Pediatric Experiential Learning Dosing Impact on Dpt Students' Self-Efficacy, Clinical Reasoning, and Critical Thinking
Purpose/Hypothesis: Experts in the field of pediatric physical therapy (PT) have suggested that experiential learning (EL) activities that include student interaction with children be incorporated in the curriculum of Doctor of Physical Therapy (DPT) programs to promote student learning and mastery of the five essential core competencies of pediatric PT.1-2While pediatric EL activities are supported in the literature, the optimal structure for pediatric EL is not yet known.3-7Therefore, the purpose of this study was to explore the changes in clinical reasoning, self-efficacy, and critical thinking in groups of DPT students who completed a high (15 hours) or low (3 hours) dose of pediatric EL as a component of their semester-long pediatric courses.
Number of Subjects: Doctor of Physical Therapy students enrolled in semester-long pediatric courses at two universities (high dose group, n=58; low dose group, n=46) were recruited to participate in the study.
Materials and Methods: A pre-test post-test comparison group design was used to examine the change in students’ clinical reasoning, self-efficacy, and critical thinking following completion of the semester long courses that included differing amounts of pediatric EL. Students in both groups completed the Self-Assessment of Clinical Reflection and Reasoning (SACRR)8, Physical Therapy Self-Efficacy Scale (PTSE)9, and Health Science Reasoning Test (HSRT)10during the first and last weeks of the semester. A mixed analysis of variance was used to examine the ability of the SACRR, PTSE, and HSRT to measure changes that occurred in the three constructs over time in both student groups.
Results: Based on scores on the SACRR and PTSE, students in the high-dose group reported a significant increase (p= 0.000) over time in self-perceived clinical reasoning and self-efficacy. The change in both groups’ overall critical thinking abilities, measured by the HSRT, also significantly improved (p= .044) over time.
Conclusions: A semester-long pediatric course, prior to full-time clinical experiences, that includes a high-dose (15 hours) of pediatric EL aided in the development of DPT students’ self-perceived clinical reasoning and self-efficacy.Additional research is needed to determine the optimal dosing and timing of EL that promotes improved overall critical thinking skills of DPT students.
Clinical Relevance: This study provides insight into the structure of pediatric EL, specifically the timing and type of activities, which leads to positive changes in clinical reasoning, self-efficacy, and critical thinking of DPT students. Physical therapy educators can use this information to inform pediatric curricular development. A vitally important next step is to determine if the changes noted, based on self-assessments and standardized, multiple-choice tests, are clinically important changes that lead to measurable improvements in pediatric clinical practice.