NEEDS ASSESSMENT AND ANALYSIS OF
POTENTIAL STRATEGIES FOR A PHYSICAL THERAPY PROGRAM FOR ALASKA
Zuzana Rogers, PT, COMT
Consultant
Advanced Physical Therapy
Abbott Rd Ste 200
Anchorage, AK 99507
February 2011
TABLE OF CONTENTS
1. Introduction ……………………………………………………………………………..3
2. Identified need……………..…………………………………………………………...4
Rural areas…………..................................................................................7
3. PT profession background…………………………………………………………….9
Practice settings……………………………………………………………….10
Direct access issues…..……………………………………………...………10
4. Practice requirements…………………………………………………………………11
5. Career outlook for physical therapists ……….…………….……………………….12
6. Physical therapist education……………….…………………………………………14
Pre-physical therapist education requirements………………………………..14
Physical therapist program overview……………………………………………15
Clinical experience………………………………………………………………..15
Supervision of student physical therapists………..……………………….......16
Distance education………………………………………………………………..16
Continuing education and advancement……………………………………….20
7. Current situation………………………………………………………………………21
8. Accreditation process………………………………………………………………...22
9. Steps towards Candidacy for Accreditation Status ……………………………….23
Program director and supporting staff………………………………………….23
Program development…………………………………………………………….24
Submission of Application for Candidacy………………………………………25
Application for Candidacy review/ Visit to the Program/ Candidacy Visit
Report………………………………………………………………………………25
Respond to Visit…………………………………………………………………..25
CAPTE makes a candidacy decision…………………………………………...26
10. Accreditation requirements…………………………………………………….........26
11. Recommendations for an Entry-Level Doctor of Physical Therapy Program at the
University of Alaska……….………………………………………………………….26
Recommended program specifics………………………………………………27
12. Issues to consider during decision-making process………………………………32
13. Recommendations……………….…………………………………………………..33
14. Additional resources…………………………………………………………………34
15. Attachments…………………………………………………………………………..36
2
The University of Alaska is considering establishing a physical therapy education
program under several scenarios;
1. Host established Physical Therapy program
2. Establishment of its own accredited Physical Therapy program, whose
outcome would be an entry-level Doctor of Physical Therapy (DPT).
This report attempts to assess the need for physical therapy 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?
3
2. What is the region’s anticipated future growth and how many practitioners will be
required to meet this anticipated growth?
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).
Identified need
Physical therapists and physical therapist assistants in Alaska are in short
supply, and pressures will continue to grow on this workforce as the population
continues to rapidly age. Regarding Alaska Workforce Report from 2006, Alaska will
experience a 36% growth of physical therapist positions projected to 2012. 1
1
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
4
The American Physical Therapy association collected series of nationwide
workforce and vacancy studies in 2010. Following is a summary of the findings:
1. Acute care hospitals:

Vacancy rate among physical therapists was 10%

Overall turnover rate among full-time physical therapists was 11.9%

Estimated time to fill a vacancy: 1 month to 1 year 2
2. Outpatient private practice

Vacancy rate among full-time physical therapists was 11.2%

Overall turnover rate among full-time physical therapists was 10.7%

Estimated time to fill a vacancy: 4 months or less3
3. Skilled Nursing Facilities

