Advancing Practice Through Serving Others - a Global Education Experience
Purpose: “Experience gained in authentic workplaces that are concurrently involved in education and delivering real-life services is the most important medium through which people learn to practice as healthcare professionals.”1 Experience is a great teacher in all aspects of life, but in the development of physical therapy students, there is little better than immersion in a situation that opens their eyes to the possibility of what practice can be, to help shape them to mold their own practice and change the trajectory of the profession. The context, or environment of learning teaches the learner and, in turn, the learner influences their environment of future practice.1 International service learning and global education programs have existed for a number of years, however many of these programs limit students as observers without engaging in the practice opportunities that these trips can provide. Outcomes of these experiences potentially expand students’ capacity to care for individuals with different world views and to collaborate in teams.2 In contrast, experiences in action legitimize students’ learning3 affording them time to develop relationships with practitioners in the clinic, time to understand the culture, time to establish and implement plans of care and time to train and develop in-country practitioners and advance their practice.Methods and/or Description of Project: Physical therapist students collaboratively engage in a variety of clinical practice settings, which shape them into the practitioners that they see in each of those settings. Academic faculty are hopeful that the learning communities in clinical education shape students positively rather than negatively, but both can occur. The constraints of the US health care delivery system limit exposures of students. For example, students rarely have the opportunity to experience into more of a direct access model of practice and/or to explore outside of the box alternatives for treating their patients. Simply ‘taking flight’ and moving our students to another country instantly opened-up new challenges and opportunities for exploring why we practice the way that we do, and to expand the context of practice from limitations imposed by resource dependency within the US system to a new level of creativity and therapeutic approach. Since 2011, students and faculty from Marymount University completed eight two-week-long faculty-guided global engagement experiences that are a recognized part of our clinical practicum curriculum where our students spend time in clinics, formerly in Costa Rica and now in Nicaragua providing physical therapy services to underserved populations. This two week trip is not an addendum to clinical practice, but is an integral part of our second long clinical practicum where the students have the opportunity to spend the final two weeks of that clinical experience abroad, or they can stay in the US and complete their affiliation. This Global Education model uses a 4-6:1 student to faculty model for delivering physical therapist services. The areas of clinical practice range from pediatrics to geriatrics, and includes inpatient and outpatient settings and traverses through general practice to specialties in orthopedics and neuro-rehab care. These settings are often resource scarce with respect to equipment and patient education level, which requires the students to reflect in-practice for creative solutions to care. This opportunity alone pushes the student’s professional identity and professional development.Results/Outcomes: Outcomes of this session Through this session we will: 1. Document student level outcomes from a two week global education service opportunity identifying how this can be a valued part of clinical experience for the students advancing their development as confident practitioners and with commitment for future service – either at home or overseas – given a better understanding of their role in social responsibility. 2. Describe the development of a long term community engagement relationship that leads to access to physical therapist services in environments that previously had none and improve equity of services both locally and ultimately globally. 3. Identify outcome measures that could be used to assess the student’s clinical skills as well as the intercultural development including a modified CPI, qualitative analysis of students’ affective pre- and post- trip as well as data from cultural awareness surveys. Self-efficacy data from the students was also collected and demonstrated student’s preparedness prior to the opportunity. 4. Next steps with regard to development of in-country relationship development, more robust assessment of both the students and the projects that they accomplish.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: So What Does This Experience Offer With Regards to Leadership and Practice? 1. Students acquire practice experience in a true direct-access climate; they participate in, and lead inter-professional discussions that demonstrate the contemporary role of the physical therapist in primary care; and students practice as primary care practitioners in the absence of other care providers. 2. Students worked alongside faculty in collegial roles to develop and deliver curriculum for teaching in-country practitioners about movement, and the specialty role of physical therapists as experts in the movement system. In so doing, in-country practitioners conceptualize a more contemporary model of physical therapist practice. 3. Data from our most recent global education experience will be presented detailing student development in the areas of social responsibility, cultural sensitivity and self-efficacy4 in physical therapist practice.References: 1. Yardley S, Teunissen PW, Dornan T. Experiential learning: Transforming theory into practice. Med Teach. 2012;34(2):161-164. doi:10.3109/0142159X.2012.643264 2. Kohlbry P, Daugherty J. International Service–Learning: An Opportunity to Engage in Cultural Competence. J Prof Nurs. 2015;31(3):242-246. doi:10.1016/j.profnurs.2014.10.009 3. Dornan T, Scherpbier A, Boshuizen H. Supporting medical students’ workplace learning: experience-based learning (ExBL). Clin Teach. 2009;6(3):167-171. doi:10.1111/j.1743-498X.2009.00305.x 4. Venskus DG, Craig JA. Development and validation of a self-efficacy scale for clinical reasoning in physical therapy. J Phys Ther Educ. 2017;31(1):14-19Course Objectives: The course objectives are: 1. To provide a framework of a long-term approach to global education and physical therapy practice through implementation of a significant portion of clinical time in a developing country. 2. To demonstrate the changes that occur in students when they are exposed to practice in different socio-economic and healthcare settings. 3. To demonstrate how students can grow through a global education opportunity and can contribute to the advancement of physical therapist practice in a country with a fledgling physcal therapy presence. 4. To challenge the audience to look at global education opportunities as more than just one week mission projects but to consider how they can assist in the transformation of practice in a distant location.Instructional Methods: - Platform style presentation will be used initially however, this session will be designed to integrate as much discussion as the audience provides with a chance for other institutions to share their experiences with this subject matter. It is our intention that participants leave with some solid ideas as to how they can improve or begin such a program. - Q&ATentative Outline/Schedule: 1. Welcome and Introductions (5 mins) 2. Global Education Defined (5 mins) 3. Our Story - Arlington to Costa Rica to Nicaragua (20 mins) 4. What About You? - Invitation for others to briefly share their global education experiences (15 mins) 5. Building for the future - discussion of how we establish our trip with the idea of returning for multiple years (15 mins) 6. Impact on Students - what have we seen over the years and what does the data show the impact is? (10 mins) 7. Where do we/you go from here? (10 mins) 8. Questions and close (10 mins)