Sailing Regatta: Is Probono Clinic Participation a Guaranteed Win in the Professional Practice Skills Race?
Purpose: Physical therapy education programs seek to provide learning opportunities for students prior to being engaged in full time clinical education experiences (CEE). The opportunity for students to be engaged in clinical practice allows for the integration of learned materials and the development of professional practice skills (PPS). PPS can be described as items (1-6) on the Clinical Performance Instrument (CPI) and include safety, professional behaviors, accountability, communication, cultural competence, and professional development. PPS can be facilitated, discussed, and simulated in the academic environment; however, it is the integration of these PPS that proliferates in the clinic.1,2 Participation in a student run pro bono (PB) clinic provides students early contextual exposure and ability to apply a variety of PPS.2,3 Studies have found that implementing learning experiences in a clinical setting enhances student readiness performance and increases positive outcomes for students involved in PB clinic during the first full time CEE.3,4 No studies have analyzed the impact on PPS comparing PB participation versus non pro-bono (NPB) participation for full time CEE across the entirety of the DPT academic program. Therefore, the purpose of this study was to compare the clinic performance of PB and NPB student participation during all full time CEE. We hypothesized that PB students would perform better on PPS as compared to non NPB students across all time points which would demonstrate that PB experiences provide a strong tailwind pushing the PB student PPS scores forward on all clinicals. Methods/Description: Students in the Marquette University Doctor of Physical Therapy program have an opportunity to participate in a student run PB clinic. To be eligible to participate, students must complete an application and interview process. Once selected, they are paired in teams of first, second, and third year DPT students working together while supervised by a licensed PT. First year students assist and perform subjective and objective components, while students in the second and third year examine, evaluate, and treat patients. The mentorship provided allows these students to participate in the evaluation and treatment of local uninsured patients. A retrospective analysis of student performance on the CPI for all CPI Professional Practice items (1-6) was conducted on the same cohort of students (PB = 10, NPB = 52) throughout the 3 year DPT curriculum. Mean scores for safety, professional behaviors, accountability, communication, cultural competence, and professional development performance was analyzed for PB and NPB students during all 4 required full-time CEE. Separate, paired t-tests were used to examine the differences in these scores between PB and NPB students. Significance level was set to 0.05. Results/Outcomes: Students that participated in the Pro-Bono Clinic scored significantly higher on the CPI Professional Practice items (1-6) upon completion of their first 4-week clinical (10.4 vs 8.9, p<0.0001). Performance was not significantly different at the remaining time points: second 10-week clinical (15.8 vs 15.8, p=0.49), third 9-week clinical (17.7 vs 17.8, p=0.26), and their fourth 9-week clinical (17.8 vs 18, p=.06). Conclusions/Relevance to the conference theme: These data suggest PB experience may provide an enhancement of PPS during initial CEE. The PB clinic introduces students to patients and the roles and responsibilities of patient care prior to their first CEE. These opportunities offer exposure to the clinical setting itself and can help promote professional socialization and enhance retention of learned materials.5 Early clinical and community engagement experiences have been recommended for active and meaningful early learning.6 Student participation in PB clinics have reported improved attitudes toward the community, cultural sensitivity, and critical thinking.7 Although our findings are supportive of the literature that participation in a PB clinic provides a tailwind to accelerate PPS scores in the first clinical, the effect is not continued into subsequent CEE and the PPS race evens out. Future studies will address the effects of PB experience on patient management skills through all full time CEE.