When the University of Pittsburgh Department of Physical Therapy was beginning to develop its Doctor of Physical Therapy (DPT) Hybrid program in 2017, it was also conducting its own research to determine how it could address the profound lack of diversity in their department and in the profession as a whole. They found that their own classes were predominantly middle to upper class, young white females. These results, as well as the ensuing nationwide reckoning of racial injustice in 2020, spurred the department to outline its inclusion initiative to ensure that “Physical Therapist Education is FOR EVERYONE.” They also developed the Advancing Diversity in Physical Therapy (ADaPT) program to engage, recruit and advance diverse students into graduate physical therapy education. Two of the keys to improving its diversity, equity and inclusion (DEI) was to make the DPT Hybrid learning experience one that embraces students from diverse backgrounds and broadens its reach to students not living in Pittsburgh.
Pitt DPT Hybrid Program Director Kim Nixon-Cave, a Pitt PT alumna herself, was hired in January 2021 to helm the design of the new DPT Hybrid program. Her PhD in Education reinforced the importance of continual learning for health care professionals, and she worked as program director for several PT programs as well as the director of clinical education and department chair. She has been a consultant for PT programs going through accreditation as well as for developing smaller hybrid programs. Having faced her own DEI challenges in school and as a health care provider, Nixon-Cave was looking for innovative ways to influence the education of physical therapists. Leading her alma mater in this effort was perfect timing.
“This was a different take on PT education and to be in the forefront of something new and different, which is fun to do. I could really develop something and challenge myself.’”
Kim Nixon-Cave
The Importance of Diversity in Health Care
Nixon-Cave explains that the importance of diversity in health care is that it results in the improvement in the quality of health care. It ranges from the patient being more comfortable seeing a health care professional who looks like them, to having decision makers from different backgrounds at the table who can change established, biased narratives.
“When you bring in people from diverse backgrounds, you decrease the biases because they can help you to recognize what’s happening. I could recognize it because I’m already at the table, whereas you may not recognize it because it’s the norm. The more diversity you have, you change the culture and you change how people make decisions. You influence what’s happening. That’s why it’s important to get a more diverse workforce in health care, because you have better care for everybody involved.”
Kim Nixon-Cave
The two DPT Hybrid cohorts have had students enrolled from 26 states and four countries. Students are aware of the influence of this diversity and how it will shape their patients’ care in the future.
“We meet people from all over the world and from all over the country. In my class, I have a young woman who’s from Croatia. I have a woman who’s Romanian. You have people who are bi- and trilingual. You get so many different walks of life and you get to really interact with them. I think it makes us more compassionate, too, because we’re all from different backgrounds. Being able to connect with that is how we’re going to connect with our patients in the future. This exposure from people across the nation and other countries is really helpful.”
Amanda Klein; Spokane, WA; U.S. Air Force Veteran; DPT ‘23
The DEI Mission of the DPT Hybrid Program
The School of Health and Rehabilitation Sciences (SHRS) leadership and Department of Physical Therapy faculty defined ambitious diversity, equity and inclusion goals for the DPT Hybrid program and put money behind the staffing and infrastructure to make it happen. Their mission is threefold:
Welcome People from Diverse Backgrounds
The main goal for the DEI component of the DPT Hybrid program is to give students that would otherwise not be able to move to Pittsburgh the opportunity to participate—especially people from diverse backgrounds. “When you open the program up to students who don’t have to move,” explains Nixon-Cave, “it really gives individuals who would otherwise not consider Pitt the opportunity to truly consider it and apply. We’re talking about military veterans and people with second careers who have families and don’t want to move, and then minority populations or students. Pitt doesn’t have the best reputation for drawing them in, so opening up the hybrid option makes them say, ‘Well maybe I can do it.’”
Make it More Affordable
Higher education is expensive and students often face graduating with a significant amount of debt. Moving to a new city for school can mean higher living expenses or uprooting family members with steady jobs. Pitt strategized to allow hybrid students to pay in-state tuition rates no matter where they live, which can save thousands of dollars each year and encourage students who may not have thought that a Pitt PT education was within their financial reach.
Stay in Your Community to Improve Local Health Care
Pitt is committed to improving access to health care providers in underserved areas and the hybrid program is one of the solutions.
“One of the things that typically happens with students is that they come from a rural area or small town. They go to university in a city, do their clinical and training, but they don’t necessarily go back home. The goal is to have these students stay where they are locally and eventually serving their own community as health care professionals.”
Kim Nixon-Cave
The students identify with this need and know that being in the Pitt program will allow them to do just that:
“The hybrid format is important because from a financial aspect, it gives more people the opportunity to pursue a physical therapy degree. It costs less money for people to stay within their hometown and within their community and give back, especially those who live in communities that don’t usually have a lot of resources for PT clinics.”
Shakari Cunningham; Kankakee, IL; DPT ‘23
Prioritizing a Sense of Belonging
It’s one thing for programs to prioritize diversity and recruit students that fit that mold, but they must retain those students through graduation and into their careers. Nixon-Cave explains that data show students can be successful the first year of the program, but for untold reasons they are later dismissed or withdraw themselves from the program. Students from racially or ethnically diverse backgrounds are the ones less likely to complete an academic program.
“Whenever someone comes to me and asks how to increase the diversity in their program, I tell them they must have a recruitment and retention plan. Within the hybrid program we have a plan and are looking at ways to retain students.”
Kim Nixon-Cave
Part of that plan is to prioritize a sense of belonging among each other, within the program and the profession. Nixon-Cave says that students and professionals will openly talk about the importance of belonging or lack thereof and she can speak from her own experience. “I was the diversity in my program at Pitt. I was bicultural. When I left school for the day, I had my PT or school world, and then I had my world outside of that with people who look like me. I didn’t always feel like I belonged in my PT school/program. And so that’s one of the things we’re really trying to work on and make sure students feel like they belong. It’s like that saying, ‘You can bring people to the party, but you have to invite them to dance.’” Students must feel that they are in an inclusive environment and have a sense of belonging.
“I like that our advisors reach out and touch base with us every week or once a month. They ask, ‘How are you doing?’ and ‘How can I help?’ and ‘What can I do to facilitate your learning in this environment?’ I think that’s been really helpful to always have that constant lifeline.”
Gabrielle Hofilena; Livingston, NJ; DPT ‘23
Nixon-Cave describes several actions the DPT program is taking to develop this sense of belonging in their students. She personally reaches out to racially and ethnically diverse students to provide them with information about professional groups across the country that bring together students like themselves on a monthly basis. The program’s academic advisors reach out to the students and ask how they can be better supported. They have added prayer rooms for religious purposes and student-led social groups, such as the DEI student group, have been formed to provide a welcoming environment.
“The more people you have that are from diverse backgrounds, the more people are going to feel like they belong here. So that is an area that I think we could do a better job at looking at, but I believe we’re moving in the right direction.”
Kim Nixon-Cave
