Does Participating in a Student-Run Free Clinic Prior to Clinical Rotations Improve First Rotation Performance?
Purpose: UT Health San Antonio Doctor of Physical Therapy (DPT) students have been providing pro bono physical therapy (PT) services to patients at two student-run free clinics (SRFCs) in San Antonio since 2016. Alpha Home, a shelter for women recovering from substance abuse, and Haven for Hope which is the largest homeless shelter in South Texas have allowed students to enrich their educational curriculum with real-life patient care. SRFCs have reciprocal benefits by providing the opportunity for students to practice their clinical skills prior to going out on clinical rotations and benefiting underserved populations who otherwise might not have access to PT services. Anecdotal feedback from students who participated indicated that the SRFCs were a beneficial activity to prepare for their first clinical rotation. The purpose of our investigation was to determine if the students who participated in the SRFC prior to their first clinical rotation had better clinical competence than the students who did not. Our hypothesis stated that students who did participate in Haven for Hope or Alpha Home SRFCs will receive a score of 7.6 or higher on their visual analog scale (VAS) rating of their overall clinical performance at the conclusion of their first clinical rotation. Methods/Description: 39 DPT students in the class of 2018 were evaluated: 28 of these students participated in a SRFC prior to their first clinical rotation (experimental) and 11 students did not (control). Participation in SRFCs was voluntary and took place during the 2nd year of the DPT program prior to the first clinical rotation, which started at the beginning of the 3rd year. All 39 DPT students were evaluated by their clinical instructor at the end of their first 10-week clinical rotation, which includes a global rating on a visual analog scale (VAS). The VAS score was documented by placing a hash mark on a 10 cm line to rate their overall level of performance on the first clinical rotation. A consensus of six clinical instructors and DPT faculty determined that a score above 7.5 was determined as a “good” rating for a student in their first clinical rotation. A “good” rating references that the student is currently at the level of an above average practitioner. A binomial distribution test was used to calculate the likelihood of students scoring above 7.5 on their first clinical rotation. Results/Outcomes: The binomial distribution results for a VAS score of 7.6 or higher was 0.027 for the students that did not participate in a SRFC and 0.219 for the students who did participate in a SRFC. This translates to a 2.7% chance that a student will score above 7.5 on their first clinical rotation if they did not go to a SRFC and a 21.9% chance of scoring above 7.5 if they did go to a SRFC. Conclusions/Relevance to the conference theme: Participating in SRFCs prior to beginning the clinical phase of DPT education allows students to practice basic patient care examination and treatment skills on real subjects. We hypothesized that the confidence gained by participating in SRFCs would translate into improved performance on the first clinical rotation. Overall, these results reject the null hypothesis that students who participated in a SRFC will receive above a 7.5 on their VAS rating; however, it does confirm that students who do not participate are less likely to get above a 7.5 rating than those who did participate in a SRFC. SRFCs offer many valuable benefits ranging from providing pro bono services to underserved patients, improving DPT students' self-efficacy with clinical skills, and providing students opportunities to interact with patients that they may not otherwise encounter in their traditional educational curriculum. The UT Health DPT program will continue to evaluate these results in our curriculum reviews as decisions are made about whether to mandate participation in SRFCs for all students to strengthen performance on their first clinical rotations.