The authors declare no conflict of interests. Mental health issues are common - about 1 in 5 American adults experiences a . She owned a private practice for twenty-five years and currently practices in a school-based setting. One of the best paths to lasting change within the industry involves recruiting more racially diverse students to the physical therapy profession. Research finds that people of color and whites are referred to rehab at equal rates; Black Americans tend to simply attend PT less. Industry data, even beyond WebPTs, indicates again and again that theres a serious diversity problem in the rehab therapy industry. 3) More URM students reported making their career decisions in the 2126 year age range than non-URM students. She has been involved with the Federation of State Boards of Physical Therapy as a member of the FSBPT Membership Survey Task Force, a member of the FSBPT Resolutions Committee, the Chair of the FSBPT Re-entry to Practice Task Force, and a recipient of the FSBPT Outstanding Service Award in 2018. Fell N, Mabey R, Mohr T, Ingram D. The preprofessional degree: Is it a P\predictor of success in physical therapy education programs? She received the Lucy Blair Service Award and was elected a Catherine Worthingham Fellow from National APTA and received an Outstanding Service Award and the President's Award from the FSBPT. This approach involved reviewing each response thoroughly for open coding of the responses. Expanding a state board's diversity and ensuring marginalized voices are represented takes courage in leadership and courage for under-represented groups to ask difficult, challenging questions. to maintaining your privacy and will not share your personal information without Perhaps one of the best ways to help improve the ability of Black Americans to enjoy the benefits PT has to offer is to provide education. At time of authorship, Ms. Ross was the director of Academic Services of the American Physical Therapy Association. The lack of change in demographics in the . This suggests lack of relationships with academic and professional mentors. She served the New Jersey Chapter as Secretary and President, and as a delegate and chief delegate to the House of Delegates. But the issue goes even deeper than mistrust. Diversity in counselling, healthcare, and other key industries . There is an obvious lack of diversity in the profession, but I believe the problem starts in the lack of diversity in physical therapy program applicants. 9) Both nonwhite and disadvantaged students were influenced by values and interests, the patienttherapist relationship, and by inclusion and diversity; inclusion and diversity, in contrast, was barely identified by white students. Only 6.5% of our workforce identifies as one or the other, even though the communities cumulatively account for more than a quarter of the countrys population. Educational, socioeconomic, and/or geographic disadvantages were indicated by students from all racial categories. The topic in question? 1. Personal experience was a strong influence for all groups, but is the primary influence for white students (Figure 2A). Interestingly, nonwhite students identified greater use of a DPT Program for their questions than all other groups, despite all respondents indicating low referral to a DPT education program for guidance with pre-PT academic planning (Table 5). EIM Classroom is where your courses actually take place. Understanding that there is racial bias in health care is the first step to curing the problem. Unfortunately, the overall disparity of URM applicants to physical therapist education programs is paralleled by a lack of racial and ethnic diversity among program faculty. The ages at which students from URM backgrounds make their decisions to pursue PT as a career tend to be shifted a bit later relative to non-URM students, which may reflect that URM students take longer to complete their undergraduate degrees and/or are less aware of careers or engaged with career mentoring at earlier academic stages. A study in the American Journal of Surgery examined utilization of rehabilitation services after hospital discharge from a trauma event. It can be a challenge for both parties to have the courage to ask uncomfortable questions and answer them. The opposite of exclusion is intentional inclusion, not the absence of something intended to exclude. 4. It is postulated that potentially qualified . It has been shown that ethnically diverse students transform both the universities they attend and the health industries that they join post-college. 2017;4(4):599-606. doi:10.1007/s40615-016-0263-7. To this end, many corporate healthcare organizations, including physical therapy companies, have pledged to act in support of more inclusive workplaces. She was also a member of the National Association of Drug Diversion Investigators (NADDI).In 2013, she was instrumental in the development, editing, and the selection of content for the board of nursings quarterly magazine, The Georgian Nurse. BIPOC patients are subject to the lingering effects of systemic racism perpetrated by healthcare institutions and providers. Wise D, Dominguez J, Kapasi Z, et al. Requiring a cultural competency credit in continuing education credits (as of April 2020), Evaluating licensing criteria for foreign-trained/immigrant populations, Implementing diversity and inclusion training for PT board members to facilitate board awareness and create the proper lens for policymaking, Planning to collaborate with educational communities to ensure a diversified pipeline of professionalsmore