The Influence of a First Clinical Education Experience on Students’ Perceptions Regarding Blood Pressure Assessment
Purpose/Hypothesis:: Health care providers utilize vital signs to make clinical decisions and gather information regarding patient health. All physical therapist (PT) professional education programs teach these skills. A strong relationship has been established between blood pressure (BP) and cardiovascular disease risk. To make sound clinical decisions, PTs must be aware of cardiovascular risks, take BP on patients and interpret readings. Current literature indicates a disparity between what students are taught in the classroom and what they see and practice in the clinic. The purpose of this study was to investigate students’ perceptions following a first clinical education experience regarding the importance of BP assessment. Number of Subjects: n=15 Materials and Methods: This study utilized qualitative methodology to explore the students’ experience assessing BP in clinical settings. A convenience sample of 15 second year Doctor of Physical Therapy students matriculated at an accredited PT professional education program were recruited. Four semi-structured focus groups of three to four students and two moderators were conducted via Zoom, an online meeting format, following participants’ first clinical education experience. Student accounts reflected experiences in various inpatient and outpatient settings. The authors developed an interview guide to facilitate discussion. Focus groups were audio recorded and transcribed by a third-party transcription service. Data was analyzed independently by two of the authors using constant comparison method. After the initial analysis, both researchers consulted and came to consensus on preliminary themes. A peer review was conducted by a third researcher to confirm the credibility of the initial findings. A member check was employed to further support the trustworthiness of the findings. Results: Three major themes emerged. The first theme was student agency; students felt an overall lack of agency to apply didactic skills in the clinic. Students expressed reluctance to independently initiate practices that differed from the usual practice of the clinic or clinical instructor. The second theme was influence of practice norms; availability of equipment and consistency of BP monitoring influenced the students’ perceived importance of assessing BP. The third theme was confidence and skill acquisition; in obtaining, assessing, and interpreting BP, more experience led to greater depth of insight and self-efficacy. Conversely, lack of experience led to decreased meaningful reflection. Conclusions: The clinical education experience has a strong influence on students’ perceptions of the importance of assessing BP. However, there are discrepancies between didactic education and clinical education. Clinical Relevance: Entry-level PTs need to be prepared to monitor patients and provide prevention and wellness services, including BP assessment and interpretation. Professional PT education programs need to reconcile differences between what is taught in the classroom and what is experienced in the clinic in order to promote safe practice.