CARE 2.0: The Benefits and Barriers of ICE
Purpose
To describe and analyze the challenges and benefits of implementing an early embedded integrated clinical education curriculum in a DPT program.
Methods and/or Description of Project
Trine University’s DPT program in Fort Wayne, Indiana has taken an innovated approach to integrated clinical education (ICE) in their Clinical Application Reflection Experience (CARE) course series. The CARE courses place students in local healthcare settings with preselected clinical instructors. These settings include outpatient, inpatient/acute and rehabilitation settings in the community of Fort Wayne. These courses utilize a two student to one clinical instructor clinical education model with one of the students being a first year DPT student and the other being a second year. During this series, students participate in patient care related activities four-six hours/every other week during the first five semesters of the program for a total of over 140 clinical hours prior to their full-time clinical experiences. These courses run concurrently with the didactic portion of the curriculum in the first five semesters to augment student learning.
Results/Outcomes
Implementation of an early embedded ICE curriculum can be challenging for numerous reasons: scheduling, resources, student engagement, continuity of the experience, design and evaluation of clinical curriculum, and both faculty and clinician workloads. The ability to overcome these obstacles requires a strong commitment by multiple stakeholders and a continual assessment process. However, all things considered all stakeholders agree that the benefits of type of educational environment far outweigh the challenges. The constant evolution of Trine University’s DPT early embedded ICE curriculum has led to significant improvements in student learning and engagement. The program continues to make enhancements that decrease the workload for faculty and clinical instructors. This presentation will focus on the challenges, benefits, and lessons learned in administering an early embedded ICE curriculum.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
Fostering Clinical Reasoning: Although early ICE experiences can pose some challenges in terms of faculty time, clinical commitments and resources, it is the opinion of Trine University’s vested parties that the benefits outweigh these barriers. By mirroring the learning objectives in the CARE courses with the learning objectives from previous courses, the students are able to routinely apply classroom concepts into patient care. Likewise, patient care experiences from CARE are brought back into the classroom for discussion and critical thinking application and reflection activities. This integration of authentic patient care scenarios into the curriculum intensifies learning for the students. The student dyad model allows the second year students the opportunity to mentor the first year students and the first year students provide an opportunity to the second year students to see how much they have learned.. Unintended benefits of the ICE experiences include easy access to local clinicians who desire to serve as adjunct faculty, formation of research opportunities with students and the institutions supporting the ICE experiences and the development of relationships in the Fort Wayne physical therapy community.
References
1) Hakim EW, Moffat M, Bell KA, Schmitt LA. Application of education theory and evidence in support of an integrated model of clinical education. J Phys Ther Educ. 2014; 28 (1):13-21.
2) American Council of Academic Physical Therapy (ACAPT) Clinical Education Summit. Clinical Education Summit Summary. Kansas City, MO. October 12-13, 2014
3) Jette DU, Nelson L, Palaima M, Weatherbee, E. How do we improve quality in clinical education? Examination of structures, processes, and outcomes. J Phys Ther Educ. 2014; 28(1):6-12.
4) Mirbagher Ajorpaz, Neda; Zagheri Tafreshi, Mansoureh; Mohtashami, Jamileh; Zayeri, Farid; Rahemi, Zahra. The effect of mentoring on clinical perioperative competence in operating room nursing students. J Clinical Nursing. 25.9-10 (May 2016): 1319-1325.
5) Hoffman SJ, Harris A , Rosenfield D. Why mentorship matters: students, staff and sustainability in interprofessional education. J Interprof Care. 2008; Jan; 22(1): 103-5.
6)Secomb J. A systematic review of peer teaching and learning in clinical education. J Clinical Nursing. 2008; Mar; 17(6): 703-716.
7) Lattanzi JB, Campbell SL , Dole RL , Palombaro KM. Students mentoring students in a service-learning clinical supervision experience: an educational case report. Phys Ther. 2011. Oct; 91(10): 1513-24.
8) King, G. A framework of personal and environmental learning-based strategies to foster therapist expertise. Learning in Health and Social Care. 2009; Sept; 8 (3): 185-199.
Course Objectives
1) Identify the benefits of early embedded ICE curriculum.
2) Describe the interfering factors of offering ICE experiences.
3) Design some strategies for overcoming the barriers to implement ICE.
4) Summarize various enhancements can be utilized to improve ICE experiences.
5) Discuss strategies for success to sustain and implement ICE.
Instructional Methods
Presentation requiring audience participation using poll everywhere and an opportunity for Q and A
Tentative Outline/Schedule
5 minutes: Introductions/Objectives/Purpose
20 minutes: Description of CARE
30 minutes: Barriers and Enhancements
20 minutes: Keys to Success
5 minutes: Conclusions 10 minutes: Q &