JOPTE

The Journal of Physical Therapy Education (JOPTE) is peer reviewed and published four times each year by theEducation Section of the American Physical Therapy Association. The Journal is indexed by Cumulative Index to Nursing & Allied Health Literature and in Physiotherapy Indexditor:

Editors:
Jan Gwyer, PT, PhD
Laurita M. Hack, PT, DPT, MBA, PhD 

2017 Volume 31 - Number 2

Editorial: We’ve Been Busy!
by Jan Gwyer, PT, PhD, FAPTA, and Laurita Hack, PT, DPT, PhD, MBA, FAPTA
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Of course the size of this issue might be a clue to just how busy we’ve been, but more on that later. We recently had the pleasure of working with the Editorial Board to do a wonderful presentation at APTA’s Combined Sections Meeting. We invited the members of the edi- torial board (MEBs) to join together to do a presentation on the importance of having theory or a conceptual framework to guide one’s research and research agenda.
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Counting the Dead: Who is Teaching Anatomy to Physical Therapy Students?
by Janet M. Cope, PhD, OTR/L, Mackenzie C. Precht, BA, PAS, Amy Klinepeter, BS, Brooke Powell, BS, and Mary C. Hannah, PT, DPT, OCS, SCS
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Background and Purpose. The purpose of this paper is to provide a summary of the history and current literature sur- rounding the use of unclaimed dead in anatomy education and to quantify the number, origin, and donation status of cadavers being used in teaching anatomy in physical therapist (PT) education pro- grams. This data will support the need for anatomy educators in PT education programs to inform themselves and their students about willed body donation pro- grams. Faculty should insist that every cadaver used in anatomy education in PT education programs has consented to be there. Participants. A list of accredited PT edu- cation programs was created (n = 217), and a survey was sent to each school for the anatomy educator to complete. Methods. An electronic survey was gen- erated to collect number, sources, and origins of cadavers used in anatomy education in PT education programs. Descriptive statistics were used to report survey responses. Results. There were 99 responses (46% response rate), representing anatomy educators from 40 states. Anatomy educators reported during the past year they have taught PT anatomy alongside a total of 930 cadavers, and identified the sources of their cadavers: medical schools (52%); in house gift programs (24%); state anatomy boards (17%); private organizations (5%); a willed body program not attached to a medical school or in house (1%); and no source, as the program does not use ca- davers (1%). Anatomy educators were asked if they knew the origin of the donors using the following definitions: (1) Regis- tered donor: individual has consented to participate in anatomy education; (2) next of kin: family member has provided con- sent; (3) unclaimed dead: neither the indi- vidual nor a family member has provided consent. Discussion and Conclusions. Seventy- eight percent of anatomy educators re- ported knowing the origin of cadavers used to teach physical therapy anatomy, 10% reported not knowing, and 12% were uncertain. Anatomy educators re- ported that 72% (n = 670) of cadavers are registered donors, 3% (n = 30) are next of kin donations, and 0% (n = 0) are un- claimed dead. Anatomy educators were not able to categorize 25% (n = 230) of cadavers used during anatomy instruc- tion in PT education programs. While the majority of PT education programs access cadavers via a medical school that has an anatomical gift program, some rely on state anatomy boards, private organizations, or on multiple sources. Most anatomy educators in PT education programs know the origin of the cadav- ers they use during instruction (78%), but some are uncertain. Anatomy educators report that their nonliving colleagues are mostly registered donors, and some are next of kin donations. No respondents re- port working with unclaimed dead. There is a difference of 230 cadavers (25%) who are not accounted for as registered, next of kin, or unclaimed. While these research- ers recommend that direct consent be obtained from all of our nonliving col- leagues, this could result in temporary donor shortages in anatomy laboratories. There is an immediate need for public education around the topic of whole body donation and increased involvement from anatomists in PT education programs in this process. Key Words: Cadaver, Anatomy education, Anatomical gift
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Physical Therapist Productivity Using a Collaborative Clinical Education Model Within an Acute Care Setting: A Longitudinal Study
by Patrick S. Pabian, PT, DPT, SCS, OCS, Jamie Dyson, PT, DPT, and Carol Levine, PT, DPT, CLT
