Impact of Integrated Clinical Experiences (ICE) on Readiness for Participation in the First Full Time Clinical Internship: Clinical Instructor and Student Perspectives
Purpose: Inclusion of Integrated Clinical Experiences (ICE) early in the DPT educational process is supported in the research literature. ICE can reinforce the relevance of educational content, utilize experiential and active learning, promote clinical reasoning, and develop peer-assisted learning. Few studies about how ICE can prepare DPT students for full affiliation are found. The purpose of this study was to attain and compare perspectives on how ICE impacted perception of clinical preparedness from both students and clinical instructors (CIs). The null hypothesis was that there would be no difference in the perspectives.Methods/Description: The study design is a cross-sectional survey. Questions were developed which addressed confidence, communication, initiative, and professional behaviors. Answers were based on a 5-point Likert scale. Students were to answer based on their own performance and clinical instructors were asked to compare Methodist students to previous students in a first full time affiliation. CIs were also asked how comfortable they were with Methodist students working with their patients as compared to other first time internship students. Inclusion criteria for students was enrollment in DPT 6940 Clinical Practicum I, which is a 10 week full time rotation following two semesters of ICE involving 80 clinic hours per semester. Inclusion criteria for CIs was instruction for students in DPT 6940 that had instructed first full time rotation students previously. A total of 18 student responses were received. For CIs, 13 initiated the survey, but three were excluded for not having prior service as a CI or not working with first full time rotation students, leaving a total of 10 responses.Results/Outcomes: Due to the difference in the number of respondents in the groups the relative frequencies for responses on each level of the Likert scale was determined. The resulting curve for CIs was bell shaped with 43% of responses at Agree and 40% at Neither Agree or Disagree. The curve for students was skewed with 51% of responses at Strongly Agree and 39% at Agree. A Chi-square goodness of fit test was performed to compare distributions of responses between groups. The analysis indicated the distribution of responses were significantly different (X2 = 1933.7, p < .05). Standardized residuals showed significant discrepancies in number of times students strongly agreed compared to CIs and in the number of times CIs selected neutral or disagree compared to students.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: The results indicate that students who participated in ICE perceive they are more prepared and confident with performing patient care and communication in the clinic on their first full time affiliation as compared to CIs. While ICE may improve student confidence and assist with developing leadership skills in the clinic DCEs need to be aware that the CIs may not feel the same and be prepared to deal with potential conflicts that could result.References: Ingram D, Hanks J. A comparison of clinical performance outcomes in short integrated versus single long-term clinical experiences of physical therapist students. Journal of Physical Therapy Education. 2011;15(1):32-35. Mai JA, Stern DF, Hollman JH, Melzer BA, Thiele AK, Rosenthal RS. Examining the Impact of an Integrated Clinical Experience (ICE) on Interpersonal Skills Prior to the First, Full-Time Clinical Internship: Cool as ICE. Journal of Physical Therapy Education. 2014;28(3):81-97. Mai JA, Thiele A, O’Dell B, Kruse B, Vaassen M, Priest A. Utilization of an Integrated Clinical Experience in a Physical Therapist Education Program. Journal of Physical Therapy Education. 2013;27(2):25-32. Sliwinski, MM,Schultze, K, Hansen, RL, Malta, S, Babyar, SR. Clinical Performance Expectations: A Preliminary Study Comparing Physical Therapist Students, Clinical Instructors, and Academic Faculty. Journal of Physical Therapy Education. 2004;18(1):50-57. Weddle ML, Sellheim DO. Linking the Classroom and the Clinic: A Model of Integrated Clinical Education for First-Year Physical Therapist Students. Journal of Physical Therapy Education. 2011;25(3):68-80.