NEEDS ASSESSMENT AND ANALYSIS OF
POTENTIAL STRATEGIES FOR A PHYSICAL THERAPY ASSISTANT PROGRAM
FOR ALASKA
Zuzana Rogers, PT, COMT
Consultant
Advanced Physical Therapy
Abbott Rd Ste 200
Anchorage, AK 99507
January 2011
TABLE OF CONTENTS
1. Introduction ……………………………………………………………………………..3
2. PTA profession background…………………………………………………………...4
What can’t a PTA do?.................................................................................6
Practice settings………………………………………………………………...6
Direct access issues…..……………………………………………...………..7
3. Practice requirements………………………………………………………………….7
4. Career outlook for physical therapist assistants…………………………………….8
Supply and demand for physical therapist assistants in Alaska ……………..11
The need for physical therapist assistant program in Alaska…………………11
Rural areas…………………………………………………………………………13
5. Physical therapist assistant education………………………………………………14
Pre-physical therapist assistant education requirements……………………..14
Physical therapist assistant program overview…………………………………15
Clinical experience………………………………………………………………..16
Supervision of student physical therapy assistants……………………….......16
Graduation requirement…………………………………………………………..17
Continuing education and advancement……………………………………….19
6. Accreditation process………………………………………………………………...22
7. Steps towards Candidacy for Accreditation Status ……………………………….23
Program development…………………………………………………………….24
Submission of Application for Candidacy………………………………………24
Application for Candidacy review/ Visit to the Program/ Candidacy Visit
Report………………………………………………………………………………25
Respond to Visit…………………………………………………………………..26
CAPTE makes a candidacy decision…………………………………………...26
8. Accreditation requirements…………………………………………………….........26
9. Recommendations for a physical therapy assistant program at the University of
Alaska………………………………………………………………………………….26
Recommended program specifics………………………………………………27
Degree offered………………………………………………………………..27
Program length……………………………………………………………….27
Program delivery……………………………………………………………..28
Students enrolled…………………………………………………………….28
Resources and facilities……………………………………………………..29
Faculty…………………………………………………………………………30
Clinical education…………………………………………………………….30
Prerequisite coursework……………………………………………………..32
Cost…………………………………………………………………………….33
10. Other avenues to explore…………………………………………………………..33
11. Recommendations…………………………………………………………………..34
12. Additional resources…………………………………………………………………35
13. Attachments…………………………………………………………………………..37
2
The University of Alaska is considering the establishment of its own accredited
physical therapist assistant program, whose outcome would be Associate degree, which
is recognized state and nationwide. This report attempts to assess the need for physical
therapist assistant education in Alaska and necessary steps to implement it. The
information presented in this document was collected from, and it is based on a variety
of sources including American Physical Therapy Association, the Commission on
Accreditation of Educational Programs (CAPTE), Alaska State Chapter of APTA, survey
of physical therapists and physical therapist assistants in Alaska, personal
communications, and meetings.
The University of Alaska has already committed itself to growth in the future as
described in the Strategic Plan. The proposed physical therapy program was seen as a
potential means to achieve this growth.
Introduction
When assessing the future need for a particular health profession in any given
geographical region, it is important to consider five distinct and variable elements:
1. Is there currently a shortage of practitioners within the region? If so, what steps
may be required to balance the market?
2. What is the region’s anticipated future growth and how many practitioners will be
required to meet this anticipated growth?
3
3. What are some of the anticipated changes in the profession’s scope of practice
and new career options and how will these changes increase or decrease the
future demand for practitioner services within the region being evaluated? Will
future practitioners require new or different skill-sets than those of current
practitioners, and if so, how will these requirements affect the available workforce
within the region?
4. What changes in technology will likely influence the productivity of physical
therapy practitioners?
5. Will the anticipated growth in the net number of practitioners keep pace with
future needs for practitioners when one considers other growth variables? (e.g.,
future graduation, retirement, and death rates; reciprocity into and away from the
state and region; and practitioners leaving the profession).
PT/ PTA profession background
Physical therapy is a healthcare profession dedicated to identifying the highest
functional potential of the individual client and striving to reach that goal through a
variety of means. Physical therapy is only provided by a licensed physical therapist (PT)
or a physical therapist assistant (PTA) under the supervision of a physical therapist. The
physical therapist performs a thorough interview, examination, and evaluation with the
patient and combines resulting findings with other health care information, such as
diagnostic test results, to determine a diagnosis and create a unique treatment plan.
4
Physical therapists utilize a variety of treatments including, but not limited to, educating
the client or caregiver, therapeutic exercise, functional training in self-care, manual
therapy, orthotics and prosthetics, wound care and integumentary protection, physical,
mechanical, and electrical modalities, and work integration and reintegration.
Physical
therapy can be beneficial to a wide range of clients, from the premature infant to the
aged, the well to the terminally ill. Physical therapists may choose to specialize in a
specific area such as cardiopulmonary, geriatrics, sports, clinical electrophysiology,
neurology, orthopaedics or pediatrics. To meet the needs of so many different types of
people, PTs and PTAs practice in a variety of settings including outpatient clinics,
fitness centers, hospitals, skilled nursing facilities, schools, patient homes, sports
teams, and work settings. They also practice in the community at health fairs or
community centers performing general fitness assessments or screening for fall and/or
injury risk. Additionally, PTs and PTAs may teach at universities or do research.
