Impact of a Self-contained Clinical Learning Space on a Physical Therapist Assistant Education Program

Abstract

Background and Purpose. Immersion within practice areas or clinical education (CE) experiences are required to be both integrated within the curriculum (ie, integrated clinical education [ICE] experiences) and at the end of the curriculum (ie, terminal clinical education [TCE] experiences) for an accredited physical therapist assistant (PTA) education program. In addition, programs must meet accreditation requirements for ICE and TCE within specified clock hour (520–720) and program length limitations (five semesters). The purpose of this article was to describe one program's model for providing integrated PTA CE in a self-contained learning space and to describe the outcomes achieved in the first 2 years of operation. Method/Model Description and Evaluation. Planning, administrative approval, community fund-raising, and institutional capital budget allocation commitments took 6 years before the Nate Waters Physical Therapy Clinic (NWPTC) at Tulsa Community College, Tulsa, OK, opened in August 2014. The clinic design is based on a learning spaces framework providing students an actual clinic setting to learn and practice skills. The learning space allows students to gain clinical confidence in a comfortable, supportive learning environment, in which time restraints, high productivity requirements, and reimbursement restrictions are eliminated or minimized for the novice student. A mixed-method program evaluation assessed the 2-year performance of the self-contained clinic with two quantitative and three qualitative assessments. Outcomes. Implementation of the self-contained clinic allowed for a curriculum reduction of clinical hours from 680 to 560. The clinic generated an average of 65 visits each month with a range of 41–124 visits. No significant difference was found on the PTA students' midterm scores from the final TCE's Clinical Performance Instrument (PTA CPI, Version 1998) for the 2015 and 2016 cohorts compared with two preclinic cohorts (2013 and 2014), despite 22% less clinical time for the studied cohorts. Qualitative interviews of faculty and students showed three parallel themes and two related themes. Parallel themes in both groups included teaching in context, confidence, and communication, whereas related themes included faculty absence of concerns or complaints and student fear of failure. Students also identified an enhanced PT/PTA role formation as a benefit of the clinic. Discussion and Conclusion. Student experiences in the NWPTC are aligned to support integration of learning in the classroom. Faculty supervision in the clinic reinforces the concepts taught in didactic courses. As a self-funded, self-contained teaching clinic, NWPTC allowed faculty control on curriculum alignment and scheduling, thus allowing for a reduction in required clinical contact hours with no indication of decreased student outcomes. While CE in PTA education programs continues to be predominantly outsourced, a self-contained ICE clinic can be of value to PTA programs.