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Editor's Notes |
alanjette{at}apta.org
Listening to Dr Becky Craik's inspirational McMillan Lecture at PT2005 in Boston,1 I was struck by her reflections on how much physical therapist professional education has changed over the past 30 years.
As a graduate of a physical therapy program in the 1970s, I was shocked when she informed us that there were only 81 physical therapist education programs in the United States in the 1970s, compared with 210 today! Even more shocking to me, however, were the statistics she provided on the number of US education institutions that have converted to the professional doctoral degree in physical therapy. Who could have predicted that in 2005, less than 10 years since Creighton University graduated the nation's first doctors of physical therapy, 133 programs in the United States would be offering the DPT? Craik went on to challenge all of us in the profession not to "rest on our laurels" but to keep pushing forward, to strive toward a shared vision for our profession. I urge all readers to be sure to read her McMillan Lecture when it is published in Physical Therapy in November.
Craik's comments about changes in professional education—along with the article titled "Association of Importance of the Doctoral Degree With Students' Perceptions and Anticipated Activities Reflecting Professionalism" (MA Johanson)—have stimulated me to reflect on the DPT. In dramatic fashion, the profession of physical therapy has adopted the professional doctoral degree as the entry-level credential. The jury is still out on whether the move to professional doctoral education will be of long-term benefit to physical therapy. I believe the answer to that question ultimately will depend on how our profession uses the clinical doctoral degree. That's why I am especially pleased to see some empirical information already beginning to emerge.
Dr Johanson presents fascinating data on the perceptions of current professional physical therapist students regarding the importance of the professional doctoral degree. Her data provide us with an opportunity to consider how some of those who are entering our profession view the changes we have wrought in our professional credentialing.
Among this sample of professional students—who were drawn from DPT and master's degree level programs across the United States and were surveyed about a wide range of topics related to the DPT degree—those who perceived the DPT as being "important" did not have strikingly different perceptions from those who did not perceive it as important. I am encouraged by this finding. It suggests that students realized that the label of the degree is not as consequential as the content of the program.
What stood out for me among the study's findings were the students' perceptions about the professional doctoral degree relative to their future roles as faculty members. The authors reported that, in their multivariate analysis, among students who perceived the DPT as "very important," the odds of anticipating becoming a faculty member were nearly twice that of students who viewed the DPT as "not important." In contrast, the percentage of students who anticipated pursuing additional graduate degrees following professional physical therapist education was about the same among those who perceived the DPT as important and among those who perceived the DPT as not important. This finding suggests that those who perceive the DPT as important were more likely to view people with the DPT credential as future faculty members but did not view themselves as more likely to pursue advanced academic degrees following their professional educational preparation.
This finding troubles me and causes me to wonder whether students view the DPT as preparation for a traditional academic career. Do these soon-to-be newest members of our profession perceive the DPT as a legitimate path to tenure-track faculty positions, of which research and scholarship are major components? Or, alternatively, do they perceive the DPT to be a professional doctoral degree that will prepare them for practice and possibly a future role as a clinical faculty member? Of course, we can't know the answer from this study, because an operational definition of "faculty member" was not provided to these students. And, as the authors themselves rightly note, we should not over-interpret this finding itself, as the confidence interval around the point estimate was quite large. Nevertheless, the finding is intriguing to me and touches a nerve because it calls to mind one of my major fears as our profession shifts to the professional doctoral degree.
The faculties of physical therapist education programs continue to have a desperate need for more highly qualified scholars and researchers who will become leaders in the development of the academic foundation of our profession. This faculty shortage is one of the unfortunate legacies of the burgeoning growth of our academic enterprise during the past 30 years. Our academic programs need faculty members with terminal academic degrees beyond their professional credentials (whether they are BS, MS, or DPT) who can function as full-fledged peers within our major research universities—faculty members who have the skills to compete for and successfully implement externally supported research grants that are the lifeblood of any profession that wants to build its evidence base. These traditional academic faculty members must work alongside highly qualified clinical faculty members, whom we need just as much as (some might argue more than) the academics, as we mentor our students to develop the clinical skills necessary for physical therapist practice.
I worry that, with the advent of the DPT, many of our academic programs may follow the path blazed in the United States by our colleagues in medicine, where the clinical doctoral degree is considered to be as adequate as the academic doctoral degree for a traditional academic faculty career. I fear that, in the face of pressures to recruit faculty, we may yield to the temptation to substitute the DPT for academic credentials such as the PhD, EdD, or ScD, and, therefore, as Dr Jules Rothstein cautioned us back in 1998 when the DPT was still being hotly debated:
"...we will have abandoned any hope of developing a mature academic enterprise, one that can supply clinicians with the research and scholarship they need to be better practitioners. In essence, we will have guaranteed a future with diminished research capabilities."2
As Dr Craik reminded all of us who were in attendance in Boston, we have come along way over the past 3 decades and (rightly) should be proud of all our accomplishments—but she also exhorted us to "never be satisfied." I believe that we must take all necessary steps to ensure the development of an evidence-based profession. Having an adequate number of faculty members with terminal academic degrees remains essential for any profession that aims to increase rather than diminish its research capabilities.
References
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