George D. Fulk, PT, PhD, FAPTA is Director of the Division of Physical Therapy and Director of the new Center for Physical Therapy and Movement Science, Department of Rehabilitation Medicine, Emory University. In this episode, George talks about how he came to physical therapy as a second/third career and how his prior training in political science helps him navigate "political waters of different higher education institutions". George's words of wisdom include "...embrace change. Because change happens all the time, and so if you're hesitant to change, then you are already going to be behind."

Resources

• Peer Instruction | Ed Mazur
• American Physical Therapy Association | APTA
• Doctor of Physical Therapy Program | Emory School of Medicine

Hello, listeners. Welcome to Educational Landscapes, Lessons From Leaders. On today's episode, we are going to learn from George Fulk.

Welcome to the show, George.

Hi, Ulemu. Thanks for having me here. I'm just wondering though, is this going to be like Car Talk? Are we going to have some people call in and we get to try to diagnose their leadership issues?

No, this is all about learning from you.

Oh, okay.

Okay. So to get us going, what is your educational leadership title or titles?

Gotcha. So here at Emory, I'm the Director of the Division of Physical Therapy, which is in the Department of Rehab Medicine, and I'm also the Director of the New Center for Physical Therapy and Movement Science.

Wonderful. What do you do in these roles?

As little as possible. No, sorry, I can't help myself.

So they're both interrelated. I'm relatively new at Emory, so I've been here almost a year now. And so as a Director of the Division of Physical Therapy, I help support all the faculty in the division. And one of our primary purposes or goals is to educate entry level physical therapy students. So probably the bulk of my time is helping to support and facilitate that.

It's a three year program, so we have between 60 and 70 students in each cohort, and they have a variety of different clinical and didactic educational components. And so we have faculty that are involved in teaching them and then helping support when they go out and do clinical practice. And then another important part of that is, so then we have some faculty have different roles. So some faculty, some of the roles are more devoted towards research, and so I help support them in terms of what resources do they need. They also have some small teachings and how to support that. So it's kind of a lot of different balls to juggle in the same time.

Indeed, indeed. And you said the role as Director of the division and then the center are intertwined. Has the center been around at Emory or is that a relatively new-

No, so it's relatively new with me coming here. We established working with Dean Sukhatme to establish that center. However, in the past year, most of my focus has been getting to learn the PT education program and the faculty here. So we haven't really pushed the center too much in terms of what we're focusing on right now with the faculty. But there'll be a lot of... So there's education component. We hope with the center that we can serve to facilitate collaborations across Emory Healthcare and with the education, the university side to help facilitate research, but then also to lend our expertise to help hopefully improve the provision of rehab and physical therapy care across all of Emory Healthcare. There's a lot of fragmentation in terms of how physical therapy services are provided. And so I think there's ways we can help provide some support and infrastructure to some of the healthcare side too, to help improve that as well.

Thank you. That will be really great, considering how large Emory Healthcare is.

Yeah. That's going to take a little bit of time to get there, but we'll chip away at it.

Absolutely. So given the range of things that you do in these roles, what skills do you find you use most often?

I think communication is probably real important. I try to, it's definitely not perfect, but try to communicate with everybody so that they know what's going on. When I learn things from the others that are in the other healthcare programs or in the MD program and, for example, how there's a big effort ongoing now around medical education transformation. So to communicate clearly with the faculty about what's happening, how that's going to impact us, and so that when we look at our curriculum and how we're going to revise it to align with others, that everybody kind of knows what's going on. So I think communication is probably real important.

It's a little bit challenging. It's been challenging, obviously with all the COVID, so people are working remotely a lot more. And so even now, I've been here only a year, but I wasn't actually here before COVID, so have not really had a time to establish really strong relationships with people being in person, because a lot of the meetings are just done through Zoom. So that's a little bit of a challenge. So then communication is important.

I'm trying to think of other skills. I mean, one is I think it's important to set an example, so I'm not going to ask people to do work that I'm not doing already. And so in terms of even teaching and service and research, to lead by example I think is important.

Thank you. So what was your journey that led to this current set of roles?

Yeah, that's a long story. So immediately prior to coming here, I was the chair of the physical therapy department at Upstate Medical University. So it's somewhat similar to Emory, but a very scaled down version. So we were a much smaller institution, but it was a academic medical center. So there were two hospitals there, some outpatient facilities, but also, there was a School of Medicine and the School of Health Professions. And so PT was in the School of Health Professions there, not in the school of medicine. So that's different.

And so I guess in terms of education, leadership kind of really started that. The one job prior to there was at Clarkson University in upstate New York, in Potsdam. It was basically southern Canada. So it's about 30 miles south of the St. Lawrence River. And so I had been there a total of about 12 years. And after about six years, I took on the role as the Department Chair as well. And then for the last three or four years, I was also Associate Dean for the health sciences there to help kind of support PT and OT program and a PA program.

