DRAFT

Synopsis of the Doctorate of Physical Therapy Proposal

Presented to the Faculty Senate

Columbia University

By the Program in Physical Therapy

Department of Rehabilitation Medicine, College of Physicians and Surgeons

Necessity to Transition to the DPT

1. Rapid growth of DPT Programs nation-wide in response to a vision statement

passed by the House of Delegates, the governing body of the American Physical Therapy Association in 2000.

This vision states that by 2020 physical therapy should be provided by physical therapists who are doctors of physical therapy. Subsequently, professional educational programs are transitioning from entry level master’s to entry-level doctorate degrees at an accelerated pace. Today, 59 (29%) of the 202 accredited programs offer the DPT degree. Another 89 institutions have stated their intention to convert to offering this degree within the next 4 years. Should all these programs covert as intended, 73% (148) of the current accredited programs would be offering the DPT by 2006. In order for Columbia to maintain its leadership role in physical therapy education, it is critical for the program to offer the DPT as the entry-level degree.

2. Change in criteria to meet accreditation standards

Concurrent with Vision 2020, the Commission on Accreditation in Physical Therapy

Education, the profession’s accrediting body, intends to revise its Evaluation Criteria for Physical Therapist Professional Educational Programs. These criteria which form the basis of accreditation decisions are presently under review. It is the Commission’s intent to make the criteria more reflective of DPT entry-level education to foster broader educational responsibilities of accredited physical therapy program nation-wide. Compliance with the new revised standards is planned for 2004.

3. Expectations for enhanced practice as mandated by state licensing boards as physical therapist gain direct access status without physician prescription

Currently patients and clients have the right to directly access physical therapists for evaluation, examination and intervention in 35 states. Columbia’s program has always drawn a diverse applicant pool from across the country. Thus program graduates must be prepared to practice under nationwide licensure requirements. Transition to the DPT is necessary to better educate the graduate to enter clinical practice able to examine, prognosticate and intervene in the management of impairments, functional limitations and disabilities of the cardiopulmonary, musculoskeletal, neuromuscular and integumentary systems. These enhanced practice expectations as mandated by state licensing boards have been incorporated into state practice acts, which clearly define the role of the physical therapist. This level of practice inherent in the patient/client management model requires considerable breadth and depth in educational preparation, not easily acquired within the time constraints of the current MSPT program.

4. Loss of market share of qualified applicants

Based on the rapid transition to entry-level DPT programs as described in (1) above, Columbia’s program is losing its market share in attracting many of the brightest, most motivated applicants. Of the students who declined Columbia’s offer for admission this year, 62% stated their reason was acceptance into a DPT program.

5. Employment opportunities and professional advancement

The shift to the DPT as the entry-level degree is already influencing the current and anticipated number and type of employment prospects available to physical therapists. While many practitioners who graduate from DPT programs initially work in clinical staff positions, they report more rapid advancement into management positions and have increased responsibility for the development of new clinical service programs. Employers believe that those who earn the professional doctoral degree are well suited to advance in clinical practice, as DPT graduates are

better equipped at critical thinking, integration of new information with existing knowledge, have the ability to investigate and communicate about professional matters and to serve as educators and consultants. Hence Columbia graduates may be at a disadvantage as they enter the practice arena initially as entry-level clinicians and later for professional advancement opportunities.

Unique Characteristics of the DPT

1. Enhancement of content hours of didactic and clinical instruction by more than a

1000 to accommodate the acquisition of enhanced knowledge and skills

necessary for a more autonomous practitioner in today’s health care arena.

2. Sequencing of courses around six domains of learning: Scientific Foundations,

Clinical Sciences, Critical Exportation, Health Care Systems and Management,

Electives and Clinical Experiences.

3. Development of advanced seminar courses and corresponding electives to meet

individual needs of students for more focused areas of practice.

4. Completion of a capstone project, as one of two final integrative experiences that

can be clinical, administrative, educational or research specific.

5. Development of a clinical internship model as the second integrative experience of

the curriculum.