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Introduction. Collaborative models in clinical education are increasing in popu- larity, but concerns exist over the potential impact on patient productivity of clinical instructors. Little empirical research has examined the impact of patient produc- tivity in the models of clinical education in the acute care setting. The objective of this study is to examine the productivity impact of physical therapists (PTs) par- ticipating in both the 1:1 and 2:1 models of clinical education over a 3-year time period in an acute care hospital setting. Methods. This study utilized a longitu- dinal, retrospective design. Productivity data of 20 PTs was examined over a 3-year timeframe (8,981 days of productivity). Productivity of each PT was cross-refer- enced with their clinical education sched- ules to evaluate patient productivity while serving as a clinical instructor in a 1:1 or 2:1 clinical education model. Results. PTs serving as clinical instruc- tors in a 2:1 model (mean 21.53 units per day; 95% confidence interval (CI), 21.15– 21.91) achieved a significantly greater productivity (P < .001) than those serving in a 1:1 model (17.05 units per day, 95% CI, 16.91–17.18). Within-group differ- ences demonstrated a significant increase (P < .001) of units billed per day with the addition of each student, both in the tran- sition from 0 to 1 student (0.591 units per day; 95% CI, 0.18–0.99) and from 1 to 2 students (4.75 units per day, 95% CI, 4.21– 5.29) for therapists who participate in the 2:1 model, and for those who participate in a 1:1 model of clinical education (0.82 units per day; 95% CI, 0.51–1.13). Discussion and Conclusions. PT pro- ductivity can increase during both a 1:1 and 2:1 model of clinical education in the acute care setting. Formal training of clin- ical instructors and continued mentorship of clinical education faculty is necessary to create an institutional culture that opti- mizes physical therapy clinical education. Key Words: Clinical education, Collab- orative model, Physical therapist produc- tivity.
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Student Team Learning in Practice (STEPs®): An Integrated Clinical Education Collaborative Model
by Kyle Covington, PT, DPT, PhD, NCS, Corrie Odom, PT, DPT, Scott Heflin, MFA, and Jan Gwyer, PT, PhD, FAPTA
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Background and Purpose. Integrated clinical education (ICE) is the clinical component of the professional curricu- lum that is conducted concurrently with the didactic curriculum. Standardized, structured ICE experiences are now rec- ommended to create a more robust cur- riculum for meaningful, early student learning. This purpose of this paper is to describe the development of an ICE cur- riculum that incorporates close clinical partnerships, explicit course curricula, and collaborative teams of students and clinical instructors (CIs). Method/Model Description and Evalua- tion. The ICE curriculum model, Student Team Experience in Practice (STEPs®), consists of teams of students who learn with CIs trained to facilitate both group learning and individual student assess- ment. The ICE curriculum structure includes the following elements: direct pa- tient care, planned learning experiences, guided reflections, skill assessment, and peer, self, and instructor assessment of behavioral objectives. The model is evalu- ated through student performance data CI performance data, and satisfaction ratings from clinical faculty and students. The resources required for the model were also evaluated. Outcomes. Greater than 95% of the 254 students received passing assessments for all skills and behavioral objectives in the STEPs® model, and the remaining students were successful after a remedia- tion. The majority of students agreed or strongly agreed that they enjoyed learn- ing in a collaborative team, that their team functioned well, that they exchanged constructive feedback, and experienced high levels of learning (93.7%–98.2%). Students’ ratings of their CIs were also positive, with greater than 97% of stu- dents indicating their CIs displayed fa- vorable teaching characteristics always or frequently. Implementing STEPs® allowed a 70% decrease in the number of clinical sites needed, compared to the program’s previous ICE program. Discussion and Conclusion. The STEPs® model for early ICE has provided an opportunity for our program to more efficiently utilize clinical resources for de- livering an ICE curriculum while enhanc- ing student and instructor satisfaction. Additionally, the model has provided op- portunities for students to demonstrate their individual performance in clinical practice across the didactic years of the curriculum. Key Words: Integrated clinical education, Collaborative model, Curriculum design, Student outcomes.
