The purpose of this educational session is to describe strategies to improve acute care curriculum using core competencies and evidence as a framework.
Methods and/or Description of Project
Physical therapy practice in the acute care setting has changed drastically over the last 25 years. In order to prepare DPT students for clinical internships and future employment in this setting, entry-level acute care curriculum must meet these needs. The Academy of Acute Care Physical Therapy has defined core competencies for entry level acute care practice and specific behaviors are identified in each section. The core competencies are:
1. Clinical decision making which is the foundation for all of the competencies,
2. Communication with the patient, family and interprofessional team,
3. Safety in the environment and with patient care,
4. Patient management including all aspects of patient care, and
5. Discharge planning.1
There is no consensus on the best methods to teach acute care competencies. Standardized patients (SP) and high fidelity human simulation (HFHS) have been shown to improve self-efficacy, knowledge, and competence in students in health professions.2-6 Although the level of evidence in many of these studies in not strong, no adverse effects have been noted.4 The use of SPs and HFHS can be very expensive. An alternative to SPs and HFHS may be the use of volunteer patients. Murphy (2015) reported that there was no perceived difference by students in an interviewing activity when volunteer patients were compared to SPs.
Our entry-level DPT program uses a variety of activities to teach acute care practice. Student role play is one method used in patient cases. A variation using associated faculty as the SP is also used to simulate acute care experiences. The benefit of using associated faculty is that they can provide feedback regarding performance of specific physical therapy skills, safety, and how they felt during the encounter. This session will describe activities that are used in our entry-level DPT program to meet each of the acute care core competencies and discuss the use of associated faculty in a modification of the usual SP model.7
Student course evaluations indicate that they value associated faculty acting as the patient more than the student role play. There is no additional cost when using associated faculty as they are already present in the lab sessions. The students have positive comments about the variety of activities in teaching about the care of medically complex patients.
Conclusions/Relevance to the conference theme: Through the Looking Glass: Transforming Physical Therapy Education
Physical therapist education must prepare entry-level students to function in a changing acute care environment. Using evidence based methods and published core competencies can assist DPT educators in transforming their acute care curriculum.
1. Core Competencies for Entry-Level Practice in Acute Care Physical Therapy, http://www.apta.org/APTAMedia/Handouts/PT2016/acute21_Greenwood_1.pdf. Accessed 3/1/17.
2. Swamy M, Bloomfield T, Thomas R, Singh, Searle R. Role of SimMan in teaching clinical skills to preclinical medical students. BMC Med Educ. 2013;13:20; http://www.biomedcentral.com/1472-6920/13/20. Accessed 4/4/17.
3. Silberman NJ, Litwin B, Panzarella KJ, Fernandez-Fernandez A. High fidelity human simulation improves physical therapist student self-efficacy for acute care clinical practice. JPTE. 2015;29(4):14-24.
4. Pritchard SA, Blackstock FC, Nestel D, Keating JL. Simulated patients in physical therapy education: systematic review and meta-analysis. Phys Ther. 2016;96:1342-1353.
5. Paparella-Pitzel S, Edmond S, DeCaro C. The use of standardized patients in physical therapist education programs. JPTE. 2009;23(2):15-23.
6. MacLean S, Kelly M, Geddes F, Della P. Use of simulated patients to develop communication skills in nursing education: an integrative review. Nurs Educ Today. 2017;48:90-98.
7. Murphy S, Imam B, MacIntyre DL. Standardized patients versus volunteer patients for physical therapy students’ interviewing practice: a pilot study. Physio Canada. 2015;67(4):378-384.
1. Identify at least one activity in each of the acute care core competencies
2. Describe the pros and cons of the different types of simulation used in health profession education
3. Discuss feasible options for achieving the acute care core competencies in entry-level DPT curriculum
Lecture and discussion
Review of the acute care core competencies (15 min)
Use of simulation activities in physical therapy education (15)
Activities to promote the acute care core competencies (40 min)
Implementation strategies and evaluation of curriculum (10)