Does the addition of a two week academic module providing practice in patient examination better prepare students for a first full time clinical experience?
Purpose
Physical therapist education programs strive to prepare students for clinical experiences. Some research addresses educational methods to develop and practice clinical skills including the use of standardized patient (SP) experiences. Limited literature however addresses the effect of specific academic educational methods on student preparation for, and performance during the clinical experience. The purpose of this mixed method study was to examine the effect on student performance in the first clinical experience following the addition of a two week academic module with multiple patient examination experiences.
Methods/Description
A 2-week module added immediately prior to the first full-time clinical experience included 2 SP experiences and laboratory sessions emphasizing observation of function to drive examination. Qualitative data on student feedback were collected at completion of the new module. For comparison quantitative data were collected for 3 cohorts of students using the 1-21 point scale Clinical Performance Instrument (CPI) Version 2006 after the first four weeks in the clinic. Cohort #1 (n = 54) were enrolled before the addition of the module and cohort #2 and #3 (n = 54 and 55) after the addition of the module. Data were analyzed retrospectively. Kruskall-Wallis ANOVA was used to examine differences between classes.
Results/Outcomes
Scores on 14 out of the 18 CPI clinical performance criteria were statistically different. Post hoc analysis revealed no difference between the two classes receiving the module. Results for the four criteria most related to the goals of the module are reported as cohort, median (first quartile, third quartile). Clinical reasoning: cohort #1, 6 (4,8), cohort #2, 9 (6,10.75), cohort #3, 9 (6,10.5) p=0.001; Screening: cohort #1, 5.5 (4,8), cohort #2, 7 (5,10), cohort #3, 8 (5,11) p=0.016; Examination: cohort #1, 6 (4,8.75), cohort #2, 9 (6,11), cohort #3, 8 (6,10) p=0.001; Evaluation: cohort #1, 6 (4,9), cohort #2, 8.5 (6,11), cohort #3, 8 (6,10.5) p=0.009. Content analysis of open-ended student surveys indicated the experience was valuable, helped organize examination plans, and improved confidence in preparation for the first clinical experience.
Conclusions/Relevance to the conference theme: Shaping the Future of Physical Therapy Education
Providing academic experiences specifically designed to focus on application and synthesis of the examination process may improve early clinical performance as measured by the CPI. Using similar methods to prepare students may enhance student organization and confidence prior to clinical experiences and be a method to evaluate student clinical readiness. These findings are consistent with active learning principles that bridge the academic and clinical curricula. Based on the findings of this study academic programs may want to consider the addition of similar educational methods to optimally prepare students for early clinical experiences.
References
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Costello, E, Plack, M, Maring, J. Validating a Standardized Patient Assessment Tool Using Published Professional Standards. Journal of Physical Therapy Education. 2011;25:30-45.
Giesbrecht EM, Wener PF, Pereira GM. A mixed methods study of student perceptions of using standardized patients for learning and evaluation. Adv Med Educ Pract. 2014;12:241-255.
LaRochelle JS, Dong T , Durning SJ. Preclerkship assessment of clinical skills and clinical reasoning: the longitudinal impact on student performance. Mil Med. 2015;180(4 suppl):43-46.
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. 2012;92:416-428.