Beginning with the End in Mind: A Product Evaluation of Integrated Clinical Education Courses
Purpose
Parameters for integrated clinical education (ICE) require specific outcomes tied to progression of knowledge, professional behaviors and skills (1). However, the comprehensive evaluation of ICE curricula has not been previously described (2). We used the Context, Input, Product, Process (CIPP) model (3) to guide an intentional process of curricular reorganization and implementation of a series of stand-alone ICE courses (4). This presentation describes outcomes of the product evaluation of this unique ICE curriculum.
Methods/Description:
Outcomes from the first ICE curriculum cohort were compared to control cohorts from the original curriculum. Primary outcomes included web-CPI results, number of clinical remediations, and program exit survey results. Clinical preparation was measured using the APTA Core Values (5) and Professional Behaviors (6) self-assessments. The Patient Practitioner Orientation (PPOS) (7) and Level of Clinical Preparedness (LCPS) Scale (8) were administered at the conclusion of the didactic curriculum, prior to full-time clinical experiences (FTCEs). Student evaluation of the clinical experience and clinical instructor (CI) was used to rule out between-group differences in types and quality of clinical experiences.
Results/Outcomes:
Web-CPI data from terminal FTCEs revealed no differences between the ICE (n=58) and control groups (n=74) in the CIÕs final assessment of student performance. However, ICE students scored higher (better) at initial and intermediate FTCEs, as well as in the cumulative average of all FTCE final evaluation scores (p<0.001). There were differences between cumulative CI and student final evaluation ratings (p<0.001), with ICE student ratings aligning more closely with CI ratings. Similar differences were observed on final evaluations of initial and intermediate FTCEs (p=0.001). Control students rated themselves higher on Core Values (p=0.004) and Professional Behaviors self-assessments (p=0.009), as well as in all areas of the LCPS (p=0.01 - <0.001). However, ICE students were more satisfied with the clinical education program (p=0.011 - <0.001). There were no differences in student evaluation of the clinical experience/instructors or remediation.
Conclusions/Relevance to the conference theme:
Our analysis revealed that the ICE curriculum met the standards of high performance established by the original curriculum. Although there were no differences in final FTCE scores, ICE students scored higher during initial and intermediate FTCEs and reported greater satisfaction with the clinical education curriculum. ICE students reported lower scores on the Core Values, Professional Behaviors, and LCPS self-assessments prior to FTCEs. However, this was not reflected in PPOS scores or web-CPI ratings. These differences likely result from a restructured curriculum in which ICE experiences during the first two didactic years explicitly emphasize professionalism and self-reflection, enhancing student performance and self-assessment during initial and intermediate FTCEs in the final curricular year. This suggests that innovative educational strategies such as ICE may maximize student potential and reduce clinic resources during clinical education, ultimately improving the patient experience of physical therapy.