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Addition of a Patient Examination Module to Address Student Preparedness for the First Full-Time Clinical Experience
by Amy H. Miller, PT, DPT, EdD, Susan Tomlinson, PT, DPT, James David Tomlinson, PT, MS, and Janet Readinger, PT, DPT
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Background and Purpose. Physical therapist (PT) education programs strive to optimize student readiness for clinical education experiences (CEE). Based on student feedback during and following the first full-time CEE, our program iden- tified that students felt least prepared and confident conducting a full patient exami- nation while on the CEE. Our goal was to develop and implement an evidence- based academic module focused on pa- tient examination skills prior to the first full-time CEE, and to base curricular de- cisions about the new module on clinical outcomes as well as student perceptions. Education literature supports the use of experiential learning opportunities, along with adult learning strategies, to help stu- dents develop and practice clinical skills. Few studies, however, address the effect of specific models on student performance during the CEE. The purpose of this paper is to describe the evidence-based 2-week education module focused on patient examination and to report themes from student perceptions along with student clinical performance using the Physical Therapist Clinical Performance Instru- ment (PT CPI). Methods. During the 2-week module, students prepared for and performed 3 standardized patient examinations, 3 “real” patient examinations, and observed 2 clinicians each perform a patient ex- amination. Students received feedback from multiple sources including patients, peers, clinicians, and faculty. Feedback and reflection was structured using for- mal checklists and open discussions. CPI data for 1 class prior to implementation of the module (Class A, n = 54) and 2 classes after implementation (classes B and C, n = 54 and n = 55, respectively) were used for comparison. Kruskall-Wallis analy- sis of variance (ANOVA) with post hoc analysis was used to examine differences on the 4 CPI criteria most closely related to the objectives for the module (clinical reasoning, screening, examination, and evaluation). Perspectives from students receiving the module were also analyzed for emerging themes. Outcomes. Over 95% of the students rated the module beneficial. Three domi- nant themes emerged from written stu- dent perspectives: (1) the module was perceived to be valuable, (2) students felt better prepared to organize an examina- tion, and (3) felt more confident in clini- cal skills. Scores on all 4 CPI criteria were signifi- cantly different (P values ranging from P < .001 to P = .016), with median ratings 1 to 3.5 points higher for classes receiving the module. Post hoc analysis revealed no difference between the 2 classes receiving the module. Discussion and Conclusion. These ben- eficial findings are consistent with educational literature supporting experiential learning principles, the use of multisource feedback, and standardized patient expe- riences. Based on statistically significant increases in ratings on CPI criteria related to the module and student perceptions about the module, we decided to con- tinue to offer this module with the goal of enhancing student readiness for the first full-time CEE. Providing similar ev- idence-based academic experiences may improve early clinical performance. Key Words: Clinical education, Educa- tion content areas, Entry-level education, Teaching methods, Teaching and learn- ing, Curriculum design.
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Investigation into Physical Therapist Students’ Interprofessional Experiences During an 8-Week Clinical Clerkship: A Qualitative Study
by Amber Fitzsimmons, PT, DPTSc, MS, Kimberly S. Topp, PT, PhD, and Bridget C. O’Brien, PhD
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Introduction. The Physical Therapy and Society Summit, convened by the Ameri- can Physical Therapy Association (APTA) in 2009, reframed the physical therapy care paradigm from a traditional 1:1 physical therapist (PT) to patient relation- ship, to one in which PTs are effective and thrive as part of a collaborative, interpro- fessional health care team with patients and families at its focus. Correspond- ingly, PT education must align with this new paradigm and provide opportunities for learners to deliver care as part of an interprofessional team. There is limited evidence in the physical therapy literature about which clinical education settings can offer the rich, contextual interpro- fessional collaborative (IPC) experiences required for optimal interprofessional learning (IPL) in the workplace. We in- vestigated first-year entry-level Doctor of Physical Therapy (DPT) student perspec- tives on the interprofessional experiences they encountered in their first clinical ex- periences. Methods. This is a qualitative study us- ing a general inductive approach. One investigator interviewed 22 first-year PT students entering their first 8-week clini- cal experience in an acute care, outpatient hospital-based, or outpatient private prac- tice setting. Results. The nature and context, struc- ture, and timing of students’ IPL expe- riences are described. IPL experiences differed depending on the clinical educa- tion setting. Findings suggest that both outpatient physical therapy and acute care settings offer very limited IPC or team- based IPL experiences. Conclusions. Our study is 1 of few stud- ies to investigate PT students’ perceptions of IPL experiences in clinical education settings. We found limited opportunities for IPL in certain settings, particularly outpatient settings. As interprofessional education (IPE) and IPC become impor- tant components of training for all health professionals, PT educational programs will need to identify settings that afford IPL opportunities, or find alternative so- lutions. Key Words: Interprofessional education, Interprofessional collaboration, Clinical education.
