J Orthop Sports Phys Ther. 1999 Nov; 29(11): 635-51; discussion 652-5.

Orthopaedic residency training: a survey of the graduates' perspective.

Smith KL, Tichenor CJ, Schroeder M.

Kaiser Permanente Medical Center, Hayward, Calif., USA.

STUDY DESIGN: A survey of residency graduates. OBJECTIVES: To establish a profile of the typical graduate and to determine the value and influence of residency training on professional development, particularly on clinical expertise. BACKGROUND: Physical therapists are involved in direct access in some states as a result of health care reform. There is increasing interest within the physical therapy profession in evaluating residency education as an avenue for providing physical therapists with the advanced skills to meet the changing nature of providing care. METHODS AND MEASURES: A questionnaire was sent to 98 graduates of a year long advanced orthopaedic manual therapy residency program. A response rate of 94.9% was obtained. RESULTS: Influence of residency training on clinical skills and expertise received high ("major positive") ratings on the abilities to logically reason (94%), thoroughly examine (95%), treat effectively (84%) and efficiently (79%), and to "diagnose" (85%). Graduates spend 23% of their time teaching in some manner. Autonomy of decision making was the primary factor (43%) in determining place of work. CONCLUSIONS: The results of this survey suggest that residency education assists physical therapists to refine and expand their clinical knowledge and skills that are important for health care roles requiring increasing autonomy of practice, such as primary care. Our questionnaire may also serve as a template for the measurement of outcome in clinical physical therapy residency programs.