specifically, the board is exploring creating outreach programs to middle and high school students, Looking into expanding the diversity of the board via public member appointments to offset the relative lack of diversity in the profession. We must recognize that even the most well-meaning people can be susceptible to skewed hiring decisions, and seek out ways to test for and remove bias in the hiring process. Out of about 35,000 PTA test-takers in a recent five-year span, 66% provided race and ethnicity information at registration: If we compare this to the data of 2019 PTA graduates, with 71% identifying as White, there is a positive trend toward diversity. Andrews A, Johansson C, Chinworth S, Akroyd D. Cognitive, collegiate, and demographic predictors of attrition in professional physical therapist education. Teaching doctors and mid-level providers about referral patterns in the Black community may help those who are referring people to PT understand the barriers to attendance to PT. She served the national association as a member of the ethics document revision task force. However, engaging in this dialogue is vital. . Potential issues include: Lack of knowledge about the client's culture - A client may wish to talk about attitudes, customs or cultural references which are unfamiliar to the therapist. Is Physical Therapy Covered By Insurance? The PTCAS addition of questions for self-report of disadvantaged background positions the profession to better collect and track URM data in PT education. Racial/ethnic composition of survey respondents compared to the PTCAS Applicants 201516 Application Cycle4 was lower for all categories except American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and white respondents (Table 1). The data nonetheless allowed for a preliminary exploration of similarities and differences in students' pathways to selection of a PT career when race, ethnicity, and disadvantage were considered. Seek learning opportunities on the causes and effects of systemic racism in healthcare and the physical therapy community. Hispanic or Latino and Black or African American therapy professionals are especially underrepresented in our industry. As an African American female PT with more than 25 years in the field, I couldnt agree more. Although all students reported low referrals to DPT programs for advising, nonwhite students identified a slightly higher influence of DPT programs on their decision-making process. Some resources include thePhysical Therapy Minimum Data Set (PTMDS)and the Healthcare Regulatory Research Institute (HRRI), an FSBPT-created nonprofit regulatory research organization. Why do people of color have worse health outcomes when it comes to PT (and other areas of health care)? The National Council of State Boards of Nursing (NCSBN) appointed her as the Promising Practice Consultant for Discipline on the Committee for the Commitment to Ongoing Regulatory Excellence (CORE). Promoting diversity in the field is a worthy endeavor. These are our unconscious biases, and theyre notoriously difficult to identify, let alone mitigate. Moerchen, Victoria PT, PhD; Williams-York, Bernadette PT, DSc, GCS; Ross, Libby J. MA; Wise, Denise PT, PhD; Dominguez, Jesus PT, PhD; Kapasi, Zoher PT, PhD, MBA; Brooks, Salome PT, EdD. Modeling a more equitable and inclusive environment creates an environment of empathy, understanding, and justice for our patients. It is also notable that in the more than twenty years since BoardSource has been collecting data, this has continued to be a problem with minimal incremental progress. However, students of color (alone and in combination with Hispanic or other races) represented the greatest percentage of disadvantaged backgrounds (Table 2). 6) URM students were less likely to be involved with pre-PT clubs. The rehab therapy industry (and especially the APTA member base) has a significantly higher percentage of white workers, and a significantly lower percentage of minority workers compared to the wider distribution across the US. What are the resulting policies, standards, and practices required to address cultural responsiveness, achieve patient outcomes, and protect the public? Another part of the issue is the woeful lack of racial diversity within the physical therapy provider workforce. In a climate of increasing diversity in the population of patients requiring physical therapy (PT) services, PT educators must prepare students and future clinicians to work competently in culturally diverse environments. If this observation holds true for other preprofessional students, guidance toward or development of undergraduate clubs for URM health care students might address this gap. 2013;77:97. While this may have been a function of the small sample captured with the survey, this finding warrants further investigation and lends itself to the question of whether second career or returning adults from URM backgrounds may be an untapped population in the effort to increase the diversity of the work force. They may regress a few years back from their current age or, in some cases, return to a child-like or infant-like state. Join the EIM Mailing List to receive next level updates on research, news, and educational offerings. Even if we have state-mandated initiatives, how the board adopts these initiatives can make a huge difference. Following the adoption of the URM definition, the DTF undertook the second part of its charge: to affirm a rationale for promoting a diverse PT student population. BoardSource is looking at not only what it has been in the past and what it is now, but also what actions