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Chinese Version
History of physical therapy education in Taiwan Authors: Shwu-Fen Wang, Huei-Ming Chai, Hua-Fang Liao, Gi-Ying Shi
Translator: @Chang-Yu J. Hsieh
 

The development of physical therapy in Taiwan began in the 1950's, continued through the later part of the 20th century, and can be divided into three periods: 1) initiation period, 2) foundation-building period, and 3) expansion period.

INTIATION PERIOD (1950-1966)

In the 1950s, poliomyelitis epidemic exploded in Taiwan and created a great demand for physical therapy to care for those children with physical handicaps due to polio. This demand spurred the development of physical therapy in Taiwan. In 1958, the Department of Surgery, National Taiwan University Hospital (NTUH) opened the very first Physical Therapy Room in the 1 west Orthopedic ward.

Many voluntary physical therapists from the United States, including Mrs. Gray, Mrs. Saembough, Mrs. Taber, Mrs. Franklin, Mrs. Godston, and Mrs. Eaton, trained the nursing staff to carry out physical therapy, such as weight training, application of assisted devices, functional training, etc.

In 1959, the president of Taipei Veteran General Hospital, Dr. Chi-Der Lu, requested support from the National Defense Medical College to have Dr. Jing-Ming Huang to organize physical therapy service, who officially opened such service in the January of 1960 and started the first class of "Physical Therapy Personnel Training Course" in order to supply the needed physical therapy manpower.

In 1960, through the scholarship of US Foreign Aid, National Taiwan University Hospital also sent two nursing staff, Ms. Pao-Yu Jiang, Nursing director of 1 west ward, and Mr. Dong-Chu Chen, Chief nurse to Osaka University, Japan for physical therapy training. In 1964, the first lady of president Chiang (Kai-shek) established "Cheng Hsin Orphanage Arrangements Committee" and in 1966, "Physical Therapy Training Class" was started.

Chang Hua Christian Hospital in 1964 opened two classes of "Physical Therapy Training Course" which were given by American physical therapists, Miss Ilten and Mrs. Eaton via translation through Mr. Wen Long Kuo, a Duke University graduate. In 1966, WHO sent Dr. Pirker, an Austrian physiatrist, and Mr. Jacques, a British physiotherapist, to NTUH to train physical therapy personnel.

They also helped set up a physical therapy department and proposed the course contents. In 1967, Medical College of National Taiwan University (NTU) established the very first baccalaureate physical therapy class as a subdivision of the School of Medical Technology and had 20 students per year under the direction of Mr. Jacques.

In summary, during the initiation period, physical therapy in Taiwan was first assisted by the western physical therapists who trained some personnel inside the island in 1950s. Subsequently, health care personnel were sent abroad to study physical therapy. Finally, in 1966, WHO sent specialists to NTU to establish a college level physical therapy educational program. Thus, the physical therapy profession in Taiwan was brought into existence with the help of other western nations.

FOUNDATION-BUILDING PERIOD (1967-1984)

Between the beginning of the first baccalaureate NTU physical therapy program in 1967 and the second baccalaureate physical therapy program in Chung Shan Medical College in 1985, the physical therapy profession in Taiwan was going through the "foundation-building period".

In 1970, NTU combined the Physical Therapy Division and the newly formed Occupational Therapy Division into the School of Rehabilitation Medicine. The first acting chairperson was the Dean of the Medical College, Dr. Huo Yiao Wei, M.D. In the same year, Mr. Jacques retired and WHO sent Mr. Robinson, an Australian physical therapist, to replace Mr. Jacques.

In 1971, WHO sent a Phillipino consultant, Mr. Leano to help Mr. Dong Chu Chen, who went to Japan to learn prosthetics and orthotics, in order to set up prosthetic and orthotic services in NTUH. In 1971, Mr. Shi-Cheng Liang, a PT teaching assistant, came back from Australia and started a professional training course for cerebral palsy.

In 1968, Dr. Yi-Nan Lien, a physiatrist and instructor, came back from United States and committed himself strongly to the development of rehabilitation medicine for 32 years before he retired in 2000.

In 1973, the development of physical therapy received a set back when WHO personnel backed out of Taiwan, when Taiwan withdrew her membership from United Nations. Fortunately, Dr. Yi-Nan Lien, MD, the chairman of the school, together with faculty members, including Shi-Jeng Liang, Li-Li Huang, Guang-Dong Hsiao, Jing-Chong Lin, Shi-Mei Liao, Bao-Chai Liu, Mei-Hwa Jan, took the great burden of educating the future generation of physical therapy without foreign assistance.

