Discovering What Experiences Physical Therapist Students Identify as Learning Facilitators in Practical Laboratories

Abstract

BACKGROUND AND PURPOSEPhysical therapist education students typically begin learning clinical skills and professional behaviors through the use of role-play, accompanied by tutor instruction in the practical laboratory setting. Tutors are registered PTs working in an academic faculty and are considered experts in their practice, with both clinical experience and specialized postgraduate qualifications in physical therapy. Use of scenariobased laboratory strategies that emulate authentic practice in the presence of an expert is a common approach used in the instruction of clinical skills to nursing and medical students.1 During the emulation of authentic practice, provision of expert feedback for novice clinicians is a method used to develop and master practical skills in the small group setting.1,2 Alternatives, including peer-assisted learning and computer-assisted learning, are considered time-efficient teaching supplements (for practical skill development) prior to clinical placement.1,3'9 In nursing education, the use of standardized patients has also been shown to promote skills common to physical therapy (communication and clinical judgement),9 but may be cost-prohibitive. Additional research suggests that other emerging teaching methods, such as student self-videoing may be equally successful at promoting reflection on performance and achieving learning outcomes.9,10 Successful clinical instruction adheres to the fact that students have their own learning styles. To promote this, tutors should adopt balanced educational strategies, accommodating all learning styles1 by selecting teaching methods that provide opportunities to best-encourage students to actively engage in learning.1,9,1114 Because student learning preferences are not fixed12 and new learning technologies continue to emerge, tutors should regularly seek student feedback on what efficiently facilitates their own learning.Practical laboratory sessions in Australian baccalaureate physical therapist education programs often use a simulated case-based format where students solve problems in small groups. In the gerontology practical laboratories, students alternate playing the role of the physical therapist, the patient, and the peer observer. Because feedback from the tutor is limited by student-tutor ratios, the peer observer was to provide the PT student with verbal feedback on their clinical performance. This scenario is designed to promote clinical learning, as suggested by previous work, which demonstrates that PT students are able to construct individual frameworks of patient care when they are actively engaged in self-assessment and direct their learning toward areas needing development.1'2,8'15 However, tutors had observed a lack of student engagement and focus on tasks during laboratory sessions, resulting in difficulty acquiring the skills and behaviors identified in the unit learning outcomes.Mandatory university teaching feedback, gathered from PT students, also indicated student learning was challenged in the laboratory environment, but did not identify improvement possibilities. To gain a better understanding of these issues in the context where they occurred, an action research design was selected. This design would grant the tutor insider access, undertaking the role of primary researcher while evaluating current practices of students in laboratory sessions.16 To minimize researcher bias, a second PT researcher, experienced in both gerontology laboratory teaching and clinical education, was recruited to participate in the study. The purpose of this paper is to discover, according to PT students, what experiences will best-facilitate student learning in practical laboratories.CASE DESCRIPTIONDesignThis study utilized an action research design with a cyclical approach to investigation, allowing multiple cycles to occur while pursuing strategies that best-facilitate student learning.17 This was selected to ensure that written and verbal student feedback could be readily captured in tandem with the practical laboratory sessions during weeks 2-3 and 5-7. …