3.4.3 The crucial component of teamwork as a physical therapist (research essay)

April 2021

When you think of the profession of Physical Therapy, what are the images or things that you first think of? You probably think of somebody walking a patient through exercises. Maybe you think of the work environment that they practice in. You may also think about what a Physical Therapist would wear for their uniform. These are probably things that most people think about when they hear that profession. Most of these things are very true, but they only scrape the surface of what a Physical Therapist does on a daily basis and the other well-rounded skills they need to succeed. For my final research essay, I will continue to look at my major of Physical Therapy and discuss how the elements in the world of literacy can be translated into a specific career field. There are so many skills used in Physical Therapy that do not just pertain to it specifically, but also skills that are practical in every professional setting. This is what makes this career so unique that you must be a well-rounded individual in general. One of the most significant aspects of this particular career choice is that you have to work really well in a team dynamic. This could be with other Physical Therapists or even different health professionals depending on what setting of practice you are in. In order to work well with other people in your team, not only do you need to understand your job, but you also need to understand what other people’s jobs and roles are. This creates a more cohesive team between the group and translates to more efficiency. This understanding of each other’s roles within a team is called Interprofessional Education (IPE). My final research essay will take a closer look at how IPE is involved in the health field but also looking specifically at how physical therapists are involved within different health settings in the context of IPE.

As I have mentioned before, Pre-Physical Therapy is what I am majoring in and this profession is something that I have known what I have wanted to do for a long time. Obviously, anybody studying Physical Therapy finds interest in how the body moves and works in general, but I find the career much more interesting for many other reasons. One of them is being able to assist people when they are at a time in their lives when they need help. I would of course find that part of the job very rewarding and give me a sense of purpose that I am going to work every day to help change people’s lives. Even though those are major components of why I want to be a Physical Therapist, I still have one major reason that interests me so much. It’s the fact that it is such a specific practice and pertains to a fraction of the medical sciences, yet it can be so applicable to many settings in the field itself and in life in general. It just shows how important it is to take care of our bodies and understanding what you do daily can influence it. Picking this topic allowed me to look deeper into those aspects of the profession and answer questions that myself and many others have about it.

Using these questions presented will allow me to be able to have those answers about Physical Therapy and be able to take a closer look at the profession instead of seeing it at face value. My questions that I will discuss in my essay are “How is literacy involved in Physical Therapy and writing evaluation notes and progress reports?”. A lot of writing goes into being a Physical Therapist because it is their responsibility to make evaluations on the patient and to do that you must be able to correctly write reports. Another question that will be asked is “How does communication between Physical Therapists and Doctors or other medical professionals affect how work is done in practice?”. This goes along with the other question “How is IPE involved with everyday practice for Physical Therapists and for the education of DPT students?”. These both revolve around the idea on how Physical therapists are involved in the health care setting in the context of IPE. My other questions are “How much does communication between the Physical Therapist and the patient affect the relationship between them?”, “Are discourse different in each specific area of practice in Physical Therapy? If so, how are they different?”,  “How does the education in DPT (Doctor Physical Therapy) prepare Physical Therapists for the practice environment?”. Being able to look at Physical Therapy with different perspectives and contexts will lead to a better understanding of what the overall job and purpose is of the career.

Although people do not associate writing with Physical Therapy, it is incredibly significant in the day-to-day practices of a Physical Therapist and is one of the aspects of the profession that people tend to look past when understanding it. A portion of the writing done in Physical Therapy is through writing evaluation assessments for patients. In the article “Physical Therapy Assessment Documentation: 3 Tips & Examples”, the author Tim Fraticelli’s target audience is to other Physical Therapists in the field that may be new to the day-to-day practices. He gives in-depth tips to formatting evaluation notes and other forms of writing that is done in the profession. Fraticelli explains to the reader about how daily notes are supposed to be done and goes into specific detail regarding this topic “You don’t need to write a paragraph for this type of documentation, but being too brief could diminish important aspects of your skilled assessment. Focus on the key elements you worked on in the session. If you targeted balance training, your assessment should reflect why” (Fraticelli). Fraticelli’s explanations and instruction about drafting these reports and notes on a detailed level show how crucial this part of the profession is. This can allow not only the Physical Therapist themselves to have a better understanding of what is the situation with the patient is, but also other health professionals involved in the patient’s care and how they are able to translate that into their practice.

These reports obviously can be done in many ways depending on what setting the Physical Therapist is in and what the patient’s situation is. This is relevant to the point of how this field in healthcare has a very specific job yet there are many different settings and discourses involved within it. In the article “6 Different types of Physical Therapy” on Movement for Life Physical Therapy, it broadly goes over the different areas of focus in Physical Therapy and the certain things that need to be looked at differently when working in that focused setting.

