Introduction of a psychologically informed educational intervention for pre-licensure physical therapists in a classroom setting.

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BACKGROUND:There is an increasing need for physical therapists to address psychosocial aspects of musculoskeletal pain. Psychologically informed practice is one way to deliver this type of care through the integration of biopsychosocial interventions into patient management. An important component of psychologically informed practice is patient centered communication. However, there is little research on how to effectively implement patient centered communication into pre-licensure training for physical therapists. METHODS:Thirty Doctor of Physical Therapy (DPT) students took part in an educational intervention that consisted of one 4-h didactic teaching session and three 1-h experiential learning sessions. Prior to the first session, students performed an examination of a standardized patient with chronic low back pain and were assessed on psychologically informed physical therapy (PIPT) adherent behaviors via a rating scale. Students also completed the Pain Attitudes and Beliefs Scale (PABS-PT). After the last experiential session, students evaluated another standardized patient and were reassessed on PIPT adherent behaviors. Students retook the PABS-PT and qualitative data was also collected. RESULTS:After the educational intervention, students had positive changes in their pain attitudes and belief scores indicating a stronger orientation toward a psychosocial approach to patient care (p < 0.05). Additionally, after the intervention, students showed improvements in their adherence to using PIPT behaviors in their simulated patient interactions (p < 0.05). Qualitatively, students reported a high acceptability of the educational intervention with common themes indicating improved confidence with treating and communicating with complex patients. CONCLUSION:Students had attitudes and beliefs shift towards a more psychosocial orientation and demonstrated improved PIPT behaviors in simulated patient interactions after a brief educational intervention. Future research should investigate best practices for implementation of psychologically informed physical therapy for licensed clinicians.





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Ballengee, Lindsay A, J Kyle Covington and Steven Z George (2020). Introduction of a psychologically informed educational intervention for pre-licensure physical therapists in a classroom setting. BMC medical education, 20(1). p. 382. 10.1186/s12909-020-02272-5 Retrieved from

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Jeffrey Kyle Covington

Associate Professor in Orthopaedic Surgery

Dr. Covington is a neurologic physical therapist and 2004 graduate of the Duke DPT Program. He joined the faculty in 2007 and served as the Associate Director of Clinical Education from 2007-2014.  During that time he led  DPT Clinical STEPs® (Student Team Experience in Practice) course series in the first six semesters of the curriculum which places teams of students in clinical practice during their course work.  The creation of this new clinical education curricular format included significant educational program planning, assessment and evaluation.   In 2015, Dr. Covington completed his PhD in Educational Research and Policy Analysis at North Carolina State University.  Study emphases included adult learning theory, educational program planning and assessment.  In 2015 Dr. Covington was named the Duke DPT Program's Director of Assessment and Evaluation.  In addition, Dr. Covington's experience as a neurologic PT is utilized in the classroom during our Foundational Examination and Neurologic Practice Management Course work. Dr. Covington's research interests in collaborative student learning, and professional development of physical therapists and their embodied use of movement in expert practice.  


Steven Zachary George

Laszlo Ormandy Distinguished Professor of Orthopaedic Surgery

Dr. George’s primary interest is research involving biopsychosocial models for the prevention and treatment of chronic musculoskeletal pain disorders.  His long term goals are to 1) improve accuracy for predicting who is going to develop chronic pain; and 2) identify non-pharmacological treatment options that limit the development of chronic pain conditions.  Dr. George is an active member of the American Physical Therapy Association, United States Association of the Study of Pain, and International Association for the Study of Pain. 

Dr. George’s research projects have been supported by the National Institutes of Health, Department of Defense, and Orthopaedic Academy of the American Physical Therapy Association.  Dr. George and his collaborators have authored over 330 peer-reviewed publications in leading medical, orthopaedic surgery, physical therapy, rehabilitation, and pain research journals.  He currently serves as Editor-in-Chief for the Physical Therapy & Rehabilitation Journal. Dr. George has also been involved with clinical practice guideline development for the Academy of Orthopaedic Physical Therapy and the American Psychological Association. 

Dr. George has been recognized with prestigious research awards from the American Physical Therapy Association, American Pain Society, and International Association for the Study of Pain. For example from the American Physical Therapy Association: he was named the  21st John H.P. Maley Lecturer, recognized as a Catherine Worthingham Fellow in 2017, and selected for the Marian Williams Award for Research in Physical Therapy in 2022.    

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