For nearly two decades, an imaging course has been a requirement for students in UNLV’s Department of Physical Therapy, but today it plays a more vital role in their education and future success than ever before.

That’s because Nevada's physical therapy board recently granted  physical therapists the ability to directly order imaging for their patients. UNLV's physical therapy department has responded with curriculum changes to make sure its graduates are well prepared for this vital part of the imaging process.

“If we wanted to get imaging before, we needed to refer our patients back to their primary care provider. Now, we can order them ourselves,” said Kai-Yu Ho, interim chair of the department.

The Course: Doctor of Physical Therapy 758 – Diagnostic Testing and Imaging

Since the state granted physical therapists the ability to order imaging for their patients, this course now centers on imaging ordering and not solely diagnostics.

“Patients want an answer as to what’s going on, and the PT having direct access [to imaging] is very important,” Ho said. “Imaging is becoming more prevalent now that PTs are getting momentum to order imaging nationwide.”

In addition to Nevada, physical therapists can order imaging in the District of Columbia and 10 other states.

Who is taking this class?

This class is offered to second-year physical therapy students.

How does this course benefit UNLV’s physical therapy students?

“Prior to DPT 758, I had some foundational knowledge of imaging. I was aware of the different types of imaging modalities and understood that there was a general progression,” said Lauren Valerio, a second-year PT student. “However, my understanding was limited when it came to the specifics.”

Since DPT 758 carries more importance for physical therapy students than it did in years past, Ho proposed a collaboration with radiography students in the Department of Health Physics and Diagnostic Sciences, also housed within the School of Integrated Health Sciences. The partnership has been a boon for both PT students learning the complexities of imaging as well as for radiography students who are able to teach the same skills they are mastering in their clinical settings.

As part of the collaboration, PT students are given different cases to carefully analyze. The PT students are tasked with analyzing the scenario and ordering the proper imaging. They’ll present their prescriptions to the radiography students and review them together, with helpful insight and constructive dialogue throughout the process.

“Any time students can gain more knowledge, it’s going to be helpful,” said Heidi Shelton, clinical coordinator for the radiography program. “I think this collaboration will give the students here at UNLV an advantage that students at other schools might not have.”

How is DPT 758 taught differently now that physical therapists in Nevada can order imaging?

“Before, PT students just focused on reading the image. Now we focus on reading the image and properly ordering it. We can see the things from our perspective that others might not look for,” Ho said. “We might focus on bone density that may cause pain or deformity of the spine, but we still read and respect the radiologists’ reports. The radiologists have their specific guidelines and we have things that we focus on.”

According to Shelton, ordering an incorrect test can have detrimental consequences for the patient. 

“Too much imaging can lead to adverse effects because of the radiation exposure. CT gives significantly more radiation dose to the patient than an X-ray,” she said. “Ninety percent of diagnosis should come from the patient history and physical. Then, imaging should confirm what the physician suspects. We always look at risk versus benefit.”

In their collaboration, radiography students explain to the PT students that each patient is different when it comes to imaging.

“Not everyone is mobile when you see them. Some patients are unconscious, so you really have to use your brain and find a way to get the images that you need,” said Ivan Corona, a second-year radiography student completing his clinicals at Sunrise Hospital.

Ho said the experience has exposed her students to the complexities of the imaging process, and why working with radiography students will benefit them as future physical therapists. As part of their curriculum, PT students learn about different body parts as well as about X-ray, MRI, CT, and ultrasound.

“In the past, we didn’t focus on reading prescription because we weren’t allowed to order imaging,” she said. “Now, we analyze the imaging methods more closely and find out the types of images we need to order.”

How does the collaboration with radiography students strengthen the educational experience for PT students?

“It provided me with greater insight into the imaging process, particularly how patient positioning and technical execution affect image quality and diagnostic accuracy,” Valerio said. “Observing their expertise firsthand deepened my appreciation for the critical role that radiographers play in patient care.”

Students and faculty alike emphasized the importance of the interprofessional educational (IPE) component afforded by this collaboration. As UNLV prioritizes its academic health center, university leadership has championed strengthening the collaborations between the health sciences schools.

And at the heart of those successful collaborations is clear and concise communications.

“We need to learn each other’s languages in IPE,” Ho said. “We have our specific terms and radiography has their terms, so working together gives us the opportunity to communicate better. It’s very beneficial for all of us.”

Although this class is part of the PT curriculum, how is it improving the educational experience for UNLV’s radiography students as well?

“Being able to teach others what we’ve learned over these past two years shows us how far we’ve come in the program,” Corona said. “If we are able to work together with our PT students, then we have a connection and can understand each other a little better. This translates over to the hospitals and the clinics.”

After their initial collaboration in March, Shelton said she received positive feedback from her students about the experience.

“In healthcare, we compartmentalize ourselves. We all do our own thing and we aren’t great about working together. We’re doing our patients a disservice when we do this,” she said. “We need each other, and it starts at school.”

A lifelong learner, Ho said she has taken down notes of her own during the exercises to better learn how radiographers approach imaging differently than physical therapists. The result has been a more immersive and complete experience for both programs in how they understand one another.

“It can be scary and overwhelming for our students, but I want them to feel comfortable making mistakes in ordering imaging,” Ho said. “Then, they can have a conversation with the radiography students. Our students really learn from the radiography students, and I also think their students learn from our students in how to better communicate with PTs.”