University of Lynchburg

Background: Workforce retention, employee engagement, and job satisfaction are ongoing challenges in outpatient physical therapy practice. Leadership style has been identified as a potentially modifiable organizational factor that may influence clinician experience and workplace outcomes. Despite extensive leadership research in other health professions, evidence specific to outpatient physical therapy settings remains limited. Purpose: To examine the relationships between private practice outpatient physical therapy clinic directors’ perceived leadership styles and staff physical therapists' work engagement, job satisfaction, turnover intention, leadership effectiveness, satisfaction with leadership, and willingness to exert extra effort. Methods: This cross-sectional correlational study surveyed licensed staff physical therapists employed in private practice outpatient clinics. Participants completed the Multifactor Leadership Questionnaire (MLQ5X), the Utrecht Work Engagement Scale (UWES9), the Job Satisfaction Survey (JSS), and the Turnover Intention Scale. Spearman's rank-order correlations were used to evaluate associations between perceived leadership styles and workforce outcomes. Fifty-one respondents met the inclusion criteria and completed the survey. Results: Transformational leadership demonstrated a significant positive association with employee engagement (ρ = 0.356, P = .010), job satisfaction (ρ = 0.568, P < .001), leadership effectiveness (ρ = 0.753, P < .001), satisfaction with leader (ρ = 0.782, P < .001), and extra effort (ρ = 0.662, P < .001). Transactional leadership was positively associated with job satisfaction, leadership effectiveness, satisfaction with the leader, and extra effort (all ≤ .002). Laissez-faire leadership demonstrated significant negative associations with job satisfaction (ρ = ­0.380, P = .006), leadership effectiveness (ρ = ­0.516, P < .001), satisfaction with the leader (ρ = -0.509, P < .001), and extra effort (ρ = ­0.383, P = .006). No significant relationships were observed between overall leadership style and turnover intention. Conclusion: Leadership style was strongly associated with multiple workforce outcomes among outpatient physical therapists. Transformational leadership demonstrated the most favorable relationships with engagement, satisfaction, and perceived leadership effectiveness, whereas laissez-faire leadership was associated with poorer workplace outcomes. Leadership development may be a practical strategy to improve clinician satisfaction, workforce stability, and organizational performance in private practice outpatient physical therapy settings.

BACKGROUND: Moulage is ubiquitous with simulated participant (SP) practice. Moulage presents a physical and psychological risk to SPs, due to the application of active products, ingredients, and the creation of highly realistic wounds, which could evoke emotional distress or overidentification. METHODS: The Moulage international Virtual Community of Practice convened in 2023 to commence standards of best practice in relation to moulage use with SPs. Using consensus methodology, the 9 authors catalogued their usual practice, reviewed relevant literature and standards to iteratively develop a conceptual framework and checklist. RESULTS: As a result, a conceptual framework and checklist were developed for safe moulage practice for pre-simulation, during-simulation, and post-simulation phases. The framework highlights key roles and corporate governance to achieve risk mitigation regardless of the simulation setting. To augment the framework, the authors developed the Moulage Application Safety Checklist, a 17-item tool for moulage in use. CONCLUSION: The conceptual framework and checklist provide an evidence-informed tool for considering moulage safety with SPs. Safe use of moulage should not be an afterthought.

