Promoting Safe Student Performance in Physical Therapy Education
Purpose
Physical therapy educators have a responsibility to graduate entry-level physical therapists who can provide high quality care through safe and effective examination and intervention techniques. Early identification of students with safety deficits is important because harm to patients, self or others may otherwise occur.1, 2 Successful safety remediation should prepare students for the complexities of patient management as they progress towards entry-level performance.3, 4 The purpose of this retrospective study was to determine if those students who demonstrated safety concerns on campus have different midterm safety behaviors on longer clinical education experiences than those students who did not show safety concerns on campus.
Methods/Description
Forty-six DPT students were categorized into two groups based on their safety performance in their first winter quarter lab courses which focused on patient examination and intervention techniques: (1) students who were not safe on campus and had successful safety remediation (n=17) and (2) students who were safe on campus (n=29). For the 10-week clinical education experiences (Practicum 2, 3, and 4), students and clinical instructors (CIs) completed 18 performance criteria on the PT Clinical Performance Instrument (CPI): Version 2006.5, 6 The CPI is a 21 point scale ranging from 1 = Beginning Performance to 21 = Beyond Entry-Level Performance.
Results/Outcomes
Preliminary Analyses: Chi-square and independent t-tests revealed no significant safety group differences for gender, overall GPA at preadmission interview, science GPA at preadmission interview, and age at program matriculation (ps >.05).
Main Analyses: Separate mixed model ANOVAs revealed that neither student self-assessment nor CI midterm CPI safety scores were significantly different between safety groups for Practicum 2, 3, and 4 (ps >.05). For both student self-assessment and CI midterm CPI safety scores, Practicum 2 was significantly lower than Practicum 3, Practicum 3 was significantly lower than Practicum 4, and Practicum 2 was significantly lower than Practicum 4 (ps<.05).
Subsidiary Analyses: Separate two-way factorial ANOVAs revealed that Practicum 2 student self-assessment midterm CPI safety scores were significantly higher in the outpatient setting (11.48 ±2.09) than the inpatient setting (9.55±1.85) (p<.05). Students who were not safe on campus had significantly lower, although acceptable, Practicum 4 CI midterm CPI safety scores in the pediatric setting (13.00±2.00) than students who were safe on campus (16.71± 2.14) (p<.05).
Conclusions/Relevance to the conference theme: Shaping the Future of Physical Therapy Education
Early identification and formal remediation of safety concerns on campus can lead to successful clinical education experiences. Type of clinical setting may influence student and CI safety expectations in the areas of patient examination and intervention techniques, equipment, and patient response to treatment. All students who remediated early safety concerns on campus passed the National Physical Therapy Examination on their first attempt.
References
1. Darragh AR, Campo M, King P. Work-related activities associated with injury in occupational and physical therapists. Work. 2012;42(3):373-384.
2. Kneafsey R, Ramsay J, Edwards H, Callaghan H. An exploration of undergraduate nursing and physiotherapy students' views regarding education for patient handling. J Clin Nurs. Dec 2012;21(23-24):3493-3503.
3. Hauer KE, Ciccone A, Henzel TR, et al. Remediation of the deficiencies of physicians across the continuum from medical school to practice: a thematic review of the literature. Acad Med. Dec 2009;84(12):1822-1832.
4. Luhanga F, Yonge O, Myrick F. Precepting an unsafe student: the role of the faculty. Nurse Educ Today. Feb 2008;28(2):227-231.
5. PT CPI Web: Physical Therapist Clinical Performance Instrument. https://cpi2.amsapps.com/. Accessed November 1, 2014.
6. Roach KE, Frost JS, Francis NJ, Giles S, Nordrum JT, Delitto A. Validation of the Revised Physical Therapist Clinical Performance Instrument (PT CPI): Version 2006. Phys Ther. Mar 2012;92(3):416-428.