The Development and Evaluation of a Pediatric Interprofessional Education (IPE) Experience for Occupational and Physical Therapy Graduate Students

Abstract

Interprofessional competence is needed to improve health care outcomes. The aim of this paper is to describe the development of theoretically grounded interprofessional education (IPE) experiences to advance interprofessional competencies for occupational and physical therapy doctoral students. In addition, a pretest/postest survey was designed to determine the participants’ perceptions of knowledge attainment, roles, and attitudes. Two cohorts of students (N = 115) completed surveys pre and post IPE experiences. Statistically significant changes were found on perception of roles and knowledge attainment. Additional studies are needed to determine if IPE leads to behavioral changes in practice and improves patient outcomes.

Keywords:

• Educational theory
• interprofessional education
• occupational therapy education
• pediatric curriculum
• physical therapy education

Background

The Joint Commission’s Center for Transforming Health Care (2014) has reported that miscommunication among healthcare providers is a major contributing factor to negative patient events in the hospital setting. The need for health care professionals to communicate effectively within and across disciplines is critical. The Interprofessional Education Collaborative (IPEC), (2016) has identified four essential competencies that support the overarching domain of interprofessional collaborative practice. These include teamwork and team-based practice, communication practices, values/ethics, and roles/responsibilities for collaborative practice. Interprofessional education (IPE) experiences have been identified as a viable way for students to develop these competencies.

Although there is an abundance of literature to support the importance of the competencies, less attention has been focused on the explicit description of relevant pedagogical approaches and/or theories to support the structure and content of IPE learning activities (Danielson & Willgerodt, 2018; Olsen & Bialocerkowsk, 2014). Mukhalalati and Taylor (2019), noted the need for theory to be overtly described as a crucial component of evidence-based educational practice.

Despite a dearth of IPE theoretical underpinnings described in the literature, the World Health Organization (World Health Organization, 2010) has stated “research indicates that interprofessional education is more effective when: principles of adult learning are used (e.g., problem-based learning and action learning sets), learning methods reflect the real-world practice experiences of students, and interaction occurs between students” (p. 24). Of the few articles that describe the application of theory to IPE learning activities, reference to principles of adult learning as well as constructivism have been noted with some regularity (Hean et al., 2018; Teodorczuk et al., 2016; Smith et al., 2017).

Both the American Council of Occupational Therapy Education (ACOTE) and the Commission on Accreditation in Physical Therapy Education (CAPTE) require identification of the theoretical model or educational theory that underly a program’s curricular design or curriculum plan (Accreditation Council for Occupational Therapy Education (ACOTE), 2018; Commission on Accreditation for Physical Therapy Education (CAPTE), 2020). They both identify IPE-related standards that must be included within the curriculum. In addition, the American Occupational Therapy Association (AOTA) and the American Council of Academic Physical Therapy (ACAPT) support IPEC core competencies and subcompetencies (Interprofessional Education Collaborative (IPEC), 2016).

The pediatric faculty in the schools of occupational and physical therapy at a private university located in the Southeastern United States, sought to develop theoretically-grounded IPE experiences to address IPEC competencies, while also meeting their respective accreditation standards. Despite the requirements to include IPE in health care education curricula, there is scant literature to describe how occupational and physical therapy programs are using educational theory to intentionally link IPEC competencies with IPE objectives, learning activities, and assignments. The primary aim of this paper is to describe the process of the development of a series of three, theoretically grounded IPE experiences to advance interprofessional competencies for occupational and physical therapy entry-level doctoral students and evaluate its effectiveness.

Development of the courses

The series of theoretically grounded IPE learning experiences were developed for occupational therapy students who were in the second year of a three-year program and physical therapy students were in the third year of a three year program. The three IPE experiences were planned as part of the students’ pediatric assessment and intervention courses. As adult learning theories and social and cognitive constructivism were already incorporated in the existing curriculum design for these particular graduate programs, the use of these theories was a natural extension of the existing curricular design. The pertinence of adult learning theories to undergird IPE initiatives has been noted by World Health Organization (2010). In addition, Cusack and O’Donoghue (2012) noted that IPE is supported by constructivism where students from different professions work together in ways that foster new understanding of their own and others’ professional roles.