Physical therapy is a dynamic profession and an integral part of healthcare services in
the 21st century.
Physical therapist assistants (PTAs) provide physical therapy services under the
direction and supervision of a physical therapist. PTAs help people of all ages who have
medical problems, or other health-related conditions that limit their ability to move and
perform functional activities in their daily lives. PTAs work in a variety of settings
including hospitals, private practices, outpatient clinics, home health, nursing homes,
schools, and sports facilities. PTAs must complete a 2-year associate's degree and are
licensed, certified, or registered in most states. Care provided by a PTA may include
teaching patients/clients exercise for mobility, strength and coordination, training for
5
activities such as walking with crutches, canes, or walkers, massage, and the use of
physical agents and electrotherapy such as ultrasound and electrical stimulation.1
What can’t a PTA do?
Primarily, physical therapy assistants cannot, under any circumstances, work
privately on their own. They must work with a physical therapist and assist with patient
care, not dictate it. There are also guidelines that vary from state-to-state regarding the
responsibilities of a PTA. The responsibilities and expectations of a PTA may also be
governed by their place of employment.
Practice settings
Physical therapists and physical therapist assistants practice in various facilities.
The 2006 APTA Practice Profile survey instrument asked a series of questions that
described how respondents provided care (Table 1)2.
Facility
Acute care
hospital
Subacute
rehab
hospital
Hospital
based
outpatient
facility
Private
practice
SNF
Home
care
Musculoskeletal
44.0
Neuromuscular
26.4
Intergumentary
10.4
Cardiopulmonary
19.2
30.4
56.7
3.2
9.7
73.4
20.9
3.4
2.2
82.6
14.8
1.4
1.2
44.8
47.1
30.9
35.8
6.3
2.9
18.0
14.1
Guide to Development of Educational Programs for Physical Therapists and Physical Therapist
Assistants. www.apta.org Accessed 12/01/2010.
1
2
www.apta.org/research. Accessed 11/23/10
6
Table 1. Mean percentage of patient care time spent per week in each system
Direct access issues
At present, there are 46 states (including Alaska) that provide patients direct
access to physical therapy services. This allows the physical therapist to evaluate and
treat patients without physician’s referral. Direct access laws vary from state to state,
with some states having more limitations than others. Full list of states that allow direct
access can be found on the American Physical Therapy Association website 3.
The Alaska Physical Therapy Practice Act from 1986 uses following language
when summarizing direct access: “No Restrictions to Access. License revocation or
suspension when failure to refer a patient to another qualified professional when the
patient’s condition is beyond PT training”.
This Practice Act is due for revision in 2014, and serious effort is exerted to
maintain and further define direct access. Any changes to the Practice Act might
influence Physical Therapist or Physical Therapist Assistant education.
Practice requirements
Requirement for physical therapist assistants to practice vary from state to
state. In order to provide physical therapy services, a physical therapist assistant in the
State of Alaska needs to meet following requirements:
1. All 50 states and three additional jurisdictions require that physical therapist
3
www.apta.org/research. Accessed 11/23/10
7
assistants pass an accredited PTA education program consisting of classroom
instruction and hands-on clinical experience. Alaska allows the use of online
schools for students training to become a Physical Therapy Assistant.
2. Passing of the National Physical Therapy Exam is a prerequisite for obtaining a
license in all states as well. The Federation of State Boards of Physical Therapy
(FSBPT) coordinates and administers all licensure examinations for potential
PTAs. Proof that the exam has been passed will be required when applying for a
physical therapy assistant license.
3. Some states also require PTAs to pass a state jurisprudence exam covering laws
and regulations in the state in which you are becoming licensed. These are
primarily multiple choice exams administered by the state. In many cases, they
are open-book or can be completed at home or online.
4. Many states also require that physical therapy assistants complete training in
CPR and First-Aid. A minimum number of clinical hours are also required in all
states. Additionally, it is possible that background checks will be administered to
PTA license applicants.
Career outlook for physical therapist assistants
The nation’s aging population and expanded health care coverage will increase
the demand for physical therapist (PT) and physical therapist assistant (PTA). It is
projected that healthcare will add the most jobs during the 2008-2016 time period. The
8
increased demand in this area stems largely from an aging population that will require
care at home, in nursing care facilities, and in inpatient and outpatient settings. The
large baby-boom generation is entering the prime age for heart attacks and strokes,
further increasing the demand for cardiac and physical rehabilitation. In addition, future
medical developments should permit an increased percentage of trauma victims to
survive, creating added demand for therapy services.
Occupations that will "likely grow in importance" include physical therapists and
physical therapist assistants. In addition, the expected expansion of health care
coverage through reform measures could lead to increased demand for health care
professionals.
Physical therapy assistants are among the highest paid individuals with just an
associate’s degree. After only two years of education, PTAs can enter the job field and
at entry level, depending on their geographic location and place of employment, earn as
much as $50,000.
The median physical therapy assistant salary in the United States is $46,140.
Annual physical therapy assistant pay, according to the U.S. Bureau of Labor Statistics,
ranges from the lowest ten percent earning $28,580 or less to the highest earning PTAs
in the country earning over $63,830. Hourly pay can vary from $13 an hour all the way
up to $31 an hour. As with any job, the geographic location and the specific place of
employment are key factors in figuring salary.
