Impact of in-Class Patient and Integrated Clinical Experiences on Physical Therapy StudentsÕ Clinical Performance
Purpose
A variety of clinical education models exist across the United States. Models emphasizing full-time clinical experiences (FTCE) often include a higher number of full-time hours (HFTH) with less prior didactic preparation and less integration with the curriculum, while models that include integrated clinical experiences (ICE), part-time integrated clinical experiences (PTICE), and in-class patient experiences (IcPE) often integrate experiences with the didactic content but include a lower number of full-time hours (LFTH). Therefore, the purpose of this study is to determine if a re-designed clinical education (CE) curricular model that emphasized IcPEs and ICE with LFTH better prepares students for CE experiences than a version that emphasized FTCEs with HFTH as measured by scores on the Clinical Performance Instrument (CPI).
Methods/Description:
A retrospective cohort study was conducted on a data set of 183 Mount St. Joseph University Doctor of Physical Therapy students who participated in an initial and final CE experience. Data variables included student admission data (undergraduate grade point average (GPA) and undergraduate science GPA), demographics, cohort year, evaluation type, and evaluation period for the initial and final CE experiences. Quantitative data were collected for each 18 CPI performance indicators for the midterm and final assessment periods of the initial and final CE experiences. Quantitative data were analyzed using descriptive statistics, Shapiro-Wilk test, independent t-tests, FischerÕs exact test, a factor analysis, Mann-Whitney U test, and a post hoc Wilcoxon signed-rank test. Three factors were identified following the factor analysis and used to compare outcomes between and within each cohort at each assessment period.
Results/Outcomes:
Data on a total of 183 students was included; 50 (27.3%) of which were in the HFTH cohort while the remaining 133 (72.7%) were in the LFTH cohort. Descriptive statistics were similar for all data except for gender (p < .001). A statistically significant difference was found between cohorts at the midterm assessment period of the initial CE experience, while only one factor was significant at the final assessment period of the initial CE experience and the midterm of the final CE experience (p < .05). Within cohort analysis revealed statistically significant differences for all three factors at all assessment periods except for the change in scores from the midterm assessment period of the initial CE experience to the final assessment period of the final CE experience.
Conclusions/Relevance to the conference theme:
Considering all students demonstrated a significant improvement from the midterm to final assessment periods of an initial and final CE experience and that student performance was similar for all factors by the final assessment period of the final CE experience, IcPE that allow faculty to observe, mentor, and provide feedback to students should be considered as an alternative to FTCE prior to student participation in an initial CE experience.