Dec 03 2020

Sledge, Rachel

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Professional Statement

I aspire to become a physical therapist who embodies the professional ideals of collaborative, holistic care to all patients and community members. My professional interests include excellence in orthopedic, vestibular, and geriatric physical therapy practice. Through my coursework, research, and clinical experiences I have developed a passion for improving the lives of older adults through fall prevention and healthy aging initiatives. I believe in treating all patients with the best evidence-based care and pursuing life-long learning through continuing education, specialization, and collaboration with other healthcare professionals.

Career Plan

  • July 2021: Sit for North Carolina Physical Therapy Licensure Examination
  • August 2021: Graduate with Doctorate in Physical Therapy
  • August/September 2021: Begin my career as a Physical Therapist in NC in orthopedics, geriatric, or acute care setting.
  • 5 years post-graduation:
    • Continue developing my knowledge and skills in orthopedics, geriatrics, and neurologic physical therapy.
    • Explore and consider enrolling in an orthopedic or geriatric residency program in order to prepare for the requisite exam and become a board-certified specialist.
    • Maintain active APTA membership and continue participating in advocacy work at the national and local level to promote physical therapy practice.
    • Become an APTA certified clinical instructor and mentor student physical therapists
    • Continue participating in research and publication with the APTA Geriatrics/National Council on Aging fall prevention task force.
    • Participate in quality improvement initiatives within the profession/workplace to promote best-practices amongst physical therapists and interdisciplinary care teams.
  • 10 years post-graduation:
    • Obtain board-certified specialist certification in practice area of choice.
    • Pursue specialty training in vestibular, falls prevention, and orthopedic assessment and intervention through.
    • Develop coursework in area of specialization for DPT and continuing education programs.

Clinical Rotations

  1. Catawba Valley Medical Center (8 weeks); Acute Care, Medically Underserved. This clinical rotation focused on acute care physical therapy for individuals on the stroke, intensive care, critical care, inpatient rehab, and general medical units.
    • Inservice Presentation: Evidence Based Practice and Recommendations for Patients with Heart Failure
  2. UNC Therapy Services at Meadowmont; Outpatient Orthopedics and Aquatic Therapy. This rotation was intended to be 8 weeks but was shortened due to COVID-19 Pandemic.
    • Inservice Presentation: Patient education and self-management strategies for patients with Postural Orthostatic Tachycardia Syndrome (POTS).
    • Inservice Presentation: Physical Therapists’ Role in Understanding and Managing Medications
  3. UNC Therapy Services at NW Cary Wellness Center (9 weeks). Returning to this setting to develop my outpatient orthopedic, older adult, and aquatic therapy interventions in a hospital-based clinic.
  4. Reynolds and Associates Physical Therapy (12 weeks); Outpatient Neuro, Orthopedics, and Geriatrics. This clinic is a specialty private practice in Chapel Hill, NC that specializes in patient-centered care for older adults with orthopedic conditions, balance and falls, Parkinson’s Disease, vestibular disorders, and deconditioning.

Personal and Professional Development

  • Coordinated, organized, promoted, and chaired the 2019 APTA SSIG National Advocacy Dinner at UNC-Chapel Hill. This annual event is a collaborative effort between Duke, Elon, and UNC-CH DPT programs to raise student awareness on current issues in the profession and promote professional and patient advocacy. The theme of 2019’s NAD was physical therapy’s response to the opioid crisis.
  • Obtained OTAGO certification for fall prevention and balance training, 2020
  • Joined the APTA and obtained membership for both academies of orthopedic and geriatric physical therapy.
  • Collaborated with the APTA Geriatrics Falls Prevention Task Force on authoring a paper for the GeriNotes Clinical Magazine on referring older adult patients to community exercise programs. Publication is currently pending.
  • Volunteer Work
    • SHAC (student-run clinic for underserved community), 2018-2020
    • UNC DPT Student Physical Therapy Association Secretary, 2019-2020

Self Assessment


  • Strong communication abilities with patients, caregivers, and colleagues.
  • Understanding and valuing the role of physical therapy in providing holistic, patient-centered care. It is essential that we understand the patient’s motivations, personal and environmental factors in order to develop effective treatment plans.
  • Staying informed on policy, standards, and evidence-based practice in order to provide and help patients access optimal care.

