Academic journal article Journal, Physical Therapy Education

The Post-Professional Doctorate of Physical Therapy: A Survey of Practicing Physical Therapists

Academic journal article Journal, Physical Therapy Education

The Post-Professional Doctorate of Physical Therapy: A Survey of Practicing Physical Therapists

Article excerpt

ABSTRACT: The purposes of this survey study were to assess whether practicing physical therapists desire a post-professional clinical doctorate of physical therapy (DPT) and to explore their expectations for such a program and future benefits they may expect from acquiring this degree. A simple random sample of 35% of all Nebraska and Iowa chapter members of the American Physical Therapy Association was .selected. This random selection resulted in 173 subjects from Nebraska and 223 subjects from Iowa, for a total of 396 subjects. The survey instrument consisted of 6 demographic questions and 21 questions regarding the curriculum content and program implementation of a postprofessional DPT program, expectations of the DPT degree, and personal views about the DPT degree. Response frequencies for all of the survey questions were determined. The data were also examined for variation in the responses across specific demographic groups based on the type of physical therapy degree held, the desire to pursue a DPT degree, the number of years of experience, and the level of exposure to the DPT degree. A total of 280 survey instruments were returned, for a response rate of 71%. One third of the respondents were interested in obtaining a post-professional DPT degree. The two most common expectations cited for the DPT degree were enhancement of professional competence of a physical therapist and assistance in career advancement. Managed care, business management/administration issues, and professional communication were identified as

desired areas of curriculum emphasis. There is interest among practicing physical therapists who share common expectations for developing further professional competence consistent with current practice demands in obtaining a postprofessional DPT degree.

INTRODUCTION

Since 1918, when the Office of the Surgeon General of the Army developed the first formalized training programs for physical therapy, there have been continuous changes in the level of education available to physical therapists. 3 In 1928, the first guidelines for minimum course requirements of schools training physical therapists were established by the American Physical Therapy Association (APTA). A Certificate in Physical Therapy was awarded for completion of this course of study.1-3 In 1960, another change in the level of physical therapy education occurred when APTA announced that the baccalaureate degree would be the required degree offered by physical therapy educational institutions.l-3 During the 1970s, there was a movement by a few institutions toward preparing physical therapists with the master's degree as the first professional (entrylevel) physical therapy degree. By 1978, a master's degree in physical therapy was offered by five educational institutions.1,3 In 1979, a resolution was adopted by the House of Delegates of APTA that proposed a postbaccalaureate degree would be the first professional degree level for entry into physical therapy practice by December 31, 1990.1,4,5 This proposal generated conflicting opinions and even opposition among members of the physical therapy community. Arguments centered on resource issues such as cost to the student and institution, lack of qualified faculty, and changes in the health care system. 1,6,7

There has been continued discussion and debate within the physical therapy professional community about the level of degree for physical therapists. These discussions now center on the clinical doctoral degree.l,6 12 In 1985, Dr Geneva Johnson said in the 20th Mary McMillan Lecture, "I expect us to develop the professional doctorate in physical therapy as the standard for entry-level education within the next five years. ... I expect us to be clear about who we are, if the physical therapist is to be recognized as a professional.8(pl694) In 1989, an APTA task force made the recommendation to the APTA Board of Directors that "...the appropriate entry-level degree, based on the framework of practice and academic requirements, is the entry-level clinical doctorate degree.""12

The purpose of a clinical doctorate degree is to prepare professionals for clinical practice, clinical scholarship, and a professional career in a specific field. The curriculum of a program offering such a degree emphasizes clinical practice, and the degree is usually awarded by professional schools. The clinical doctorate differs from a Doctor of Philosophy (PhD) degree, which is a research-based degree, focused more on preparation for the research field, and is usually awarded by the graduate school.l3,14 The Doctor of Physical Therapy (DPT) degree is a clinical degree and, as such, differs from the Doctor of Philosophy in Physical Therapy degree, which is more research oriented and has the prerequisite for program admission of an entry-level bachelor's or master's degree in physical therapy.l,l5 Many other health care professions, including medicine and dentistry, educate at the clinical doctorate level (eg, Doctor of Medicine [MD], Doctor of Podiatric Medicine [DPM], Doctor of Osteopathy [DO], Doctor of Chiropractic [DC]). 13-17