6. Curriculum design, which reflects hours of instruction rather than semester credit to afford a more independent learning environment that facilitates the attainment of knowledge and skills.

7. Use of an adult learning pedagogy that focuses on more independent student-directed learning activities and outcomes.

8. Development of a sequential curriculum building upon the knowledge and skills

mastered in the previous semester.

9. Development of course objectives that illustrate a hierarchy of learning within each semester and throughout the curriculum.

10. Development of courses that reflect a taxonomy of expected student behaviors for the cognitive, psychomotor and affective domains of learning.

Expertise of the Faculty

The existing core and adjunct faculty have the expertise to teach the proposed curriculum and are ready to transition to admit a charter class of DPT students, fall semester 2003. Plans to recruit three additional faculty, one per year, during the initial three year offering of the DPT curriculum will ensure a critical mass of master clinicians-academicians-scholars for the program to maintain its leadership role in physical therapy education.

The core faculty is comprised of highly experienced individuals whose primary professional commitment is to Columbia University’s Program in Physical Therapy and whose collective expertise is wide-ranging and impressive in its scope. Eight of the nine faculty hold doctorates, three have received research awards, one the Lindback Award for Teaching Excellence as well as APTA recognition with the Leadership in Education Award. The faculty has published in peer-review journals both internal and external to the profession and is sought-after speakers for their content expertise at state and national meetings. All faculty members have direct responsibility for teaching, student advising and the supervision of independent student learning and critical exploration.

Accreditation Approval Required Prior to Admitting the Charter DPT Class

Approval by Columbia University and the New York State Education Department is only the first stage in the program’s ability to offer the DPT degree.

The program will need to submit to the Commission on Accreditation in Physical Therapy Education by March 1, 2003, an Application for Approval of Substantive Change (AASC). This self-study document is used by the Commission for accredited master degree programs in physical therapy seeking approval of a doctoral program to replace the existing master’s. The information and data submitted in the AASC will be used by the Commission to evaluate Columbia’s proposed DPT program. The Commission will render its accreditation status decision at its spring meeting in late April 2003. No students can be admitted in the proposed DPT until Commission approval is forthcoming.

Table 1. Professional DPT Program Status as of August 6, 2002

Accredited Programs (First graduating class)

Andrews University

Arcadia University (Beaver College)

Arizona School of Health Science

Belmont University

Boston University

Chapman University

Concordia University

Creighton University

Des Moines University

Duke University

Duquesne University

Elon University

Emory University

Finch University

Hardy Simmons University

Idaho State

Indiana University

Lorna Linda University

Marquette University

MCP Hahnemann University

MGH Institute of Health Professions

Mt. St. Mary’s College

New York Medical College

New York University

Northern Arizona University

Northwestern University

Oakland University

Pacific University

Regis University

(2001)

(2002)

(2005)

(2001)

(2005)

(2003)

(2006)

(1996) (2002) (2002)

(2005)

(2006)

(2001)

(2005)

(2001)

(2005)

(2003) (2002)

(2006)

(2005)

(2001)

(2005)

(2003)

(2005)

(2004)

Samuel Merritt College

Shenandoah University

Simmons College

Slippery Rock University

Temple University

SUNY- Buffalo

SUNY- Stony Brook

University of Colorado

University of Central Arkansas

University of Delaware

University of Illinois at Chicago

University of Indianapolis

University of Maryland - Baltimore

University of Maryland - Eastern Shore

University of Medicine & Dentistry of NJ

University Of Miami

University Of Michigan Flint

University of Minnesota

University of Montana -Missoula

University of Nebraska

University of North Dakota

University of Pittsburgh

University of Puerto Rico

University of Puget Sound

University Of St. Augustine

University of Southern California

US Army – Baylor University

Virginia Commonwealth University

Washington University of St. Louis

Widener University

(2006)

(2004) (2002) (1998) (2003) (2004)

(2005)

(2003)

(2005)

(2004)

(2005)

(2006)

(2003)

(2004)

(2005)

(2003)

(2005)

(2006)

(2004)

(2006)

(1998)

(2005)

(2004) (2003)