The highest paying states for physical therapy assistants are California
($55,730), Nevada ($54,070), Texas ($53,530), Florida ($50,270), and Tennessee
9
($49,840). The top paying metropolitan areas for this occupation are all located in
California and Texas with annual mean wage topping out at $67,700 in OxnardThousand Oaks-Ventura, California.
The top paying industries for this occupation are as follows, with the annual
mean wage and annual hourly wage included:
Home Health Care Services - $56,460, $27.14
Employment Services - $51,890, $24.95
Nursing Care Facilities - $50,070, $24.07
Individual and Family Services - $49,340, $24.72
Vocational Rehabilitation Services - $48,610, $23.37
General Medical and Surgical Hospitals - $45,190, $21.73
Health Practitioner Offices - $44,800, $21.54
Physician Offices - $43,170, $20.76
The majority of physical therapy assistants work full-time. They receive benefits
comparable to other healthcare professionals including insurance, pension, vacation,
disability, and retirement. Bonuses may also be included in the salary package for some
PTAs. In addition, some industries of employment, such as hospitals may offer signing
bonuses or incentives.
Popular job listing sites, such as indeed.com and salary.com currently list jobs for
physical therapy assistants with salaries that range from $34,000 to $80,000 for full-time
workers.
Additional costs that may be associated with physical therapy assistants primarily
10
will come from license renewal and continuing education. Most states require PTAs to
renew their license biennially and complete a specific number of continuing education
hours. State-to-state renewal requirements vary for physical therapy assistants.
Supply and demand for physical therapy practitioners in Alaska
In 2009, there were 1,008 Licensed PTs in Alaska, of which 503 resided in the
state. Licensed PTs per 100,000 population was 144.31, while licensed PTs that reside
in the State per 100,000 population was 72.01. National average of PTs per 100,000
population was 58.434.
Currently, there are 121 licensed PTAs in the State of Alaska, of which 60 reside
in the state5. Licensed PTAs per 100,000 population is 17.32, which is below nationwide
average of 26.61 PTAs per 100,000 population.
The need for a physical therapy assistant program in Alaska.
Regarding Alaska Workforce Report from 2006, Alaska will experience a 36%
growth of physical therapist positions projected to 2012. With the growth of physical
therapy profession, the need for physical therapy assistants will grow as well. US
Department of Labor projects 32.4% growth of Physical Therapist Assistants though
2016. The vacancy rate in private practice identified by a 2010 survey performed by the
American Physical Therapy Association was found to be 14.4% among full-time PTAs,
4
5
www.apta.org, accessed 09/28/2010.
www.apta.org accessed 1/12/2011
11
increase from 8.8% from 20086.
Currently, there are no PTA programs in the State of Alaska. There are 6 PTA
programs in the state of Washington, of which one is private. There is one PTA program
in Montana, Oregon, and Idaho. Alaska students might chose one of these programs
due to proximity to their state, but may also enter more distant programs. However,
Alaska students often chose to enter different profession due to inability to study in-state
and due to cost of out-of-state education.
A survey given in 2010 assessed the need for physical therapists and physical
therapist assistants in Alaska. The survey answered 67 members of the Alaska
Chapter of APTA. The average distribution of physical therapists per clinic was 4.44
PTs/ clinic, with average of 1 PTA per 2 clinics. Twenty four members (36.4%) indicated
vacancy for PTs/PTAs, of which 69% can be filled with PTAs. The survey also indicated
that 39.7% of respondents would hire a PTA graduate from Alaska–based PTA
program, 33.3% of respondents were not sure. Several respondents commented on the
need for PT/ PTA program in Alaska (Table 3).
Pro PT/PTA program in
Alaska
Support Alaska
Communities
Support rural areas
Pro PTA Program
The need for
“professional extenders”
in physical therapy
practice
Respondents had
difficulty hiring a PTA
Enroll Alaska Native
The demand for PTAs
students who will practice might increase with
in rural areas
increasing cost of
6
Pro PT program
Limit on who PTAs can
treat (Tricare insurance
does not allow it)
PTs might be better
suited for rural areas due
to supervision issues
There might be limited
number of clinical sites
available to for PTA
American Physical Therapy Association. Physical Therapy Vacancy and Turnover Rates in
Outpatient Private Practice Facilities. Available at: www.apta.org/research. Accessed 07/27/2010
12
healthcare
students due to
supervision requirements
Increase diversity for
health careers in Alaska
In-state tuition
Table 3: AK Chapter of APTA survey results and comments, 2010
Rural areas
The Alaska Center for Rural Health, in a November 2000 survey, identified
shortages of nurses, social workers, dentists, dental assistants, pharmacists, opticians,
speech pathologists, school psychologists, physical therapists, emergency medical
technicians, mental health counselors, medical transcriptionists, radiologists, respiratory
therapists, community health aides, and certified nursing assistants.
Alaska Small Hospital Performance Improvement Network (ASHPIN, or Network)
emerged in 2003 to form a network of the smallest, most rural hospitals. Its mission is to
improve the clinical, operational, and financial performance of Alaska 's small rural
hospitals to ensure patient access to appropriate healthcare services. Six (6) of the 13
Network members are healthcare providers located in medically underserved (MUS)
communities serving medically underserved populations.
It is important to note that of Alaska's 24 acute care hospitals, all but four of those
hospitals have fewer than 100 beds , and of those 20, only two have more than 50
beds. Therefore, 75%, or 18 of Alaska 's 24 hospitals qualify as HRSA Small Hospital
Improvement Project (SHIP) hospitals. The four relatively large non-military,
medical/surgical hospitals in Anchorage (3) and Fairbanks (1) serve as regional referral
facilities for providers from rural areas of the state, and all of Alaska's hospitals serve an
13
area larger - often much larger - than the community in which they are physically
located.
