Clinical-Academic Partnership Innovation: DPT Students Serving an Urban Population Experiencing Homelessness
Purpose: Access is a shared challenge for clinical and academic institutions. For the most vulnerable patients, access to quality healthcare remains burdensome. Healthcare for underserved populations is often limited due to financial constraints.1 New healthcare graduates may also be unwilling to work with these patients.2 Physical therapy is a valuable adjunct in helping underserved people with common conditions.3 A student-led pro bono clinic in the city provides physical therapy services,4 but may miss patients experiencing homelessness. For academic institutions, access to clinical experiences can be problematic. Specific curricula may encourage students to work with underserved populations, 5 thereby increasing learning opportunities. The purpose of this program is to address these shared access challenges by deepening the partnership between an urban safety net hospital and a DPT program. In a primary care clinic exclusively serving the city’s homeless population, students now provide limited physical therapy services under the supervision of the physician. Students are exposed to ethics in action and patients receive assistance with their movement system needs that the physician is unable to provide.Methods/Description: Students preparing for their final clinical experience are offered this unique learning opportunity. Final student selection is made based on academic and professional proficiency, and student interest in this patient population. Students spend five weeks with a qualified physical therapist clinical instructor (CI) in the outpatient rehabilitation clinic to establish competence, then transition to two days per week in the primary care clinic. Students provide consultation and treatment to patients experiencing homelessness under established guidelines and services are not billed. They routinely consult with their CI about patient encounters. Services are adjusted as needed based on these discussions.Results/Outcomes: The program was designed by two DPT students, and two additional students have completed it to date. Six to eight patient encounters per day are observed with the physician and physical therapy services are provided for two to three patients per day over 10 weeks. Students anecdotally report high satisfaction with the experience and clinic staff has requested a long-term model to allow provision of physical therapy services throughout the year.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: This clinical experience allows students to gain a better appreciation for the experiences of patients experiencing homelessness and to develop unique leadership skills as a result.6 Primary care clinic staff are able to improve the breadth of their services to patients without additional financial burden. Patients receive specific information about their condition and may appreciate the benefit of continuing with outpatient care.References: 1. Elrod JK, Fortenberry Jr. JL. Bridging access gaps experienced by the underserved: The need for healthcare providers to look within for answers. BMC Health Serv Res. 2017; 17(Suppl 4):38-41. 2. Major N, McQuistan MR, Qian F. Changes in dental students’ attitudes about treating underserved populations: A longitudinal study. J Den Educ. 2016;80(5):517-525. 3. Chou R, Côte P, Randhawa K, et al. The Global Spine Care Initiative: Applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities. Eur Spine J. 2018:1-10. 4. George L, Bemenderfer S, Cappel M, et al. A model for providing free patient care and integrating student learning and professional development in an interprofessional student-led clinic. J Phys Ther Educ. 2017,31(2):54-66. 5. Roy V, Hurley K, Plumb E, Castellan C, McManus P. Urban underserved program: An analysis of factors affecting practice outcomes. Fam Med. 2015;47(5):373-377. 6. Stickler L, Grapczynski C, Ritch J. Student perceptions of outcomes from participation in physical therapy pro bono clinics: a qualitative study. J Allied Health. 2013;42(1):46-55.