PATTERNS OF PHYSICAL THERAPY STUDENT BEHAVIORS DURING A FIRST STANDARDIZED PATIENT EXPERIENCE
Purpose
Students in physical therapy education programs (PTEPs) are required to participate in full-time clinical experiences (FTEs). While on these clinical experiences, students are expected to demonstrate proficient clinical and behavioral skills, while under the supervision of clinical instructors. To date, PTEPs do not have standardized times when students are placed on these experiences, nor are there established methods of assessing students’ readiness to participate in FTEs.1 As part of the preparation for students to participate in FTEs, some PTEPs are employing standardized patients (SPs) to simulate clinical situations, at which time students must demonstrate a combination of affective, cognitive and psychomotor skills that are commonly required in clinical settings. 2,3,4 The purpose of this retrospective study is to determine if novice students demonstrated common patterns of inappropriate clinical behaviors when they were presented with a simulated clinical situation.
Methods/Description
This simulated experience occurred during the students’ first graduate year of a physical therapy program, as part of an introductory course in clinical decision making. This study included analysis of 21 groups of 3-4 students enrolled in the course. Groups of students were presented with a clinical situation in which a SP presented with a postoperative hip replacement in a sub-acute setting. The SP had a comorbid pathologies of emphysema, and a post-surgical aspiration pneumonia that had required intubation. Students had to conduct an initial examination and instruct the SP in basic mobility, including ambulation with an appropriate assistive device. Students were videotaped during the entire clinical situation. Faculty members individually reviewed students’ performance during the videos and recorded inappropriate clinical behaviors that occurred during the simulated experience. Faculty members then discussed their findings and common themes were identified.
Results/Outcomes
Preliminary results suggest novice students present with common patterns of inappropriate clinical behaviors within five categories: 1) Communication 2) Sequencing of examination procedures 3) Accuracy, adaptation and analysis of examination 4) Safety and 5) Patient education.
Conclusions/Relevance to the conference theme: Shaping the Future of Physical Therapy Education
This data will help to inform PT educators about the educational needs of students at introductory levels. This may allow for curricular refinements resulting in an enhanced level of student preparation for full-time clinical experiences. The data will also be used to refine an existing departmental rubric used to assess students’ performance in ICVs and simulated experiences, allowing for more precise assessments of readiness for FTEs.
References
1. Jette E, Nelson L, Palaima M, Wetherbee E. How Do We Improve Quality in Clinical Education?
Examination of Structures, Processes, and Outcomes. J of Phys Ther Educ. 2014; 28(Supp 1):6-12.
2.Paparell-Pitzel S, Edmond S, DeCaro C. The use of standardized patients in physical therapy education programs. J Phys Ther Educ. 2009;23(2):15-23.
3. Yan J, Gilbert J, & Hoffman S J. World Health Organization Study Group on Interprofessional Education and Collaborative Practice. J of Interprofessional Care. 2007; 21: 588-589.
4.Ladyshewsky R, Baker R, Jones M, Nelson L. Evaluating clinical performance in physical therapy with simulated patients. J Phys Ther Educ. 2000;14(1):31-37.