Table 2. State and Regional Programs Offering or Developing the DPT

Region	Accredited DPT	Developing DPT
New York City Area	New York Medical College New York University	Long Island University (NY Board of Regents approval Sept. 02)
New York State	SUNY Buffalo SUNY Stony Brook
Connecticut		Sacred Heart University
Delaware	University of Delaware
Massachusetts	Boston University MGH Institute of Health Professions Simmons College	Northeastern University Springfield College University of Lowell
New Jersey	UMDNJ	Seton Hall University
Pennsylvania	Arcadia University (Beaver College) Chapman University Drexel University (MCP Hahnemann) Duquesne University Slippery Rock University Temple University University of Pittsburgh Widener University	College of Misericordia Gannon University St. Francis University University of Scranton

Table 6. Courses Found in the MSPT Program which have been Retained, Augmented for the

DPT and Newly Created DPT Courses by Curricular Component

Curricular

Component

MSPT

Program

MSPT Courses

Retained

MSPT Courses

Augmented

New DPT Courses

Scientific

Foundations

Human Anatomy

Neural Science

Pathology in Internal

Medicine

Neurological &

Orthopedic Disorders

Adult Neurology

Life Span

Kinesiology &

Biomechanics

Cardiopulmonary &

Exercise Physiology

Analysis of Motor

Control & Motor

Learning

Kinesiology &

Biomechanics

Gross Anatomy

Neuroscience

Movement Science

Histology & Pathology

Applied Physiology

Pharmacology

Clinical

Sciences

Examination &

Evaluation

PT Procedures

Physical Modalities

Therapeutic Exercise

Prosthetics & Orthotics

Orthopedics I, II

Adult Neurology

Pediatrics

Examination &

Evaluation

Prosthetics &

Orthotics

Physical Agents & Integumentary

Management

PT Interventions I: Therapeutic

Exercise & Patient Mobility

PT Interventions II: Advanced

Therapeutic Exercise

PT Management of Orthopedic

Conditions I, II, III

Advanced Seminar in Orthopedics

PT Management of Adult

Neurological Conditions I, II, III

Advanced Seminar in

Adult Neuro-Rehabilitation

PT Management of

Pediatric Conditions I, II

Advanced Seminar in

Pediatrics

PT Management of

Cardiopulmonary

Conditions I, II

Advanced Seminar in

Cardiopulmonary PT

Advanced Biomechanics

Health Education & Promotion in

PT Practice

Critical Exploration

Scientific Inquiry

Research Processes

Thesis Development

Master’s Thesis

Theory & Application in PT Research

Capstone Advisement I, II, III, IV

& Presentation

Clinical Case Management Seminar I,

II, III

Seminar in Evidence-Based Practice

Health Care

Systems &

Management

Psychosocial Aspects of

Illness & Disability

PT Management

Teaching Strategies

Psychosocial

Adaptation

to Illness &

Disability

Issues & Approaches in Health Policy

& Management

PT as an Educator & Consultant

Electives

Anatomy Dissection

Clinical & Laboratory

Gait Analysis

Diagnostic Imaging for

the PT

Women’s Health Issues in

Ergonomics & Industrial

Performance in PT

PT for Athletes

Practicum in Pediatric PT

Selected Topics in

Orthopedic PT

Seminar in School-Based

Pediatric PT

Anatomy

Dissection

Diagnostic

Imaging for the

Women’s Health

Issues in PT

Ergonomics &

Industrial PT

Performance in

Seminar in

School-Based

Pediatric PT

Sports Medicine

Clinical

Experiences

Clinical Seminar I, II, III

Clinical Education I, II,

III

Clinical Seminar

I, II, III

Clinical

Education I, II

Clinical Internship

Table 8. A Synopsis of the Major Differences Between the MSPT and DPT Programs

Program Area	MS	DPT
Student Inquiry	Master's Thesis	Capstone Project
Full-time Clinical Education Experiences	24 weeks	38 weeks
Clinical Internship	Not available	Unique to the program
Advanced Seminars	Not provided	Developed to offer the opportunity for clinical specialization
Electives	3 elective courses equating to a total of 72 contact hours	3-4 elective courses equating to a total of 82-100 contact hours
Program Length	22 months	33 months

