Service is the Cultural Norm in Physical Therapy Program
In a fifth-floor office overlooking University Avenue, a service dog named Tucker lounges on his doggie bed as a student delivers a few well-placed scratches behind the ears.
Easily enough, Tucker applies his droopy-eyed pet therapy tactics to students between exams and study sessions and leaves them with a smile and a little extra energy. He’s good at it. After all, he’s a service dog.
Tucker, the students and the director of the University of Wisconsin School of Medicine and Public Health (SMPH) Physical Therapy (PT) Program, Lisa Steinkamp, PT, MS, MBA, work on the fourth and fifth floors of the Medical Sciences Center, ready to provide their own brand of service.
While Tucker is tail-waggingly happy to do his work, everyone else - from first-year students working toward doctor of physical therapy degrees, to faculty members of more than a decade - finds it equally satisfying. The many people involved in the PT Program have cultivated a culture of service, and they elevated that focus in 1997.
Three years before that, Steinkamp left a private practice in California and moved to Wisconsin with her husband, a large-animal veterinarian who landed a new job in the Badger State. Upon arrival, she pursued a master’s of business administration degree with plans to open her own Madison-based sports medicine practice.
Because she also wanted to teach, she stopped by the kinesiology department in the UW-Madison School of Education, the PT Program’s home at the time. Thinking she would volunteer a little time, she left with a full-time job offer as the director of clinical education, charged with placing students into clinics where they could apply their education.
A year later, Steinkamp was considering accepting a new role as the program director. Because the program had no funding or support, no core faculty and a location away from the medical school, she began discussions with Gordon Ridley, then the School of Medicine and Public Health associate dean for administration, who facilitated conversations with the SMPH, Department of Surgery and UW-Madison.
The university, UW Hospital and Clinics and the medical school provided funding, and the Department of Surgery’s Division of Orthopedics sponsored the program beginning in 1996, notes Ridley.
Steinkamp recalls, “The hospital’s CEO at the time, Gordon Derzon, said the program provided physical therapists for the hospital, and Dr. Layton Rikkers, the former chair of the Department of Surgery, provided me with much needed moral support.”
Ridley shares that as the new program director, Steinkamp made a huge difference. “She turned the program’s future around,” he says.
Indeed, with funds in hand and a new home in the Division of Orthopedics, Steinkamp hired PT faculty members and worked with them to develop a curriculum.
“I was lucky because I got to start from scratch,” notes Steinkamp. “Some people say it would be more difficult to be given free rein to develop a program than to take over an existing one, but I loved the opportunity. It was a lot of work, but it resulted in a quality program that practically runs itself.”
Focus on Service
The Physical Therapy Program began with 60 students who were working toward a bachelor’s degree in the field. Steinkamp and others helped the program evolve into a master’s degree in 1999 and a doctoral degree in 2007. When the Division of Orthopedics was set to transition out of the Department of Surgery, the Physical Therapy Program did the same - together forming the Department of Orthopedics and Rehabilitation.
Today, the program is fully accredited and ranks in the top 1 percent of PT programs in the nation in terms of outcomes such as the rate of students who graduate, pass their licensing boards and get jobs in the field.
In January 2014, the Physical Therapy Program ranked tops in the nation in a survey by graduateprograms.com. Based on more than 40,000 student reviews, it ranked first overall and for career support, second for faculty accessibility and support, and third for value, compared to 226 PT programs around the country.
“I’ve hired self-motivated, engaged faculty members who do not need to be micromanaged because that wouldn’t work in our culture. Our faculty passes on to students a spirit of community involvement. We’re pretty informal and family-like, and we look for students who can thrive in such an environment,” says Steinkamp. “Our faculty and students are immersed in an amazing number of service-related activities outside of the program.”
In fact, the program’s leaders stress this ethos of volunteerism and engagement as much as academics, and service plays a heavy role in the application process.
