Forming Meaningful Connections: A Mixed-Methods Survey Study of Hybrid Doctor of Physical Therapy Students' Insights, Well-Being, and Recommendations on Fostering Belonging

Forming Meaningful Connections: A Mixed-Methods Survey Study of Hybrid Doctor of Physical Therapy Students' Insights, Well-Being, and Recommendations on Fostering Belonging | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Forming Meaningful Connections: A Mixed-Methods Survey Study of Hybrid Doctor of Physical Therapy Students' Insights, Well-Being, and Recommendations on Fostering Belonging Brett D Neilson, Rebecca E. Parr, Melissa J. Yeung, Jennifer C. Kish, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6595794/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Mar, 2026 Read the published version in BMC Medical Education → Version 1 posted 12 You are reading this latest preprint version Abstract Background A sense of belonging, feeling accepted, respected, and supported, is crucial for student success. Hybrid Doctor of Physical Therapist Educational Programs (PTEPs), which blend online and in-person learning, present unique challenges to fostering belonging. This study explored students' insights on belonging in hybrid PTEPs, identifying facilitators and barriers and the relationship with well-being, leading to program recommendations. Methods This cross-sectional, mixed-methods survey study of 138 students enrolled in 18 hybrid PTEPs measured belonging, explored belonging factors, and linked well-being with belonging. Quantitative data were analyzed using descriptive statistics, tests of association, and unadjusted odds ratios, while open responses underwent inductive qualitative coding. Results Students demonstrated above-average belonging (3.38/5; SD 0.92), with academic belonging (3.71, SD 0.90) rated higher than interpersonal belonging (2.98, SD 0.96). A sense of belonging demonstrated protective effects against anxiety (OR 2.62, 95CI: 1.22, 5.62) and was associated with positive well-being (OR 2.68, 95CI: 1.29, 5.59). Students endorsed faculty and peer respect, a welcoming culture, and in-person experiences as the most substantial contributors to belonging. While most (76.7%) identified the hybrid format as a barrier, inclusive online learning environments and student-led communication supported belonging. Qualitative themes for belonging included motivation to belong, opportunities for connection, program policies and faculty/administration support, and relational competencies. Conclusion While hybrid PTEPs foster a sense of belonging, gaps in interpersonal connections persist. Programs should implement strategies to enhance faculty and peer support, structured interactions, and face-to-face engagements while also integrating mental health resources to strengthen student connections and well-being. Belonging Well-being Hybrid Distance education Physical therapy Figures Figure 1 Figure 2 BACKGROUND “Hybrid PT programs,” defined as entry-level, distance professional physical therapist education programs (PTEP), emerged in 2015 and expanded due to the COVID-19 pandemic as traditional programs shifted to online delivery methods. These programs blend online and in-person learning experiences where at least 50% or more of the required coursework, excluding clinical education, is delivered online through synchronous and/or asynchronous instruction ( 1 ). In-person learning experiences are often structured as limited immersive sessions lasting one to two weeks or several weekends. While hybrid programs provide increased flexibility and access to physical therapy education ( 2 ), they also pose unique challenges, such as dispersed geographic locations of students and faculty, decreased spontaneous human interaction, a less personal online learning environment, and limited in-person interactions, which can contribute to feelings of loneliness, stress, and anxiety ( 3 – 6 ). Feelings of loneliness and anxiety are common among students in graduate-level education, including PTEPs ( 3 , 7 , 8 ). Belonging—the perception of social support, connection, acceptance, and respect within one’s academic community ( 9 )—is the antithesis of loneliness and exclusion ( 10 ). Importantly, belonging is a dynamic experience, with belonging and loneliness coexisting along a spectrum where students may feel a sense of belonging in particular social, environmental, and time-based contexts while simultaneously experiencing loneliness in others ( 10 ). This duality is especially pertinent in hybrid education, where students navigate both virtual and in-person learning environments. Recently, there has been an increased focus on students’ sense of belonging, as studies indicate that a stronger sense of belonging positively influences mental well-being ( 3 ) and academic success ( 8 , 9 , 11 – 13 ). Within higher education, facilitators of belonging include geographic proximity, supportive faculty, inclusive curricula, accessible peer networks, and engagement-promoting programs ( 3 , 12 , 14 , 15 ), which are all challenged by the unique hybrid learning environment. Given the connection between belonging, success, and mental well-being ( 3 , 13 ), examining how belonging affects the educational experience of students enrolled in hybrid PTEPs is essential, as these experiences may differ from those in traditional PTEPs. How to effectively address the unique belonging needs in distance or hybrid programs is unclear ( 12 ). Given the importance of belonging, the challenges identified, and the growth of hybrid PTEPs, the primary purpose of this mixed-methods survey study was to evaluate the rate of belonging among entry-level students enrolled in hybrid PTEPs to determine if students are able to foster a sense of belonging within the hybrid PTEP learning environment. The secondary objective was to explore students’ insights into the facilitators and barriers that influence their sense of belonging and to assess the relationship between the well-being and belonging of hybrid PTEP students. Finally, the overarching goal was to share recommendations based on students’ lived experiences to enhance the understanding of the ideal learning environment for hybrid PTEP students. Review of Literature Research on belonging in graduate education is limited and significantly different from undergraduate experiences ( 6 ). A 2022 scoping review of belongingness in graduate health education identified one study focusing on PT education, with six additional studies emerging since, though none specifically examine hybrid PTEPs ( 5 , 8 , 11 , 12 , 16 – 18 ). Only Ratoza, Sykes, and North (2024) included one hybrid (48-month) program in their analysis, but they did not examine it separately, highlighting a gap in understanding how students in hybrid learning environments experience belonging. Existing literature on belonging in PTEPs is primarily qualitative, with no known quantitative studies on U.S.-based hybrid programs. Although quantitative belonging scales exist, most were designed for university-wide assessment, which limits their application at the program level ( 11 ). However, the Sense of Belonging at Imperial College London scale, developed by Imperial College London, was designed to be adaptable for program-level analysis ( 19 ). It has also been used with PT students learning online, enabling meaningful comparisons ( 20 ). Recent studies have begun validating additional quantitative tools specific to PTEPs, but their application remains preliminary ( 11 , 18 ). When considering the existing theoretical literature on belonging is broad and diverse, with authors from various disciplines approaching the concept from different perspectives ( 21 ). Allen, Kern, Rozek, McInereny, and Slavich (2021) developed an integrative framework based on prior theories that identified four key components: 1) relational competencies, 2) opportunities for connection, 3) motivation to be accepted, and 4) subjective perceptions of belonging. These components emphasize the significance of meaningful relationships and a supportive environment, both of which are challenged by the hybrid environment. This framework guided the development of this study and our exploration of belonging within hybrid PTEPs. Relational competencies significantly influence students' sense of belonging, primarily through perceived respect and support from faculty and peers. PTEP students report a greater sense of belonging when they experience empathetic faculty and supportive peer relationships ( 12 ). Similarly, online learners enjoy a stronger sense of belonging when they perceive support from faculty in their online learning environment ( 22 ). However, not all students encounter such support. Racially minoritized and equity-deserving students in traditional PTEPs—residential programs—have reported facing discrimination, microaggressions, and insufficient support, which negatively affects their confidence and academic success ( 12 , 17 , 23 – 25 ). Representation within the program, coursework, and instructional methods enhances belonging for students from equity-deserving backgrounds ( 12 ). Opportunities for peer connection, both virtual and in-person, play a crucial role in fostering belonging in PTEPs ( 12 , 16 , 26 ). Cohort-based models offer built-in peer support through shared experiences and structured engagement opportunities, helping to mitigate feelings of isolation ( 12 ). Student organizations and virtual mentorship programs within PTEPs enhance connection opportunities, reducing loneliness and social isolation ( 12 , 16 ). Opportunities to build supportive relationships with faculty further strengthen belonging by fostering a sense of acceptance within the professional community ( 8 , 12 ). Learners in online environments emphasize the importance of instructor engagement, particularly in creating “safe” or “brave” spaces ( 5 ) and establishing an active online presence ( 22 ). Graduate students with faculty mentors are more likely to engage in academic and personal discussions, reinforcing their sense of connection and belonging ( 27 ). Students’ intrinsic motivation and desire for acceptance influence their engagement and, consequently, their perceptions of belonging ( 9 , 28 – 30 ). This motivation stems from two constructs: interpersonal belonging—social and interpersonal connections and relations, and academic belonging—acceptance within the academic community and environment ( 31 ). Associated with academic belonging is academic self-efficacy, which also affects student motivation and learning ( 13 ). Recognizing students' contributions boosts their motivation and sense of connection within the academic community ( 21 ). Collaborative activities, such as assigned group work, are linked to increased student motivation and perceptions of interpersonal belonging in online science courses ( 4 ). Interestingly, Young Ahn and Davis found that academic and social engagement influence belonging independently; some students gain motivation primarily from academic belonging, while others depend on interpersonal belonging, highlighting the importance of nurturing both ( 32 ). However, not all students seek belonging within institutional frameworks. Some may view belonging as necessitating conformity and instead develop alternate spaces where they feel safe to be authentic ( 13 , 33 ). Variability in belonging needs and motivations emphasizes institutions’ need to cultivate belonging while honoring students’ agency ( 33 ). While qualitative research on belonging in traditional PTEPs is increasing, there remains a lack of quantitative studies measuring belonging rates, and there are no studies on hybrid PTEPs. Given the growing prevalence of hybrid learning models in physical therapy education, this study aimed to address this gap by quantitatively measuring belonging and identifying factors that influence students’ sense of belonging through mixed methods to triangulate the findings and highlight students’ perspectives. METHODS Study Design and Data Collection This cross-sectional, concurrent mixed-methods survey study followed the Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR-RHS) guidelines ( 34 ). Ethical approval was obtained from Hawai’i Pacific University (5604202347) and Hanover College (2023 − 0318). Data was collected between August 2023 and February 2024 using the REDCap (Research Electronic Data Capture) tool with audit tracking ( 35 , 36 ). The participants consented to participate and could refrain from answering any questions. Participants Students actively enrolled in 18 entry-level hybrid PTEPs, identified as distance education programs from the Commission on Accreditation in Physical Therapy Education database, were invited to participate in the study by their program director. Purposive heterogeneous sampling was utilized for this study to ensure the distribution of geographic location, enrollment duration, and program length. Consequently, the exact number of respondents invited to participate is unknown due to the sampling method. Participants were excluded from the study if they were not enrolled in a hybrid PTEP or did not complete the initial questionnaire with the sense of belonging instrument. Based on a priori sample size calculation with an alpha of 0.05 and power at 0.80 and expecting that 50% of individuals would express a sense of belonging, a minimum sample size of 85 was anticipated. See the Results section and Table 1 for program and participant demographics. Survey Instrument The survey included demographic questions, the Imperial College London Sense of Belonging Scale , questions about potential contributing factors and barriers to belonging, and the Generalized Anxiety Disorder-7 (GAD-7) questionnaire ( 37 ). Two open-ended questions were included to capture students’ insights and allow for the expression of the student voice in the findings. The survey was developed using best practice in survey design principles ( 38 ) and piloted with a small group of students prior to dissemination. Student and Program Demographics - Self-reported variables included age, biological sex, gender identity, race, ethnicity, geographic region of residence, geographic area, PTEP geographic region, PTEP program length, month of study, class/cohort size, marital status, LGBTQIA + identity, disability, first-generation college student status, economically disadvantaged background, non-native English speaker status, and caregiving responsibilities. Questions regarding lab immersion included students' residences during lab immersion and who they lived with during that time. Sense of Belonging Questionnaire - The Sense of Belonging at Imperial College London scale ( 19 ) is a 10-item survey divided into three sub-domains (academic, interpersonal, and overall belonging) that has undergone a rigorous, research-based development process to improve reliability and validity ( 19 , 39 ). It is designed to be adaptable by modifying the subject of the question ( 19 ). The authors of this study adapted this instrument by replacing the named university with “the DPT (Doctor of Physical Therapy) Program” to make it generalizable for all survey participants. Further, one additional question was added: ‘How connected do you feel to other students in the DPT Program?’. This question was excluded from the average composite score calculated to maintain validity. Item 11, ‘Overall, how much do you feel like you belong at the program,’ was used to dichotomize respondents into a high sense of belonging group (score of 4 ‘belong quite a bit’ or 5 ‘completely belong’) or low sense of belonging group (score of 3 ‘belong somewhat,’ 2 ‘belong a little,’ or 1 ‘do not belong at all’). Well-being - Student participants rated their overall physical, mental, and emotional well-being on most days throughout the program, using a five-point Likert scale from very poor to very good. 7-item Generalized Anxiety Disorders Scale (GAD-7) - The GAD-7 has been increasingly utilized in clinical practice and research to measure generalized anxiety because of its clinometric properties; the specifics of this measure are published elsewhere ( 37 ). The instrument reportedly maintains an adequate balance between sensitivity and specificity values to use a cut-off of greater than or equal to a score of 8, indicating the presence of generalized anxiety ( 37 ). The GAD-7 has been found to have good internal consistency (alpha of 0.82) and high convergent and discriminant validity ( 37 ). Data Analysis All data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 29, with the assistance of a statistician. The authors initially cleaned the data to ensure eligibility and completeness. The statistician assessed the data for normality and identified suitable statistical tests to establish differences. Descriptive characteristics from student and program demographics are reported in Table 1 for those with a high sense of belonging and a low sense of belonging, using chi-square tests for categorical variables and independent t-tests for continuous variables. Demographic information is reported using measures of central tendency and frequencies. Means (SD) are reported for the overall composite belonging score and the GAD-7 score. Correlations were used to establish relationships between belonging and individual and programmatic factors that facilitate belonging. Unadjusted odds ratios were calculated to identify associations between well-being and belonging, as well as anxiety and belonging. Using an inductive coding process, the authors assessed responses to the two open-ended survey questions to identify additional facilitators and barriers to belonging. First, author BDN reviewed all student responses to the open-ended questions and created a list of general codes for the responses to “What other aspects of your DPT Program foster your sense of belonging?” and “What other aspects pose barriers to your sense of belonging?”