Results from the Cardiovascular and Pulmonary Physical Therapy Practice Examination and Intervention Surveys
Task Force for CVP PT Examination and Intervention Practice Survey:
Gary Brooks, PT, DrPH, CCS
Pamela Bartlo, PT, DPT, CCS
Meryl Cohen, PT, DPT, MS, CCS
Efforts to define practice and establish competencies in cardiovascular and pulmonary PT go back to the late 1970s and early 1980s when the APTA established specialty areas of care. Led by Patrick R. Arthur, the CV&P Section developed a survey to delineate what constituted advanced as opposed to entry level practice in the cardiovascular and pulmonary areas of PT practice. The survey was administered in 1981 to members of the Cardiopulmonary Section who were asked to identify competencies that were very, or extremely essential to cardiopulmonary PT practice and were in fact being performed very, or extremely frequently. In 1993, Linda Crane validated and prioritized the competencies with the goal of generating a guide for PT educational program curricula. She also proposed that future revisions of the Entry-level Cardiopulmonary Competencies should be consistent with The Guide to PT Practice.
Meanwhile, as clinical specialization evolved, the American Board of Physical Therapy Specialties (ABPTS) conducted several surveys that identified advanced practice in all specialty areas including CV&P. The current revision of the competencies began in 2004 when a task force of CV&P Section members was charged with developing a survey of entry-level CV&P PT practice. The purpose of this survey was to identify practice behaviors that were considered to be entry-level as distinguished from advanced. Using behaviors outlined in the Guide to Physical Therapist Practice, examination or intervention procedures that were likely to be used for patients/clients with cardiovascular and/or pulmonary conditions were included. Because of the large number of questions needed to comprehensively assess cardiovascular and pulmonary PT practice, the task force decided to develop and administer two separate surveys in order to reduce respondent burden. The survey on CV&P Examinations was administered in 2005, and comprised 156 practice behaviors in 6 domains. The categories included:
- Diagnostic Studies and Lab Data
- Therapeutic Regimes
- Individual Patient Characteristics
- Tests and Measures
- Factors That Influence Complexity
The examination survey was administered in an online format. Random samples totaling 2,300 PTs were drawn from the general APTA membership, yielding a usable return of 192 responses. The demographic and professional characteristics of the sample from the examination survey are displayed in the following tables.
The intervention survey was administered in 2008. One hundred five individual practice behaviors were nested within 8 intervention domains including:
- Patient/Client Related Instruction
- Therapeutic Exercise
- Activities of Daily Living, Functional, and Instrumental Activities of Daily Living Training
- Manual Therapy Techniques
- Prescription/application of Devices/equipment
- Airway Clearance Methods
- Other Procedural Interventions
- Marketing and Program Development Related to Public Policy
The intervention survey was also administered in an online format. To insure a larger response, a random sample of 8,000 APTA members was drawn, yielding 354 usable responses. The demographic and professional characteristics of the sample from the intervention survey are displayed in the tables included here.
* One note is that for both Examinations and Interventions surveys, observations by those who worked fewer than 10 hours per week were excluded from analyses.
For both the examination and intervention surveys, response levels for each item were summed and expressed as a percentage of the total number of responses. For display purposes, data were sorted by entry-level status in descending order within each domain of practice behavior. Findings from the examination survey are presented here, and findings from the intervention survey are presented here.
A complete account of the history and description of the methods used for both surveys will be published in the Cardiopulmonary Physical Therapy Journal.