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A Model for Providing Free Patient Care and Integrating Student Learning and Professional Development in an Interprofessional Student-Led Clinic
by Lydia George, PT, DPT, Sara Bemenderfer, PT, DPT, Maggie Cappel, PT, DPT, Kathryn Goncalves, PT, DPT, Micaela Hornstein, PT, DPT, Chelsea Savage, PT, DPT, OCS, Peter Altenburger, PT, PhD, James Bellew, PT, EdD, and M. Terry Loghmani, PT, PhD
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Background and Purpose. The need to reduce the barriers of access and af- fordability in health care is evident. The Indiana University Student Outreach Clinic (IU SOC) is a community-based, pro bono, interprofessional, student-led clinic dedicated to removing barriers to health care. The purpose of this report is to describe the implementation sustainability efforts, and initial outcomes of this community-based physical therapy clinic model with the aim of making it transparent for others to replicate. Method/Model Description and Evalu- ation. An overview of the IU SOC, im- plementation and sustainability of the physical therapy clinic model, and student learning opportunities are described. Keys to successful implementation are enumer- ated. Learning opportunities include: clinical competency, professional values, civic engagement, interprofessional edu- cation and collaborative practice (IPECP), peer mentorship, and leadership develop- ment. Outcomes. Preliminary clinic and learn- ing opportunity outcomes collected from patient databases and student surveys and reflections suggest the IU SOC is having a positive impact on the community it serves by providing care patients would otherwise have not received, while si- multaneously supporting learning. Pa- tient volume and student participation are expanding. Initial outcomes suggest this model is valuable for the professional growth of future physical therapists. Discussion and Conclusion. The impact of this clinic model on the community and students is just beginning to be real- ized and understood. Key elements of suc- cess are that it’s (a) community-based, (b) interprofessional, and (c) highly collabor- ative. Free, student-led, interprofessional health care clinics may offer an important means for improving health care access while simultaneously preparing entry- level professionals for practice. Key Words: Student-led pro bono health care clinic, Interprofessional education, Collaborative practice, Professionalism.
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A Practical Guide to Teaching Measures of Effect Size in Physical Therapist Education
by Marc Campo, PT, PhD, OCS, Patricia Eckardt, RN, PhD, Jill Lucas Findley, PT, PhD, John A. Cardinale, PhD, and Mariya P. Shiyko, PhD
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Background and Purpose. Evidence- based practice (EBP) is a key component of physical therapist (PT) education. Ef- fect size is an increasingly important con- cept in EBP because effect sizes enable the comparison of results between studies and may provide measures of clinical signifi- cance. Effect sizes are also an important part of meta-analytic techniques. Knowl- edge of effect sizes will therefore help students to critically appraise research findings and will enhance EBP education. The purpose of this paper is to review commonly used effect sizes and to present opportunities for related learning activi- ties. A variety of common measures are reviewed and discussed. Position and Rationale. It is our position that a detailed, yet balanced presentation of effect sizes should be included in PT education curricula. To interpret effect sizes accurately, students should be famil- iar with the underlying concepts, nuances, and limitations of each measure. The ef- fect size literature can be complex but we present several learning activities that would be appropriate for PT education. Conclusions. We support and encourage the use of effect sizes in research report- ing and PT education. Students at the doctoral level should receive enough cur- ricular content on effect sizes so that they can interpret and apply the concepts ap- propriately. Key Words: Biostatistics, Meta-analysis, Regression analysis, Evidence-based prac- tice, Teaching methods.
