% (n) | |
---|---|
Time dedicated to oncology practice in a full-time week | |
0%-25% | 8.8% (5) |
26%-50% | 17.5% (10) |
51%-75% | 7.0% (4) |
76%-100% | 66.7% (38) |
Primary work setting | |
Acute care | 31.6% (18) |
Inpatient rehabilitation facility | 1.8% (1) |
Skilled nursing facility/long-term care | 0.0% (0.0) |
Outpatient | 63.2% (36) |
Patient's home/home care | 1.8% (1) |
Other: Academic teaching | 1.8% (1) |
Health care center of primary employer | |
Rehabilitation department in hospital or health system (nonacademic) | 36.8% (21) |
Rehabilitation department in hospital or health care system (academic) | 33.3% (19) |
PT department in an academic setting | 7.0% (4) |
Non-PT department in an academic setting | 0.0% (0) |
Cancer center in a hospital of health care system | 15.9% (9) |
Private rehabilitation practice | 0.0% (0) |
Private oncology practice | 3.5% (2) |
National rehabilitation company | 1.8% (1) |
Health and wellness facility | 0.0% (0) |
Industry | 0.0% (0) |
Research center | 0.0% (0) |
Other: Home health | 1.8% (1) |
APTA academy or section membership | |
Acute care | 16.2% (16) |
Aquatic | 1.0% (1) |
Cardiopulmonary | 1.0% (1) |
Clinical electrophysiology and wound Management | 0.0% (0) |
Education | 4.0% (4) |
Federal | 0.0% (0) |
Geriatric | 3.0% (3) |
Hand | 0.0% (0) |
Health policy and administration | 3.0% (3) |
Home health | 0.0% (0) |
Neurologic | 2.0% (2) |
Oncologic | 91.2% (52) |
Orthopedic | 5.1% (5) |
Pediatric | 1.0% (1) |
Private practice | 0.0% (0) |
Research | 2.0% (2) |
Sports | 0.0% (0) |
Pelvic health | 6.1% (6) |
None of the above | 3.0% (3) |
Hold other ABPTS specialty certifications | |
Geriatric | 4.6% (2) |
Neurologic | 2.3% (1) |
Geriatric | 4.6% (2) |
Women's health | 4.6% (2) |
None | 88.6% (39) |
Does your facility have an oncology residency program? | |
We have an accredited residency program | 14.8% (8) |
We have a residency program that is not yet accredited | 3.7% (2) |
We are actively developing a residency program | 5.5% (3) |
We are investigating the development of a residency program | 18.5% (10) |
We are not considering a residency program currently | 57.4% (31) |
Provide patient consultations or treatment in the physical space of a cancer center ( = .026) | |
Yes | 52.6% (30) |
No | 47.4% (27) |
Percentage of professional work time spent specific to oncology: | |
Patient care | 71.0 (±30.7) |
Academic teaching | 6.4 (±16.9) |
Research | 1.7 (±4.8) |
Student mentorship | 4.8 (±8.4) |
Professional roles related to oncology (eg, tumor board) | 14.3 (±23.4) |
Figure 1 illustrates the clinical specialists' practice location, by zip code, including designations of rurality. Distribution of the respondents favors coastal regions and larger metropolitan areas. Three practice settings were in United States Department of Agriculture Rural-Urban Continuum Codes designated rural counties.
On average, 71% (SD ± 30.7) of the OncPT respondents' weekly work time is spent in a clinical role providing patient care; 14% (SD ± 23.4) of time is devoted to professional service activities that include tumor boards or oncology program development. Time dedicated to academic teaching was 6.4% (SD ± 16.9), 4.8% (SD ± 8.4) to student mentorship, and 1.7% (SD ± 4.8) to research. Figure 2 outlines the ways in which specialists are working to maintain their specialty knowledge and skills.
Eighty-three percent of respondents reported receiving some form of recognition from employers ( Figure 3 ). The majority of respondents (n = 31) reported that board specialty certification resulted in recognition by their employer, while 8 respondents received changes either in their job responsibilities or their title without monetary compensations. Only 3 respondents received increases in their salary and 2 received a bonus.
Job responsibility changes described by respondents included oncology-specific program development and leadership, residency program development, teaching, developing specialty clinics or classes for cancer survivors, developing care transition pathways across settings, and leading specialty groups to develop cancer care best practices. Figure 4 identifies the oncology-specific professional activities, reported as job responsibilities, that respondents had taken on in their work setting since becoming specialists.
