Work Type




Faculty Advisor

Robert Boyles




Title: Musculoskeletal Imaging Education in a Doctor of Physical Therapy Program

Authors: Rebecca Lancaster, SPT1; Chaz Sak-Ocbina, SPT1; Travis Muraoka, SPT1; Robert Boyles, PT, DSc, OCS, FAAOMPT1

Affiliation: 1. The School of Physical Therapy, University of Puget Sound

Purpose: Physical Therapists (PTs) are commonly referred to as the musculoskeletal experts in the medical field. As direct access laws have passed, PTs now must demonstrate appropriate clinical decision making and select suitable patients to refer for imaging services. Evidence suggests that, with adequate imaging education, PTs decrease imaging and overall health care costs compared to other primary care providers. In certain settings, research has shown PTs to be comparable to orthopedic surgeons in the area of appropriate imaging referrals for patients. The APTA’s goal is for entry level DPT programs to partake in enough imaging education to provide PTs with imaging privileges. The purpose of this study is to survey the amount and type of imaging education received in one entry-level DPT program.

Subjects: 70

Materials/Methods: From Jan. 2015 to May 2016, students from a DPT program participated in this survey. The survey measured the amount of imaging content students were exposed to during their didactic and clinical experiences. The modalities of focus included X-Ray, CT, MRI, Bone Scan, and Ultrasound. The categories were further broken down into body regions.

Results: The study showed that the majority of imaging hours were experienced during the clinical internships. Total averages for on-site clinical experiences were 2.5 hours, and for off-site clinical internships were 41 hours. The totals average for the didactic portion included 34 hours over 5 academic semesters.

Conclusion: In the DPT program surveyed, each student must complete 2 on-site clinical experiences and 3 full-time off-site clinical internship experiences, averaging up to 77.13 hours of imaging content exposure (32.60 spine and 44.53 extremity). Some students had no imaging exposure in their clinical experiences, but each student received a minimum of 27.75 hours (12.75 spine and 20 extremity) of imaging exposure during the didactic portion of the program. The fifth semester of the didactic portion includes elective courses which can affect the number of imaging exposure hours. The clinical experiences were variable depending on the clinical placement and the number of respondents to the survey. The survey reflects the responses of students in one DPT program only.

Clinical Relevance: This is the first study to examine the actual contact hours related to musculoskeletal imaging within an entry-level DPT program. Educational programs can use this information, in combination with the APTA’s imaging education guidelines, when assessing their imaging education in order to better prepare students for the responsibility of appropriate imaging referral as future direct access healthcare providers. This survey is one of the first steps towards greater efficiency with imaging curriculum and improved patient outcomes in all physical therapy settings.


1. American Physical Therapy Association. Imaging education manual for doctorate of physical therapy professional degree programs. Alexandria, VA: APTA; 2015.

2. Boissonnault WG, White DM, Carney S, Malin B, Smith W. Diagnostic and procedural imaging curricula in physical therapist professional degree programs. J Orthop Sports Phys Ther. 2014;44(8):579-B12.

3. Boyles RE, Gorman I, Pinto D, Ross MD. Physical therapist practice and the role of diagnostic imaging. J Orthop Sports Phys Ther. 2011;41(11):829-837.

4. Orthopaedic Section of the American Physical Therapy Association. Diagnostic and procedural imaging in physical therapist practice. May, 2016.

Keywords: imaging, MRI, X-ray, ultrasound, education, direct access, imaging exposure, DPT curriculum


University of Puget Sound