Quality Assurance in the Implicit Curricula: The Ties that Bind Clinical Readiness
Health profession education programs must ensure that all students reach a minimum level of clinical competency before full-time internships. Research has shown GPA alone is an inadequate benchmark in predicting success in internships. Students should be provided clear expectations for performance and held accountable to meeting benchmarks throughout their professional education. Professional behavior is commonly an implicit expectation, not consistently measured and students provided explicit, formative feedback during the didactic portion of their program.
Donabedian theoretical framework of quality assurance was applied to our educational approach for assessment of student clinical competency. This model is integrated across the curriculum, using formative and summative assessments. Each component of the model has an integral assessment process, reflecting cognitive, psychomotor and affective domains. Overlapping processes of integrated clinical experiences, cumulative, integrated practical examinations and professional behavior reporting is used to identify students at-risk prior to internship initiation. Faculty provides identified students with explicit, formative remediation each semester. This feedback becomes integrated into a personalized remediation plan. Cumulative student data from the domains and remediation process becomes important in determining internship placement.
This model provides the framework to look at student readiness from multiple domains. Practical examinations, integrated clinicals and professional behavior reporting integrate to make explicit the otherwise covert aspects of professional education. Surveys of core academic program faculty, adjunct ICE faculty and standardized patient practitioners demonstrate importance and effectiveness of this assessment. Core faculty appreciate having objective feedback on student performance that can be used to structure advising sessions. Clinical education faculty value this feedback as an important piece of matching students to internship placements. Students have displayed anxiousness about aspects of the processes, but in later reflection also relate value in these processes regarding their professional development and clinic-readiness.
Conclusions/Relevance to the conference theme: Shaping the Future of Physical Therapy Education
Health professions education programs strive to ensure student clinical competency, while meeting institutional demands and accreditation criteria. Maintaining a strong clinical education network can be challenging, as clinical sites becomes more competitive; students must be ready to assume the multi-faceted role of fledgling clinician at commencement of internships. Clinical competency assessment should be multi-faceted, incorporating didactic knowledge, psychomotor skills, professional behavior, and communication. This model provides a framework to assure stakeholders that students have been effectively assessed and are ready for their first full time internship.
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