Does a Structured Clinical Education Program Enhance Physical Therapy StudentÕs Clinical and Professional Development?
Purpose
: The purpose of this quality improvement project was to evaluate the perceived benefits of a 12-week structured clinical affiliation education program in orthopaedics on Doctor of Physical Therapy (DPT) student clinical knowledge, professional skills, and clinical reasoning
Methods/Description:
This was a pre-post evaluation of a 12-week clinical affiliation education program that was implemented at a single outpatient clinic at Vanderbilt University Medical Center. The program was focused on enhancing orthopaedic specialty practice knowledge and skills in DPT students. The program was developed by two residency-trained physical therapists who hold specialty certifications in orthopaedics. Educational content was delivered through weekly 1-hour lecture and clinical skills labs. Case rounds involved discussion of patient cases with clinical mentors for evaluating decision making. The program was initially piloted in a group of 19 DPT students and results indicated the program was helpful for clinical reasoning, especially for challenging patient cases. In the current project, we compared pre-post evaluation results to a control group of DPT students at Vanderbilt clinical sites not participating in the orthopaedic curriculum. Orthopaedic knowledge was assessed with a 20-item quiz, which included case-based questions. Perceived benefit was assessed with a survey on confidence (0-100 visual analog scale) in the following areas: professionalism, interviewing, differential diagnosis, ICF classification, clinical reasoning, special testing, manual therapy, movement analysis, plan of care development, patient education, exercise prescription, and chronic pain management. Open-ended feedback on student experiences was obtained through a written questionnaire. Pre-post changes were assessed using a paired t-test and compared between the two groups.
Results/Outcomes:
Pre and post-affiliation data from 12 third year DPT students were examined. Eight DPT students completed the clinical affiliation education program and four students from an off-site outpatient clinic acted as a control group. There was a non-significant increase in quiz scores in the curriculum group (p=0.20) and a non-significant decrease in quiz scores for the control group (p=0.09). Curriculum participants rated statistically significant higher confidence for 11 of 12 areas (p<0.05), whereas the control group demonstrated significant change in 1 of 12 areas (p<0.05). DPT student feedback suggested the program created an Òopen learning environmentÓ that facilitated growth in confidence and skills. Additional feedback applauded the programÕs Òfocused and simplified structureÓ that helped improve clinical reasoning, movement analysis, special tests, and hands-on techniques
Conclusions/Relevance to the conference theme:
The results of this project indicate that DPT students who complete a structured clinical affiliation educational program report perceived benefits in professional skills to a greater degree than students who do not. These preliminary evaluation results offer support for structured experiences similar to residency programs for DPT interns. However, data from a larger sample are needed to validate findings