Barbara Tschoepe - Academia.edu (original) (raw)

Papers by Barbara Tschoepe

Journal, physical therapy education, 2015

Physical therapy, May 13, 2022

This Perspective issues a challenge to physical therapists to reorient physical therapist educati... more This Perspective issues a challenge to physical therapists to reorient physical therapist education in ways that directly address the crises of COVID-19 and systemic racism. We advocate that professional education obligates us to embrace the role of trusteeship that demands working to meet society’s needs by producing graduates who accept their social and moral responsibilities as agents and advocates who act to improve health and health care. To achieve this, we must adopt a curriculum philosophy of social reconstruction and think more deeply about the why and how of learning. Currently, health professions education places strong emphasis on habits of head (cognitive knowledge) and hand (clinical skills) and less focus on habits of heart (professional formation). We believe that habits of heart are the essential foundations of the humanistic practice needed to address health inequities, find the moral courage to change the status quo, and address imbalances of power, privilege, and access. A social reconstruction orientation in physical therapist education not only places habits of heart at the center of curricula, but it also requires intentional planning to create pathways into the profession for individuals from underrepresented groups. Adopting social reconstructionism begins with a faculty paradigm shift emphasizing the learning sciences, facilitating learning, metacognition, and development of a lifelong master adaptive learner. Achieving this vision depends not only on our ability to meet the physical therapy needs of persons with COVID-19 and its sequalae but also on our collective courage to address injustice and systemic racism. It is imperative that the physical therapy community find the moral courage to act quickly and boldly to transform DPT education in ways that enable graduates to address the social determinants of health and their systemic and structural causes that result in health disparities. To succeed in this transformation, we are inspired and strengthened by the example set by Geneva R. Johnson, who has never wavered in recognizing the power of physical therapy to meet the needs of society.

Physical therapy, Mar 23, 2022

Evidence that supports the explicit need to develop leadership skills at all levels of clinical p... more Evidence that supports the explicit need to develop leadership skills at all levels of clinical practice is prevalent,1–8 yet intentional development of “self-leadership” within health care, and particularly within physical therapy, remains slow, fragmented, and inconsistent. Delineation and standardization of the definition of leadership, and the approach to developing leadership skills in individuals practicing within health care continues to be debated, producing several key dilemmas. Moreover, there is a lingering misperception that developing leadership capacity is reserved for physical therapists who assume positional or formal roles as “leaders” within communities, health care organizations, practices, or teams. This misperception focuses leadership development on “leading others” rather than “leading self.” Similarly, challenges exist between balancing the leadership development needs of the leader as a positional role and the act of “leading” as physical therapists practice and engage within all levels of care and within different communities—as individuals and within teams. This tension further complicates when and how best to prepare physical therapists to meet this essential skill set in clinical practice. The purpose of this perspective is to describe nonpositional self-leadership and its importance to physical therapy practice, to propose common or contemporary leadership-related terminology, and to suggest a framework for leadership development. Through accomplishing these purposes, readers may be encouraged to change and adopt recommendations.

Journal of Electromyography and Kinesiology, 1994

While much is known about the physiological basis of local muscular fatigue, little is known abou... more While much is known about the physiological basis of local muscular fatigue, little is known about the kinematic and electromyographic (EMG) consequences of brief fatiguing isometric contractions. Five male subjects performed a horizontal elbow flexion-extension reversal movement over 90 in 250 ms to reversal before and after one of five single maximal isometric elbow flexions ranging in duration from B-120 s. Surface EMG signals were recorded from the biceps brachii, the long head of the triceps, the clavicular portion of the pectoralis major, and the posterior deltoid. Spatial and temporal errors were computed from potentiometer output. During the fatiguing bouts, maximum voluntary force dropped linearly an average of 4% in the 15 s condition and 58% in the 120 s condition relative to maximum force. The associated biceps rectified-integrated EMG signal increased from the onset of each fatigue bout for 15-30 s, then decreased over the remainder of the longer bouts. Following the fatieue bout, subjects undershot the target distance on ~~~(3 .___ _.~~~~.-_-_-___-__ the first movement trial in all conditions. Following short fatigue durations (i.e. 15-30 s), the peak biceps EMG amplitude was disrupted and movement velocity decreased, but both measures recovered within seconds. As fatigue duration increased, progressive decreases in peak velocity occurred with increased time to reversal, reduced EMG amplitude, and longer recovery times. However, the relative timing of the EMG pattern was maintained suggesting the temporal structure was not altered by fatigue. The findings suggest that even short single isometric contractions can disrupt certain elements of the motor control system.

