Teaching Social Determinants of Health in Physical Therapist Professional Education Programs: Exploring Curricular Approaches and Examining an Assessment Tool

There is a growing emphasis and need for physical therapists (PTs) to serve not only as clinicians but also as advocates to pursue health equity. Clinical practice for preventing and rehabilitating injuries and promoting physical activity will not eliminate health disparities resulting from the social determinants of health (SDH). Leaders in the field of physical therapy have charged physical therapist professional education programs to teach future PTs to address SDH, however, as of August 2023, the Standards and Required Elements for Accreditation of Physical Therapist Education Programs does not specifically require curricular content regarding SDH. The purposes of this dissertation were to explore what is known about teaching SDH in physical therapist professional education programs and examine an assessment tool that programs could use to evaluate student outcomes regarding SDH training. A scoping review of 91 articles describing how SDH is taught in health professional training programs in the United States revealed the only published articles addressing physical therapy were through interprofessional education (IPE). The review demonstrated variability in content, educational methods, assessment methods, and curricular logistics across health professional training programs. Consensual qualitative research methodology was used to explore the phenomenon of teaching SDH content as experienced by core faculty in physical therapist professional education programs. Five themes and associated categories emerged regarding the 14 faculty members’ educational approaches, preparedness, and resources for incorporating SDH into curricula at their respective programs. Finally, pilot testing of the Physical Therapy Social Determinants of Health Scale (PTSDHS) was conducted to assess structural validity and internal consistency of the tool. Exploratory factor analysis suggested a 4-factor model of a 27-item instrument, with 3 of the factors having acceptable internal consistency as subscales. Findings suggest that faculty must look to other health professional training programs to determine how to incorporate SDH content into a physical therapist professional education program’s curriculum and will need to decide what topics and educational approaches are most appropriate for their program and context. Faculty already teaching this content should pursue dissemination to share knowledge and resources. Further development of the PT-SDHS is warranted to provide a robust, validated tool