Self-Efficacy in Pediatric Physical Therapy Education: Considering Domain-Specific Experiential Learning
Purpose/Hypothesis: Pediatric content has been an accreditation standard for professional physical therapy (PT) programs since the early 1970s.1 Entry-level PTs are trained to treat patients across the lifespan.2 Essential competencies, curriculum components (didactic, lab, and experiential), and recommended hours are established to promote consistency across pediatric PT education.3–5 Despite guidelines for consistency, wide variability in curriculum components and hours exists.4 Few options exist for measuring outcomes to inform pediatric curricular enhancement.6,7 One possible measure is self-efficacy (SE). Perceived SE is individual belief in the ability to be successful in a behavior.8 SE is domain-specific, so efficacy beliefs in one area of clinical practice (e.g., orthopedics) is not related to efficacy beliefs in another area of clinical practice (e.g., pediatrics).9 Based on the idea that efficacy beliefs of students have the potential to enhance learning outcomes, researchers developed a measure of SE related to pediatric experiential learning opportunities.10 The Pediatric Communication and Handling Self-Efficacy Scale (PCHSES) is a domain-specific, self-report tool.10 Items relate to confidence in communication and direct handling of children and caregivers.10 There is evidence that gains in SE result after as few as 8 hours of community-based pediatric experiential learning.10 Given that SE is domain-specific, variability in PCHSES scores may be related to previous associated experiences. The purpose of this study is to quantify relationships between prior pediatric experience and pediatric-specific SE among DPT students. Number of Subjects: 48 students starting the second year of a DPT program Materials and Methods: DPT students completed the PCHSES and a survey about prior pediatric experiences. Average scores for communication skills, handling skills and overall SE were calculated from PCHSES responses. “Experience” included time spent with children ages 0-11 years, parents, and pediatric patients. Pearson correlation coefficients were calculated for (1) pediatric experience and average SE; (2) domain-specific experience (e.g., experience with nonverbal children) and associated PCHSES items (e.g., confidence in communicating with a child who is nonverbal), and (3) non-associated experience-SE pairs. Results: Statistically significant large correlations were found for pediatric experience and overall SE (r=0.618, p<0.001) and experience and associated SE (e.g., experience with nonverbal children vs SE with communicating with nonverbal child, r=0.707, p<0,01). Significant correlation was not found for non-associated experience-SE pairs. Conclusions: SE is related to domain-specific experience. The PCHSES appears to capture SE related to prior pediatric-domain experience. Pediatric PT curriculum could focus on domain-specific, experiential learning opportunities to promote confidence in entry-level communication and handling skills with a pediatric population. Clinical Relevance: These findings highlight that domain-specific experience appears to relate to learner confidence in that domain. This concept could be applied broadly across PT education.