In the health care professions where the professional doctorate does not have a long history, there is often confusion and debate within the profession about whether the degree is the first professional degree or a degree that represents advanced skills, or perhaps both.7,16-18 Physical therapy is no different, as clinical doctoral degree (DPT) programs are developing at both the entry level and the post-professional level.19 -22 The forces that lead an occupation to consider doctoral education have to do with key issues of what it means to be a profession-legitimization and accountability.23-25 Historically, professions were a privileged group in society, given the responsibility and obligation of meeting societal needs. The profession has the responsibility of preparing competent professionals who can meet those present and future societal needs. This includes providing high-quality patient care, creating and validating a knowledge base, and continuing to analyze and evaluate societal needs.23,zs Professional doctoral education among the health care professions (eg, medicine, dentistry, podiatry, and more recently, pharmacy) in the United States is a recognized indicator of legitimization and accountability. 13-17

To practice physical therapy in today's society requires the ability to handle complex and uncertain situations. Social, economic, technical, political, and health care environments are changing at a rapid pace. Therapists need a broad knowledge base that incorporates fundamental knowledge of physical therapy as well as managing patients in an ever-changing health care delivery system.26 Much of the discussion about clinical doctoral education has focused on the entrylevel degree,1 12-Iz whereas there has been little focus on the needs of the practitioner. In an APTA conference on post-professional education in 1998, participants discussed various pathways ( transition or advanced) for physical therapists to obtain the clinical doctorate. Plans are under way to continue to develop documentation and ongoing dialogue about the configuration of the post-professional clinical doctorate.27

In constructing academic programs for practicing physical therapists, it is necessary to identify practitioners' perceptions regarding the value of and need for such programs as well as their preferences for program structure. The purpose of this study was to determine the preferences of practicing physical therapists in Nebraska and Iowa regarding post-professional clinical doctoral education.

METHOD

Survey Instrument Design

The initial design of the survey instrument was based on key concepts from professional education and expectations of clinical doctoratesl.5,8,13-17,23 and interviews with practicing physical therapists (n=7) from the greater Omaha, Nebraska, metropolitan area. The interviewed physical therapists were selected based on availability and/or willingness to participate. Open-ended questions were used by the researchers (BD and DB) in the interview process to give each interviewee the opportunity to express his or her own ideas and opinions. Interviews were recorded, and recurring themes and concepts from these interviews and the literature review were used to develop questions for the survey instrument. This was done to help ensure the content validity of the survey instrument.

The initial draft of the survey instrument was reviewed and critiqued by two experts in survey questionnaire construction. In addition, a draft of the survey instrument was administered to a panel of practicing physical therapists at a local hospital (n=6) to ensure that the survey instrument was clear and understandable. Comments and suggestions from both the experts and the panel were then considered in the development of the final survey instrument.

To help ensure the test-retest reliability of this survey instrument, we administered the completed questionnaire to practicing physical therapists (n=ll) on two separate occasions, approximately 7 days apart, and compared each individual's responses for reliability. This process demonstrated 93% test-retest reliability.

Survey Instrument

The survey instrument was divided into a demographic section and a section of fivepoint Likert scale questions, which were divided into four categories. The four categories were curriculum content, program implementation, expectations of a postprofessional DPT degree, and personal views (Appendix). The demographic questions asked for information about respondents' degree(s), current work setting, primary position at work, number of years of practice, number of clock hours of continuing education, and level of exposure to the DPT degree. A five-point Likert scale28 was used for all questions in the curriculum content, program implementation, and personal views sections of the survey instrument. The personal views category contained one question that did not use the Likert scale responses and instead gave respondents a list of five options to select from (Appendix, question 21). This survey required approximately 5 to 10 minutes for the respondents to complete.

Sample

The population from which the sample for this study was obtained consisted of all Nebraska and Iowa chapter members of APTA. From this population, a simple random sample of 35% of the APTA members from each state was selected. This process resulted in the random selection of 173 subjects from Nebraska and 223 subjects from Iowa, for a total of 396 subjects. We chose to obtain our sample from these two states because they are in close proximity to Creighton University, where this study was conducted.

Procedure

We used the Dillman Total Survey Design Method in this study.28 The first mailing, including a cover letter, a copy of the survey instrument, and a self-addressed postage-paid envelope, was sent to the entire sample of 396 subjects with instructions to return the survey questionnaire within 2 weeks of receiving the mailing. A reminder letter and was mailed 2 weeks after the initial mailing to all subjects who had not responded by that date. The third mailing consisted of a cover letter, a copy of the survey instrument, and a selfaddressed postage-paid envelope. This mailing was mailed 1 week after the reminder letter to all subjects who had not responded by that date. In order to monitor the response rate and assist with follow-up mailings, a code number was written at the top of each survey instrument. No names were written on the survey instruments, and all data were recorded by the code number to ensure the anonymity of the subjects.