Table 3 outlines oncology-specific professional roles that respondents identify as part of their job duties. The most common roles include leadership roles within their facility (n = 25), developing and providing cancer rehabilitation educational programs for other health care providers (n = 24), and serving as an entry-level clinical instructor (n = 19). Five individuals reported that they are actively developing residency programs and 10 indicated actively investigating residency program development. Thirty-one percent (n = 18) reported serving on an oncology-related committee at their facility.
Oncologic PT Roles | % (n) |
---|---|
Scholarship and teaching | |
Presenting at PT national and international conferences | 22.8% (13) |
Presenting at PT state and local conferences | 22.8% (13) |
Presenting at multidisciplinary oncology conferences | 24.6% (14) |
Authoring oncology-related manuscripts | 17.5% (10) |
Performing journal reviews | 10.5% (6) |
Oncology residency course teaching | 10.5% (6) |
Oncology residency clinical mentor | 15.8% (9) |
Research mentor | 0.0% (0) |
Conducting research | 14.0% (8) |
Entry-level clinical instructor | 33.3% (19) |
Developing and providing cancer rehabilitation educational programs for other health care providers | 42.1% (24) |
Professional service | |
Serving on a committee for the Academy of Oncologic Physical Therapy | 22.8% (13) |
Serving in a leadership position for the Academy of Oncologic Physical Therapy | 12.30% (7) |
Serving on a committee for a multidisciplinary oncology organization | 8.8% (5) |
Serving in a leadership position for a multidisciplinary oncology organization | 10.5% (6) |
Serving on a committee with an international oncology rehabilitation organization | 0.0 (0) |
Serving in a leadership role with an international oncology rehabilitation organization | 1.8 (1) |
Serving on an oncology-related committee at your facility | 31.6% (18) |
Serving in a leadership position in your facility | 43.9% (25) |
Community service | |
Developing community programs for cancer rehabilitation education targeting patients and caregivers | 31.6% (18) |
Advising on state policy issues regarding cancer rehabilitation | 0.0% (0) |
Advising private payers on issues regarding cancer rehabilitation | 0.0% (0) |
Advising on federal policy issues regarding cancer rehabilitation | 0.0% (0) |
Membership in cancer-specific organizations | |
American Society of Clinical Oncology (ASCO) | 17.14% (6) |
American Society for Radiation Oncology (ASTRO) | 0.0% (0) |
American Association for Cancer Research (AACR) | 2.9% (1) |
Association of Community Cancer Centers (ACCC) | 0.0% (0) |
International Society of Geriatric Oncology (SIOG) | 0.0% (0) |
Oncology Nursing Society (ONS) | 5.7% (2) |
Academy of Oncology Nurse & Patients Navigators (AONN) | 0.0% (0) |
American Congress of Rehabilitation Medicine Cancer Rehabilitation Networking group | 5.7% (2) |
State Cancer Coalition | 0.0% (0) |
American College of Sports Medicine | 8.6% (3) |
Lymphology Association of North America (LANA) | 42.8% (15) |
International Physical Therapists for HIV/AIDS, Oncology, Hospice and Palliative Care | 0.0% (0) |
National Hospice and Palliative Care Organization (NHPCO) | 0.0% (0) |
Other: | 10.5% (6) |
1. None | (n = 3) |
2. CAPC | (n = 1) |
3. NCCN | (n = 1) |
4. ABWM | (n =1) |
The respondents primarily reported participating in physical therapy–specific national and local conferences and service to the Academy of Oncologic Physical Therapy. Fewer respondents reported participation or leadership in multidisciplinary oncology organizations and only 1 reported committee engagement or leadership with an international oncology organization.
Eighteen respondents reported engagement in community education efforts for patients and caregivers; however, in terms of other societal-level roles, only 1 respondent reported participation in advising State or Federal policy or payer groups.
Cancer rehabilitation is a practice area of increasing importance in cancer care delivery and one with a growing evidence base. The OncPTs are an emerging cohort of clinical care providers that support cancer treatment planning and delivery. While the primary focus of the specialization is on clinical practice, there are professional roles and responsibilities that the OncPT must play specific to cancer care delivery These roles extend beyond the rehabilitation care delivery setting and beyond what may be considered historically as key roles for a OncPTs. This survey is the first to assess the professional roles of the first 2 cohorts of individuals who have achieved the designation of OncPT.