According to Steinkamp, success in physical therapy depends on the following 10 “Generic Abilities” - developed in the Madison program by Warren May, PT, MPH, and colleagues - that are professional behaviors beyond core knowledge and technical skills:
- Commitment to learning
- Interpersonal skills
- Communication skills
- Effective use of time and resources
- Use of constructive feedback
- Problem solving
- Critical thinking
- Stress management
“We evaluate applicants by asking those who write letters of recommendation to address these qualities. We weigh this as half of the application process and the other half on grades and academic assessments. This assures that our students are excelling in all of these areas, and we continue to nurture the traits throughout the program and evaluate them through employers after students graduate,” says Steinkamp.
Learning While Serving
Altruism is also important. While most who pursue health professions have an overarching desire to help people, that characteristic reaches a critical mass in the Physical Therapy Program.
“I started getting our students involved with the MEDiC student-run free clinics about 10 years ago, and that became a great opportunity,” says Steinkamp. “We mandate that they participate in a MEDiC clinic once per semester. Many are intimidated by this at first, but once they start, they love it.”
Steinkamp adds that the PT students’ experiences working with medical students in MEDiC clinics piqued their interest in creating a PT Program pro bono clinic.
“At the MEDiC clinics, we saw people with back, shoulder and knee pain, and they often do well if you give them programs to do at home. But that is not sufficient for patients who have had a spinal cord injury or a stroke,” says Judy Dewane, PT, DSc, NCS, an assistant professor in the Physical Therapy Program.
Frustrated with the inability to provide follow-up PT care, a group of students approached Dewane about starting a free clinic in the Physical Therapy Program, and together, they opened such a clinic in April 2012.
Dewane recalls that the clinic initially had one patient and six students, with the goal to provide ongoing treatment for underinsured and uninsured people in Dane County.
“This lets them learn as they serve, so it’s a win-win situation,” says Dewane, who supervises the clinic and advises students.
The clinic has grown steadily. Patients generally receive treatment for a year or longer, and the 48 students involved are serving about nine patients. The clinic is near capacity for its space, so to care for more patients, the students are considering adding an hour to the clinic next fall.
With the clinic in its fifth semester, word has spread. Therapists and discharge planners from UW Hospital and Clinics and Meriter Hospital, as well as private physical therapists throughout the county, refer their patients who need additional therapy.
Clinic coordinators assign a team of firstand second-year students to each patient, which offers student mentoring opportunities, explains Jessica Dietz, a second-year PT student who co-coordinates the pro bono clinic with fellow second-year student Megan Brothen. They note that, this year, the program has successfully met a major goal to foster such mentoring.
“It’s been fun to see how much the patients and students are progressing,” says Dietz, of Hartland, Wisconsin. “It’s been cool to see the second-year students teach and the first-year students blossom.”
Dietz and Brothen became coordinators during the clinic’s second year because they saw the service’s huge potential when they volunteered during its first year.
“It’s been great to get involved in the community and show people what physical therapy can do,” says Brothen. “We even received an e-mail from a student at Georgia State who wanted advice about starting a pro bono clinic there. For people to want to model their clinic after ours - and to know that work here can make an impact in other communities - that’s pretty sweet.”
After the first big group of students finished working in the clinic last year, Dewane conducted a survey to learn what was working well or could be improved. Students said they could read about patients but, through the clinic, they gained a much better understanding of how a patient progresses through a program and how that varies for different patients. After working in the pro bono clinic, students reported much higher confidence about starting their final internships. Some also wrote that the pro bono clinic allows them to “keep it real.”
“Sometimes it’s easy to get stuck in a routine of going to class, working on grades and worrying about a future career, but it’s really important for us to get involved in the community and help where we can,” says Brothen, a Kenosha, Wisconsin, native. Dewane concludes, “This experience reminds students why they went into PT and the good they can do. I think that says it all.”
By Ian Clark
This article appears in the spring 2014 issue of Quarterly.
Date Published: 07/03/2014