Four Year Evolution of a Pro Bono Clinic Integrated into a PT Curriculum
Background and Purpose: Pro bono clinics provide necessary services not be accessible to part of the population.1-2 As part of a PT educational program, pro bono clinics provide students increased community awareness and social responsibility, enhanced clinical decision-making, and real world learning not available in a classroom.3-5 Improved communication, professional behaviors and hands-on skills also result.4-5 PhysZOU is a free clinic embedded in the University of Missouri (MU) PT program curriculum. This case study provides patient visit data and analysis modifications made over 4 years.
Case Description: PhysZOU is a pro bono clinic for clients with limited/no funding. It’s staffed by PT students and faculty treating neurological, musculoskeletal and pediatric patients. It was imbedded in the curriculum fall 2013, a required activity linked to classes. Students participate every semester in groups of 2: 1 hr, 2x/wk in 4 week rotations = 16 hrs/ semester. They are graded pass/fail each rotation and provided feedback throughout.
Outcomes: Last 4 years: yearly visits offered: 2,064, 2,527, 2,303, 2,380; visits completed: 1,770, 2,060, 1,937, 2,066; visit rate: 86%, 81%, 84%, 88%. Modifications to the experience over the years: 1) added additional group every hour for each rotation; 2) patients can be prioritized by faculty based on referral and case information; 3) pairing 2nd or 3rd Year with a 1st Year all 6 semesters (occurred 2 of 6 semesters prior); 4) peers providing written feedback to partner at completion of rotation; 5) Student Directors’ role expanded: update physicians on client status, enter patient information in database and reminder calls to clients; 6) health psychology and social service provided starting fall 2017.
Discussion: Number of visits offered and completed increased due to additional groups every hour. The number of students each year increased from 44 to 60; the additional groups kept each at 2 students providing an ideal amount of direct patient contact. Visit rate and number of visits increased due to the additional groups combined with student director reminder calls to clients. Changing every group to students of different levels improved patient care with presence of an experienced student every session. Experienced students mentoring less practiced peers allows the advanced student to teach others while the novice has additional guidance. Required peer feedback provides a source of additional feedback to each student. Student Director new responsibilities improved communication with referral sources and allowed for better tracking of client information and outcomes. Prioritizing clients allows for acute patients to be seen in a timely manner. Health psychology and social services were identified as needs and referral for free care within the MU system has been established. These changes over the past 4 years have enhanced client services and student learning.