OBJECTIVE:This umbrella review will synthesize evidence on the effectiveness of immersive virtual reality (iVR) simulation using head-mounted-display (HMD) on educational outcomes for entry-to-practice health professional learners. INTRODUCTION:HMD-based iVR is increasingly used in health professions education because it can offer engaging, interactive simulation experiences. However, educators, regulators, and decision-makers remain uncertain about when iVR provides unique educational benefits that justify widespread implementation. A high-level synthesis that isolates HMD-based iVR outcomes is needed to support evidence-informed policy, curricular, and budgetary decisions. ELIGIBILITY CRITERIA:We will include systematic reviews and meta-analyses that evaluate entry-to-practice learners' quantifiable outcomes aligned with the Kirkpatrick Four-Level Training Evaluation Model when using HMD-delivered iVR interventions. Reviews will be excluded if they focus on practicing clinicians, continuing professional development, patient-facing therapeutic virtual reality, veterinary education, or if they combine immersive and non-immersive modalities without reporting HMD-specific results separately. METHODS:This umbrella review will follow JBI methodology. We will systematically search PubMed, APA PsycINFO (EBSCOhost), CINAHL Plus with Full Text (EBSCOhost), Education Full Text (EBSCOhost), Embase, ERIC (EBSCOhost), and Scopus. Two independent reviewers will conduct screening and data extraction. Methodological quality will be appraised using the JBI critical appraisal instrument and data will be extracted using a modified JBI umbrella review extraction tool. Outcomes will be analyzed using the Kirkpatrick Four-Level Training Evaluation Model and the National League for Nursing/Jeffries Simulation Theory. Certainty of evidence will be assessed using the GRADE approach. REVIEW REGISTRATION:PROSPERO CRD420251075197.

Background: Professional values are foundational to physical therapy practice and are emphasized throughout Doctor of Physical Therapy (DPT) education. Although identity formation literature suggests that core values may persist after graduation, less is known about how workplace context, career stage, and clinical performance relate to the long-term enactment of values among practicing clinicians. Purpose: To examine whether professional values among DPT alumni differ across demographic groups, career stages, and outpatient settings, and to explore associations among organizational support, workplace value alignment, and historical educational performance. Methods: A cross-sectional survey study was conducted among University of Lynchburg DPT alumni employed in outpatient practice settings. Alumni completed a 26-item survey incorporating elements of the American Physical Therapy Association Professionalism in Physical Therapy Core Values Self-Assessment instrument and an additional measure of organizational support and workplace value alignment. Fifty-one eligible respondents met the inclusion criteria and were included in the final analysis (9.6% of alumni contacted; 13.3% response rate). Internal consistency was good (Cronbach α = .87). Reliability analyses were not conducted separately for individual subscales. Nonparametric analyses, including Mann-Whitney U, Kruskal-Wallis, Pearson, and Spearman correlations, were used to evaluate group differences and associations. Results: Respondents reported high endorsement of patient-centered professional values, including communication, shared decision-making, and patient advocacy. Societal behaviors, including political advocacy, volunteerism, and pro bono service, were reported less frequently. No statistically significant differences in composite professional value scores were identified across sex, generation, career stage, or outpatient practice setting (P > .05). Organizational support differed across graduating cohorts (H = 22.01, P = .024, η² = .28). However, post hoc comparisons were not significant after adjustment for multiple comparisons. Cohort-level Clinical Performance Instrument (CPI) measures were not significantly associated with current professional value scores. Conclusions: DPT alumni reported strong patient-centered professional values across demographic groups and practice settings, whereas societal-level professional behaviors were less frequently endorsed. Findings suggest that workplace context may influence value enactment and support the importance of organizational environments that facilitate advocacy, community engagement, and value-congruent practice.

The earthworm fauna of North America consists of a dynamic pool of native and non-native species. History of glaciation during the Pleistocene may strongly affect present earthworm assemblages, but its importance relative to other factors is unclear. We used a standard sampling protocol at 94 sites across 13 states to better understand the factors affecting diversity and abundance of earthworms in the eastern and central United States. We divided our sites into Northeastern Glaciated, Midwestern Glaciated, and Non-glaciated regions. Habitat type, proximity to water and roads, soil type and drainage, and soil pH were measured. A small number of European species was dominant throughout the sampled region. Native earthworms were rare and pheretimoid (“jumping worm”) species were present only at a small portion of our sites. Earthworms were most abundant and diverse in the Midwestern Glaciated region, where non-native earthworm invasion was the most recent, and least common and diverse below the southern limit of glaciation. Soil pH had a subtle positive effect on earthworm abundance and diversity. Community composition differed among regions and habitats. Assemblages also differed between summer and autumn/spring, probably due to seasonal sampling biases. Earthworm communities in previously glaciated areas, and especially in the recently invaded Upper Midwest, may benefit from soil organic matter accumulated during millennia without earthworms since glacial retreat.