Clinical education is a critical component of entry level doctoral physical therapy programs. High stress levels are experienced by physical therapy and other health profession students during clinical rotations. Prior research suggests that resilience interventions for physical therapy students can increase positive emotions and higher resilience in self-reported outcome measures. However, there is a lack of research investigating how resilience training affects a studentÕs clinical performance. This study sought to determine if a resilience intervention during the didactic curriculum of a physical therapy doctoral program increased clinical instructor-rated student performance across the terminal clinical experience (TCE).
In this quantitative study, we analyzed clinical performance from the Northern Arizona University physical therapy class of 2019 based on the clinical instructor (CI) ratings from the Clinical Performance Instrument (CPI). We compared CPI performance for 12 students who participated in resilience training via The Remen Institute for Healing and IllnessÕ 15-hour HealerÕs Art elective course with performance from the remaining 35 students in the class. Through discussion with the instructors of The HealerÕs Art program, we identified the five CPI criteria most-relevant to the resilience training curriculum: Communication, Accountability, Professional Behavior, Clinical Reasoning and Cultural Competence. We used 2-tailed unpaired t-tests to determine if the change in CPI ratings across the TCE for these five criteria were significantly different between the group of students who completed The HealerÕs Art training and those who did not.
For the 3 ten-week TCEs, we examined the change in CI CPI ratings for the 5 criteria related to resilience. The results demonstrated a significant difference with improvement in the Accountability criterion rating levels from the first TCE to the final TCE for those who participated in The HealerÕs Art training compared to those who did not.
Conclusions/Relevance to the conference theme:
Stress is a known factor for students in physical therapy doctoral education. As the first study to explore the effect of resilience training on clinical performance, this provides nuanced information and serves as a foundation for greater examination. The primary goals of the HealerÕs art program are to foster a greater sense of meaning and commitment to the practice of physical therapy. The increased accountability demonstrated in this study may be a reflection of the courseÕs outcome. Thus, the results of this preliminary study demonstrate that there is a potential to increase attributes of resilience seen on an evaluative tool during student TCE. Future studies should include a larger data set as well as a self-rated outcome measure to produce a global look at how resilience intervention truly affects clinical performance.