Movement System Theory and Anatomical Competence: Threshold Concepts for Physical Therapist Anatomy Education

Abstract

This viewpoint proposes eight anatomy threshold concepts related to physical therapist education, considering both movement system theory and anatomical competence. Movement system theory provides classifications and terminology that succinctly identifies and describes physical therapy practice from a theoretical and philosophical framework. The cardiovascular, pulmonary, endocrine, integumentary, nervous, and musculoskeletal systems are all included within this schema as the movement system theory encompasses all body systems interacting to create movement across the lifespan. Implementing movement system theory requires an ability to use human anatomy in physical therapist education and practice. Understanding the human body is a mandatory prerequisite for effective diagnosis, assessment, treatment, and patient evaluation. Anatomical competence refers to the ability to apply anatomic knowledge within the appropriate professional and clinical contexts. Exploring the required anatomical concepts for competent entry‐level physical therapist education and clinical practice is warranted. The recommended threshold concepts (fluency, dimensionality, adaptability, connectivity, complexity, stability or homeostasis, progression or development, and humanity) could serve as an integral and long‐awaited tool for guiding anatomy educators in physical therapy education.

A core musculoskeletal anatomy syllabus for undergraduate physical therapy student education

“…The inclusion of a detailed list of items has been suggested to be important in terms of addressing student insecurity regarding the depth and breadth of anatomy knowledge required (Bergman et al, 2014). Also, although physical therapy students require a deep understanding of anatomy to ensure competency, they also need to be able to apply this within a clinical context (Carroll et al, 2022), while avoiding cognitive overload (Webb et al, 2019).…”

“…Like anatomy, an understanding of pathology is considered a foundation of allied health professional curricula (Fenderson, 2005); however, as noted by the panelists, pathology may be taught in, and best suited to, other courses (e.g., specific pathology or clinical classes). Alternatively, retaining pathology items within an anatomy syllabus enables them to be used as examples to provide context to anatomical structures or concepts (e.g., compression of the median nerve in the carpal tunnel and the resulting sensory and motor dysfunction), assisting students to differentiate from what is "normal" structure and function (Carroll et al, 2022) and to integrate clinical relevance.…”

“…Physical therapy is focused on optimizing movement and function (American Physical Therapy Association, 2015; WCPT, 2019) and while a number of concepts have been suggested to be associated with the movement system (Carroll et al, 2022), musculoskeletal anatomy is one of the underlying foundational sciences. Furthermore, musculoskeletal anatomy knowledge has been reported by undergraduate physical therapy students to be critical in particular aspects of clinical practice (Turhan & Kocamaz, 2021).…”

A proposed anatomy syllabus for entry‐level physiotherapists in the United Kingdom: A modified Delphi methodology by physiotherapists who teach anatomy

“…These have been presented as a series of lists and phrases, rather than learning objectives, and generally does not include non‐musculoskeletal anatomy (Woodley et al, 2022). Additionally, threshold pedagogical concepts for entry‐level physiotherapists were suggested in the USA (Carroll, McKenzie, & Tracy‐Bee, 2022).…”

“…The Anatomical Society of Great Britain and Ireland, propelled by a lack of statutory and regulatory guidance (Smith, Finn, Stewart, & McHanwell, 2016) has led the way in designing appropriate national anatomy syllabuses for the United Kingdom, and mapped the core anatomy syllabus for entry‐level medical doctors (McHanwell et al, 2007; Smith, Finn, Stewart, Atkinson, et al, 2016), nurses (Connolly et al, 2018), pharmacists (Finn et al, 2018) and dentists (Matthan et al, 2020). The anatomy syllabus void still persists for physiotherapy curricula in the UK (Gangata & Vigurs, 2017), USA (APTA, 2020; Carroll, McKenzie, & Tracy‐Bee, 2022; Carroll, Tracy‐Bee, & McKenzie, 2021; Worthingham, 1968) and South Africa (Shead et al, 2018). The IFAA initiated compilation of musculoskeletal anatomy learning concepts for physiotherapy for a global physiotherapy audience (Carroll, Tracy‐Bee, & McKenzie, 2021; IFAA, 2019; Woodley et al, 2022).…”