Challenges in the affective domain: Early identification and notification
Purpose: Performance in the cognitive and psychomotor domains are commonly addressed in physical therapy programs. Skills in the affective domain are critical to student success, yet are the most challenging to objectively identify and remediate. Recognizing and addressing issues early in the academic process allows more time for development and opportunity for improved performance. The purpose of this session is to describe a formal process to identify and address student performance issues in the affective domain during the didactic portion of an entry level curriculum.Methods and/or Description of Project: Our program implemented a process for formal early identification (EID) of students who struggle to succeed in the first year of their professional education. Systems already existed to remediate both cognitive and psychomotor deficiencies. We recognized the need for a formal mechanism to address issues in the affective domain and implemented the Notice of Deficiency (NOD), designed to formally alert the student of performance deficiencies in the affective domain. The goal of the NOD is to clarify performance expectations required to continue in the academic program, allow opportunity for change, and establish formal documentation of poor performance. In the EID academic advisers take the lead in identifying students who may need additional support for success in the program. Advisers review ongoing student performance in written exams and practical exams administered every three weeks throughout the program. On all practical exams students are scored on performance in all three domains including the affective domain. At the end of the first semester and again at six weeks into the second semester advisers review advisee performance to determine if action is required to support the student. Thresholds for formal intervention include one failure or repeated low performance on written or practical examinations including affective domain scores, issues identified in experiential learning or integrated clinical education, and unsolicited comments from other core or associated faculty members. When the deficiencies are specific to the affective domain, an individualized NOD is developed. The NOD places the student on departmental probation specifying a timeline for the resolution of performance deficiencies. It is implemented in a meeting with the department chair, a faculty witness (often the adviser), and the student. Each attendee signs and receives a copy of the document. To foster student growth, all faculty are informed of the NOD and share responsibility in ongoing assessment for student development providing performance feedback directly to the student and/or adviser. Advisers offer continued mentorship and collaborate with the student to identify strategies and develop a comprehensive plan directed by the performance deficiencies noted on the NOD. Re-evaluation of student progress occurs within a specified time frame and the NOD may stay in effect for the remainder of the program including the clinical education experience.Results/Outcomes: The EID has been in place for the past 5 years, with the NOD instituted for the past three student cohorts. Through EID, 14 students received formal meetings and follow-up learning support. The NOD has been implemented three times. Two of these students were able to improve performance to meet established expectations; another remains in progress. The NOD serves as a catalyst for change and as documentation for future action in the absence of change. Faculty have agreed to continue to utilize both of these processes.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: We recognized the need to identify problematic student performance early in the academic program. The NOD is an innovative way to address student performance in the affective domain. Though this feedback is often difficult for students to hear, the NOD clarifies expectations in the affective domain encouraging students to recognize a need for change and may foster resilience in the underperforming student. For our department, both the EID and the NOD have increased emphasis on development in the affective domain, an area critical to success in the profession.References: 1. Bayliss A, Strunk V. Measurement of Empathy Changes During a Physical Therapist's Education and Beyond. Journal of Physical Therapy Education. 2015;29(2):6-12. 2. Choi Y, Song E, Oh E. 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Generic Inabilities and the use of a decision-making rubric for addressing deficits in professional behavior. Journal of Physical Therapy Education. 2007;21(3):13-22.Course Objectives: 1) Identify challenges and common approaches for addressing performance issues in the affective domain in an entry level DPT curriculum. 2) Describe a process for early identification of student performance issues. 3) Examine use of a formal notification of deficiency to facilitate student performance in the affective domain. 4) Assess outcomes of the early identification and notice of deficiency processes to inform discussion of similar approaches from other programs.Instructional Methods: Lecture, discussion (small group and large group), questions/answers.Tentative Outline/Schedule: 0-5 Introduction of topic and speakers 5-15 Common challenges and approaches for addressing performance issues in the affective domain. 15-25 Describe a process for early identification of student performance issues. 25-45 Examine a process for formal notification of deficiency to facilitate student performance in the affective domain 45-60 Case examples 60-80 Discuss outcomes related to the processes of early identification and notice of deficiency, including group discussion sharing other similar approaches. 80-90 Questions/answers