. BDN, REP, and MJY refined the list of codes. Using the finalized code lists (described in Table 4 ), authors BDN and REP independently assigned one or more codes to each response (blind copy). Initial inter-rater reliability was 81%, indicating ‘substantial agreement.’ BDN and REP discussed any discrepancies until they reached an agreement, with MJY serving as the tiebreaker. RESULTS Of the 191 students who opened the survey, 168 started it. The authors excluded thirty students from the analysis: 26 did not finish the initial questionnaire containing items related to belonging, and four were not enrolled in a hybrid DPT program. Therefore, 138 participants were deemed eligible and included in the analysis. Demographics Hybrid DPT program lab immersion locations and the percentage representation of the study sample were most frequent in the Midwest (39.1%), followed by the West (34.8%), Southeast (14.5%), and Southwest (8.7%) regions. Most programs were 24 months long (79.7%), with 20.3% ranging from 25 to 37 + months. The average reported class size was 87 (SD 19.9), varying from 25 to 111 students. Student demographic information is provided in Table 1 . Table 1 Descriptive Statistics for Student Comparison Groups Variable Overall (N = 138) c High Sense of Belonging (N = 68) a Low Sense of Belonging (N = 70) a P b Age, mean (SD) 29.07 (6.58) 28.79 (6.89) 29.36 (6.3) 0.44 Gender: Female/Woman 96 (69.6) 48 (70.6) 48 (68.6) 0.80 Identify as LGBTQIA+ (N = 131) 10 (7.2) 6 (9.4) 4 (6.0) 0.53 Disability (N = 129) 9 (6.5) 3 (4.9) 6 (8.8) 0.50 First Generation College Graduate (N = 134) 40 (29.0) 17 (26.2) 23 (33.3) 0.36 Economically Disadvantaged (N = 132) 48 (34.8) 25 (38.5) 23 (34.3) 0.62 English Not 1st Language (N = 132) 12 (8.7) 6 (9.4) 6 (8.8) 0.91 Married/Cohabitant (N = 133) 50 (36.2) 25 (39.1) 25 (39.1) 0.74 Caregiver (N = 133) 34 (24.6) 22 (34.4) 12 (17.4) 0.03 Race and Ethnicity American Indian or Alaska Native 2 (1.4) 1 (1.5) 1 (1.4) 0.45 Asian 18 (13.0) 7 (10.3) 11 (15.7) Black or African American 9 (6.5) 4 (5.9) 5 (7.1) Hispanic/Latino/Latinx 13 (9.4) 7 (10.3) 6 (8.6) Native Hawaiian or Other Pacific Islander 5 (3.6) 4 (5.9) 1 (1.4) White 85 (61.6) 41 (60.3) 44 (62.9) Other/Missing 6 (4.4) 4 (5.9) 2 (2.9) Home Location Type (N = 132) Urban 29 (21.0) 15 (22.1) 14 (21.9) 0.04 Suburban 82 (59.4) 37 (54.4) 45 (70.3) Rural 21 (15.2) 16 (23.5) 5 (7.8) Reside with While at the Lab Immersion (N = 133) Alone 36 (26.1) 12 (17.6) 24 (35.3) 0.08 Classmates 54 (39.1) 33 (48.5) 21 (30.9) Family 30 (21.7) 14 (20.6) 16 (23.5) Friends/acquaintances 13 (9.4) 6 (8.8) 7 (10.3) Composite Belonging Score, mean (SD) 3.38 (0.92) 4.04 (0.53) 2.74 (0.74) < .001 GAD-7, mean (SD) 7.77 (5.63) 6.20 (4.70) 9.28 (6.07) .003 a Reported as number (percentage) of students unless otherwise indicated. b Values in bold were significant at a P value of < .05. c Unless otherwise noted Sense of Belonging The average composite sense of belonging score among the student participants was 3.38 out of five (SD 0.92), with 49.3% (68 out of 138) classified as having a high sense of belonging (Table 1 ) . Academic belonging received more substantial support from the overall sample, with a mean score of 3.71 (SD 0.90), compared to interpersonal belonging, with a mean of 2.98 (SD 0.96). The sense of belonging items that significantly contributed to students’ overall perception of belonging—evidenced by a higher frequency of ‘Quite a bit’ or ‘Completely/Extremely’ responses—were respect faculty show (69.6%), the welcoming nature of the DPT Program (66%), the respect demonstrated by other students (64.5%) and satisfaction with their choice to enroll in the program (63.1%). The complete responses of all participants are provided in Table 2 . Table 2 Sense of Belonging scale questions ordered by average response in each sub-domain, frequency (percentage) Item Not at all a Slightly a Somewhat a Quite a Completely/ Extremely a Average Response a Sub Domain 6. How much respect do faculty members within the DPT Program show toward you? 3 (2.2) 10 (7.2) 20 (21.0) 60 (43.5) 36 (26.1) 3.84 (0.97) Academic 5. How much respect do other students within the DPT Program show toward you? 3 (2.2) 14 (10.1) 32 (23.2) 56 (40.6) 33 (23.9) 3.74 (1.01) 8. How happy are you with your choice to be a student in the DPT Program? 7 (5.1) 13 (9.4) 31 (22.5) 47 (34.1) 40 (29.0) 3.72 (1.13) 9. How enriching is your experience in the DPT Program? 7 (5.1) 17 (12.3) 37 (26.8) 51 (37.0 26 (18.8) 3.52 (1.89) 4. How welcoming have you found the DPT Program to be? 7 (5.1) 14 (10.1) 26 (18.8) 52 (37.7) 39 (28.3) 3.74 (1.13) Overall 11. Overall, how much do you feel like you belong in the DPT Program? 12 (8.7) 21 (15.2) 37 (26.8) 38 (27.5) 30 (21.7) 3.38 (1.23) 10. How 'at home' do you feel in the DPT Program? 18 (13.0) 26 (18.8) 38 (27.5) 35 (25.4) 21 (15.2) 3.11 (1.25) 3. How connected do you feel to other students in the DPT Program? 8 (5.8) 33 (23.9) 40 (29.0) 39 (28.3) 18 (13.0) 3.19 (1.11) Interpersonal 1. How well do people in the DPT Program understand you as a person? 11 (8.0) 33 (23.9) 49 (35.5) 36 (26.1) 9 (6.5) 2.99 (1.04) 7. How much do you matter to others in the DPT Program? 17 (12.3) 33 (23.9) 43 (31.2) 35 (25.4) 10 (7.2) 2.91 (1.13) 2. How connected do you feel to the Program faculty? 22 (15.9) 34 (24.6) 39 (28.3) 35 (25.4) 8 (5.8) 2.8 (1.16) a Reported as number (percentage) of students unless otherwise indicated. Facilitators to Belonging Students most frequently rated having classmates (42.7%) and faculty/staff (31.9%) with similar interests as ‘very important’ or ‘absolutely essential’ for fostering their sense of belonging. They viewed the lab immersion (70.3%) and online learning environments (88.4%) as 'very important' or ‘absolutely essential.’ Students similarly endorsed student-led communication (64%) and activities outside class (55.8%) as critical to fostering belonging. These environments and activities demonstrated small positive correlations (r = 0.21–0.37, p ≤ .01) with the composite sense of belonging score, while orientation activities showed a moderate correlation (r = 0.43, p < .001). Complete responses to quantitative contributing factors and program activities are available in Table 3 . Table 3 Contributing Factors and Program Activities Facilitators Did Not Answer Not Important At All a Of Little Importance a Of Average Importance a Very Important a Absolutely Essential a Students with similar visual appearance as me (e.g. race, ethnicity, hairstyle, etc) 3 37 (26.8) 33 (23.9) 38 (27.5) 21 (15.2) 6 (4.3) Faculty/staff with similar visual appearance as me (e.g. race, ethnicity, gender identity, hairstyle, etc) 3 41 (29.7) 32 (23.2) 34 (24.6) 22 (15.9) 6 (4.3) Students who have similar life experiences as me (e.g. childhood, community, background, etc) 2 21 (15.2) 31 (22.5) 50 (36.2) 25 (18.1) 9 (6.5) Faculty/staff who have similar life experiences as me (e.g. childhood, community, background, etc) 3 24 (17.4) 30 (21.7) 48 (34.8) 26 (18.8) 7 (5.1) Students with similar interests as me (e.g. life interests, values, etc.) 2 10 (7.2) 13 (9.4) 54 (39.1) 49 (35.5) 10 (7.2) Faculty/staff with similar interests as me (e.g. life interests, values, etc.) 2 14 (10.1) 23 (16.7) 55 (39.9) 37 (26.8) 7 (5.1) Orientation activities 0 13 (9.4) 21 (15.2) 48 (34.8) 40 (29.0) 16 (11.6) Online learning environment 0 2 (1.4) 7 (5.1) 32 (23.2) 64 (46.4) 33 (23.9) Lab immersion environment 0 1 (0.7) 3 (2.2) 12 (8.7) 36 (26.1) 86 (62.3) Student-led communication outside of class 0 7 (5.1) 10 (7.4) 32 (23.5) 50 (36.8) 37 (27.2) Student activities or gatherings outside of class 0 4 (2.9) 15 (11.0) 41 (30.1) 35 (25.7) 41 (30.1) Barriers Did Not Answer Not a barrier a Somewhat of a Barrier a Moderate Barrier a Significant Barrier a Extreme Barrier a Hybrid (online/in-person) delivery of the program 4 32 (23.3) 33 (23.9) 39 (28.3) 22 (15.9) 8 (5.8) Cohort or class size 4 53 (38.4) 39 (28.3) 18 (13.0) 16 (11.6) 8 (5.8) My overall physical and mental well-being 5 36 (26.1) 40 (29.0) 26 (18.8) 22 (15.9) 9 (6.5) Social/personal differences between me and my peers 5 49 (35.5) 28 (27.5) 20 (14.5) 15 (10.9) 11 (8.0) Cultural differences between me and my peers 7 69 (50.0) 35 (25.4) 17 (12.3) 5 (3.6) 5 (3.6) a Reported as number (percentage) of students unless otherwise indicated. Forty-nine participants completed the open-ended question, “What other aspects of your DPT Program foster your sense of belonging?”. The percentage of total coded responses per theme is available in Table 4 . Four main themes emerged from student responses: motivation to belong, opportunities for connection, program policies and faculty/administration support, and relational competencies (Fig. 1 ). The theme ‘motivation to belong’ highlighted the significance of feeling valued and respected. Three participants expressed “unbelonging,” described as a lack of desire to belong, or a choice not to belong ( 33 ). ‘Opportunities for connection’ emphasized the importance of structured and spontaneous interactions in virtual and in-person environments. The theme ‘Program policies and faculty/administration support’ underlined the necessity for intentional program policies that foster belonging and active support from faculty and administrators. Finally, ‘relational competencies’ reflected the importance of recognizing shared experiences and similarities among students. Table 4: Positive Factors Contributing to Sense of Belonging and Identified Barriers Code Percent (No.) Participants Sample Quotes Motivation to Belong Positive Contributing Factors Feeling valued and respected 20.4 (10) “Having opportunities for individual responsibility. Knowing that my faculty or peers trust me to complete a task and deliver quality results. I feel valued when I'm recognized as a capable person with valuable skills.” Peer support 8.2 (4) “The emotional support my peers offer each other.” Identified Barriers Lack of connection 9.1 (3) “Not knowing anyone in the program previously.” Limited time 9.1 (3) “Too busy surviving to make the effort to form connections.” Negative connection 17.6 (6) “Feeling scared to talk openly because someone might take what I say incorrectly.” Poor well-being 12.1 (4) “Most influential barrier is personal health.” Unbelonging 3.1 (1) “My lack of outgoingness and apathy toward "belonging".” Relational Competencies Positive Contributing Factors Similar life experiences 6.1 (3) “Having others in my cohort of a similar age.” Similar visual appearances 2.0 (1) “There is a lot of diversity among the students as well as the location of the program. It makes you feel more welcomed as someone of color. There is also a lot of culture and respect for the world around us which has been instrumental to my personal experience.” Identified Barriers Disability 3.0 (1) “autistic” Lack of representation (age and military status) 18.2 (6) “Having so many students in the cohort of different ages and stages of life makes it more difficult to relate to others.” Religion 3.0 (1) “Religious beliefs” Social/attribute cliques 3.0 (1) “I feel as a whole, our student cohort is extremely cliquey…people quickly found their own groups and dismissed all others after first lab.” Opportunities for Connection Positive Contributing Factors Spontaneous peer connection 28.6 (14) “Adequately long lunch breaks with provided spaces that foster communication and connection with peers and faculty.” Structured peer connection 36.7 (18) “[Program formed] smaller, personable coaching groups of 10 students per 1 faculty. I love how well my coaching group gets along. We all have different backgrounds and work experience, and we supported each other since the start.” Group work 22.4 (11) “Working in small groups in class and lab environments to allow students to get to know each other.” In-person interaction 12.2 (6) “Interactions during lab” Identified Barriers Geographic distance 18.2 (6) “physical distance from peers” Limited opportunities for connection 6.0 (2) “only monthly interactions” Program Policies and Faculty/Administration Support Positive Contributing Factors Program policies and administration support 20.4 (10) “Being checked on and encouraged by administrators when noticeable signs of improvement need to be addressed such as hours studying, turning in assignments ahead of time, and helping me understand what track I need to be on. Having people actually look into those things to keep me on track.” Faculty support 16.3 (8) “The role of student support and having the program's student success coach [faculty coach/advisor] available. These resources have been a tremendous help with being successful in the program while dealing with personal stressors.” Identified Barriers Cohort size 6.1 (2) “Large class size leading to not feeling connected with many classmates at labs.” Program structure (environment and delivery) 12.1 (4) “Being on a satellite campus as opposed to the main campus.” [Suggested placement of Table 4 ] Barriers to Belonging Students viewed the hybrid environment (76.7%) and class size (61.6%) as barriers to their sense of belonging. They also view social and personal differences with peers as a barrier (64.5% of students); however, half of students (50%) considered cultural differences ‘not a barrier.’ Complete quantitative responses regarding barriers are available in Table 3 . Thirty-three participants answered the open-ended question, “What other aspects pose barriers to your sense of belonging?”. The identified barriers were incorporated within the four themes mentioned earlier. The percentage of total coded responses is available in Table 4 . [Suggested placement of Fig. 1] Equity-Deserving Groups and Belonging Thirty-two students (23.2%) identified as belonging to an underrepresented racial or ethnic minority in physical therapy education. Of those, 19 (28.4%) reported a high sense of belonging, compared to 13 (19.1%) in the low sense of belonging group (p = 0.21). No statistically significant differences existed between high and low belonging for all equity-deserving groups; see Table 1 for additional details. Acting as a family caregiver was statistically significant (p = 0.03), with 149% higher odds of experiencing a high sense of belonging (OR 2.49, 95CI 1.11, 5.58). Well-being, Anxiety, and Belonging Approximately three-fourths of students (73.9%) identified their well-being as a barrier to belonging, with 36.4% rating their well-being as ‘good’ or ‘very good,’ 38.6% as ‘fair,’ and 25% as ‘poor’ or ‘very poor.’ Students with ‘good/very good’ well-being had 168% higher odds of feeling a strong sense of belonging (OR 2.68, 95CI: 1.29, 5.59). Experiencing moderate to severe anxiety (GAD-7 score > 9) resulted in 162% increased odds of having a low sense of belonging (OR 2.62, 95CI: 1.22, 5.62). Refer to Table 1 for GAD-7 comparisons. DISCUSSION This study is the first to report hybrid PTEP students’ sense of belonging and to identify the facilitators and barriers to belonging in this unique learning environment. While most participants reported some level of belonging to their program, about half expressed a strong sense of belonging. Interestingly, students with higher feelings of belonging reported lower generalized anxiety, highlighting the protective effects of belonging on mental well-being. Faculty, peer respect, and a welcoming program culture were the most significant contributors to belonging. Small group connections and meaningful in-person interactions during the lab immersions were also regarded by many as crucial to fostering opportunities for belonging. The four themes identified—motivation to belong, opportunities for connection, program policies and faculty/administration support, and relational competencies—build off of Allen et al.’s (2021) integrative framework theory by highlighting the importance of program policies and faculty/administration support. The overall findings of this study suggest that hybrid PTEPs cultivate social support, connection, acceptance, and respect, even amidst the physical and geographical distances between faculty and students. Rate of Belonging While comparative data on the belonging rate for US-based PTEPs is unavailable ( 11 , 18 ), an overall composite score greater than three—the mid-point—indicates higher than average belonging ( 31 ), as demonstrated by this study’s sample (3.38). Most participants (63%) in this study felt ‘quite’ or ‘extremely’ happy with their choice of PTEP, and two-thirds (66%) found their program welcoming. These findings align with an Australian study of clinical health students learning online, including PT education, where 74% of participants were happy with their choice of university, and 68% felt welcomed by the institution ( 20 ). Similarly, most students felt respected by both staff (70%) and students (60%) ( 20 ), aligning with this study’s results that show approximately two-thirds of participants felt respected by peers (65%) and faculty (70%). Furthermore, these findings are consistent with other studies that highlight positive relationships with faculty and peers as factors contributing to satisfaction with their programs ( 12 , 24 ). Interestingly, participants in this study more strongly endorsed aspects of academic belonging over interpersonal belonging, echoing previously reported findings ( 31 ). This does not suggest that academic belonging is more important than interpersonal belonging; instead, it may further highlight the challenges of forming meaningful interpersonal relationships within hybrid PTEPs. Facilitators to Belonging This study highlights the complex and individualized factors of belonging, providing several novel considerations for hybrid PTEPs. One participant noted several facilitators, stating, “ I feel orientation, a positive online learning environment, a [positive] lab immersion environment, and students keeping in touch outside of class all contribute to my sense of belonging, if executed properly .” Along with this individual, most participants indicated that the lab immersion environment was crucial in fostering their sense of belonging, emphasizing the importance of face-to-face interaction. This finding aligns with Allen et al.’s (2021) framework, which highlighted the necessity of opportunities for connections. Additionally, the online learning environment was essential to their sense of belonging. These findings support the potential of hybrid education models to combine the benefits of in-person interaction with the flexibility of online learning environments, creating engaging and inclusive spaces through the intentional design of both online and in-person components ( 2 , 40 ). Students acknowledge the importance of orientation in nurturing early feelings of belonging. The hybrid PTEPs in this study differed in their approaches (online vs in-person orientation), and students seemed to prefer the in-person environment over the online environment. One student remarked, “ I feel orientation should have been in person. The people who were from [the local community] had already known each other and been studying and meeting up together for months prior to everyone else meeting for the first time .” These findings indicate that conducting in-person orientation could help level the social playing field and encourage early connections at hybrid PTEPs. Participants also appreciated student-led communication and activities beyond the classroom in fostering a sense of belonging. Small group interactions, social engagement groups, and collaborative study sessions enhanced the feeling of belonging, aligning with previous literature ( 12 , 41 ). Program-structured connection opportunities also contributed to this sense of belonging. One participant noted, “I love how well my [assigned academic] coaching group gets along. We all have different backgrounds and work experience, and we supported each other since the start.” Furthermore, shared interests and values with faculty and peers promote belonging. These findings underscore the significance of structured and spontaneous connections in hybrid programs. Previous research confirms that relationships with faculty and peers support a sense of belonging in hybrid learning models, even when most coursework is online ( 2 , 12 , 40 , 41 ). Barriers to Belonging The primary identified barriers were the hybrid structure and geographic distance between peers, which limited opportunities for connection. Students also highlighted a lack of representation—particularly age and military status—and personal or social differences as barriers, confirming prior findings ( 12 ). As an example, one student shared, “ Having so many students in the cohort of different ages and stages of life makes it more difficult to relate to others.” An important discovery in our study is that some participants did not view belonging as essential to their educational experience, contrasting with research linking belonging to student success and well-being ( 13 , 24 ). One student remarked, “I have no need to feel like I belong at school. I want this education. I worked my tail off to get here. I am confident that I earned my place in my program. I do not look toward school to foster a sense of belonging.” While belonging supports positive outcomes, not all students prioritize it. Institutions must create inclusive environments while recognizing that “unbelonging” can be a deliberate and positive choice ( 33 ). Equity-Deserving Groups and Belonging Most participants in our study indicated that visual similarities, cultural differences, and life experiences of peers and faculty were not particularly important in their sense of belonging. These findings contradict prior studies that suggest otherwise ( 12 , 23 , 42 , 43 ). However, hybrid learning environments can increase access and promote inclusivity in professional education settings ( 40 , 41 ), which has led to higher enrollment of diverse students ( 44 ). A more diverse student cohort may alter the perceptions of the importance of visual similarities, cultural differences, and life experiences among peers. One participant from this study noted, “There is a lot of diversity among the students. It makes you feel more welcomed as someone of color.” These distinctive features of hybrid education may contribute to fostering a more inclusive and equitable learning environment, supporting equity-deserving groups. Generalized Anxiety and Belonging The study’s findings enhance the understanding of the relationship between the anxiety levels of hybrid PTEP students and their sense of belonging. Nearly three-fourths of the participants acknowledged that their physical and mental well-being acts as a barrier to feeling they belong, and over 30% reported experiencing moderate to severe anxiety. These results are consistent with a recent study that found that 30% of students enrolled in traditional and hybrid PTEPs experienced moderate to severe generalized anxiety ( 7 ). Dudley-Javoroski and Shields (2022) noted that 33.6% of PTEP graduates believe their program did not effectively promote overall psychological well-being, presenting this as an opportunity to improve PTEPs. The current study also identified a link between mental health and a sense of belonging, aligning with existing research ( 3 , 8 , 45 , 46 ). Based on these findings, a bidirectional relationship likely exists between generalized anxiety and belonging, where a low sense of belonging may heighten anxiety, and increased anxiety may hinder one’s ability to form meaningful connections that foster belonging. These findings suggest that enhancing mental health support may improve feelings of belonging ( 25 ). Implications for Hybrid Physical Therapist Education Programs While students enrolled in hybrid PTEPs report a sense of belonging, gaps remain, particularly in interpersonal connections. Programs should adopt intentional strategies to cultivate a culture of belonging (Fig. 2), aligning program policies while recognizing that not all students prioritize belonging. Given the strong link between faculty and peer support with feelings of belonging, hybrid PTEPs should emphasize regular structured opportunities for interaction within the virtual and in-person environments. Faculty should receive training in inclusive teaching and mentorship strategies, focusing on active engagement in virtual and in-person settings to create positive learning environments. PTEPs should enhance small group activities and peer and faculty mentorship programs to foster connection. They should also encourage student-driven communication, activities and engagement outside of the classroom. This study underscores the significance of face-to-face interactions, especially during lab immersions and orientation, in nurturing belonging. Hybrid PTEPs should improve these in-person experiences by ensuring they are skill-focused and designed to strengthen peer and faculty relationships. Programs should evaluate lab immersions' structure, frequency, and duration to maximize their impact on student belonging. Finally, PTEPs should incorporate mental health support within their curricula, including increased access to counseling resources, stress management workshops, and faculty training on trauma-informed approaches to student support. [Suggested placement of Fig. 2] Figure 2. Roadmap to Cultivate a Sense of Belonging in Hybrid Physical Therapist Education Limitations and Future Directions The study’s cross-sectional design limited its ability to track dynamic changes in belonging and well-being over time. The relatively small sample may have introduced self-selection bias, as students with strong or weak feelings of belonging may have been more inclined to participate. Variations in PTEP program structure, lab immersions, and student demographics may also influence generalizability. Additionally, reliance on self-reported data introduces potential social desirability bias and inaccuracies in mental health reporting. Future research should utilize longitudinal designs to evaluate changes in belonging over time. Qualitative research could further identify facilitators and barriers to belonging in hybrid environments, including why serving as a caregiver was related to higher belongingness. Additionally, future researchers should examine the sense of belonging within hybrid physical therapist assistant education programs, as these students may face unique challenges in hybrid learning settings due to variations in curriculum and professional pathways. Finally, studies should assess the effects of program changes to enhance belonging and support students who may not pursue traditional forms of connection. CONCLUSION This study highlights that most students enrolled in hybrid PTEPs report a sense of belonging to their program community. However, some may choose not to seek belonging, and programs should support these individuals while fostering an inclusive learning environment. Faculty and peer support are essential in fostering a sense of belonging, which should be a priority of PTEPs. Hybrid PTEPs should optimize virtual engagement strategies to create meaningful connection opportunities during online coursework while refining the frequency, duration, and timing of in-person lab immersions to support early and sustained relationships. The strong link between mental well-being and belonging suggests that programs should integrate mental health support as a key component of student success. Future research should delve into qualitative assessments of hybrid PTEP student and faculty experiences to further explore the cultivation of belonging in hybrid educational settings. Continued investigation into effective interventions and program strategies will be essential in shaping more inclusive, supportive, and engaging hybrid learning environments. Abbreviations DPT Doctor of Physical Therapy GAD 7—Generalized Anxiety Disorder—7 questionnaire PTEP Physical Therapist Education Program Declarations Human Ethics Approval and Consent to Participate This study was approved by the institutional review boards of Hawai’i Pacific University (5604202347) and Hannover College (2023 − 0318). Informed consent was obtained from all participants involved in the study. This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Clinical Trial Number Not applicable Consent for Publication: Not applicable Competing Interests: The authors declare that they have no competing interests Funding: Not applicable Author Contribution All authors qualify for authorship per the criteria of the International Committee of Medical Journal Editors (ICMJE). All authors made substantial contributions to the conception or design of the work; the acquisition, analysis, or interpretation of data. Specifically, all authors were involved in the original concept design of the study. B.D.N., R.E.P., and G.M.K. submitted the study for ethics approval at their respective institutions. B.D.N., R.E.P., G.M.K., and J.C.K. determined the methodology and constructed the survey using validated measures. B.D.N. was in charge of survey dissemination and follow-up. B.D.N. oversaw the statistical analysis with help from a statistician provided by G.M.K. and R.E.P.'s institution. B.D.N., R.E.P., and M.J.Y. were responsible for the qualitative analysis. B.D.N. created all tables and figures with critical review provided by R.E.P., M.J.Y., and G.M.K. All authors contributed to the initial draft of the manuscript. B.D.N. and R.E.P. edited and finalized the manuscript. G.M.K. served as the senior author, overseeing and guiding all activities. All authors reviewed and approved the final version. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6595794","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":476502191,"identity":"3735f1a7-2791-40d6-b8ea-7c9969d4c91d","order_by":0,"name":"Brett D Neilson","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwUlEQVRIiWNgGAWjYBACAyA+8ABI8EuA+cxEakkAEpIzSNHCANJicINYLebSzQcPJPyxyTO+3XtMgqHCOrGBkBbLOccSDiS2pRWb3TmXJsFwJp2wFoMbOQYHEhsOJ267kWMmwdh2mBgt+R+ADjucuHkGSMs/orTkAEOM7XDiBgmQlgYitFjOSDMA+SVxxo28ZIuEY+nGBLWYSyQ//vDhj01i/4zcgzc+1FjLEtSCBHggEUQK4CFR/SgYBaNgFIwYAAD7O0UFj3p1CgAAAABJRU5ErkJggg==","orcid":"","institution":"Hawaii Pacific University","correspondingAuthor":true,"prefix":"","firstName":"Brett","middleName":"D","lastName":"Neilson","suffix":""},{"id":476502192,"identity":"5c4c4bb6-3f69-4451-88a7-0d3050a92d3b","order_by":1,"name":"Rebecca E. Parr","email":"","orcid":"","institution":"Hanover College","correspondingAuthor":false,"prefix":"","firstName":"Rebecca","middleName":"E.","lastName":"Parr","suffix":""},{"id":476502193,"identity":"b0c28368-e1b8-4cc6-83e3-1ae55b9b84f2","order_by":2,"name":"Melissa J. Yeung","email":"","orcid":"","institution":"Bowling Green State University","correspondingAuthor":false,"prefix":"","firstName":"Melissa","middleName":"J.","lastName":"Yeung","suffix":""},{"id":476502194,"identity":"52f55f64-8409-4d2a-9a1a-1693eec117f0","order_by":3,"name":"Jennifer C. Kish","email":"","orcid":"","institution":"Bowling Green State University","correspondingAuthor":false,"prefix":"","firstName":"Jennifer","middleName":"C.","lastName":"Kish","suffix":""},{"id":476502195,"identity":"76802f5f-15aa-4e9a-bdab-5434bd73c04e","order_by":4,"name":"Monique Flemings","email":"","orcid":"","institution":"South College","correspondingAuthor":false,"prefix":"","firstName":"Monique","middleName":"","lastName":"Flemings","suffix":""},{"id":476502196,"identity":"168bfda4-0b68-4e92-bfe6-4f963f79ff18","order_by":5,"name":"Arvie Vitente","email":"","orcid":"","institution":"Lewis University","correspondingAuthor":false,"prefix":"","firstName":"Arvie","middleName":"","lastName":"Vitente","suffix":""},{"id":476502198,"identity":"dbd0cb3e-8e95-44ab-a772-d5be53c65760","order_by":6,"name":"Gregory M. Kline","email":"","orcid":"","institution":"Hanover College","correspondingAuthor":false,"prefix":"","firstName":"Gregory","middleName":"M.","lastName":"Kline","suffix":""}],"badges":[],"createdAt":"2025-05-05 15:38:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6595794/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6595794/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12909-026-08910-8","type":"published","date":"2026-03-03T15:59:27+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":85475415,"identity":"b4409869-5301-480a-b9a2-e5a2506ed21d","added_by":"auto","created_at":"2025-06-26 09:57:29","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":237355,"visible":true,"origin":"","legend":"\u003cp\u003eThemes of Student Belonging in Hybrid Doctor of Physical Therapist Programs\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6595794/v1/a4e37fd0c9c08cf49bb8cabd.jpg"},{"id":85475404,"identity":"7361aef4-88fc-4c4f-80a4-fa99c55df528","added_by":"auto","created_at":"2025-06-26 09:57:29","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":326825,"visible":true,"origin":"","legend":"\u003cp\u003eRoadmap to Cultivate a Sense of Belonging in Hybrid Physical Therapist Education\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6595794/v1/94c083ccf8b7861a58fd1c14.jpg"},{"id":104250801,"identity":"9bf126df-6384-4e4b-9148-1f9ab2478e80","added_by":"auto","created_at":"2026-03-09 16:08:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2005851,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6595794/v1/05d5d2a9-c9c7-4128-a8d0-73750ec19d90.