Step Up: APhysical Therapy/Multiple Sclerosis Scholarship Track

1. Step Up: APhysicalTherapy/Multiple Sclerosis Scholarship Track Going to Scale A National Rehabilitation Scholarship Model Angela Rosenberg, DrPH, PT l

2. The Science of Implementation “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

3. Creating a “Culture of Collaboration” • 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

4. An Equal Opportunity Diagnosis • Neurology • Sensory-motor • Balance • Proprioception • Orthopedics • Gait • Assistive devices • Orthotics

5. An Equal Opportunity Diagnosis • Radiography and Pharmacology • MRI • Current and emerging drug therapies • Cardiopulmonary • Fatigue • Breath control • Exertion Assessment and QOL Scales

6. Anticipated Outcomes • 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

7. 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

8. 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

9. 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

10. 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

11. Implementation and Scale-Up • 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)

14. Scale Considerations • Adopt what we know • Clear and standardized implementation path • Ensure fidelity and good outcomes • Ensure fidelity despite staff/volunteer turnover

15. Important Factors • 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

16. 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

17. Important Implementation 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

18. 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

19. Effective Implementation versusPositive Program Outcomes • 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

20. What Works…. • 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

21. What works…. • Excellence in: • Diffusion and dissemination of information • Training of mentors and clinical preceptors • Curriculum elements and support(s) • Policies and financial support

22. Implementation Framework

23. Implementation Framework

24. Websites and Materials • Physical Therapy / MS Scholarship • Curriculum Link • Fundraising Links • Videos and You-Tube links • Educational Links • Other