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Step Up: APhysical Therapy/Multiple Sclerosis
Scholarship Track
Going to ScaleA National Rehabilitation Scholarship
Model
Angela Rosenberg, DrPH, PT
l
“In theory there is no difference between theory and practice; in practice, there is”
Variously attributed to Jan La Van De Snepscheut or Albert Einstein or Yogi Berra
The Science of Implementation
Academic-NFP Organization Partners Joint decision-making process Non-ownership Creating a “new culture” Community of Practice
◦ Education and Training◦ Clinical Practice◦ Research◦ Advocacy and Fundraising
Creating a “Culture of Collaboration”
Neurology◦ Sensory-motor ◦ Balance◦ Proprioception
Orthopedics◦ Gait◦ Assistive devices◦ Orthotics
An Equal Opportunity Diagnosis
Radiography and Pharmacology◦ MRI◦ Current and emerging drug therapies
Cardiopulmonary◦ Fatigue◦ Breath control◦ Exertion
Assessment and QOL Scales
An Equal Opportunity Diagnosis
◦Curriculum Model Tier One: Faculty and Chapter Tier Two: Volunteer Leadership Team Tier Three: Scholars Tier Four: Individuals with
Diagnosis/Family members Tier Five: Other practitioners and
community members
Anticipated Outcomes
◦Education Increased numbers of graduates with specialized
knowledge and skills Scholarship funding Increased awareness by interdisciplinary mentor-
practitioners Increased knowledge dissemination through
scholarly products Enhanced curriculum opportunity for all students
Anticipated Outcomes
◦Clinical Practice Increased numbers of physical therapists with specialized
knowledge Increased skills and knowledge: increased # of publications,
participation in local/regional/national forums related to PT clinical relevance/MS
Increased awareness of community of interdisciplinary practitioners
Increased level of clinical competency of graduates (post and CMSC certification post 1 year)
Enhanced practice of local/regional/state PT’s and Directory of PT’s with specialized knowledge
Anticipated Outcomes
◦ Research (Post 5-10 years of program) Increased numbers of rehabilitation professionals
with specialized knowledge Increased discipline specific clinical research Increased research collaboration with
interdisciplinary practitioners Increased clinical research grants by discipline
related to specific diagnosis Enhanced rehabilitation techniques due to increasing
evidence-base
Anticipated Outcomes
Service and Advocacy Increased numbers graduate sponsored activities
and fundraising Increased scholar learning opportunities (e.g. Scholar
participation on Chapter Board, CAC) Scholar support for NFP fundraising and advocacy
efforts (e.g. MS Walk) Scholar – Chapter education and training (e.g.
Speakers at State Conference, Book Reviews) Increased interdisciplinary collaboration Increased knowledge dissemination (Scholar
fundraisers) Enhanced service opportunities for all students
Anticipated Outcomes
First implement then scale-up with attention to science and practice
Requirements◦ Practice Level (Chapter Staff, Academic Faculty,
Community MS Practitioners, National Course Facilitators)
◦ Organizational Level (MS Society Chapters and Directors, Chapter Volunteer Committee, NMSS, Clinical Advisory Committee, University / College)
◦ System Level (Funders, NMSS Support, Regulatory Bodies)
Implementation and Scale-Up
• Individual endowment
•MS Chapter/NMSS•University In-kind
•MS Chapter/ Volunteer Committee
•PT Program Academic Support
•Faculty mentor(s)
•MS Clinical Advisory Committee
Community of Practice PT Academic Program
Funding
MS Chapter
Adopt what we know Clear and standardized implementation
path Ensure fidelity and good outcomes Ensure fidelity despite staff/volunteer
turnover
Scale Considerations
Receptive University/Academic PT Program◦ Dean/Director Support◦ Faculty support and mentorship◦ Faculty “Champion”◦ Receptive ACCE◦ Academic Public Relations◦ Academic Fundraising / Foundation◦ Receptivity to MS Chapter partnership
Important Factors
Receptive MS Chapter◦ Rehabilitation need in community◦ Receptive Chapter director and staff◦ Chapter “designated” PT volunteer committee◦ Chapter Clinical Advisory committee link◦ Chapter Public Relations/ Material development◦ Receptive to academic partnership
Important Factors
Receptive Community of MS Clinical Practitioners◦ PT ACCE Faculty liaison to UNC Core◦ Chapter Clinical Advisory committee◦ Available community of MS Clinical mentors◦ Receptive interdisciplinary practice mentors (e.g.
Neurologists, Nurse Practitioners)◦ Receptive PT clinical affiliation sites
Important Implementation Factors
Receptive Community of MS Clinical Practitioners◦ Chapter Sponsored Clinical Advisory Committee◦ ACCE and Clinical affiliate sites both local/national
Fundraising Campaign◦ Development plan◦ Public Relations plan◦ Academic and Organizational development
partnership◦ Service and Specialized funding opportunities
Important Implementation Factors
Implementation is not achieved by doing more or better research on the model
The usability of the model has to do with the “fit” and commitment of the new site with the anticipated outcomes of the original program◦ The outcomes of the UNC MS/PT Scholars program
does help a program decide whether they have the ‘right combination’ to implement
◦ Evidence of UNC success does not equal success of new programs
Effective Implementation versusPositive Program Outcomes
A Purveyor◦ An individual or group of individuals representing
a program or practice who actively work to implement the initiative with fidelity and good effect
◦ Purveyors accumulate data and experiential knowledge and become more effective and efficient over time
What Works….
Excellence in:◦ Diffusion and dissemination of information ◦ Training of mentors and clinical preceptors◦ Curriculum elements and support(s)◦ Policies and financial support
What works….
Evaluated Model : UNC MS/PT
Purveyor: NFP OrganizationAnd Academic Partner
Scholarship Program Engaged practice communityEnhanced rehabilitation services and research
Implementation Framework
Successful
Scholarship Model
Purveyor
Fidelity and
Outcome Measure
s
Evidence-based Model
Implementation Framework
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