Going to Scale A National Rehabilitation Scholarship Model Angela Rosenberg, DrPH, PT l.

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

PT/MS Scholars

Community Support

MS Society Chapter

Endowment or Funding

PT Academic Program

• 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

Physical Therapy / MS Scholarship Curriculum Link Fundraising Links Videos and You-Tube links Educational Links Other

Websites and Materials