Forensics: A Community Clinical Education Pilot Project

Abstract

Background and Purpose. Physical therapists (PTs) have been providing services to inmates both inside and outside penal institutions for over 2 decades. The key issue in rehabilitation services in penal institutions is ensuring the practitioner has a sound understanding of the unique culture and environment of the patient population. This population is growing, and there is an increasing need for physical therapy services, yet PTs are either unaware of the opportunities or are concerned about the inherent risks of working with this population. In an effort to meet the growing societal need for physical rehabilitation of inmates while broadening the clinical experiences for PT students and enhancing their professional opportunities, a descriptive pilot project was undertaken to investigate the feasibility of student placements in Canadian federal cor rectional facilities. Case Description. The forensics pilot project was undertaken as one of ten community pilot projects developed by the Ontario Council for University Programs in the Rehabilitation Sciences to enhance clinical education for students in the rehabilitation disciplines. Four PT student volunteers were selected to undertake a 2:1 supervision model, 5-week clinical placement at one of two penitentiaries. The students underwent special training, had an extensive preplacement orientation, and attended weekly debriefing sessions. Outcome measures included preplacement and postplacement reflection questions, student journals, exit questionnaires (given to both students and clinical instructors [CIs]), weekly debriefing sessions, Queen's University midterm and final student clinical performance instruments and site evaluation forms, and a midterm telephone interview. Outcomes. It was demonstrated that implementation of student forensic clinical placements is feasible and that the benefits of the learning experience far outweighed the risks and limitations of the placement. Students performed well clinically while demonstrating significant changes in professional attributes and generic behaviors. Discussion. The academic coordinator of clinical education (ACCE), both CIs, and all four students concur red that the placement of PT students in penal institutions is a “value added” experience for the students demanding more flexible, innovative treatment approaches and more sensitive interpersonal communication and interaction skills. Student prejudices and biases brought into the placement were replaced by more open-minded, thoughtful, and impartial qualities. Recommendations include establishing forensic placements for intermediate and senior students, expanding the preplacement orientation, and developing advanced forensic placement handbooks.