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Hand Therapy Content for Entry-Level Physical Therapist Education: A Consensus-Based Study
by Mia Erickson, PT, EdD, CHT, ATC, Jacqueline Faeth, PT, DPT, Bethany Gaston, PT, DPT, Jenna Wood, PT, DPT, Emily Yoder, PT, DPT, Cheryl A. Caldwell, PT, PhD, CHT, and Cindy J. Armstrong, PT, DPT, CHT
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Background and Purpose. Hand therapy is an area of physical therapist (PT) spe- cialty practice, and its scope has been well-defined by its parent organization, the Hand Therapy Certification Com- mission (HTCC). It can be difficult for PT educators to determine the depth and breadth of a specialty area to include in an entry-level program. Educators must balance the volume of content required for entry-level practice with time con- straints, while also providing introduc- tory coverage of specialty practice areas. The purpose of this study was to establish guidelines for hand therapy content in en- try-level PT education using a consensus- based approach.Methods. Three questionnaires were de- veloped by the researchers to identify hand therapy content that should be in- cluded in entry-level PT education. The initial questionnaire (89 forced-choice and 4 open-ended items) sought to iden- tify content that should or should not be included as well as the level of teaching and learning that should be achieved. Subsequent questionnaires were devel- oped based on responses from the previ- ous round and included new items as well as items requiring consensus. Percent- ages of responses were used to determine consensus, and topics that did not reach consensus were carried forward to subse- quent rounds. Results. Thirty individuals completed 3 questionnaires over a 5-month period, for a 100% response rate. Participants agreed on 64 content items for inclusion in the cognitive domain and 52 items in the psy- chomotor domain. Consensus on the level of teaching and learning for these items was also achieved. Conclusion. Results provide PT educa- tors with guidance on determining the breadth and depth of hand therapy con- tent for entry-level PT education. Key Words: Hand therapy, Physical thera- pist education, Entry-level physical thera- pist education.
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Forum: Formation of a Doctoring Professional: Are We Shying Away From Education that Really Matters in the Lives of Our Graduates?
by Barbara A. Tschoepe, PT, DPT, PhD, and Caroline Goulet, PT, PhD, FNAP
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Dr. Geneva R. Johnson (Figure 1) continues to influence physical therapy education as an inspirational participant in the Third Annual Geneva R. Johnson Innovations in Physical Therapy Education Forum (GRJ Forum). Dr Johnson is recognized for her longstanding leadership and mentorship, having contrib- uted to the advancement of physical therapy education, practice, and research for over 60 years. The GRJ Forum started in 2014 through the collaborative efforts of the Aca- demic Council of Academic Physical Therapy (ACAPT) and the Physical Therapy Learn- ing Institute (PTLI).3,12 Once again it was the keynote for the 2016 Education Leadership Conference (ELC) held in Phoenix, Arizona. As expected, the Forum continues to foster creative ideas for positive change to promote excellence in physical therapist education, a hallmark of Dr Johnson’s legacy.
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Editorial: Stepping OUT in Educational Research: Pediatric Physical Therapy Education has Learned to Walk
by Mary Jane Rapport, PT, DPT, PhD, FAPTA, and Jennifer Furze, PT, DPT, PCS
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It is our pleasure to introduce a special series of articles that will appear in each of the next 3 issues of this journal highlighting key areas of educational research specific to pediatric physical therapy education. The purpose of this special series, as stated in the initial call for proposals in 2014, is “to focus on identify- ing the curricular elements and instructional changes that will be necessary to ensure the provision of high quality physical therapy services for pediatric patients and adults with lifelong developmental disabilities.” To this end, we found it was both necessary to enhance our collective understanding of best practice in pediatric physical therapy education and to share that more broadly with the physical therapy education commu- nity. While the literature on the scholarship of teaching and learning (SoTL) in physi- cal therapy education continues to expand in both breadth and depth, the variability of educational practices relative to the educa- tion of pediatric physical therapy knowledge, skills, and abilities is highly variable across professional physical therapy curriculum. In fact, many of the concerns first identified in 1993 by Cherry and Knutson1 and by Martin2 regarding the limited amount of time spent and the variability in teaching pediatric con- tent as part of the entry-level physical therapy curriculum are still unresolved
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A Course of Its Own: A Stand-Alone Pediatric Course Designed to Meet the Essential Core Competencies and Program Goals
by Marisa Birkmeier, PT, DPT, PCS, Margaret M. Plack, PT, DPT, EdD, Erin Wentzell, PT, DPT, PCS, and Joyce Maring, PT, DPT, EdD
