FAY EDSALL, MEd, RICHARD DARNELL, PhD, JOHN IVANOFF, BS, and KAREN KOBUS, BS

A procedure for facilitating research by physical therapists in a multidimensional practice setting is presented. The article addresses the need for physical therapists to be aware of research opportunities, and provides them with a means for action when such opportunities occur. The developmental sequence of events is described starting with conceptualization and moving through current utilization of the procedure.

Physical therapists need to undertake research activities within clinical and academic divisions of the profession. A number of articles related to the topic of research published in PHYSICAL THERAPY in the 1970s indicates a recognition of this need. 1 - 4 Perhaps physical therapists are hampered in their pursuit of these activities by insufficient knowledge of guidelines and procedures. Physical therapists at the University of Michigan (U-M) designed proce­ dures to meet this need. The procedures which are described were mutually formulated by U-M physi­ cal therapists from the University Hospital. Chelsea Medical Center, Mott Children's Hospital, the Insti­ tute for the Study of Mental Retardation and Re­ lated Disabilities (ISMRRD), and the university's academic program. Development of the overall plan, from conceptualization through evaluation, covered a period of two years, from June 1974 to July 1976 (Tab. 1). BACKGROUND Four physical therapists elected by peers and rep­ resentatives of both clinical and academic programs Ms. Esdall is an Instructor in the curriculum in Physical Ther­ apy, University of Michigan, Ann Arbor, MI 48109. Dr. Darnell was the Program Director of the Institute for the Study of Mental Retardation and Related Disabilities, University of Michigan, when this study was conducted. He is currently Direc­ tor of the curriculum in Physical Therapy, University of Michigan, Ann Arbor, MI 48109. Mr. Ivanoff is a staff physical therapist at the University of Michigan Medical Center, Ann Arbor, MI 48109. Ms. Kobus, a staff physical therapist at the University of Michi­ gan when this study was conducted, is currently at Guy's Hospital, London SE-1-9RT, England.

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A Procedure for Facilitating Physical Therapy Research

met in January 1975 to formulate a Physical Ther­ apy Research Committee (PTRC). The efforts were endorsed by the Chairman of the Department of Physical Medicine and Rehabilitation. The purpose of the committee was to design a plan, and establish procedures, which would augment the efforts of those physical therapists who wished to pursue re­ search activities. The committee selected a chairman, secretary, and additional committee members when they met in January. The positions were filled for the dura­ tion of the two year developmental period; commit­ tee members were required to attend at least four meetings annually. Committee meetings were open to all interested physical therapists. Clinical and academic divisions agreed to provide equipment and secretarial support when needed. During the plan­ ning stage, directors of all participating clinical and academic divisions were contacted to determine and ensure their degree of support for the plan. The goals established by the committee were to 1) serve as a liaison between physical therapists and their department administration in order to encour­ age the participation of department personnel; 2) assess and disseminate information of specific inter­ est to staff physical therapists; 3) provide technical assistance to physical therapists, for example, litera­ ture search methods, data analysis, dissemination of findings, creation of a data file, and methods of acquiring financial support; 4) provide feedback to physical therapists regarding committee activities; 5) help therapists assess their own function and accomplishments; and 6) serve as a liaison with other related research groups. PHYSICAL THERAPY

Conceptuali­ zation June 1974

Planning

Implementation

Evaluation

January 1975 January 1975 October 1975 January 1976

May 1976

Endorsement of PTRC by the Chair­ man of Physical Medicine and Reha­ bilitation Election of Physical Therapy Formulation Represent­ and testing atives of interest and exper­ tise survey Selection of secretary and chair­ man Recognition Contact with of need for directors of research ac­ clinical and faculty tivities compo­ nents

Current Utili­ zation June 1976

July 1976 and on going

Consultation in the de­ velopment of research projects

Inservice training and work­ shop Distribution of feedback question­ naire and assessment of data re­ ceived

Compilation and distri­ bution of interest and expertise list Distribution of commit­ tee minutes

Interaction with Physi­ cal Medi­ cine and Rehabilita­ tion Re­ search Committee

Establishment Establishment of prelimi­ of central nary goal reference and pur­ file pose of Physical Therapy Research Committee

Compilation and distri­ bution of annual re­ port

METHOD AND RESULTS

some aspect of research and 55 percent were inter­ ested in becoming involved. Survey results showed the range of interest to be broad; 34 areas were identified. Those mentioned most frequently were teaching, chest physical therapy, pediatrics, burns, and administration (Tab. 2). Many therapists showed multiple interests. Eighteen areas of indi­ vidual expertise were identified (Tab. 3). When the results of the survey were compiled, lists matching the names of people whose interest and experiential expertise coincided were distributed to all partici­ pants. Committee members were each given copies of the survey results and all related data; this informa-