Areas for Development

  • Gain more vestibular rehabilitation understanding and experience through continuing education courses and training.
  • Staying informed on professional and payor policy changes through the active engagement with the professional organization.
  • Broaden my experience and comfort with the direction and supervision of PTAs and support staff


  • Sit for and pass the North Carolina Physical Therapy Licensure Exam, July 2021
  • Graduate from UNC- Chapel Hill DPT program, August 2021
  • Obtain employment in the state of NC working with an orthopedic, vestibular, or geriatric population either in an outpatient or hospital setting, September 2021
  • Obtain specialty training in vestibular rehabilitation, August 2022
  • Take the requisite coursework and attain credentialing as a Certified Exercise Expert for Ageing Adults (CEEAA), December 2022
  • Become a clinical instructor, 2023-2024
  • Become a Board-Certified Clinical Specialist in the area of geriatrics of orthopedics by 2028

Specific Strategies

  • Prepare for upcoming graduation and licensure with taking practice NPTE exams, reviewing course material, and reading review books. Practice at “entry level” status per the Web CPI by the end of my final clinical rotation.
  • Apply for PT positions in the greater NC Triangle area during my final clinical rotation and maintain connections with past CIs to becomes employed post-graduation and licensure.
  • Continue academic research and publication with members of the APTA Geriatrics-National Council on Aging partnership task force
  • Take the IHI Course in Healthcare Quality Improvement through the UNC Gillings School of Public Health as an elective course or independently upon graduation.
  • Pursue continuing education in the areas of vestibular rehabilitation, geriatrics, orthopedic assessment and intervention, and aquatics therapy.
  • Maintain an active professional network of PTs, providers of other disciplines (physicians, advanced practice providers, OT/ST, nursing, exercise specialists) and collaborate as indicated.

Elective Coursework

  • Fall 2020: Advanced Orthopedic Assessment and Intervention (3 credit hours)
  • Spring 2021: Integrated Clinical Experience- Outpatient Orthopedics (1 credit hour), Introduction to Sports Physical Therapy (1 credit hour), Teaching Assistant for Musculoskeletal I (1 credit hour)

Product Examples

Diversity, Equity, and Inclusion Activities

  • Article 1: Gebauer, S., Salas, J. and Scherrer, J.F. 2017. Neighborhood socioeconomic status and receipt of opioid medication for new back pain diagnosis. Journal of the American Board of Family Medicine 30(6), pp. 775–783.

    This original research article explores the relationship between individual patient factors and treatment recommendations, including PT referral, for patients with low back pain by primary care providers. Low back pain is the most common reason why primary care providers prescribed opioid medications, despite known recommendations against their use due to the risk of dependence and poor outcomes. The authors used neighborhood socioeconomic status (nSES) as an important social determinant of health because it can be identified by zip code and has been associated with many health outcomes including rates of obesity, heart disease, cancer, and pain treatment options. The study results indicated that patients who live in low nSES areas were 63% more likely to receive an opioid prescription than patients who did not and had higher levels of comorbidities, higher health care utilization, and smoked. Patients who were younger or had fewer comorbidities were referred to physical therapy or prescribed a non-opioid analgesic. Interestingly, race was considered an independent variable from nSES status and was not significantly associated with any one type of pharmacologic intervention. The authors noted that insurance status could not be controlled for in this data set, and previous research indicated that patients living in low nSES areas are more likely to have public insurance which is associated with increased rates of opioid prescriptions. As health care providers, it’s critical to be aware of which factors drive decision making on patient treatment recommendations. If a patient has low health literacy, they may not understand or believe patient education interventions on the transient nature of low back pain and the indications for opioid and non-opioid therapies. Given the associated lower health status of patients who live in low nSES areas, it’s troubling that they are at highest risk of being prescribed narcotics and the least likely to receive a referral for physical therapy to address the root cause of low back pain. As physical therapists, it’s critical that we advocate for increased access to non-opioid approaches to managing low back pain, including PT, for patients in low nSES areas to improve health outcomes.

  • Article 2: Meyer C, Appannah A, McMillan S, Browning C, Ogrin R. “One size does not fit all”: Perspectives on diversity in community aged care. Australas J Ageing. 2018;37(4):268-274. doi:10.1111/ajag.12534.

