Welcome to the Real World: Integrated Clinical Experiences in the First Year of a Physical Therapy Program
To describe the development, implementation, and preliminary results of a novel integrated clinical experience model in the first year of a physical therapy program.
Defined by the American Council of Academic Physical Therapy (ACAPT) as “a clinical education experience that occurs during an academic term in a coordinated fashion concurrent with didactic courses,”  integrated clinical experiences (ICE) allow students to immediately translate concepts and skills learned in the classroom into the clinical environment. The University of [blinded] Medical Center has developed a unique ICE model wherein Doctor of Physical Therapy (DPT) students are divided into small groups, or societies, which are maintained throughout the duration of the curriculum. Within these societies, first year DPT students complete a total of 14 four-hour clinical experiences in inpatient and skilled nursing settings, concurrent with coursework applicable to these settings. This is complimented by a series of faculty-led seminar sessions designed to suffuse didactic content with clinical context. In addition to the application of basic technical skills, emphasis is placed on the development of professional behaviors, interpersonal and interprofessional communication, and teamwork.
Data regarding the nature and type of skills observed and performed in the clinical setting, student self-assessment of Professional Behaviors  and Core Values  at baseline, midpoint, and one year, and student evaluation of the program have been gathered from a total of 58 first year DPT students. Analysis of this data is in progress; however student self-assessments of Professional Behaviors reflect a transition from beginning level (rating of 2-3 out of 7) to developing level (rating of 3-5 out of 7) in each of 10 areas (Critical Thinking, Communication, Problem Solving, Interpersonal Skills, Responsibility, Professionalism, Use of Constructive Feedback, Use of Time and Resources, Stress Management, and Commitment to Learning). The largest improvements were observed in the areas of Commitment to Learning, Use of Constructive Feedback, Communication, and Professionalism, respectively. Problem behaviors  were identified in a total of four students. Student feedback was largely favorable and highlighted the direct translation of didactic learning to clinical application. Suggestions for improvement included requests to increase the number and frequency of ICE sessions and the amount of individualized feedback.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
In addition to bridging the didactic and clinical environments, implementation of ICE sessions and targeted seminars may enhance the development of professional behaviors and communication skills and aid in the identification of problem behaviors early in the DPT curriculum [5,6]. By maximizing academic and clinical resources, this and other integrated clinical models may help raise the bar for excellence in clinical education.
1. American Council of Academic Physical Therapy. AC-2-13: terminology for clinical education. http://www.acapt.org/images/AC-2-13_Terminology_for_Clincal_Education_PASSED.pdf. Published 2014. Accessed April 17, 2016.
2. May WW, Kontney, L, Iglarsh A. Professional behaviors for the 21st century. http://marquette.edu/physical-therapy/documents/ProfessionalBehaviors.pdf. Published 2010. Accessed April 17, 2016.
3. American Physical Therapy Association. Professionalism in physical therapy: core values. http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/BOD/Judicial/ProfessionalisminPT.pdf. Amended 2003. Accessed April 17, 2016.
4. Wolff-Burke, M. Clinical instructors’ descriptions of physical therapist student professional behaviors. J Phys Ther Educ. 2005;19(1):67-75.
5. Hakim EW, Moffat M, Becker E, et al. Application of educational theory and evidence in support of an integrated model of clinical education. J Phys Ther Educ. 2014; 28(1):13-21.
6. Weddle ML and Sellheim DO. Linking the classroom and the clinic: a model of integrated clinical education for first-year physical therapy students. J Phys Ther Educ. 2011;25(3):68-79.