Doctor of Physical Therapy Student Perceptions of a Pediatric Integrated Clinical Experience
Background and Purpose: Doctor of physical therapy (DPT) students have limited exposure working with children, and there are limited numbers of pediatric clinical education experiences within their programs. This leads to reduced exposure and comfort when working with children with gross motor deficits in a physical therapy (PT) setting. Specialized pediatric PT clinics do not exist in all geographic areas, so many children with gross motor deficits are seen in other clinics. Entry-level graduates should have exposure working with children and their families in order to provide high quality care across PT settings and with all patients. Providing opportunities for students to work with children within a PT curriculum has been shown to improve comfort, self-awareness, and skill.1,2,3. The purpose of this case report is to describe a student pediatric integrated clinical experience (SPICE) designed for all DPT students to enhance their pediatric PT knowledge, skill and application. Case Description: As part of the Pediatric PT course learning objectives at the University of Washington’s DPT program, an on-site SPICE opportunity was designed to give students more practice with providing hands-on pediatric PT evaluation and intervention under licensed PT clinical instructors (CI).4 Since its inception in 2013, each cohort of DPT students (n =48), divided into pairs or trios, had a total of 5 visits with a child with gross motor deficits (0-22 years old) and their family. Students completed a hypothesis-oriented preparation form prior to visits.5. Students in the past 2 years were surveyed three times (prior to SPICE, after 2 visits [PT exam and evaluation], and after SPICE) about their confidence levels working with children with gross motor deficits and performing a PT evaluation and interventions. Outcomes: When asked about their comfort in interacting with children with disabilities prior to their first SPICE visit, 63.3% of students reported positive feelings. After the 2nd and their final visit, the numbers rose to 80.9% and 90.5%, respectively. Similar increases were seen with questions about comfort with PT evaluation (21.1% initially, 67.0% after 2 visits, and 82.5% at the end) and intervention (36.7%, 57.4%, and 93.7%, respectively). Most students reported that SPICE, the preparation, hands-on learning, and feedback from an experienced CI contributed greatly to their learning. Discussion: Providing students with a SPICE opportunity is a feasible way to increase exposure to pediatric PT and leads to increased confidence working with children in a PT setting. There are several logistics and details to consider when creating a SPICE opportunity including child/family and CI recruitment & compensation, instructor & student time, clinic location, and equipment. This experience allows students to learn how to work with children as a PT, directly from pediatric CIs, in a safe and effective learning environment and complements the pediatric PT curriculum.