Early Identification of Barriers to Student Success in Clinical Education: Utilization of a Week One Clinical Survey Tool
Doctor of Physical Therapy (DPT) clinical education programs commonly assign students to extended clinical experiences (CEs) located at national and international sites. Initial assessment of the student CE is commonly completed by academic faculty during midpoint calls or visits. Multiple student concerns including personal safety, professional ethics, inadequate orientation, inappropriate supervision, and poor communication have been identified as barriers to the learning experience at this time (reference?). Failure to identify student concerns early can impact student success or satisfaction. The primary purpose of this mixed-methods study was to explore the perceptions of DPT students with utilization of a safety check survey completed at the end of the first week of their CE. Secondary aims included: examining the experiences between cohorts and levels of CE.
All DPT students (n = 112) engaged in full-time CEs were required to complete a week one safety check via electronic survey, consisting of 10 questions related to demographics, student safety, clinical instructor (CI) satisfaction, and initial challenges. Frequency and descriptive data were tabulated, and data were assessed to compare second versus third year responses using a Mann-Whitney U test. Qualitative data was assessed to identify themes and analysis of the open-ended questions included an incident coding process of the narrative responses.
Only two students (1.8%) indicated they felt unsafe at their clinical site. Most students (n = 73, 65.1%) indicated high satisfaction with their CI (³ 9 on a 10-pt scale), 35 students (31.3%) gave their CI a rating of 6-8, and 4 students (3.6%) rated their CI at 5 or lower. There were no differences between cohorts for site safety or completion of orientation, but there was a difference for how they rated their experience with the CI (p = .008). The 2019 cohort rated their CI lower (8.6 ± 1.6) than the 2021 cohort (9.4 ± 0.8). Analyzing by level of CE(1st, 2nd, or 3rd) showed that students on their terminal experience rated their CI satisfaction lower (8.7 ± 1.4) than students completing their first experience (9.4 ± 0.8), p = .047. Narrative responses revealed that students commented on CI characteristics being related to their overall CI satisfaction. The clinical environment was cited as being a significant challenge to their first week of a CE. There were no differences between cohorts or levels of CE in overall themes from the open-ended questions, but there was a difference in the impact of each theme and associated subcategories.
Conclusions/Relevance to the conference theme:
Early identification of safety concerns and clinical challenges allows immediate intervention, including advising by DCE for mitigation of barriers to success. Advising on stress management, effective communication, and professional behaviors enhances student resilience and success in physical therapy education.