Skating on thin ICE: Clinical performance of students with minimal ICE prior to terminal clinical internships


Many programs have begun to “flip the classroom,” but our university has flipped the entire curriculum in order to meet the needs of working, non-traditional students. A huge challenge in the hybrid program was how to create integrated clinical experiences (ICE) for working students who live across the US. Could our students be successful in internships without significant ICE experiences? Could alternative strategies such as patient experiences (PE) inside the classroom prepare students for internships and ultimately clinical practice?

The purpose of this platform presentation is to: 1) describe an alternative model of ICE to accommodate our non-traditional students, and 2) provide outcome data from 2 student cohorts who experienced this alternative model.


Model: Our students’ clinical experiences prior to terminal internships were primarily “in house.” Volunteer patients were brought into the classroom, where students practiced their clinical and professional skills under direct supervision of faculty and lab assistants as clinical instructors. Students were also sent out to various settings for ½ or full day experiences. In total, students had combined on-site and off-site patient experiences ranging from 2 to 3 weeks prior to their first internship. This model sharply contrasts student exposure in our parent (traditional) program, with 8 weeks of full-time ICE experiences along with 2-3 weeks of half or full day experiences. It is no wonder that many perceived us as “Skating on thin ICE.”

Method: Midterm and final CPI data from two cohorts in the traditional and hybrid programs were analyzed. Feedback from clinical instructors and students were also summarized and compared.


Midterm CPI ratings during the first internship were slightly lower in the hybrid program compared to the traditional program, however there was no difference in readiness based on final CPI data across the 3 internships. CIs reported being surprised that students with minimal formal experience performed no differently than those with substantially more preparation. While more research is needed, these findings provide baseline data supporting an alternative model of ICE. Multi-site, large-scale research studies are needed to further investigate the efficacy of our clinical education models.

Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education

Discussions at the 2014 Clinical Education Summit centered on the growing challenge of finding clinical placements for PT students. The demand for clinical sites is impacted by many factors including the need for ICE placements.

This presentation relates to the sub-theme of “Instructional Strategies for the Classroom and Clinic” because it provides an alternative model to traditional “ICE” experiences that meets the needs of non-traditional students while also decreasing the demand on clinical sites. This theme relates to the overarching theme, “The pursuit of excellence in PT education” because it explores the clinical performance outcomes of students in an alternative model of ICE


Euype, S. Clinical educators on the summit. Journal of Physical Therapy Education. 2014;28:5-5.

Kelly, S. On the summit. Journal of Physical Therapy Education. 2014;28:3-4.

Mai, J. A., et al. 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. 2014;28(3): 81-97.

Mai, J. A., et al. Utilization of an integrated clinical experience in a physical therapist education program. Journal of Physical Therapy Education. 2013;27(2):25-32.

McCallum, C. A., et al. Quality in physical therapist clinical education: a systematic review. Physical Therapy. 2013;93(10):1298-1311.

Wruble E, Moffat M, Becker E, et al. Application of educational theory and evidence in support of an integrated model of clinical education. Journal of Physical Therapy Education. 2014;28:13-21.

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  • Control #: 2526551
  • Type: Platforms
  • Event/Year: ELC2016
  • Authors: Dr. Robin Galley
  • Keywords:

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