Implementation of the goals started with a survey to assess the interests and expertise of U-M physical therapists. The survey was designed to determine professional preparation and experience, interest in future research, areas of specialization, professional interest, and how the PTRC could help respondents in their pursuit and publication of clinical or aca­ demic research. Thirty-eight questionnaires were distributed and 30 were returned, a response rate of 79 percent. Results showed that 20 percent of the physical ther­ apists who responded were currently involved in Volume 57 / Number 10, October 1977

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TABLE 1 Developmental Sequence of Events

TABLE 2 Areas of Research Interest Identified by 30 Physical Therapists

TABLE 3 Areas of Expertise Identified by 30 Physical Therapists Areas of Expertise Identified (18) Administrative Surveys and Physical Ther­ apy Support Surveys Chest Physical Therapy Child Development Cardiopulmonary Rehabilitation Editing Geriatrics Hemiplegic Gait Legislative Activity Literature Search Media Productions Methodology Analysis and Implication Orthopedics (Total Hip Replacements) Pediatric Chest Physical Therapy Physical Therapy in Burn Care Prepared Childbirth Rehabilitation Treatment of Cerebral Palsy Wheelchair Prescription in Spinal Cord In­ jured Patients

Number of Participants/ Area

J 22

Areas of Interest Identified (34) Administration Arthritis Burns Cerebral Palsy Cerebral Vascular Accidents Chest Physical Therapy Community Health Care Delivery Consultation Delivery Systems and Service Manage­ ment Developmental Disabilities Early Intervention Electromyography General Clinic Geriatrics Growth and Development Hemiplegia Interdisciplinary Function Management by Objectives Media Production and Use Mental Retardation Multiple Sclerosis Neurology Orthopedics Parent Training Pediatrics Prosthetics Rehabilitation Sensory Evaluation Spinal Cord Injured Patients Standards of Practice Supervisory Management Teaching Wheelchairs Whirlpool and Wounds

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Number of Par­ ticipants/Area 3 1 3 1 1 6 1 1 1 1 2 1 1 2 1 1 1 1 1 1 1 2 2 1 5 1 1 1 1 1 2 7 1 _1 58

No Specific Area of Expertise Identified

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tion was also filed in the office of the committee secretary. Committee members wrote summary re­ ports of all action taken to date; these reports were either posted or discussed with participating clinical and academic personnel. The PTRC distributed an annual report in Janu­ ary 1976 to involved administrative, clinical, and academic divisions. Included in the report were a summary of the committee meetings and activities, membership composition, short and long-term goals, and reference to assistance received from the Division of Research Development and Administra­ tion (DRDA). The DRDA is the administrative office of the Vice President for Research on campus. It provides activities in support of the Office of Academic Affairs in the areas of research, training, program development and publications, relation-

ships with industry, and administrative services. An addendum to the report contained copies of the bylaws, questionnaires, data analysis, correspond­ ence with administrators, lists of financial and tech­ nical resources, local resource people, and a listing of the professional work in which participating phys­ ical therapists were involved. Survey findings established major areas of research-related interest held by the respondents. Based upon these findings, a sequence of three inservice meetings and a workshop were scheduled in May 1976 for all members of the Physical Medicine and Rehabilitation Department. The first meeting provided an overview of research. A member of the academic program spoke on the skills necessary for initiating research and described common ap­ proaches to research. Skills required for data collec­ tion, data analysis, and writing articles were briefly summarized. The second meeting was led by a representative from DRDA who reviewed some of the financial and technical resources available through the var­ ious divisions of the University, and of state, and federal governments. The third meeting was led by a member from the University's Committee to Re­ view Grants for Clinical Research and Investigation involving Human Beings who spoke of the protocol used to review proposed research projects. These three meetings provided the groundwork PHYSICAL THERAPY

for physical therapists to participate in a workshop. The participants were divided into groups, contain­ ing five or six people, in order to stimulate discus­ sion of the actual stages of a research project. These stages included identification of a researchable proj­ ect, selection of the process most suitable for re­ searching this problem, determination of an appro­ priate source for funding, determination of any re­ strictions on the use of human subjects, and selec­ tion of a group member to present a summary to all. The small groups used a research oriented group leader who was able to guide members through each task. Following the workshop, the therapists were asked to complete a feedback questionnaire, de­ signed by the PTRC. Participants agreed that the workshop was a valuable experience. Seventeen of those completing the questionnaire, 89 percent, wanted research to continue. Future topics sug­ gested by participants included further identification and formulation of good research problems, review and interpretation of basic statistical methods for use in research projects, and evaluation of research done and reported in PHYSICAL THERAPY . Fortyseven percent of the respondents wanted to have seminars dealing with the components of research

theory and methodology and indicated a desire to use the PTRC on a consultative basis.