Impacting the quality of local care is the fact that many of the healthcare workers
hired to work in rural settings are not of people of color, or even of Alaska Native
descent. Attempts to increase the number and proportion of members of underrepresented racial and ethnic groups who are primary care providers are important,
because ethnically diverse workers are more likely to provide services in a culturally
appropriate manner, but these efforts have been largely unsuccessful in Alaska. For
example, Alaska Natives trained in healthcare professions often do not practice in areas
where health services are in short supply, or in areas with high percentages of underrepresented racial and ethnic populations7.
An Allied Health Program, such as physical therapist or physical therapist
assistant program that would allow Alaskans to study while living in the home state,
might supply practitioners who are skilled in working with the underserved population.
Physical therapist assistant education
Pre-physical therapist assistant education requirements
All physical therapy assistants (PTA) must complete a high school education or
GED program. High school level classes that will prove helpful in the physical therapy
field include Math, English, Anatomy, Physiology, and Psychology. After high school,
7
Alaska Center for Rural Health. Alaska 's Allied Health Workforce: A Statewide Assessment.
University of Alaska Anchorage , March, 2001
14
potential PTAs will need to apply to an accredited physical therapy assistant education
program. There are currently around 300 physical therapy assistant education programs
accredited by the American Physical Therapy Association’s Commission on
Accreditation in Physical Therapy Education.
Physical therapist assistant program overview
Physical therapy assistant degree programs typically take two years or five
semesters to complete. An associate’s degree is issued upon the successful completion
of a PTA education program. Most states do require that physical therapy assistants
obtain an associates degree prior to filing for a PTA license. PTA education programs
are available at technical or community colleges and some four-year colleges and
universities.
Physical Therapy Assistant Degrees are divided into academic coursework and
hands-on clinical experience. Some programs may require students to get certified in
CPR and complete a semester of coursework in anatomy and physiology before they
can begin their clinical field experience. Other first aid certifications may also be
required.
Academic coursework includes instruction in the following:
Algebra and Mathematics
Anatomy
Biology
Chemistry
15
English
Kinesiology
Neurological Concepts
Orthopedics
Pathology
Pediatrics
Psychology
Physical Therapy Techniques
Physiology
Clinical Experience
Clinical experience is viewed as being absolutely essential to ensuring that
students understand the concepts they have covered in the classroom and can properly
perform their expected responsibilities. Most hand-on experience will take place in
treatment centers.
Supervision of student physical therapy assistants
Student physical therapist assistants, when participating as part of a physical
therapist assistant education curriculum, and when acting in accordance with the
American Physical Therapy Association policy and applicable state laws and
regulations, are qualified to perform selected physical therapy interventions under the
direction and direct supervision of either the physical therapist alone or the physical
16
therapist and physical therapist assistant. The physical therapist is responsible for
patient/client management. Direct supervision means the physical therapist is
physically present and immediately available for direction and supervision. The physical
therapist will have direct contact with the patient/client during each visit that is defined in
the Guide to Physical Therapist Practice. Telecommunications does not meet the
requirement of direct supervision 8
As of 10/01/10, Medicare Part A and Part B implemented new therapy student
supervision guidelines in Skilled Nursing Facilities, which describes strictly 1:1, direct
line of sight supervision of the PTA student by PT/ PTA (Attachment 1).
Graduation requirements
The completion of the degree also requires students to receive hands-on clinical
experience to fulfill the degree requirements. The clinical experience gives students the
first hand knowledge of the human anatomy and the basic physical therapist techniques
they will need in the medical field. Employers won’t often hire graduates unless they
have clinical experience.
Upon completion of an accredited physical therapy assistant program, potential
PTAs will need to obtain a license, certification, or register in order to practice. License,
registration and certification requirements vary from state-to-state. However, most
states will require the completion of an accredited PTA education program, as covered
above, and the passing of the National Physical Therapy Exam. Some states also
require PTA candidates to pass a state jurisprudence examination.
http://www.apta.org/
Supervision of Student Physical Therapy Assistants HOD P06-00-19-31
[Amended HOD 06-96-20-35; HOD 06-95-20-11] [Position] [Document updated: 12/14/2009]
8
17
Overview of existing PTA programs which offer distance education9
Whatcom
Community
College, WA
GateWay
Community
College,
Phoenix, AZ
San Juan
College,
Farmington, NM
Accredited
Yes, Northwest
Commission on
Colleges and
Universities
Yes, Higher
learning
Commission of the
North Central
Association of
Colleges and
Schools
Yes, Higher
learning
Commission of the
North Central
Association of
Colleges and
Schools
Classification
Public rural,
serving Medium
Public Urban –
serving
Multicampus
Public Rural serving Large
Degree offered
Associate in
Science
Associate in
Applied Science
Associate in
Applied Science
Program length
113 quarter hours
1. Full-time
program
Enrollment
24 students every
fall/ 5,500 total
24/ year students
into full-time
program; 20
students every
May into hybrid
program,
9
2 years (6
semesters) to
complete the
2. Hybrid weekend program for
program
distance
incorporating
education
distance
students. Format:
education and on- online coursework
campus weekend with on-campus
courses. Can be
labs
completed in 21
months
www.apta.org accessed 11/13/10
18
20 students every
admission cycle
Admission
requirements
-Experience in the
field
-2 quarters of labbased courses in
Anatomy and
Physiology
-lab-based
chemistry, biology,
or physics
-English 101
(Composition I)
-college level
math
-general
psychology
(GERs are
automatically met
if completed
bachelor’s degree)
-min GPA of 2.5
-high school
diploma or GED
-40 hours of
experience in the
field
-college level
English
-college-level
anatomy and
physiology
-min GPA 2.4
-at least 5 hours of
experience in the
field
-Human Body
Structure and
Function course (4
cr)
-Musculoskeletal
Focus for PTAs
(3cr)
-higher-level math
-English
composition
-min 2.5 GPA
Average tuition
cost
In state: $1,920/
year
Out-of-state:
$6,750/ year with
possibility of a
waiver
Two part time,
Two 7-week full
time
Resident: $71/
credit hour
Resident:
$43/credit hour;
Non-resident: not
known
Non-resident:
$97/credit hour
Three full-time 6
week experiences
One 4-week
externship, Two 7week externships,
One full-time, 4
part-time. Faculty
to student ratio
1:24
Three full-time,
several adjunct
faculty. Faculty to
student ratio 1;12
in labs, 1;2 in
lecture classes
Five full-time, 2
adjunct faculty.
Faculty to student
ratio 1:10
Clinical
experience
Faculty
Continuing education and advancement
The license of a physical therapy assistant will need to be renewed on a regular
basis. Most states issue a two-year license. Certifications and registrations may also
19
need to be renewed. In addition, continuing education might be required in order for
physical therapist assistants to maintain licensure. Continuing education most often
takes the form of online courses, college courses, seminars and conferences. The
American Physical Therapy Association is a great resource for exploring continuing
education options.
Physical therapy assistants who wish to gain further knowledge in their field can
obtain additional skills in geriatric, pediatric, musculoskeletal, neuromuscular,
integumentary, and cardiopulmonary physical therapy. The American Physical Therapy
Associations gives recognition to such PTAs.
There is minimal room for advancement as a physical therapy assistant. One
option might be advanced training and certification in geriatrics, pediatrics,
musculoskeletal, neuromuscular, integumentary, and cardiopulmonary physical therapy.
Other PTA’s, with years of experience, may advance into non-clinical areas like
administrative or academic teaching positions.
Becoming a physical therapy assistant is not a stepping stone to becoming a
physical therapist. While there are a few “bridge” programs that allow PTAs to work
while going to school on weekends to become a physical therapist, they are rare. Such
programs will award a Master’s degree in Physical Therapy upon completion. However,
courses completed in a PT program are on the graduate level, while PTA courses are
on the undergraduate level, so they don’t meet the graduate degree requirements of
most physical therapy courses. Due to the intense study of physical therapy assistant
programs in such a short time frame, there simply is just not enough time for the
20
prerequisites to be met that allows PTAs to go directly on to PT educational programs.
Through campus based and online programs, aspiring Physical Therapy
Assistants in Anchorage, Fairbanks, Juneau and Sitka, Alaska may be able to prepare
themselves for the possibility of employment in some of the largest hospitals and
healthcare facilities in the state including Providence Alaska Medical Center, Fairbanks
Memorial Hospital, Alaska Regional Hospital, and Central Peninsula Regional Hospital.
Current situation regarding physical therapist and physical therapist assistant
education nationwide
PT: US Programs
PT: Non-US
Program
PTA: US
Programs
PTA: Non-US
Programs
Accredited
200 institutions
supporting 213
programs
Developing
15 institutions
developing 15
programs
MS/ MPT: 7
programs
MS/ MPT: 0
programs
Totals
215 institutions
supporting/
developing 228
programs
MS/ MPT: 7
programs
DPT: 206
programs
3 institutions
supporting 3
programs
DPT: 15 programs
DPT: 221 programs
N/A
3 institutions
supporting 3
programs
Canada: 2
International: 1
244 Institutions
supporting 263
programs
52 institutions
developing 52
programs
479 accredited
programs
67 developing
programs
Canada: 2
International: 1
296 institutions
supporting/
developing 315
programs
546
accredited/developing
programs
Table 3: Number of PT and PTA programs as of December 13, 201010
10
http://www.apta.org/AM/Template.cfm?Section=PT_Programs3&TEMPLATE=/CM/Conte
ntDisplay.cfm&CONTENTID=45221
21
Accreditation process through CAPTE
The Commission on Accreditation in Physical Therapy Education (CAPTE) is the
only recognized agency in the United States for accrediting education programs for the
preparation of physical therapists and physical therapist assistants. CAPTE grants
specialized accreditation status to qualified entry-level education programs for physical
therapists and physical therapist assistants. Accreditation is a process used in the US to
assure the quality of the education that students receive. It is a voluntary, nongovernmental, peer-review process that occurs on a regular basis. CAPTE is appointed
by the Board of Directors of the American Physical Therapy Association; however, it
makes autonomous decisions concerning the Evaluative Criteria, its Rules and
Procedures, and the accreditation status of education programs for the preparation of
physical therapists and physical therapist assistants. The 30 members of the
Commission represent the communities of interest, including physical therapy and
physical therapist assistant educators, clinicians, consumers, employers,
representatives of institutions of higher education, and the public. 11
Robin Wahto attended CAPTE accreditation workshop in San Antonio, TX (Sept
2010). Please see lecture notes for complete detail. A summary of the accreditation
process is provided below.