Physical Therapy, 2007

For more than 20 years, the faculty of the Program in Physical Therapy at Washington University i... more For more than 20 years, the faculty of the Program in Physical Therapy at Washington University in St Louis has focused on diagnosis and classification. Steven Rose, PT, PhD, FAPTA, who directed the program in the 1980s, and Shirley Sahrmann, PT, PhD, FAPTA, Associate Director for Doctoral (PhD) Studies, were the primary initiators of the efforts made by many faculty members to conduct research and refine, elaborate, clarify, and teach the concepts. The program often had considered hosting a conference on diagnosis and classification. After Cynthia Zadai, PT, DPT, CCS, FAPTA, delivered the 2004 John P Maley Lecture at the PT 2004 Meeting in Chicago, it was clear that the time was right for planning an invitational conference. (See page 641 for a Perspective1 adapted from that seminal lecture, from which the title of this editorial is borrowed.) “Diagnosis Dialog I: Defining the ‘ x ’ in D x PT” was held at Washington University in St Louis in July 2006 (Diagnosis Dialog II was held at the Institute of Health Professions of Massachusetts General Hospital in Boston in February 2007). Participants from many different areas of the profession were invited to attend—individuals with recognized expertise in major areas of clinical practice, editors of Association and section journals, Association leaders and senior staff, researchers, academicians—all of whom were known to have an interest in diagnosis. First, the group reviewed a history of diagnosis in physical therapy based on a collection of publications and personal accounts of events. Then, the participants determined the agenda for the rest of the meeting by rank ordering, based on perceived importance, a set of 16 questions derived from the pre-meeting survey that they had completed. There were no formal presentations, just free and open discussions that were spirited, respectful, and extremely rich in information …

Physical therapy, Jul 22, 2022

Physical Therapy

Physiotherapy Canada, 2022

Purpose: The purpose of this study was to examine the perceptions of physical therapists practisi... more Purpose: The purpose of this study was to examine the perceptions of physical therapists practising in the United States of the importance of leadership characteristics and of demographic traits and other factors that might be associated with perceptions of leadership in three contexts: workplace, health care system, and society. Method: An online questionnaire was distributed through snowball sampling to physical therapists practising in the United States over an 8-week period between October and November 2019. A total of 15 leadership characteristics were rated on a 5-point scale of importance. Results: A total of 278 physical therapists responded to the questionnaire. They rated communication and professionalism as the top two leadership characteristics across all settings. Self-awareness and business acumen were not perceived as important for leadership. No relationship was found between gender and self-declaration as a leader or between a participant’s practice setting and thei...

Journal of Geriatric Physical Therapy, 2005

Purpose/Hypothesis: Physical activity (PA) has been shown to have positive effects on physical an... more Purpose/Hypothesis: Physical activity (PA) has been shown to have positive effects on physical and mental health including reducing risk for heart disease, hypertension, depression, other chronic illnesses, and falls in the elderly. The purpose of this study was to design and implement an intervention that fostered increased PA for residents of an assisted-living (AL) and independent-living (IL) facility to determine effects of regular light PA on health profiles. Number of Subjects: Thirty subjects (22 women, 8 men) with a mean age of 79.96 plus or minus 6.7 years participated in the study. Materials/Methods: A voluntary 14-week walking program was instituted at an AL and IL facility housed in separate buildings. This 'virtual' walking program encouraged participants to contribute to the cumulative miles needed to travel to Pikes Peak, 78 miles from Denver. Because many residents reported that seasonal variations in weather limited their walking, an indoor walking ' track' was identified and measured at each facility for use during the study. Twice weekly, physical therapy faculty members were present at a designated location and time to monitor and record participation, blood pressure, and distances. To document distances completed, participants received a sticker that they affixed to a name tag to mark each lap. Verbal tips were offered for safety, to adjust pace, direction, and gait kinematics. Total distance walked by each participant was kept and cumulative distance achieved was displayed next to a poster of Pikes Peak. Outcomes evaluated included: resting vital signs, body mass index, 6 minute walk test (6MWT), timed sit-to-stand, perceived health status, perceived exertion, and maximal distance walked. Results: Paired t tests showed significant differences in distance walked in both AL and IL (p=.000; p=.013, respectively), while those in AL also showed differences in 6MWT (p=.022) over the 14 weeks. Positive trends were noted for sit-to-stand at both residences and for 6MWT in IL. Interaction with others combined with selfreports of improved fitness motivated residents to continue beyond the 78 mile ' virtual road marker' to travel to the Royal Gorge, and then walk home to Denver, a total of more than 200 cumulative miles! Qualitative assessment of comments provided at the end of the study showed that the positive social networking encouraged ongoing participation. Conclusions: A low-budget structured walking program to enhance PA has physical and social benefits. As expected, older residents had reduced 6MWT and initial distances compared to younger, however, most were able to double their walking distance. Older adults have capabilities for improvement that often go untapped related to PA. Clinical Relevance: Similar programs can be initiated with minimal costs in residential centers to encourage increased PA and social networking for seniors. Programs like this that encourage increased walking speed and distance may help reduce morbidity and risk for falls in the elderly.

