Utilization of an Integrated Clinical Experience in a Physical Therapist Education Program:

Influence of a clinical experiential activity on student confidence in conducting effective fall-risk assessment on older adults

The ability to confidently perform fall-risk assessment on older adults is critical for Doctor of Physical Therapy (DPT) students prior to entering workforce. The complex nature of falls makes it challenging to teach it realistically in traditional classroom settings. This could lead to lack of confidence in performing effective assessments in real clinical situations. For this purpose, an evidence-based experiential fall-risk assessment activity was implemented in the curriculum. The purpose was to investigate if this activity improved students' confidence in performing fall-risk assessment. Twenty-eight students completed this activity on thirty-three older adults from a senior living community. A 13-item questionnaire was used to investigate confidence before and after the activity. Significant improvements in students' confidence were noted for administering client interview (p = .001, r = -0.43), 30-Second Chair Stand Test (p = .046, r = -0.34) and 10-Meter Walk Test (p = .011, r = -0.27). Additionally, students demonstrated excellent inter-rater reliability (ICC > 0.9) with the faculty experts for administering 5-Times Sit-to-Stand, 10-Meter Walk, Berg Balance Scale, 4-Stage Balance, Timed Up and Go and 30-Second Chair Stand tests, and good inter-rater reliability (ICC = 0.78) for Single-Limb Stance Time test. This activity had a positive impact on DPT students' confidence in conducting effective fall-risk assessment.

Learning activities without patient interactions can achieve pediatric curricular objectives for adult learners

BACKGROUND

The literature is lacking in studies about what specific types of learning activities are most effective for adult learners.

PURPOSE

To examine the effectiveness of a learning activity with patient interactions as compared to a learning activity without patient interactions.

METHODS

A convenience sample of third year Doctor of Physical Therapy students participated in this retrospective cross-sectional study (n = 47). Data were a clinical reasoning assignment, the Andragogy in Practice Inventory (API) and Intent to Use Scale, and the Behavioral Engagement Related to Instruction (BERI) protocol. Data analysis included descriptive frequencies, paired t-tests, Wilcoxon Signed Rank Tests and Multivariate Analysis of Variance.

RESULTS

Significant differences were noted between the learning activity with and the learning activity without patient interaction on several API subscales: prepare the learner, climate setting, setting of objectives and learning activities as well as in the conceptual reasoning area of the clinical reasoning assignment (p = .005, p = .036, p = .002, p = .047, and p = .038, respectively). No other significant differences were noted in other outcome variables. No significant influence of age or gender was found.

CONCLUSION

This study demonstrated that, overall, both the with and without patient interaction learning activities were compatible with the preferences of the adult learner.

Considering Domain-Specific Experiential Learning: Self-Efficacy in Pediatric Physical Therapy Education

BACKGROUND

Variability exists in pediatric training in physical therapy programs. Little is known about educator implementation of curriculum recommendations. Few options exist for evaluating student outcomes following pediatric instruction.

PURPOSE

The purposes of this study are to describe the pediatric curriculum of a physical therapy program, quantify changes in self-efficacy following pediatric instruction, and define relationships between self-efficacy, prior experience, and interest in future pediatric practice.

METHODS

A prospective cohort study included 48 students. Measures were pediatric content hours, the Pediatric Communication and Handling Self-Efficacy Scale, prior experience, and self-reported interest in future pediatric practice.

RESULTS

Pediatric content hours followed published recommendations. There was a significant increase in self-efficacy after pediatric instruction. Prior experience and interest in future pediatric practice were significantly related to self-efficacy.

CONCLUSIONS

Our results indicate that physical therapy programs reaching the recommended content hours for pediatric instruction support growth in student communication and handling self-efficacy.

The Integrated Clinical Education Strategic Initiatives Project-Development of Parameters to Guide Harmonization in Clinical Education: A Scoping Review

BACKGROUND

Clinical education curricular models specifically related to integrated clinical education (ICE) vary across physical therapist education programs. The interconnectedness of ICE to the advancement of a shared vision for clinical education in professional physical therapist education needs investigating.

PURPOSE

The purpose of this scoping review was to: (1) define ICE, (2) define baseline expectations and parameters of ICE, and (3) discern and describe current ICE models.

DATA SOURCES

Databases accessed included Medline, MedlinePlus with Full, CINAHL, and CINAHL Plus with full text.

STUDY SELECTION

A multimodal data collection scoping review was completed. Data collection included survey research, a systematic review of the literature, and a series of focus groups. The McMaster Critical Appraisal Tool assessed methodological study quality. A qualitative, metasynthesis approach was used for data synthesis. Consensus agreement produced results.