The joint experiences were planned to support the development of IPEC competencies and ACOTE and CAPTE accreditation standards. Content to support development of the competencies was arranged in a developmentally progressive manner using the concepts of modeling and scaffolding. Both social and cognitive constructivism emphasize modeling and scaffolding to help students build, organize and reorganize knowledge. Modeling refers to the process where an “actor” can influence a learner by showing that the learner can succeed by following the same set of steps as the actor (Trif, 2015). Scaffolding refers to structuring the learning activity in a manner that is adapted to the learners’ current skills and providing the support necessary to facilitate a higher level of learning. Scaffolding is consistent with constructivist viewpoints, as well as adult learning theorists (Anderson, 2016). Specific educational objectives that related to the competencies were identified. Table 1 includes an example of the mapping that was done to link learning theory with IPEC competencies, educational objectives, session content, and learning activities for the sessions.

Table 1. Overview of IPE mapping for the three OTD-DPT student sessions.

Targeted IPEC competencies	Educational objectives	Learning activity/description	Adult learning theory and constructivist principles
Session 1: Hour 1
2	Describe differences and similarities in the role of pediatric PT’s and OT’s. Discuss principles of family-centered care related to parent interview process. Compare and contrast unique aspects of scope of practice for each profession and areas of overlap in the management of children.	Instructor-facilitated video analysis of OT/PT child assessment. Activity Description Students view short video of OT/PT evaluation of a child followed by faculty-led discussion of role delineation, scope of practice, and family-centered care. Interprofessional Interaction/Assignment: Low threat, supportive environment facilitated through modeling, and coaching. Students work in interprofessional groups during guided discussion and generated two mock interview questions.	Instructors model interprofessional collaboration during discussion of OT/PT roles. Students reflect on and co-construct knowledge of roles. Students mental models of roles and family-centered interview questions challenged based on instructor prompting/feedback.
Session 1: Hours 2 and 3
1, 2 3	Engage in team-based interview of family using a client-centered approach Communicate respectfully in an interprofessional group to determine family and child needs and goals.	Parent interview and instructor-modeled interprofessional treatment session Activity Description Student interprofessional groups engage in the following activities: 1) Propose parent interview questions with instructor feedback, 2) Participate in family interview with instructor support utilizing principles of family centered care, 3) Observe OT and PT instructors performing a short co-treatment of the child, 4) Discuss child and family strengths and needs with the goal of each group achieving consensus on OT and PT needs. Interprofessional Interaction/Assignment Moderate. Student groups supported by faculty prior to and during family interview and treatment observation. Complete goal sheet.	Instructors-model interprofessional treatment session. Scaffolding of learning from drafting interview questions, receiving instructor feedback, followed by participating in interview. Student groups co-construct knowledge of family and child needs, strengths and goals by sharing perspectives. Meaningful and relevant learning by students’ assistance in parent interview
Session 2
1,2,3,4	Collaborate with interprofessional team to select and justify appropriate assistive technology for children with special needs Demonstrate the ability to identify and define problems, critically compare options, and make timely decisions or recommendation in light of evidence.	Assistive Technology Vendor Fair Activity Description Equipment vendors present assistive technology used for mobility and ADLs. Student interprofessional groups explore equipment and clarify questions with instructors and vendors. Interprofessional Interaction/Assignment: High. Students work in interprofessional groups throughout the session to complete a common graded assistive technology justification worksheet.	Scaffold learning from identification of child needs and goals to selecting and justifying most appropriate adaptive equipment. Facilitate co-construction of knowledge through adaptive equipment considerations. Instructor and vendors challenge student thinking “in the moment” to facilitate discussion and problem-solving.
Session 3
1,2,3,4	Demonstrate the ability to collaborate with diverse team members, families, and other individuals to perform comprehensive assessment that is respectful of and responsive to family preferences, needs, attitudes, beliefs, and values Demonstrate knowledge of team-based professional skills, roles, and responsibilities to ensure an environment for safe, efficient, and effective child assessment.	Comprehensive evaluation of child with assistive technology needs. Activity Description: Students work in small interprofessional groups to evaluate a child and identify assistive technology needs. Students interview parent, consider child’s history, and perform an evaluation of the child. Interprofessional Interaction/Assignment: High: students work in interprofessional groups to plan and execute an evaluation of the child. They will prepare a common graded letter of medical necessity and adapted play needs work sheet. Students determine how to work together based on knowledge of roles, scope of practice, and unique abilities and strengths of team members	Student-led session with instructors assuming a coach/facilitator role. Faculty challenge critical thinking by asking students for rationale “in the moment.” Students reflect on action to identify “what could be done” (e.g., behavioral management). Meaningful and relevant learning through actual child assessment with instructor support and supervision. Debriefing after session to identify “what worked” and “what could you have done differently”

IPEC Core Competencies for Interprofessional Collaborative Practice: 1 = Values/Ethics, 2= Roles/Responsibilities, 3= Interprofessional communication, 4 = Teamwork.

