Hybrid and Traditional Instruction: A Controlled Comparison of Student Performance in a Clinical Skills Course
Purpose/Hypothesis: Advances in technology have created new opportunities for delivery of doctor of physical therapy (DPT) education beyond a traditional, on-campus model. An accredited DPT program adapted a traditional instructional model to include a hybrid online/on-campus delivery method of the same curriculum. Empirical analyses of hybrid delivery models are limited, particularly with respect to clinical courses that require acquisition and mastery of psychomotor skills. This report presents student performance in a clinical skills course delivered simultaneously through both models. Number of Subjects: Two consecutive graduate student cohorts enrolled in the first year of an accredited DPT program (2018-2019) Materials and Methods: Students participated in a four credit DPT introductory clinical course consistent with their enrollment in either the hybrid or traditional version of the curriculum. Student demographic characteristics were collected through the admissions process. Performance on written and practical skills exams were collected as part of the planned curriculum. Data was de-identified for statistical analysis. Performance from two consecutive cohorts will be compared for total exam score, cumulative written, and cumulative practical exams using parametric statistics with bonferroni adjustment to account for multiple comparisons. Results: Results for the first of two cohorts (n=144) are reported here. Forty six students enrolled in the hybrid model (48% female; 20% underrepresented minority; mean age 26.7±4.3 years; 37% live driving distance to campus); 98 in the traditional model (64% female; 12.1% underrepresented minority; mean age 25.0±3.0 years; 100% live driving distance to campus). There were no significant differences in overall exam performance or written exam performance. For example, overall exam scores were, hybrid mean(SD)=84.8%(±5.3), range=73.2-94.0%; traditional mean=86.6%(±5.1), range=71.0-96.3%. However, there was a small but statistically significant difference in cumulative practical exam scores (hybrid: 86.4%(±5.4), residential, 89.0%(±4.6); p<0.05). Instructional delivery explained 5.6% (r2=0.05) of the variance in practical exam scores. Conclusions: Overall student performance was equivalent between hybrid and traditional delivery of an introductory clinical skills course. A small difference in practical exam performance, while not substantially explained by delivery model, supports ongoing innovation for optimizing physical skills acquisition in the hybrid model. Clinical Relevance: Physical therapist educators have a responsibility to critically and empirically assess the effectiveness of education delivery models, both new and traditional. This study provides a rare opportunity to advance educational science through a controlled comparison of simultaneous delivery of a clinical skills course using hybrid and traditional models. The overall equivalency of the early results suggests that the hybrid delivery model has promise as a valuable contribution to the landscape of educational options for students.