New England Consortium Focus Groups: Identification of Economic Factors in Clinical Education

Abstract

BACKGROUND AND PURPOSEAt 2012 American Physical Therapy Association's (APTA) Combined Sections Meeting (CSM), the construct of a process for developing a vision for physical therapist clinical began.1 As a result of this discussion, APTA organized a task force to promote optimal clinical educational experiences (CEEs) for physical therapist (PT) students that would strengthen partnerships between all levels of PT programs and clinical practice. Dunfee2 outlined several challenges to provision of quality CEEs in her guest editorial in Journal of Physical Therapy Education. These challenges included, but were not limited to, productivity demands on clinical facilities and regulatory and reimbursement environment. These factors have an impact on ability of clinical facilities to provide CEEs for students and, as Blau et al3 described in their research, have often had negative influences on clinicians' perceptions of their work environment.The challenges to provision of CEEs are not unique to physical therapy profession or to practice in United States (US). In medicine, Von Below et al4 reported that facilitators who supervised students during CEEs took pleasure in being clinical teachers and felt that these experiences were worthwhile. However, these facilitators also reported that they lacked support from their superiors for their role as clinical teachers and, furthermore, authors noted a tension between productivity demands and contributing to of future professionals. In 2008, Rodger et al5 reported findings from an international, interdisciplinary discussion about key issues related to clinical (CE) and practice placements. In their report they noted that detrimental influences on CEEs have included fiscal constraints, changes in practice models, and reduced staffing.Prior to APTA CSM, New England Consortium of Academic Coordinators of Clinical Education (NEC-ACCE) organized a meeting, in spring of 2011, with PT program directors and directors of clinical (DCEs) of 17 member institutions to discuss contemporary concerns regarding physical therapist education. NEC-ACCE membership includes all DCEs from 17 PT academic programs in a 6-state area, including Maine, New Hampshire, Vermont, Massachusetts, Connecticut, and Rhode Island. The impetus for this meeting was based on NEC-ACCE member experiences that indicated that clinical facilities were having greater difficulty accommodating requests for student CEEs. During all-day workshop, this select group of stakeholders discussed challenges associated with CE from multiple perspectives. At conclusion of this meeting, participants expressed a common concern that CE may not be sustainable in its current form. Similar to premise of a shared vision for PT education that would later be promoted at 2012 APTA CSM, consortium recognized that it did not have enough direct information from wide breadth of clinical personnel who served needs of academic institutions and students. Participants acknowledged that more information was needed from regional clinical educators to make informed decisions about how academic programs and clinical educators could work collaboratively to meet challenges surrounding provision of CE. The NEC-ACCE charged a 6-member task force to gather this information and report back to group. Specifically, task force's objectives were to obtain New England clinicians' feedback on: (1) variables that impact physical therapy practice and CE; (2) how to strengthen partnership between academic programs and clinical facilities; and (3) possible strategies to manage challenges associated with CE.METHODSDesignA series of regionally based focus group discussions were organized to maximize clinician feedback on status and future of physical therapist education. …