Consistent with the concept of scaffolding, the first session was designed to entail instructor-guided discussion and instructor modeling of an occupational and physical therapy co-treatment session. Sessions two and three were developed to build upon the content provided in the first session. Instructor roles evolved to that of a facilitator for session two. Creating activities to foster idea exchange in a supportive and respectful environment was a key component of the sessions and is drawn from adult learning theory as described by Knowles (1988). The child observed in session one was “re-visited” to scaffold content and support the objectives for the session two experience.

Session three entailed a four-hour session that required a group of five to six students to work together to perform a comprehensive evaluation of a child. A licensed pediatric occupational therapist and/or physical therapist supervised and supported each group of students. Students took a “lead” role in conducting the occupational and physical therapy assessment, including interviewing caregivers, while the faculty assumed a coach/facilitator role. Consistent with cognitive constructivism, faculty challenged the students’ critical thinking by asking them to provide a rationale for certain actions “in the moment”. Additionally, students were asked to reflect collaboratively in groups as to “what worked” and “what could you do or have done differently” which is consistent with social constructivism. Thus, a higher level of student autonomy as well as thinking and reflection in action occurred during session three and was an intentional part of the IPE design.

In developing any new component of a professional program, it is critical to assess the impact of the component, in this case, a series of IPE experiences. Thus, a study was designed to determine participants’ perceptions of knowledge and roles as well as attitudes toward interprofessional practice and shared learning before and after a series of the IPE experiences. Specifically, the research question was “Is there a difference in participants’ perception of knowledge and roles and attitudes toward interprofessional practice and shared learning after a series of three IPE experiences?

Methods

Survey development

Survey methodology, using a pretest/post-test design, was employed to conduct the study. A nine-question survey, based on The Readiness for Interprofessional Learning Scale, (RIPLS), (McFadyen et al., 2005), Interdisciplinary Education Perception Scale, (IEPS), (McFadyen et al., 2007), and IPEC competencies, as well as course-specific content was developed.

Instrument

Two subject matter experts developed a draft survey to ascertain students’ perceptions of roles, knowledge, and attitudes in addition to the other course assignments to be used as outcome measures. Both of the subject matter experts had over twenty years of clinical experience in pediatrics and more than fifteen years of experience teaching in graduate level occupational or physical therapy programs. The occupational therapist expert was Board Certified in Pediatrics through the AOTA. The other was certified as a clinical specialist in Neurologic Physical Therapy by the American Board of Physical Therapy Specialties and a developer of widely used physical therapy assessment in pediatrics. Both had previously participated in extensive IPE professional education experiences and presented on IPE nationally.

To determine survey content, the subject matter experts examined IPEC competencies, course content in relation to CAPTE and ACOTE standards, and considered the students’ progression in their respective curricula including prior IPE experiences. Survey tools used in IPE-related research were reviewed, including the RIPLS and IEPS, as their purpose is to determine ‘readiness” for interprofessional learning (McFadyen et al., 2005; McFadyen et al., 2007). However, since students in these courses had multiple previous interprofessional experiences, readiness for interprofessional learning did not appear relevant the purpose of this research. In addition, Visser et al. (2018) reported that a pre-post comparison of readiness for interprofessional learning has limited benefit as an IPE outcome measure. Instead, more specific wording related to understanding of roles and responsibilities appeared important and addressed in both the ACOTE and CAPTE Standards and Essentials. For example, ACOTE Standard B.5.21 was that “students will be able to effectively communicate, coordinate, and work interprofessionally with those who provide services to individuals, organizations, and/or populations in order to clarify each member’s responsibility (italics added for emphasis) in executing components of an intervention plan,” (Accreditation Council for Occupational Therapy Education (ACOTE), 2012, S48). In addition, Interprofessional Education Collaborative Expert (IPECE) (2011) also noted that the competencies they identified do not address the unique aspect of each health profession. They stated that “we recognize that greater awareness of shared areas might lead to greater efficiencies in health professions education” (p. 37).