11
Guide to Development of Educational Programs for Physical Therapists and Physical Therapist
Assistants. www.apta.org Accessed 12/01/2010.
22
The accreditation process through CAPTE consists of two steps:
1. Application for Candidacy and achievement of Candidacy status
The granting of Candidate for Accreditation status must occur prior to
enrollment of students in the professional/technical phase of the physical
therapist assistant program.
2. Accreditation
STEPS TOWARDS CANDIDACY FOR ACCREDITATION STATUS
1. Program director and supporting staff
1A. Employ a Program Director
The program director should be employed full time 6-9 months prior to planned
date for submission of AFC (Application for Candidacy), to develop the program. The
program director for a PTA program should have following qualifications: PT or a PTA
with minimum of Master’s degree, licensure or certificate in the state, experience in
higher education (didactic/ teaching), experience in clinical practice, experience in
administration, experience in curriculum design, development, implementation, and
evaluation, and minimum of 5 years physical therapy experience. The program director
must be working for the institution on a full-time basis to develop the program. The
Program Director and at least one higher administrator from the institution must attend a
workshop to learn about the candidacy process. This must be done prior to the
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Application for Candidacy. Three workshops are conducted by the Department of
Accreditation staff annually in February, June/July, and October.
1B. Notify CAPTE
CAPTE needs to be notified of new program development when Program Director is
hired (the notification letter should be official with PD’s CV attached). CAPTE then will
add the program to the list of developing programs and will allow the PD access to
electronic Portal.
1C. Employ an ACCE/ DCE
Clinical education makes up approximately 1/3 of the curriculum. CAPTE does
not require this step but strongly recommends it. The program director and clinical
Coordinator then should work together to develop the program.
2. Program Development
2A. Selection of timing cycle.
Application for Candidacy
and fee due
Staff determination that
AFC is bona fide
AFC sent to Candidacy
reviewer
Candidacy visits between
Report of Candidacy Visit
to program
Response to Report of
Candidacy Visit due
CAPTE decision
Cycle A
March 1
Cycle B
June 1
Cycle C
Sept 1
Cycle D
Dec 1
March 10
June 10
Sept 10
Dec 10
March 15
June 15
Sept 15
Dec 15
April 15-30
May 15
July 16-31
August 15
Oct 16-31
Nov 15
Jan 16-31
Feb 15
June 15
Sept 15
Dec 15
March 15
Late July
Late Oct
Late Jan
Late April
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It is estimated that it takes 4-5 months after AFC submission before the program can be
implemented. Timing is crucial.
2B. Program development

Mission, goals

Expected outcomes

Policies, procedures, and practices

Curriculum

Resources

Clinical education program

All other aspects of the program
2C. Write the Application for Candidacy
The Application for Candidacy is a report through which institution provides
information about the institution’s plans for development and implementation of the
proposed program, such that it will meet the Evaluative Criteria for accreditation.
3. Submission of Application for Candidacy
The AFC must be submitted on or before Mar 1, Jun 1, Sep 1, Dec 1.
4. AFC review by Candidacy Reviewer/ Visit to the program/ Candidacy Visit
Report
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When the Application for Candidacy is considered bona fide by the reviewers and
is complete, the Candidacy Reviewer conducts a two-day visit to the program.
5. Respond to visit report
Due 30 days after receipt of report, approximately 5 weeks prior to CAPTE
review
6. CAPTE makes a candidacy decision
Upon CAPTE’s determination to grant a program Candidate for Accreditation
Status, students may be enrolled/ matriculated into the program’s first
professional/technical courses.
ACCREDITATION REQUIREMENTS
1. Full complement of core faculty
2. Complete curriculum, implemented
3. All necessary space and equipment
4. All needed clinical education placement
Recommendations for a Physical Therapist Program at the University of Alaska
The University of Alaska is well-suited for a physical therapist assistant program.
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The mission of the University of Alaska Anchorage is “to discover and disseminate
knowledge through teaching, research, engagement, and creative expression. Located
in Anchorage and on community campuses in Southcentral Alaska, UAA is committed
to serving the higher education needs of the state, its communities, and its diverse
peoples. The University of Alaska Anchorage is an open access university with
academic programs leading to occupational endorsements; undergraduate and
graduate certificates; and associate, baccalaureate, and graduate degrees in a rich,
diverse, and inclusive environment.”12
The potential PTA program should be an integral part of the University. Allied
Health programs are designed to prepare graduates for work in rewarding careers in
Alaska’s rapidly growing health care industry. Each program provides experiential
education with students working alongside health professionals in real-work situations.
The current and well-designed Allied Health Sciences Division is part of the
Community and Technical College at UAA and should support a PTA program.
Recommended Program Specifics
Degree offered:
Associate in Science or Associate in Applied Science
Program length:
5 semesters (CAPTE requirements)
12
http://www.uaa.alaska.edu/chancellor/uaa-mission-statement.cfm Accessed 1/20/2010
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Program delivery
The two curricular format options that are utilized are an integrated, 2-year format
or a 1+1 format, where the general education courses are taught in the first year and the
technical PTA courses are offered in the second year. Admission requirements may
vary depending on the format selected. A hybrid program with didactic courses in pure
online delivery and procedural courses with online delivery of didactic material and face
to face delivery of hands-on materials and skills seems to be the most suited for Alaska.
