Student Readiness: Working with the Challenging or Exceptional Student
Purpose
In order to address the ongoing need to ensure student readiness of all physical therapy (PT) students, we must consider all PT students, including those that are exceptional and/or challenging in nature. The purpose of this presentation is to define the exceptional and challenging student, as well as successful clinical education; to provide current evidence for the causes of student challenges and success in clinical education; to enable the application of the evidence to handle student challenges and facilitate clinical education success; and finally, to problem solve situations with exceptional and challenging students.
Methods and/or Description of Project
We first examined what a successful or ideal clinical experience would look like from the perspective of the student, the academic institution, the clinical faculty and the clinical site. Knowing that professional behavior and safety are the key inherent behaviors that our students should be exhibiting, these are the primary areas of concern for academic and clinical faculty for all levels of students. We examined the warning signs, where these issues originate - the classroom, and how to address these areas of concern early in order to avoid poor outcomes during the clinical experiences, including remediation and termination. We learned that negative experiences can shape a student into developing into a strong clinician with the proper and early implementation of ongoing communication of all stakeholders, learning contracts and consistent feedback.
Results/Outcomes
After discussing how to address the needs of the exceptional or challenging student, we will share real-life case scenarios with the audience of clinical educators and directors of clinical education. We will introduce one case scenario to the audience and demonstrate how to problem solve the case via the SBAR method. In groups, a team would then able to collaboratively problem solve the issues and offer suggestions of how to best handle the situation for the student's best interest. Finally, the outcomes of the collaboarations would be shared amongst the entire audience for further discussion.
Conclusions/Relevance to the conference theme: Through the Looking Glass: Transforming Physical Therapy Education
We learned, and hope that our colleagues will learn from this presentation, that in order to transform physical therapy education, we must be able to look through the lens of each stakeholder's perspective (the student, the clinical faculty, the clinical site, the academic institution) to understand what is the ideal clinical experience is for each stakeholder. Understanding and appreciating the perspective and goals of each stakeholder involved in the clincial experience would facilitate clearer communication and expectations for all. When we factor our students who have exceptional or challenging issues, then we definitely need to ensure that we are implementing and utilizing all of our resources and tools to ensure a successful clinical experience and are ensuring that all of our students, including our exceptional and challenging students, are meeting the expectations of professional, entry-level physical therapists.
References
Engelhard, C; Leugers, R; Stephan, J. Effectiveness of pre-admission data and letters of recommendation to predict students who will need professional behavior intervention during clinical rotations in the United States. Journal of Educational Education for Health Professions. June 2016; 13:26.
Phelan, T. Professional Behavior In Physical Therapist Educational Programs: Perspectives of Selected Senior Faculty. Internet Journal of Allied Health Sciences and Practice. April 2014; 12:2.
Hayes, K; Huber, G; Rogers, J; Sanders, B. Behaviors That Cause Clinical Instructors to Question the Clinical Competence of Physical Therapist Students. Physical Therapy. July 1999; 79:7.
McGinnis, P; Guenther, L; Wainwright, S. Development and Integration of Professional Core Values Among Practicing Clinicians. Physical Therapy. September 2016. 96:9.
Hayward, L; Black, L; Mostrom, E; Jensen, G; Ritzline, P; Perkins, J. The First Two Years of Practice: A Longitudinal Perspective on the Learning and Professional Development of Promising Novice Physical Therapists. Physical Therapy. March 2013. 93:3.
Recker-Hughes, C; Wetherbee, E; Buccieri, K; Timmerberg, J; Stolfi, A. Position Paper - Essential Characteristics of Quality Clinical Education Experiences: Standards to Facilitate Student Learning. Journal of Physical Therapy Education. Supplement 1, 2014. 28.
Boud, D., Keogh, R., & Walker, D. (1985). Reflection: Turning Learning Into Experience. RoutledgeFalmer.
Jette, D. U., Bertoni, A., Coots, R., Johnson, H., McLaughlin, C., & Weisbach, C. (2007). Clinical Instructors’ Perceptions of Behaviors That Comprise Entry-Level Clinical Performance in Physical Therapist Students: A Qualitative Study. Physical Therapy, 87(7), 833–843.
Kelly Macauley, P. T., DPI, C., & others. (2016). Simulation in Physical Therapy Education and Practice Opportunities and Evidence-Based Instruction to Achieve Meaningful Learning Outcomes. Journal of Physical Therapy Education, 30(1), 3.
Norman, K. E., & Booth, R. (2015). Observations and Performances “with distinction” by Physical Therapy Students in Clinical Education: Analysis of Checkboxes on the Physical Therapist Clinical Performance Instrument (PT-CPI) over a 4-Year Period. Physiotherapy Canada, 67(1), 17–29.
Ozga, K. L., Kenyon, L. K., Engel, A. J., Kool, P. A., Sievers, M. E., & Stephenson, P. (2016). Physical Therapist Students’ Perceptions of Effective Clinical Instructor Behaviors: A Pilot Study. Journal of Physical Therapy Education, 30(4).
Kirsch, N. R. (2016). Rotation Notations: A clinical instructor identifies disturbing student behaviors. PT in Motion, 10–13.
Tyreman, S. (2000). Promoting critical thinking in health care: Phronesis and criticality. Medicine, Health Care and Philosophy, (3), 117–224.
Course Objectives
1. To define the exceptional and challenging student, as well as successful clinical education;
2. To provide current evidence for the causes of student challenges and success in clinical education;
3. To enable the application of the evidence to handle student challenges and facilitate clinical education success; and
4. To problem solve situations with exceptional and challenging students.
Instructional Methods
1. Power Point
2. Video
3. Lecture
4. Handouts
5. Group discussion with case scenarios
6. Question and answer
Tentative Outline/Schedule
I. Introduction: 10 minutes
II. Video: 5 minutes
III. Power Point Lecture: 30 minutes
IV. Case Study Example: 10 minutes
V. Group Case Study Discussions: 20 minutes
VI. Conclusions/Question and Answers: 15 minutes