Determining Clinical Experience Readiness of First Rotation Dpt Students Based upon Current Practicing Clinical Instructors
Purpose/Hypothesis:
Currently in the United States, there is a standard of grading and site management of clinical experiences, but little research on the standardization of education sequencing among physical therapy (PT) programs. This study was designed to explore Doctor of Physical Therapy (DPT) students clinical readiness for first-rotation using the expectations of current practicing clinical instructors (CIs). The researchers’ hypothesized, that a different skill set was expected of a first-rotation DPT students for each setting inpatient/subacute (IP) and outpatient (OP).
Number of Subjects:
A total of 80 IP and OP CIs, with a range of 37 years of experience and 99 student experiences, surveys were collected. The population studied consisted of current practicing CIs for DPT programs. Inclusion criteria consisted of being a licensed PT and has been a clinical instructor for a entry-level PT student in either New Jersey or New York.
Materials and Methods:
Participants completed an 18-question 5-point Likert scale survey to determine the minimum required skills per setting of a first-rotation DPT student. The creation of this study was reviewed and accepted by the IRB instated at Dominican College of Blauvelt. Its contents were inspired by the American Physical Therapy Association's "Minimum Required Skills for an Entry-level Physical Therapist” and the definition set by CPI of "Beginner Performance" level. The survey was dispersed manually and online; utilizing snowball sampling to reach desired population. The paper copy surveys were handed directly to CIs and were contained in an unidentifiable folder to deter biased responses. The online survey utilized a computer program called "Survey Monkey”. Statistical analysis was assessed using completed surveys and Statistical Package of the Social Sciences version 24 (SPSS 24). An independent t-test was completed between IP and OP data with alpha set equal to 0.05 for statistical significance.
Results:
The study found, IP CIs rated the following skill of higher importance as compared to OP knowledge and examination of cardiovascular and pulmonary systems (p=0.021). OP setting rated the following skills of higher importance, as compared to their IP counterparts, selection of outcome measures for levels of impairment (p= 0.005), knowledge of appropriate manual therapies (p = 0.041) and use of modalities ( p= 0.035). No significant statistical difference were found between IP and OP settings within the survey, suggesting CIs may have similar expectations of those skills from DPT students.
Conclusions:
This study highlighted valued skill expectations between IP and OP CIs suggesting a need for standardized sequencing to prepare DPT students for first clinical affiliations. According to the data, IP CIs expect a DPT student to possess examination skills of cardiovascular and pulmonary systems, including but not limited to heart rate, respiratory rate and blood pressure. OP CIs expect a DPT student to possess the skills of: manual therapy skills, knowledge of appropriate modalities and selection of outcome measures based on level of impairment. Skills sets that lacked statistical difference suggest CIs of both setting may have common expectations for first clinical experience DPT students. These skills may be necessary prior to first clinical rotation. This may lead to the future standardization of clinical education, and clinical experience assessment that future PT students are expected prior to entering to an IP or OP setting.
Clinical Relevance:
PT educators may consider the skills deemed necessary for first clinical rotation success by CIs when placining future DPT students. Future studies may expand on this study to establish a standard of skills per clinical affiliation, as objective tools of measurement in future student first clinical experiences. As well as investigate, potential differences between first and later staged clinical experiences.