Geriatric Physical Therapy Description of Specialty Practice Specialty Council on Geriatric Physical Therapy N BOA ICA RD ER O M F A P S H E Y I S T I L C IA A C L T PE HERAPY S American Board of Physical Therapy Specialties The Geriatric Description of Specialty Practice was prepared by the members of a subject matter expert group and members of the Specialty Council on Geriatric Physical Therapy and approved by the American Board of Physical Therapy Specialties of the American Physical Therapy Association. Specialty Council on Geriatric Physical Therapy Deborah Kegelmeyer, PT, DPT, GCS Myla Quiben, PT, DPT, GCS, NCS Tamara Gravano, PT, DPT, GCS Subject Matter Experts Don Backstrom, PT, MBA, GCS Maureen Euhardy, PT, MS, GCS Celinda Evitt, PT, PhD, GCS Jill Heitzman, PT, DPT, GCS, FCCWS Anne Myer, PT, DPT, GCS, FCCWS Sue Schuerman, PT, PhD, GCS William Staples, PT, DPT, GCS Consultant Jean Bryan Coe, PT, DPT, PhD Throughout this document, the editors have attempted to use lan- guage consistent with the Guide to Physical Therapist Practice and universally accepted concepts and terminology, without bias to any particular philosophy or school of thought. The references cited with the case scenarios are given only to help the reader understand the specific examples and are not intended to favor any particular school of thought or philosophy. In addition, these references are not intended to be inclusive. The Specialty Council on Geriatric Physical Therapy encourages your suggestions for improvement of this document. Your input and suggestions will be considered in the development of the next revision. This is a working document and will be modified as necessary. N BOA ICA RD ER O M F American Board of Physical Therapy Specialties A P S H Specialty Council on Geriatric Physical Therapy E Y I S T I L C IA A C L T PE HERAPY S ©2009, 1999, 1990 by the American Physical Therapy Association. All rights reserved. No part of this document may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission of the publisher. ISBN 978-1-931369-65-7 For more information about this and other APTA publications, contact the American Physical Therapy Association, 1111 North Fairfax Street, Alexandria, VA 22314-1488, 800/999-APTA (2782), www.apta.org. [Order No. E-45] Geriatric Physical Therapy Description of Specialty Practice Specialty Council on Geriatric Physical Therapy N BOA ICA RD ER O M F A P S H E Y I S T I L C IA A C L T PE HERAPY S American Board of Physical Therapy Specialties Geriatric Physical Therapy Table of Contents Introduction . 1 Chapter 1: Description of Board-Certified Specialists in Geriatric Physical Therapy . 2 Chapter 2: Description of Specialty Practice in Geriatric Physical Therapy . 4 I . Knowledge Areas of Clinical Specialists in Geriatrics . 4 A . Foundation Sciences . 4 B . Clinical Sciences . 4 C . Behavioral Sciences . 4 II . Professional Roles, Responsibilities, and Values of Clinical Specialists in Geriatrics . 4 A . Professional Behavior . 4 B . Professional Development . 4 C . Communication . 5 D . Social Responsibility . 5 E . Leadership . 5 F . Education . 5 G . Administration . 5 H . Consultation . 5 I . Advocacy . 5 J . Evidence-based Practice . 6 III . Practice Expectations for Clinical Specialists in Geriatrics in the Patient/Client Management Model . 6 A .Examination . 6 B .Evaluation . 9 C .Diagnosis . 9 D .Prognosis . 9 E .Intervention . 10 F . Outcomes Assessment . 12 Chapter 3: Linking Practice Dimensions and Professional Responsibilities to Knowledge Areas . .13 I . Introduction . 13 II . Case Scenarios . 13 Chapter 4: Examination Content Outline and List of Medical Conditions Seen by Specialists . 21 Chapter 5: Executive Summary of Practice Analysis . 22 I . Introduction . 22 II . Methods . 22 A .Survey Instrument . 22 B .Pilot Surveys . 22 III . Final Survey Administration . 22 IV . Data Analysis . 23 V . Results . 23 VI . Conclusions . 23 IIii Description of Specialty Practice Introduction the American Board of Physical Therapy Specialties (ABPTS) History of Specialization in Physical Therapy in June 1990 . The first geriatrics specialist certification exami- 3 In 1975, the House of Delegates of the American Physical nation was given in February 1992 . Therapy Association (APTA) approved the concept of special- ization and created the Task Force on Clinical Specialization . The original Geriatric Physical Therapy Competencies were The task force was charged with identifying and defining based on the work of Wharton and were divided into seven physical therapy specialty practice areas and with developing areas: (1) biology, psychology, and sociology of aging; (2) the structure for and function of a Board-certified process . patient