Medical Screening Beliefs and Behaviors of Physical Therapist Clinical Instructors: An Assessment of Essential Skill Performance and Importance

BACKGROUND: Assessing the delivery of medical screening content in entry-level doctor of physical therapy (DPT) educational programs is essential to inform curricula as physical therapists (PTs) are called upon to fill broader roles in the healthcare system. The purpose of this study was to survey clinical instructors (CIs) across three DPT programs as a practice analysis regarding beliefs toward medical screening, the frequency performing medical screening skills, and the importance placed on the skills for their clinical students. METHODS: CIs from three DPT programs were recruited via e-mail to participate in this survey study over a total duration of 4 weeks. Respondents completed an anonymous 24-item electronic survey that assessed medical screening skill performance and beliefs. Content areas in the survey included the frequency that clinical instructors included aspects of medical screening in their practice, their perceived importance of emphasizing aspects of medical screening skills with students, CI qualifications and perceived competence to medically screen patients/clients, and the role of medical screening in entry-level PT clinical practice. RESULTS: 269 CIs responded to the survey. 93% felt competent to medically screen patients via referral and 94% via direct access, although 37% felt direct access PT was an advanced skill set. CIs placed greater emphasis on medical screening skills with students compared to what they reported for their own medical screening practices. There were statistically significant differences between CI performance of mental status assessment and vital sign collections in orthopedic/sports vs other settings and for those who are residency/fellowship trained vs not (all p<0.05). Significantly more PTs in other settings emphasized vital sign collection for all patients than those CIs within orthopedic and sports settings (p<0.05). CONCLUSION: PTs continue to provide care to direct access patients and are broadening their roles in the military and civilian healthcare systems to be first contact providers. It is imperative to assess and potentially standardize medical screening content taught in DPT programs. Considerable variability exists between medical screening practices of CIs and in what CIs emphasized with students during clinical rotations. The current study may serve as a benchmark for faculty to assess existing practices of CIs regarding medical screening. The authors suggest there is a need for guidelines to emphasize medical screening for CIs.