As a result of synthesizing these sources of information, nine survey questions were drafted. Five of the nine questions focused on roles and responsibilities commonly required in pediatric practice. These questions were adapted from the Interprofessional Education Collaborative (IPEC) (2016) roles and responsibilities, subcompetencies, accreditation standards, and course content. Two questions were included to determine attitudes. One of these questions was designed to examine attitude toward shared learning (modified from numerous questions on shared learning on the RIPLS, 2005) and the other was intended to examine attitude toward collaboration (modified from question six on the IEPS, 2007). Two additional questions were added that related to perception of knowledge. The knowledge-related questions directly addressed course content.

The survey was submitted to an expert panel to establish face and content validity. The panel consisted of three individuals who were asked to address content and clarity of questions. All panel members had over ten years of experience in pediatric practice. All had over five years of experience in teaching in a higher education setting, experience with IPE, and were familiar with pediatric course content for accredited occupational and physical therapy programs. To improve clarity of survey questions, modifications were made to the wording of two questions based on committee input.

Table 2 contains a list of the survey questions. Participants rated responses using a 4 point Likert scale that ranged from 1 indicating strongly disagree to 4 indicating strongly agree. A demographic questionnaire was also developed.

Table 2. Student reported outcomes of pediatric interprofessional education survey.

Question	Domain
Occupational and physical therapists often provide interventions that target very different goals/outcomes of children.	Roles
There are many overlapping areas of responsibility between occupational and physical therapists who work with children.	Roles
Physical and occupational therapists possess expertise that enables both to contribute to decisions regarding positioning for function and functional mobility of a child.	Roles
Both occupational and physical therapists attend to the psychological as well as motor aspects of a child’s function when recommending equipment for positioning and functional mobility.	Roles
I have observed a high degree of collaboration between occupational therapists and physical therapists with goal planning and intervention with children.	Roles
I feel that a high degree of collaboration between occupational therapists and physical therapists can benefit goal planning and intervention with children.	Attitude
Shared learning experiences are beneficial to help occupational and physical therapy students to learn unique roles of occupational and physical therapy professionals.	Attitude
I understand the rationale for using alternative positions in pediatrics.	Knowledge
I feel knowledgeable regarding the similarities and differences in occupational and physical therapy approaches to assessment and intervention planning for a child	Knowledge

Note: Participants rated responses using a 4 point Likert scale that ranged from 1 indicating strongly disagree to 4 indicating strongly agree. Bolding added to denote language associated with the domain based on IPEC competencies, RIPLS, IEPS, and/or accreditation standards.

Procedures

After approval was received by the Belmont University Institutional Review Board, students were invited to participate in the study. Students who provided informed consent completed the pretest before the first IPE session. Prior to the start of the first session, the course instructors assigned students to groups of four to five in size that worked together during the three IPE sessions. Although some of the students were already familiar with one another, they were provided time at the beginning of the first class for introductions. Students were encouraged to obtain contact information and determine time available outside of class to work together. Time was provided within class to work on the assignment although roughly 50% of groups needed additional time and completed the assignment outside of class. All assignments were graded collaboratively between the primary course instructors. The assignments were weighted equally in the students’ respective curriculum. After session three, students completed the IPE post-assessment. The three sessions were held over a fifteen-week period of time.

Data analysis

Data from two cohorts of students over a two-year period of time was included in the study. SPSS, V. 25, was used to analyze the survey data. Inferential statistics employed were the mixed effects generalized linear model and Mann-Whitney U tests. The mixed effects generalized linear model was used to examine change over time as a result of participation in the IPE experiences. This model examines the variables of discipline (occupational therapy versus physical therapy), time (pretest to post-test), as well as the interaction between time and discipline (did one group change more than the other over time). The Mann-Whitney U was used to determine if there were statistically significant differences between the groups of students at pretest.

Results

One-hundred twenty-six students were invited to participate and 115 students completed consent forms as well as both the pre- and post-test. The response rate was 91.3% percent. Participants included 63 OTD and 52 DPT entry level students. Ten (8.7%) participants were males and 105 (91.3%) were females. The majority of students (n = 86, 75%) were between the ages of 21 to 25. Twenty-three percent (n = 27) were between the ages of 26–35 while 2% (n = 2) were over age 35.

The Mann-Whitney U was used to identify significant differences between the students’ responses at pretest. There were only statistically significant differences at pretest for questions three (U = 1345, p=.05), five (U = 1296, p=.042) and eight (U = 1284, p=.029). OTD students more strongly agreed with survey questions three and eight than DPT students. On survey question five, DPT students more strongly agreed with the statement than OTD students at pretest.