The first type of Physical Therapy the article discusses is in the pediatric setting. The article explains the job of the Physical Therapist in this setting, “Childhood is a time when the body grows very fast, and problems in childhood can have a negative effect on the rest of a person’s life…often teaching them movement types and ranges of movement which they may never have experienced before” (6 Different Types of Physical Therapy 2018). This shows the significance of how working with a certain age demographic, specifically children requires a different type of communication between the Physical Therapist and the patient. Although it is the complete opposite, the next type of Physical Therapy discussed which is Geriatric Physical Therapy has the same principle of working with a particular age demographic and approaching certain situations in different ways. The article explains the specific approach when looking at this particular area of focus “but as we get older, we may notice more problems, as our muscles stop being strong enough to compensate as they have in the past. Geriatric physical therapy is about taking steps to use the muscles you have in a way which is more efficient and safe, and is less likely to lead to injuries” (6 Different Types of Physical Therapy 2018). Comparing the two age demographics, Both Pediatrics and Geriatrics are both learning new movements but in the Geriatric setting, the patients have to relearn the way they move and do something different from what they have been doing their whole lives. This requires a different approach on the Physical Therapists part to look at the situation differently and plan out the care from a different avenue.

The other discourses discussed in this article are less focused on age demographic and more focused on recovery from specific issues with the body. The first type presented is Vestibular Physical Therapy. The article goes into more depth about the focus, “Vestibular rehabilitation focuses on helping you to overcome problems of the inner ear which can destroy your balance and be seriously debilitating, including chronic dizziness and vertigo. Physical therapy can help you to teach your body to have better balance and use its muscles to be steadier and sturdier” (6 Different Types of Physical Therapy 2018). This specfic area of focus in the field of Physical Therapy and the others that will be presented, may require working with several types of Health Professionals that focus on specific health issues. This can be applied to the next discourse of Physical Therapy discussed in this article which is Neurological Physical Therapy. This discourse focuses on caring for patients with issues that have to do with the brain making the body function (6 Different Types of Physical Therapy 2018). It is crucial for the Physical Therapists to be able to communicate with Health Professionals like Neurologists that are working with the patient to supply the most quality and efficient care. This is the same with the next discourse of Orthopedic Physical Therapy. The article talks about the purpose of this type, “Orthopedic physical therapy is designed to help you to recover muscle strength, as you might need to after an injury has left you unable to use certain muscles” (6 Different Types of Physical Therapy 2018). Working with orthopedic surgeons and understanding where the patient is coming from in their care is crucial for assessing the situation and making a plan for them. Cardiologists and Health Professionals working specifically with issues of the heart are going to be working with the Physical Therapists in the final discourse of Cardiovascular/Pulmonary Physical Therapy (6 Different Types of Physical Therapy 2018). All of these discourses presented in the article are what a future Physical Therapist or a current Physical Therapist should be familiar with in order to give the patient a quality plan to improve their health.

Not only understanding where the patient is coming from in their healthcare and communicating with other health professionals, but also from there being able to communicate with the patient themselves is as just as important to improving their health and looking at different ways to approach their care. In the article “The Added Value of Therapist Communication on the Effect of Physical Therapy Treatment in Older Adults; a Systematic Review and Meta-Analysis.”, Sandra Lakke et. al., discusses the effects of communication between the Physical Therapist and the Patient. They specifically wanted to find out if more communication between the patient and the Physical Therapist will increase the patients amount of being physically active (Lakke et. Al. 3). This study was conducted by doing a meta-analysis where they collected multiple studies done to conclude their findings. The journal briefly gives an overall idea of how the study would be conducted, “For the first selection of studies, one researcher (SL) performed an electronic search and screened the titles for potentially relevant studies. Two researchers (SL and MF) screened the abstracts for the second selection” (Lakke et. al. 5). Their conclusions to this study were not necessarily consistent with the hypothesis made. They could not necessarily find a direct correlation between communication of the Physical Therapist and patient to translate to the patient becoming more physically active(Lakke et. al. 12). They were able to conclude that there were changes in physical activity when they used generalization in practice (Lakke et. al. 12). The article goes into more detail regarding this, “When separated in BCT-categories, the only behavior change technique that was effective on older adult’s perceived physical activity was Generalisation of target behavior (i.e., giving confidence and reinforcing transition of exercise to activities of daily living)” (Lakke et. al. 12). The article also gives a recommendation about applying these conclusions into the practice, “it is recommended that physical therapists add behavior change techniques to interventions with older adults when the aim of treatment is to increase self-reported physical activity” (Lakke et. al. 12). This study shows the significance of communication in a general sense with the patient. It represents that being able to provide motivation and give the patient confidence can allow greater success in their recovery by doing exercises on their own.

