COVID-19 and Shorted Integrated Clinical Experiences: Impacts on Acute Care Confidence and Interpersonal Communication
Integrated clinical experiences (ICEs) early in the Doctor of Physical Therapy (DPT) curriculum may promote readiness for full-time clinical experiences.1-4 The effects of ICEs on DPT student development and the recommended duration of exposure is not well documented. Further complicating matters, programs have recently had to make significant alterations in their curricula to accommodate shelter in place orders due to COVID-19. This has no doubt impacted hands-on clinical opportunities for students. The purposes of this study were to: (1) track the changes in acute care confidence and interpersonal communication in two cohorts of students along the course of their DPT curriculum and (2) to contrast the acute care confidence and interpersonal communication among students who were enrolled in shortened ICE exposures, versus a fully executed ICE exposure, due to the COVID-19 pandemic.
Two cohorts of DPT students (n = 74) enrolled in the DPT program at an academic medical center participated in two ICEs each that were incorporated into the second and sixth academic semester of an eight semester DPT program (ICE 1 and ICE 2, respectively). The second cohort completed only the first half of their ICE 2 due to the unforeseen cancellations in ICE experiences from the COVID-19 pandemic. We measured confidence in patient management in acute care with the Acute Care Confidence Survey5 (ACCS) and interpersonal communication via the Interpersonal Communication Questionnaire1,6 (ICQ). Outcomes were assessed pre- and post-ICE 1 and pre- and post-ICE 2 for all students.
74 students in the two cohorts completed the ACCS and ICQ. Paired t-tests of both the ACCS and ICQ were statistically significant between pre/post ICE 1 and 2, with p < 0.002 for both cohorts. Repeated measures ANOVAs found statistically significant differences between cohorts on the ACCS and ICQ, with p < 0.001 in each case. The Class of 2020 (who had a shortened ICE experience) had statistically significantly lower scores (mean of 1231 out of 1500 possible points) on the ACCS than the Class of 2019 (1292 points) who had additional exposures. There was no statistically significant difference between these cohorts after ICE 1, in which both cohorts had equivalent time in ICE. Results for the ICQ similarly demonstrated statistically significant differences post-ICE 2, with the Class of 2020 (mean of 35.5 out of 40 possible points) having less confidence and more anxiety communicating than those students in the Class of 2019 (mean of 36.9).
Conclusions/Relevance to the conference theme:
Students gain confidence when involved in hands-on ICEs in the acute care setting. Acute care confidence and interpersonal communication appear to be conditioned on the amount of ICE exposure. The well-being of healthcare teams may be positively influenced through ICEs that improve student confidence and communication skills.