Data Analysis

Data were recorded and analyzed on a personal computer using the SPSS Release 6.1 for Microsoft Windows.29 Response frequencies for all of the survey questions were determined, and this information was examined for possible discussion topics. The responses of the subjects who agreed or disagreed with the survey question that asked whether the subject would be interested in obtaining a postprofessional clinical DPT degree were then compared and examined for trends in their response frequencies. A post hoc analysis of the data was done to examine for differences in the response frequencies across specific demographic groups using chi-square tests. These groups included: 1) the type of physical therapy degree held (master's, bachelor's, or certificate), 2) the number of years of practice (0-5, 6-15, and 16 or more years), and 3) the level of exposure to the DPT degree (none, reading literature, and a working relationship) (Appendix).

RESULTS

Respondent Profile

A total of 396 survey instruments were mailed, 173 to Nebraska APTA members, and 223 to Iowa APTA members. Of these, a total of 280 survey instruments were returned, for an overall response rate of 71%. Of the 280 questionnaire returned, 118 (42%) were from Nebraska and 162 (58%) were from Iowa. The response rate was 68% for subjects from Nebraska and 73% for subjects from Iowa. Of the 280 questionnaires returned, 19 were rejected because they were incomplete. Thus, data were collected from a total of 261 (66%) of the 396 survey instruments mailed.

The respondents represented a diverse group of physical therapists in Nebraska and Iowa. The demographic profile obtained with this survey was similar to that described in the 1993 APTA Active Membership Profile Report.30 Only 1% of the respondents had received a PhD degree in addition to a physical therapy degree. Thirty-four percent worked primarily in a hospital setting, and 54% worked as staff physical therapists. Thirty percent of the respondents had practiced for 5 years or less, and 37% had practiced for 16 or more years. Only 27% of the respondents had no exposure to the DPT degree (Table 1).

Expectations for the DPT Degree

Curriculum

Ninety percent of the respondents believed that a DPT program should include courses in nonclinical areas such as managed care or insurance regulations. Eighty-five percent agreed that a DPT program should include courses on business management/administration. Seventy-two percent of the respondents agreed that a DPT program should include a strong research component. A specific specialty area was seen as more important than training across several specialty areas. The majority (60%) of the respondents also agreed that the DPT degree should prepare graduates for teaching in a physical therapy program (Table 2).

Seventy-five percent of the respondents agreed that prior clinical experience of practicing therapists should be considered in meeting the graduation requirements of a DPT program. The majority of respondents (69%) agreed that practicing physical therapists should be able to maintain their current job while obtaining a DPT degree and that obtaining a DPT degree should allow practicing physical therapists to acquire continuing education credits (79%) (Table 3).

Professional preparation

A slight majority of the respondents (56%) agreed that a DPT degree would assist in career advancement; however, only 40% believed it would assist them in gaining a higher salary. Sixty-three percent of the respondents believed that obtaining a DPT degree will enhance their professional competence, but only 16% believed that it would assist with obtaining reimbursement by thirdparty payers. Forty-two percent of those who responded to the survey agreed that obtaining the degree will enhance the public's recognition of the profession's knowledge base and integrity (Table 4).

Personal views

Under personal views, one question dealt with respondents perceptions of the entrylevel clinical doctoral degree. In response to this question, the majority of respondents (79%) did not believe that all entry-level programs should move to an entry-level clinical doctorate degree. The other questions assessed their personal views of post-professional clinical doctoral education. In response to these questions, 44% agreed that there are some advantages to obtaining the DPT and 30% would be interested in obtaining a postprofessional clinical DPT (Table 5).

Comparison by Desire to Obtain or Not Obtain a DPT Degree

Of those interested in obtaining a post-professional DPT degree (n=79), only 13% held a Certificate of Physical Therapy degree. Thirty-two percent of those who were not interested in obtaining a post-professional DPT degree held a Certificate of Physical Therapy degree. Of those interested in obtaining a DPT degree, 39% had been practicing for 0 to 5 years, and this percentage steadily declined to 3% who had been practicing for 26 or more years. In the group interested in obtaining a post-professional DPT degree, 49% reported a working relationship with DPT students/graduates, whereas 44% of those not interested in obtaining the DPT degree had exposure to DPT students/graduates or education only through literature (Tab. 6). A higher percentage of the respondents who were interested in the postprofessional DPT degree agreed with the seven "expectations of the DPT degree" questions, as compared with all of the respondents together as well as compared with only those who were not interested in obtaining this degree (Tables 4 and 7). Of those interested in obtaining the DPT degree, 67% believe that there are currently advantages to obtaining this degree, whereas only 26% of those who are not interested in the degree feel that there are advantages to the DPT degree at the present time (Table 7).