Vacancy rate among full-time physical therapists was 18.6%
 Vacancy rates in hospitals were 13.8%
 Overall turnover rate among full-time physical therapists was 85.2%,
which is somewhat alarming. The extremely high turnover rate
indicates that, on average, skilled nursing facilities have to replace the
equivalent of an entire staff during the course of a year.
 Time to fill a position appeared to be an extreme problem in this setting,
up to 10 years. The data seem to indicate that the shortage reported
by physical therapists in a number of settings is even more troubling in
American Physical therapy Association
http://www.apta.org/ Accessed 12/13/2010
3 American Physical Therapy Association
http://www.apta.org/ Accessed 12/13/2010
2
5
skilled nursing facilities.
4
In 2009, Alaska had 1,008 licensed physical therapists of which 503 practiced in
the state, which indicates 72.01 licensed physical therapist per 100,000
population. Nationwide average was 58.43 per 100,000 population.5
Currently, there are no PT programs in the State of Alaska. There are 20
PT programs in the Pacific region (AK, CA, HI, OR, WA). 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 1).
American Physical Therapy Association
http://www.apta.org/ Accessed 12/13/2010
4
5
http://www.apta.org/AM/Template.cfm?Section=Workforce_Salaries_and_Stats&Template
=/MembersOnly.cfm&NavMenuID=2894&ContentID=71492&DirectListComboInd=D
6
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
healthcare
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
students due to
supervision requirements
Increase diversity for
health careers in Alaska
In-state tuition
Table 1: Survey of physical therapists and physical therapist assistants in Alaska
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.
7
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
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 populations6.
An Allied Health Program, such as physical therapist 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.
6
Alaska Center for Rural Health. Alaska 's Allied Health Workforce: A Statewide Assessment.
University of Alaska Anchorage , March, 2001
8
Physical Therapy 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.
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 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.
9
Additionally, PTs may teach at universities or do research. Physical therapy is a
dynamic profession and an integral part of healthcare services in the 21st century.
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)7.
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
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,
7
www.apta.org/research. Accessed 11/23/10
10
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 8.
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
In order to provide physical therapy services, a physical therapist needs to
meet following requirements:
1. In Alaska: Must have graduated from a school of physical therapy approved by
the Council on Medical Education and Hospitals of the American Medical
Association, or the American Physical Therapy Association. Foreign-trained PTs
must show they have completed a course of study equivalent to that provided by
a school approved by the Council on Medical Education and Hospitals of the
American Medical Association or the American Physical Therapy Association and
have completed an approved internship. Must also complete an approved 6
months internship in Alaska.
8
www.apta.org/research. Accessed 11/23/10
11
I have contacted Connie Petz, licensing examiner for the State Physical Therapy and
Occupational therapy Board regarding clarification of “approved schools”. The state
relies on the Federation of State Boards (FSBPT) to identify approved Physical Therapy
schools.
2. Pass the National Physical Therapy Exam (NPTE) for physical therapists. This
exam is based on a comprehensive practice analysis conducted to determine
critical knowledge, skills and abilities of physical therapists. All PTs must receive
a graduate degree from an accredited physical therapist program before taking
the national licensure examination that allows them to practice.
3. TOEFL, TWE and TSE are all required for foreign trained physical therapist
candidates.
4. Licensure by acceptance of credentials if PT is licensed in another state if the
requirements for licensure in that state were, at the date of the applicant’s
licensure, substantially equal to the requirements in Alaska.
Career outlook for physical therapists
The nation’s aging population and expanded health care coverage will increase
the demand for physical therapists (PT). It is projected that healthcare will add the most
jobs during the 2008-2016 time period. The 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
12
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.
Regarding the Alaska Workforce Reports from 2006, physical therapists held 298
jobs on 2002, a number that will climb 36% in 2012, to 405. Thanks to the rapidly
growing elderly population that is particularly vulnerable to chronic conditions requiring
therapeutic services, as well as to the use of physical therapists at the workplace, to
evaluate worksites, develop exercise programs, and teach safe work habits to
employees – the demand for physical therapists will be strong.
The median physical therapist salary in the United States ranged from $73,000 to
$86,000, based on experience, geographical region, and practice settings. The largest
percentage changes in income between 2002 and 2008 were reported by physical
therapists employed in SNF/ECF/ICFs (40%) and Patient’s home/Home care (38%).
Respondents working in Industry ($90,000) and SNF/ECF/ICFs ($85,000) had the
highest income, while those working in School Systems reported the lowest ($64,200).
The fact that large gains and high salaries were reported in SNF/ECF/ICF was not
surprising. These were the settings most negatively affected by the Balanced Budget
Act. The recently conducted Vacancy Rate Study indicated that these settings continue
to have a difficult time recruiting physical therapists. It would appear that increasing
13
salaries is one strategy used to aid recruitment.9
Additional costs that may be associated with physical therapists’ career primarily
will come from license renewal and continuing education. Most states require PTs to
renew their license biennially and complete a specific number of continuing education
hours. State-to-state renewal requirements vary for physical therapists.
Education
Pre-physical therapist education requirements
Most physical therapist education programs require applicants to earn a
bachelor's degree prior to admission into the professional DPT/MPT program. Other
programs offer a 3+3 curricular format in which 3 years of specific pre-professional
(undergraduate/pre-PT) courses must be taken before the student can advance into a
3-year professional PT program.
The University of Alaska offers classes that satisfy the pre-physical therapy
education requirements to most DPT programs. These classes include (but are not
limited to):