The Mixed Effects Generalized Linear Model examined overall change post intervention. Using this model, significant differences were found for particular variables (e.g., discipline, time, or discipline X time) using a p of <.05 for questions five, eight, and nine (see Table 3). Table 3 indicates that both groups’ degree of agreement with the statement changed over time for those questions. While one group did not change to a greater degree than the other for questions five or nine, the amount of change over time was statistically different with the DPT group changing more than the OTD group for survey question eight.

Table 3. Results of mixed effects generalized linear model.

Survey question	Discipline	Time	Discipline X time
5: I have observed a high degree of collaboration between occupational therapists and physical therapists with goal planning and intervention with children	p = 0.018*	p=.00*	p=.735
8: I understand the rationale for alternative positioning in pediatrics….	p=.310	p= .003*	p=.007*
9. I feel knowledgeable in similarities and differences in OT and PT approaches to assessment and intervention planning for a child	p= .525	p = 0.00*	p=.125

Note: *Indicates statistical significance based on a p value of <.05.

Discussion

Reforms in health care require educators of professional programs to prepare students to enter the workforce with the ability to work collaboratively. The need for deliberate design, incorporation of adult learning principles, and promotion of exchange of information are key features for facilitating quality IPE identified in the Guidance on Developing Quality Interprofessional Education for the Health Professions (Health Professions Accreditors Collaborative, 2019). This paper described a deliberate approach in using constructivism and adult learning theories to ground a series of three IPE experiences which were embedded into pediatric course content for doctoral students in the occupational and physical therapy programs. A mapping process was completed to link the educational theories with IPEC competencies, as well as, session objectives, session content, and learning activities as well as assignments.

Although careful IPE planning is crucial, assessing outcomes or the effectiveness of IPE sessions is also necessary. For this study, a survey was developed to determine if students’ attitudes and perceptions, including perception of interprofessional roles and perception of knowledge attainment, would change from pre- to post-test. Regarding perception of knowledge and knowledge of roles, both DPT and OTD students perceived that they better understood the rationale for alternative positioning in pediatrics and felt more knowledgeable regarding similarities and differences in assessment and intervention planning after the IPE experiences. They also more strongly agreed that they had observed a high degree of collaboration between occupational therapists and physical therapists with goal planning and intervention with children at after the educational experience in comparison to before their participation on the courses.

Knowledge regarding similarities and differences in occupational and physical therapy approaches is an important competency related to identification of professional role responsibilities and differences. This competency is most related to role/responsibility sub-competency four identified by Interprofessional Education Collaborative (IPEC) (2016) that states “Explain the roles and responsibilities of other providers and how the team works together to provide care, promote health, and prevent disease” (p. 12). Students perceived they were better able to identify similarities and differences in each profession’s approaches. The deliberate emphasis on principles associated with adult learning and constructivism, namely promoting idea exchange, fostering respectful social discourse, and providing opportunities for reflection, may have aided the students’ perception of competence related to role responsibilities and differences.

Students more strongly agreed that they had observed a high degree of collaboration between occupational and physical therapists after the IPE experience. This finding may have been influenced by modeling that occurred between course instructors or increased opportunities for collaboration that were fostered during the IPE sessions. During session three, the students worked together in interprofessional teams to assess a child including equipment and play needs. This type of authentic experience is reinforced by World Health Organization (2010) who noted that real-world practice and interaction between students is associated with more effective IPE. The end-products of this session (letter of medical necessity and play needs worksheet) required a high degree of collaboration.

Students also reported that they better understood the rationale for use of alternative positioning in pediatrics. This finding suggests that students felt more knowledgeable regarding this intervention after participation in the IPE sessions. Consistent with constructivist principles, the adaptive equipment sessions were intentionally designed to facilitate co-construction of knowledge. Knowledge of content related to one professional role is important for issues related to understanding professional scope of practice. This perceived enhancement of disciplinary knowledge is also related to the IPEC competency of roles and responsibilities. This competency states that professionals should apply understanding of disciplinary and interdisciplinary roles to determine and meet clients’ health care needs to enhance population health (Interprofessional Education Collaborative (IPEC), 2016, p. 10).

