Leveraging a Student Run Free Clinic, Translating Evidence into Practice
Purpose: Translating evidence into rehabilitative practice is challenging and takes on average 17 years.1 There are many reasons cited for this “lag” including lack of time, lack of research skills, decreased access to current literature, conflicting and poor-quality evidence, and lack of a learning environment.2-7 Jensen et al, recommend that DPT curricula include “early authentic clinical experiences”, as these experiences offer essential evidence based, explicit, learning opportunities.8 Student run free clinics are becoming more prevalent in health professions with over 100 nationally.9 These pro bono clinics offer students early access to patients allowing for integrated, authentic learning experiences that help them gain proficiency in clinical skills and cultural competency.9 Student-led clinics also provide educators with the opportunity to embed assignments and facilitate learning in an authentic environment. The purpose of this report is to introduce a method to facilitate and practice evidence translation in a DPT curriculum by leveraging a student run free clinic as a means to provide an authentic learning experience.
Description: 64 DPT students enrolled in neuromuscular course work at the Medical University of South Carolina were assigned a patient and scheduled to treat the patient in the Neuromuscular student run free clinic (SRFC) The night before the scheduled visit, the students were required to do a thorough chart review and identify the patients’ impairments using an worksheet based on the international classification (ICF) model. 30 minutes prior to the visit, the students were tasked with identifying the patient’s primary impairment limiting function and searching the evidence to find the best evidence-based intervention applicable to their patient to address that impairment. The students reported their treatment plan to the primary instructor, which included the evidence-based intervention they planned to integrate into the session. During the patient interaction they executed their plan, making modifications as needed under the supervision of a volunteer clinician. The final component of the assignment included a reflection on the effectiveness of the treatment implemented and another evidence-based intervention that may have been more effective. The participating students were surveyed on their last clinical rotation with a 75% response rate. 98% of respondents indicated that the assignment in the SRFC made them more confident translating evidence into care while on their clinical rotations, 93% stated they went to the evidence regularly during their clinical rotations, and 75% stated that they used best evidence when designing their patient intervention for their capstone case study.
Summary of Use: Translating evidence into practice is a challenge for new clinicians and students. Educators often use journal reviews and paper case studies to get students to access and critique the evidence. Prevalence of student run free clinics is increasing in DPT programs. Leveraging the clinic as a means to get authentic learning experiences, and in this case, practicing translating evidence was very successful. The assignment can be easily modified and incorporated into any integrated learning activity and is useful for practicing evidence translation.
Importance to Members: This education model was effective and provided an authentic and valuable learning experience to the DPT students. The students found it a valuable learning experience and it increased their confidence once in the clinic setting.