General College Chemistry I and II

General College Physics I and II

General College Biology I and II

Anatomy and Physiology
9
http://www.apta.org/AM/Template.cfm?Section=Workforce_Salaries_and_Stats&Template
=/MembersOnly.cfm&NavMenuID=455&ContentID=71469&DirectListComboInd=D
accessed 1/03/2011
14

Social Science

Psychology/ Sociology

Statistics

English composition and writing
In addition, prospective physical therapy students are strongly encouraged to obtain
physical therapy experience such as observing physical therapists in their clinics,
volunteering, or work experience as a physical therapy aide.
Physical therapist program overview
The length of professional DPT programs is typically 3 years. Primary content
areas in the curriculum may include, but are not limited to, biology/anatomy, cellular
histology, physiology, exercise physiology, biomechanics, kinesiology, neuroscience,
pharmacology, pathology, behavioral sciences, communication, ethics/values,
management sciences, finance, sociology, clinical reasoning, evidence-based practice,
cardiovascular and pulmonary, endocrine and metabolic, and musculoskeletal. Eighty
percent (80%) of the DPT curriculum comprises classroom (didactic) and lab study and
the remaining 20 percent (20%) is dedicated to clinical education. PT students spend on
average 27.5 weeks in their final clinical experience.
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
15
treatment centers.
Supervision of student physical therapists
Student physical therapists, when participating as part of a physical therapist
education curriculum, and when acting in accordance with the American Physical
Therapy Association policy and applicable state laws and regulations, are qualified to
perform physical therapy evaluations and interventions under the direction and direct
supervision of physical therapist. 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 10
Distance education
Distance education programs are becoming increasingly popular in physical
therapy profession, as they allow working clinicians to advance their education and
maintain their current employment. Transitional DPT programs (t-DPT) are plentiful, and
they are used to bridge the Master of Physical Therapy (MPT) and Master of Science in
Physical Therapy (MSPT) with a Doctorate in Physical Therapy (DPT) degree.
However, there seems to be only limited number of entry-level DPT programs that offer
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]
10
16
distance education format (Table 2).
Texas tech
University,
Lubbock,
Odessa,
Amarillo, TX
University of St.
Augustine for
Health Sciences,
FL
Nova
Southeastern
University
Degree offered
Entry-level DPT
Entry-level DPT
(Flex, part-time),
in St. Augustine
FL and San Diego
CA. Also full-time
DPT
Hybrid entry-level
DPT online and
classroom settings
Program length
3 years
12 trimesters (4
years)
4 years
Format
Full-time program
offered on 3
campuses. No
online portion
Online
coursework,
weekend
classroom
sessions up to 16
hours of
laboratory classes
per weekend for
no more than
eight weekends a
trimester.
Online learning for
flexibility plus
face-to-face
campus-based
classes at the
Tampa, Florida
once per month
(4-5 days each)
month) for
instruction,
practice, and
feedback on
hands-on skills.
Accredited
Yes, CAPTE
Yes, CAPTE. The
Flex program is
accredited by the
Distance
Education and
Training Council.
Pending approval,
CAPTE.
Classification
private
Admission
3x/ year (Fall,
Spring, Summer)
Charter class of
20 students to
begin May 31,
17
2011
Admission
requirements
-
-GRE
-GPA 3.0 and
higher is
encouraged
-Experience in the
field
-General College
Chem I and II (6
cr)
-General college
Physics I and II (6
cr)
-General college
biology I and II
(6cr)
-Anatomy and
Physiology (6 cr)
-Social Science
(9cr)
Average tuition
cost
Tuition for the St.
Augustine Flex
DPT program is
$5,950 per
trimester for the
20102011 academic
year
-Bachelor’s
degree
-GRE
-min 2.75 GPA
-previous
experience
-interview
-Psychology/
Sociology 2
semesters
-Statistics 1
semester
-Biology 1
semester
-Anatomy and
Physiology 2
semesters
-Chemistry with
lab 2 semesters
-Physics with lab 2
semesters
-English 1
semester
composition and
writing
$19,500 resident
and non-resident
plus fees
Tuition for the San
Diego Flex DPT
program is $7,150
per trimester for
the 2010-2011
academic year.*
Clinical
experience
3 full-time clinical
internships that
18
are seven to eight
weeks in length in
the second half of
the program
Table 2: Overview of existing entry-level DPT programs which offer distance education11
Distance education programs need to fulfill same, rigid accreditation criteria as
full-time DPT programs. They have same admission requirements, pre-requisites,
tuition, and policies as the full-time equivalent at the same University. The only
difference between a full-time DPT program and a distance DPT program might be
reduction of credit hours per semester and thus slightly longer program duration, and
the distance education delivery format. In this format, majority of the coursework is
delivered to the students online. The online courses consist of web-based text with
extensive graphics, videos, and audio clips, with opportunities provided for faculty-tostudent and student-to-student synchronous and asynchronous interactive
collaboration. Assessment of online learning outcomes may includes a wide variety of
evaluation tools depending on the course objectives such as: 1) regular quizzes
completed online, 2) graded bulletin board assignments, 3) case reports, 4) group
projects, 5) research papers, and 6) article critiques.
In courses with a lab component, students engage in laboratory classes during
weekends. The number of hours spent in lab depends on the design of the
program. The lab sessions provide an avenue for teaching activities not well suited for
online delivery such as the hands-on learning that is vital to physical therapy education,
as well as oral presentations, lab practical testing, socialization activities, and some
11
www.apta.org accessed 11/13/10
19
proctored written examinations.
Continuing education and advancement
The license of a physical therapist will need to be renewed on a regular basis.
Most states issue a two-year license. Certifications and registrations may also need to
be renewed. In addition, continuing education is required in order for physical therapists
to maintain licensure. Continuing education most often takes the form of online courses,
