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By Claire Coyne

To provide optimal patient care in today's evidence-based practice environments, physical therapists (PTs) and physical therapist assistants (PTAs) are moving beyond simply fulfilling state licensure requirements to seek advanced education that addresses specific clinical situations, treatment challenges, and professional goals.

The decision to pursue lifelong learning is easy. Finding the CE opportunities that are best for you, though, isn't necessarily. Choosing CE offerings begins with self-assessment, according to Marilyn Phillips, PT, MS, CAE, APTA's director, professional development. Practitioners should “choose CE offerings based on their evaluation of their own specific knowledge and skills--their own personal scope of practice--with the goal of furthering the development of those skills within the confines and definitions of their specific practice acts, as well as the dictates of their work environments,” Phillips says.

A key step is to move outside oneself and seek the expertise of a mentor, ideally a fellow professional practicing in an area or at a level to which you aspire.

Sandy Ridout, who is responsible for APTA's Members Mentoring Members program, notes the personal impact that mentoring can have on educational choices: “A mentor can help guide you through the myriad CE choices, tailoring the selection of courses or training needed to keep you on track for a specialty practice area, research, academia-wherever it is you want to go professionally,” she explains.

She cites another practical benefit: “Having a mentor assist you with an educational plan also will save you time and money. Simply speaking with a clinician who has a broad understanding of the field, and personal and professional connections, can save many hours of research time, and ensure that your CE dollars are wisely spent,” Ridout says.

According to the interviewees, some of the most important information regarding CE options and choices is indeed gained by word of mouth-speaking with others in the field, and hearing their stories. Following are accounts of personal, professional, and CE choices that illustrate the many options available for self development, and the varying educational roads that PTs and PTAs may take to achieve their goals.

Seeking Answers to Treatment Questions

Susan Crouch, PTA, of Houston, Texas, entered the field of physical therapy when she was in her forties. “I was at the point when I wanted a profession in which I could help other people,” she recalls. Her brother, a nurse, encouraged her to investigate physical therapy, and physical therapist assistants in particular.

Crouch, a senior PTA at Harris County Hospital District in Houston, serves as a clinical instructor and lectures at the PTA program for Coleman College for Health Sciences at HCC and at Texas Woman's University. In 2006, Crouch received her Musculoskeletal Advanced Proficiency from APTA. She also is a respiratory therapist.

“Observe the wide range of treatment environments,” she advises, “and the different patient populations. Decide where you would most want to work, then match your continuing education to those goals.”

Crouch continues to take her own advice to heart. She is studying aquatic therapy and is a member of APTA's Aquatics Section. Her long-term goal? “I want to teach aquatic exercise programs in the local community,” she states. “As the population ages, aquatics will prove to be a safe and easy option for maintaining health and fitness as well as encouraging socialization.”

Benefiting Patients and The Profession

Robert DuVall, PT, DHSc, MMSc, ATC, OCS, FAAOMPT, CSCS, sees great value in continuing education not only for practitioners but also for patients and the profession. As president and director of the Orthopedic Manual Fellowship Program at Sports Medicine of Atlanta, DuVall says, “If we look at APTA's 'professional values,' we have an obligation as professionals to stay current and to integrate the current evidence into practice. That's an obligation [beyond] any state requirements.”

He also suggests that an economic downturn could strengthen continuing education and those who avail themselves of it: “If we have another downturn like the 1997 Balanced Budget Act-when I can recall having a stack of resumes on my desk of PTs looking for work-then your credentialing and continuing education become distinguishing factors in gaining employment. I tell the new graduates who do internships here: It's wonderful you currently have so many employment opportunities, but it does take away from the desire for lifelong learning from a competitive market standpoint.”

As for the factors a PT or PTA should evaluate when considering continuing education, DuVall says that continuing education should transform the student. He explains, “Are learner outcomes clearly stated that will enhance practice? Can what is taught be put into practice, in which someone can perform at a higher level? Will it result in a transformation of practice?

“Practicality can be defined in two ways: First, administrative process skills, such as a movement impaired-based differential diagnosis policy. After you take a course, you can implement that policy on the following work day. The second practicality is hands-on-the psychomotor practicality of a course. Either way, you want to get a course that will be transforming after you've invested your time and money,” DuVall says.

