Exploring the Factors that Influenced Underrepresented Doctor of Physical Therapy Graduates’ Career Choice

The purpose of this qualitative collective case study, conducted through the lens of the constructivist paradigm, was to explore the factors that influenced underrepresented (UR) physical therapy (PT) graduates’ career choice. Of specific interest were the early experiences that influenced their career choice, undergraduate experiences, and perceptions of their experiences during PT school. In addition, of interest were UR graduates’ recommendations for PT programs to diversify their student populations. For the purposes of this study, an UR graduate is defined as a racial minority that is African American, Hispanic, or two or more races. Early experiences and opportunities are those that the UR graduate encountered during the K-12 years. Undergraduate influences included those factors UR graduates experienced prior to attending PT school while in community college and or at a four year university. The higher education problem of practice addressed in this study is the lack of diversity in the student population of PT educational programs. The setting for the study was a multi-campus PT program housed in a large, academic health sciences center located in the Southwestern U.S. Participants included 15 purposefully-selected UR PT graduates who had completed the program within five years at the time of this study. Data collection included the lens of the researcher, semi-structured interviews, field notes, document review, the researcher’s reflexive journal. Data were analyzed using the data analysis spiral and included the constant comparative method as well as open and axial coding to identify emerging themes to answer the four research questions. Trustworthiness of the study was ensured through triangulation of data sources, researcher’s prolonged engagement with study participants, member checking, and rich, thick descriptions of the conduction of the study and the voices of the participants. The findings of the study indicated that family were a strong influence during the early years and during graduate school. High school counselors and undergraduate advisors were not helpful in a career choice. Health-related high school programs were not an influence in a career choice, but sports and exercise involvement was an influence. During undergraduate education, a major that met PT school prerequisites and an observation in a PT setting were influences in career choice. Affordable cost and admissions interviews were an influence in graduate school choice while peers and faculty available were supports during PT school. Negative experiences during clinical education was the only barrier found during graduate school. Increasing the visibility of the PT profession to UR groups through career days and providing PT services in underserved communities were recommendations to increase diversity in PT education. The results of this study suggest several implications and recommendations for higher education practice. These implications include that there should be more efforts to expose UR youth to health care professions and without better advising and support, UR students will continue to fall out of the educational pathway into health care professions. In addition, the high cost of graduate school may be a barrier for many UR students. Finally, the admissions interview was an important influence in PT school choice and student peers were a great source of support during PT school. The recommendations for higher education practice include more organized efforts to increase exposure of UR youth to the PT profession, improve the support for high school and undergraduate advisors, control costs of higher education graduate school, consider holistic admissions process, and facilitate the socialization process for UR students. Recommendations for future research include a similar qualitative study at a PT program housed within a different setting. A quantitative study utilizing a survey instrument based on the findings of this study could be sent to a larger population of UR PT students or a quantitative study that assesses the factors that influence an UR student to decline a position at a PT program. Finally, a qualitative study that explores the factors that influence rural students and their choice of career in health care.