The impact of the prospective payment system: perceived changes in the nature of practice and clinical education.

Journal Article (Journal Article)

BACKGROUND AND PURPOSE: Health care financing for teaching hospitals has undergone significant change in the past decade. This report describes changes in physical therapy practice and clinical education in three New England hospitals from 1984 to 1988. SUBJECTS: Hospital administrators, physical therapy managers, and clinical educators (N = 18) from the three teaching hospitals participated in this descriptive study. METHODS: Demographic, environmental, and participant interview data were gathered and examined to identify changes during this period. RESULTS: Perceived changes in practice include growth in specialized knowledge; increased emphasis on health care quality, efficiency, and accountability; new ethical dilemmas for practitioners; and a changing physical therapy role with new professional development opportunities. Perceived changes associated with clinical education were increased student performance expectations, unchanged resources for clinical education, greater emphasis on student self-directedness, and continued high valuing of this setting for physical therapy clinical education. CONCLUSION AND DISCUSSION: These results indicate significant change in the role of the physical therapist within these settings and suggest how these changes influence the clinical education of physical therapy students in these teaching hospitals.

Full Text

Duke Authors

Cited Authors

  • Emery, MJ

Published Date

  • January 1, 1993

Published In

Volume / Issue

  • 73 / 1

Start / End Page

  • 18 - 29

PubMed ID

  • 8417456

International Standard Serial Number (ISSN)

  • 0031-9023

Digital Object Identifier (DOI)

  • 10.1093/ptj/73.1.11


  • eng

Conference Location

  • United States