Navigating a Post-Pandemic World
As researchers continue to learn more about the virus and its long-term consequences, health sciences educators worldwide are left to wrestle with the question of how to best prepare students for careers in fields that may increasingly be defined by how well they adapt to the challenges posed by COVID-19.
In Creighton University’s School of Pharmacy and Health Professions (SPAHP), educators and administrators in the pharmacy, physical therapy and occupational therapy programs are keenly observing the latest professional guidance and industry trends to equip students with the knowledge and skills they’ll need to enter a workforce forever changed by the pandemic.
“I would hope that, across the health sciences, there’s a greater understanding of what public health means,” says Evan Robinson, RPh, PhD, FNAP, dean of the School of Pharmacy and Health Professions. “Here at Creighton, I believe we’re uniquely well-suited to train the newest generation of health care professionals to meet these complex public health challenges, given our emphasis on cura personalis, or ‘care for the whole person.’”
For physical therapy and a number of other health professions, the earliest conversations regarding the impact of the pandemic focused on the dramatic shift toward remote visits, or “telehealth,” says Kirk Peck, PT, PhD, chair of the Department of Physical Therapy.
Prior to the pandemic, telehealth “was the exception to the rule” for physical therapists, according to a COVID-19 impact report released by the American Physical Therapy Association (APTA) in August 2020.
But as the crisis wore on — and in particular after the Centers for Medicare and Medicaid Services eased restrictions on digital visits — the number of physical therapists adopting telehealth practices skyrocketed. Before the pandemic, 98% of physical therapists surveyed by the APTA said they were not providing live video consults. By July of 2020, almost 50% reported they were. Some surveyed said the digital visits actually proved helpful in some cases, allowing therapists to observe patients’ body positions in their everyday settings, such as sitting on the couch, watching TV.
As the pandemic has progressed, Peck says, conversations within the profession have shifted to the role of physical therapy in treating COVID-19 patients in the short and long terms.
“What came out fairly early — late last fall and into the summer — we started seeing literature on the value of patients receiving early rehabilitation in acute care settings. Getting physical therapy in the hospital room as early as people could tolerate it, largely because of cardiopulmonary-related issues,” Peck says. However recent research on the so-called COVID “long haulers,” patients who exhibit a range of symptoms for weeks or months after first being infected with the virus, indicates that too much exercise may trigger certain autoimmune responses, making the condition worse.
So, Peck says, the question for the Department of Physical Therapy is what to tell students who will have to meet the public health crisis in the real world, while learning more about the virus and its effects continues to evolve.
“It comes back to the heart and soul of what our profession truly is about: Education,” Peck says. “We have to start educating our clients better on not only when to exercise but how to appropriately dose the intensity of physical activity, to ensure they have a high quality of life.
To the occupational therapist, the “occupation” is anything that’s part of someone’s daily routine. For children, that can mean school. For adults, work. For older adults, often leisure.
The pandemic, of course, upended all of this, says Keli Mu, PhD, OTR/L, chair of the Department of Occupational Therapy. “When you think of any patient who has COVID, their occupation is affected. If you think about our older adults, a meaningful occupation for them could be just seeing and interacting with their grandchildren. So, when they’re not able to do that, it has an effect on their mental health and their psychological well-being,” Mu says. “OT is there to help everybody re-engage with the occupation that has meaning for them.”
With this holistic approach to health and wellness, occupational therapists can be called on to provide help to anyone whose life has been altered by the pandemic, not necessarily only COVID patients. According to an impact report published by the World Federation of Occupational Therapists, “the continued provision of occupational therapy for existing service users had heightened importance. In addition, new demand for occupational therapy rehabilitation services was created by the pandemic.”
At Creighton, within the Department of Occupational Therapy, this has meant taking a thorough look at the curriculum and finding areas to strengthen it, Mu says. Particularly in regard to material covering wellbeing and psychosocial health.
But in one way in particular, Mu says, the department was ahead of the curve when it came to meeting the pandemic challenges. Creighton’s Department of Occupational Therapy was one of the nation’s first to offer a hybrid pathway program, positioning it as an established name among conversations about a broader shift toward hybrid education and telehealth.
Though widespread vaccination has now made in-person clinic visits safer, experts predict that telehealth will likely play an important role in health care moving forward.
In April, the American Hospital Association (AHA) issued a statement to the U.S. House of Representatives asking Congress to eliminate geographic and originating site restrictions for providing health care.
“One of the most salient benefits of telehealth is the access to care it creates for broad patient populations,” the statement reads. “Telecommunications technology connects patients to vital health care services through videoconferencing, remote monitoring, electronic consults and wireless communications. It increases patients’ access to physicians, therapists and other practitioners.”
For many, receiving the COVID-19 vaccine was a deeply emotional experience. For millions of Americans, it meant being able to see friends and family members for the first time after a long and painful year. And for some, it meant getting a fresh perspective on the role of the pharmacist in public health.
“To a degree, I think the vaccine rollout has raised the profile of pharmacy as a profession,” Dean Robinson says. “It has shined a light on pharmacists’ ability to be immunizers and vaccinators. I think it points to the idea of the distributive nature of community pharmacy. It’s changed and, in some ways, it’s elevated the view of the profession, which I think is a wonderful thing in and of itself.”
For Lucinda Maine, RPh, PhD, executive vice president and CEO of the American Association of Colleges of Pharmacy, the pandemic has highlighted the importance of the pharmacist’s role in public health, particularly at a time in which pharmacy programs nationwide are facing a decline in applicants.
Moving forward, Maine predicts pharmacists will continue to play an active role in the public health sphere, lending their skills and expertise as the world grapples with still more questions about the crisis, such as when and how best to vaccinate children and adolescents.
“We do know that there has never been the positive amount of attention on our profession that’s been published in local and national media stories,” Maine says. “We’re honestly hoping that it really opens the eyes of some of the young people in the pipeline who say, ‘Wow, pharmacists really are important.’”
For all three professions, Robinson says, the pandemic has forced change. Change that, he hopes, has made them stronger and more prepared to handle the challenges of a rapidly evolving world in the decades to come. “Specific to the school, I think that occupational therapy, pharmacy and physical therapy and, to a greater extent, the health care system as a whole, will emerge from the pandemic with new wisdom and greater foresight,” he says. “Here at Creighton, we’re committed to taking those lessons and using them to shape the next generation of health care professionals.”
By Blake Ursch