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Forming Meaningful Connections: A Mixed-Methods Survey Study of Hybrid Doctor of Physical Therapy Students' Insights, Well-Being, and Recommendations on Fostering Belonging","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003e“Hybrid PT programs,” defined as entry-level, distance professional physical therapist education programs (PTEP), emerged in 2015 and expanded due to the COVID-19 pandemic as traditional programs shifted to online delivery methods. These programs blend online and in-person learning experiences where at least 50% or more of the required coursework, excluding clinical education, is delivered online through synchronous and/or asynchronous instruction (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In-person learning experiences are often structured as limited immersive sessions lasting one to two weeks or several weekends. While hybrid programs provide increased flexibility and access to physical therapy education (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), they also pose unique challenges, such as dispersed geographic locations of students and faculty, decreased spontaneous human interaction, a less personal online learning environment, and limited in-person interactions, which can contribute to feelings of loneliness, stress, and anxiety (\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e–\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFeelings of loneliness and anxiety are common among students in graduate-level education, including PTEPs (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Belonging—the perception of social support, connection, acceptance, and respect within one’s academic community (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)—is the antithesis of loneliness and exclusion (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Importantly, belonging is a dynamic experience, with belonging and loneliness coexisting along a spectrum where students may feel a sense of belonging in particular social, environmental, and time-based contexts while simultaneously experiencing loneliness in others (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). This duality is especially pertinent in hybrid education, where students navigate both virtual and in-person learning environments. Recently, there has been an increased focus on students’ sense of belonging, as studies indicate that a stronger sense of belonging positively influences mental well-being (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) and academic success (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e–\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Within higher education, facilitators of belonging include geographic proximity, supportive faculty, inclusive curricula, accessible peer networks, and engagement-promoting programs (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), which are all challenged by the unique hybrid learning environment.\u003c/p\u003e \u003cp\u003eGiven the connection between belonging, success, and mental well-being (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), examining how belonging affects the educational experience of students enrolled in hybrid PTEPs is essential, as these experiences may differ from those in traditional PTEPs. How to effectively address the unique belonging needs in distance or hybrid programs is unclear (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Given the importance of belonging, the challenges identified, and the growth of hybrid PTEPs, the primary purpose of this mixed-methods survey study was to evaluate the rate of belonging among entry-level students enrolled in hybrid PTEPs to determine if students are able to foster a sense of belonging within the hybrid PTEP learning environment. The secondary objective was to explore students’ insights into the facilitators and barriers that influence their sense of belonging and to assess the relationship between the well-being and belonging of hybrid PTEP students. Finally, the overarching goal was to share recommendations based on students’ lived experiences to enhance the understanding of the ideal learning environment for hybrid PTEP students.\u003c/p\u003e\n\u003ch3\u003eReview of Literature\u003c/h3\u003e\n\u003cp\u003eResearch on belonging in graduate education is limited and significantly different from undergraduate experiences (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). A 2022 scoping review of belongingness in graduate health education identified one study focusing on PT education, with six additional studies emerging since, though none specifically examine hybrid PTEPs (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e–\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Only Ratoza, Sykes, and North (2024) included one hybrid (48-month) program in their analysis, but they did not examine it separately, highlighting a gap in understanding how students in hybrid learning environments experience belonging.\u003c/p\u003e \u003cp\u003eExisting literature on belonging in PTEPs is primarily qualitative, with no known quantitative studies on U.S.-based hybrid programs. Although quantitative belonging scales exist, most were designed for university-wide assessment, which limits their application at the program level (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). However, the Sense of Belonging at Imperial College London scale, developed by Imperial College London, was designed to be adaptable for program-level analysis (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). It has also been used with PT students learning online, enabling meaningful comparisons (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Recent studies have begun validating additional quantitative tools specific to PTEPs, but their application remains preliminary (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhen considering the existing theoretical literature on belonging is broad and diverse, with authors from various disciplines approaching the concept from different perspectives (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Allen, Kern, Rozek, McInereny, and Slavich (2021) developed an integrative framework based on prior theories that identified four key components: 1) relational competencies, 2) opportunities for connection, 3) motivation to be accepted, and 4) subjective perceptions of belonging. These components emphasize the significance of meaningful relationships and a supportive environment, both of which are challenged by the hybrid environment. This framework guided the development of this study and our exploration of belonging within hybrid PTEPs.\u003c/p\u003e \u003cp\u003eRelational competencies significantly influence students' sense of belonging, primarily through perceived respect and support from faculty and peers. PTEP students report a greater sense of belonging when they experience empathetic faculty and supportive peer relationships (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Similarly, online learners enjoy a stronger sense of belonging when they perceive support from faculty in their online learning environment (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). However, not all students encounter such support. Racially minoritized and equity-deserving students in traditional PTEPs—residential programs—have reported facing discrimination, microaggressions, and insufficient support, which negatively affects their confidence and academic success (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e–\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Representation within the program, coursework, and instructional methods enhances belonging for students from equity-deserving backgrounds (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOpportunities for peer connection, both virtual and in-person, play a crucial role in fostering belonging in PTEPs (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Cohort-based models offer built-in peer support through shared experiences and structured engagement opportunities, helping to mitigate feelings of isolation (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Student organizations and virtual mentorship programs within PTEPs enhance connection opportunities, reducing loneliness and social isolation (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Opportunities to build supportive relationships with faculty further strengthen belonging by fostering a sense of acceptance within the professional community (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Learners in online environments emphasize the importance of instructor engagement, particularly in creating “safe” or “brave” spaces (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) and establishing an active online presence (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Graduate students with faculty mentors are more likely to engage in academic and personal discussions, reinforcing their sense of connection and belonging (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents’ intrinsic motivation and desire for acceptance influence their engagement and, consequently, their perceptions of belonging (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR29\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e–\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). This motivation stems from two constructs: interpersonal belonging—social and interpersonal connections and relations, and academic belonging—acceptance within the academic community and environment (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Associated with academic belonging is academic self-efficacy, which also affects student motivation and learning (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Recognizing students' contributions boosts their motivation and sense of connection within the academic community (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Collaborative activities, such as assigned group work, are linked to increased student motivation and perceptions of interpersonal belonging in online science courses (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Interestingly, Young Ahn and Davis found that academic and social engagement influence belonging independently; some students gain motivation primarily from academic belonging, while others depend on interpersonal belonging, highlighting the importance of nurturing both (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). However, not all students seek belonging within institutional frameworks. Some may view belonging as necessitating conformity and instead develop alternate spaces where they feel safe to be authentic (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Variability in belonging needs and motivations emphasizes institutions’ need to cultivate belonging while honoring students’ agency (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhile qualitative research on belonging in traditional PTEPs is increasing, there remains a lack of quantitative studies measuring belonging rates, and there are no studies on hybrid PTEPs. Given the growing prevalence of hybrid learning models in physical therapy education, this study aimed to address this gap by quantitatively measuring belonging and identifying factors that influence students’ sense of belonging through mixed methods to triangulate the findings and highlight students’ perspectives.\u003c/p\u003e "},{"header":"METHODS","content":"\u003ch2\u003eStudy Design and Data Collection\u003c/h2\u003e\u003cp\u003eThis cross-sectional, concurrent mixed-methods survey study followed the Mixed Methods Reporting in Rehabilitation \u0026amp; Health Sciences (MMR-RHS) guidelines (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Ethical approval was obtained from Hawai’i Pacific University (5604202347) and Hanover College (2023 − 0318). Data was collected between August 2023 and February 2024 using the REDCap (Research Electronic Data Capture) tool with audit tracking (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). The participants consented to participate and could refrain from answering any questions.\u003c/p\u003e\u003ch3\u003eParticipants\u003c/h3\u003e\u003cp\u003eStudents actively enrolled in 18 entry-level hybrid PTEPs, identified as distance education programs from the Commission on Accreditation in Physical Therapy Education database, were invited to participate in the study by their program director. Purposive heterogeneous sampling was utilized for this study to ensure the distribution of geographic location, enrollment duration, and program length. Consequently, the exact number of respondents invited to participate is unknown due to the sampling method. Participants were excluded from the study if they were not enrolled in a hybrid PTEP or did not complete the initial questionnaire with the sense of belonging instrument. Based on \u003cem\u003ea priori\u003c/em\u003e sample size calculation with an alpha of 0.05 and power at 0.80 and expecting that 50% of individuals would express a sense of belonging, a minimum sample size of 85 was anticipated. See the Results section and Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e for program and participant demographics.\u003c/p\u003e\u003ch3\u003eSurvey Instrument\u003c/h3\u003e\u003cp\u003eThe survey included demographic questions, the Imperial College London \u003cem\u003eSense of Belonging Scale\u003c/em\u003e, questions about potential contributing factors and barriers to belonging, and the Generalized Anxiety Disorder-7 (GAD-7) questionnaire (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Two open-ended questions were included to capture students’ insights and allow for the expression of the student voice in the findings. The survey was developed using best practice in survey design principles (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e) and piloted with a small group of students prior to dissemination.\u003c/p\u003e\u003cp\u003e \u003cem\u003eStudent and Program Demographics\u003c/em\u003e - Self-reported variables included age, biological sex, gender identity, race, ethnicity, geographic region of residence, geographic area, PTEP geographic region, PTEP program length, month of study, class/cohort size, marital status, LGBTQIA + identity, disability, first-generation college student status, economically disadvantaged background, non-native English speaker status, and caregiving responsibilities. Questions regarding lab immersion included students' residences during lab immersion and who they lived with during that time.\u003c/p\u003e\u003cp\u003e \u003cem\u003eSense of Belonging Questionnaire\u003c/em\u003e - The Sense of Belonging at Imperial College London scale (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e) is a 10-item survey divided into three sub-domains (academic, interpersonal, and overall belonging) that has undergone a rigorous, research-based development process to improve reliability and validity (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). It is designed to be adaptable by modifying the subject of the question (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). The authors of this study adapted this instrument by replacing the named university with “the DPT (Doctor of Physical Therapy) Program” to make it generalizable for all survey participants. Further, one additional question was added: ‘How connected do you feel to other students in the DPT Program?’