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Education Special Series |
MA Johanson, PT, PhD, OCS, is Assistant Professor, Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, 1441 Clifton Rd, Suite 170, Atlanta, GA 30322 (USA)
Address all correspondence to Dr Johanson at: majohan{at}emory.edu
Submitted September 22, 2006;
Accepted May 4, 2007
 | Abstract |
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Subjects: Participants were 919 physical therapist students.
Methods: Faculty at 34 physical therapist education programs distributed questionnaires to 1,172 of their students. The 919 returned questionnaires generated a response rate of 78.4%. Sex differences in career expectations were statistically analyzed with logistic regression.
Results: Men showed statistically significantly higher odds than women of expecting to own a private practice, to become a faculty member, to become a physical therapist manager or administrator, to publish articles in professional journals, and to have a higher income in the first year of employment.
Discussion and Conclusion: At the outset of physical therapist education, there are sex differences in the career expectations of physical therapist students.
| Introduction |
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The American Physical Therapy Association (APTA) has long been aware of sex differences in the careers of physical therapists. In 1991, the APTA Executive Committee appointed a task force to focus on women's issues in physical therapy.10 The APTA House of Delegates adopted goals in 1992 to improve the status of women in physical therapy; these goals were subsequently amended twice.10 The 4 goals of the plan are: (1) to increase awareness of the issues of inequity for women, (2) to recognize barriers to professional growth and career development and promote mechanisms to eliminate or reduce these barriers, (3) to promote physical therapy as a life-long profession, and (4) to provide for the systematic evaluation of women's status and APTA action concerning women's issues. However, the goals of APTA for improving the status of women are focused on physical therapists, rather than physical therapist students. It is possible that physical therapist students exhibit sex differences in career expectations. If that is the case, then the recognition of barriers to the full range of career options and the promotion of mechanisms to eliminate or reduce these barriers may best be implemented during students’ professional education, rather than after entry into the profession.
There is no research to indicate whether physical therapist students enter their professional programs with sex differences in career expectations. Knowledge of students’ career expectations as they begin their professional education may provide initial insight as to whether sex differences exist and, if so, whether such differences mirror the current sex differences in physical therapists’ career paths. If APTA is to achieve the aforementioned goals for improving the status of women in physical therapy, then interventions to support women's career development and participation in the full range of career options may best be targeted to students as well as clinicians. The purpose of this study was to determine whether physical therapist students show evidence of sex differences in career expectations before any potential influences from faculty and clinicians during their professional education.
| Method |
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Previous research explored the factors that influence the educational aspirations of high school students, those that influence college graduates to persist to graduate education and to choose a particular graduate program, and those that influence college graduates’ academic and career expectations. Those data suggested for use in the survey the factors, besides sex, that might explain physical therapist students’ career expectations. These factors included socioeconomic status (SES),14–18 other demographic characteristics,14,16 student ability,14–17 and institutional characteristics.17 Questions 8, 10, 11, 13, 14, 19–23, 26–29, and 31 were used in this study; some additional items were used in 2 studies previously conducted by this author.12,13
Sample
A random sample of 10 accredited physical therapist education programs in the United States (cluster sampling) was drawn from 4 stratified groups: programs in private institutions conferring the Doctor of Physical Therapy (DPT) degree, programs in private institutions conferring the Master of Physical Therapy (MPT) degree, programs in public institutions conferring the DPT degree, and programs in public institutions conferring the MPT degree. The physical therapist education programs were stratified to ensure the representation of students in both public and private programs and both MPT and DPT degree programs. An explanation of the target sample size is provided in a previously published study.12
Procedure
The directors of selected programs were contacted first by mail to provide a brief description of the purpose of the study. Telephone and e-mail follow-up to these directors was done within 2 weeks to elicit their participation. They were offered descriptive data to be generated by the study on the factors that influenced students to choose their program or similar programs and the students’ career expectations following graduation. Program directors who did not respond to the second contact were recontacted via both telephone and e-mail 2 weeks later, and those not responding to the third contact were contacted again 4 weeks later.
Survey questionnaires, along with a cover letter, were mailed to the faculty facilitator approximately 1 week prior to the matriculation date of the program. Because data have shown that even nonfinancial incentives can increase the response rate,19 an assortment of chewing gum was included for the students filling out the survey questionnaires. The faculty contacts were requested to distribute the survey questionnaires to students either during orientation or anytime within the first 2 weeks of the program. Large, self-addressed envelopes with prepaid postage were included in the survey packets to allow faculty members to mail the survey to the faculty facilitator back in groups. Attached to the return envelopes was a form asking the faculty members to indicate the number of students enrolled in the first-year professional class to allow calculation of the response rate. No determination of differences between nonrespondents and respondents could be made. The cover letter for the survey advised the potential respondents that any oral or written study reports would contain only grouped data and that no individual respondents would be identified.
