PEDIATRIC EDUCATION SPECIAL SERIES: Assessment of Teaching and Learning Activities in Pediatric Physical Therapy: Factors Influencing Knowledge Development and Confidence

Abstract

INTRODUCTIONFor nearly 100 years, physical therapist (PT) education programs have focused on preparing professionals for practice.1 The goal of these professional programs has been to provide high quality instructional activities that enable PT students to move from being unconsciously incompetent to becoming consciously competent professionals who are able to intentionally apply their knowledge and skills to effectively treat their patients.2-5 Bruno3 and Hunt and Furustig,4 in their confidence-based learning work, described this situation when they reported that learners who are highly confident, but possess low levels of knowledge, will often take actions that lead to negative outcomes. Alternatively, students who have high levels of knowledge, but lack confidence in their knowledge, may be reluctant to act in practice.3,4,6,7 Thus, the development of knowledge and knowledge confidence are essential aspects of competence, ones that PT students need to acquire as they prepare to enter the profession.Competence generally refers to the ability of someone to successfully complete a given task or demonstrate a specific skill.3,4,8,9 Recently, Rapport et al10 identified 5 essential core competencies around pediatrics that all PT students should attain in professional PT education. These competencies reflect a student's ability to successfully demonstrate knowledge, psychomotor skills, and other abilities such as self-confidence, interpersonal skills, clinical reasoning, and knowledge confidence, as related to human development, age-appropriate patient/client management, family-centered care for all patient/ client and family interactions, health promotion and safety, and understanding of legislation, policy, and systems. The focus of the current paper is on the teaching and learning activities that promote or inhibit the development of self-rated knowledge and knowledge confidence by PT students during a pediatric physical therapy course. Due to the limited amount of evidence that exists regarding the development of knowledge and knowledge confidence in pediatric PT education, the research questions for this study were: (1) Do the teaching and learning activities utilized in a pediatric physical therapy course result in an increase of students' self-rated knowledge and knowledge confidence regarding pediatric physical therapy? And, (2) which teaching and learning activities did students perceive as promoting or inhibiting the development of their self-rated knowledge and knowledge confidence in pediatric physical therapy content during this pediatric physical therapy course?Knowledge consists of the information, facts, and skills gained through education and experience.11 Knowledge confidence has been described and was operationally defined here as how certain someone is of their knowledge.12,13 Self-confidence has been defined as a general feeling of self-worth coupled with a belief in one's ability to handle certain situations or complete certain tasks, while a person's belief or confidence in being able to successfully execute a particular skill or behavior is known as self-efficacy.7,8,14-19 For example, to effectively assess a child's gait pattern, a therapist must understand concepts like step and stride length, initial contact, femoral anteversion, etc, then assess the child's range of motion and strength, interact effectively with the child and his/her family member(s), and confidently and accurately evaluate the presence or absence of critical events typical in gait. It is important to recognize that competence, confidence, and self-efficacy are closely related, but not synonymous.6 As noted above, students and practitioners with more confidence than knowledge may be dangerous in the clinic, while those with too little confidence in their knowledge and skills may not be willing to implement a given plan of care.3,4.6,7The development of competence in PT students occurs over time as a result of students who actively engage in their didactic education and clinical experiences. …