Wow. That's amazing. I am really curious, what drew you to physical therapy?

Yeah, it's a good... So physical therapy for me was kind of a second or third career. So my undergraduate major was in political science. So I jokingly tell people that that's helped. My political science piece has helped me navigate some of the political waters of different higher education institutions.

So I originally then worked in a law firm for about two years, didn't really like that that much. Then actually worked in a residential home with emotionally disturbed children. So these were kids between the ages of probably 6 and 14 that were taken out of their homes. They were in abusive situations. And so we helped basically their living situation. So we all lived on units. So I worked there for about six years. I liked that job, but it's not something I could see myself doing. It's very emotionally draining. I was working 60 or 80 hours a week.

So I had been injured and received physical therapy in college a couple of times. I used to run on the track and cross country teams. And then I had a friend whose friend owned a PT practice, so I went and shadowed a while. And so that kind of got me into physical therapy there.

Interesting. I love that it wasn't a clear trajectory. I feel like a lot of people are-

Well, it wasn't a linear path, that's for sure.

Indeed. But it's all connected. It's all connected.

Yeah.

So as you said, that political science background really helped with all of the navigating the politics of... You've had multiple leadership roles. And so I would love to hear what do you wish you knew before stepping into those types of roles?

Yeah, that's a good... I don't know if I so much stepped in as everybody else stepped back and I was left standing forward maybe initially. I think I've obviously just matured a lot over that time. So I think one is, I've learned it's really important as an effective leader, is really put the needs of, particularly in higher education, the faculty ahead of your own in the program. And so I think I've really tried to help support faculty and their growth. So I think if I hadn't learned that a little bit earlier, I might have not been quite so rocky at first. So I think that's one thing.

I think another is just, this isn't so much from a leadership, a more administrative standpoint, of all of the administrative things you have to deal with on a day-to-day basis from the registrar, financial aid, student support. It's just a lot of things like that in this role. In this position, people tend to come to you first.

And then here at Emory it's a little bit challenging because it's a very matrix system. So it's hard to know who to go to as I'm learning how the system works. Do I go to the School of Medicine? Do I go to the university side? Do I go to the healthcare side to try to find answers? So I think knowing a little bit more about all the administrative stuff would've been helpful at first.

Indeed. Indeed. All of that navigating the systems, you know, the system's systems.

Yeah.

What continuing professional development do you do in order to keep up with the needs of your roles?

So I think, well one, not, I don't continue to do this, but after my second year as Chair, our professional association, the American Physical Therapy Association had a leadership fellowship. So I did that and that was really helpful because we had some really good mentors who were physical therapists but were also in higher education and were deans or chairs for a long time. And it started different programs.

And then another thing that I've done well is just I'm good at meeting smarter people than I am, which is obviously a lot of smarter people than I am. But so we've kind of formed an informal support group. So there's about four or five people that I know that are also directors of PT programs and chairs of departments. And so usually once a month or every other month we get together on Zoom and just have questions for each other, commiserate a little bit, and also seek answers when we're not sure. So that's been really helpful in this role.

Also just read a lot. So there's different... Actually Twitter's been pretty good for that lately. You can follow some different educators and read articles that they've written and posted about. And then also there's conferences that have some continued education. So a variety of different ways to help me continue to learn.

Great. Are there any of those Twitter folks that you would recommend folks look up?

I'm trying to think. So this isn't so much leadership, but it's the one interesting one about teaching. I think it's Ed Mazur. So he's out of Harvard. He's done a lot in STEM education around peer-based instruction. So that's kind of interesting.

Cool. Thank you. So as you reflect on the various leadership roles that you have, what advice would you give someone interested in doing the same types of roles that you've had?

Run for the hills before they get you. No, so that's a good question. I mean, let me think about that for a minute.

So one I think would be to find mentors, are important. That's been very helpful for me is having a network of mentors from many different institutions, and not even necessarily physical therapists, but just others in higher education has been helpful.

I think, as I said earlier to you kind of got to put your ego aside. That's a little bit challenging at times, especially when you're first starting out. And so I think that would be an important thing.

And then also to take some leadership course. So the fellowship I did was really helpful. I think a lot of... Some, not a lot, but some of the things we learned there, I think maybe I did intuitively or I'd heard about, but it's nice to have it formalized and have a name to go with it at times. So I think that's some steps I would take.

Thank you. So recognizing that you've moved around and had different leadership roles, how do you view succession planning?

