Experiential Service Learning in a Neurorehabilitation Classroom: Impact on Students and Patients
Purpose/Hypothesis: The purpose of this project was to examine the educational and therapeutic benefit of a neurological rehabilitation clinic implemented within a classroom environment. Number of Subjects: 46 patients who completed a satisfaction survey; 185 DPT students who completed a clinic evaluation form of which 153 also completed pre and post clinical confidence questionnaires. Materials and Methods: This was a mixed methods project with quantitative and qualitative self-reported data from students and patients participating in a classroom-based neuro-wellness clinic (NWC) over a five-year period. The NWC is a 4-week clinic that enrolls patients to work with a team of DPT students for an episode of physical therapy care. Patient satisfaction surveys were mailed out after the clinic with a self-addressed, stamped envelope. The surveys included 10 Likert type questions (1=strongly disagree to 5=strongly agree) and open-ended questions about the quality of the clinic. The students completed pre/post clinical confidence questionnaires and an NWC evaluation after the clinic. The pre/post confidence questionnaire was a 40-item instrument that asked students to rate their clinical confidence (0-100%) on neurological clinical skills. The responses were totaled and averaged for an overall confidence score (0-100%). The NWC evaluation included 10 Likert type questions (1=strongly disagree to 5=strongly agree) and open-ended questions about the educational benefits of the clinic. The pre/post confidence questionnaires were analyzed with paired T-test (p<0.05). The patient satisfaction and NWC evaluation Likert type questions were analyzed with descriptive statistics, and the open-ended questions were analyzed with a qualitative content analysis approach. Results: The average patient satisfaction on the Likert type questions was 4.7/5 (range 3.5 – 5). Three primary themes emerged from the open-ended questions: patient benefits, barriers for access, and suggestions for improvement. Student confidence improved significantly between pre and post questionnaires (72% to 85%, p<0.0001, n=153). Student satisfaction with participating in the NWC averaged 4.6/5 (range 3.5 – 5). Students identified 14 areas where the NWC contributed positively to their educational progress in the open-ended questions. The three most reported benefits were practicing clinical skills on real patients, developing critical thinking skills, and educating patients and families. Conclusions: Experiential and service learning through a classroom clinic was impactful for both patients and students. Patients experienced physical and social benefits while students improved their clinical confidence preparing them for the transition to the clinic. Clinical Relevance: A free in-class clinic may be a good alternative for patients who do not have resources for long-term rehabilitation care. In addition, the classroom clinic provides students with opportunity to become comfortable with learned skills prior to entering into a clinical setting.