Their hard work along with further contribution from other later faculty members enabled the continuation of cultivating physical therapists in Taiwan, such as Wen-Shen Liao, Ru- Mei Du, Ar-Tyan Hsu, Hua-Fang Liao, Ying-Jing Liu, Hui-Yuan Lee, Mu-Rong Kao, Jau-Yih Tsauo, Huei-Ming Chai, Mei-Wen Tsai, etc. All faculty members took their responsibilities readily and made their best effort to contribute so that the instruction of physical therapy could gain a solid foundation for future growth.

In the early years, in order to improve the quality of therapy, small group seminars were held annually at each of the following Christian hospitals in turn, including Pingtong, Changhua, Chiayi, Mengno, Taiang, Mackay, Puli etc. For years, foreign physical therapy professors were invited to come to Taiwan to give lectures. In 1975, physical therapists realized the importance of professional development and formally established "Physical Therapy Association of Republic of Taiwan" which then took over the role of organizing and holding seminars.

In 1980, Mr. and Mrs. Larry and Sally Ho, NTUPT alumni, were invited from United States to lecture on spinal mobilization. In 1981, Dr. M. Moffat, Professor, Department of Physical Therapy, New York University, was invited to give continuing education courses for one week.

In view of the whole "foundation building period", although there were external factors limiting the development of physical therapy, physical therapy services gradually became popular because the Taiwan society evolved and hospitals recognized the importance of physical therapy. With the advancement in the therapist's knowledge and skills, service items and fields enlarged gradually. On the other hand, quality of the physical therapy manpower also improved due to the persistency and tenacity of the teaching faculties.

Although the numbers of physical therapy personnel grew slowly during this period, the NTU PT program established a model for a complete and solid physical therapy education system which many other universities followed in the next growing period. The foundation-building period eventually escalated so that new physical therapy frontiers can be explored within Taiwan island and shared into the outside world internationally.

EXPANSION PERIOD (1985- till now)

Since the first baccalaureate physical therapy education program was established at NTU, it was the only program in Taiwan for 18 years until the secondary baccalaureate physical therapy program began at Chung Shan Medical College in 1985. The number of therapists increased dramatically, and physical therapy was promoted.

Dr. Yi-Nan Lien, M.D., chairman of School of Rehabilitation Medicine, NTU gave full support to the establishment of physical therapy program at Chung Shan Medical College. He and his faculty traveled to Taichung to assist teaching on weekends, as well as recruiting Bing-Yen Chiang to be the chairman, and staffing faculty and physical therapists in the affiliated hospital. Four years later, there were more than 80 graduates joining the physical therapy profession in Taiwan.

Since then, undergraduate physical therapy programs have been established one after another, including National Yang-Ming medical college (now National Yang-Ming University, 1988), Kaohsiung medical college (now Kaohsiung Medical University, 1988), China Medical College (1990), National Cheng Kung University (1990), Chang Gung University (1994), Tzu Chi College of Technology (2-year completion undergraduate program, 1999-2000; 4-year undergraduate program 2001), Fooyin College of Technology (4-year undergraduate program,1999), Hong Kuang College of Technology (4-year undergraduate program,1999). There are now ten schools in all.ollege (now Kaohsiung Medical University, 1988), China Medical College (1990), National Cheng Kung University (1990), Chang Gung University (1994), Tzu Chi College of Technology (2-year completion undergraduate program, 1999-2000; 4-year undergraduate program 2001), Fooyin College of Technology (4-year undergraduate program,1999), Hong Kuang College of Technology (4-year undergraduate program,1999). There are now ten schools in all.ollege (now Kaohsiung Medical University, 1988), China Medical College (1990), National Cheng Kung University (1990), Chang Gung University (1994), Tzu Chi College of Technology (2-year completion undergraduate program, 1999-2000; 4-year undergraduate program 2001), Fooyin College of Technology (4-year undergraduate program,1999), Hong Kuang College of Technology (4-year undergraduate program,1999

There are approximately 500 new baccalaureate-level physical therapists each year since year 2001. The ratio of physical therapists to physical therapy assistants changed from 1:3 in 1992 to 1: 0.6 in February 2000. There were two junior college programs, Tzu Chi Nursing College (2-year completion undergraduate program, 1994; now Tzu Chi College of Technology), Fooyin Nursing College (2-year completion undergraduate program, 1996; now Fooyin College of Technology) in the past.

They do not take new students in the junior college programs anymore because they have been promoted to 4-year programs. Between1999-2000, Departments of Rehabilitation Technology at Shu Jen Medical Vocational High School (1981) and Jen Der Medical Vocational High School (1982), where students studied to become physical therapy assistants, were promoted to 5-year programs. After 5 years, the programs will produce approximately 400 physical therapists a year.