Building a relationship with the patient is important for Physical Therapists to do in order to improve the quality of treatment. New factors in our world today due to the COVID-19 pandemic can make that part of the job exceedingly difficult for them to do. Becoming more creative about how appointments are carried out so that they are as safe as possible is another element that comes into play when working as a Physical Therapist and in the health field in general. In the article, “Physical Therapist Management of Patients With or Recovering From COVID-19″, the American Physical Therapy Association goes over the specifics of the steps that need to be taken when a patient comes to a practice. In the article it says, “All health care providers are at some risk for exposure to COVID-19, whether in the workplace or in the community. Providers in any risk exposure category (high, medium, low, or no risk) who develop signs or symptoms compatible with COVID-19 must contact their established point of contact” (American Physical Therapy Association). This is significant because it shows that there is a risk for a Physical Therapist and the patient to be present for an appointment which can make it difficult for the treatment to be carried out on a consistent basis. The article also discusses the certain precautions that the practice needs to take in order to make the experience for the individual going there to be as safe as possible, “Evaluate your treatment and waiting room space design to ensure that patients are always a minimum of six feet apart from one another” (American Physical Therapy Association). It also talks about other precautions that need to be taken like cleaning surfaces multiple times throughout the day, taking temperatures, wearing face masks and many other courses of action to ensure safety (American Physical Therapy Association). The article also briefly talks about Physical Therapists working in a home health environment and how that is impacted by the pandemic. The article gives the point of making sure the patient is informed that telehealth and virtual visits are available to them if they choose to do so (American Physical Therapy Association). The overarching theme of this article is not only relevant to being a Physical Therapists during this time but also being a health professional in general and the obstacles that they face to care for patients. Having to do things differently like being more virtual than having in-person visits with them can affect the relationship that is made between the patient and the Physical Therapists which can become challenging over time.

Being able to build the relationship between the Physical Therapist and the patient requires much more than directly communicating with them but also knowing where they are coming from and who else in the health field cared for them prior. Understanding what the other health professionals are doing to contribute to the care for them and being able to work with those professionals will help you develop a better course of action for the care that you will provide. This recognition and understanding of the jobs in the field other than yours, is Interprofessional Education (IPE). Teamwork is valued in the medical field and IPE is crucial to the success of a Physical Therapist and many others as well. This literal translation of this idea of IPE is expressed in the article “How PT, OT Work Together to Help Memorial Regional Health Patients Heal”, by memorial regional health. Even though this article puts this idea into the context of their specific hospital, it still gives a notable example of how it can be applied in the professional setting. In the article it says, “For example, with a hip replacement, a physical therapist works on ambulation, muscle strengthening and balance, while an occupational therapist works on teaching patients how to dress with limited movement, deciding what supportive equipment they need during recovery and adapting their dressing, bathing, toileting and grooming habits during recovery” (memorial regional health). This general and basic example gives an example that is easy to understand to people who are not as informed about this certain topic. This also gives us a specific look at how these two professions work together on a daily basis and the similarities and differences between them. The artice also mentions the common goal of the two profeessions, “All therapy disciplines work together to help find the meaning behind the healing process. For example, PTs work on helping a person relearn to walk, and OTs helps the patient return to their daily occupations with as much independence as possible. OTs and PTs write goals together with the patient, as this is the optimal way to achieve success in therapy” (memorial regional health). The message that the article is conveying to the audience is that it takes a team to give a patient good care and that the best way for that team to function is to work together. A part of this is to understand what your teammate is doing so you can have a better understanding of what you are doing to contribute to the common goal. These skills are something that every health professional should have, especially Physical Therapists, when entering the medical field.

Because of the high demand for having these IPE skills are very prominent in the health field today, many health professional programs are incorporating education in these skills throughout the curriculum to better prepare the students for the workforce. The journal “Student experiences of interprofessional simulation: findings from a qualitative study” by Margaret Costello et. al. gives an idea to the audience of what DPT (Doctor of Physical Therapy) students think of learning about Interprofessional Education. The study that was conducted asked students to freely express their opinions about what their opinions were of IPE exercises (Costello et. al. 2). The overall theme of the findings in the study were that students supported it. In the article, Costello et. al. Reflects on the feedback from the students, “These feelings indicate that IPS increased stu- dent knowledge of the role of other health professions, and thus may improve their ability to work in an interprofes- sional team” (Costello et. al. 2). The article also discusses the fact that these exercises allow students be more confident in themselves in practice (Costello et. al. 2). This study provides support to the hypothesis that IPE experiences are beneficial for DPT students by presenting overall opinions regarding this subject.