Although there were not significant differences in pre to post-test responses on six of nine survey questions, the descriptive statistics results for the survey item on shared learning experiences being beneficial to learn the unique roles of occupational and physical therapy professionals was of interest. Although all students agreed or strongly agreed with this statement prior to the education, 5% of students disagreed after the experience (DPT = 5, 4.4%; OTD =1, .87%). Although further study is warranted, some may not have viewed shared learning as beneficial due to the challenge inherent in coordinating schedules to complete the joint assignments. Although the pediatric IPE experience described in this study was not the students’ first IPE experience in the OTD and DPT curricula, it was the first IPE experience in which assignments were graded and all members of the team received the same grade. Similarly, Kerfeld et al. (2017) reported that although students’ attitude toward a pediatric occupational and physical therapy IPE experience were generally positive, students were challenged by the need to negotiate their different course schedules in order to meet after class time to complete joint assignments. Related to this challenge, the higher dissatisfaction rate among DPT students may stem from a difference in curricular alignment between OTD and DPT students. Physical therapy students had more clinical and didactic experience including practice with goal writing and with the documentation process. Since these skills were required for several joint assignments, the learning curve may have been greater and increased time may have been needed by some OTD students in comparison to DPT students. Some DPT students may have felt frustrated by this difference. Although the need for graded activities may need to be further examined, it appears critical for IPE planners to include a number of assessment measures to determine preparation for clinical situations where effective communication, collaboration, and negotiation are required for safe and effective patient care.

Limitations

As with all studies, there are limitations. The survey portion of the study used a one-group, pretest/post-test design. Although a more rigorous design may have included a control group, this was not possible in the current situation as all students were required to participate in the IPE sessions. Additionally, there is a paucity of validated assessments to evaluate attainment of IPE competencies while simultaneously obtaining content-specific information regarding knowledge of course content. As a result, the instructors created a unique survey which was not validated beyond establishment of face validity and content validity by an expert panel.

Another limitation is that although the sessions were planned to adhere to principles of social and cognitive constructivism as well as adult learning, there is limited evidence that these theories are the best theories to support the attainment of IPE competencies. Further evaluation of the pedagogical approaches and theories to support the IPE process in relation to development of the IPE competencies is warranted.

Implications for occupational and physical therapy education

Quality IPE initiatives necessitate use of a deliberate design supported by sound theoretical principles that address the developmental stage of the learner (Health Professions Accreditors Collaborative, 2019). This study is intended to add to the literature by providing a mapping process that could be duplicated by occupational and physical therapy educators to advance IPEC competencies. The mapping reflects a developmental progression and provides a framework to link theory, IPEC competencies, IPE objectives, learning activities, and assignments. The examples and linkages, including guiding theoretical principles, may provide a springboard for analysis to advance IPEC competencies within a pediatric curriculum.

Conclusions

The results of this study indicate that an IPE program can be developed for occupational and physical therapy students that meets accreditation criteria. This IPE program culminated in student collaboration in interprofessional teams to practice pediatric assessments. Although the students’ effectiveness in working in teams was not directly assessed, the participants more strongly agreed that they better understood roles, had observed a high degree of collaboration between occupational and physical therapists, and perceived an increase in knowledge with respect to the pediatric content included in the sessions. The majority of students viewed shared learning as beneficial to learn the unique roles of occupational and physical therapy professionals although a small minority of students did not perceive shared learning to be helpful for this purpose. Analysis of evidence-based use of theory in relation to advancement toward IPEC competencies and will be a fruitful area for future research.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Additional information

Notes on contributors

Lorry Liotta-Kleinfeld

Lorry Liotta-Kleinfeld, EdD, OTR, FAOTA is Professor and Chair of the School of Occupational Therapy at Belmont University. She has published on social justice, neuroscience, curricular design, and instructional methods. Nancy Darr, PT, D.Sc., NCS is a Professor in the School of Physical Therapy at Belmont University. She is one of the Developers of the Pediatric Balance Scale. Her research focuses on development of balance and movement in children. Tamara Lemmonds, Ed.D, OTR/L is OTD Program Director and Assistant Professor in the School of Occupational Therapy at Belmont University. Her research focuses on interprofessional education through cultural immersion. She completed AOTA’s academic leadership certification in 2020. Teresa Plummer, PhD, OTR/L, CAPS, CEAS, ATP is an Associate Professor in the School of Occupational Therapy at Belmont University. She has published on leadership, assistive technology, and cognition, vision and perception, as well as a new pediatric mobility device for infants and children.