Yeah, that's a challenging one, right? Because it's hard to know. Every institution you're at is a little bit different in how that can work. Are there the resources there that you can appoint somebody as an assistant director or associate director? Or what's the structure of the current department or division that you're in? So I think it'd be good important to look at all those things because I think it's important to think about succession planning. I haven't really spent a lot of time on that here because I've only been here less than a year, so hopefully we're not trying to succeed me already.

But I think it's important to, again, communicate with people, find out what their desires are, and you have people that want to take more of a leadership role then to see, okay, what areas are they interested in? And then find projects that are ongoing that they can take some leads in, or even the day-to-day operations, instead of me doing something, let's work on you taking the bulk of this moving forward. You can do that around a variety of different things. You could have someone appointed as the Chair of the Curriculum Committee or Chair of Admissions or leading components of a self-study, things like that. And then that gives people opportunity to have, take on a larger role in what they're doing. So I think it's important to do that throughout and not kind of wait until the end.

Thank you. So as you continue to reflect on your experiences to date, what contributed to your biggest successes thus far?

Probably two things. One would be luck. Two, and maybe good and bad luck depending on the situation, I think I mentioned this earlier. I think the biggest thing for me was really having a really strong network of mentors. I think that's a key probably in any profession as you want to learn more, so to find people that can support you, that are willing to give some of their time to help you out and learn.

I think also I've tried to do a good job of when I have mentors is to see how I can help support them afterwards or in an ongoing basis when we have more of a collaborative relationship rather than just mentee-mentor relationship. So I think probably to me that'd what's helped me the most is having really strong mentors.

Great. As you think about that, because we hear about mentors and mentorship as being important, at what stage did you start to actively look for mentors in your career?

I think from the very beginning, even before I was... So when I started out as a physical therapist, one of my former faculty members reached out to me to see if I would want to write a chapter for a textbook that she edits and help teach in her labs. So she helped establish that right away. And that's my relationship with Susan has kind of been ongoing through my whole career as a physical therapist, which has been great.

And so I think some of it just kind of happened. It's hard to set up a formal... I mean, I think you want to have some formal mentors and look in your institution not only in the department or the division that you're in, but outside of there so you can meet others and learn from there. Because a lot of the issues that you might have to address are going to be similar. It's not just only for physical therapy, it's some similar stuff across all of higher education. So I think it's important to reach out because you can learn a lot of good things from people who aren't right in your own kind of profession there. So I think that's important, and it just kind of happens gradually over time, I think.

Okay. Thank you. So recognizing, I feel like as educators, we are lifelong learners, so, what are or were some of your biggest growth opportunities thus far?

Well, I think coming to Emory is a really big growth opportunity. Just the size of the place and the complexity is a challenge. And then they have been, prior to me coming here with an interim director for a number of years, for four years. So it's a really good opportunity, but a challenge at the same time too. There's a lot that we can do here at Emory in terms of growing the program in terms of growing physical therapy and movement science within Emory and even across the whole profession.

But then it's just having to, I think part of my issue is that I like to move fast and I like to get things done and keep moving on to the next one, but it's just going to take some time to build these things. And so I think it's a really good opportunity. I have to be a little patient to have it all get there, but then at the same time, communicate well with everybody because it's not something that I can just push the ship in this direction. We got to get everybody on board to kind of help.

Right. Getting back, as you said, that whole matrix, that system upon systems.

Right. Yeah.

Yeah. So what do you love most about your work and what you do?

I mean, I like seeing the students. It's great to develop relationships with them. I don't teach as much as I used to, obviously in this role and haven't; I've been in and out of some classrooms, but not a lot yet this first year as I'm kind of getting to know the curriculum and the program and the whole university. But I enjoy that piece of seeing students learn. When they have an aha moment that's really nice. And it's also nice to see faculty over time grow in the areas that they're interested in. So that part is nice. And then I also still can maintain my own research to a little bit. So I enjoy doing that. So it's nice when you learn new skills around your research or collect some data and find something novel and interesting. So that part is nice.

Nice. So can you tell us a bit more about your research?

So I am interested mainly in looking at how people recover after stroke, and in particular, how they recover their ability to walk and be more active in their community. And recently starting to look at, we have a grant where we're looking at how sleep impacts recovery after stroke. And so there's quite a bit of research on obstructive sleep apnea and stroke, because obstructive sleep apnea is a risk factor for stroke. And if you have a stroke, you're more likely to develop obstructive sleep apnea.

However, we're looking at other types of sleep disorders, so there's really not a lot of research on other types of sleep disorders like insomnia, restless leg syndrome, et cetera. And so we're following a cohort of people for three months after their stroke and taking a bunch of clinical measures. The one part that's really interesting is we're having them wear activity monitors, so small little, I guess, fancy research grade Fitbits to measure their sleep and how active they are. And so from that, we can look at, there's a big interaction between sleep and activity and exercise. So we can look at how do they interact together.

