Journal of Education and Health Promotion

Abstract BACKGROUND: Physical therapists provide important services for improving health and function for
the general population; however, physical therapy (PT) is infrequently accessed by persons with a
primary diagnosis of severe mental illness (SMI). This study examined the attitudes of PT students
before and during their participation in a service‑learning (SL) program for people with SMI.
MATERIALS AND METHODS: A cross‑sectional institutional review board approved qualitative study
collected 1‑h semi‑structured qualitative interviews from seven graduates of a doctor of PT program.
Participants were from a New Jersey University program in the USA who participated in an SMI SL
experience. Participants were asked about participant attitudes toward people with SMI and their
observations during a SL experience using an interview guide. All interviews were digitally recorded,
transcribed, and coded using interpretive phenomenological analysis by a team of researchers. This
type of qualitative analysis aims to explore participants understanding of their experience without
pre‑conceived theoretical direction. Recordings, transcripts, and field notes were reviewed for
recurring ideas that were summarized into codes. Through independent coding, reflexivity memos,
and consensus meetings, data were further analyzed to identify themes. Investigator triangulation
addressed differences and aided consensus development.
RESULTS: Before the SL experience, the students reported negative perceptions about people
with SMI and feelings of uncertainty and unpreparedness to work with this population. According
to student reports, SL supported their personal and professional development and allowed them to
see that PT services are beneficial for people with SMI.
CONCLUSIONS: The results of this study indicate that PT students have negative attitudes of people
with SMI and feel unprepared to work with this population. The results also support SL as an effective
strategy for helping students in their preparation for working with people with SMI.

Abstract INTRODUCTION: Physical therapists provide important services to improve physical health for
the general population; however, physical therapy interventions are less utilized with underserved
populations such as those with severe mental illness (SMI). The quality of services for these
populations is impacted in part by negative provider attitudes and lack of preparation to work with
the SMI population. This study examined the impact of structured educational field experience on the
physical therapist’s attitudes and knowledge about working with the SMI population. This will inform
future educational practices to best prepare students to provide quality of healthcare to the population.
MATERIALS AND METHODS: Seven graduates of a doctor of physical therapy (DPT) program
from a Mid‑Atlantic University in the United States who participated in an SMI service‑learning (SL)
experience completed a semi‑structured qualitative interview in 2016. Questions about how the
experience impacted their current work were asked. Interviews were digitally recorded, transcribed,
and examined using interpretive phenomenological analysis. Coding and investigator triangulation
were conducted. All interviews reached thematic saturation.
RESULTS: The graduated DPT students reported attitudinal changes toward people with SMI through
qualitative interviews. They reported an improvement in their skills, greater competence to work with
the SMI population, and an increased focus in the use of person‑centered services.
CONCLUSIONS: The results of this study suggest that DPT students gain an understanding of both
the SMI population and themselves during SL. Using SL as part of the DPT educational curriculum
can offer students and the opportunity to build confidence in working with the SMI population. SL
can also improve their skills and attitudes toward the population, key areas that are identified as
barriers to receiving quality physical healthcare among the SMI population.