The authors review the recognition of physical therapy education programs from 1928 to the present and describe the chronological activities that led to the accreditation process as we know it today. The history, current practice, and the broader national accreditation environment in which the Commission on Accreditation in Physical Therapy Education (CAPTE) must operate are explained. The evolution of the standards used in making accreditation decisions in physical therapist professional education is described along with the changes in the arenas of education and practice that have influenced the accreditation process. Possible and probable changes for the future are proposed.

In 2003, the year after the Commission on Accreditation in Physical Therapy Education (CAPTE) celebrated its 25th year of national recognition as an accrediting agency, a 1977 quote from Rosemary Scully, PT, EdD, which predated CAPTE’s initial recognition, is still quite applicable to the profession:

Physical Therapy has an ancient history, a proud past, an exciting present, and a challenging future. Education for physical therapy practice has been built on a strong foundation and with resourcefulness and wisdom it should be able to meet the demands of the present and the challenges of the future.1(p159)

This article will explore the history of accreditation in physical therapy and the evolution of the standards used in making accreditation decisions in physical therapist professional education. It will describe the changes in the arenas of education and practice that have influenced the accreditation process and the national environmental influences with which each nationally recognized accreditation agency must deal. The work of CAPTE also includes the activities of accreditation related to physical therapist assistant education programs. However, this article will not compare the evolution of the criteria related to those programs nor the changes within the practices of physical therapists that have clearly led to changes in the work done by physical therapist assistants.

HISTORY-THE EARLY YEARS

Education programs for the preparation of physical therapists have been recognized in some manner since 1928. The American Physical Therapy Association (APTA) first published a list of approved programs in the June 1928 issue of The Physiotherapy Review and continued to publish such a list through 1933. Little is known about the process used to approve programs, but the standards by which they were measured are well documented in the Minimum Standard for Schools of Physical Therapy.2

In 1933, because APTA lucked the financial and human resources needed to manage the accreditation effort, APTA requested and received agreement from the American Medical Association’s Council on Medical Education and Hospitals (AMA/CME) to become involved in accreditation and recognition of programs in physical therapy.3 During 1934 and 1935, no additional programs were granted approval, nor was approval withdrawn by either organization.

The AMA/CME inspected and approved13 programs in physical therapy using as its standards for approval the Essentials of an Acceptable School for Physical Therapy Technicians.4 An annual list of approved programs was published in the Journal of the American Medical Association beginning August 29, 1936. From 1936 to 1956, the AMA was solely responsible for accreditation activities, though AMA staff did submit a report on each program to the APTA Executive Committee prior the AMA/CME action.5 The Essentials of an Acceptable School of Physical Therapy6 was developed and adopted in December 1949 in collaboration and cooperation with the Council on Physical Medicine and Rehabilitation, APTA, and the AMA Council on Medical Education and Hospitals.

COLLABORATION AND CHANGE Although documented evidence is difficult to find, it is rumored that in the mid 1950s the AMA approached APTA and requested that its members become involved in a collaborative accreditation effort. The APIA’S former director of education, Patti Evans, recalls Sarah Rogers’ vivid recollections of the complaints, conditions, and conversations that led to the request that physical therapists join in that collaboration (Patricia Evans; personal communication; September 16, 2003). One might surmise that by this time APTA’s members were well prepared to assume roles of responsibility in the survey visits and decision-making processes and were more plentiful in numbers than during the 20 years prior when a similar request was made by APTA to the AMA.

From 1957 to 1963, AMA and APTA shared an informal arrangement, and from 1964 to 1976, a formal collaborative arrangement existed for accreditation of only physical therapist education programs using the December 1955 revision of the Essentials of an Acceptable School of Physical Theraphy.7

In 1967, while the collaborative effort with the AMA was operating for the accreditation of physical therapist education programs, the APTA House of Delegates (House) authorized the education of physical therapist assistants at APTA’s Annual Conference by adopting a policy statement regarding the training and utilization of physical therapist assistants.5 At th time, the AMA/CME was not interested in accrediting these programs, so APTA developed standards for education programs for the physical therapist assistant and established approval procedures. The first Standards for Physical Theraphist Assistant Education were adopted by the APTA Board of Directors (Board) in June 1972 and were published in the September 1972 issue of Physical Theraphy.8 After discussion with representatives from the National Commission on Accreditation, the US Office of Education (USOE), and the American Association of Community and Junior Colleges, the APTA Board adopted the Statement of Interpretations and implemented the Interim Approval Program for Education Programs for the Physical Therapist Assistant.5 The first interim approval decisions were granted by APTA in 1971 with effective dates that retroactively included graduates of the first class from each approved program. The first published list of APTA interim approved programs for the physical mcrapist assistant appeared in Physical Theraphy in 1972.9