college courses, seminars and conferences. The American Physical Therapist
Association is a great resource for exploring continuing education options.
Licensed physical therapists may choose to pursue a residency or fellowship
program to enhance their knowledge and practice, or a specialty certification. A clinical
residency is a planned program of postprofessional clinical and didactic education for
physical therapists that is designed to significantly advance the physical therapist
resident's preparation as a provider of patient care services in a defined area of clinical
practice. It combines opportunities for ongoing clinical supervision and mentoring with a
theoretical basis for advanced practice and scientific inquiry. A clinical fellowship is a
planned program of postprofessional clinical and didactic education for physical
therapists who demonstrate clinical expertise, prior to commencing the program, in a
learning experience in an area of clinical practice related to the practice focus of the
fellowship. (Fellows are frequently post-residency prepared or board-certified
specialists.)
Physical therapists also have the opportunity to become board-certified clinical
20
specialists through the American Board of Physical Therapy Specialties (ABPTS).
Specialization is the process by which a physical therapist builds on a broad base of
professional education and practice to develop a greater depth of knowledge and skills
related to a particular area of practice. Specialty certification is voluntary. PTs are not
required to be certified in order to practice in a specific area.
Current situation
Following is an overview of existing and developing program in physical therapy field.
PT: 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: 221 programs
DPT: 206 programs
DPT: 15 programs
PT: NonUS
Program
PTA: US
Programs
3 institutions
supporting 3
programs
Canada: 2
International: 1
244 Institutions
supporting 263
programs
479 accredited
programs
3 institutions supporting
3 programs
Canada: 2
International: 1
52 institutions
developing 52
programs
67 developing
programs
296 institutions
supporting/ developing
315 programs
PTA: Non546
US
accredited/developing
Programs
programs
Table 3: Number of PT and PTA programs as of December 13, 201012
12
http://www.apta.org/AM/Template.cfm?Section=PT_Programs3&TEMPLATE=/CM/Conte
ntDisplay.cfm&CONTENTID=45221
21
Accreditation process
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. CAPTE grants specialized accreditation status to
qualified entry-level education programs for physical therapists. Accreditation is a
process used in the US to assure the quality of the education that students receive. It is
a voluntary, non-governmental, 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. 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. 13
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.
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
13
Guide to Development of Educational Programs for Physical Therapists and Physical Therapist
Assistants. www.apta.org Accessed 12/01/2010.
22
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 DPT program should have following qualifications: Physical
Therapist with an earned doctorate degree, senior faculty status, and an understanding
of higher education and contemporary clinical practice appropriate for leadership in
physical therapy education. 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 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
23
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
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
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
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
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
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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
Full complement of core faculty
1. Complete curriculum, implemented
2. All necessary space and equipment
3. All needed clinical education placement
Recommendations for an Entry-Level DPT Program at the University of Alaska
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.”14
14
http://www.uaa.alaska.edu/chancellor/uaa-mission-statement.cfm Accessed 1/20/2010
26
The potential entry-level DPT 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 be able to support a DPT
program.
Recommended Program Specifics
Degree offered:
Doctor of Physical Therapy (DPT) as the first professional degree for physical
therapists at completion of the program
Program length:
Average length of the program is 119.7 weeks (83.3 didactic weeks and 36.4 clinical
education weeks) In general, the clinical education account for 1/3 of the curriculum
(whether measured in credit hours, contact hours, or length in weeks). On average,
DPT programs require 234 credits.
Program delivery
Recommend purchasing A Normative Model of Physical Therapist Professional
27
Education: Version 2004. A Guideline for the Profession, from the American Physical
Therapy Association. It is a revised consensus-based document that reflects the broadbased consensus and voice of the profession regarding the purpose, scope, and
content of physical therapist professional education.
(To order A Normative Model of Physical Therapist Professional Education: Version
2004, call APTA's Service Center at 800/999-2782, ext 3395, Mon-Fri, 8:30 am-8:00
pm, Eastern time and ask for Order No. E-33) .
Resources and Facilities
Significant resources are needed to develop and implement a DPT 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.
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 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
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 PT 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. 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
Physical therapist education programs must have sufficient numbers and varieties
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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 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 PT 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.
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Prerequisite coursework
The University of Alaska offers classes that satisfy the pre-physical therapy
education requirements to most DPT programs. These classes include (but are not
limited to):

