Enculturating and Advancing Expertise: Learners' Insights and Visions for the Military Musculoskeletal Physical...

Musculoskeletal injuries represent a large component of medical care needs across the Defense Health Agency, and effective management of these injuries is crucial for maintaining military readiness. Physical therapists (PTs) serve as vital musculoskeletal care experts, possessing advanced practice privileges like evaluating patients via direct access, ordering diagnostic imaging, prescribing medications, and initiating duty limitations. With the high demands of military PTs and the need for specialized training programs for them to effectively manage advanced injuries seen in military settings, the Military Musculoskeletal (MSK) PT residency program was developed. However, there is limited understanding of how current musculoskeletal curricula affect learning and learners' experiences. This qualitative study investigates learner experiences of recent graduates of the Military PT MSK Residency Program, aiming to identify areas of strength and areas for potential improvement.

Semi-structured interviews were conducted with recent graduates of the Military Musculoskeletal Physical Therapy Residency Program to elicit learner-centered perspectives of the Military PT MSK program. Data was analyzed using inductive thematic analysis, guided by the Six-Step Model for curriculum development.

Learners appreciated the program's comprehensive curriculum, strong use of relevant research, focus on military-specific needs, development and enculturation of military physical therapists, and the opportunity for networking with colleagues across the Defense Health Agency. However, learners also identified challenges associated with the virtual learning environment, complexities of a geographically dispersed cohort, mentorship availability, and board examination preparation. As such, they noted potential improvements through alignment of education strategies with specific learners' duty stations and improved discussion platforms. Learners envisioned an ideal MSK curriculum with a more immersive, on-site experience with consistent mentorship employing board-style questions and practice environments.

Despite identified shortcomings of the program, learners expressed largely positive views of the program and its impact on their clinical practice. However, learners also identified multiple areas that can be adjusted to improve learners' experiences. These findings highlight the importance of incorporating learner feedback to optimize military medical education programs and ensure graduates are well-prepared to address the unique MSK needs of military personnel. Future research should focus on the perceptions of faculty and/or interventional efforts that address identified areas for improvement.