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Background and Purpose. Professional physical therapist (PT) education pro- grams must prepare graduates to effec- tively provide physical therapy for patients throughout the lifespan. A number of models, standards, and competencies are available to guide the development of the pediatric curricular content. However, none are prescriptive, and pediatric con- tent and delivery vary in programs across the nation. The Academy of Pediatric Physical Therapy developed 5 essential core competencies (ECCs) foundational for entry-level pediatric PT practice. Still, challenges remain in how best to deliver pediatric content using educational prin- ciples that meet the needs of a diverse group of stakeholders. Two major strate- gies for delivering this content in profes- sional PT curricula have been discussed in the pediatric physical therapy community: stand-alone pediatric courses and threading content across the curriculum. This paper presents the evaluation of a stand-alone pediatric course in a Doc- tor of Physical Therapy (DPT) program grounded in adult learning principles and educational theory. Method/Model Description and Evalu- ation. A 4-credit, stand-alone pediatric course was designed using the theoretical frameworks of adult learning principles, communities of practice, and reflective practice. Situating the course later in the DPT curriculum enables students to think critically, apply new knowledge, and adapt prior knowledge to the complex pediatric environment. To determine the efficacy of this model, quantitative and qualita- tive data were collected from enrolled students. Student ratings on course evalu- ations and assessment of student perfor- mance on the Physical Therapist Clinical Performance Instrument (PT CPI) were analyzed and summarized using descrip- tive statistics. Course objectives, learn- ing activities, and exam questions were mapped to the ECCs. Two reflective as- signments were analyzed using qualitative methods. Multiple methods and research- ers, including peer reviewers, were used to ensure trustworthiness and confirm accu- racy of the findings. Outcomes. Mapping course objectives, activities, and assessments to the ECCs demonstrated congruence, and combined with PT CPI data, mapping indicated stu- dents are well-prepared for entry-level pediatric practice. Course evaluations substantiated the diverse needs of learners were met by the course design. The quali- tative analyses provided evidence of the following themes related to student learn- ing: experiential learning activities rein- forced key concepts and validated their learning; critical thinking about learning and prior knowledge was enhanced; chal- lenges and required skills were identi- fied; and theory and practice were linked across populations and cases including those beyond pediatric practice. Discussion and Conclusion. Outcomes of the model demonstrate that a stand- alone pediatric course grounded in adult learning principles and educational the- ory and mapped to the ECCs was effec- tive in preparing learners for entry-level pediatric practice. The course addressed the needs of diverse learners and facili- tated clinical reasoning and higher order thinking through reflective processes. The course and curriculum design facilitated the application of previously learned con- tent and skills to the pediatric population. Key Words: Curriculum design, Pedi- atrics, Entry-level education, Learning theory, Student learning, Essential core competencies, Active learning strategies.
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Assessment of Teaching and Learning Activities in Pediatric Physical Therapy: Factors Influencing Knowledge Development and Confidence
by David D. Chapman, PT, PhD, and Debra O. Sellheim, PT, PhD
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Background and Purpose. Little is known about teaching and learning ac- tivities that influence the development of knowledge and knowledge confidence of entry-level physical therapist (PT) stu- dents regarding pediatric physical therapy content. This study was designed to inves- tigate teaching and learning activities that promoted or inhibited the development of the students’ self-rated knowledge and knowledge confidence during a pediatric physical therapy course. Subjects. Twenty second-year entry-level PT students participated in this study. Methods. Quantitative data were collected through online surveys to capture stu- dent ratings of knowledge and knowledge confidence regarding selected course ob- jectives before and after 5 instructional units. Qualitative data were gathered us- ing audiotaped focus group interviews and weekly journal entries addressing questions about teaching and learning ac- tivities that enhanced or diminished the subjects’ knowledge and knowledge con- fidence. Results. For each instructional unit, stu- dents self-rated their postinstruction knowledge and knowledge confidence significantly higher than their self-rated preinstruction knowledge and knowledge confidence. Factors found to promote self-rated knowledge and knowledge con- fidence included self-directed learning activities, a positive, supportive learning climate, well organized class sessions, and repeated experiences with children. Alter- natively, poorly organized class sessions, feeling intimidated in class, a lack of expe- rience working with children, and a lack of explicit clinical reasoning by faculty were factors identified as inhibiting the students’ ability to increase their knowl- edge and knowledge confidence. Discussion and Conclusion. The results of the current study reflect the devel- opmental process that PT students go through as they work to acquire knowl- edge and develop knowledge confidence. Both traits appear to be influenced by the type and quality of the teaching and learning activities provided during a pe- diatric physical therapy course, as well as the strength of the relationship that ex- ists between PT students and core faculty members. Key Words: Pediatrics, Entry-level educa- tion, Student learning, Teaching methods.