DATA EXTRACTION

Twenty-two articles were included in the literature review from the health disciplines of medicine, nursing, physical therapy, occupational therapy, and speech-language pathology. Data synthesis produced 8 parameters defining the factors essential to categorizing clinical education experiences as ICE in physical therapist education. The 8 parameters and ICE definition are supported by a description of models of ICE that currently exist within health profession curricula.

DATA SYNTHESIS

Data synthesis followed a qualitative, metasynthesis approach. Themes emerged from the surveys, literature review, and focus group data. Patterns were compared, analyzed, and synthesized to generate the themes and ICE parameters.

LIMITATIONS

Selection bias from the literature search could have limited the richness of the model descriptions by unintentional exclusion of articles, and might limit the applicability of results beyond the United States. Sampling bias from survey and focus groups, although purposeful, might have limited a broader description of current viewpoints about ICE. However, the data sources, including multiple health profession perspectives coupled with consensus agreement, provide sound evidence in development of profession-based parameters.

CONCLUSIONS

The results of this scoping review provide the profession with a standard definition of ICE and parameters that can guide a program in designing a curriculum using ICE experiences as a foundation. A recommended next step is to design education research studies using reliable and valid outcome measures across programs to determine impact and effectiveness of ICE as an educational intervention.

A Pediatric Service-Learning Program in Physical Therapy Education

PURPOSE

The purpose of this report was to describe a pediatric service-learning program in entry-level physical therapy (PT) education in Taiwan.

KEY POINTS

To meet the needs of the local community and provide preclinical service-learning experience to PT students with people with physical disability, a service-learning program of a 2-day camp for children with cerebral palsy (CP) was developed in 2012. To date, 356 entry-level PT students have participated in this program, serving 286 children and their families. Important professional attributes, identified by the World Confederation for Physical Therapy guideline, such as altruism, compassion and caring, cultural competence, personal and professional development, professional duty, social responsibility and advocacy, and teamwork, were in the reflective reports of some of the PT students.

CONCLUSIONS

The experiences provided by this pediatric PT service-learning program appear to have the potential to foster the development of professional attributes in entry-level PT students.

Effects of an integrated geriatric group balance class within an entry-level Doctorate of Physical Therapy program on students' perceptions of geriatrics and geriatric education in the United States

This study was aimed at determining the effect of an integrated group balance class for community-dwelling older adults within entry-level physical therapist coursework on student perceptions of geriatric physical therapy and geriatric physical therapy education. Twenty-nine Doctor of Physical Therapy (DPT) students, 21-33 years old, in their second year of coursework in 2012, participated in an integrated clinical experience with exposure to geriatric patients at an outpatient facility at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center in Akron, Ohio, USA. Student perceptions were collected before and after participation in the 8-week balance class. The Wilcoxon sign-ranked test was used to identify differences in perceptions after participation in the group balance class. Cohen's d values were calculated to measure the size of the pre-participation to post-participation effect for each measure. At the conclusion of the group class, the DPT students demonstrated an increase in positive perceptions of geriatric physical therapy in 8 measures, with small effect sizes (d=0.15-0.30). Two perceptions of geriatric physical therapy demonstrated a significant positive increase (P<.05) with moderate effect sizes (d=0.47 and d=0.50). The students' perceptions of geriatric education in the curriculum demonstrated a large positive effect for quality (d=1.68) and enjoyment (d=1.96). Positive changes were found in most of the perceptions of geriatrics and geriatric education after participation, suggesting that integrated clinical experiences with geriatric patients are an effective way to positively influence perceptions of physical therapist practice with older adults.

Experiential Learning With Children: An Essential Component of Professional Physical Therapy Education

PURPOSE

The Section on Pediatrics of the American Physical Therapy Association has developed a number of resources to support and improve the consistency of professional pediatric physical therapy education, including a set of core competencies that all graduates must attain. The purpose of this article is to advocate for the inclusion of experiential learning activities with children, including children with participation restrictions, as a necessary component to achieve the core competencies.

KEY POINTS

Experiential learning is a form of practice-based education that provides exposures and opportunities for students to explore the work, roles, and identities they will encounter as future professionals. Experiential learning is learning by doing, and occurs within a relevant setting. Six representative curricular exemplars are presented to provide readers with a variety of suggestions for development and integration of experiential learning.

SUMMARY

Recommendations for future research are provided and 4 key recommendations are provided.