At the level of the rehabilitation clinical practice setting, specialists reported oncology-specific program development across 3 themes: (i) workforce development efforts such as mentoring and teaching peers and staff in oncology-specific content; (ii) establishing clinical practice guidelines that include standardizing assessment tools and clinical pathways to predict outcomes; and (iii) conducting clinical program assessment through quality improvement projects and research. These capacity-building efforts are requisite and could be considered foundational principles to guide the development and sustainability of a specialty practice line in a physical therapy clinical setting.
The descriptive results suggest that while OncPTs are serving rehabilitation-centric clinical, administrative, and teaching roles, they may not be engaging as commonly in cancer care delivery at the health system level. This is a notable gap considering the rehabilitation specialist's role on system-level cancer committees and cancer care delivery–specific engagement. New accreditation standards for rehabilitation services, put forth by the American College of Surgeons Commission on Cancer, 4 and a recent report from the National Academies of Health workshop report on long-term survivorship 11 call for better integration of rehabilitation into cancer care delivery. Engaging with the cancer care delivery system not only puts rehabilitation providers at the interface of care with the patient but also solidifies their role on cancer multidisciplinary teams, an important place for the OncPT's insights to be shared to contribute to cancer care outcomes.
Multidisciplinarity in cancer care extends beyond the traditional rehabilitation team and requires the OncPT to step into roles more aligned with the cancer care delivery system. This includes applying clinical knowledge and expertise to inform tumor board decisions and cancer care plan development, advising in patient navigation and supportive care delivery, as well as serving as a consultant to oncology administrative and care delivery pathways, and representation in key accreditation roles.
Engaging in these avenues of cancer care delivery requires the OncPT to take a different approach to applying his or her knowledge and skills as a specialist. Rather than addressing cancer treatment–related physical and functional impairment through reactive, referral-based care models, the field of oncology rehabilitation leverages prehabilitation and prospective surveillance clinical models to proactively engage the rehabilitation provider in cancer care delivery. 9 , 12–16 This is unique to cancer care, deviating from how a physical therapist commonly functions in a traditional clinic setting, and requires rehabilitation administrative policies that enable better engagement with the cancer care delivery system. 17 Colocated supportive care services in cancer care improve patient satisfaction and may improve costs associated with chemotherapy delivery. 18 Cancer navigation, a specific workflow of cancer care coordination, improves timeliness and efficiency in providing services to patients with supportive care needs. 19 Calls have been made for cancer rehabilitation specialists to participate as members of the oncology care team 20 and to participate broadly in translational research and policy efforts to influence cancer care delivery. 7 , 14 , 21 , 22 To an extent, the OncPT is qualified to engage with the cancer care team beyond a clinical role to influence the cancer care delivery system in their setting.
The gaps identified in this study were primarily at the societal level where OncPTs are currently rarely serving in professional roles that advise and advocate in matters of cancer care policy and payer guidelines. The complex needs of society, such as those resulting from a sedentary lifestyle, beckon for the physical therapy profession to engage with consumers to reduce preventable health care costs and overcome barriers to participation in society to ensure the successful existence of society far into the future. While this is APTA's vision for the physical therapy profession, it is meant also to inspire others throughout society to create systems that optimize movement and function for all people. This report illustrates the roles OncPTs are fulfilling; however, work remains to enhance effect of these specialists on the multidisciplinary cancer care and the community. Enhancing the effect of these new specialists to improve cancer care will require additional resources to support these expanded responsibilities.
OncPT is a new area of board certification with only 106 current specialists in the United States. These data represent only 53% of the current cohort of clinical specialists and should be interpreted with this awareness. Although the survey enabled open-ended responses for many questions, respondents may not have fully described their professional roles. Distribution of the survey online and for a short period was further limitation that could have limited participation. It is worth noting that this survey was distributed during the COVID-19 pandemic, a challenging time for practicing clinicians, which may have influenced the availability and ability of practicing therapists to respond to the survey.
Using the socioecological model as a framework, we suggest multilevel stakeholder interventions that can promote oncology specialists' engagement in the professional roles associated with cancer care ( Table 4 ). 23 , 24 We suggest that these interventions can be used by any individual clinician, administrator, or health care system that is interested in developing a service line in cancer rehabilitation. Program development, even in the absence of a board-certified clinical specialist, is suggested to improve rehabilitation service integration into cancer care. Programs in cancer rehabilitation can be implemented to varying degrees based on the workforce knowledge and skills and interest. Using a 4-level framework 25 and guiding principles identified by working groups in the United Kingdom, 26 rehabilitation staff can begin to develop a clinical service line for oncology rehabilitation.
