study was initiated to assess the effect of financial education on health indicators in single-mother families. A thorough discussion of the FSP and interprofessional model will be discussed as a framework for addressing public health needs in a financially stressed population.

Given the complexity of the current health care environment, effective clinical reasoning skills are fundamental to making critical patient care decisions. The purpose of this study was to explore the clinical reasoning abilities of students across time in 1 professional Doctor of Physical Therapy (DPT) curriculum. Qualitative methods were used to describe the longitudinal development of students' clinical reasoning skills. Ninety-eight students from 2 consecutive class cohorts participated. Low inference data from the Clinical Reasoning Reflection Questionnaire (CRRQ) and narrative comments from the Clinical Performance Instrument (CPI) were analyzed using the constant comparative method. Open coding was used to initially categorize the data followed by axial coding to identify resulting themes. Three categories (beginning, intermediate, and entry-level) and 8 themes emerged from the data describing student development of clinical reasoning skills. The following themes surfaced under the beginning clinical reasoning process category: focus on self, compartmentalized thinking, and limited acceptance of responsibility. Themes in the intermediate category were: procedural performance, initial stages of recognition and using context, and improved reflection on performance. Themes in the final entry-level category were: dynamic patient interaction and integrating situational awareness. Discussion and Conclusion. The results of this study demonstrate a progression in the development of these students' clinical reasoning process around the dimensions of self, context, and responsibility across the curriculum. Outcomes reveal these key aspects of the clinical reasoning process: (1) it is a gradual developmental process across time; (2) the Dreyfus model of skill acquisition may apply to the development of clinical reasoning skills in physical therapy students; and (3) increasing intensity and depth of the reflective process may be a critical component in the advancement of the clinical reasoning process. Further research is needed to determine the best strategies to assess clinical reasoning abilities in physical therapy students and to discern approaches to enhance this learning process.

Clinical reasoning is a complex but vital skill required for professional physical therapy practice. Experts agree that clinical reasoning is both difficult to define and challenging to assess. In order to facilitate the development of clinical reasoning skills in physical therapist (PT) students, educators need to be able to evaluate this process. The purpose of this paper is to describe the development and revision of a tool to assess PT student clinical reasoning skills across the curriculum. A Clinical Reasoning Grading Rubric was created using the following multistep process: (1) Initial pilot research exploring the clinical reasoning process students used in a performance-based examination, (2) use of theoretical constructs from cognitive learning theory and learner skill acquisition, (3) content expert review, and (4) feedback from key stakeholder groups (clinicians, faculty, and students). The rubric was developed to assess student clinical reasoning skills across the curriculum and evaluate student readiness for the clinical setting. The tool allows faculty and students a structure to identify and track the progression of student reasoning skill development. The Clinical Reasoning Grading Rubric is 1 tool that can be used to evaluate the clinical reasoning of students at multiple points in time across the curriculum. This instrument has applicability for assessment of clinical reasoning skill development from clinical to residency education. The rubric also provides insight into the teaching and learning environment and may be helpful in informing pedagogical strategies and curriculum change.

Literature suggests an association between poverty, gender, and health. The Financial Success Program (FSP) provides financial education and support to low-income, single mothers. This study assessed the effect of the FSP on health and quality of life in participants and their children. From 2011-2012, 36 women and 28 children were enrolled. Indicators of health and quality of life were assessed pre-and post-year-long intervention. In addition to improvements in financial outcomes, participants demonstrated a significant reduction in fast food consumption and significant improvements in hopefulness and quality of life. Over 30% of mothers experienced weight loss, 52% a reduction in BMI, and 41% a reduction in body fat percentage. Many children experienced reductions in BMI and BMI percentile. This study is the first to report the health effect of financial education in low-income single mothers. When designing multifaceted community-based cardiovascular risk reduction programs, financial stress should be addressed through education.