The History of Physical Therapy Education in the United States

Article excerpt

The emphasis of this special issue is on the history of physical therapist education; one manuscript, however, specifically illustrates the history of physical therapist assistant education. All of the authors describe the early days of physical therapy in the United States and the external and internal influences that make physical therapist practice and education what it is today.

As you read this issue, you will be impressed by the way societal and political factors, along with the continual evolution of disease, have affected physical therapist practice. Over the years, the manner in which physical therapy professionals dress, talk, and relate to patients has changed markedly. Surges or resurgences of certain diseases have impacted the profession, as has the political arena, from payment structures to the domination by physicians of our profession in the early days.

The key elements of our profession include practice, teaching, and research. The transformations in physical therapy education and practice were very difficult to capture in short manuscripts. The authors have provided you with a tour of critical past events.

Physical therapy practice has evolved from being prescriptive, with physicians telling physical therapists exactly what to do, to physical therapists practicing independently. The proposed national Medicare regulations for payment for direct-access services substantiates how far this profession has come; this issue is discussed by Marilyn Moffat, PT, PhD, CSCS, FAPTA, in "The History of Physical Therapy Practice in the United States" and by John L Echternach, PT, RdD, HCS, FAITA, in his article "The Political and Social Issues That Have Shaped Physical Therapy Education over the Decades."

Education has also changed from being prescriptive to evidence-based over the last 80 years, as illustrated by Elizabeth H Littell, PT, PhD, and Geneva Richard Johnson, PT, PhD, FAPTA, in their article "Professional Entry Education in Physical Therapy during the 20th Century." At one time, when a teacher entered the room all of the students had to stand up in deference to the instructor. Those days are long gone! Students now expect excellence and challenge their instructors, which would not have been accepted in the early days of physical therapy education.

Clinical instruction has also changed with the evolution of the profession. With entry-level doctoral education, identifying and developing superb clinical instructors (CIs) is a challenge. Issues such as finding talented CIs to mentor students continue to be a concern, as does the number of clinical placement sites. Jan Gwyer, PT, PhD, and colleagues, in "The History of Clinical Education in Physical Therapy in the United States," describe critical issues that have shaped clinical education.

The evolution of the Doctorate in Physical Therapy (DPT) has recently been a catalyst for change in the profession. Schools across the county have followed the Creighton University faculty in offering a DPT degree. The Creighton University faculty's decision to train doctorally prepared clinicians was controversial, widely discussed, and criticized. They believed in their goal and persevered. Sidney J Stohs, PhD, FASAHP, FACN, CNS, FATS, and colleagues explain the steps in the evolution of the first physical therapist doctoral program in their paper, "Initiating Clinical Doctoral Education in Physical Therapy: The case of Creighton University. …