Students would meet on regular basis for lab instructions and practice. All practical skills
would be taught, practiced, and tested during these lab sessions, as well as all written
exams would be completed during these lab sessions.
Accreditation standards require distant delivery strategies to achieve equivalent
curricular outcomes and all delivery models require students to complete the same
curriculum and learning strategies - laboratories, small group discussions, and
experiential education programs - regardless of their physical location. The major
differences between the models are the degree to which students are required to be
independent learners and the amount of direct engagement between faculty and
students.
Students enrolled:
8-10 students enrolled in the program (based on conversation with Jan Harris
and Robin Wahto). This number of students should be able to meet the workforce need
in the State of Alaska. Based on Vacancy data described earlier, the clinical community
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will be able to absorb the number of graduates expected (8-10 graduating PTA students
per 2 year period).
Resources and Facilities
Significant resources are needed to develop and implement a PT or PTA
education program. This includes, but is not limited to:
1. Financial resources for
 Renovations of existing facilities or for new facilities
 Appropriate student services.
 Faculty recruitment
 Faculty salaries that may need to be competitive with the clinical salaries
 Faculty development
 Equipment and supplies
 Travel (clinical education; professional development)
 Library and learning resources
2. Space/Facilities
 Appropriate student services.
 Classrooms that will accommodate planned class size
 Laboratory space that accommodates needed treatment tables and physical
therapy equipment for planned class size; laboratory space will need appropriate
water and electrical access that will meet the needs of lab activities. Lab space
is typically dedicated space. The students will need access to this lab outside of
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class time for additional practice.
 Storage: of laboratory equipment and supplies
 Offices: space that ensures confidentiality
 Space for dressing/locker room space, computer labs, student gatherings
Faculty:
Recruiting a qualified director is typically a difficult task due to the ongoing
shortage of qualified program directors for both PT and PTA programs. A program
director with expertise in curriculum development, accreditation requirements and
academic administration is vital to the success of a new program. Two full time faculty
members are required, including a full-time program director (hired 6-9 months prior to
application for candidacy), and adjunct faculty as needed. One of the full-time faculty
must be a PT (per CAPTE). Because there is also a shortage of qualified faculty,
recruiting qualified core (physical therapy educators) faculty will need to occur early
during program development and could also impact the timeline for starting the
program.
Clinical Education
Both PT and PTA programs must have sufficient numbers and varieties of clinical
sites to ensure that students achieve expected program outcomes. It is important to
have an abundance of available clinical education sites as staff shortages and
competition from other physical therapy education programs may limit the number and
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quality of available clinical experiences. The accreditation criteria require that the
number of clinical sites be 125% of the number of students seeking those sites. That
would result in the necessity of 10-13 clinical sites. Based on personal communication
with practicing physical therapists and clinic owners/ directors, there seems to be
sufficient number of clinics that would be available for clinical education in the
Anchorage and Mat-Su area. The potential availability of physical therapy clinics in
Fairbanks, Kenai Peninsula, and Southeast is unknown.
Because developing the clinical education component of the curriculum is a time
consuming activity, the Director of Clinical Education/Academic Coordinator of Clinical
Education (DCE/ACCE) is often the second person to be hired.
Curriculum development in physical therapy education requires careful
coordination of the classroom/laboratory and clinical components. Clinical education
sites must be recruited and developed to provide the appropriate clinical experiences for
the level of student preparation.
Qualified clinical instructors are essential to ensure sufficient clinical mentoring
and teaching. Clinical education experiences are typically completed at clinical sites in
the immediate geographic area for PTA programs. Sufficient time, personnel and
budget will be needed to obtain and develop clinical education sites that will meet the
needs of the program related to program and institutional mission, curricular
expectations, curricular format, and planned class size.
Prerequisite coursework
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Current University of Alaska coursework that might satisfy admission requirement to a
PTA program:
Category
UA course
Written Communication
Skills
ENGL 111 Methods of written communication
Quantitative Skills
MATH 107 College Algebra
MATH 108 Trigonometry
Human Anatomy and
Physiology with lab
BIOL111 Human Anatomy and Physiology I
BIOL 112 Human Anatomy and Physiology II
Natural Sciences
BIOL A102 Introductory Biology
(Lab – based Biology,
Chemistry, or Physics)
Optional BIOL A103 Introductory Biology Lab
CHEM A105/L General Chemistry I
CHEM A106/L General Chemistry II
PHYS A123/L Basic Physics I
PHYS A124/L Basic Physics II
Sociology
SOC 101 Introduction to Sociology
Psychology
PSY 111 General psychology
PSY 150 Lifespan Development
Note:
If the University of Alaska decides to address rural population, the mission of the
program needs to reflect it. Also, might consider adding Alaska History / Culture to the
program prerequisites or core curriculum.
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Cost
The costs for the Alaska student to complete an in-state program would be
significantly less expensive as compared to relocating out-of-state to study.
Other avenues to explore
Partnership with already existing PTA programs
The partnership model for physical therapy assistant education is one viable option
for the University of Alaska; it would provide the opportunity for Alaska residents to
receive a physical therapy assistant education and generate a meaningful increase in
PTA manpower for the state. Although there are no sources of data to determine the
number of students who studied out-of-state and then returned to practice in Alaska, the
general consensus is that students tend to locate close to where they complete their
education and thus don’t return to Alaska. If this tenet is true, then it is logical that
conducting— at a minimum—the last semester of full-time experiential education in
Alaska will increase the likelihood that Alaska residents who study physical therapy will
be more likely to remain in the state to practice.