And that transformation ultimately will benefit patients and clients. “We let consumers know we're providing an evidence-based approach so we can provide them with a more predictable outcome. It allows us to establish a prognosis for the patient, and an anticipated outcome of an anticipated amount of time, using these evidence-based practice patterns.”

New Approaches to Clinical Challenges

From a young age, Marc O'Neal, PT, DPT, CSCS, was involved in athletics; he knew while studying for the DPT that he eventually wanted to apply his skills to sports physical therapy.

O'Neal now practices as a physical therapist at a clinic outside Chicago. As with other interviewees, he bases his CE choices on clinical challenges and treatment questions, and considers himself a lifelong learner. “There is a wide range of treatment approaches to address different conditions,” he says. “While I am comfortable with my current skills, I am always aware that there are new and different techniques to learn. When I have done the best I can with a patient and I am not satisfied with the outcome, I want to have other approaches to apply.”

He cites an example: “While my treatment approach is to empower patients and encourage them to take an active role in their rehabilitation, I have encountered patients who balk and prefer to have me do it for them. For that reason, I have taken CE courses to improve my hands-on skills, so I can begin by solely providing treatment, and slowly ease them in to taking more control of their own treatment process,” he explains.

O'Neal's advice to those seeking to combine appropriate continuing education with their career path? “Other PTs are your best mentors. Find colleagues practicing within an area in which you are developing an interest,” he says. “And be aware of just how broad the range of this profession is, and of your options within it. Look into every aspect of the profession, and decide on where you want to focus; then gain the appropriate training for that next step.”

Responding to an Ever-changing Environment

As a student, Tia DeLash, PTA, felt drawn to patient care, and decided to enter the PTA program at Northern Virginia Community College (NOVA) “to experience the curriculum, in order to decide if I wanted to be a PT,” she explains. During her first year, she decided that the PTA degree actually was the best fit for her professional goals. “I preferred the focus on immediate patient care, with fewer administrative duties, that being a PTA offers,” she explains. She graduated magna cum laude in 1991 as a PTA.

In the past few years, DeLash has received the APTA award for Recognition of Advanced Proficiency for the PTA in Musculoskeletal Physical Therapy, and also has become a credentialed clinical instructor after having successfully completed the APTA Clinical Instructor Education and Credentialing Program.

“Achieving my credential as a clinical instructor reinforced my dedication to lifelong learning-both my own, and that of my students,” she notes. “The credential enhances your professionalism, and I feel it is important that PTAs share their knowledge in the clinic.”

The team at the INOVA Physical Therapy Center conducts in-service training sessions following each team member's CE experiences. “We always have one goal in mind-optimum patient care-but there constantly are new ways to reach that goal,” DeLash explains.

She reports that the new techniques she learns through continuing education often are incorporated into patient care by the INOVA team. She demonstrates techniques to team members, and explains the theory behind them. “We then discuss implementing them in the clinic.” It is an ongoing cycle in an ever-changing treatment environment. “So much of our innovation begins with clinical questions; we then seek the appropriate education to answer those questions,” she explains. “Treatment questions increase learning.”

The View From Academia

“The continuing education path is a personal one for each individual,” says Steven Chesbro, PT, DPT, EdD, GCS. Chesbro has garnered seven degrees along his career and educational path; his years of practice combined with study have led him to his current position as associate professor and chair of the Department of Physical Therapy at Howard University in Washington, DC.

When faced with a CE decision, Chesbro advises, “Consider your previous background, your current qualifications, and your goals. Add to these your academic preparation to this point, and your personal experiences. If you plan to enter higher education, research how different degrees are viewed in the area in which you wish to teach.”

APTA's Phillips seconds that approach. The key to making the right choices, she says, is “to make sure your professional development is organized and sequenced in a logical way, so that you are consistently building advanced evidence-based practice skills throughout your career.”

Terrence Nordstrom, PT, MA, chairperson of the Physical Therapy Department at Samuel Merritt College, says it is important for lifelong learners to always be aware of any discomfort they are feeling with the status quo-that gnawing need to know more. “Be aware of when you are sensing it's time for a change,” he advises. “Assess what is around you. Speak with colleagues. Ask questions to formulate where it is you want to go, and what you need to learn to get there. That process will help you ultimately make the right choice,” he explains.

Finally, there is one last crucial step in the process, according to Nordstrom-a decision that lifelong learners make many times in their careers: “Take the risk,” he says.
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Claire Coyne is a freelance writer.

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