. This question was excluded from the average composite score calculated to maintain validity. Item 11, ‘Overall, how much do you feel like you belong at the program,’ was used to dichotomize respondents into a high sense of belonging group (score of 4 ‘belong quite a bit’ or 5 ‘completely belong’) or low sense of belonging group (score of 3 ‘belong somewhat,’ 2 ‘belong a little,’ or 1 ‘do not belong at all’).\u003c/p\u003e\u003cp\u003e \u003cem\u003eWell-being\u003c/em\u003e - Student participants rated their overall physical, mental, and emotional well-being on most days throughout the program, using a five-point Likert scale from very poor to very good.\u003c/p\u003e\u003cp\u003e \u003cem\u003e7-item Generalized Anxiety Disorders Scale (GAD-7)\u003c/em\u003e - The GAD-7 has been increasingly utilized in clinical practice and research to measure generalized anxiety because of its clinometric properties; the specifics of this measure are published elsewhere (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). The instrument reportedly maintains an adequate balance between sensitivity and specificity values to use a cut-off of greater than or equal to a score of 8, indicating the presence of generalized anxiety (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). The GAD-7 has been found to have good internal consistency (alpha of 0.82) and high convergent and discriminant validity (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eAll data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 29, with the assistance of a statistician. The authors initially cleaned the data to ensure eligibility and completeness. The statistician assessed the data for normality and identified suitable statistical tests to establish differences. Descriptive characteristics from student and program demographics are reported in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e for those with a high sense of belonging and a low sense of belonging, using chi-square tests for categorical variables and independent t-tests for continuous variables. Demographic information is reported using measures of central tendency and frequencies. Means (SD) are reported for the overall composite belonging score and the GAD-7 score. Correlations were used to establish relationships between belonging and individual and programmatic factors that facilitate belonging. Unadjusted odds ratios were calculated to identify associations between well-being and belonging, as well as anxiety and belonging.\u003c/p\u003e\u003cp\u003eUsing an inductive coding process, the authors assessed responses to the two open-ended survey questions to identify additional facilitators and barriers to belonging. First, author BDN reviewed all student responses to the open-ended questions and created a list of general codes for the responses to “What other aspects of your DPT Program foster your sense of belonging?” and “What other aspects pose barriers to your sense of belonging?”. BDN, REP, and MJY refined the list of codes. Using the finalized code lists (described in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e4\u003c/span\u003e), authors BDN and REP independently assigned one or more codes to each response (blind copy). Initial inter-rater reliability was 81%, indicating ‘substantial agreement.’ BDN and REP discussed any discrepancies until they reached an agreement, with MJY serving as the tiebreaker.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eOf the 191 students who opened the survey, 168 started it. The authors excluded thirty students from the analysis: 26 did not finish the initial questionnaire containing items related to belonging, and four were not enrolled in a hybrid DPT program. Therefore, 138 participants were deemed eligible and included in the analysis.\u003c/p\u003e\n\u003ch3\u003eDemographics\u003c/h3\u003e\n\u003cp\u003e Hybrid DPT program lab immersion locations and the percentage representation of the study sample were most frequent in the Midwest (39.1%), followed by the West (34.8%), Southeast (14.5%), and Southwest (8.7%) regions. Most programs were 24 months long (79.7%), with 20.3% ranging from 25 to 37\u0026thinsp;+\u0026thinsp;months. The average reported class size was 87 (SD 19.9), varying from 25 to 111 students. Student demographic information is provided in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive Statistics for Student Comparison Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverall (N\u0026thinsp;=\u0026thinsp;138)\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh Sense of Belonging (N\u0026thinsp;=\u0026thinsp;68)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLow Sense of Belonging\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;70)\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003csup\u003e\u003cem\u003eb\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29.07 (6.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.79 (6.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.36 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender: Female/Woman\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e96 (69.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48 (70.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48 (68.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIdentify as LGBTQIA+ (N\u0026thinsp;=\u0026thinsp;131)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (6.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisability (N\u0026thinsp;=\u0026thinsp;129)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (6.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (4.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (8.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFirst Generation College Graduate (N\u0026thinsp;=\u0026thinsp;134)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40 (29.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (26.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEconomically Disadvantaged (N\u0026thinsp;=\u0026thinsp;132)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48 (34.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (38.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (34.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnglish Not 1st Language (N\u0026thinsp;=\u0026thinsp;132)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (8.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried/Cohabitant (N\u0026thinsp;=\u0026thinsp;133)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50 (36.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (39.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (39.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver (N\u0026thinsp;=\u0026thinsp;133)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34 (24.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (34.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (17.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.03\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eRace and Ethnicity\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmerican Indian or Alaska Native\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (15.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack or African American\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (6.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (7.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHispanic/Latino/Latinx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (8.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNative Hawaiian or Other Pacific Islander\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (1.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e85 (61.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41 (60.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44 (62.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther/Missing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (2.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eHome Location Type (N\u0026thinsp;=\u0026thinsp;132)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (21.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (22.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (21.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003e0.04\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuburban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82 (59.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37 (54.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 (70.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (23.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (7.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eReside with While at the Lab Immersion (N\u0026thinsp;=\u0026thinsp;133)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (35.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClassmates\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (39.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (48.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (30.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (21.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (20.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (23.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriends/acquaintances\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (8.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (10.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComposite Belonging Score, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.38 (0.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.04 (0.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.74 (0.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGAD-7, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.77 (5.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.20 (4.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.28 (6.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003eReported as number (percentage) of students unless otherwise indicated.\u003c/p\u003e \u003cp\u003e \u003csup\u003eb\u003c/sup\u003eValues in bold were significant at a \u003cem\u003eP\u003c/em\u003e value of \u0026lt;\u0026thinsp;.05.\u003c/p\u003e \u003cp\u003e \u003csup\u003ec\u003c/sup\u003eUnless otherwise noted\u003c/p\u003e\n\u003ch3\u003eSense of Belonging\u003c/h3\u003e\n\u003cp\u003eThe average composite sense of belonging score among the student participants was 3.38 out of five (SD 0.92), with 49.3% (68 out of 138) classified as having a high sense of belonging (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Academic belonging received more substantial support from the overall sample, with a mean score of 3.71 (SD 0.90), compared to interpersonal belonging, with a mean of 2.98 (SD 0.96). The sense of belonging items that significantly contributed to students\u0026rsquo; overall perception of belonging\u0026mdash;evidenced by a higher frequency of \u0026lsquo;Quite a bit\u0026rsquo; or \u0026lsquo;Completely/Extremely\u0026rsquo; responses\u0026mdash;were respect faculty show (69.6%), the welcoming nature of the DPT Program (66%), the respect demonstrated by other students (64.5%) and satisfaction with their choice to enroll in the program (63.1%). The complete responses of all participants are provided in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSense of Belonging scale questions ordered by average response in each sub-domain, frequency (percentage)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot at all\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSlightly\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSomewhat\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eQuite\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCompletely/ Extremely\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAverage Response\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSub Domain\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6. How much respect do faculty members within the DPT Program show toward you?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (2.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20 (21.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e60 (43.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e36 (26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.84 (0.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAcademic\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5. How much respect do other students within the DPT Program show toward you?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (2.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32 (23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e56 (40.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e33 (23.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.74 (1.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8. How happy are you with your choice to be a student in the DPT Program?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (22.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e47 (34.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e40 (29.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.72 (1.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9. How enriching is your experience in the DPT Program?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37 (26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e51 (37.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e26 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.52 (1.89)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. How welcoming have you found the DPT Program to be?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e52 (37.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e39 (28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.74 (1.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11. Overall, how much do you feel like you belong in the DPT Program?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37 (26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38 (27.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e30 (21.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.38 (1.23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10. How 'at home' do you feel in the DPT Program?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38 (27.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35 (25.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e21 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.11 (1.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. How connected do you feel to other students in the DPT Program?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (23.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40 (29.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e39 (28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e18 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.19 (1.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eInterpersonal\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. How well do people in the DPT Program understand you as a person?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (23.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49 (35.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e36 (26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9 (6.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.99 (1.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7. How much do you matter to others in the DPT Program?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17 (12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (23.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43 (31.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35 (25.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.91 (1.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. How connected do you feel to the Program faculty?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (15.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34 (24.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39 (28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35 (25.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8 (5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.8 (1.16)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003eReported as number (percentage) of students unless otherwise indicated.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eFacilitators to Belonging\u003c/h2\u003e \u003cp\u003eStudents most frequently rated having classmates (42.7%) and faculty/staff (31.9%) with similar interests as \u0026lsquo;very important\u0026rsquo; or \u0026lsquo;absolutely essential\u0026rsquo; for fostering their sense of belonging. They viewed the lab immersion (70.3%) and online learning environments (88.4%) as 'very important' or \u0026lsquo;absolutely essential.