An Integrated Experiential Service Learning Activity for Dpt Students for Assessing Fall-Risk in Older Adults
Concerns have been raised in the literature regarding physical therapy studentsÕ attitudes and perceptions regarding working with older adults. This has been attributed to negative stereotypes and ageism regarding the level of motivation and functional capabilities of older adults. As a result, many student physical therapists lack interest in working with this patient demographic. Increased interaction with older adults has been associated with improving studentsÕ attitudes, level of interest and confidence in working with older adults. The purpose of this study was to investigate the impact of a service learning activity to increase the confidence of physical therapy students in achieving the essential competencies of fall-risk management of older adults as described by the Academy of Geriatric Physical Therapy (AGPT) using members of a local senior independent living community.
Researchers created a 13-item questionnaire to investigate studentsÕ level of confidence in performing a comprehensive fall-risk assessment, including conducting client interview, performing physical measurements, interpreting outcomes, and planning appropriate interventions. Second year DPT students first completed didactic course instruction, laboratory practice and assessment of competency in administering fall-risk assessments. Students then completed a confidence questionnaire as pre-test. Older adults for this activity were recruited through the facilityÕs wellness program. Following screening and selection of older adults, students administered a medical-history questionnaire and the Activities-Specific Balance Confidence Scale via phone interview. The medical-history questions and fall-risk assessment measures were chosen based on the recommendations of AGPT Essential Competencies in the Care of Older Adults and Center for Disease ControlÕs Stopping Elderly Accidents, Deaths and Injuries (STEADI) program. On the day of the activity, students performed physical measurements, including the Five Time Sit to Stand Test, 30 Second Chair Stand Test, Berg Balance Scale, Timed Up and Go, Single Limb Stance Test, Ten Meter Walk Test, and the 4 Stage Balance Test. Following the activity, students completed the questionnaire again as post-test.
The questionnaire had good content and face validity judged by 3 board-certified clinical experts in physical therapy, and had good internal consistency (ChronbachÕs alpha = 0.871). Students showed a mean improvement in their confidence with all items following the activity with older adults. Students showed significant improvements with three survey items using Wilcoxon signed-rank test. These items assessed studentsÕ confidence conducting client interview (p=0.001), 10 Meter Walk Test (p=0.011) and 30 Second Chair Stand Test (p=0.046).
Conclusions/Relevance to the conference theme:
A service learning activity increased student confidence in conducting effective interview and performing evidence-based fall-risk assessment of older adults. Service learning experiences allow students to practice communication and psychomotor skills to develop confidence during Òreal worldÓ experiences that may not be replicated with traditional didactic course instruction.