The next sources look at DPT student experiences as well but look at studies regarding specific IPE experiences. In the article “Students’ motivation for interprofessional collaboration after their experience on an IPE ward: A qualitative analysis framed by self-determination theory.”,  Cora LF Visser et. al. conduct a study where multiple health professional students are put in a IPE ward and are to work as a team to care for real patients (Visser et. al. 2). Students were then interviewed on their experiences in the IPE ward and those respeonses were used as the data for this study (Visser et. al. 3). The journal discusses the outcome of the study, “From the ana- lysis of the interviews with the students and the supervisors, we conclude that it was the overall set-up of the IPE ward that enhanced the autonomy, not simply the responsibility or type of supervision (Visser et. al. 7). This shows the significance of these IPE exercises and how they build good teamwork skills for future health professionals. The article also looks at how this study specfically benefited for DPT students, “For the physical therapy students and the pharmacy students: their professional per- spective was relatively unknown to the other students. Being able to add their professional insights in the patient- care meeting added to their feeling of competence and autonomy, because they could offer information rather than wait for the question or consultation” (Visser et. al. 7). Since other health professionals were not as educated in what the Physical Therapy Students jobs were, it shows the importance of having these activities. By doing this, everybody is more educated on what each other’s jobs are so that when they go into a professional environment, they are more prepared.

The article “Does Mode Matter? Perception of Student Competence Following an IPE Communication Experience.” by Sherman, Erica, et al. also looks at a specific IPE experience with Health professional students. In the article they discuss the test that was used for this study, “The Interprofessional Collaborative Competencies Attainment Survey-Revised (ICCAS-R) was used to gather data about students’ perceived competency both before and after the communication activ- ity” (Sherman et. al. 2). This test was used before and after the IPE study was conducted. (Sherman et. al. 2). The results of the study presented an increase in scores for ICCAS-R after the IPE experience in both audio and video setting (Sherman et. al. 4). This study is significant because it shows that just by having one IPE experience, health professional students can gain so much knowledge about the rest of the health field. A common theme between studies is that many health professionals do not fully understand the job of a Physical Therapist. By having more activities throughout all health profession programs, it can allow more students to have knowledge of what a Physical Therapist does so that they can value their input and knowledge when it comes to a real-life practice setting.

There are many diverse components of the career of Physical Therapy and in the context of literacy. Writing is used on a daily basis when making progress reports and evaluation notes. Communication between the Physical therapist and the patient is a crucial factor in the job and can dictate the quality of care for the patient. It is also important to be able to communicate and have knowledge of the other health professionals that you are working with when a patient has a particular health issue. The best way to do this is through interprofessional education and doing activities where the medical professionals are together for a common goal. The foundation of the medical field is teamwork. These professionals have to put themselves aside to work toward the common goal which to give the patient the best care possible. Without communication and understanding the big picture of the job, the result will be inadequate quality. People who choose Physical Therapy are caring, knowledgeable, and are good problem solvers. They can use these qualities in a teamwork setting to improve the efficiency and effectiveness of the medical field overall.

Works Cited

Costello, Margaret, et al. “Student experiences of interprofessional simulation: findings from a qualitative study.” Journal of Interprofessional Care32.1 (2018): 95-97.

Fraticelli, Tim. “Physical Therapy Assessment Documentation: 3 Tips & Examples”, PTProgress,https://www.ptprogress.com/therapy-assessment-documentation/

“How PT, OT Work Together to Help Memorial Regional Health Patients Heal”, memorial regional health, https://memorialregionalhealth.com/health-topics/primary-care-general-health/pt-ot-work-together-help-memorial-regional-health-patients-heal/

Lakke, Sandra, et al. “The Added Value of Therapist Communication on the Effect of Physical Therapy Treatment in Older Adults; a Systematic Review and Meta-Analysis.” Patient Education and Counseling, Jan. 2018. EBSCOhost, doi:10.1016/j.pec.2018.09.020.

“Physical Therapist Management of Patients With or Recovering From COVID-19″, American Physical Therapy Association, https://www.apta.org/patient-care/public-health-population-care/coronavirus/management-of-patients

Sherman, Erica, et al. “Does Mode Matter? Perception of Student Competence Following an IPE Communication Experience.” Journal of Interprofessional Education & Practice, vol. 21, Dec. 2020. EBSCOhost, doi:10.1016/j.xjep.2020.100363.

Visser, Cora LF, et al. “Students’ motivation for interprofessional collaboration after their experience on an IPE ward: A qualitative analysis framed by self-determination theory.” Medical teacher41.1 (2019): 44-52.

“6 Different Types of Physical Therapy”, Movement for Life Physical Therapy, https://www.movementforlife.com/blog/6-different-types-of-physical-therapy.php