\u0026rsquo; Students similarly endorsed student-led communication (64%) and activities outside class (55.8%) as critical to fostering belonging. These environments and activities demonstrated small positive correlations (r\u0026thinsp;=\u0026thinsp;0.21\u0026ndash;0.37, p\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026le;\u003c/span\u003e\u0026thinsp;.01) with the composite sense of belonging score, while orientation activities showed a moderate correlation (r\u0026thinsp;=\u0026thinsp;0.43, p\u0026thinsp;\u0026lt;\u0026thinsp;.001). Complete responses to quantitative contributing factors and program activities are available in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eContributing Factors and Program Activities\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFacilitators\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDid Not Answer\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNot Important At All\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOf Little Importance\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOf Average Importance\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVery Important\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAbsolutely Essential\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudents with similar visual appearance as me (e.g. race, ethnicity, hairstyle, etc)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37 (26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33 (23.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38 (27.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6 (4.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFaculty/staff with similar visual appearance as me (e.g. race, ethnicity, gender identity, hairstyle, etc)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41 (29.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32 (23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34 (24.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22 (15.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6 (4.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudents who have similar life experiences as me (e.g. childhood, community, background, etc)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31 (22.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e50 (36.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25 (18.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9 (6.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFaculty/staff who have similar life experiences as me (e.g. childhood, community, background, etc)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (17.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (21.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48 (34.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7 (5.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudents with similar interests as me (e.g. life interests, values, etc.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e54 (39.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49 (35.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10 (7.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFaculty/staff with similar interests as me (e.g. life interests, values, etc.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55 (39.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37 (26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7 (5.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOrientation activities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48 (34.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40 (29.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16 (11.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnline learning environment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32 (23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e64 (46.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e33 (23.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLab immersion environment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (2.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e36 (26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e86 (62.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent-led communication outside of class\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (7.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32 (23.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50 (36.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e37 (27.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent activities or gatherings outside of class\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (11.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41 (30.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e35 (25.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e41 (30.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBarriers\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eDid Not Answer\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eNot a barrier\u003c/b\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eSomewhat of a Barrier\u003c/b\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eModerate Barrier\u003c/b\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eSignificant Barrier\u003c/b\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eExtreme Barrier\u003c/b\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHybrid (online/in-person) delivery of the program\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (23.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33 (23.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39 (28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22 (15.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 (5.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCohort or class size\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (38.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39 (28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16 (11.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 (5.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMy overall physical and mental well-being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40 (29.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22 (15.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9 (6.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial/personal differences between me and my peers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (35.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (27.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20 (14.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15 (10.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11 (8.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCultural differences between me and my peers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35 (25.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 (12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5 (3.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003eReported as number (percentage) of students unless otherwise indicated.\u003c/p\u003e \u003cp\u003e Forty-nine participants completed the open-ended question, \u0026ldquo;What other aspects of your DPT Program foster your sense of belonging?\u0026rdquo;. The percentage of total coded responses per theme is available in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Four main themes emerged from student responses: motivation to belong, opportunities for connection, program policies and faculty/administration support, and relational competencies (Fig.\u0026nbsp;1\u003cb\u003e).\u003c/b\u003e The theme \u0026lsquo;motivation to belong\u0026rsquo; highlighted the significance of feeling valued and respected. Three participants expressed \u0026ldquo;unbelonging,\u0026rdquo; described as a lack of desire to belong, or a choice not to belong (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). \u0026lsquo;Opportunities for connection\u0026rsquo; emphasized the importance of structured and spontaneous interactions in virtual and in-person environments. The theme \u0026lsquo;Program policies and faculty/administration support\u0026rsquo; underlined the necessity for intentional program policies that foster belonging and active support from faculty and administrators. Finally, \u0026lsquo;relational competencies\u0026rsquo; reflected the importance of recognizing shared experiences and similarities among students.\u003c/p\u003e\u003cp\u003eTable 4: Positive Factors Contributing to Sense of Belonging and Identified Barriers\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"632\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCode\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (No.) Participants\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSample Quotes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 632px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMotivation to Belong\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003ePositive Contributing Factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eFeeling valued and respected\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e20.4 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Having opportunities for individual responsibility. Knowing that my faculty or peers trust me to complete a task and deliver quality results. I feel valued when I\u0026apos;m recognized as a capable person with valuable skills.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003ePeer support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e8.2 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;The emotional support my peers offer each other.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eIdentified Barriers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eLack of connection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e9.1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Not knowing anyone in the program previously.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eLimited time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e9.1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Too busy surviving to make the effort to form connections.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eNegative connection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e17.6 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Feeling scared to talk openly because someone might take what I say incorrectly.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003ePoor well-being\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e12.1 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Most influential barrier is personal health.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eUnbelonging\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e3.1 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;My lack of outgoingness and apathy toward \u0026quot;belonging\u0026quot;.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 632px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRelational Competencies\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003ePositive Contributing Factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eSimilar life experiences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e6.1 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Having others in my cohort of a similar age.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eSimilar visual appearances\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e2.0 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;There is a lot of diversity among the students as well as the location of the program. It makes you feel more welcomed as someone of color. There is also a lot of culture and respect for the world around us which has been instrumental to my personal experience.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eIdentified Barriers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eDisability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e3.0 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;autistic\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eLack of representation (age and military status)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e18.2 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Having so many students in the cohort of different ages and stages of life makes it more difficult to relate to others.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eReligion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e3.0 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Religious beliefs\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eSocial/attribute cliques\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e3.0 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;I feel as a whole, our student cohort is extremely cliquey\u0026hellip;people quickly found their own groups and dismissed all others after first lab.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 632px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOpportunities for Connection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003ePositive Contributing Factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eSpontaneous peer connection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e28.6 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Adequately long lunch breaks with provided spaces that foster communication and connection with peers and faculty.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eStructured peer connection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e36.7 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;[Program formed] smaller, personable coaching groups of 10 students per 1 faculty. I love how well my coaching group gets along. We all have different backgrounds and work experience, and we supported each other since the start.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eGroup work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e22.4 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Working in small groups in class and lab environments to allow students to get to know each other.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eIn-person interaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e12.2 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Interactions during lab\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eIdentified Barriers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eGeographic distance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e18.2 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;physical distance from peers\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eLimited opportunities for connection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e6.0 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;only monthly interactions\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 632px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProgram Policies and Faculty/Administration Support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003ePositive Contributing Factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eProgram policies and administration support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e20.4 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Being checked on and encouraged by administrators when noticeable signs of improvement need to be addressed such as hours studying, turning in assignments ahead of time, and helping me understand what track I need to be on. Having people actually look into those things to keep me on track.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eFaculty support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e16.3 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;The role of student support and having the program\u0026apos;s student success coach [faculty coach/advisor] available. These resources have been a tremendous help with being successful in the program while dealing with personal stressors.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eIdentified Barriers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eCohort size\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e6.1 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Large class size leading to not feeling connected with many classmates at labs.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 131px;\"\u003e\n \u003cp\u003eProgram structure (environment and delivery)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e12.1 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 273px;\"\u003e\n \u003cp\u003e\u0026ldquo;Being on a satellite campus as opposed to the main campus.