Clinical Instructor Perceptions of a Structured Dpt Clinical Affiliation Program in Orthopaedics
Purpose/Hypothesis: Clinical affiliation partners rarely offer structured educational experiences to accelerate specialty practice knowledge or clinical reasoning in Doctor of Physical Therapy (DPT) students. In 2016, a structured clinical affiliation education program was implemented within a single outpatient orthopaedic clinic. Preliminary outcome data suggested DPT students improve orthopaedic specialty practice knowledge and perceive the program to be beneficial for enhancing clinical reasoning. Understanding clinical instructor (CI) perceptions about benefits and barriers of a structured clinical affiliation education program has potential to inform and optimize implementation efforts. The purpose of this survey study was to assess CI perceptions on the benefits and barriers of clinical affiliation education program implemented within their clinic setting Number of Subjects: Seven APTA-credentialed CIs (mean ± SD years of CI experience = 14.6 ± 4.4; 2 (29%) APTA specialty-certified) whose DPT student interns completed the program Materials and Methods: CIs completed a written survey on their level of involvement with the program and facilitators, and perceptions of program helpfulness for improving student specialty knowledge, reasoning, and overall student benefit. Questions were answered using an 11-point rating scale with higher values indicating greater involvement, helpfulness, and benefit. Open-ended questions asked about important aspects of the program, barriers for involvement, and suggestions for better integration. Results: CIs perceived high levels of program helpfulness for improving student orthopaedic knowledge (mean ± SD = 8.4 ± 1.0) and clinical reasoning (mean ± SD = 8.6 ± 0.8), and for overall student benefit (mean ± SD = 8.3 ± 1.7). Specifically, CIs perceived an impact on clinical reasoning: “Clinical reasoning has been much improved” and from student skills training: “Hands-on skill labs is another component that is beneficial.” CIs expressed support for student involvement and declared few student barriers. CIs reported low level of involvement with the program (mean ± SD = 2.1 ± 3.2) and program facilitators (mean ± SD = 3.4 ± 3.4). Time and schedule conflicts were viewed as a barrier for CI involvement: “times at which these sessions take place are over my patient care time.” There was an awareness that integration of program content into clinical care could be improved: “all CIs need to be on the same page as what you are teaching and using the same clinical reasoning process.” Conclusions: CIs express support for DPT student involvement in a structured clinical affiliation education program. Because of barriers to CI participation, there is a need for improved clinical integration of educational components. Clinical Relevance: Offering a structured educational experience to DPT students within their clinical internships is feasible and may result in accelerated specialty practice knowledge, skills, and behaviors. Overcoming real-world challenges for CI engagement will be crucial for sustaining these efforts long-term.