The Effect of Early Integrated Clinical Education Experiences on Clinician Productivity
Purpose: Early integrated clinical education (ICE) experiences in physical therapy programs have recently been recommended. The effect of experienced students on clinician productivity has been studied; however, the effect of ICE experiences on clinician productivity has not yet been evaluated. The purpose of this study is to examine the effect of ICE experiences on clinician productivity.Methods/Description: The productivity of 14 licensed physical therapists (PTs) from a local health system was collected over a period of 32 pay periods between 2014 and 2015. The productivity was calculated by the total number of hours billed via billed treatment units (BTUs) divided by the total number of hours worked in each pay period. The data was de-identified and released to the author for retrospective analysis. The PTs practiced at one of three different hospital-based outpatient practice locations within four specialty patient populations (women’s health, pediatrics, adult neuro, and adult orthopedics). Two of the 14 PTs were clinical instructors for students in a university’s ICE course series, while the remaining 12 PTs did not have a student. Each of these two PTs supervised 8 students in a 2:1 triad model each semester for 8 hours each week during the weeks that the students attended ICE. A primary analysis of the data from these two PTs was conducted to discriminate productivity variances between pay periods when the PTs were with (21 pay periods) and without (7 pay periods) the students. The remaining 4 pay periods in the data set included students during one of the two weeks in the pay period and were excluded from the analysis. In a secondary analysis, these results were compared to the 12 PTs that did not have students.Results/Outcomes: The primary analysis of the two PTs revealed that the mean (two standard deviations) productivity for the pay periods without ICE students were 78.0% (10.4%) and 59% (19.7%) compared to the pay periods that the PTs supervised ICE students were 77.2% (13.0%) and 67.5% (15.6%). The effect size between these two data sets, with and without students was negligible (d=0.1 and d=-.09). In the secondary analysis, one of the PTs only reported data for three pay periods and was thus excluded from the data analysis. The productivity of the remaining 11 PTs in the data set had a mean (two standard deviations) productivity rate of 63.2% (13.6%), similar to the productivity of the two PTs in the primary analysis.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: Historical concerns about the impact of students on PT productivity have been disproven for students in full-time clinical experiences. In fact, even students in their first full-time clinical experience have been shown to positively contribute to PT productivity. This study is the first to explore the impact of students in an ICE course series on PT productivity. While further studies are needed, the preliminary results indicate that student in ICE have a negligible negative impact on productivity and may in fact contribute to enhanced PT productivity.References: 1. Dillon LS, Tomaka JW, Chriss CE, et al. The effect of student clinical experiences on clinician productivity. J Allied Health. 2003; 32 (4):261-265. 2. Lopopolo RB. Financial model to determine the effect of clinical education programs on physical therapy departments. Phys Ther. 1984; 64:1396-1402. 3. Ladyshewsky RK, Barrie SC, Drake VM. A comparison of productivity and learning outcome in individual and cooperative physical therapy clinical education models. Phys Ther. 1998; 78:1288-1297. 4. Leiken AM. Method to determine the effect of clinical education on production in a health care facility. Phys Ther. 1983; 63:56-59. 5. Ladyshewsky RK. Enhancing service productivity in acute care inpatient settings using a collaborative clinical education model. Phys Ther. 1995; 75:503-510. 6. Jette DU, Nelson L, Palaima M, Weatherbee, E. How do we improve quality in clinical education? Examination of structures, processes, and outcomes. J Phys Ther Educ. 2014; 28(1):6-12. 7. Hakim EW, Moffat M, Becker E, Bell KA, Manal TJ, Schmitt LA, Ciolek C. Application of educational theory and evidence in support of an integrated model of clinical education. J Phys Ther Educ. 2014; 28(1):13-21 8. Dobrzykowski, E. Measurement of productivity. 2012. Available from: https://hpaapta.wordpress.com/2012/01/09/measurement-of-productivity/. Accessed January 25, 2016.