care; (3) communication; (4) education; (5) admin- istration; (6) consultation; and (7) scientific inquiry .1 Since The document developed by the task force, “Essentials for 1989 major changes have occurred in the field of geriatrics Certification of Advanced Clinical Competence in Physical and gerontology . For example, the science of age-related and Therapy,” was adopted by the House of Delegates in 1978 . At pathological changes with aging has increased; the knowledge that time, the House recognized four specialty areas: cardiovas- of physical therapy examinations and interventions has grown; cular/pulmonary, neurology, orthopedics, and pediatrics . and the settings and regulations in practice have changed . By In 1979, the House appointed the Commission for the the mid-1990s these changes were so pervasive that the special- Certification of Advanced Clinical Competence . Specialty ty council felt strongly that the original framework might not councils for each of the four specialty areas were appointed by be adequate to revalidate geriatric specialty practice . Therefore, the commission and charged with the development of com- a panel of past and current members of the Specialty Council petencies unique to the advanced clinician in their respective on Geriatric Physical Therapy met in Washington, DC, in areas . April 1996 to discuss a framework for the new Description of Advanced Clinical Practice (DACP) . Those who attended In 1980, the Commission became the Board of Certification this meeting were Rita Wong, Marybeth Brown, Andrew of Advanced Clinical Competencies (BCACC) . The House Guccione, Jill Johnson, PT, MS, GCS, Linda Crews, PT, of Delegates recognized two more specialty areas that same MHS, GCS, and Kathleen Kline Mangione, PT, PhD, GCS . year: sports and clinical electrophysiology . In 1985, the This group constituted the subject matter experts (SME) for “Essentials for Certification of Advanced Clinical Competence the revalidation study . The day-long meeting resulted in a con- in Physical Therapy” was revised by the House of Delegates sensus decision that the framework for the DACP would be A and the title was changed to “Essentials for Certification of Normative Model of Physical Therapist Professional Education: 4 5 Physical Therapist Specialists ”. The BCACC was renamed the Version 97 and the Guide to Physical Therapist Practice . American Board of Physical Therapy Specialties (ABPTS), and Laurita Hack, PT, PhD, FAPTA, was the survey consultant . the first specialty examination was administered in cardiovas- References cular/pulmonary physical therapy that same year . The specialty 1 . Greenwald NF . Educational activities related to geriatrics in physical therapy . Geritopics . area of geriatrics was approved in 1989 . In June of 2006, the 1982;5(3):9-10 . APTA House of Delegates approved Women’s Health as the 2 . Wharton MA . Identification of Advanced Level Performance Tasks in Geriatric Physical Therapy newest area of physical therapist specialty practice . [master’s thesis] . Pittsburgh, PA: University of Pittsburgh; 1985 . 3 . Guccione AA, Brown M, Wong RA . Geriatric Physical Therapy Specialty Competencies . History of Specialization in Geriatric Physical Therapy Alexandria, VA: American Board of Physical Therapy Specialties; 1990 . The Section on Geriatrics published its first report on special- 4 . A Normative Model of Physical Therapist Professional Education: Version 97 . Alexandria, VA: ization in geriatric physical therapy in 1982 .1 In 1984 Wharton American Physical Therapy Association; 1997 . conducted a study that identified advanced-level tasks and the 5 . Guide to Physical Therapist Practice . Phys Ther . 1997;77:1163-1650 . knowledge, skills, and attitudes needed for competent prac- tice by physical therapists who work with geriatric patients 2. In 1987 the Section on Geriatrics appointed a specialization task force, chaired by Bonnie Teschendorf . In 1989 the APTA House of Delegates accepted the Section on Geriatrics’ petition in support of geriatric specialization . Andrew Guccione, PT, PhD, FAPTA, Marybeth Brown, PT, PhD, and Rita Wong, PT, EdD, were appointed as the first members of the Specialty Council on Geriatric Physical Therapy . The council surveyed selected members of the Section on Geriatrics and members of other sections who were considered content experts in the competencies originally identified in the Wharton study and the Teschendorf task force . These survey data were used to fully develop the competencies that were subsequently approved by 1 Geriatric Physical Therapy Chapter 1: Description of Board-Certified Specialists in Geriatric Physical Therapy The practice analysis survey drew responses from 395 practitioners,