\u0026rdquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e \u003cp\u003e[Suggested placement of Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eBarriers to Belonging\u003c/h2\u003e \u003cp\u003eStudents viewed the hybrid environment (76.7%) and class size (61.6%) as barriers to their sense of belonging. They also view social and personal differences with peers as a barrier (64.5% of students); however, half of students (50%) considered cultural differences \u0026lsquo;not a barrier.\u0026rsquo; Complete quantitative responses regarding barriers are available in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Thirty-three participants answered the open-ended question, \u0026ldquo;What other aspects pose barriers to your sense of belonging?\u0026rdquo;. The identified barriers were incorporated within the four themes mentioned earlier. The percentage of total coded responses is available in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e[Suggested placement of Fig.\u0026nbsp;1]\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eEquity-Deserving Groups and Belonging\u003c/h2\u003e \u003cp\u003eThirty-two students (23.2%) identified as belonging to an underrepresented racial or ethnic minority in physical therapy education. Of those, 19 (28.4%) reported a high sense of belonging, compared to 13 (19.1%) in the low sense of belonging group (p\u0026thinsp;=\u0026thinsp;0.21). No statistically significant differences existed between high and low belonging for all equity-deserving groups; see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e for additional details. Acting as a family caregiver was statistically significant (p\u0026thinsp;=\u0026thinsp;0.03), with 149% higher odds of experiencing a high sense of belonging (OR 2.49, 95CI 1.11, 5.58).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eWell-being, Anxiety, and Belonging\u003c/h2\u003e \u003cp\u003eApproximately three-fourths of students (73.9%) identified their well-being as a barrier to belonging, with 36.4% rating their well-being as \u0026lsquo;good\u0026rsquo; or \u0026lsquo;very good,\u0026rsquo; 38.6% as \u0026lsquo;fair,\u0026rsquo; and 25% as \u0026lsquo;poor\u0026rsquo; or \u0026lsquo;very poor.\u0026rsquo; Students with \u0026lsquo;good/very good\u0026rsquo; well-being had 168% higher odds of feeling a strong sense of belonging (OR 2.68, 95CI: 1.29, 5.59). Experiencing moderate to severe anxiety (GAD-7 score\u0026thinsp;\u0026gt;\u0026thinsp;9) resulted in 162% increased odds of having a low sense of belonging (OR 2.62, 95CI: 1.22, 5.62). Refer to Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e for GAD-7 comparisons.\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study is the first to report hybrid PTEP students\u0026rsquo; sense of belonging and to identify the facilitators and barriers to belonging in this unique learning environment. While most participants reported some level of belonging to their program, about half expressed a strong sense of belonging. Interestingly, students with higher feelings of belonging reported lower generalized anxiety, highlighting the protective effects of belonging on mental well-being. Faculty, peer respect, and a welcoming program culture were the most significant contributors to belonging. Small group connections and meaningful in-person interactions during the lab immersions were also regarded by many as crucial to fostering opportunities for belonging. The four themes identified\u0026mdash;motivation to belong, opportunities for connection, program policies and faculty/administration support, and relational competencies\u0026mdash;build off of Allen et al.\u0026rsquo;s (2021) integrative framework theory by highlighting the importance of program policies and faculty/administration support. The overall findings of this study suggest that hybrid PTEPs cultivate social support, connection, acceptance, and respect, even amidst the physical and geographical distances between faculty and students.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eRate of Belonging\u003c/h2\u003e \u003cp\u003eWhile comparative data on the belonging rate for US-based PTEPs is unavailable (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), an overall composite score greater than three\u0026mdash;the mid-point\u0026mdash;indicates higher than average belonging (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e), as demonstrated by this study\u0026rsquo;s sample (3.38). Most participants (63%) in this study felt \u0026lsquo;quite\u0026rsquo; or \u0026lsquo;extremely\u0026rsquo; happy with their choice of PTEP, and two-thirds (66%) found their program welcoming. These findings align with an Australian study of clinical health students learning online, including PT education, where 74% of participants were happy with their choice of university, and 68% felt welcomed by the institution (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Similarly, most students felt respected by both staff (70%) and students (60%) (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), aligning with this study\u0026rsquo;s results that show approximately two-thirds of participants felt respected by peers (65%) and faculty (70%). Furthermore, these findings are consistent with other studies that highlight positive relationships with faculty and peers as factors contributing to satisfaction with their programs (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Interestingly, participants in this study more strongly endorsed aspects of academic belonging over interpersonal belonging, echoing previously reported findings (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). This does not suggest that academic belonging is more important than interpersonal belonging; instead, it may further highlight the challenges of forming meaningful interpersonal relationships within hybrid PTEPs.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eFacilitators to Belonging\u003c/h2\u003e \u003cp\u003eThis study highlights the complex and individualized factors of belonging, providing several novel considerations for hybrid PTEPs. One participant noted several facilitators, stating, \u0026ldquo;\u003cem\u003eI feel orientation, a positive online learning environment, a [positive] lab immersion environment, and students keeping in touch outside of class all contribute to my sense of belonging, if executed properly\u003c/em\u003e.\u0026rdquo; Along with this individual, most participants indicated that the lab immersion environment was crucial in fostering their sense of belonging, emphasizing the importance of face-to-face interaction. This finding aligns with Allen et al.\u0026rsquo;s (2021) framework, which highlighted the necessity of opportunities for connections. Additionally, the online learning environment was essential to their sense of belonging. These findings support the potential of hybrid education models to combine the benefits of in-person interaction with the flexibility of online learning environments, creating engaging and inclusive spaces through the intentional design of both online and in-person components (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents acknowledge the importance of orientation in nurturing early feelings of belonging. The hybrid PTEPs in this study differed in their approaches (online vs in-person orientation), and students seemed to prefer the in-person environment over the online environment. One student remarked, \u0026ldquo;\u003cem\u003eI feel orientation should have been in person. The people who were from [the local community] had already known each other and been studying and meeting up together for months prior to everyone else meeting for the first time\u003c/em\u003e.\u0026rdquo; These findings indicate that conducting in-person orientation could help level the social playing field and encourage early connections at hybrid PTEPs.\u003c/p\u003e \u003cp\u003e Participants also appreciated student-led communication and activities beyond the classroom in fostering a sense of belonging. Small group interactions, social engagement groups, and collaborative study sessions enhanced the feeling of belonging, aligning with previous literature (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). Program-structured connection opportunities also contributed to this sense of belonging. One participant noted, \u003cem\u003e\u0026ldquo;I love how well my [assigned academic] coaching group gets along. We all have different backgrounds and work experience, and we supported each other since the start.\u0026rdquo;\u003c/em\u003e Furthermore, shared interests and values with faculty and peers promote belonging. These findings underscore the significance of structured and spontaneous connections in hybrid programs. Previous research confirms that relationships with faculty and peers support a sense of belonging in hybrid learning models, even when most coursework is online (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eBarriers to Belonging\u003c/h2\u003e \u003cp\u003eThe primary identified barriers were the hybrid structure and geographic distance between peers, which limited opportunities for connection. Students also highlighted a lack of representation\u0026mdash;particularly age and military status\u0026mdash;and personal or social differences as barriers, confirming prior findings (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). As an example, one student shared, \u0026ldquo;\u003cem\u003eHaving so many students in the cohort of different ages and stages of life makes it more difficult to relate to others.\u0026rdquo;\u003c/em\u003eAn important discovery in our study is that some participants did not view belonging as essential to their educational experience, contrasting with research linking belonging to student success and well-being (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). One student remarked, \u003cem\u003e\u0026ldquo;I have no need to feel like I belong at school. I want this education. I worked my tail off to get here. I am confident that I earned my place in my program. I do not look toward school to foster a sense of belonging.\u0026rdquo;\u003c/em\u003e While belonging supports positive outcomes, not all students prioritize it. Institutions must create inclusive environments while recognizing that \u0026ldquo;unbelonging\u0026rdquo; can be a deliberate and positive choice (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eEquity-Deserving Groups and Belonging\u003c/h2\u003e \u003cp\u003eMost participants in our study indicated that visual similarities, cultural differences, and life experiences of peers and faculty were not particularly important in their sense of belonging. These findings contradict prior studies that suggest otherwise (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). However, hybrid learning environments can increase access and promote inclusivity in professional education settings (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e), which has led to higher enrollment of diverse students (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). A more diverse student cohort may alter the perceptions of the importance of visual similarities, cultural differences, and life experiences among peers. One participant from this study noted, \u003cem\u003e\u0026ldquo;There is a lot of diversity among the students. It makes you feel more welcomed as someone of color.\u0026rdquo;\u003c/em\u003e These distinctive features of hybrid education may contribute to fostering a more inclusive and equitable learning environment, supporting equity-deserving groups.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eGeneralized Anxiety and Belonging\u003c/h2\u003e \u003cp\u003eThe study\u0026rsquo;s findings enhance the understanding of the relationship between the anxiety levels of hybrid PTEP students and their sense of belonging. Nearly three-fourths of the participants acknowledged that their physical and mental well-being acts as a barrier to feeling they belong, and over 30% reported experiencing moderate to severe anxiety. These results are consistent with a recent study that found that 30% of students enrolled in traditional and hybrid PTEPs experienced moderate to severe generalized anxiety (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Dudley-Javoroski and Shields (2022) noted that 33.6% of PTEP graduates believe their program did \u003cem\u003enot\u003c/em\u003e effectively promote overall psychological well-being, presenting this as an opportunity to improve PTEPs. The current study also identified a link between mental health and a sense of belonging, aligning with existing research (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). Based on these findings, a bidirectional relationship likely exists between generalized anxiety and belonging, where a low sense of belonging may heighten anxiety, and increased anxiety may hinder one\u0026rsquo;s ability to form meaningful connections that foster belonging. These findings suggest that enhancing mental health support may improve feelings of belonging (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eImplications for Hybrid Physical Therapist Education Programs\u003c/h2\u003e \u003cp\u003eWhile students enrolled in hybrid PTEPs report a sense of belonging, gaps remain, particularly in interpersonal connections. Programs should adopt intentional strategies to cultivate a culture of belonging (Fig.\u0026nbsp;2), aligning program policies while recognizing that not all students prioritize belonging. Given the strong link between faculty and peer support with feelings of belonging, hybrid PTEPs should emphasize regular structured opportunities for interaction within the virtual and in-person environments. Faculty should receive training in inclusive teaching and mentorship strategies, focusing on active engagement in virtual and in-person settings to create positive learning environments. PTEPs should enhance small group activities and peer and faculty mentorship programs to foster connection. They should also encourage student-driven communication, activities and engagement outside of the classroom. This study underscores the significance of face-to-face interactions, especially during lab immersions and orientation, in nurturing belonging. Hybrid PTEPs should improve these in-person experiences by ensuring they are skill-focused and designed to strengthen peer and faculty relationships. Programs should evaluate lab immersions' structure, frequency, and duration to maximize their impact on student belonging. Finally, PTEPs should incorporate mental health support within their curricula, including increased access to counseling resources, stress management workshops, and faculty training on trauma-informed approaches to student support.\u003c/p\u003e \u003cp\u003e[Suggested placement of Fig.\u0026nbsp;2]\u003c/p\u003e \u003cp\u003eFigure 2. Roadmap to Cultivate a Sense of Belonging in Hybrid Physical Therapist Education\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and Future Directions\u003c/h2\u003e \u003cp\u003eThe study\u0026rsquo;s cross-sectional design limited its ability to track dynamic changes in belonging and well-being over time. The relatively small sample may have introduced self-selection bias, as students with strong or weak feelings of belonging may have been more inclined to participate. Variations in PTEP program structure, lab immersions, and student demographics may also influence generalizability. Additionally, reliance on self-reported data introduces potential social desirability bias and inaccuracies in mental health reporting.\u003c/p\u003e \u003cp\u003eFuture research should utilize longitudinal designs to evaluate changes in belonging over time. Qualitative research could further identify facilitators and barriers to belonging in hybrid environments, including why serving as a caregiver was related to higher belongingness. Additionally, future researchers should examine the sense of belonging within hybrid physical therapist assistant education programs, as these students may face unique challenges in hybrid learning settings due to variations in curriculum and professional pathways. Finally, studies should assess the effects of program changes to enhance belonging and support students who may not pursue traditional forms of connection.