If UA were to partner with an existing accredited physical therapist assistant
program experienced in satellite program delivery, a satellite campus delivery model for
local access to PTA education could provide Alaska residents with an opportunity to
remain in Alaska to complete their entire PTA degree.
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RECOMMENDATIONS
1. Organize an Advisory board consisting of:
a. UAA representative (budget, timeline, organization, academic affairs,
etc)
b. PT/ PTA with experience in higher PT/ PTA education (prerequisites,
curriculum, student selection process, student advisor)
c. PT/ PTA with experience in clinical placement and equipment issues
(developing clinical rotation sites, sequencing, contracts with clinical
sites)
d. Accreditation consultant
Consultant services are strongly advised for institutions considering developing a
new physical therapy education program for guidance in program planning,
development, and implementation, including program assessment. Consultants that are
experienced physical therapy educators can facilitate discussions about whether or not
to proceed with program development. Should the decision be made to move forward,
consultants may be beneficial to guide program development or to provide expertise in
a specific area of program development; for example, curriculum development, faculty
development or outcomes assessment.
A list of educational consultants may be obtained by contacting Jody Gandy, Director,
Department of Academic/Clinical Education Affairs at jodygandy@apta.org.
13 13 Guide
13
to Development of Educational Programs for Physical Therapists and Physical Therapist
Assistants. www.apta.org Accessed 01/10/2011.
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Additional Resources:
Administrators of established education programs for the preparation of physical
therapists and physical therapist assistants: Personnel from the institution
considering the establishment of a program may find it helpful to visit other programs
from similar academic institutions to gather information on space, staffing, equipment,
and other resources. The director of an existing program may be willing to share
information on essential resources and costs. However, since a new program may be in
competition with an existing program for students, faculty and clinical education sites,
program directors may be limited in the amount or type of assistance they can provide.
Physical therapists and physical therapist assistants employed in varied practice
settings within the community: Physical therapists in the community may be able to
assist in the assessment of the availability and accessibility of local clinical education
sites and the potential for positions in the local area for graduates of the proposed
program. These individuals may be good sources for members of a program advisory
committee.
Advisory Committee: Advisory committees typically include representatives from
stakeholder groups from within and outside the college. In addition to the clinicians,
advisory committees often include leaders in the health care community, other health
care professionals, health care administrators, future employers, and consumers.
Representatives from within the college may include faculty and administrators of the
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basic sciences and other health care professions, admissions officials, student services
personnel, and the deans of appropriate colleges.
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ATTACHEMENTS
Implementing MDS 3.0: Use of Therapy Students
As facilities continue to change their current practices to implement the Minimum Data
Set Version 3.0 (better known as MDS 3.0), one of the emerging issues is the manner in
which they document and utilize therapy students. Under the new rules, in order to
record the minutes as individual therapy when a therapy student is involved in the
treatment of a resident, only one resident can be treated by the therapy student and the
supervising therapist or assistant (for Medicare Part A and Part B). In addition, the
supervising therapist or assistant cannot engage in any other activity or treatment when
the resident is receiving treatment under
Medicare Part B. However, for those residents whose stay is covered under Medicare
Part A, the supervising therapist or assistant cannot be treating or supervising other
individuals and the therapist or assistant must be able to immediately intervene or assist
the student as needed while the student and resident are both within line of sight
supervision. For example under Part A, the therapist or assistant could be attending to
paperwork while supervising the student and resident.
Under Medicare Part A, when a therapy student is involved with the treatment, and one
of the following occurs, the minutes may be coded as concurrent therapy:
• The therapy student is treating one resident and the supervising therapist or assistant
is treating another resident and the therapy student and the resident the student is
treating are in line of sight of the supervising therapist or assistant; or
• The therapy student is treating two residents, both of whom are in line of sight of the
therapy student and the supervising therapist or assistant, and the therapist is not
treating any residents and not supervising other individuals; or
• The therapy student is not treating any residents and the supervising therapist or
assistant is treating two residents at the same time, regardless of payer source, both of
whom are in line of sight.
The student would be precluded from treating the resident and recording the minutes as
concurrent therapy under Medicare Part B.
Under Medicare Part A, when a therapy student is involved with group therapy
treatment, and one of the following occurs, the minutes may be coded as group therapy:
• The therapy student is providing the group treatment and all the residents participating
in the group and the therapy student are in line of sight of the supervising therapist or
assistant who is not treating any residents and is not supervising other individuals
(students or residents); or
• The supervising therapist/assistant is providing the group treatment and the therapy
student is not providing treatment to any resident.
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Under Medicare Part B, when a therapy student is involved with group therapy
treatment, and one of the following occurs, the minutes may be coded as group therapy:
• The therapy student is providing group treatment and the supervising therapist or
assistant is present and in the room and is not engaged in any other activity or
treatment; or
• The supervising therapist or assistant is providing group treatment and the therapy
student is not providing treatment to any resident.
These changes as well as other changes regarding MDS 3.0 took effect October 1,
2010. If you have questions regarding this provision or other provisions within MDS 3.0,
please contact the APTA at advocacy@apta.org or at 888.999.2782 ext. 8533.
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