Do Observation Hours Prior to PT Education Impact Scores Reported on the Clinical Performance Instrument?
Observation hours, paid or unpaid (volunteer), with a licensed physical therapist have long been a requirement for entrance into physical therapist (PT) education programs. This experience prior to PT school should give students insight to improved performance criterion such as professional behaviors and communication skills because they would have observed and participated in this during their time in the physical therapy clinic or department. The number of required hours is highly variable with some programs only recommending hours to programs requiring over 500 hours. However, the benefit of observation hours is questionable since there is little research that supports that observation hours contribute to student success, academically or professionally. Contention around this subject has fostered the American Council of Academic Physical Therapy to call for a task force to analyze this topic further. Push-back about observation hours also comes from physical therapy clinics and departments. These sites are inundated with requests to take on students for undergraduate internships, pre-professional school observation hours as well as clinical sites for physical therapy students. This is especially a questionable practice with the international pandemic of COVID-19 reducing the number of patients in clinics causing many physical therapy clinics to move to telehealth, reduced hours or close temporarily. Clinics and departments are restricting non-essential individuals from entering the locations for the safety of therapists and patients. Therefore, the purpose of this study is to determine if a higher number of observation hours leads to improved outcomes in a physical therapist education program. The outcomes examined are scores from Clinical Performance Instrument (CPI)(Professional Behaviors, Professional Communication and Total Score) on students first clinical experience.
Data from 285 students over a five year period (2017-2021) in one Doctor of Physical Therapy program were extracted from the Physical Therapy Central Application Service (PTCAS) and the Clinical Performance Instrument (CPI) from their first clinical experience (5 weeks, beginning of 2nd year). Variables of interest including the number of observation hours and the total CPI (CPI-T), CPI professional behavior (CPI-PB), and CPI professional communication (CPI-PC) scores. Linear regression analyses were used to identify the ability of observation hours to predict the total CPI (CPI-T), CPI professional behavior (CPI-PB), and CPI professional communication (CPI-PC) scores. Independent t-tests were used to identify differences in CPI-T, CPI-PB, or CPI-PC scores between: 1) students with greater and less than 500 observation hours, and 2) students that completed their hours in volunteer or paid positions.
The total number of observational hours did not predict student performance on CPI-T (R2=0.001, p=0.68), CPI-PB (R2=0.003, p=0.36), or CPI-PC (R2=0.004, p=0.28). When dichotomizing based on number of hours, there were no significant differences in CPI-T (p=0.37), CPI-PB (p=0.59), or CPI-PC (p=0.12) scores between students with less than and greater than 500 hours. Additionally, there were no significant differences in CPI-T (p=0.91), CPI-PB (p=0.47), and CPI-PC (p=0.47) between students who completed observation hours in a volunteer or paid setting.
Conclusions/Relevance to the conference theme:
Observation hours prior to entrance PT school has been thought to better equip students with the knowledge of the profession of physical therapy. However, during the pandemic of COVID-19, applicants seeking observation opportunities will present an undue burden on already strained physical therapy clinics and department making these hours difficult for applicants to obtain. Our outcomes support that number of observation hours does not equate to higher total scores or individual section scores on the CPI for the first clinical experience in a group of DPT students. It calls to reason that if observation hours do not benefit students and only inconvenience clinics and departments, that this practice should be either given less weight in the admissions process or removed completely.