PTR 102: PT ROLE 2

College of Physical Therapy

Prepared by: Janice N. Laluces

MODULE 2
MANAGEMENT IN ORGANIZATION
JULIA REI ILAGAN, BSPT III

Brief Description
This part will introduce several concepts of Management and Leadership, transition from Patient care to
Management and Mentoring a Manager’s Sense of perspective and Industriousness.

Learning Outcomes:

By the end of the module, you should be able to:

1. Effectively negotiate or mediate issues for successful problem resolution

2. Teach employees in physical therapy clinical settings about basic negotiation principles.
3. Compare the qualifications of health-care managers with prior clinical experience to those with
academic degrees in management and no clinical experience.
4. Determine the role of mentoring physical therapist as they transition from clinical to managerial roles.
5. Discuss the relationship of direct patient care skills and management skills of physical therapist,
regardless of their job titles.
6. Discuss the need for new managers to possess communication skills a sense of perspective, and
industriousness.

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 PTR 102: PT ROLE 2
College of Physical Therapy
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Pre-Activity - Before Reading Questions/This part may also contain motivational activities
Reading the book entitled:
 Chapter 1 Scott, R.W., Petrosino C., L., (2008) Physical Therapy Management 1st
Edition, Mosby
 Chapter 1 Page, C. G., Management in Physical Therapy Practices (2015) F.A.
Davis Company

 Define the following terms:

1. Interpersonal communication – plays a pivotal role in business managemenet and
conflict management.
2. Collaboration- it is used to arrive to a win-win situation
3. Competition- it is also known as win-lose situation; all parties involved to be assertive in
the used of their power with less or no regard for satisfying the other’s concerns
4. Negotiation- can be used in interpersonal relationships; considered a subcategory of
alternative dispute resolution (ADR)
5. Mediation- the third party helps to negotiated a resolution by bringing the parties in
dispute closer to a mutual and fair resolution
6. Management- it is an administrative, bureaucratic function, in which an appointed
superior orders subordinates to carry out duties associated with employment
7. Manager- someone situated in a position of relative authority on an organizational chart
who conducts the activities of a business, department or unit
8. Strategic plan- an action plan in business
9. SWOT Analysis- acronym for strength, weaknesses, opportunities, and threats, an
approach used to an environmental assessment to consider the internal strengths, and
weaknesses of the business and external opportunities and threats.
10. Formative evaluation- an examination in which can contain brief, readily available data
for quick feedback or detailed information gathered at designated points on a timeline;
intended to give timely feedback to guide, modify, or redirect the strategic plan toward
the intended goal in light of developments
11. Summative evaluation- focuses on outcomes at a critical point in the strategic plan; it is
intended to identify possible problems, assess performance of members, seek resolution
to problems found and appropriately adjust the strategic planning process to meet
current needs and future expectations; it is written and distributed to stakeholders

LESSON 1:
Read and understand the statement.

Interpersonal communication plays a pivotal role in business management and conflict management.
Successful conflict management centers on the appropriate use of power and the application of negotiation
tactics, which begins with interpersonal discourse. Through conversations, the physical therapist manager or
staff physical therapist can influence decisions in a company by influencing the behaviors of others, as well as
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 PTR 102: PT ROLE 2
College of Physical Therapy
Prepared by: Janice N. Laluces