Journal of Physical Therapy Education

Background and Purpose. “Leadership at all levels” has been identified as one of the 12 critical ... more Background and Purpose. “Leadership at all levels” has been identified as one of the 12 critical issues facing organizations around the world. e American Physical erapy Association Vision calls physical therapists “to lead” efforts to transform society. Leadership competencies essential for practice recently have been identified. ese competencies illustrate how physical therapists independent of professional role and position can support achievement of the Quadruple Aim.e profession has taken steps to prepare physical therapists with clinical competencies to practice as movement system experts; however, like many health professions, education has struggled to keep pace with professional formation and leadership skills that shape role identity. More emphasis needs to be placed on developing skills needed to lead, advocate, and influence change. e purpose of this position article was to expand conversation on leadership and propose an evidence-based framework, which can be used to build competence throughout entry-level curricula. is framework can bring the profession one step closer to adopting leadership as an essential domain of competency and providing the missing link to bridge the gap in achievement of the Vision. Position and Rationale. Leadership should be recognized as an obligation of all physical therapists and developing leadership an obligation of education, as it is critical to our evolving role identity. Adoption of a leadership competency framework informed by competencies will help assure graduates exhibit leadership skills to challenge current practices and advocate for transformation of the health care system. e team explored established leadership frameworks to evaluate “fit” of the 57 leadership competencies. Although frameworks offered valuable perspectives, none sufficiently “fit” the evidence to support widespread adoption. is led us to design a Leadership Competency Framework for Physical erapists (LCF-PT) to categorize, enhance utility, and clarify interpretation of these competencies. Discussion and Conclusion.e LCF-PT organizes 57 competencies into 3 tiers and 11 thematic clusters that can further advance our role as movement system experts and build a more robust role identity consistent with a doctoral profession. Without a framework, DPT education programs will likely remain fragmented, unintentional, and inconsistent in the development of leadership competencies in Doctor of Physical erapy graduates. Future research needs to validate the LCFPT by stakeholders to confirm the framework is sufficiently robust to guide leadership development at all levels. is framework also can support eventual benchmarking of best practices in education in the future. To move forward as practitioners of choice and to ensure our voices are heard, all physical therapists must acknowledge that “to lead” at all levels is critical to role identity, achievement of the Quadruple Aim and the Vision to transform society by improving the human experience. is clarity will move us closer to “dreaming the not-soimpossible dream,” challenge current practices, implement evidence, and advocate for transformation of the health care system.

Physiotherapy Theory and Practice, 2014

Based on indicators that emerged from The First Physical Therapy Summit on Global Health (2007), ... more Based on indicators that emerged from The First Physical Therapy Summit on Global Health (2007), the Second Summit (2011) identified themes to inform a global physical therapy action plan to integrate health promotion into practice across the World Confederation for Physical Therapy (WCPT) regions. Working questions were: (1) how well is health promotion implemented within physical therapy practice; and (2) how might this be improved across five target audiences (i.e. physical therapist practitioners, educators, researchers, professional body representatives, and government liaisons/consultants). In structured facilitated sessions, Summit representatives (n ¼ 32) discussed: (1) within WCPT regions, what is working and the challenges; and (2) across WCPT regions, what are potential directions using World Café TM methodology. Commonalities outweighed differences with respect to strategies to advance health-focused physical therapy as a clinical competency across regions and within target audiences. Participants agreed that healthfocused practice is a professional priority, and a strategic action plan was needed to develop it as a clinical competency. The action plan and recommendations largely paralleled the principles and objectives of the World Health Organization's non-communicable diseases action plan. A third Summit planned for 2015 will provide a mechanism for follow-up to evaluate progress in integrating health-focused physical therapy within the profession.

Topics in Geriatric Rehabilitation, 2014

Journal of Physical Therapy Education

Journal, physical therapy education, 2015

Physical therapy, May 13, 2022

Physical therapy, Mar 23, 2022

Journal of Electromyography and Kinesiology, 1994

Physical Therapy, 2007

Physical therapy, Jul 22, 2022

Physical Therapy

Physiotherapy Canada, 2022

Journal of Geriatric Physical Therapy, 2005

Journal of Physical Therapy Education

Physiotherapy Theory and Practice, 2014

Topics in Geriatric Rehabilitation, 2014

Journal of Physical Therapy Education