CARE: An Institution’s Approach to Early Embedded Integrated Clinical Education


To introduce and explain the innovative implementation of early embedded integrated clinical education by one DPT program and to share the lessons learned during the first year.

Methods and/or Description of Project

Trine University’s DPT program in Fort Wayne Indiana has taken a novel approach to integrated clinical education in their CARE (Clinical Application Reflection Experience) course series. The CARE courses place students in local healthcare settings with preselected clinical instructors. These settings include outpatient, inpatient/acute and rehabilitation settings in the community of Fort Wayne. These courses utilize a 2 student: 1 clinical instructor clinical education model. During this series, students participate in patient care related activities 4-6 hours/every other week during the first five semesters of the program. This course runs concurrently with the didactic portion of the curriculum to enhance student learning.


Although this curriculum component is still in its infancy stages, already the qualitative benefits of the CARE course series has been perceived by numerous stakeholders. Students enjoy the opportunity to practice what they are learning in an authentic situation. Students also are able to appreciate the clinical relevance of their classroom learning as it applies to patient care. Faculty are able to create assignments that encourage students to apply new knowledge and psychomotor skills to genuine clinical situations. The director of clinical education is able to routinely evaluate students’ professional behaviors and turn less than desirable situations into excellent learning opportunities. The communication between the program and these healthcare settings including the clinical instructors, center coordinators of clinical education (CCCEs) and department supervisors, is enhanced which promotes a bidirectional partnership. This partnership benefits the clinical instructors by helping them to maintain the most current clinical expertise and provides clinical teaching guidance. In addition, it encourages volunteer opportunities for the students at these healthcare settings and promotes clinical placements for full-time clinical affiliations.

Conclusions/Relevance to the conference theme: Shaping the Future of Physical Therapy Education

Conclusions: Although early integrated clinical education experiences can pose some challenges in terms of faculty time, clinical commitments and financial resources, it has been the opinion of Trine University’s vested parties that the benefits far outweigh the obstacles. It has also been concluded that the greater the direct involvement of the program faculty the more enriched the experience is for all stakeholders. These courses give students the opportunity to engage in authentic learning experiences while being engaged in the didactical portion of the curriculum. This allows the students to actively and realistically apply what they are learning in the classroom to actual patient care.
Relevance: Integrated clinical education experiences have been cited as having significant positive impact on student learning and outcomes for numerous professions.1 Early exposure of students to clinical situations not completely addressed in the classroom has been identified as a means of promoting students’ problem solving skills and their ability to apply foundational principles to unusual scenarios.1 Furthermore, it has been proposed that early integrated clinical education can “facilitate the development of a strong and diverse entry-level practitioner”.1 This topic was further emphasized at the 2014 Clinical Education Summit of the American Council of Academic Physical Therapists (ACAPT) led to the recommendation that “all programs offer goal oriented, diverse active-learning experiences that are developed in collaboration with invested stakeholders and embedded within the didactic curriculum, prior to terminal experiences”.2
In response to convincing research and recurrent expert opinion supporting the educational value of early embedded integrated clinical education, Trine University’s DPT program designed an innovated curriculum with this type of clinical education as a core component. There were several intended goals of this curricular component: bridge the gap between theory and practice in professional education, help students to realize the importance of what they are learning and why they are learning it, allow for formal assessment of professional behaviors prior to students beginning full-time clinical placements, facilitate students' development of the metacognitive skills necessary to become expert clinicians, and encourage the clinical community’s involvement in the DPT program.


1) Hakim EW, Moffat M, Bell KA, Schmitt LA. Application of education theory and evidence in support of an integrated model of clinical education. J Phys Ther Educ. 2014; 28 (1):13-21.
2) American Council of Academic Physical Therapy (ACAPT) Clinical Education Summit. Summit Report and Recommendations. Kansas City, MO. October 12-13, 2014.

Course Objectives

1) Define early embedded integrated clinical education.
2) Identify the benefits of early embedded integrated clinical education curriculum.
3) Differentiate between the benefits and challenges of early embedded integrated clinical education.
4) Describe one model of early embedded integrated clinical education.
5) Formulate a potential plan for implementation of an early embedded integrated clinical education curriculum.

Instructional Methods

Lecture requiring audience participation using turning point technology and an opportunity for Q and A.

Tentative Outline/Schedule

5 minutes: Introductions/Objectives/Purpose
20 minutes: Background Information and Rationale why to implement an early embedded integrated clinical education program
30 minutes: Description of CARE course series
20 minutes: Results/Outcomes
5 minutes: Conclusions
10 minutes: Q & A

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  • Control #: 2290649
  • Type: Educational Session
  • Event/Year: ELC2015
  • Authors: Dr. Kimberly Beran-Shepler, Chris Rakoczy, Zach Beiswanger, Dr. Max Baumgartner
  • Keywords:

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