May 17, 2022

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About 78 percent of physical therapists (PT) are white compared to 60 percent of the U.S. population. It’s a significant gap that is more pronounced than what we see in other health professions, including nursing and medicine. It also has many PT programs refocusing their efforts on recruitment and selection so that PTs can better support an increasingly diverse population. 

When asked why this diversity gap is larger in PT than other fields, Lara Canham, Senior Instructor and Chair of Admissions at the University of Colorado’s Physical Therapy program says, “we simply don’t have enough under-represented minorities applying.”

She goes on to explain that exposure to physical therapy is often what drives people to pursue the profession, “but many under-represented minorities don’t know the profession exists, because those who have direct or indirect exposure to physical therapists tend to come from more privileged backgrounds.”

This lack of exposure to the field has led the American Physical Therapy Association and physical therapy programs to launch campaigns that raise awareness of the profession, even as early as middle school.

“We’re certainly doing a better job of showcasing the profession these days, but now we have to ensure that admissions processes evaluate a more diverse applicant pool with equity,” shares Lara.

Why is this so important? A growing body of research has shown that patients prefer to be treated by health care providers of their own race or ethnicity, and individuals with strong racial or ethnic preferences would more likely seek out treatment and adhere to their plan of care if their health care provider shared their ethnicity. Research also suggests that increasing the diversity of students in medical schools and health sciences programs can better prepare those students for interactions with patients from different backgrounds, which could then increase the quality of the treatment they provide. Simply put, diversity helps advance patient-centered care.

Lara knew as soon as she joined the university’s PT program in 2015 that she wanted to see what improvements could be made to the admissions process to build a more diverse student body. Around that time, many medical schools and health sciences programs were already undertaking research in holistic admissions, hosting conferences on the topic, and experimenting with different holistic admissions processes to see what could work. 

“There were many lessons and examples to draw from, it was time to try something different,” shares Lara.

Ultimately, Lara and her colleagues decided to develop a holistic review rubric for their admissions process. Focusing on the program’s mission and values, the rubric looks at factors such as intellectual curiosity, scholarly aptitude, commitment to the profession, community engagement and leadership, and the applicant’s own appreciation of diversity, equity, and inclusion. 

Since using the rubric, the university’s PT program has admitted more diverse cohorts without compromising its high academic standards set during the admissions process. “You don’t necessarily need to give anything up,” shares Lara. “It’s more about finding a balance between all the necessary skills and attributes required to be successful in the field, and that really takes more than just good grades.”

Crucial to the program’s success with the rubric was the diversity of the team involved in creating and using it. “We benefited from our leadership’s support of the initiative and approving the required resources for this effort,” explains Lara. “Holistic review takes time and it needs people.” In fact, the PT program had a diverse group of 15 individuals of faculty, staff, and clinicians/alumni involved in the entire process.

“You can’t increase diversity if the team involved is not diverse itself,” says Lara.

So, how can other programs begin their holistic admissions journey and navigate the resource challenges involved? Lara shares these four steps:

1. Go back to your program’s mission statement and values. Those are crucial to aligning your team on decision-making criteria about the students you’ll admit to your program.
2. Assess your program’s resources to see what capacity exists to implement a holistic admissions process. If you don’t have enough faculty/staff members, think about bringing in clinicians from the field and alumni. There are also many non-cognitive assessment tools in the market that can support this process while addressing resource constraints.
3. As a team, take a hard look at your admissions requirements and check for biases. For example, are hard cut-offs for GPA and GRE excluding really well-rounded applicants from different backgrounds?
4. Don’t lose sight of recruitment. Your admissions process can only work if you actively recruit diverse applicants in the first place.

Read more about holistic applicant review on our blog