Table 9. Total Amount of Instruction for all Three Years of the DPT

Year	Weeks of Instruction	Hours of Instruction
Year	Weeks of Instruction	Didactic	Lab	Seminar	Clinical	Total
First Year (Fall, Spring, Summer)	41	598	339	36	46	1019
Second Year (Fall, Spring Summer)	47	360	189	108	800	1457
Third Year (Fall, Spring)	34	192		112	720	1024
Total Amount of Program Instruction	122	1150	528	256	1566	3500

DPT has 8 semesters totaling 122 weeks (33 months) of instruction that equates to a typical fall and spring 4-year semester calendar.

The existing MS program is 5 semesters long totaling 68 weeks (22 months of instruction).

Table 10. Comparison of the Curricular Components by Contract Hours

Between the MSPT and DPT Programs

Curricular Component	MSPT Total Contact Hours	DPT Total Contact Hours
Scientific Foundations	336	410
Clinical Sciences	800	1098
Critical Exploration	120	236
Health Care Systems & Management	96	90
Electives	72	100
Clinical Experiences	1048	1566
Total	2472	3500

Table 11.1. Courses and Hours of Instruction in the First DPT Year.

First Year
Course		Weeks of Instruction	Hours of Instruction
Course		Weeks of Instruction	Didactic	Lab	Seminar	Clinical	Total
Fall
Anatomy	16		64	64			128
Neuroscience	16		56	8			64
Histology & Pathology	16		32				32
Kinesiology & Biomechanics	16		64	32			96
Examination & Evaluation	16		32	32			64

Total	16		248	136			384
Spring
Applied Physiology	16		45				45
PT Interventions I: Patient Mobility and Therapeutic Exercise	16		48	64			112
PT Management in Cardiopulmonary Conditions I: Cardiac Rehab	16		32	32			64
PT Management of Cardiopulmonary Conditions II: Pulmonary Rehab	16		32	32			64
Physical Modalities	16		48	48			96
Theory & Application in Physical Therapy Research	16		64				64
Clinical Mentorship I	16					30	30
Total	16		269	176		30	475
Summer
Movement Science	9		27				27
Pharmacology	9		18				18
PT Interventions II: Advanced Therapeutic Exercise	9		36	27			63
Clinical Case Management Seminar I	9				18		18
Clinical Seminar I	9				18		18
Clinical Mentorship II	9					16	16
Total	9		81	27	36	16	160

Total Amount of Instruction - First Year	41		598	339	36	46	1019

Note: The nine and 16-week academic semesters include the final examination week.
Table 11.2. Courses and Hours of Instruction in the Second DPT Year.

Second Year
Course	Weeks of Instruction		Hours of Instruction
Course	Weeks of Instruction		Didactic	Lab	Seminar	Clinical	Total
Fall – Part A: 10 weeks
*Clinical Experience I*	10					400	400
Fall – Part B
PT Management of Orthopedic Conditions I	9		36	27			63
PT Management of Adult Neurological Conditions I	9		27	18			45
PT Management of Pediatric Conditions I	9		36	18			54
Clinical Case Management Seminar II	9				18		18
Capstone Project Advisement I	9				18		18
*Subtotal*	9		99	63	36	400	198
Total	19		99	63	36	400	598
Spring – Part A
PT Management of Orthopedic Conditions II	9		36	27			63
PT Management of Adult Neurological Conditions II	9		27	18			45
PT Management of Pediatric Conditions II	9		36	18			54
Prosthetics & Orthotics (2/2)	9		18	18			36
Capstone Project Advisement II	9				18		18
Elective: 1 required to be taken either during spring A or B, 2^nd optional			18				18
*Subtotal*	9		135	81	18		234