accomplish such tasks as gaining patient adherence to treatment protocols and gaining staff support of
initiatives, while creating a rapport with colleagues or patients.
On the most basic level, in order to be competent at communication, the physical therapist manager or staff
physical therapist must be attentive to and mindful of the other person during each interaction and provide
appropriate expressiveness both verbally and nonverbally to develop understanding while creating or
managing an effective rapport. The intended outcome of the interaction should remain the focus of the
communication. One challenge is to keep one’s mind from wandering from the current interaction by making a
conscious effort to orient oneself to the conversation during discourse. Everyone is capable of processing
multiple sensory inputs while entertaining various thoughts in a matter of seconds, and training is required to
hone the skill of focusing on the interaction.
Another challenge is to closely monitor and appropriately interpret the other person’s verbal and nonverbal
cues. When the physical therapist is mindful of verbal communication, he or she takes into account the
content, variations in language, tone, pitch, and pace of the other’s verbalizations. Taking mental note of these
elements can lead to important insights into the emotional undertones of the discourse. Physical therapists
who are sensitive to nonverbal forms of communication take into account gestures, timing, use of touch, facial
expressions, use of space, and artifacts such as dress and office arrangement when interpreting intent. It is
important to listen attentively to and develop understanding from what the other person is saying before
developing a response. Critically thinking about what has been said is also essential when considering the
potential result of a response.
While engaged in communication, each participant should remain mindful of how less salient factors play a role
in competent communication. Examples of these factors include issues of the past (e.g., experience,
education, relationships), present (e.g., orientation, knowledge at hand, framing of the conversation, timing, an
individual’s power), and future (e.g., goals, agendas, strategic plans, positioning, expectations, predictions,
forecasts). With all of these considerations being enacted in a matter of seconds, it is no wonder that much of
what is communicated is misinterpreted and has the potential to cause conflict. Communication is a skill that
every manager needs to continuously improve and maintain. Even those who are viewed as very competent
communicators require practice to hone the skill; even when the skills are well established, occasional
communication episodes can be viewed as incompetent. Because of the fluidness of discourse and ever-
changing contexts, it is virtually impossible to always be competent in communication interactions, but the
greater the knowledge of the variables affecting the situation, the better the potential outcome of the
communication.
A common instrument used to assess conflict management strategies is the Thomas-Kilmann Conflict Mode
Instrument.47 Kenneth Thomas and Ralph Kilmann identified five different modes of addressing conflict:
collaboration, compromise, accommodation, competition, and avoiding. Basing their theory on the Managerial
Grid Model developed by Robert Blake and Jane Mouton,11 Thomas and Kilmann focused on the degree of
concern for people versus the concern for task completion to determine the mode of conflict resolution utilized.
Collaboration, sometimes considered a negotiation technique used to arrive at a win-win situation, occurs
when the parties involved in the conflict exchange information openly, seek solutions that are acceptable to
everyone involved, and work together without becoming entrenched in an opinion. Arriving at a solution
through collaboration typically takes time and energy, but the participants have a high regard for one another
and are assertive in satisfying their own concerns for task completion. Compromise, sometimes referred to as
“reaching a middle ground,” requires that the participants in the conflict define the concessions that each party
is willing to make to resolve the conflict. The defining difference between collaboration and compromise is that
the participants involved in compromise have taken a particular stance on the resolution of the conflict. A
compromise is more likely to occur when the goals of the participants are mutually exclusive, participant power
has been equalized, and participants are committed to resolving the issue without a stalemate.
Accommodation is a resolution of conflict in which the opposing participant’s request is granted. When a
manager reaches a resolution through accommodation, he or she cooperates while suppressing an attempt to
satisfy his or her own concerns. A mode of conflict resolution that is considered opposite to accommodation is
competition.
Competition, also known as a win-lose situation, requires all parties involved to be assertive in the use of their
power with less or no regard for satisfying the others’ concerns. The individual with the most power in the

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 PTR 102: PT ROLE 2
College of Physical Therapy
Prepared by: Janice N. Laluces

conflict situation will move forward with his or her resolution of the conflict. This strategy is typically employed
when a decision must be made quickly, there is a perceived need to protect one’s self-interest, or the
resolution of the conflict is vital to the company. The final mode of conflict management addressed by Thomas
and Kilmann is avoiding. Avoiding, sometimes viewed as an opposite to collaboration, is a strategy of
withdrawing from the conflict. Avoidance is typically used when there is a fear of being in a position of lower
power, when the issue is not important to the participant, or when the issue can be resolved by others.
Avoidance may also be used as a strategy to allow time for the intensity of the conflict to diminish or for
additional information to be gathered, or when the cost of engaging in the conflict outweighs the benefit of
resolving the conflict. The appropriate use of any and all strategies depends on reflective analysis and
response to a particular situation.
Physical therapy managers should not develop rules for when to use a strategy but should instead become
proficient enough to use each strategy appropriately for the desired outcome. They should always weigh the
consequences of initiating a specific strategy before implementation.
Physical therapy managers who are interested in a conflict management tool that takes into account shifts in
stress levels and cultural sensitivity should refer to the Kraybill Conflict Style Inventory.35 Ron Kraybill
identified five styles of responding to conflict (i.e., directing, harmonizing, avoiding, cooperating, and
compromising), a schema that accounts for varying responses in “calm” and “storm” conditions and
differentiates responses on the basis of whether the user comes from a collectivist- as
opposed to an individualist-oriented culture.
Negotiation is a term that can be used in interpersonal relationships, such as negotiating the perception of our
identity, in addition to legal contexts, wherein two individuals negotiate a contract. In a broader sense,
negotiation is considered a subcategory of alternative dispute resolution (ADR). When a third party becomes
involved in the resolution of a conflict, the terms mediation or arbitration are used. Mediation is when a third
party helps to negotiate a resolution by bringing the parties in dispute closer to a mutual and fair resolution. In
arbitration the third party is given the power to adjudicate or impose a solution on the parties in dispute. For
further information on mediation, refer to “Model of Standards of Conduct for Mediators,” created
collaboratively by the American Bar Association, the American Arbitration Association, and the Association for
Conflict Resolution (2005).
Excerpt from the CHAPTER 1 of Physical Therapy Management

