ONE BUM KNEE MEETS FIVE PHYSICAL THERAPISTS: USING AN ENCOUNTER WITH THE NON-REFERRED LITERATURE TO TEACH CRITICAL INQUIRY SKILLS TO FIRST-YEAR PHYSICAL THERAPY STUDENTS.

Wellmon R, Institute for Physical Therapy Education, Widener University, Chester, PA.

Purpose: The purpose of the presentation is to describe an instructional approach that has been used to teach critical inquiry and evidence-based practice skills to first-year physical therapy students. Acquiring the ability to generate relevant and answerable clinical questions, methodically searching for the best available evidence, and critically evaluating the literature are necessary and important skills in the profession's movement toward an evidence-based practice model.

Description: One Bum Knee Meets Five Physical Therapist was published in the Wall Street Journal in 1994 and documents the author's experiences when seeking treatment for chronic knee pain. Physical therapy is portrayed in a less than positive manner because of the lack of consensus regarding best clinical practice, diagnosis, and prognosis among the five clinicians. At the first class meeting, the article is read by first-year physical therapy students who are enrolled in a critical inquiry course. The article provides the impetus for an open and frank discussion about how practicing therapists make clinical decisions. The outcome of the dialogue is the identification of clinical practice issues related to the author's encounter with physical therapy. This helps the students begin the process of acquiring the skills that are fundamental to critical inquiry and evidence-based practice. The article is used as the basis for a series of assignments throughout the semester and a capstone experience that culminates in an oral presentation and a first experience in scientific writing.

Summary of the Experience: The students experience a range of emotions after reading the article for the first time. Initially, the author of the article is perceived negatively and vilified by the students. Much of the first session together is spent discussing how the author could arrive at her perceptions of physical therapy. While unflattering, the article provides the foundation for an ongoing, semester-long dialogue addressing principles of critical inquiry and evidence-based practice. The related course assignments provide learning experiences that foster the acquisition of critical inquiry skills. Overall, the encounter with the non-peer reviewed literature and the related classroom experiences help the students understand the importance of critically evaluating the assumptions underlying current physical therapy practice and provide a first experience in applying principles of evidence-based practice.

Importance to Section Members: This approach represents one method that can be used to begin the process of cultivating critical inquiry skills among first year students who have a limited knowledge of the profession. The experience can be simulated using the literature that appears in many publications intended for the health care consumer.

Paper presented at the American Physical Therapy Association 2003 Combined Sections Meeting, Tampa, FL.