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A Novel Approach to Pediatric Education Using Interprofessional Collaboration
by Lauren Del Rossi, PT, DPT, PCS, Mary Kientz, OTD, OTR, Mary Padden, PhD, APN-C, Patricia McGinnis, PT, PhD, and Monika Pawlowska, PhD
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Background and Purpose. Interprofes- sional Education (IPE) challenges stu- dents of health care disciplines to learn with, about, and from each other, and aims to develop competency in skills that are necessary for future interprofessional collaborative practice (IPCP). The skills necessary to engage in IPCP are not in- nate to students and require intentional educational activities. IPCP is especially important in the management of pediat- ric clients due to the complex and unique nature of their care. For many students, interaction with infants and parents is novel, as many have never experienced these aspects of care. The purpose of this paper is to describe the development and implementation of Baby Lab, a combined interprofessional lab experience designed to provide physical therapy, occupational therapy, and nursing students an opportu- nity to experience team building and col- laboration while interacting with young children and their parents in a controlled environment. Method/Model Description and Evalu- ation. We invited parents with infants/ toddlers (n = 16) age 30 months and younger from the community to partici- pate in Baby Lab. Students (n = 79) from the 3 disciplines worked in interprofes- sional teams and interacted with the child and parents for 60 minutes. Completion of this activity from prelab preparation to postlab reflection occurred in 5 stag- es. Student learning objectives for this experience were derived from the Core Competencies from the Interprofessional Education Collaborative. Outcomes. The impact of this experience was measured utilizing the Interprofes- sional Collaborator Assessment Rubric (ICAR), student evaluation forms, and qualitative data from student reflections. All 3 data sources provided evidence that the learning objectives were met and sug- gest that offering Baby Lab as an inter- professional learning experience added significant value to an already successful, established learning activity. Discussion and Conclusion. Baby Lab was an innovative and effective IP learn- ing experience that introduced a col- laborative practice experience into the classroom. Students gained an apprecia- tion of the importance of collaborating with team members and families, an un- derstanding of the value of working with other disciplines, and confidence in these interactions. Developing these skills can help prepare students for clinical experi- ences with pediatric clients as a member of a health care team. Key Words: Pediatrics, Interprofessional education, Physical therapist education, Creative educational strategies.
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A Collaborative Model of Integrated Clinical Education in Physical Therapist Education: Application to the Pediatric Essential Core Competency of Family-Centered Care
by Kara L. Lardinois, PT, DPT, C/NDT, Dora Gosselin, PT, DPT, PCS, C/NDT, Dana McCarty, PT, DPT, PCS, C/NDT, Kathleen Ollendick, PT, DPT, PCS, and Kyle Covington, PT, DPT, PhD, NCS
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Background and Purpose. Physical ther- apist (PT) clinical education models in the pediatric setting need to be evaluated. An early, collaborative, integrated clinical ed- ucation (ICE) model was examined in the pediatric setting to determine the extent to which key characteristics (KCs) and entrustable professional activities (EPAs) of the pediatric essential core competency (ECC) of “family-centered care for all patient/client and family interactions” are reflected in student self-evaluation and guided reflection responses. Method/Model Description and Evalua- tion. Students’ self-evaluation and guided reflection responses were analyzed using retrospective document analysis. Qualita- tive coding procedures were used to assess documents for a priori codes including the pediatric ECC of “family-centered care for all patient/client and family interactions.” Outcomes. In both student self-evalu- ation and student guided reflection re- sponses, analysis consistently revealed student discussion of all KCs and most EPAs; the guided reflection responses demonstrated all KCs and nearly all EPAs. Overall, students’ assignments revealed a clear emphasis on the KCs of “positiv- ity,” “sensitive,” and “collaborative.” The assignments revealed an emphasis on the KC of “responsive,” and the EPAs “factors of the family system that influence the child” and “collaborate with families.” Discussion and Conclusion. The pedi- atric ECC of “family-centered care for all patient/client and family interactions” most likely emerged through this early collaborative ICE model due to the mod- el’s conceptual framework as well as stu- dents having concrete experience in the pediatric setting. Key Words: Curriculum, Creative edu- cational strategies, Pediatrics/education, Reflection, Self-evaluation, Qualitative research.