Data Analysis
Descriptive data compilation included means and standard deviations for continuous data and frequencies and percentages for categorical data. Chi-square analysis was used to test for proportional differences in career expectations between men and women. Asymptotic probabilities were obtained for the chi-square values unless fewer than 5 cases were expected in a cell. For the latter situation, exact probabilities were obtained for the chi-square values whenever possible, because the chi-square distribution may not closely approximate the actual distribution of cases.20 Logistic regression was used to determine whether the odds of career expectations were significantly different for men and women when numerous other variables were controlled for. An alpha level of .05 was set for all statistical tests.
A total of 12 predictor variables were entered into logistic regression models constructed for the 12 dependent variables related to career expectations. Ten of the dependent variables addressed career expectations of students 10 years following graduation (question 28), and 2 additional dependent variables related to other career expectations (questions 8 and 11). All 10 dependent variables that addressed the students’ career expectations 10 years following graduation were recoded into dichotomous variables (ie, either "agree" or "disagree, neutral, or do not know") for the logistic regression analyses. The remaining 2 dependent variables also were recoded into dichotomous variables for the logistic regression analyses. For each of the 12 logistic regression models, the 12 predictor variables were entered in 2 steps.
Variables entered in the first step of the logistic regression models were those that previous research showed to significantly predict college graduates’ enrollment in graduate school or in particular types of graduate institutions and programs, high school students’ educational aspirations,14–18,21–33 and medical students’ choice of specialty.1
Variables defined as SES variables were the educational level of students’ parents (questions 19 and 20), parents’ occupational prestige scores (questions 21 and 22), and the source of the majority of financing (recoded into parents’ aid or other) for physical therapist education programs (question 10). Occupations were coded by use of the 1980 Census Occupational Category,34 and the occupational prestige scores assigned to the occupational codes were those established by the National Opinion Research Center.34 Socioeconomic status is strongly related to educational and career aspirations for high school and college students14,17,18,22–25,27 and choice of specialty for medical students.1 Variables defined as other background characteristics consisted of racial or ethnic identity (recoded into nonwhite or white) and age (questions 14 and 31). Factors that affect graduate students’ enrollment, educational aspirations of college students, and choice of specialty for medical students have been shown to differ by age1,30 and racial or ethnic identity.1,14,16,29
Variables defined as those related to student ability and the attributes of students’ academic institutions (questions 23 and 29) consisted of undergraduate grade point average (GPA), control of a student's primary undergraduate institution (public or private), and control of the institution in which the student was enrolled in a physical therapist education program (public or private). Student ability factors significantly predict educational aspirations at the graduate27 and undergraduate14–18,21,22,25 levels and medical students’ choice of specialty.1 Control of medical school (public versus private) also influences medical students’ choice of specialty.1 Undergraduate GPA significantly influences educational aspirations for both graduate and professional programs,29 and Medical College Admission Test scores affect choice of specialty for medical students.1
The variable entered in the second step was sex. There were between 535 and 551 cases with complete data from which to predict the dependent variables, except for plans to obtain an additional degree, for which 316 cases had complete data.
| Results |
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The overall rate of response to the survey was 78.4%; 919 of 1,172 enrolled first-year professional physical therapist students completed the survey. Men comprised 238 (26.0%) of the respondents, and women comprised 678 (74.0%) of the respondents. Students enrolled in public programs comprised 431 (47.0%) of the respondents, and 485 students (53.0%) were enrolled in private programs. Students enrolled in MPT degree programs comprised 275 (29.9%) of the respondents, and students enrolled in DPT degree programs comprised 641 (69.7%) of the respondents.
Bivariate Analyses
The mean ages of the men and women were 24.7 years (SD=4.5) and 23.3 years (SD=3.7), respectively. Other characteristics of the respondents are summarized in Table 1. Chi-square analysis showed that men were more likely to be married than women and more likely to be enrolled in programs conferring the MPT degree (Tab. 1).
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| Discussion |
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Sex differences in income expectations also may be related to the anticipation of career patterns associated with family responsibilities. It is possible that, regardless of expected practice setting or position, the men in this study had an expectation of a higher income because of a greater anticipation of full-time continuous employment,6,7,9 whereas women anticipated more part-time employment7,9 and more leave time related to family responsibilities.6,7
With 2 exceptions (plan to practice as a staff therapist and plan to obtain an additional degree), sex differences in career expectations were largely consistent between the bivariate and multivariate analyses, even though the variables related to career expectations were recoded into dichotomous variables only for the multivariate analysis. However, it is important to note that many students responded to the queries regarding career expectations with "neutral" or "do not know" (Tab. 2). For some career expectations, as many as one third to one half of the students did not respond with either "agree" or "disagree." Moreover, lower percentages of male students responded to the queries with "do not know"; therefore, it appears that more male students than female students made decisions about their career paths at the point of entry into educational programs. Female students with unknown career plans may be the most influenced by the implementation of mechanisms to eliminate or reduce barriers to the full range of career options during their professional education.
