Cognitive-Affective Learning in Physical Therapy Education: From Implicit to Explicit
Goulet, Caroline, Owen-Smith, Patricia, Journal of Physical Therapy Education
Background and Purpose. Practice expectations that describe the knowledge, skills, and behaviors defining the performance of physical therapists encompass the cognitive, psychomotor, and affective learning domains. As in virtually all disciplines in higher education, learning in the affective domain pertains for the most part in the implicit curriculum of physical therapist education. However, no one would argue that the focus on the cognitive domain alone without addressing the affective domain is sufficient to meet today's professional practice expectations. The objectives of this paper are: (1) to define the cognitive affective relationship, (2) to describe the significance of affect in intellectual inquiry, and (3) to suggest enhanced focus on cognitive-affective learning into physical therapist professional education.
Position and Rationale. Although recognized as an essential and integral part of becoming a health care professional, physical therapist student development in the affective domain remains part of the implicit curriculum. Physical therapist education should be grounded in all domains of learning-affective, cognitive, and psychomotor-with physical therapy care and core abilities developed in parallel and feeding off of each other. Teaching practices should nurture student development in the affective learningdomain without over-romanticizing the emotional and reducing disciplinary content to secondary stature. A commitment to do so will require having explicit program goals, course objectives, and graduate outcomes specifically related to the affective domain, with serious consideration of how to evaluate students with regard to the affective domain.
Discussion and Conclusion. If physical therapist educators believe that the affective domain is a critical component of the curriculum, affective objectives need to be explicit and integrated throughout the curriculum. From a curricular point of view, faculty buyin, decreased traditional lecture time in favor of more active-learning time, faculty and student development, increased resources, and solid clinical community support are essential elements to facilitate the transition.
Key Words: Physical therapist education, Cognitive-affective learning, Learning model.
BACKGROUND AND PURPOSE
Basic scientists have more to say about the significance of emotions in learning than most educators. The brain does not separate emotions and cognition; both thinking and cognition are outcomes of the affective domain.1 Health care education programs are now asked to honor the central place of the affective domain in the health care practitioner and in the patient's health.2
The mission of physical therapist education is "to develop knowledgeable, serviceoriented, self-assured, adaptable, reflective practitioners who, by virtue of critical and integrative thinking, lifelong learning, and ethical values, render independent judgments concerning patient/client needs that are supported by evidence; promote the health of the client; and enhance the professional, contextual, and collaborative foundations for practice."3 Practice expectations that describe the knowledge, skills, and behaviors defining the performance of physical therapists encompass all learning domains.4 The American Physical Therapy Association Vision Statement for Physical Therapy 2020 proclaims that physical therapists will be "guided by integrity and lifelong learning" and that "they will provide culturally sensitive care distinguished by trust, respect, and an appreciation for individual differences."5 However, today's scope of physical therapist practice as described in the Guide to Physical Therapist Practice consists of the recurrent cycle of patient examination, evaluation of findings, physical therapy diagnosis, prognosis, intervention, and outcomes.3,6 These physical therapy care abilities -patient examination, patient evaluation and diagnosis, patient prognosis, patient intervention, and patient reevaluation - remain at the core of the explicit curriculum of all physical therapist education programs, that portion of the curriculum that is unambiguously defined and overtly assessed. …