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Pediatric Integrated Clinical Experiences: Enhancing Learning Through a Series of Clinical Exposures
by Melissa Moran Tovin, PT, PhD, MA, PCS, Alicia Fernandez-Fernandez, PT, DPT, PhD, CNT, and Kimberly Smith, PT, DPT, NCS
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Background and Purpose. Physical therapists (PTs) provide services to indi- viduals throughout the lifespan. Previous research supports the inclusion of oppor- tunities for PT students in entry-level pro- grams to observe and interact with both children who are typically developing and those with disabilities. Currently, there are limited opportunities for clinical intern- ship placement in specialized settings, such as pediatrics, and programs and stu- dents compete to secure such placements. Method/Model Description. A unique model of integrated clinical experiences (ICEs) was implemented at 1 university. The model, which interweaves clinical exposure in diverse pediatric settings throughout a 2-semester pediatric course series, was designed to enable students to practice applying the components of the patient/client management model with children, and to facilitate integration of pediatric content. Outcome data were col- lected from PT students in the 2014 and 2015 cohorts, and from clinical instruc- tors (CIs) involved in the model since its inception. The model was evaluated using a mixed-method, case study design con- sisting of 2 phases. Phase 1 of the design consisted of pre and postintervention survey methodology including a reflec- tion component. Phase 2 consisted of in- terviews with students and CIs to gather qualitative data about their experience with participating in the model. Outcomes. Results indicate that the inte- grated labs achieved the intended objec- tives. Furthermore, real-life interactions with children and members of the in- terprofessional team improved students’ confidence for working with the pediatric population, improved interprofessional communication skills, and enabled clini- cal application of content and concepts of family-centered care learned in the class- room. Conclusion. Findings can inform pedi- atric curriculum design for PT education programs to better prepare students for pediatric clinical practice. Key Words: Clinical education, Pediatrics, Curriculum design, Integrated clinical ex- periences.
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Use of Academic-Community Partnerships in Teaching Pediatric Physical Therapy
by Kimberly D. Wynarczuk, PT, DPT, MPH, and Eric S. Pelletier, PT, DPT
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Background and Purpose. Learning in pediatric physical therapy for entry-level physical therapist (PT) students is thought to be enhanced by including experiential learning as part of the curriculum. The use of an academic-community partner- ship program within a pediatric physical therapy course is presented here. Case Description. An academic-commu- nity partnership program was used as part of an entry-level pediatric physical ther- apy course. This academic-community partnership program included: (1) expe- riential learning, (2) topic/issue selection, (3) literature review, (4) development of an evidence-based project, and (5) re- search utilization. The methodical use of these components provided students with opportunities to interact closely with practicing pediatric clinicians, patients/ clients, and families. Students had oppor- tunities to integrate knowledge obtained in the classroom as well as knowledge gleaned from review of current evidence to develop evidence-based projects. Ques- tionnaires were administered pre and postcourse to students and postcourse to partnering clinicians to explore the per- ceptions of students and clinicians. Outcomes. The results of the question- naires demonstrated that after the course, students felt more confident in their abili- ties to work with children from birth to 12 years of age than they had prior to taking the course. Clinical partners were satisfied with the interaction with the students and pleased with the projects the students de- veloped. Discussion and Conclusion. This aca- demic-community partnership program provided students with experience in pediatric physical therapy and allowed them to integrate knowledge gained in the classroom, clinic, and through literature to create translatable projects and inter- ventions for clinical partners and the pa- tients they treat. Further development of a model of academic-community partner- ships and comparative objective assess- ment of its use as an educational strategy is recommended. Key Words: Entry-level education, Pe- diatrics, Community education, Coop- erative learning, Creative educational strategies.
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