Quiz 1: Professionalism and Communications

Essential Principle of a Profession (5)

Specialized Education

Evidence-Informed Decision Making

Ethical Responsibility

Commitment to Lifelong Learning

Governing Bodies

Professional Identity: The Process of “Becoming” (3)

Internal Factors

External Factors

Professional Feedback

APTA Core Values In Clinical Practice (9)

Accountability

Altruism

Collaboration

Compassion/Caring

Duty

Excellence

Inclusion

Integrity

Social Responsibility

Fundamental Ethical Principles (APTA Code of Ethics built on 6 foundational principles)

Autonomy

Beneficence

Non-maleficence

Justice

Veracity

Fidelity

The RIPS Framework

Realm

Individual Process

Situation

Realm

(where is the conflict occurring)

Individual

Organization

Society

Individual Process

(how is the clinician responding)

Moral Awareness

Moral Judgement

Moral Motivation

Moral Action

Situation

(what type of ethical conflict is this)

Ethical Distress (barriers to right course of action)

Ethical Dilemma (two morally acceptable actions conflicting)

Ethical Temptation (benefit from doing wrong)

Silence (issue is ignored)

Ethics vs. Law

Something can be legal (e.g., double-booking or minimal treatment time) but still be unethical based on professional standards

Ethical Fading

a gradual desensitization to unethical behavior over time

Moral Residue

the stress and guilt that remains after a clinician is forced to compromise their values due to external pressures

Knowles’ 6 Assumptions of Adult Learners

Relevance

Readiness

Autonomy

Experience

Problem Orientation

Motivation

Major Learning Theories in PT

Transformative Learning

Humanistic Learning

Experiential Learning (Kolb’s Cycle)

Barriers to Effective Learning

pain

fear-avoidance beliefs

low health literacy

low self-efficacy

Transformative Learning

occurs when a “disorienting dilemma” challenges a patient’s old beliefs

Humanistic Learning

the PT acts as a facilitator rather than an instructor, prioritizing psychological safety, empathy, and the therapeutic alliance

Experiential Learning (Kolb’s Cycle)

learning through a four stage cycle:

Concrete experience (doing) → Reflective Observation (reviewing) → Abstract Conceptualization (learning) → Active Experimentation (trying again)

Motor Learning Vs. Performance

performance is temporary, short-term change in movement observed during a single session

motor learning is a set of processes associated with practice leading to relatively permanent changes in movement skill and long-term retention

Constraints Framework (Dynamic Systems)

Individual

Task

Environment

Individual Constraints

strength

pain

fear

cognition

balance

Task Constraints

complexity

speed requirements

precision

Environment Constraints

Surface

lighting

equipment

social context

Practice & Feedback Strategies

Blocked vs Random Practice

Knowledge of Performance (KP) vs Knowledge of Results (KR)

Blocked Practice

repeating the same task over and over

may help establish initial consistency under stable conditions

Random Practice

practicing tasks in a variable order

best for long-term retention, adaptability, and real-world transfer

Knowledge of Performance (KP)

feedback on movement quality

can clarify a movement error that the learner cannot yet identify

Knowledge of Results (KR)

feedback on the outcome

useful to motivate and confirm success

Focus of Attention: Internal vs. External

Internal focus directs attention to body parts

External Focus directs focus to the movement’s effect on the environment (evidence strongly suggests that an external focus improves automaticity and retention)

Fitts and Posner Stages of Learning

Cognitive Stage

Associative Stage

Autonomous Stage

Cognitive Stage

high attention required, many errors, inconsistent performance

Associative Stage

refining the movement, fewer errors, more consistency

Autonomous Stage

Movement is efficient, requires little conscious. effort, and is adaptable to different contexts

Principles of Knowledge Learning/Motor Learning

Salience

Active Participation

OPTIMAL Theory

Salience

task must be meaningful to patient to trigger neuroplasticity

Active Participation

discovery learning is superior for long-term retention than providing constant guidance

OPTIMAL Theory

suggests that motor learning is optimized when the clinician enhances the patient’s expectancy of success, provides autonomy, and uses and external focus of attention

Common Misunderstandings to Avoid

Money Fallacy

Supervision vs Competence

Guidance vs Learning

Money Fallacy

not every conflict involving money is a “temptation”

Supervision vs Competence

clinical competence of an aide does not replace the legal and ethical requirment for direct, on-site supervision by a licensed PT or PTA

Guidance vs Learning

frequent feedback or physical guidance may improve immediate performance while limiting independent error detection and retention

Prompts

Core Value Conflict

RIPS Analysis

Adult Learning Application

Motor Learning Strategy

Core Value Conflict Prompt

Think of a scenario where "Excellence" (continuing to treat a patient to perfect their gait) might conflict with "Social Responsibility" (discharging that patient to open a spot for someone in the community with no access to care). How would you navigate this?

RIPS Analysis Prompt

Create a brief clinical scenario illustrating one RIPS situation type. Identify the realm, situation type, and facts that support your classification.

Adult Learning Application

A patient says, "I've had back pain for 10 years; movement just makes it worse." Which adult learning theory (Transformative, Humanistic, or Experiential) would be most appropriate to address this "disorienting dilemma"?

Motor Learning Strategy Prompt

For a high-level athlete returning to sport (Autonomous stage), would you prioritize Blocked or Random practice? Would you use an Internal or External focus of attention to improve their performance under pressure? Why?