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis study highlights that most students enrolled in hybrid PTEPs report a sense of belonging to their program community. However, some may choose not to seek belonging, and programs should support these individuals while fostering an inclusive learning environment. Faculty and peer support are essential in fostering a sense of belonging, which should be a priority of PTEPs. Hybrid PTEPs should optimize virtual engagement strategies to create meaningful connection opportunities during online coursework while refining the frequency, duration, and timing of in-person lab immersions to support early and sustained relationships. The strong link between mental well-being and belonging suggests that programs should integrate mental health support as a key component of student success. Future research should delve into qualitative assessments of hybrid PTEP student and faculty experiences to further explore the cultivation of belonging in hybrid educational settings. Continued investigation into effective interventions and program strategies will be essential in shaping more inclusive, supportive, and engaging hybrid learning environments.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDPT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDoctor of Physical Therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGAD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003e7\u0026mdash;Generalized Anxiety Disorder\u0026mdash;7 questionnaire\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePTEP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePhysical Therapist Education Program\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eHuman Ethics Approval and Consent to Participate\u003c/strong\u003e \u003cp\u003e This study was approved by the institutional review boards of Hawai\u0026rsquo;i Pacific University (5604202347) and Hannover College (2023\u0026thinsp;\u0026minus;\u0026thinsp;0318). Informed consent was obtained from all participants involved in the study. This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eClinical Trial Number\u003c/strong\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for Publication:\u003c/strong\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCompeting Interests:\u003c/strong\u003e \u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eNot applicable\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAll authors qualify for authorship per the criteria of the International Committee of Medical Journal Editors (ICMJE). All authors made substantial contributions to the conception or design of the work; the acquisition, analysis, or interpretation of data. Specifically, all authors were involved in the original concept design of the study. B.D.N., R.E.P., and G.M.K. submitted the study for ethics approval at their respective institutions. B.D.N., R.E.P., G.M.K., and J.C.K. determined the methodology and constructed the survey using validated measures. B.D.N. was in charge of survey dissemination and follow-up. B.D.N. oversaw the statistical analysis with help from a statistician provided by G.M.K. and R.E.P.'s institution. B.D.N., R.E.P., and M.J.Y. were responsible for the qualitative analysis. B.D.N. created all tables and figures with critical review provided by R.E.P., M.J.Y., and G.M.K. All authors contributed to the initial draft of the manuscript. B.D.N. and R.E.P. edited and finalized the manuscript. G.M.K. served as the senior author, overseeing and guiding all activities. All authors reviewed and approved the final version.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to acknowledge Grant Smith, PhD, (Bellarmine University, Louisville, KY) for his assistance with the statistical analysis of this study.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCommission on Accreditation in Physical Therapy Education. Standards and required elements for accreditation of physical therapist education programs [Internet]. 2024 [cited 2024 Sep 21]. Available from: https://www.capteonline.org/globalassets/capte-docs/2024-capte-pt-standards-required-elements.pdf\u003c/li\u003e\n\u003cli\u003eGagnon K, Bachman T, Beuning B, Koppenhaver S, Unverzagt C, Feda J, et al. 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Impact of online learning on sense of belonging among first year clinical health students during COVID-19: student and academic perspectives. BMC Med Educ [Internet]. 2023 Feb 8;23(1):100. Available from: http://dx.doi.org/10.1186/s12909-023-04061-2\u003c/li\u003e\n\u003cli\u003eAllen KA, Kern ML, Rozek CS, McInereney D, Slavich GM. Belonging: a review of conceptual issues, an integrative framework, and directions for future research. Aust J Psychol [Internet]. 2021 Mar 10;73(1):87\u0026ndash;102. Available from: http://dx.doi.org/10.1080/00049530.2021.1883409\u003c/li\u003e\n\u003cli\u003ePeacock S, Cowan J, Irvine L, Williams J. An exploration into the importance of a sense of belonging for online learners. Int Rev Res Open Distrib Learn [Internet]. 2020 Apr 8 [cited 2025 Feb 3];21(2):18\u0026ndash;35. Available from: https://id.erudit.org/iderudit/1069026ar\u003c/li\u003e\n\u003cli\u003eBakouetila-Martin M, Duke B, Pantoja-Aming A, Alfaro S, Williams S, Mbah N, et al. The experiences of black students in physical therapy education in Texas: a qualitative study. Journal of Physical Therapy Education [Internet]. 2023 Aug 30;37(4):278\u0026ndash;83. Available from: http://journals.lww.com/jopte\u003c/li\u003e\n\u003cli\u003eShields RK, Chevan J, Kennedy K, Bailey C, Dudley-Javoroski S. National benchmarks to understand how doctor of physical therapy learners from minoritized race and ethnicity groups perceive their physical therapist education program. Phys Ther [Internet]. 2024 Mar 22 [cited 2024 Jul 23];zae047. Available from: https://academic.oup.com/ptj/advance-article-pdf/doi/10.1093/ptj/pzae047/57067528/pzae047.pdf\u003c/li\u003e\n\u003cli\u003eWilliams-York B, Guenther GA, Patterson DG, Mohammed SA, Kett PM, Dahal A, et al. Burnout, exhaustion, experiences of discrimination, and stress among underrepresented and first-generation college students in graduate health profession education. Phys Ther [Internet]. 2024 Jul 17 [cited 2024 Sep 5];104(9). Available from: https://pubmed.ncbi.nlm.nih.gov/39018222/\u003c/li\u003e\n\u003cli\u003eBaldwin J, Schmidt C, Plummer L, Gochyyev P, Battista JE, Kaur S, et al. How doctor of physical therapy students overcome academic challenges to achieve first-attempt success on the National Physical Therapy Examination: a mixed methods study. Education Sciences [Internet]. 2023 Apr 22 [cited 2023 May 22];13(5):430. Available from: https://www.mdpi.com/2227-7102/13/5/430\u003c/li\u003e\n\u003cli\u003eHolloway-Friesen H. The role of mentoring on Hispanic graduate students\u0026rsquo; sense of belonging and academic self-efficacy. J Hispanic High Educ [Internet]. 2019;0(0):1\u0026ndash;13. Available from: http://dx.doi.org/10.1177/1538192718823716\u003c/li\u003e\n\u003cli\u003eCrawford J, Allen KA, Sanders T, Baumeister R, Parker P, Saunders C, et al. Sense of belonging in higher education students: an Australian longitudinal study from 2013 to 2019. Stud High Educ [Internet]. 2024 Mar 3 [cited 2024 Nov 19];49(3):395\u0026ndash;409. Available from: https://www.tandfonline.com/doi/abs/10.1080/03075079.2023.2238006\u003c/li\u003e\n\u003cli\u003ePedler ML, Willis R, Nieuwoudt JE. A sense of belonging at university: student retention, motivation and enjoyment. J Furth High Educ [Internet]. 2022 Mar 16 [cited 2024 Nov 19];46(3):397\u0026ndash;408. Available from: https://www.tandfonline.com/doi/abs/10.1080/0309877X.2021.1955844\u003c/li\u003e\n\u003cli\u003eO\u0026rsquo;Meara K, A. Griffin K, Kuvaeva A, Nyunt G, N Robinson T. Sense of belonging and its contributing factors in graduate education. International Journal of Doctoral Studies [Internet]. 2017;12:251\u0026ndash;79. Available from: http://dx.doi.org/10.28945/3903\u003c/li\u003e\n\u003cli\u003eCohen E, Viola J. The role of pedagogy and the curriculum in university students\u0026rsquo; sense of belonging. J Univ Teach Learn Pract [Internet]. 2022 Aug 2;19(4). Available from: http://dx.doi.org/10.53761/1.19.4.6\u003c/li\u003e\n\u003cli\u003eAhn MY, Davis HH. Four domains of students\u0026rsquo; sense of belonging to university. Stud High Educ [Internet]. 2020 Mar 3 [cited 2024 Nov 19];45(3):622\u0026ndash;34. Available from: https://www.tandfonline.com/doi/abs/10.1080/03075079.2018.1564902\u003c/li\u003e\n\u003cli\u003eNaidoo K. (UN)belonging-inclusive learning environments should also provide the space for learners who choose not to belong. J Phys Ther Educ [Internet]. 2024 Jun 1 [cited 2025 Jan 31];38(2):91. Available from: https://journals.lww.com/jopte/abstract/2024/06000/_un_belonging_inclusive_learning_environments.1.aspx\u003c/li\u003e\n\u003cli\u003eTovin MM, Wormley ME. Systematic development of standards for mixed Methods Reporting in rehabilitation Health Sciences research. Phys Ther [Internet]. 2023 Nov 4;103(11). Available from: http://dx.doi.org/10.1093/ptj/pzad084\u003c/li\u003e\n\u003cli\u003eHarris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform [Internet]. 2009 Apr;42(2):377\u0026ndash;81. Available from: http://dx.doi.org/10.1016/j.jbi.2008.08.010\u003c/li\u003e\n\u003cli\u003eHarris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O\u0026rsquo;Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform [Internet]. 2019 Jul 1;95:103208. Available from: https://www.sciencedirect.com/science/article/pii/S1532046419301261\u003c/li\u003e\n\u003cli\u003eJohnson SU, Ulvenes PG, \u0026Oslash;ktedalen T, Hoffart A. Psychometric properties of the general anxiety disorder 7-Item (GAD-7) scale in a heterogeneous psychiatric sample. Front Psychol [Internet]. 2019 Aug 6;10:1713. Available from: http://dx.doi.org/10.3389/fpsyg.2019.01713\u003c/li\u003e\n\u003cli\u003eGehlbach H, Artino AR Jr. The survey checklist (manifesto). Acad Med [Internet]. 2018 Mar;93(3):360\u0026ndash;6. Available from: http://dx.doi.org/10.1097/ACM.0000000000002083\u003c/li\u003e\n\u003cli\u003eYorke M. The development and initial use of a survey of student \u0026ldquo;belongingness\u0026rdquo;, engagement and self-confidence in UK higher education. Assess Eval High Educ [Internet]. 2016 Jan 2;41(1):154\u0026ndash;66. Available from: http://dx.doi.org/10.1080/02602938.2014.990415\u003c/li\u003e\n\u003cli\u003eGagnon K, Young B, Bachman T, Longbottom T, Severin R, Walker MJ. Doctor of physical therapy education in a hybrid learning environment: Reimagining the possibilities and navigating a \u0026ldquo;new normal.\u0026rdquo; Phys Ther [Internet]. 2020 Aug 12 [cited 2025 Jan 28];100(8):1268\u0026ndash;77. Available from: https://pubmed.ncbi.nlm.nih.gov/32424417/\u003c/li\u003e\n\u003cli\u003eWoods LD, Colton S. An exploration of students\u0026rsquo; experiences in a hybrid doctor of physical therapy program: Aa. J Natl Soc Allied Health [Internet]. 2023 [cited 2025 Jan 29];20:57\u0026ndash;67. Available from: https://openurl.ebsco.com/contentitem/ccm:176132901?sid=ebsco:plink:crawler\u0026amp;id=ebsco:ccm:176132901\u0026amp;crl=c\u003c/li\u003e\n\u003cli\u003eNaidoo K, Yuhaniak H, Borkoski C, Levangie P, Abel Y. Networked mentoring to promote social belonging among minority physical therapist students and develop faculty cross-cultural psychological capital. Mentoring \u0026amp; Tutoring: Partnership in Learning [Internet]. 2021 Oct 20;29(5):586\u0026ndash;606. Available from: https://doi.org/10.1080/13611267.2021.1986794\u003c/li\u003e\n\u003cli\u003eNaidoo K, Yuhaniak H, Abel Y. An ecological systems approach to exploring facilitators and barriers to success for minority students enrolled in a doctor of physical therapy program. Health Professions Education [Internet]. 2020 Sep 1;6(3):394\u0026ndash;405. Available from: https://www.sciencedirect.com/science/article/pii/S2452301120300572\u003c/li\u003e\n\u003cli\u003eHogan AJ. Accessibility in health professions education: The Flexner Report and barriers to diversity in American physical therapy. Soc Sci Med [Internet]. 2024 Jan 1 [cited 2025 Jan 28];341(116519):116519. Available from: http://dx.doi.org/10.1016/j.socscimed.2023.116519\u003c/li\u003e\n\u003cli\u003eBork SJ, Mondisa JL. Engineering graduate students\u0026rsquo; mental health: a scoping literature review. J Eng Educ [Internet]. 2022 Jul;111(3):665\u0026ndash;702. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/jee.20465\u003c/li\u003e\n\u003cli\u003eMiller AN, Orsillo SM. Values, acceptance, and belongingness in graduate school: Perspectives from underrepresented minority students. Journal of Contextual Behavioral Science [Internet]. 2020 Jan 1;15:197\u0026ndash;206. Available from: https://www.sciencedirect.com/science/article/pii/S2212144719302194\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Belonging, Well-being, Hybrid, Distance education, Physical therapy","lastPublishedDoi":"10.21203/rs.3.rs-6595794/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6595794/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eA sense of belonging, feeling accepted, respected, and supported, is crucial for student success. Hybrid Doctor of Physical Therapist Educational Programs (PTEPs), which blend online and in-person learning, present unique challenges to fostering belonging. This study explored students' insights on belonging in hybrid PTEPs, identifying facilitators and barriers and the relationship with well-being, leading to program recommendations.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis cross-sectional, mixed-methods survey study of 138 students enrolled in 18 hybrid PTEPs measured belonging, explored belonging factors, and linked well-being with belonging. Quantitative data were analyzed using descriptive statistics, tests of association, and unadjusted odds ratios, while open responses underwent inductive qualitative coding.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eStudents demonstrated above-average belonging (3.38/5; SD 0.92), with academic belonging (3.71, SD 0.90) rated higher than interpersonal belonging (2.98, SD 0.96). A sense of belonging demonstrated protective effects against anxiety (OR 2.62, 95CI: 1.22, 5.62) and was associated with positive well-being (OR 2.68, 95CI: 1.29, 5.59). Students endorsed faculty and peer respect, a welcoming culture, and in-person experiences as the most substantial contributors to belonging. While most (76.7%) identified the hybrid format as a barrier, inclusive online learning environments and student-led communication supported belonging. Qualitative themes for belonging included motivation to belong, opportunities for connection, program policies and faculty/administration support, and relational competencies.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWhile hybrid PTEPs foster a sense of belonging, gaps in interpersonal connections persist. Programs should implement strategies to enhance faculty and peer support, structured interactions, and face-to-face engagements while also integrating mental health resources to strengthen student connections and well-being.\u003c/p\u003e","manuscriptTitle":"Forming Meaningful Connections: A Mixed-Methods Survey Study of Hybrid Doctor of Physical Therapy Students' Insights, Well-Being, and Recommendations on Fostering Belonging","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-26 09:57:24","doi":"10.21203/rs.3.rs-6595794/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-22T09:06:57+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-21T20:06:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"318978117428618870427638757477910705092","date":"2025-12-01T15:17:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-30T16:03:17+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-27T02:25:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"87411680776904387057435607465259768677","date":"2025-06-26T11:43:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"202878358002878709324913458479387695693","date":"2025-06-24T13:28:39+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-24T07:08:47+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-19T00:10:29+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-23T06:32:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-22T21:23:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-05-22T21:22:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0365312e-c290-450a-8b49-eeb2a517b067","owner":[],"postedDate":"June 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-09T16:05:18+00:00","versionOfRecord":{"articleIdentity":"rs-6595794","link":"https://doi.org/10.1186/s12909-026-08910-8","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2026-03-03 15:59:27","publishedOnDateReadable":"March 3rd, 2026"},"versionCreatedAt":"2025-06-26 09:57:24","video":"","vorDoi":"10.1186/s12909-026-08910-8","vorDoiUrl":"https://doi.org/10.1186/s12909-026-08910-8","workflowStages":[]},"version":"v1","identity":"rs-6595794","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6595794","identity":"rs-6595794","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}