Student Confidence Levels in Engaging in and Initiating Crucial Conversations during Clinical Education
Purpose/Hypothesis:
Four domains have been identified as core competencies for effective interprofessional (IP) collaboration. These have recently become part of DPT educational accreditation standards: Values/ethics, professional roles and responsibilities, teamwork, and communication. Research indicates that effective communication in healthcare saves lives and improves patient outcomes and patient satisfaction. While Physical Therapy is considered an important role in an IP environment, some therapists may not feel inclined to speak up in a leadership role. Additionally, students in a clinical education experience may choose to remain silent when effective communication would yield better patient and/or learning environment outcomes. The purpose of this project was an exploration to better understand the nature of physical therapy students at a state university school as it relates to confidence levels in the initiation of and engaging in crucial conversations (CC) with a variety of stakeholders in a clinical education and healthcare environment. Hypotheses: 1. Students’ ability to recognize elements of a crucial conversation will improve; 2. Students’ conflict avoidance scores will correlate with confidence levels in engaging in crucial conversations during clinical education; 3. Students’ conflict avoidance scores will correlate with confidence levels in initiating crucial conversations during clinical education.
Number of Subjects:
41 students in their final year of DPT program completed web-based pre and post surveys surrounding a 12 week clinical experience. Participation was voluntary.
Materials and Methods:
Crosstabulations, t-tests, and ANOVAs were used (SPSS) to analyze pre and post survey responses. A one-hour training in crucial conversations was provided by the primary author to the student cohort after administration of the first survey and before the 12-week clinical experience.
Results:
The ability of students to recognize common elements of a crucial conversation increased after explicit training (p < .05). The post survey revealed a statistically significant increase in students’ confidence levels in engaging in a CC with a primary care provider as well as the ability to initiate a CC with a clinician that was not the student’s clinical instructor (CI) (p < .05). According to self-identified personality types, blue and gold personalities had significantly higher confidence avoidance scores than green and orange. In both the pre and post surveys, females were more conflict avoidant (p < .05) than males. Females were also significantly less likely to report being confident in engaging in and initiating a CC with other clinicians and a PCP. In the post survey, these differences disappeared; females indicated greater confidence in both engaging in and initiating CCs.
Conclusions:
Explicitly teaching and training students in crucial conversations during their professional development can help students recognize the need to use such skills in clinical education. Confidence levels increased throughout a 12-week clinical education experience, primarily for females.
Clinical Relevance:
If people entering the PT profession tend to be more conflict avoidant, as indicated by the females in our study and the blue and gold personality profiles, this warrants the need to identify and teach strategies to minimize the negative effects of inefficient or absent communication in a healthcare environment. Students’ confidence levels in engaging in and initiating effective communication can, in the end, facilitate successful clinical education experiences and produce improved patient outcomes.