Innovation and Collaboration in Development of Specialized Clinical Experiences
Purpose: The primary focus of clinical experiences in entry-level education is to establish a firm foundation in fundamental areas of physical therapist practice. Many therapists transition to a specialty setting after having completed a period of generalist practice. Progression to an area of specialty practice requires additional education and training after graduation or participation in a residency. Specialty skill development is beyond the scope of required clinical experiences.4 Some students identify interest in a specialty area of practice early in their entry-level programs and are motivated to seek clinical experiences in these areas. Similarly, clinicians with specialized expertise may be under-utilized as clinical instructors given the specialized nature of their practice areas.6 We saw an opportunity to collaborate by supporting student interest in specialty practice while engaging expert clinicians through the development of specialized clinical experiences. The purpose of this session is to share the process, examples, and lessons learned during the collaborative development of specialty experiences in the areas of pelvic health, chronic pain, lymphedema, and research. Example student training pre-requisites, assessment measures, and clinical instructor support methods which enhanced collaboration will be provided. Attendees will use a template to brainstorm development of a specialty experience at their institution. Methods and/or Description of Project: Our first specialty clinical experience in clinical research was designed to support a DPT/PhD student, and developed with a lens to this single opportunity. However, as other student interests were identified, we recognized the wisdom of becoming more explicit about our definitions, expectations, processes, and assessment measures to ensure consistency in rigor and benefit to the student, our clinical partners, and the PT Program. We developed an optimal timeline for planning the experience and considerations for identifying and forming a collaboration with suitable expert clinicians. We sought methods to assess needs and develop resources for clinical instruction by the expert clinicians, who were unaccustomed to working with entry-level students. This included establishing a progression in patient management capability over the course of the experience for a defined set of patient conditions. We identified the need for and developed modified formative and summative assessment measures for the experience. We determined what data specific to the experience would be valuable to measure success and plan for future experiences. Results/Outcomes: Each of the developed clinical experiences has strengthened the communication, trust, and collaboration between the clinical sites, clinical instructors and our academic program. This process has engaged expert clinicians as clinical instructors, supported the need of students, met clinic needs, and promoted the early engagement of motivated students on the pathway to practice specialization. The success of the template has been such that the addition of new specialty experiences is manageable and partners easily identified. Students who have completed specialty experiences have successfully obtained employment in their desired areas of practice, benefiting both patients and clinicians. Specialty experiences serve to meet multiple stakeholder needs. Despite requiring pre-requisite training and asking students to fully commit through additional assessments and regular reading, the demand for these experiences has not diminished. At the time of this submission students have completed pelvic health and research specialty experiences. Two students are currently completing experiences in pelvic health and chronic pain, while five others are interviewing for placements (pelvic health, chronic pain, and lymphedema) in the 2020 clinical year. We have identified potential expansion areas of temporomandibular disorders and vestibular rehabilitation and plan to utilize our template to begin the expansion process. Conclusions/Relevance to the conference theme: We believe collaboration was essential for our success. Without input of the expert clinicians we could not have sufficiently defined the timeline for the experience, or drafted the necessary learning objectives and related assessment measures. Similarly, the clinicians relied on program support in identification of motivated students, in ensuring the students are academically and professionally prepared for experience in a specialty setting, and in formulating the structure for the experience overall. The degree of collaboration utilized resulted in increased mutual understanding, respect, and communication. Collaboration in planning and providing these clinical experiences greatly enhanced the education of our students. We suggest our template and history in developing these experiences will be useful to colleagues with a similar interest in meeting the needs of students and patients.