Using SBAR and Video Assignments to Facilitate Communication and Clinical Reasoning in Physical Therapy Students
Background and Purpose: In a physical therapy (PT) education curriculum, teaching professional behaviors such as communication skills is achieved though coursework, role modeling, and clinical experiences. Clinical reasoning is a complex process integrating cognitive, psychomotor, and affective skills. The SBAR (Situation-Background-Assessment-Recommendation) technique was originally developed to maximize patient safety and provides a framework for communication between members of a health care team. The purpose of this case report is to describe the use of SBAR in self-recorded video assignments for 2nd year PT students and the perceived effect on professional communication and clinical reasoning. Case Description: Sixty-four 2nd year physical therapy students were enrolled in a musculoskeletal physical therapy course focused on the lower quarter. Three oral case presentations were required. For the first 2 cases, students were presented with a patient vignette which included comprehensive details from the history and exam. They were to assume they performed the exam without a Clinical Instructor (CI) in the room. Students had to prioritize data, prepare a summary using SBAR framework and video-capture their oral presentation of the summary with a time limit of 2-minutes; they were to assume the summary was being presented to a CI. The video was submitted for both peer assessment and a grade. The 3rd oral case was fashioned similarly; however, the student presentation was made face-to-face with an instructor as part of their lab practical exam. The following semester students completed their first 8-week internship. They were asked to complete a survey about the video case assignments immediately after the internship was finished. Outcomes: Forty-three students (67%) completed the survey, the majority of whom (82%) had just completed an outpatient clinic internship. The SBAR format was reported to have been used by 67% of the students to communicate with their CI or other healthcare professionals. Ninety-five percent of all respondents answered “yes” when asked if the oral case assignments were helpful in preparing for professional communication while 93% agreed that the assignments were helpful in developing their clinical reasoning skills. When asked about the number of times they recorded their video before submitting a file for each of the 2 assignments, most indicated ranges of 1-5 or 6-10 times with 5 students recording > 20 times. Discussion: This case report shows that an oral video assignment using the SBAR framework for a clinical case was perceived to be beneficial for professional communication and clinical reasoning by PT students during their clinical internships. Most students practiced multiple times before they actually submitted their videos which provided multiple opportunities for practice and self-assessment. Students also noted that having to prioritize the data from the patient vignettes helped to develop their clinical reasoning skills.