General College Chemistry I and II

General College Physics I and II

General College Biology I and II

Anatomy and Physiology

Social Science

Psychology/ Sociology

Statistics

English composition and writing
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.
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.
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Issues to consider during decision-making process
1. Hosting established distance PT program
In this scenario, the University of Alaska would coordinate with a University with
already established distance PT program, set seats aside for Alaska students,
and seek discounted tuition.
The main advantages of pursuing a partnership are: virtually immediate
implementation, minimal initial or ongoing need for Alaska resources, Alaskans
would have advantage during the application process (applying in much smaller
pool), and excellent opportunity to complete clinical rotations in Alaska.
A disadvantage of this scenario might be that this program would likely not
contribute to the University of Alaska’s strength in offering its own advanced
program in the future.
2. Develop UA Physical Therapy school
Advantages of own DPT program include design for best fit to serve Alaskans,
especially rural areas, and encourage widespread participation of current UA
faculty as well as the state practitioners.
Disadvantages might include major start up cost, length of the pre-accreditation
and accreditation process, and difficulty hiring qualified faculty. Also, the class
size needs to be considered carefully to balance tuition, program operating costs,
and possibility of market saturation with new graduates.
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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. 15
15 15 Guide
to Development of Educational Programs for Physical Therapists and Physical Therapist
Assistants. www.apta.org Accessed 01/10/2011.
33
Additional Resources:
A Normative Model of Physical Therapist Professional Education: Version 2004.
A Guideline for the Profession, from the American Physical Therapy Association. It is a
revised consensus-based document that reflects the broad-based consensus and voice
of the profession regarding the purpose, scope, and content of physical therapist
professional education.
(To order A Normative Model of Physical Therapist Professional Education: Version
2004, call APTA's Service Center at 800/999-2782, ext 3395, Mon-Fri, 8:30 am-8:00
pm, Eastern time and ask for Order No. E-33) .
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
34
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
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.
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
36
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 will take 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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