Spring – Part B
PT Management of Orthopedic Conditions III	9		36	27			63
PT Management of Adult Neurological Conditions III	9		27	18			45
Health Education & Promotion in PT Practice	9		27				27
Psychosocial Adaptation to Illness & Disability	9		18				18
Clinical Case Management seminar III	9				18		18
Capstone Project Advisement III	9				18		18
Clinical Seminar II	9				18		18
Elective:1 required to be taken either during spring A or B, 2^nd optional	9		18				18
*Subtotal*	9		126	45	54		225

Summer: 10 weeks
*Clinical Experience II*	10					400	400
*Subtotal*	10					400	400

Total Amount of Instruction – Second Year		47	360	189	108	800	1457

Table 11.3. Courses and Hours of Instruction in the Third DPT Year

Third Year
Course	Weeks of Instruction	Hours of Instruction
Course	Weeks of Instruction	Didactic	Lab	Seminar		Clinical	Total
Fall
Issues & Approaches in Health Policy & Management	16	48					48
Advanced Biomechanics: Clinical & Laboratory Gait Analysis	8	24					24
Education & Consultation in Physical Therapy	8	24					24
Evidence Based Practice	16	32					32
Specialty Seminars (student selects 1 of the following) Advanced Seminar in Orthopedics Advanced Seminar in Adult Neuro Rehab Advanced Seminar in Pediatrics Advanced Seminar in Cardiopulmonary	16			48			48
Clinical Seminar III	16			32			32
Capstone Advisement III & Presentation	16			32			32
Electives: 2 required	16	64					64
Total	16	192		112			304
Spring: 18 weeks
*Clinical Internship*	18					720	720
Total	18					720	720

Total Amount of Instruction – Third Year	34	192			112	720	1024

Educational Characteristics	Proposed DPT	Accredited DPT Programs Mean Range
Total Contact Hours	3500	1948 1432-2880
Academic Weeks	84	81.38	71-96
Total Weeks of Full-Time Clinical Education	38	36.75	24-53

Educational Characteristics	Proposed DPT	Accredited Programs in Research I Institutions Mean Range
Total Contact Hours	3500	2056 1442-2880
Academic Weeks	84	81.38	71-81.38
Total Weeks of Full-Time Clinical Education	38	36.75	32-42

Description	Examples
Education Module
The development of a specific content area for a particular audience (entry level students, advanced students/clinicians, consumers, etc.). The educational module topic is selected with the approval of the advisor. It must be a scholarly synthesis of the theoretical and research literature in a focused area and it must make clinical application to the physical therapy profession. It may take the traditional format of lecture/seminar and laboratory components or a more non-traditional format like video or computer instruction.	“A Therapeutic Exercise Program for ALS patients” This project entails preparation of an educational packed for health care providers and care givers.
Clinical Practice Module
A clinical practice module describes physical therapy practice in a patient or a group of patients and will take the format of a patient-related case report. The clinical practice module process should assist the student to develop critical-thinking and problem-solving skills and should support, enhance or cast doubt on a theory underlying physical therapy practice. The specific patient or group of patients that the student selects for the case report is selected with the approval of the clinical instructor and advisor. The report can be a prospective, retrospective or a combination case study.	“Physical Therapy in Huntington’s Disease: Current Perspectives and Case Report.” This case report highlights a physical therapy intervention program for patients with Huntington’s disease.
Research Module
Students perform a research project from review of literature through design, execution and documentation. The research topic is selected with the approval of the advisor and should be a faculty generated research question. It may encompass physical therapy topics with relevance to clinical practice, education or administration. Prior to commencing a research project, all students must obtain the Good Clinical Research Practice certificate and have approval from the IRB.	“The Effects of an Exercise Program on Diastasis Recti Abdominis in Pregnant Women.” This study compared the abdominal separation in pregnant women who participated in an abdominal strengthening program to those who did not participate in an exercise program.
Administration Module
The intent of the administration module is to allow the student to focus on furthering their understanding of the physical therapist’s role in administration. Thus, the student will explore issues of health care delivery, public policy and administration of physical therapy services.	“A Cost Benefit Analysis and Business plan for a Proposed Community-based Physical Therapy Practice.” Students prepare a business plan and cost benefit analysis.

Expertise of the Faculty

Third Year (Fall, Spring)