Further post hoc analysis of the data using a chi-square test comparing the responses by dividing the sample according to educational degree, years of experience, and level of exposure to DPT students/graduates or education did not reveal any differences in responses between groups.

DISCUSSION

Professional Community Interest

The results of this survey demonstrate that there is interest in obtaining a postprofessional DPT degree among practicing therapists in Nebraska and Iowa. The characteristics of this therapist sample were similar to the characteristics of the 1993 APTA Active Membership Profile30; therefore, this group of physical therapists is representative of practicing therapists who are members of the APTA. This expressed interest and perceived need for obtaining a post-professional DPT degree supports continued discussion and development of post-professional DPT programs.

Curriculum Content and Program Implementation

The non-patient care areas of managed care, business management/administration issues, and professional communication were identified by physical therapists in this study as very important for a post-professional DPT program. This finding may indicate physical therapists' concern about preparation for the changes that are occurring in today's health care management system (Table 2).

The results also indicate that the vast majority of physical therapists surveyed believe that additional research preparation is an essential aspect of a post-professional DPT program. Practitioners may well be responding to the increased demands in the health care arena for providing evidence to support their treatment interventions.26,31 Although the focus of clinical doctoral programs is on practice, clinical research has an important role to play in developing scientific knowledge for a practice-based discipline such as physical therapy.l3-17 Therapists are interested in seeking additional education as a means to develop an area of established clinical competence or specialty rather than additional education across clinical areas. This may indicate that therapists are seeking ways to develop an area of clinical specialty practice in physical therapy. This would be consistent with the growth of the profession into the "clinical specialization movement."32

Most of the therapists saw the DPT degree as providing necessary background for teaching in a physical therapy education program (Table 2). The post-professional DPT degree could provide another avenue for preparing physical therapy faculty. This would be consistent with other professional schools where faculty who hold terminal degrees in the profession (eg, medicine, dentistry, law) teach.8-10,16-18

Prior clinical experience is seen as an essential dimension of program requirements and implementation. The majority of the responding therapists would want to maintain their current position while pursuing a DPT degree and also support the opportunity to acquire continuing education credits as part of post-professional DPT education. They prefer an educational setting that has the flexibility to accommodate for their current employment and maintain their financial stability (Table 3). This is consistent with postprofessional clinical doctoral education in other health care professions where program flexibility and consideration of nontraditional teaching methods is appealing to the working professional.l7,33,34

Expectations

In general, responding therapists expect that a post-professional DPT degree will assist them in increasing their level of knowledge and professional ability. These therapists, however, do not believe that obtaining a DPT degree will assist with reimbursement and independent practice issues. This finding may indicate that many therapists believe that a DPT degree will be recognized by other health care professionals, administrators, and the general public but not by insurance companies and government officials. However, although it is important to be recognized by other health care professionals, if physical therapists truly desire professional status and autonomy, additional image building and education must be done with the public, including insurance companies and government officials. Public recognition of the profession as the primary provider of their service (ie, "physical therapy care") is an essential element for professional status.23

Personal Views

Although the majority of therapists do not believe that all entry-level programs should move toward an entry-level DPT degree, many therapists see advantages to the DPT at the present time and would be interested in obtaining a post-professional DPT degree (Table 5). Therapists may not believe that all entry-level programs should move to a DPT degree for several reasons. First, therapists may believe the DPT degree should be awarded only as post-professional/graduate degree versus an entry-level degree.7 Another reason is that perhaps therapists do not believe that all entry-level programs would be qualified or have the resources to offer a DPT degree. Some may also believe that another physical therapy degree would only add to the confusion created by the number of physical therapy degrees already in existence. The fact, however, fact that 30% of the therapists would be interested in obtaining a post-professional DPT degree and an additional 28% were neutral indicates that it may be time to give additional consideration to nontraditional paths to earning the DPT degree.