Individual OncPT Level | Clinical Administrative Level | Cancer Care Delivery System Level | Societal Level |
---|---|---|---|
What | |||
Awareness of cancer-related committees and development opportunities. Participation in cancer-specific professional organizations and societies. Cancer-specific professional development. Oncology education in local DPT/PTA programs. | Dedicated workforce and clinical infrastructure that supports cancer rehabilitation as a service. Dedicated program development time and resources for program development. Policies that enable engagement at the cancer care delivery system level. A career development pathway unique to the OncPT. Facilitate models of training for staff development. | Engagement of the rehabilitation provider in cancer care planning and intervention. Including rehabilitation providers in quality improvement projects. Cost and utilization analysis. Quality of life and outcomes assessment. | Community-based patient and caregiver educational programs. Payment policies for rehabilitation services. Regulatory policy at state and federal levels to reduce barriers to access. Accreditation and quality standards that promote guideline concordant care. Guideline and best practice development. |
How | |||
Attending oncology grand rounds and other scientific or professional educational forums that bring together interdisciplinary cancer care perspectives. Participate in clinical inquiry and research through data collection and collaboration on writing grants, serving as an advisor to quality improvement initiatives. Dissemination of cancer rehabilitation guidelines and evidence to cancer care interdisciplinary groups to highlight the role of rehabilitation. Seeking and providing mentorship opportunities within physical therapy and beyond through multidisciplinary engagements with navigators, nurses, physicians, and other providers. Actively participate in oncology-specific societies and professional associations. | Develop a career ladder with salary/bonus incentives that augment progressive leadership roles. Provide resources for residency program development. Provide protected time for program development and adapt productivity standards as necessary. Actively promote the OncPT to serve on administrative policy committees that inform cancer care delivery. | Functional assessment findings provided at tumor board discussions to inform plan of care. Advising cancer service lines on appropriate functional measures and patient-reported outcomes measures. Supporting policy development that includes proactive supportive care models in cancer care delivery. | Engaging in patient advocacy efforts. Participating in professional societies and organizations that develop positions and policies on cancer care. Community-based patient and stakeholder education initiatives. Participating in guideline development work. |
Considering that the OncPT specialty is new, these data represent the beginning of program and professional development for specialists in this field. Future cohorts of clinical specialists could be surveyed to better understand how the professional roles of the specialist change as the field matures.
Oncology practice is strongly influenced by policy, specifically accreditation standards, clinical practice guidelines, quality initiatives, and payment policy. 17 , 18 , 27 Physical therapists in oncology practice need to be aware of prevailing policy changes and should seek to position themselves to influence policy at the clinic, health care system, and societal levels. Enhanced participation in oncology-specific professional societies and associations can improve awareness of policy issues and enable engagement of OncPTs to influence policy changes.
This is the first report of the demographics and professional roles of the OncPT. Our study demonstrates that physical therapists with the oncologic clinical specialist designation practicing in the United States have the potential to leverage their expertise on multiple levels to enhance cancer care outcomes and advocate for the advancement of OncPT professionals across the continuum of care and beyond.
* West Virginia University Institutional Review Board approved. Protocol number 2104299359.
† https://www.qualtrics.com/ Qualtrics LLC, Provo, Utah. IBM SPSS, Armonk, New York, 10504.
advanced practice; cancer rehabilitation; oncology; physical therapy; professional competencies; professional roles
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HOD P06‐19‐76‐42: APTA supports rigorous scientific inquiry as an essential requisite for developing and advancing the physical therapy profession.
Date: September 20, 2019 Contact: [email protected] Content Type: Policies & Bylaws
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The Foundation for Physical Therapy Research funds research and develops researchers to optimize movement and health. Celebrating more than 40 years as an independent 501(c)(3) charitable organization, FPTR has funded more than $23.4 million in research grants, scholarships, and fellowships. SUPPORT OUR WORK.
The Research Agenda for Physical Therapy expands on our profession's continued advancement and considers current issues, new innovations, and forward-thinking viewpoints. The research agenda outlines research priorities that are vital to advancing physical therapist practice and the profession. The development of the research agenda included ...
National Benchmarks to Understand how Doctor of Physical Therapy Learners from Minoritized Race and Ethnicity Groups Perceive their Physical Therapist Education Program ... Equity, Inclusion, and Antiracism Research in Physical Therapy over the Last 25 Years: A Scoping Review . News From the Foundation for Physical Therapy Research, May 2024 ...
