At the PT 2013 conference earlier this summer, one of the speakers encouraged physical therapy programs to transition away from education on passive modalities and objective measurements such as range of motion or manual muscle testing to instead focus on functional limitations and progress towards functional goals.
I've thought a lot about this idea since hearing it and gone through a few "phases" of acceptance. At first, I was in complete agreement. In most of my patient experiences, I've been able to track a patient's progress with gross strength and range-of-motion measurements compared to the exact goniometer alignment and measurement of a patient's range I learned about in school. There are times with a post-operative patient when that quantitative data is needed, but in most cases I focus on the functional impairments. I use passive modalities mostly for pain control, but have found most effective treatments using exercise and manual techniques. So overall, I was happy to hear that other practitioners held a similar opinion to my own and expressed it at the conference.
The second part, as I'm experiencing now nearly three months after hearing this proposal, is my curiosity about how these changes will be implemented. Passive modalities have been a part of physical therapy curriculums for decades. How can we transition away from that? My thought is that teaching content like modalities is either an all or none topic; is there any gray area to teaching only part of the material?
I give a lot of credit to the people involved with establishing the content for physical therapy programs. It cannot be an easy task to sort through the latest research while also balancing that with traditional practice techniques. I can't imagine being the person to say, "Okay, we aren't going to teach anything about ultrasound this year" because it seems like such a "basic" to being a physical therapist. I'm sure other content was phased out in PT programs during the years before I was a student, and I know educational programs in the future will continue to focus on the most relevant components of being a physical therapist.
What do you think? Is it important to continue teaching students about passive modalities, range of motion and manual muscle testing? Have you experienced changes in PT program curriculum during your years of practice? If you are an experienced clinician, are you ever surprised by what students are learning?