Although we recognize the entry-level clinical doctoral degree was not the central focus of this descriptive survey, the discussion of the role of the clinical doctoral degree for the profession, regardless of entry-level or postprofessional level, will continue. It is difficult to discuss one pathway (entry-level) without consideration of the other (post-professional). How the profession chooses to define the pathways to the clinical doctoral degree (transition, advanced, entry-level) is an important internal focus for physical therapy, yet is likely to have little meaning to the society we serve. It seems we must not lose sight of an essential question: What degree do we want the public to associate with physical therapists, or does it matter? Providing multiple pathways to obtain a clinical doctoral degree has the potential to unify the profession and clarify the profession's public image.

Comparison by Desire to Obtain or Not Obtain a DPT Degree

Physical therapists with either a bachelor's or master's degree in physical therapy expressed more interest in obtaining a postprofessional DPT degree than did those with a Certificate of Physical Therapy degree. One reason for this response variance is that the Certificate of Physical Therapy degree is the older of the three degrees.1 Thus, therapists with this degree have been practicing longer, are more established in their career, and may be near retirement age; therefore, they may be less likely to pursue an additional degree. This is reinforced by the finding that the majority of the physical therapists interested in obtaining a post-professional DPT degree (64%) had been practicing 10 years or less (Table 6).

Almost one half (49%) of those who were interested in obtaining a post-professional DPT degree had experienced a working relationship with an entry-level DPT student/graduate. This finding may indicate that interaction with DPT students/graduates provides additional exposure and understanding of the DPT degree in a way that makes those who work with them desire such a degree. It may also indicate that many people do not correctly understand the goals and philosophy of the entry-level DPT degree until they have spoken with someone familiar with the degree. Almost one half (44%) of those who were not interested in obtaining a postprofessional DPT degree had been exposed to the DPT degree through reading literature, which may reflect continuing controversy and debate within the profession. Additionally, one might project that as the number of graduates of DPT programs increases, the exposure and understanding of the DPT degree will also increase in the professional community. The interest in the DPT degree may also be higher in Nebraska and Iowa because Creighton University, which offers an entrylevel DPT degree, is located in this area (Table 6).

The following limitations may have affected the results of this study. The sample population consisted only of practicing therapists in two predominantly rural states (Nebraska and Iowa). Practicing therapists in this area may have different views about the DPT degree because Creighton University, which currently offers an entry-level clinical DPT degree, is located in this area. Additionally, because this study was associated with Creighton University, respondents may have responded in a manner that was more favorable toward the DPT degree.

Future investigations are necessary to continue to explore the beliefs and expectations of the variety of stakeholders in the educational system and the health care system (eg, patients, therapists, employers, insurance companies, higher education administrators, and students). Further research involving subjects from more diverse, populated states would also be beneficial.

CONCLUSION

It appears that there is interest among practicing physical therapists in obtaining a postprofessional DPT degree. Additionally, the more common expectations of such a degree included enhanced professional competence and career advancement. Non-patient care areas of managed care, business management/administration issues, and professional communication were seen as areas of curriculum emphasis. Survey respondents supported a flexible designed post-professional DPT program that allows the therapist to maintain employment and provides an opportunity to specialize in a specialty area of physical therapy. This information may be valuable to educational institutions that may be considering developing a post-professional DPT program.

ACKNOWLEDGMENTS

This study was funded by the Department of Physical Therapy, Creighton University. We thank all respondents who completed the survey.

[Reference]

REFERENCES

[Reference]

Hummer LA, Hunt KS, Figuers CC. Predominant thoughts regarding entry-level doctor of physical therapy programs. Journal of Physical Therapy Education. 1994;8(2):60-66.

The Beginnings: Physical Therapy and the APTA. Alexandria, Va: American Physical Therapy Association; 1979. Pinkston D. Evolution of the practice of physical therapy in the United States. In: Scully R, Barnes M, eds. Physical Therapy. Philadelphia, Pa: JB Lippincott Co; 1989:2-30.

[Reference]

4. Report of the House of Delegates Session. Phys Ther. 1979;59:1396-1400. 5. Warren SC, Pierson FM. Comparison of characteristics and attitudes of entry-level bachelor's and master's degree students in physical therapy. Phys Ther. 1994;74: 333-348.

[Reference]

6. Daniels L. Ninth Mary McMillan Lecture: Tomorrow now: the master's degree for physical therapy education. Phys Ther. 1974;54:463-473.

[Reference]

7. Deusinger SS, Deusinger RH, Minor SD, et al. Letter to the editor [RE: DPT controversy]. Phys Ther.1993;73:329-330. 8. Johnson G. Twentieth Mary McMillan Lecture: Great expectations: a force in growth and change. Phys Ther. 1985;65:1690-1695. 9. Soderberg GL. Twenty-Seventh Mary McMillan Lecture: On passing from ignorance to knowledge. Phys Ther. 1993;73:797-807.