The Foundation for Physical Therapy Research funds research and develops researchers to optimize movement and health. Celebrating more than 40 years as an independent 501(c)(3) charitable organization, FPTR has funded more than $23.4 million in research grants, scholarships, and fellowships.
PTs reflect on changes in research and their potential impact on the future of the profession. Feature. Date: Wednesday, September 1, 2021. Author: Keith Loria. Physical therapy research has come a very long way over the 100 years since APTA's founding. Research has helped to make the profession vital in the eyes of the health care community ...
The Foundation for Physical Therapy Research funds research and develops researchers to optimize movement and health. Celebrating more than 40 years as an independent 501(c)(3) charitable organization, FPTR has funded more than $23.4 million in research grants, scholarships, and fellowships.
Research in the discipline of physical therapy has grown rapidly over the last 20 years, reflected in the exponential growth of randomized clinical trials (RCTs). 16 Unfortunately, there is often a substantial delay in implementing interventions with positive clinical effects on patient outcomes. 11 Delayed or absent implementation may occur if interventions cannot be fully replicated due to ...
Abstract. Research agendas play an important role in directing scholarly inquiry in a field. The Research Agenda for Physical Therapy From the American Physical Therapy Association (APTA) outlines research priorities that are vital to advancing physical therapist practice and the profession. The development of the research agenda included ...
Physical Therapy research participation involves working with patients having a wide range of rare diagnoses. Physical Therapy assessments may include muscle strength, range of motion, cardiopulmonary function, gait, pain, posture, foot and ankle alignment, edema, and pediatric developmental patterns. Physical therapists participate in protocol ...
Our studies investigate the effectiveness of physical therapy-related interventions in patients with musculoskeletal and neuromuscular disorders throughout the lifespan. We also lead health services research on management of chronic conditions and delivery of value-based care. The reputation of our research spans over three decades and has ...
Physiotherapy Research International ( PRI) is a multidisciplinary journal published 4 times per year. It aims to publish high quality and impactful articles dedicated to specialist areas of physiotherapy theory, practice, and research. Further, we aim to publish papers that represent the range of cultures and settings where physiotherapy ...
Congratulations on making the decision to pursue board certification under the APTA Specialist Certification Program governed by ABPTS. ... Foundation for Physical Therapy Research; PTPAC; 3030 Potomac Ave., Suite 100 | Alexandria, VA | 22305-3085 800-999-2782, ext. 8520. For Advertisers ...
This in-person (face-to-face) program is designed to develop research scientists in rehabilitation and movement science across the spectrum of research from pre-clinical to clinical to implementation. Areas of research focus may include: musculoskeletal health and disorders, neuromuscular health and disorders, biomechanics, movement science.
Physical Therapy Research (PTR) is an official journal of the Japanese Society of Physical Therapy. This peer-reviewed international journal focuses on research in physical therapy and related fields (previously Journal of the Japanese Physical Therapy Association (JJPTA)). Article types accepted are: Scientific Research Articles (Original ...
The Foundation for Physical Therapy Research is an independent 501 (c) (3) governed by a Board of Trustees. Our work would not be possible without the guidance and expertise of an extraordinary group of volunteers who serve on our board and those who serve on special committees. Many have first-hand experience as past recipients of Foundation ...
ect aims to assess the professional roles that OncPTs play in cancer care delivery. Methods: A 27-item survey was developed by the Oncologic Specialty Council of the American Board of Physical Therapy Specialties and sent electronically to board-certified oncologic clinical specialists in the United States. The survey was open for 45 days. Demographics of the population and frequency data were ...
Pediatric Clinical Specialist (PCS) Pediatric specialists develop treatment plans for conditions specific to young children and teens including cystic fibrosis, autism, Down's Syndrome, and more. A therapist can further fine-tune their clinical expertise by choosing to work with a certain age group such as newborns.
The directory of board-certified specialists is a portal in which consumers, PTs, PTAs, and other health care professionals can find board-certified physical therapists. ... Foundation for Physical Therapy Research; PTPAC; 3030 Potomac Ave., Suite 100 | Alexandria, VA | 22305-3085
Finding Physical Therapy Literature. Article. Date: Monday, March 23, 2020. Keeping up to date on evidence-based practice requires finding and accessing physical therapy literature. No single database or website provides access to every journal or magazine article ever published. So here are some places to start your research quest.
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Why Specialist Certification. Join over 30,000 physical therapists who have earned certification since 1985. Increase your earning potential: Recent APTA reports show that board-certified clinical specialists earned, on average, $4,540 more annually than PTs who are not board certified. Enhance your professional growth and open doors to new ...