Alexis A. Wright

Introduction.: It is essential that students perform optimally on multiple-choice examinations such as the National Physical Therapy Examination, which is comprised entirely of multiple-choice questions. Students are frequently advised to avoid changing initial answers on multiple-choice examinations. This belief is reinforced by faculty and student misconceptions. This study investigated the frequency and impact of answer changes among physical therapy students completing anatomy examinations on a computer-based platform. Review of Literature.: Prior studies show that answer changing is generally beneficial. However, most studies were conducted decades ago, and only a few were found that were conducted in health care education. Almost all previously published studies used paper examinations and were limited to 3 main answer-changing patterns, whereas computer-based testing can more accurately identify patterns in how students change their answers. Subjects.: Subjects include 174 first-year hybrid Doctor of Physical Therapy students. Methods.: In this retrospective cohort study, participants completed 4 computer-based multiple-choice examinations. Exam snapshot data from ExamSoft were imported into MATLAB, which categorized items into 1 of 7 answer-changing patterns. Examination scores were calculated with and without answer changes. Analyses included descriptive statistics, a generalized linear mixed model, a linear mixed-effects model, Pearson correlations, and a partial correlation. Results.: Across 30,133 answered items, 11.3% involved an answer change, with an average of 94.07% of students changing answers. The most common change was from incorrect to correct, representing 52.41% of changed items, whereas only 12.8% of changes were from correct to incorrect. Examination scores allowing answer changes were, on average, 5% higher than scores based on initial responses. Lower-performing students changed more answers, showing greater total benefit, while higher-performing students benefited more per question. Discussion and Conclusion.: Students frequently changed answers on computer-based examinations, and answer changing generally improved performance. Although some students experienced detrimental changes, beneficial changes occurred far more often. Findings suggest that discouraging answer changing may disadvantage students, and educators should promote informed reconsideration of responses during multiple-choice testing.

Health equity is a common theme discussed in health professions education, yet only some researchers have addressed it in entry-level education. The purpose of this study is to serve as an educational intervention pilot to 1) evaluate students’ perception of the effectiveness of the DPT program in providing a foundation for health equity education, with or without the benefit of a supplemental resource and 2) establishing priorities for the program related to educating students on health inequities in physical therapy clinical practice. A mixed method design with a focus-group interview was utilized to explore students’ perceptions of the DPT program's commitment to advancing health equity. A three-staged sequential mixed methods study was conducted. Stage 1 began with quantitative data collection after completing the DEI Bundle utilizing the Tripod DEI survey. Stage 2 involved identifying themes from the Tripod Survey data and creating semi-structured interview questions. Stage 3 consisted of a focus group interview process. A total of 78 students completed the Tripod DEI survey upon completing 70% of the curriculum. Thirty-five students, eight core faculty, 13 associated faculty, and four clinical instructors completed the APTA DEI Bundle Course Series. According to the Tripod DEI Survey results, program stakeholders found the program’s commitment to DEI and overall climate to be inclusive, fair, caring, safe, welcoming, and understanding of individuals from different backgrounds, including a sense of student belonging where students feel valued and respected. Three themes emerged from the qualitative focus group interviews, including the value of inclusivity, health equity curricular foundations, and DEI in entry-level DPT education. This study highlights the value of incorporating health equity and DEI topics into curricula while fostering an incluse program culture.

Background: Shoulder instabilities constitute a large proportion of shoulder injuries and have a wide range of presentations. While evidence regarding glenohumeral dislocations and associated risk factors has been reported, less is known regarding the full spectrum of instabilities and their risk factors. Purpose: The purpose of this systematic review was to identify modifiable risk factors to guide patient management decisions with regards to implementation of interventions to prevent or reduce the risk of shoulder instability. Study Design: Systematic Review Methods: A systematic, computerized search of electronic databases (CINAHL, Cochrane, Embase, PubMed, SportDiscus, and Web of Science) was performed. Inclusion criteria were: (1) a diagnosis of shoulder instability (2) the statistical association of at least one risk factor was reported, (3) study designs appropriate for risk factors, (4) written in English, and (5) used an acceptable reference standard for diagnosed shoulder instability. Titles and abstracts were independently screened by at least two reviewers. All reviewers examined the quality studies using the Newcastle-Ottawa Scale (NOS). At least two reviewers independently extracted information and data regarding author, year, study population, study design, criterion standard, and strength of association statistics with risk factors. Results: Male sex, participation in sport, hypermobility in males, and glenoid index demonstrated moderate to large risk associated with first time shoulder instability. Male sex, age <30 years, and history of glenohumeral instability with concomitant injury demonstrated moderate to large risk associated with recurrent shoulder instability. Conclusion: There may be an opportunity for patient education in particular populations as to their increased risk for suffering shoulder instability, particularly in young males who appear to be at increased risk for recurrent shoulder instability. Level of Evidence: Level III

Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting examples for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify examples of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality.