Orthopaedic Physical Therapy Residency Program

The Physical Therapy (PT) Service at the Columbia VA Health Care System (CVAHCS) is proud to offer two-positions for a one-year Orthopedic Physical Therapy Residency Program. The first in VISN7.

The Residency Program is established in 2021 during the Expanded Physical Therapy Residency funded by the Office of Academic Affiliations (OAA). Our Program is in the process of accreditation by the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) as a postprofessional residency program for physical therapists in Orthopedic Physical herapy.

Residents will start their year-long program in July. They will be employed by the Columbia VA Medical Center, and therefore need to be a US citizen. Residents will treat a primarily Orthopedic/Musculoskeletal patient caseload. Residents are involved in mentoring sessions with expert clinicians for not less than 4 hours/week and didactic coursework not more than 8 hours/week. The residents will also participate in periodic specialty clinics (e.g. Pain Management, Primary Care, Urgent Care, Amputee, Orthopedics and PMR), as well as program development and a variety of teaching opportunities with the University of South Carolina, DPT Program. Residents who successfully complete the program will be eligible to apply to sit for the Orthopedic Clinical Specialist (OCS) exam.

Upon receiving the program candidacy status, applications are reviewed starting in January, with interviews offered to those who meet the eligibility and requirements with final decision no later than April 30. Candidates can apply as students but need to have a plan to graduate and become licensed physical therapists prior to the start date of the residency.

Mission and Goals

The faculty and staff of the CVAHCS Orthopedic PT Residency are committed to developing residents who are recognized leaders within their specialty. Residents who develop distinction in examination, diagnosis, intervention, consultation, teaching and the integration of best evidence into the patient care they provide. A resource for the community in prevention and rehabilitation of orthopedic conditions and will contribute to the profession through teaching and leadership.

Mission Statement

To train qualified Doctors of Physical Therapy (DPT) in advanced orthopedic specialty practice employing the mentorship of experienced clinicians, incorporating evidence-informed practice in providing quality care and improved patient outcomes. The program delivers orthopedic clinical experiences, mentoring, and didactic education to advance the level of orthopedic physical therapy practitioners who exercise fiscal responsibility, evidence-informed practice dedicated to meeting the long-term health, wellness and specialized needs of our Veterans.

Goals and Objectives

Program Goals
Goal #1. To support the mission of the VA to achieve excellence in veterans patient care services, education, research, and leadership in orthopedic PT practice by sharing the expertise of the faculty to new physical therapy graduates or general practitioners.

Objectives:

• The residency program will provide education focusing on evidence-based and patient-centered care in all elements of the patient/client management model as described in the APTA’s Guide to Physical Therapist Practice;
• The residency program will lead to competencies in advanced orthopedic PT practice across the continuum of care, including the orthopedic acute care, chronic musculoskeletal pain, and outpatient musculoskeletal care;
• The faculty will provide clinical mentoring to residents at selected clinical sites within the Columbia VA Health Care System.

Goal #2. To develop an Orthopedic Residency that meets the credentialing criteria of the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) of the American Physical Therapy Association (APTA).

Objectives:

• The program will recruit qualified physical therapy residents who desire to pursue advanced practice in orthopedic physical therapy.
• The program will support the faculty in receiving continuing education (CE) and training in areas relevant to teaching, mentoring, and advanced practice in orthopedic physical therapy.
• The faculty will evaluate the program performance according to the credentialing requirements of ABPTRFE/APTA, and develop appropriate strategies to improve program outcomes through formal and informal discussion at regularly scheduled and other face to face meetings.

Goal #3. To provide the post-professional education in advanced practice that integrates the current best evidence about orthopedic physical therapy and foundational sciences in orthopedic rehabilitation.

Objectives:

• The program curriculum, including didactic courses and clinical mentoring, will address all areas of the Description of Residency Practice in Orthopedic Physical Therapy.
• The faculty will provide additional instruction as needed based on the finding obtained through the evaluation of the resident’s performance and learning outcomes.

Goal #4. To produce graduates of physical therapy residents who will demonstrate competencies in advanced orthopedic practice as evidenced by attainment and passing of the orthopedic specialist certification (OCS).

Objectives

• The program curriculum will prepare the resident to sit for and pass the Orthopedic Clinical Specialist examination on the first attempt after graduation.
• The faculty will mentor the resident in professionalism, advocacy, leadership, professional development, and other scholarly activities, and provide opportunities for the resident to participate in professional meetings at the regional, state, or national levels.

Goals for the Residents

Goal #1: The residents will adapt to emerging roles as physical therapists in the VA health care system.

Objectives:

• Meet the unique rehab needs of Veterans by becoming advanced practitioners of orthopedic physical therapy while being sensitive to VA initiatives;
• Support the mission of Department of Veterans Affairs (DVA) and the Veterans Healthcare Administration (VHA) by providing an organized educational opportunity that facilitates and accelerates excellence in orthopedic physical therapy.

Goal #2: The residents will demonstrate clinical expertise for advanced practice in orthopedic physical therapy.

Objectives:

• Complete all written, oral, and practical examinations in the didactic and clinical components of the residency successfully in good academic standing (80% and above).
• Attain advanced knowledge and skills in clinical reasoning and evidence based practice to prepare the resident in passing the Orthopedic Clinical Specialist (OCS) examination on the first attempt after graduation.
• Provide efficient and effective patient-centered care consistent with the most recent Orthopedic Physical Therapy Description of Residency Practice and the VA core values.
• Evaluate the ethical and legal considerations that impact orthopedic physical therapy.
• Conduct a systematic search of literature and critically appraise the literature to inform evidence-based practice for patients/clients.
• Select appropriate and evidence-based outcome measures in both simple and complex clinical cases and incorporate the exam findings to develop the treatment plan, ongoing reassessment of patient progress, and in the discharge planning process. 
  Observe at specialty clinics and multidisciplinary management for patients with orthopedic diseases and disorders.

Goal #3: The residents will become clinical mentors, teachers, and consultants for other physical therapists and members of the health care community.

Objectives:

• Complete a case report or other scholarly products to present at a national, state or local professional meetings or conferences.
• Develop an educational module on a topic related to advanced practice in orthopedic physical therapy to an interdisciplinary team of healthcare professionals, physical therapy students, clinical mentors, and/or other physical therapists.

Program Curriculum

The Columbia VA Orthopaedic Physical Therapy Residency is a 12-month program that starts a new cohort in July. Two residents are admitted and are full-time, one-year limited appointment employees with the VA (with benefits) who work 30 hours per week independently in the clinic. Additionally, residents complete weekly learning activities in a mixed format (reading, researching, discussion, observation, online posts, lab practice and teaching).

An example of a typical week may be:

Residency Hours Distribution:

1650 hours:     Patient care hours inclusive of 172 hours of 1:1 mentoring hours
430 hours:     100% education hours
2080 hours:     Total residency hours including 11 federal holidays of 88 hours

There are fourteen modules that make up the didactic component of the Columbia VA Orthopedic Physical Therapy Residency. The development of the curricular contents in these courses was completed by referencing the American Board of Physical Therapy Specialties (ABPTS) Orthopedic Descriptions of Specialty & Residency Practice (DSP/DRP) and the Orthopedic Physical Therapy Residency Curriculum by the Orthopedic Section (AOPT)* of the American Physical Therapy Association (APTA).

The skills and didactic knowledge described are requirements for advanced clinical practice and are included in the curricular modules. Modules 1, 2, and 3 (Introduction to Orthopedic PT Theories/Clinical Reasoning, Evidence-Based Practice and Research Methods, and Advanced Pain Science) are the modules that will be covered in the first six weeks during Educational Weeks that will serve as introductory modules to cover clinically relevant theories, critical inquiry, advanced pain education, and research principles that will prepare the residents for the clinical mentoring and independent clinical experience.

These modules are presented through multimodal approaches. Residents perform independent readings, monograph, and journal reviews and then supplement with an online blackboard platform with the faculty for discussion forums, assignments, and post-module competencies. The modules are designed and represent the progression of learning so that the congruency between the didactic and clinical components of the residency experience is ensured. Modules related to diseases and disorders encountered in orthopedic physical therapy practice and those related to physical therapy examination, evaluation, and intervention are taught in sequence so that the residents have the opportunity to build upon previous didactic knowledge as they move towards advanced clinical practice. This allows the residents to have baseline knowledge as their clinical practice exposure becomes more complex.

References:

AOPT Residency Curriculum*:

a. Current Concepts of Orthopedic Physical Therapy, 4th Ed.
b. Clinical Imaging
c. Postoperative Management of Orthopedic Surgeries
d. Pharmacology
e. Frontiers in Orthopedic Science
f. Basic Research Methods for Understanding PT Literature
g. Outcomes in Orthopedic PT Practice
h. Screening for Orthopedics

Other references:

i. Pediatric Orthopaedics:

• Paterno, Mark V., and Steven R. Tippett. "Considerations for the Pediatric Patient." Musculoskeletal Interventions: Techniques for Therapeutic Exercise, 4e Eds. Barbara J. Hoogenboom, et al. McGraw Hill, 2021.

j. Movement Science:

• Hamilton N, & Weimar W, & Luttgens K(Eds.), (2011). Kinesiology: Scientific Basis of Human Motion, 12th Edition.

k. Pain Science:

• Diener I, Kargela M, Louw A. Listening is therapy: Patient interviewing from a        pain science perspective. Physiother Theory Pract. 2016 Jul;32(5):356-67. Hylands-White N.
• Duarte RV, Raphael JH. An overview of treatment   approaches for chronic           pain management. Rheumatol Int. 2017 Jan;37(1):29-42.Louw A, Zimney K,     Puentedur EJ,
• Diener I. The efficacy of pain neuroscience education on     musculoskeletal          pain: A systematic review of the literature. Physiother Theory Pract. 2016         Jul;32(5):332 55. K.
• Louw A, Nijs J, Puentedura EJ. A clinical perspective on a pain neuroscience education approach to manual therapy. J Man Manip Ther. 2017;25(3):160-168

Access to VA Library:

Remote Access: can be accessed anywhere: https://www.va.gov/LIBRARY/remote_access.asp

Faculty and Staff

Core Faculty and Support Staff of the Columbia VA Physical Therapy Orthopedic Residency Program

Meredith Hall, PT, DPT  
          CVAHCS Physical Therapy Supervisor

Ryan Gadow, PT, DPT
          Out-Patient PT Section Chief

CVAHCS Core Faculty

Matthew Anderson, PT, DPT      
          Board-Certified Specialist in Orthopaedic Physical Therapy
          Fellow of the American Academy of Orthopaedic Manual Physical Therapists

Ulysses Juntilla, PT, DPT (Residency Director)
          Board-Certified Specialist in Orthopaedic Physical Therapy
          Fellow of the American Academy of Orthopaedic Manual Physical Therapists

Catherine Houston, PT, DPT        
          Board-Certified Specialist in Orthopaedic Physical Therapy

Steve Matusiak, PT, MS, DPT      
          Board-Certified Specialist in Orthopaedic Physical Therapy

Rachel Waring, PT, DPT 
          Board-Certified Specialist in Orthopaedic Physical Therapy

Mentors in specialty areas:

Cory Sailer, PT, DPT 
          Board-Certified Specialist in Geriatric Physical Therapy
          CVAHCS Mentor- Acute/ In-Patient/Geriatric Population

Richard Osborn, OTRL
          Certified Hand Therapist 
          CVAHCS Hand/Wrist Specialist

Rhonda Grant, PT, DPT
          Vestibular Rehabilitation Certified
          CVAHCS Neurovestibular

Sarah Derenbecker, PT, DPT       
          CVAHCS Amputee/OrthoProsthetics Rehab

Mentors in partner sites: 

Cathy Arnot, PT, DPT
          Board-Certified Specialist in Orthopaedic Physical Therapy
          Fellow of the American Academy of Orthopaedic Manual Physical Therapists
          University of South Carolina -DPT Program Mentor

Amber Gadow, PT, DPT
          Board-Certified Specialist in Pediatric Physical Therapy
          Palmetto- USC Pediatric Rehab Mentor