In addition to sex differences, there were also some differences in career expectations between students enrolled in MPT degree programs and those enrolled in DPT degree programs. These differences were the focus of an article previously published in Physical Therapy.12
Students’ Career Expectations in Comparison With Those of Other Health Care Professionals
Sex differences in career expectations among physical therapist students not only are similar to sex differences in career activities among physical therapists but also show similarities to those among students and clinicians in other historically male-dominated as well as historically female-dominated health professions. Sex differences among physical therapist students in marital status, career expectations, and career activities mirror those of medical students,1,2,36,37 physicians,38 veterinary students,4 veterinarians,4 and nurses.8
In this study, only about 14% of female physical therapist students were married, and more than 90% had no children; therefore, it is unlikely that current family responsibilities accounted for the sex differences in their career plans. However, it is possible that female students anticipate greater future child care or other family responsibilities and, consequently, already constrain some of their career expectations.
Minority Students’ Career Expectations
Another factor that appears to be associated with divergence in the career expectations of students is racial or ethnic identity. Nonwhite students had higher odds than white students of expecting to own a physical therapist practice, become a manager or administrator, have a higher income in the first year of employment, become board-certified clinical specialists, and obtain additional degrees. However, nonwhite students had lower odds than white students of expecting to become faculty members or publish articles in professional journals. Although speculative, these findings seem to indicate that nonwhite students have greater career expectations than white students in clinical settings but not in academic settings. Thus, there is evidence of a future potential for increasing the number of minority physical therapists in clinical leadership positions. However, there is also the potential for continued discrepancies between the number of minority students entering the physical therapist profession and the number of minority physical therapists in core faculty positions. In 2005, minority physical therapist students constituted slightly more than 20% of all students, whereas minority core physical therapist faculty members constituted less than 10% of all core faculty members.35
Implications for Educators and APTA Leaders
Despite the fact that physical therapy is a female-dominated profession, the career expectations of women matriculating into professional physical therapist programs already appear to be constrained compared with those of men. These data may be useful for faculty involved in admissions. Some applicants may have already formed strategies for balancing career and current or future family responsibilities. However, discussion of this topic during preapplication visits or during the application process may heighten some students’ awareness that strategies to achieve a balance between career and family responsibilities may offer students the greatest future career options.
For faculty involved in physical therapist education programs, it seems to be crucial to study strategies that promote the full range of career activities for female students and to implement these strategies during their professional education. Because previous research suggested that women in physical therapy often place a high value on the balance between career and family responsibilities in defining professional success,7,39 strategies to achieve such a balance may be the ideal intervention to introduce early in women's professional education.
As the career expectations and career activities of women in physical therapy appear to mirror those of women in historically male-dominated health care professions, it is unlikely that a shift in the sex distribution will affect the career expectations or career paths of women in physical therapy. Moreover, if the sex distribution remains about the same, the career expectations and career activities of women in physical therapy will have an overall stronger influence on the professional goals of APTA than will those of men. Thus, it is imperative that physical therapist educators and APTA leaders closely examine the career development of women as students and clinicians.
Limitations
Physical therapist students’ expectations of future family responsibilities were not assessed; therefore, associations between sex differences in career expectations and sex differences in family responsibility expectations are purely speculative. There was no determination of any differences between respondents and nonrespondents. Furthermore, about 375 respondents who provided incomplete data were excluded from the multivariate analysis. Substantial differences between respondents and nonrespondents or between respondents with and respondents without complete data may cause study results to be poorly representative of the general population of physical therapist students. Additionally, the test-retest reliability of students’ responses on the questionnaires was not assessed.
Recommendations
Because the predictor variables explained no more than 16.1% of the variance in the variables related to career expectations, further studies, both qualitative and quantitative, will be important for identifying other factors that were not included in this study but that are predictive of students’ career expectations. Particularly important for further study are factors related to expected future family responsibilities and their association with career expectations. Students’ career expectations were examined prior to the influence of their professional curriculum. It would be illuminating to survey students both at the beginning and at the end of their professional education to study the effect of the physical therapist educational curriculum on students’ career expectations. As APTA continues to monitor women's careers, future investigations are imperative. Studies are needed to assess the effects on women's career expectations and actual career status of particular programs, resources, and educational activities designed to eliminate barriers or to advance the careers of women in physical therapy. Furthermore, the effects of preprofessional versus postprofessional introduction of programs, resources, and educational activities designed to eliminate barriers or to advance the careers of women in physical therapy are worthy of future investigation.
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| Footnotes |
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The Institutional Review Board for the Protection of Human Subjects of Georgia State University approved the study.
This article was derived from the author's dissertation completed in partial fulfillment of her doctoral degree at Georgia State University.
This research was presented at the American Physical Therapy Association Combined Sections Meeting; February 14–18, 2007; Boston, Mass.
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| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