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 PTR 102: PT ROLE 2
College of Physical Therapy
Prepared by: Janice N. Laluces

Activity - After Reading, research the following and cite the references: (as needed)
1. Identified five different modes of addressing conflict.
a. Collaboration
b. Compromise
c. Accommodation
d. Competition
e. Avoiding

2. Search for the Kraybill Conflict Style Inventory, five styles of responding to conflict.
a. Directing
b. Harmonizing
c. Avoiding
d. Cooperating
e. Compromising
3. Search for characteristics or traits of leadership by the Ohio State Leadership
Studies.
a. Physical vitality and stamina
b. Intelligence and action-oriented judgement
c. Eagerness to accept responsibility
d. Task competence
e. Understanding of followers and their needs
f. Skill in dealing w people
g. Need for achievement
h. Courage and resolve
i. Trustworthiness
j. Decisiveness
k. Self-confidence
l. Assertiveness
m. Adaptability/flexibility

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 PTR 102: PT ROLE 2
College of Physical Therapy
Prepared by: Janice N. Laluces

LESSON 2:
Read and understand the statement.

The first step is to review the mission and vision of the physical therapy practice. The mission statement should
be relatively stable, enduring, and referred to often; however, it is a good practice to consider revision of a
physical therapy practice mission statement every 5 to 7 years to reflect changes in the business and health
care environments. The vision statement should be developed with the mission in mind and remain relevant for
a period of 3 to 5 years or longer. The vision statement should be a common topic of discussion among
employees and harmonious with the mission, goals, and strategies of the business.
The second step is to conduct a thorough assessment of environmental opportunities and constraints. A
common approach to an environmental assessment is to consider the internal strengths and weaknesses of
the business and external opportunities and threats (or barriers) affecting the business. This approach is called
a SWOT (or SWOB) analysis (an acronym for strengths, weaknesses, opportunities, and threats [or barriers]).
A SWOT analysis assists in assessing the internal and external environmental factors that have an impact on
the physical therapy practice. Some common internal factors that may be identified as strengths or
weaknesses include financial stability, personnel, facilities, material resources, and so on. Common external
factors include competitors, changes in the economy, governmental health care regulation changes, third-party
payer reimbursement changes, and other social or client influences. Two other approaches are occasionally
used in businesses to perform an environmental audit: the five forces analysis and the PEST analysis.

Excerpt from the CHAPTER 1 of Physical Therapy Management

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 PTR 102: PT ROLE 2
College of Physical Therapy
Prepared by: Janice N. Laluces

Activity - After Reading, answer the questions: (as needed)

1. Make your own SWOT Analysis assessing the internal and external environmental
factors that have an impact on the physical therapy student
*adjust the box size if needed

STRENGTH WEAKNESSES
 able to help improve one’s life through  having a little knowledge for fist aides
therapy  belittled by other professions
 gives a quality life to patients  perceived as “manghihilot’ or “lang”
 gives hope to patients by people
 gives an opportunities to patient to be  have a low income in the PH
able to do a “normal” daily living  only 3 chances on board exams

OPPORTUNITIES THREATS
 high paid in other countries once  Economical changes in the country
become a PTRP  Government incompitencies
 PT is an in demand job  Low paid in the country
 Easier opportunity in medical school
 High chances of having a clinic in the
future
 High chances of getting job or getting
a job to a great performing hospitals
on the different countries which are in
need of PT

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 PTR 102: PT ROLE 2
College of Physical Therapy
Prepared by: Janice N. Laluces

