Following the Map for Clinical Instructor Success in ICE


The purpose of this educational session is to describe how the analysis of student mind maps following a collaborative integrated clinical education (ICE) experience can influence clinical instructors’ instructional strategies. The Clinical Education Summit held by the American Council of Academic Physical Therapy in 2014 resulted in a shared vision for clinical education as well as guiding principles and recommendations. One of the Summit recommendations was that “all programs will offer integrated clinical education experiences prior to terminal experiences.”1 Integrated clinical education has been defined as clinical learning experiences developed in collaboration with invested stakeholders and embedded within the didactic curriculum.2 The collaborative model is one model of clinical education (CE) that has been applied to ICE experiences in DPT curricula. The emphasis of collaborative models of clinical education is on teamwork and collaboration, communication, reflection, and lifelong learning.3-5 The benefits of the collaborative clinical education model have been documented and include collaborative learning through peer interaction; deeper level of problem-solving and critical thinking; greater self-reliance, independence, and interdependence; and enhanced clinical competence.6,7 Despite the benefits of including ICE in a DPT curriculum, as well as the benefits of the collaborative model of clinical education, the physical therapy literature does not describe the impact on student learning when these two models of CE are combined. Two leading DPT programs formed partnerships with local clinical entities to develop and implement ICE curricula that utilize the collaborative model. Following the implementation of the curricula, the CE faculty from both programs were interested in factors students reported as facilitators of the team’s learning during ICE. The two programs utilized the same assessment method to gather this data, seeking to better understand factors that contribute to both the successful implementation of an ICE experience as well as the factors that were specific to the clinical instructor preparation to teach in a unique model of clinical education. This interactive session will describe the specific factors our students identified following their ICE experiences, and offer suggestions for applying these factors when academic and clinical sites partner to effectively prepare clinical instructors involved in collaborative clinical education experiences.

Methods and/or Description of Project

The two DPT programs developed their CE curricula with a focus on collaborative learning during short-term, unique ICE experiences. During the first year of both programs, students are in the clinical setting in teams of 3-4 for two one-week blocks. The team, the clinical site, and the clinical instructors remain the same from the first to the second week of ICE. In order to explore how students learn in the clinic during the team-based experience, both DPT programs utilized mind-mapping as a strategy to allow students to reflect on their ICE experience. Two cohorts of first year students from one program and one cohort of first year students from the second program participated in this study, for a total of 51 student teams. The students at each institution were provided with an identical lecture following their first ICE experience on how to create a mind-map using an online mapping tool, Coggle It. Students were then instructed to work with their ICE team to create a mind-map that depicted the aspects of their experience that they found contributed to their learning as a team. Team maps were analyzed retrospectively using line-by-line coding processes. The researchers coded only the primary concepts on each map, or those concepts that were most influential to the team’s function.


Following the final review of all 51 mind-maps, 24 distinct codes had been assigned. No significant differences between the three cohorts were found using Chi Square Analysis across all codes so further analysis of the codes was performed with the cohorts aggregated. More than 50% of teams indicated that “group dynamics” and “team communication” were vital to the effective functioning of their team in the clinic. More than 25% of the teams included “individual student qualities”, “the learning environment”, “practicing skills”, “the instructor’s teaching strategies”, “adult learner characteristics”, and the “clinical instructor” of key importance. Four thematic concepts emerged as being important for effective collaborative learning in an ICE. The first theme, The Team, includes the students and the clinical instructor as one cohesive learning unit. Each member of the team uniquely contributes to the group based on their individual skills, training, and personality. The second theme, The Clinical Practice Environment, emerged as student groups found success when the clinical learning environment provided opportunities to extend the didactic preparation of the program, and could provide unique experiences they may not ordinarily be exposed to in the classroom or other clinical setting. The third theme, The Individual Student, was developed based on teams indicating that the mix of personality traits, coded as “individual student qualities” provided a balance within each team. Teams also noted that individual students possessing adult learner qualities, demonstrating professionalism, and having sufficient didactic preparation was important to the team function. The fourth theme, The Clinical Instructor, emerged as groups indicated the importance of the CI’s qualities, behaviors, and specific teaching strategies in promoting team learning.

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

This session examines student perceptions of important aspects of their team’s function and learning during collaborative ICE experiences. The four themes that emerged from the outcome data are consistent with factors described in the literature.8-10 This session will describe and apply these themes for clinical educators interested in implementing collaborative ICE models. The presenters will further describe how the application of these themes to the design and preparation of this unique ICE model can enhance academic-clinical partnerships. This session will provide both clinical instructors and academic programs suggestions for factors to consider to ensure the CI’s success in this innovative model of clinical education.


1. The American Council of Academic Physical T. American Council of Academic Physical Therapy Clinical Education Summit, Summit Report and Recommendations. Vol 20152014.

2. American Council of Academic Physical Therapy. Terminology for Clinical Education. Accessed April 1, 2016.

3. Cohn ES, Dooley NR, Simmons LA. Collaborative learning applied to fieldwork education. Occupational Therapy in Health Care. 2002;15(1-2):69-83.

4. Rindflesch AB, Dunfee HJ, Cieslak KR, et al. Collaborative model of clinical education in physical and occupational therapy at the Mayo Clinic. Journal of allied health. 2009;38(3):132-142.

5. DeClute J, Ladyshewsky R. Enhancing Clinical Competence Using a Collaborative Clinical Education Model. Physical Therapy. 1993;73(10):683-689.

6. Frost JS. Handbook of teaching and learning for physical therapists. In: Jensen GM, Mostrom E, eds. Vol 3rd. St. Louis, Mo.: Elsevier/Butterworth-Heinemann; 2013

7. Strohschein J, Hagler P, May L. Assessing the need for change in clinical education practices. Physical Therapy. 2002;82(2):160-172.

8. Plack MM. The learning triad: potential barriers and supports to learning in the physical therapy clinical environment. Journal of physical therapy Education. 2008;22(3):7.

9. Healey WE. Physical therapist student approaches to learning during clinical education experiences: a qualitative study. Journal of Physical Therapy Education. 2008;22(1):49.

10. Morren KK, Gordon SP, Sawyer BA. The relationship between clinical instructor characteristics and student perceptions of clinical instructor effectiveness. Journal of Physical Therapy Education. 2008;22(3):52.

Course Objectives

At the completion of this course, participants will:
1. Understand the impact of including an integrated clinical education experience as part of a larger DPT curriculum.
2. Understand the factors students identify as important to learning in a collaborative ICE experience.
3. Appreciate the importance of targeted CI training on instructional effectivness in the collaborative model.
4. Identify resources necessary to establish a training program for their collaborative ICE instructors.
5. Recognize the impact of academic and clinical partnership in promoting instuctor effectiveness during ICE.

Instructional Methods


Tentative Outline/Schedule

20 minutes: Present background from the literature and the Clinical Education Summit regarding the collaborative model of clinical education and integrated clinical education.
5 minutes: Describe the ICE curricula implemented the two DPT programs represented
10 minutes: Describe the methods utilized in the study, including brief background on mind-mapping as an effective outcome tool.
10 minutes: Describe results of the study, including a detailed description of the four themes that emerged from the results
30 minutes: Describe the application of four themes to training and preparation of collaborative ICE clinical instructors
15 minutes: Q&A with presenters and large group

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  • Control #: 2526982
  • Type: Educational Session
  • Event/Year: ELC2016
  • Authors: Katherine Myers, Kyle Covington
  • Keywords:

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