and initiatives need to happen to create change. The education community should go beyond just being intentional with recruitment and also provide additional services to students with different needs. That . While there are, indeed, initiatives and programs in place that have a unified focus in diversifying our profession, the lack of minority representation remains evident in the numbers for DPT program enrollment and in licensed physical . URM definition. While FSBPT has always valued diversity, the events of the last few years have made FSBPT and members hypersensitive to it and eager to find out what actions we can implement to address this need. 20152016 PTCAS applicant data report. In 2018, 50% of Black and African Americans with a serious mental illness did not receive mental health treatment. In summary: Data on disadvantaged backgrounds have not been routinely collected by PT education programs or by the PT profession. This post was written with assistance from Dana Gundrum, WebPTs Culture Captain. As Ive said before, patients should have the option to choose a therapy provider who they feel comfortable with, who they can relate to. The Century Foundation. Within this subgroup, students who identified as racial minorities were 34 times more likely than white students to report having received meals at school during primary education and/or being from a family who received some form of public assistance. This can only help us in our relentless pursuit of reducing the percentage of patients (more than 90%) who have a musculoskeletal diagnosis but dont seek PT care. Recruitment strategies should then be tailored specifically to these practices to attract URM applicants for PT education. A total of 886 students (35.2% of the survey sample) responded to the open-ended question regarding identifying and selecting PT as a career choice. One study found that after inpatient rehabilitation for hip fracture, Black Americans had a longer length of stay, worse functional scores on the Functional Independence Measure, and were more likely to be discharged home rather than continue their rehab in a sub-acute rehab facility. If we sit on our hands and pretend that all of this will go away, or, even worse, lash out when someone tries to initiate an open conversation, were perpetuating the problem and dooming ourselves to failure. Solicitation efforts targeted the more than 25,000 students currently enrolled in DPT programs and included four communications to program directors asking them to encourage student participation and five total communications to enrolled DPT students using Facebook, Twitter, and the Student Pulse. Educationally disadvantaged background was reported by 34% of the total sample. Institutional strategies to achieve diversity and inclusion in pharmacy education. The shortage of health care professionals from underrepresented groups significantly undermines the national effort to reduce health disparities and achieve a health care workforce that matches the US demographic.1 To prepare more diverse graduates, professional physical therapist (PT) education in the United States must recruit, admit, and retain a student body that is congruent with the demographics of our rapidly changing population. 1) With data collapsed across race and ethnicity, 34% of the sample reported educational disadvantage, 9.6% reported economic disadvantage, and 4.5% reported geographic disadvantage. Needless to say, we were unprepared for the wave of impassioned responses (and, frankly, pure vitriol) that flooded our Facebook post. Highlight selected keywords in the article text. The second open-ended question asked students to describe factors affecting their decision to pursue PT as a career. Before we coded, we used a random numbers generator to randomly select 142 responses from both the white and disadvantaged groups, so as to assess 142 open-ended responses for all three groups (ie, 142 was the maximum number in the nonwhite group). Heidi advises on WebPT's product vision, company culture, branding efforts and internal operations, while advocating for the rehab therapy profession on a national and . "In our community, there is a longstanding belief that [seeking] therapy automatically means . Geographically underrepresented areas include specific regions (eg, Appalachia) and/or may be defined as a medically underserved area or a designated area with a shortage of health professionals.5 The PT profession has not examined the disadvantaged profile of its applicant pool or student demographic. Dr. Heidi Jannenga, PT, DPT, ATC, is the founder of the Rizing Tide Foundation and co-founder and Chief Clinical Officer of WebPT. Racial Disparities in PT and Rehab Outcomes. Taken together, these factors severely limit BIPOC patients from accessing the benefits of physical therapy. These are the top 7 challenges that are affecting PT's, as well as some suggestions on what you can do to overcome them: 1. She also served a five-year term on the APTA Ethics and Judicial Committee and the APTA Reference Committee. These challenges may include organizational intent and leadership. Of the 8% of Americans with self-reported arthritis who attend at least one in-office PT visit each year, Black Americans are less likely to attendeven after variables like insurance, income, and education level are corrected. CDC COVID-19 response health equity strategy: Accelerating progress towards reducing COVID-19 disparities and achieving health equity. The programs goal is to support potential physical therapists in overcoming the most common barrier to entry: tuition or the burden of student debt, as well as creating an empowering community that will allow these future therapists to see themselves as an integral part of this thriving industry. People may want to include someone, but they may also be hesitant to ask about various potentially sensitive categories someone might belong to. Search for Similar Articles J Natl Med Assoc. American Council of Academic Physical Therapy. 