LESSON 3

Becoming a Manager
Regardless of the type of health-care organization, physical therapists have many opportunities to pursue
management roles at many levels, or they may assume all managerial roles in businesses they own. Although
many upper-level managers and some midlevel managers may start their careers directly into these positions,
some of them are patient care providers who work their way up the corporate health-care ladder. These
clinicians often leave behind their professional roles in patient care as they assume new managerial duties.
Private practice physical therapists often divide their time between their business and patient care
responsibilities.
It is certainly common in many organizations for expert clinicians to evolve into at least supervisory or mid-level
manager positions. In fact, many health-care corporations offer in-house training programs or tuition deferment
programs to encourage promotion from within their ranks of health-care professionals. Other large health-care
organizations often prefer to hire people with degrees in health-care management or health services
administration strictly for their managerial expertise, particularly at the executive levels.
Transitioning From Patient Care to Management
Some health-care professionals find themselves formally and deliberately seeking management positions or
independent practices. Others are forced, or coaxed, into managerial roles that they reluctantly accept. They
all face the same transitional challenges. Lombardi identifies these transitions as moving from:1
✦ Self-direction to selfless service. Managerial work depends on highly variable and unpredictable factors
rather than on the more specific professional needs and desires that drive professional performance.
✦ Autonomous control to circumstantial control. The work of managers depends on unpredictable
circumstances and situations rather than on assigned caseloads and productivity expectations. Flexibility is
much more critical.
✦ Quantitative to qualitative outcomes. The outcomes of the efforts of managers are more dependent on
perception than on clearly defined measures. The immediate gratification and rewards for stellar performance
found in reaching productivity goals and patient outcome measures as a health-care professional diminish.
✦ Definitive clinical criteria to overall comprehensive goals. The performance criteria for managers are often
gray and flexible as organizations change, and managers’ responsibilities fluctuate with the needs of the
organization. The clear job descriptions of clinicians are replaced with more ambiguous expectations.
The transition to management certainly involves exciting opportunities for the acquisition of a new skill set for new duties. At the
same time, there is that period of discomfort that comes from leaving behind the structure and familiarity with patient care to take on
the uncertainties of management. Managerial opportunities and possibilities to expand upon and enrich a professional career can be
intimidating, but it soon grows on people, including some managers who protest too strongly about their new roles.

Mentoring
Another important consideration in transitioning from clinical care to management responsibilities is to identify
mentors who can help in the process. Morton Cooper has identified the importance of mentoring in health-care
careers and suggests that it should begin with the very first clinical position. In his model, the person who
seeks mentoring must initiate it as a long term intimate, personal, enabling relationship. A mentor does not
formally assess the person but rather provides unstructured support for learning and for facilitating access to
the important social and political networks needed for continued career socialization.
Mentoring when taking on new managerial responsibilities may be even more critical than having a clinical
mentor. Because the roles and expectations of managers are much more unpredictable and dependent on the
changing needs of the organization, the support of a mentor or mentors to “think out loud” is a very important
asset in long-term career development and in meeting day-to-day managerial challenges.

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 PTR 102: PT ROLE 2
College of Physical Therapy
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Six Simple Words

“How can I help you today?” is a question that is key to successful vertical and horizontal management
communication as well as patient care success. It gives the person questioned an open-ended chance to
define the interaction and its importance. It allows managers to then focus on facilitating the most important
work of health care at any moment.

A Manager’s Sense of Perspective and Industriousness

When problem solving or making decisions, midlevel managers need to consider the points of view of all
stakeholders in order to take action that is most likely to be successful. The perspective of patients is foremost
in health care and will be discussed in more depth. However, determining the other perspectives on a
particular issue—what does the boss think?, what do my team members think?, what do the other managers
think?—is a much more important process than determining their self-interest. Effectively synthesizing all of
these perspectives is a challenge that is easier said than done. Failure to identify the perspectives is perhaps
riskier than failure to reconcile them effectively.
Industriousness is another important characteristic for mid-level managers to have. If for no other reason than
managers who are industrious role model the hard-working, conscientious, and energetic behaviors that are
desired in the people they supervise to accomplish patient care goals. It also means taking initiative and
learning to delegate effectively. It does not mean doing it alone and it does not mean delegating it all. Why and
how often tasks are delegated is a major factor in the determination of managerial effectiveness.

Excerpt from the CHAPTER 1 of Management in Physical Therapy Practices

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 PTR 102: PT ROLE 2
College of Physical Therapy
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Research Activity:

1. Explore the mentoring program available through the American Physical Therapy Association at
http://www.apta.org/
2. Search for the comparison between Horizontal Communication and Vertical Communication.
a. Horizontal communication – linear communication; done with an equal position without
hierarchy
b. Vertical Communication – up-down communication; there is a consideration on the position or
there is an hierarchy

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College of Physical Therapy
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Quiz 1
Choose the answer inside the box and put your answer if it is in column A and B.

Choose the

Things to Delegate and Not to Delegate

The team needs leadership in determining priorities

The responsibilities are more about operations than about planning and organizing
Coaching and motivating are needed
Assignments require evaluation and recommendations
Evaluating performance of subordinates
The tasks are more routine requiring only minor decision.
Rewarding or disciplining personnel
There are clear job descriptions and work expectations
The tasks involves planning and solving new problems
Responsibilities can be provided that allow people to grow and challenge them.

