This educational case report describes an innovative interdisciplinary healthcare model developed between a DPT program and a regional hospital’s nursing department. The Early Mobility Program (EMP) is designed to assist nursing with patient mobility needs while at the same time providing DPT students with an early, experiential learning opportunity in an acute care setting during their first year.
Need. Early experiential learning is a form of practice-based education that provides opportunities for students to initiate the work, roles, and identities that their profession requires of them. Current clinical education models are struggling under current healthcare system constraints to provide early clinical experiences. Consequently, educators are faced with the challenge and opportunity for developing new models of early clinical experiences. Rather than burdening an already burdened healthcare system, strategies can be developed that support these systems while at the same time supporting clinical education needs. Essentially, partnerships between healthcare educators and healthcare providers can afford solutions to obstacles faced by both through accessing the resources of each entity.
Concept: Place first year DPT students in a hospital setting with clinical faculty for two days per week (4 hours total) to mobilize patients in interface with the hospital services of Nursing and Physical Therapy. Concomitantly, the students will practice and refine their psychomotor and professional behaviors, perceptions, attitudes, and knowledge base.
Program development: An Early Mobility Program proposal was submitted to Brenau University and NGHS nursing administrations, and approved. An interdisciplinary Early Mobility Task Force consisting of members from both organizations was constructed to further develop the concept and implementation of the program, as well as provide program oversight during the implementation phase.
Program implementation: First semester DPT students were trained in professional behaviors and basic mobility techniques in Basic Skills I. In the second semester they were assigned to an early mobility team consisting of 3-4 students, a PT supervisor, and patient nurse(s). Two patient floors were covered by three teams, twice daily.
Outcomes will include a tally of services rendered, evaluation of student performance, student evaluations of the experience, and student, nursing, and PT supervisor perceptions through focus group interviews.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
The Early Mobility Program serves as a pilot collaboration model between acute care nursing and a DPT program. The program is aimed at partnering trained DPT students and adjunct faculty with nursing staff for the purpose of safely mobilizing select patients while providing an exceptional experiential learning environment for the DPT student.
1. Graf C. Functional decline in hospitalized older adults. American Journal of Nursing. 2006; 106(1):58-67.
2. Landi F, Bernabei R, Russo A, Zuccalà G, Onder G, Carosella L, Cesari M, Cocchi A. Journal American Geriatric Society. 2002 Apr;50(4):679-84.
3. Hastings SN, Sloane R, Morey MC, Pavon JM, Hoenig H. Assisted early mobility for hospitalized older veterans: preliminary data from the STRIDE program. J Am Geriatric Society. 2014; 62(11):2180-2184.
4. Padula CA, Hughes C, Baumhover L. Impact of a nurse-driven mobility protocol on functionaldecline in hospitalized older adults. J Nurs Care Qual. 2009; 24:325–331.
5. So C and Pierluissi E. Attitudes and expectations regarding exercise in the hospital of hospitalized older adults: a qualitative study. Journal Americal Geriatric Society. 2012; 60(4):713-718.
6. Hakim EW, Moffat M, Becker E, Schmitt LA, and Ciolek C. Application of educational theory and evidence in support of an integrated model of clinical education. Journal of Physical Therapy Education. 2014; Vol 28, Supplement 1.
7. Darrah J, Loomis J, Manns P, Norton B, and May L. Role of conceptual models in physical therapy curriculum: application of an integrated model of theory, research, and clinical practice. Physiotherapy Theory and Practice. 2006; 22(5):239-250.
8. Gwyer J, Odom c, Gandy J. History of clinical education in the United States. Journal of Physical Therapy Education. Winter. 2003; 17(3).
9. Ladyshewsky RK. Enhancing service productivity in acute care inpatient settings using a collaborative education model. Physical Therapy. 1996. 75:503-510.
10. Ladyshewsky RK, Barrie SC, and Drake VM. A comparison of productivity and learning outcomes in individual and cooperative physical therapy clinical education models. Physical Therapy. 1998. 78:1288-1298.
11. DeClute J and Ladyshewsky R. Enhancing clinical competence using a collaborative clinical education model. Physical Therapy. 1993; 73:683-689.
12. Stern D and Rone-Adams S. An alternative model for fist level clinical education experiences in physical therapy. The Internet Journal of Allied Health Sciences and Practice. 2006; 4(3).
13. Weddle ML and Sellheim DO. Linking the classroom and the clinic: a model of integrated clinical education for first-year physical therapist students. Journal of Physical Therapy Education. 2011; 25(3).
14. Strohschein J, Hagler P, and May L. Assessing the need for change in clinical education practices. Physical Therapy. 2002. 82:160-172
15. Kolb DA, Boyatzis RE, and Mainemelis C. Experiential learning theory: previous research and new directions. In: RJ Sternberg and LF Zhang (eds), Perspectives on cognitive, learning, and thinking styles. NJ: Lawrence Erlbaum, 2000.
16. Kolb AY and Kolb DA. Learning styles and learning spaces: enhancing experiential learning in higher education. Academy of Management Learning & Education. 2005; 4(2).
17. Yardley S, Teunissen PW, and Dornan T. Experiential learning: AMEE Guide no. 63. Medical Teacher. 2012;34:3102-e115.
18. Applebaum D, Portney LG, Kolosky L, McSorley O, Olimpio, D, Pelletier, D, and Zupkus. Building physical therapist education networks. Journal of Physical Therapy Education. 2014; Vol 28, Supplement 1.
19. Stevens DP, Leach DC, Warden GL Cherniak NS. A strategy for coping with change: an affiliation between a medical school and a managed care health system. Academic Medicine. 1996; 71:133-137.
20. Mumford DB. Clinical academies: innovative school-health services partnerships to deliver clinical education. Academic Medicine. 2007;82:435-44
21. Hammick M, Olckers L, Campion-Smith. Learning in interprofessional teams: AMEE Guide no 38. Medical Teacher. 2009;31(1).
22. Howe A, Dagley V, Hopayian K, Lillicrap M. Patient contact in the first year of basic medical training-feasible, educational, acceptable? Medical Teacher. 2007;29(2-3):237-245.
23. Mai JA, 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. 2013;27(2):25-30.
24. Wainwright SF, Shpard KF, Harman LB, Stephens J. Factors that influence the clinical decision making of novice and experienced physical therapists. Physical Therapy. 2011;91:87-101.