Impact of Doctor of Physical Therapy Student Participation in Pro Bono Clinic on Cultural Competence
Purpose: Cultural competence has become an essential and vital skill for physical therapists given an increasingly diversified population in society. The Commission on Accreditation in Physical Therapy Education (CAPTE) mandates that physical therapy education programs assess standards that embody cultural competency (refer to 7D8, 7D10) and pro bono service (7D13, 7D14). In addition, the American Physical Therapy Association (APTA) emphasizes the role of culturally competent care in the pursuit of best practice in physical therapy. To date, several educational models have been implemented to advance this effort including pro bono clinic. However, research is still lacking as to how culturally competent care may be best developed and assessed in physical therapy students. This research study sought to address this knowledge gap by examining the impact of participation in a pro bono physical therapy clinic on first-year students’ cultural competence.
Methods/Description: Forty-two first-year Doctor of Physical Therapy (DPT) students at the University [reference removed] participated in this survey research. Per curricular requirements, each student attended a faculty mentored clinical experience at a local pro bono physical therapy clinic for 3 individual sessions during a fall semester. No other formalized cultural competency training was provided during this time frame or leading up to this point in the curriculum. Participants consented and voluntarily completed an anonymous survey via Qualtrics™ using a unique identifier, both pre and post pro bono clinic experience. The survey was designed to measure the constructs of students’ attitudes, beliefs, and viewpoints (Part I) as well as their level of confidence/experience (Part II) with respect to cultural competence. The survey, developed by authors of this study, was validated by content experts prior to delivery. A survey link was emailed to students both pre and post completion of the required pro bono clinic participation (within 3 weeks prior to first experience and 3 weeks post final experience). Wilcoxon signed-rank test was performed to analyze within group pretest and posttest change. SPSS Version 24 was utilized for statistical analysis.
Results/Outcomes: Previous studies have established the effectiveness of student-run pro bono clinics regarding patient outcomes. This study sought to investigate outcomes related to student experiences and found that mean scores increased from pretest of 4.13 ± 0.55 to posttest of 4.22 ± 0.48 for Part I (5 = highest score) and from 7.34 ± 0.96 to 8.01 ± 0.79 for Part II (10 = highest score) of the survey questionnaire, respectively. There was no statistically significant change in the measure of Part I - positive attitudes and beliefs regarding cultural competency, whereas significant improvements were found in levels of confidence toward cultural competency - Part II (p = 0.018). Potential limitations of this study include a training effect of using the same tool both pre and post intervention, sample of convenience and other confounding variables in the curriculum during the same semester. In addition, although individual results remained confidential, there is likely a degree of student bias to answer positively, since pro bono clinic participation was a requirement of an enrolled course.
Conclusions/Relevance to the conference theme: The findings of this study show a positive impact from working with a diverse population on students’ attitudes and beliefs, and their self-perceived confidence toward cultural competence. Research on cultural competence in DPT education is emerging. To our best knowledge, previous studies have not specifically examined how participation in a pro bono clinic within a DPT curriculum may influence cultural competence in DPT students, particularly in first-year students and in a single semester. Pro bono clinic participation may be an effective and viable approach to developing and promoting a culturally competent future workforce and warrants further investigation. We recommend that future research explore a variety of settings and models of pro bono clinic participation’s impact on both cultural beliefs and confidence, as well as frequency of participation to explore ideal curricular saturation.