And then the ideal is, once we finish collecting data on this grant, have some good information about how sleep and activity interacts so that then we can develop some interventions to help improve people's sleep and their rehab at the same time and maybe get a little bit added effect if we can help improve their sleep at the same time that they're receiving physical therapy.

That's amazing. Great stuff. Yeah. When you're doing that type of research, I think about the traditional PhD program where there's a research lab and the students are involved. Is that similar for PT?

It is, but not with this research project. So our researchers, all of the researchers in the program have a lab space in the Emory Rehab Hospital. And so they probably... What I was looking at, more basic mechanisms of how people are impacted by their stroke and how they recover. So they'll have a lab where there's different instrumentation there to measure movement, to measure different neural processes. So one of our researchers, they use like TMS, so it's delivers a magnetic pulse, which causes an electrical signal that we can use to measure connections within the brain and see what's connected or not and what's impacted after stroke and after interventions.

But most of the research I do is more, I would say, clinically based. So I don't have a individual lab, but we're more collecting data from patients that are in the hospital and we would follow up with them afterwards where we might be in a lab but not collecting more clinical data.

Okay. Thank you for that clarification. So overall, reflecting on your experiences to date, what would you say are your passions around education?

That's a good question. So I think, again, it's looking at ways that students learn. I think we, meaning higher education, and at least my experience, is that we don't like to change. It's like, okay, I learned this way. I learned by sitting in a lecture hall, listening to somebody talk at me for 20 hours a week, and I would just go read stuff.

But I think today's students are very different. We've gone through COVID and had to learn how to teach remotely many of the different things that we have done and so looking at how can we develop and integrate more active learning when we're teaching the students. I think that's a real important thing to look at is how can we really better serve our students? Because once they graduate, things are going to change within weeks and months of after they leave, let alone years. And so they need to learn how to process and synthesize information because there's just so much information out there. So we don't need to give them the information anymore. We need to do a better job of helping them discern what's good information and then how to synthesize it and apply it. And so what are things that we can do early on to help students become effective active learners here.

Thank you. I think that's so important because as you're highlighting, the inundation of information that comes our way and being able to go, "How do I focus in," is quite a skill. Yeah.

Yeah. I mean, you can almost spend all day, every day just reading new information about even about a very small area that you're interested in. And so I think it's an important skill to have.

So recognizing you are more than your career, what are some things you do outside of work to help you maintain joy in life and practice?

No, that's good. So I enjoy mountain biking. I bike into work, but then also at least once, try to do it more often, a week is go out, there's a lot of trails in the Atlanta area, surprisingly, so I was excited about that. You have to drive maybe in a half an hour to an hour, but there's a good network of different trails, mountain bike trails in there. So I do that pretty often. I read a lot of non-work stuff, so I read a lot of non-fiction, history, biography books.

Any particular ones you've read recently that you like?

Yeah. Well, right now I'm reading interesting one called Freedom at Midnight. So it's about the partition of Indian Pakistan after the British Raj left after what? Three centuries plus or minus of rule of India. So it's just really interesting to learn about that period and a lot of challenges there in that area of the world still, but just interesting to learn the history behind that.

Absolutely. My brother loves history and so does my partner. I, on the other hand, are not as much into history, but I appreciate all the things I learned from them. So I know they would really appreciate hearing about the book you're reading.

Yeah, it's a good book. One very interesting historical tidbit from that book, I don't know what you know about it, but Louis Mountbatton was appointed as the last Raj to help partition India and Pakistan. And Jinnah, who was the leader of the Muslims, he was adamant about there needed to be a separate state, and that was a big roadblock. So they finally decided, fine, we'll divide it up.

So interestingly when all this was happening, unbeknownst to anybody but Jinnah and his physician, was that he was basically on his deathbed with tuberculosis.

Oh, wow.

And so the guys that wrote the book, they interviewed Mountbatten, and when they told him that he was shocked because he didn't know. And he had said he had known he would've delayed the whole thing possibly until Jinnah possibly died, and then maybe they wouldn't have had to actually partition India. So just really interesting pieces like that. So history would've been a lot different if he had known that one little bit of information.

Yeah, those are amazing little bits that show up.

That change history, yeah.

Indeed, indeed. Well, thank you, George, for your time. Those were my main questions, but before I let you go, any last words of wisdom for aspiring educators or education leaders?

Yeah, to me, again, the big thing is just mentoring. So find multiple people, try to find people outside of your main area to help. And then also, I think another, I didn't really mention this, but to really embrace change. Because change happens all the time, and so if you're hesitant to change, then you are already going to be behind because things are changing so fast now that we have to change all the time. So embrace it, I guess.

Wise words to end off on, embrace change because it has always happened.

ight.

Thank you again.

Okay. Thanks.