1. While race, ethnicity, and lower socioeconomic strata within this definition are commonly understood, educational, and geographic disadvantages may require explanation. Her primary passion is being a key advocate for her patients and aiding to diminish health disparities among minority groups through avenues of mindfulness and optimizing health & wellness. 13. According to CAPTE, in 2019, the majority of graduates from PTA programs were white: When looking at thePTAs in practice from 2016-2017, it is evident that more work needs to be done to have a more inclusive profession: While this is not where we want to be, there are some reasons for optimism. Some error has occurred while processing your request. Am J Pharm Educ. Ruggiero (Ruggie) S. Canizares, PT, MS, MBA, CMPT, received his PT degree from University of Santo Tomas, his Master's in Exercise Physiology from Southern Connecticut State University, his Master's in Business Administration from Northwest Christian University (MBA Sigma Beta Delta International Honor Society), and his Certified Manual Physical Therapist (CMPT certified with distinction) from The North American Institute of Orthopedic Manual Therapy. We argue that this may be critical for efforts to increase recruitment and admission of URM students. So what can be done to improve access to PT services and to ensure positive outcomes for people of color? So do patients experience different outcomes from PT and rehab due to a referral problem? Nancy has been active in the American Physical Therapy Association since she was a student. Unfortunately, this is not the case with PTs. Biases arent just limited to race, ethnicity, and gender; they can crop up around religion, age, sexual orientation, or socioeconomic class. The field's continued lack of diversity stems from educational barriers. They need to know the board will accept and listen to them to feel comfortable. Please try again soon. This article is based on a 2020 Annual Meeting Webinar panel discussion with Anne Wallestad, Ruggie Canizares, Nancy Kirsch, and Adrienne Price. We currently have a bill on the table, The Physical Therapist Workforce and Patient Access Act (H.R. As a result, student diversity and the profession's diversity have been measured, tracked, and understood solely on the basis of racial/ethnic origin, which may not adequately capture true diversity as defined by a broader set of metrics. Adrienne D. Price, RN, BA, MSN, obtained her associates of science in nursing from Macon State College, her bachelor of arts degree from Mercer University, and her masters of science in nursing from the University of Phoenix. Additionally, individuals may wonder if the given labels are appropriate for them, so they may opt to just not to share that data instead. Students who identified as having disadvantaged backgrounds were nearly equally impacted by factors related to values + interests as they were by personal experience in making their decisions to pursue a PT career. Diversity gaps generally dont happen because of a conscious decision or action; most people dont purposely weed out prospective employees because of their race or ethnicity. Am J Prev Cardiol. The purpose of this position paper was to examine recruitment into PT education through the lens of the new URM definition by examining how students from underrepresented and disadvantaged backgrounds make the decision to pursue a PT career. Holistic, systemic change will require partnerships with other organizations, especially educational institutions, to address the need for more professional candidates from under-represented groups in the educational pipeline. While jurisdictional legislation may prevent specific data collection, there should still be some available options. For example, they may have concerns about exclusion and inclusion or how that information might be used. Required fields are marked *. A comprehensive definition of underrepresented minorities (URMs) in professional physical therapy education was recently expanded to include educational, economic, and geographic disadvantage in addition to race and ethnicity. The lack of funding for a DPT education is a key . To date, this has not been achieved, and the diversity gap in professional PT education is widening. Guidelines for Continuing Professional Development, Continuing Competence Articles & Resources, ProCert Activities Certified through 2021, Credentialing Organizations for Non-US Candidates, A Collective Approach to Increasing Fairness and Reducing Bias on the NPTE, Model Practice Act: Reviewed, Revised, and Ready for Action, Revised Model Practice Act: Spotlight on Animal Physical Therapy, Enhancing Healthy Practice through Self-Reflection, President's Perspective: The Importance of Understanding the Physical Therapy Workforce, Professional Issues with a PT Practitioner Who May Have a Substance Use Disorder, Exploring the Challenges of Regulating a 'Hands on' Profession in a 'Hands off' Era, Physical Therapy Reaches Across Borders with the PT Compact, Presidents Perspective: The Case for Evidence-Based Regulation, The CBA Forum: Kudos for Bridging the Great Divide.
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