A Novel Approach to Integrated Clinical Experiences: To the Clinic and Beyond
Purpose
Integrated Clinical Experiences (ICEs) in physical therapy education afford students the opportunity to apply knowledge in realistic learning environments. These experiences allow students to apply newly learned psychomotor skills on actual patients and to develop clinical decision making and interpersonal skills. Despite the known benefits of ICE experiences, part time placements can be difficult for academic institutions to secure due to the current challenges in healthcare, decreased capacity of local clinics, and increased curricular content demands. The purpose of this educational session is to describe a novel model for ICEs designed to develop students’ psychomotor/interpersonal skills and professional behavior.
Methods and/or Description of Project
Prior to entering the clinic for full time internships, it is imperative that Doctor of Physical Therapy (DPT) students demonstrate interpersonal skills and professional behaviors1. To maximize the benefits of ICEs, our institution has created an ICE model that includes 5 components aimed to develop not only clinical skills but opportunities for interpersonal and professional growth. We will review each of the model’s components which include: 1) Traditional part time clinic visits 2) Individualized Professional Practice Opportunities (PPO) 3) Intra- and Interprofessional Education Labs, 4) Student Advocacy Day, and 5) Mock Clinical Instructor Interactive Experience.
1. Traditional Clinical Visits: Each ICE course runs concurrently with the neuromuscular and musculoskeletal clinical courses for a duration of 15 weeks. Students complete clinic visits one day a week for 8 weeks. During the remainder weeks, students participate in a variety of professional learning experiences.
2. Professional Practice Opportunities: PPOs were created to provide students exposure, insight, and experience as a complement to direct patient care. There are a variety of structured faculty-lead PPOs that students can participate in, however students are also given the opportunity to create their own PPO experience. These opportunities provide students exposure to professional and community service that may not be experienced during traditional clinic visits.
3. Intra- and Interprofessional Collaborative Experiences: Mai et al. found there is a lack of education for Physical Therapists (PT) and Physical Therapy Assistants (PTA) on each other’s roles and preferred relationship2. During the first ICE block, there is an interactive lab with PTA students at a local PTA program to introduce the rules and regulations of the PT/PTA relationship. During the second ICE block, there is an allied health interprofessional lab, including OT, SLP, and audiology students from a neighboring university.
4. Student Advocacy Day: In order to promote political awareness into health policy issues, students are provided professional insight into how policy changes occur. Students participate each Spring in the Student Advocacy Day hosted by the state APTA chapter. Students are partnered with licensed clinicians and other DPT and PTA students to lobby to local legislators on policies that impact the practice of physical therapy.
5. Mock Clinical Instructor Interactive Experience: Local Clinical Instructors (CIs) volunteer to participate in a recorded role-playing activity where the students are provided controversial clinical scenarios. Students must work thru the scenario with the CI to determine how they would manage the simulated situation. In addition to feedback from the CI, students must also reflect on their recorded session. This opportunity allows students to opportunity to develop communication and interpersonal skills.
Results/Outcomes
The development of this ICE model has provided many benefits to students and the program including: enhancing interpersonal skills, understanding the importance of interprofessional education, defining the PT/PTA relationship in regards to state laws, and promoting lifelong learning and professional responsibility. Through these experiences, students are afforded opportunities in addition to traditional clinical education to prepare for full time internships. Data from course evaluations over the last 2 years demonstrates that over 90% of the students feel PPOs have improved their skill set in non-clinical care and broadened their perspective of the role of PTs in non-clinical interactions. Pre and post tests indicate that an average of 94% of students had an overall net positive level of understanding of working in an interprofessional rehabilitation team. Similarly, an average of 94% reported an increase in confidence with their communication skills after the mock CI experience.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
Consistent with the conference theme of Instructional Strategies for the Classroom and Clinic, we believe this novel model for ICEs demonstrates one method that has been effective at developing student psychomotor and interpersonal skills, as well as professional behavior. This ICE model has been a beneficial addition to the DPT curriculum and can be easily incorporated in to any DPT program. Modifications can be made based on community needs and institutional resources.
References
1. Mai J, Stern D, Hollman J, Melzer B, Thiele A, Rosenthal R. Examining the Impact of an Integrated Clinical Experience (ICE) on Interpersonal Skills Prior to the First, Full-Time Clinical Internship: Cool as ICE. Journal Of Physical Therapy Education [serial online]. September 2014;28(3):81-97. Available from: CINAHL with Full Text, Ipswich, MA.
2. Mathews H, Smith S, Hussey J, Plack M. Investigation of the preferred PT-PTA relationship in a 2:2 clinical education model. Journal Of Physical Therapy Education [serial online]. Fall 2010 2010;24(3):50-61. Available from: CINAHL with Full Text, Ipswich, MA.
3. World Health Organization. Learning together to work together for health. Report of a WHO Study Group on Multiprofessional Education of Health Personnel: A Team Approach. Geneva 1988.
