Éducation à la santé (document en anglais)

Benchmarking curriculum content in entry-level health

professional education with special reference to health

promotion practice in physical therapy:

a multi-institutional international study

Michael E. Bodner • Ryan E. Rhodes • William C. Miller •

Elizabeth Dean

Received: 7 February 2012 / Accepted: 4 September 2012 / Published online: 18 September 2012

 Springer Science+Business Media B.V. 2012

Abstract Health promotion (HP) warrants being a clinical competency for health professionals

given the global burden of lifestyle-related conditions; these are largely preventable

with lifestyle behavior change. Physical therapists have a practice pattern

conducive to HP, including lifestyle behavior change. The extent to which HP content is

included in entry-level physical therapy (PT) curricula, and how it is taught however, is

unknown. The aim of this study was to benchmark lifestyle behavior HP content within

entry-level curricula of international PT programs. The sampling frame included 258

accredited PT academic programs spanning six countries. An internet-based survey was

used to assess HP curricular content. Descriptive questions for HP topics (smoking cessation,

nutrition, weight control, alcohol consumption, exercise, and stress management)

included hours allotted and instructional methods used. Chi square tests examined differences

between the proportion of programs in the United States (US) and other countries

(combined) for HP topics, and among HP topics regarding instructional methods. The

M. E. Bodner (&)

School of Human Kinetics, Trinity Western University, 7600 Glover Road, Langley, BC V2Y 1Y1,

Canada

e-mail: mike.bodner@twu.ca

M. E. Bodner

Cancer Prevention, Detection, and Control Research Program, Duke Cancer Institute, Duke University,

Durham, NC, USA

R. E. Rhodes

Behavioural Medicine Laboratory, Faculty of Education, University of Victoria, Victoria, BC, Canada

W. C. Miller

Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University

of British Columbia, Vancouver, BC, Canada

W. C. Miller

G.F. Strong Rehabilitation Research Lab, Vancouver, BC, Canada

E. Dean

Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada

123

Adv in Health Sci Educ (2013) 18:645–657

DOI 10.1007/s10459-012-9404-x

response rate was 48 %. Most programs ([80 %) included all HP topics except alcohol

consumption (65.5 % of programs). Instructional methods used were primarily theorybased;

few programs (range 2.6–24.1 %) combined theory, practical and attainment of

clinical competency for all HP topics (exercise prescription notwithstanding). Proportionally,

more US programs included alcohol and nutrition than other countries combined.

Overall, HP lifestyle behavior topics were included to varying extent; however, instructional

methods used and hours allotted per topic varied across PT curricula. Universal

standards of HP practice as a clinical competency are warranted within the profession.

Keywords Clinical competency  Curricula  Health promotion  Physical therapy 

Survey

Introduction

Lifestyle-related conditions, namely, ischemic heart disease, smoking-related conditions,

hypertension and stroke, cancer, and type II diabetes mellitus are pandemic (Dean 2009a,

b; World Health Organization 2008). The global burden of these conditions is unequivocally

associated with lifestyle behaviors such as smoking, physical inactivity, lack of

regular exercise, poor dietary practices, risky alcohol consumption, and undue stress; these

behaviors underpin the leading causes of premature death today (Dean 2009a; Mokdad

et al. 2004). Of the high-income countries, the United States (US) has one of the highest

incidence of lifestyle-related conditions, e.g., type II diabetes mellitus and obesity, contributing

to enormous social and economic burdens of disease (Centers for Disease Control

and Prevention 2011; Flegal et al. 2010; Withrow and Akter 2011).

Health professionals including physical therapists could take particular advantage of

being well positioned to ensure their practices are responsive to their patients’ unhealthy

behaviors by attaining competency in HP practice. HP has been defined as assisting people

to move towards a state of optimal health by enabling them to change their lifestyle

behaviors (Downie et al. 1996; O’Donnell 1989). Methods of effecting positive health

behavior change and reducing the risk of ill-health requires the integration of health

education,

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