As a result of the work undertaken by the PTRC the members have become involved in many activi­ ties. 1. Members have been asked to act as consultants in the development of three research projects. These projects varied widely; the first deals with intractable pain, the second with spinal cord in­ juries, and the third with handicapped children from a statewide 4H program. It is anticipated that improved patient care will result. 2. A member of the PTRC has been asked to repre­ sent physical therapy within the Physical Medi­ cine and Rehabilitation Research Committee, a group composed of selected medical faculty, house officers, senior engineering faculty, occu­ pational therapists, physical therapists, speech therapists, orthotists, prosthetists, and repre­ sentatives from biomedical research (Figure). 3. Administrators within the physical therapy divi­ sion have used the PTRC members in depart­ mental inservice programs on seven occasions in the last year.

Sources of Support

Resources

Physical Therapy Academic Program

Physical Medicine and Rehabilitation Administration

PHYSICAL THERAPY RESEARCH COMMITTEE

Physical Therapy Clinical Services

Physical Medicine and Rehabilitation Research Committee

Physical Therapy Specialized Institute (ISMRRD) Committees to Review Grants for Clinical Research and Investigation Involving Human Beings

Utilization and Impact Community Services MSU 4H, Cheff Center, and Special Educators

Patient Care Projects Pain Accessibility

Inservice Education Programs Research

Division of Research Development and Administration

Acting Director, Hospital

Figure. Representation of components involved in procedure designed to facilitate physical therapy research.

Volume 57 / Number 10, October 1977

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UTILIZATION OF COMMITTEE

DISCUSSION AND CONCLUSIONS The process and procedures which have been described may be useful in facilitating the creative efforts of physical therapists employed in similar settings and can be modified to accommodate spe­ cialized needs. Although the PTRC was initially

developed as a mechanism for increasing scholarly endeavor, activities of the members have been found to be of value in reducing disparities between "clinical" and "academic" groups. Clinically ori­ ented therapists have found local resources for as­ sistance and support which will augment their prac­ tical, field-research efforts. In addition to enhancing cooperation and sharing of knowledge, participating physical therapists employed at the U-M have be­ come aware of a process available to them to en­ hance the accomplishment of research goals. A sampling of 30 physical therapists identified 58 areas of interest and 22 areas of expertise indicating both the breadth of intellectual curiosity, the depth of capabilities, and involvement within the profes­ sion. Other fruitful outcomes are the recognition and support of other health professionals of the efforts of physical therapists who wish to participate in research.

REFERENCES Research, Statistics, and Communications: An Anthology. Washington, DC, The American Physical Therapy Associa­ tion, 1977 Eruiti VF, Scott M: Research design and statistics in an under­

graduate physical therapy curriculum. Phys Ther 54:256-259, 1974 3. Gonnella C: What's the answer? Phys Ther 53:566-568, 1973 4. Griffin JE: What's the answer? Phys Ther 50:259, 1970

Our newest anthology consists of articles published in the Journal on Research, Statistics, and Communications. One source for the best in reference material to assist researchers and writers in pre­ paring for publication. This anthology was introduced at the Combined Sec­ tions Meeting in Phoenix and sales were brisk! Paper, 138 pp, $5.00 ppd. Make check payable to APT A, 1156 15 th Street NW, Washington, DC 20005.

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4. Community service has been augmented by com­ mittee members participating in the Michigan State University 4H program with the Cheff Center for the Handicapped in which numerous Special Educators are involved in an attempt to determine the effects of horseback riding on orthopedically handicapped children. So that the positive results from the PTRC con­ tinue to accrue, regular meetings still occur as the committee tries to implement requests and sugges­ tions taken from the feedback questionnaire.

PHYSICAL THERAPY

A procedure for facilitating physical therapy research.

FAY EDSALL, MEd, RICHARD DARNELL, PhD, JOHN IVANOFF, BS, and KAREN KOBUS, BS A procedure for facilitating research by physical therapists in a multid...
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