4. Mai J, Thiele A, O'Dell B, Kruse B, Vaassen M, Priest A. Utilization of an Integrated Clinical Experience in a Physical Therapist Education Program. Journal Of Physical Therapy Education [serial online]. Spring2013 2013;27(2):25-32. Available from: CINAHL with Full Text, Ipswich, MA.
5. Jette D, Nelson L, Palaima M, Wetherbee E. How Do We Improve Quality in Clinical Education? Examination of Structures, Processes, and Outcomes. Journal Of Physical Therapy Education [serial online]. January 2, 2014;28(Supp 1):6-12. Available from: CINAHL with Full Text, Ipswich, MA.
6. Wruble Hakim E, Moffat M, Ciolek C, et al. Application of Educational Theory and Evidence in Support of an Integrated Model of Clinical Education. Journal Of Physical Therapy Education [serial online]. January 2, 2014;28(Supp 1):13-21. Available from: CINAHL with Full Text, Ipswich, MA.
7. Fernandes A, Palombella A, Salfi J, Wainman B. Dissecting through Barriers: A Mixed-Methods Study on the Effect of Interprofessional Education in a Dissection Course with Healthcare Professional Students. Anatomical Sciences Education [serial online]. July 1, 2015;8(4):305-316. Available from: ERIC, Ipswich, MA.
8. Francis-Coad J, Hill A. Discovering What Experiences Physical Therapist Students Identify as Learning Facilitators in Practical Laboratories. Journal Of Physical Therapy Education [serial online]. September 2014;28(3):42-49. Available from: CINAHL with Full Text, Ipswich, MA.
9. Jelley W, Larocque N, Patterson S. Intradisciplinary clinical education for physiotherapists and physiotherapist assistants: a pilot study. Physiotherapy Canada [serial online]. Winter2010 2010;62(1):75-80. Available from: CINAHL with Full Text, Ipswich, MA.
10. Olson R, Bialocerkowski A. Interprofessional education in allied health: a systematic review. Medical Education [serial online]. March 2014;48(3):236-246. Available from: CINAHL with Full Text, Ipswich, MA.
11. McNair R. The case for educating health care students in professionalism as the core content of interprofessional education. Medical Education [serial online]. May 2005;39(5):456-464. Available from: CINAHL with Full Text, Ipswich, MA.
12. Plack M, Williams S, Gilner G, et al. Collaboration between physical therapists and physical therapist assistants: fostering the development of the preferred relationship within a classroom setting. Journal Of Physical Therapy Education [serial online]. Spring2006 2006;20(1):3-13. Available from: CINAHL with Full Text, Ipswich, MA.
13. Reicherter E, McCombe Waller S. Professional Practice Opportunities: Preparing Students to Care for an Aging Population. Journal Of Physical Therapy Education [serial online]. May 2014;28(2):60-68. Available from: CINAHL with Full Text, Ipswich, MA.
14. Shoemaker M, Platko C, Cleghorn S, Booth A. Virtual patient care: an interprofessional education approach for physician assistant, physical therapy and occupational therapy students. Journal Of Interprofessional Care [serial online]. July 2014;28(4):365-367. Available from: CINAHL with Full Text, Ipswich, MA.
15. Stemmons Mercer V, Zimmerman M, Schrodt L, Palmer W, Samuels V. Interprofessional Education in a Rural Community-Based Falls Prevention Project: The CHAMP Experience. Journal Of Physical Therapy Education [serial online]. May 2014;28(2):35-45. Available from: CINAHL with Full Text, Ipswich, MA.
16. Sytsma T, Haller E, Lachman N, et al. Long-Term Effect of a Short Interprofessional Education Interaction between Medical and Physical Therapy Students. Anatomical Sciences Education [serial online]. July 1, 2015;8(4):317-323. Available from: ERIC, Ipswich, MA.
17. Wise H, Frost J, Resnik C, Davis B, Iglarsh Z. Interprofessional Education: An Exploration in Physical Therapist Education. Journal Of Physical Therapy Education [serial online]. May 2015;29(2):72-83. Available from: CINAHL with Full Text, Ipswich, MA.
18. Wise H, Yuen K. Effect of Community-based Service Learning on Professionalism in Student Physical Therapists. Journal Of Physical Therapy Education [serial online]. Spring2013 2013;27(2):58-647. Available from: CINAHL with Full Text, Ipswich, MA.
Course Objectives
At the end of this session, attendees will:
1. List key concepts and program goals related to clinical education which could benefit from multifaceted learning
2. Discuss challenges to ICE placements and strategize ways to augment clinical education
3. List creative ways to enhance interpersonal skills and prepare students for full time internships
Instructional Methods
Lecture with Question and Answers
Tentative Outline/Schedule
Challenges for Integrated Clinical Education Introduction of the Model - 15 mins
Professional Practice Opportunities - 15 mins
Student Advocacy Day - 15 mins
CI Interactive - 15 mins
Intra and Interprofessional Education Labs - 15 mins
Question and Answers - 15 mins