Since baccalaureate physical therapy education programs were being offered through the School of Rehabilitation medicine, there was confusion between the roles of physical therapists and medical doctors of rehabilitation. In 1992, the first Department of Physical Therapy to be promoted to School of Physical Therapy was at the NTU. The other schools soon followed the NTU example, with the last Department of Physical Therapy scheduled to be converted to School of Physical Therapy in 2002 at Kaoshiung Medical University.

The first Graduate Institute of Physical Therapy was instituted at NTU in 1997, and includes orthopedic physical therapy, neurological physical therapy, cardiopulmonary physical therapy and pediatric physical therapy, the four major research areas in studying movement science, industrial injury, exercise medicine, long term care, respiratory physiology, cardiac rehabilitation, child development, premature infant early intervention, etc, in order to train and prepare clinical professional physical therapists, top level administration and research specialists.

The university is also working on establishing a Ph.D. program to initiate the preparation for advanced physical therapists. In 2000, the National Yang-Ming University established a graduate institute of physical therapy, including orthopedic physical therapy, neurology physical therapy, cardiopulmonary physical therapy, the three major research areas in studying muscle physiology, assistive technology, neurological physiology, long-term care, exercise medicine, child development, etc. They can produce 20 something master level physical therapists.

Physical Therapy Association of Republic of China has been working hard to promote continuing education units system to maintain professional quality. There are more than 10 continuing education classes offered for working physical therapists each year. Many famous scholars were invited to give lectures, seminars and training courses, so that physical therapists could take them on weekends. For example, Dr. P.E. Sullivan from Boston University came to Taiwan, giving lectures for 3 months in movement therapy.

The School of Physical Therapy at NTU was asked to host national physical therapy education seminar and national clinical physical therapy education seminar in 1999 and 2000, inviting officials of Department of Education, teachers from different schools, and clinical instructors from various facilities, that provide internships, to discuss the problems in physical therapy education, and to find solutions.

Reference:
(1)Lee MB. Centennial history of National Taiwan University Hospital. Taipei: Medical College, National Taiwan University; 1999 (Chinese).
(2)Tsao JY, Lee JY (ed.) Special 20th anniversary issue of School of Physical Therapy, National Taiwan University. Taipei: School of Rehabilitation Medicine, National Taiwan University; 1987 (Chinese).
(3)Lin KW, Hu MH (ed.) Special 30th anniversary issue of School of Physical Therapy, National Taiwan University. Taipei: School of Physical Therapy, National Taiwan University; August, 1997 (Chinese).
(4)Wang SF, Chai HM (ed.) History of NTU School of Physical Therapy. Taipei: School of Physical Therapy, National Taiwan University; April 2001 (Chinese).
(5)Hsieh LF (ed.) Special issue on the retirement of Dr. Yi-Nan Lien- the father of the rehabilitation medicine in Taiwan. Taipei: Department of Physical Medicine and Rehabilitation, National Taiwan Un
(6)Chuang YM. History of Medicine in Taiwan. Taipei: Yuan Liu Publishing, Ltd.
(7)Centennial publication committee (ed.) Centennial special issue of Chang Hua Christian Hospital. Changhua Chritian Hospital; November 1996 (Chinese).
(8)Centennial history of Changhua Christian Hospital. CCH Museum. ; October, 2001 (Chinese).
(9)The beginning and key events of first thirty years of Cheng Hsin Rehabilitation Medical Center; October, 2001 (Chinese).
(10)History of Physical Medicine and Rehabilitation Medicine at Taipei Veterans General Hospital; October, 2001 (Chinese).
(11)History of School of Physical Therapy at National Cheng Kung University; November, 2000 (Chinese).
(12)History of Department of Rehabilitation Medicine at Chung Shan Medical College; October, 2001 (Chinese).
(13)History of Department of Physical Therapy at Chang Gung University; October, 2001 (Chinese).
(14)Introduction of Department of Physical Therapy at Fooyin Institute of Technology; October, 2001 (Chinese).
(15)Key events of Department of Physical Therapy at Tzu-Chi College of Technology; October, 2001 (Chinese).
(16)Introduction of Department of Physical Therapy at China Medical College; November, 2000 (Chinese).
(17)History of development of Department of Rehabilitation Medicine at Kaohsiung Medical College; October, 2001 (Chinese).
(18)Introduction of School and Graduate Institute of Physical Therapy at National Yang-Ming University; October, 2001 (Chinese).

 

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