A B
DELEGATE WHEN… DO NOT DELEGATE WHEN…
The team needs leadership in determining priorities The responsibilities are more about operations than
about planning and organizing
Coaching and motivating are needed The tasks are more routine requiring only minor
decision.
Assignments require evaluation and
recommendations
Evaluating performance of subordinates
Rewarding or disciplining personnel
There are clear job descriptions and work
expectations
The tasks involves planning and solving new
problems
Responsibilities can be provided that allow people to
grow and challenge them.

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 PTR 102: PT ROLE 2
College of Physical Therapy
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No part of this material may be reproduced, stored in a retrieval system or transmitted in any form or by any
means – electronic, mechanical, photocopying, recording or otherwise, without permission in writing from the
author or lecturer.

Learning Tasks:
1. Offline Reading
2. Student Output Activity: Definition of Terms and answered questions.
3. Online/ Offline Quiz: Posted in WELA LMS or during Face to Face classes.
4. Online/ Face to face Graded Recitation or Reporting: Performance in the interactive discussion and
presentation of assignments/ assigned topic.
5. Offline Homework/ assignment: Reflective essay
6. Offline/ Online Research: Answering the given questions in Research Activity

Reference:
 Scott, R.W., Petrosino C., L., (2008) Physical Therapy Management 1st Edition, Mosby

 Page, C. G., Management in Physical Therapy Practices (2015) F.A. Davis Company

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 PTR 102: PT ROLE 2
College of Physical Therapy
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Rubrics: (based on learning tasks)

Assignment/ Essay
CRITERIA EXCELLENT GOOD (3) SATISFACTO INSUFFICIENT INCOMPLETE POINTS
(4) RY (2) (1) (0)
Assignment Intro, body, Intro, body, Intro, body, and Intro, body, and Assignment
Component and and conclusion conclusion was not
conclusion conclusion Paragraphs are Paragraphs are submitted.
Paragraphs Paragraphs present but not missing/ not
are clear and are clear, but well organized clear
well not well used
organized,
Topic is
introduced,
discussed/
analyzed,
and
summarized
Completene Addresses all Addresses Addresses only Does not Assignment
ss questions all questions, part of the address the was not
thoroughly but less question question or topic submitted
and weighted assigned in the
completely given to one assignment
or more
component
Neatness All Most Some Few homework/ No homework/
homework/as homework/ homework/ assignments assignment
signment assignment assignment were turned in was turned in
were turned were turned was turned in neat and orderly neat and
in neat and in neat and neat and orderly
orderly orderly orderly
Supporting The research The research The research The research is Assignment
Research provided from provided provided but misguided by was not
credible mostly from with low level of the assigned submitted
sources, credible evidence topic
Systematic sources,
review, RCT, Meta-
highest level Analysis
of evidence
TOTAL
POINTS
Comments:

Adapted from: Mary J. Allen, [email protected]

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College of Physical Therapy
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Reporting/Presentations
Exceeds Satisfactory Needs Below Score
Expectations (4) (3) Improvement (2) Expectation (1)
Organization The presentation is The presentation There is some There is some
carefully organized has a focus and organization, but organization, but
and provides provides some the speaker the speaker
convincing evidence reasonable occasionally goes occasionally goes
to support evidence to off topic. Evidence off topic.
conclusions. support used to support Evidence used to
conclusions. conclusions is support
weak. conclusions is
weak.

Content The content is The content is The content is The content is

accurate and generally accurate sometimes inaccurate or
comprehensive. and reasonably inaccurate or overly general.
Listeners are likely complete. incomplete. Listeners are
to gain new insights Listeners may Listeners may unlikely to learn
about the topic. develop a few learn some anything or may
insights about the isolated facts, but be misled.
topic they are unlikely to
gain new insights
about the topic.

Delivery The speaker is The speaker is The speaker The speaker

professional, generally relaxed occasionally appears anxious
relaxed, and and comfortable. appears anxious or and
comfortable and Listeners are uncomfortable, uncomfortable
interacts effectively generally and may and reads notes,
with listeners. recognized and occasionally read rather than
understood. notes, rather than speaks. Listeners
speak. Listeners are ignored.
are often ignored
or misunderstood.

Comments: Total
Score:
Adapted from: Allen, Mary J. Using Rubrics to Grade, Assess, and Improve Student Learning, 2014, Strengthening Our Roots: Quality,
Opportunity & Success Professional Development Day, Miami-Dade College

No part of this material may be reproduced, stored in a retrieval system or transmitted in any form or by any
means – electronic, mechanical, photocopying, recording or otherwise, without permission in writing from the
author or lecturer.

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