This article explored the perspectives and attitudes of health care workers on diversity 3 months after taking a diversity and inclusion workshop. The authors used structured interviews and thematic analysis to understand the ability of the care providers to apply the concepts presented in the training on their practice, barriers and facilitators to implementation, and key takeaways from the training. Themes identified by the researchers included the importance of effective communication using inclusive language, having an increased awareness of the role of bias in health care, and the importance of culture change within organizations to effect meaningful change. Some of the themes identified by the study participants are takeaways I have also experienced with DEI training and implementation while on clinical rotations. DEI trainings and discussions throughout UNC’s program have increased my own awareness on the impact of implicit bias on health care delivery and the need for equity-focused care. Unfortunately, I have also been challenged to implement some of these best practices without the support of cultural and policy change throughout the system. For example, when I take a patient’s subjective history, I have made it my personal practice to use open ended questions such as “do you have strong social supports who could provide assistance to you if needed?” instead of assuming the patient has a husband or wife. Unfortunately, intake paperwork or other medical documentation is often not structured to account for individual situations such as living with other family members, same-sex partners, or single people with strong community connections. As a student PT, I feel privileged to spend so much face-to-face time with my patients each week getting to know them personally and establishing a positive therapeutic alliance. It is imperative that all members of the health care team, especially administrators, prioritize the implementation of DEI best practices and empower clinicians to act on their training.

  • Article 3: Cavanaugh AM, Rauh MJ. Does patient race affect physical therapy treatment recommendations? J Racial Ethn Health Disparities. October 2020. doi:10.1007/s40615-020-00899-0

This article analyzed the effects of patient race on physical therapist’ treatment recommendations in a case study of a woman with osteoarthritis (OA). PTs regularly treat patients with arthritis, and the article highlighted research that suggests that Black adults with knee OA are more likely to have worse functional outcomes and pain than Whites who undergo knee replacements. The study asked PTs and PT students in California to make treatment, referral, and home exercise program recommendations for a case vignette of a woman with knee OA. Half of the participants’ vignette included a picture of a White woman, and the other half included a picture of a similarly aged Black woman. The authors found that no significant differences existed between the recommendations for referral, frequency of PT visits, or inclusion of a home exercise program (HEP); however, statistically fewer exercises were recommended in the HEP for the case with the picture of the Black woman than the White woman. It was highly reassuring to read that the study participants did not show explicit examples of bias in their overall treatment recommendations for a woman with knee OA, especially on key factors such as frequency of treatment and referral to other providers. These factors are generally standardized across PT practice patterns, so significant deviations based on race would be a major cause for concern. In my clinical experience, the number and intensity of HEPs is highly variable amongst PTs based on their training, setting, and clinical reasoning. When I looked closely at the results, the median number of exercises recommended for both groups was 4, leading me to question how the “statistically significant difference in number of exercises” were identified. The interquartile range for the Black vignette was lower than the White vignette (3, 4 vs. 4, 5); however, I’m not sure if the difference between 3 or 5 exercises is clinically significant given the high amount of HEP prescription variability amongst PTs. It is important to consider if giving fewer exercises for the Black vignette may be a reflection of implicit bias or stereotypes by the study participants regarding race and cooperation or compliance with medical recommendations. This study serves as an important reminder to consider the impacts of implicit bias when making treatment recommendations, especially in clinical “gray areas” where there is less standardization.

Self Reflection

Looking back on the past on the past three years of UNC’s DPT program, I see tremendous growth in my professional interests, clinical reasoning, and personal development. After taking a fairly direct path to PT school, one of my goals with the program was to keep an open mind and explore a wide variety of areas of PT practice, and I’m so grateful that I did! Through my didactic and clinic education I have developed a passion for working with older adults, especially in the areas of balance and falls prevention, that I never anticipated upon entering the program. I have been so fortunate to have the guidance of experienced professors and clinical educators who pushed me to think critically, ask nuanced questions, and grow beyond my comfort zone. Above all, I am beyond excited to begin my career as a physical therapist and work collaboratively with my future patients to help them achieve their goals.

One response so far

One Response to “Sledge, Rachel”

  1.   Lisa Johnstonon 02 Jun 2021 at 2:55 pm

    Rachel: Great job on your portfolio! Nice to see your work come together. I really appreciated your detailed and thoughtful comments about the DEI readings you completed. Nice job with all of your work. Take care, and stay in touch!. Lisa


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