Motivations to Pursue Physical Therapy Residency Training: A Q-Methodology Study of Stakeholder Perspectives

Abstract

Background: Residency training is recognized as a valuable form of professional development and pathway to specialization. Currently residency is voluntary for physical therapists, with less than 12% of DPT students choosing to apply upon graduation. Motivations that drive the decision to pursue residency are currently unknown as is the extent of similarity and difference in perspective among various stakeholders. Objective: The purpose of this study was to identify the dominant perspectives on motivations to pursue residency held by various stakeholders. Design: This study was conducted using Q Methodology, which incorporates aspects of quantitative and qualitative techniques into the examination of human subjectivity. Methods: Program directors, faculty, and current residents from all accredited physical therapy residency programs were invited to complete a forced-choice sorting activity where potential motivations for residency were sorted by perceived level of importance. Principal component analysis was used to identify dominant perspectives, which were interpreted based on emergent themes in the cluster of motivations identified as most important. Results: Four dominant perspectives were identified: (1) desire to provide better patient care, (2) preparation for specialty practice, (3) fast track to expert practice, and (4) career advancement. These perspectives provided context and utility to 2 broad meta-motivations: improved clinical reasoning and receiving mentoring. Both within-and between-group differences among stakeholders were identified. However, subsets from each role-group population were found to share similar perspectives. Limitations: Results from this study may not apply to potential residents in all specialty areas, and the implications of having a particular perspective are unknown. Conclusions: Identification of the dominant perspective on motivations for pursuing residency may aid in promoting participation, program development, matching residents to programs and mentors, and future research.