10. Moffat M. Presidents message [some simple truths in a complicated time: on the DPT and other issues in physical therapy

[Reference]

education]. PT-Magazine of Physical Therapy. November 1993:4142.

I 1. Rothstein JM. Editor's note: A matter of degree. Phys Ther. 1996;76:1054-1055. 12. Report on Doctoral Education. Alexandria, Va: American Physical Therapy Association; 1989.

[Reference]

13. Starck P, Duffy M, Vogler R. Developing a nursing doctorate for the 21 st century. JProf Nurs. 1993;9:212-219.

14. Downs F. Differences between the professional doctorate and the academic/research doctorate. J Prof Nurs. 1989;5:261-265. 15. Soderberg GL. The future of physical therapy doctoral education. Journal of Physical Therapy Education. 1989;3(1): 15-19. 16. Forni PR. Models for doctoral programs: first professional degree or terminal degree? Nursing and Health Care. 1989;10:428-434. 17. The Papers of the Commission to Implement Change in Pharmaceutical Education. Alexandria, Va: American Association of Colleges of Pharmacy; 1994.

18. Pierce D, Peyton C. An historical cross-disciplinary perspective on the professional

[Reference]

doctorate in occupational therapy. Am J Occup Ther. In press.

19. Fearon FJ, Smith DD, Voight M, et al. Letter to the editor [RE: DPT controversy]. Phys Ther 1993;73:550.

[Reference]

20. Paris SV Letter to the editor [RE: DPT controversy]. Phys Ther 1993;73:548-549. 21. American Physical Therapy Association. Ac

creditation Update. 1998;3(1):1-28. 22. American Physical Therapy Association. Guide to Postprofessional Programs in Physical Therapy. 1998. Available at: http://www. apta.org/education/postprof.html. 23. Forsyth P, Danisiewicz T. Toward a theory of professionalization. Work and Occupation. 1985; 12:59-76.

24. Houle C. Continuing Learning in the Health Professions. San Francisco, Calif JosseyBass Inc Publishers; 1984:19-33. 25. Ford PJ. The nature of graduate professional education: some implications for raising the entry level. Journal of Physical Therapy Education. 1990;4(1):3-6.

26. Guide to Physical Therapist Practice. Alexandria, Va: American Physical Therapy Association; 1997.

[Reference]

27. Progress Report: Thinking in the future tense: postprofessional education. PT-Magazine of Physical Therapy. 1998;6(11):89. 28. Rossi PH, Wright JD, Anderson AB. Handbook of Survey Research. San Diego, Calif: Academic Press Inc; 1983:359-377. 29. Statistical Package for the Social Sciences 6.1 Version for Windows. Chicago, Ill: SPSS Inc: 1997.

[Reference]

30. 1993 Active Membership Profile Report. Alexandria, Va: American Physical Therapy Association; 1994.

31. Duncan P Evidence-based practice: a new model for physical therapy. PT-Magazine of Physical Therapy. 1996;4(12):44-48. 32. Tichenor CJ. Clinical residency: another turning point for our profession? PT-Magazine of Physical Therapy. 1995;(3):49-51. 33. Learn C. Distance learning: issues and applications for nontraditional programs. Am JPharm Ed.1994;58:406410.

34. Carter R. In nontraditional education: assuring quality is job one. Am JPharm Ed. 1994;58:411-413.

[Author Affiliation]

Dr Detweiler is Staff Physical Therapist, Park Rapids Physical Therapy and Rehab, 200 South Main St, Park Rapids, MN 56470. Dr Baird is a physical therapist in private practice, Ironwood Drive Physical Therapy, Coeur-d'Alene, ID 83814. Dr Jensen is Associate Professor, Department of Physical Therapy, and Faculty Associate, Center for Health Policy and Ethics, Creighton University, Omaha, NE 68178 (Gjensen@Creighton.edu). Dr Threlkeld is Director and Associate Professor, Department of Physical Therapy, Creighton University, Omaha, NE 68178 (Jthrel@Creighton.edu). Address all correspondence to Dr Jensen and Dr Threlkeld. Dr Detweiler and Dr Baird were students in the Doctor of Physical Therapy Program at Creighton University at the time the study was conducted.

[Author Affiliation]

Dr Gail Jensen

Creighton University

Department of Physical Therapy

2500 California Plaza

Omaha, NE 68178.

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