Factors Which Influence Physical Therapists' Decision to Practice in Pediatrics

Purpose/Hypothesis: Pediatric physical therapy is a specialty area of practice, currently demonstrating a workforce shortage. Because this is a self-selected area of practice, it is important to understand what factors influence a physical therapist’s (PT) decision to specialize in pediatric physical therapy. The purpose of this study was to investigate the factors (demographic, educational, clinical practice, mentorship, and personal/professional), perceptions and influences, associated with a PT's decision to practice in pediatrics.

Number of Subjects: Participants included 245 pediatric PTs. A pediatric (PT) was defined as a PT whose caseload was >50% pediatric patients and/or a board-certified pediatric clinical specialist.

Materials/Methods: The study was a nonexperimental multi-methods design implementing cross-sectional survey methodology. Data was collected using a previously validated online questionnaire. The questionnaire consisted of 22 demographic questions, 2 open-ended questions and 2 questions with 22 individual items investigating factors associated with a PT’s choice of pediatric physical therapy practice. The items were rated using a 5-point Likert scale. One set of items measured the participant’s level of perception of pediatric physical therapy compared to other specialty areas of practice and the other set of items measured the influence of factors on the choice of pediatric specialty.

Results: 80% of respondents chose their specialty prior to or during their professional education and participated in a full time pediatric clinical experience. All factors investigated positively (1=strongly negative, 5=strongly positive) influenced the participants’ choice of the pediatric specialty. Mean scores of the factors were clinical patient care (4.2), mentorship (4.1), education (3.9), and personal/professional (3.4). The perception of pediatric physical therapy compared to other areas of practice was more positive (1=much less, 5=much more) in 3 of 4 factors. Mean scores of the factors, perceived as more positive, were clinical patient care (4.0), mentorship (3.6), and education (3.5). The mean score of the personal/professional factor (2.6) was perceived as more negative.

Conclusions: PTs who chose pediatric physical therapy as a specialty area were most likely to choose the specialty prior to or during their professional education. The choice to pursue pediatric physical therapy is most positively influenced by items representing clinical patient care, mentorship, and education. Items associated with clinical patient care were most influential and require engagement with children and families through intentional experiences.

Clinical Relevance: Opportunities to expose pre- and professional physical therapy students and new professionals to engaging interactions with children and families is warranted. These critical interactions can occur in the classroom, during integrated or full-time clinical experiences both early and late in the curriculum, and as a component of clinical practice. The ultimate goal is to mitigate the shortage of pediatric PTs that is hindering access to care needed by children in our country.