Physical Therapist Studentsʼ Conceptualizations of Clinical Practice

Abstract

Introduction. Patient-centered collaborative reasoning is a hallmark of expert practice in physical therapy that is not consistently demonstrated in the work of novices. Current theories suggest that professional competence extends beyond skills and knowledge to also include an individual's conceptions of the role and identity of the professional, though few studies have addressed physical therapist (PT) student professional development from this perspective. The purpose of this study was to examine the ways PT students conceptualize the practice of physical therapy. Subjects. Eight entry-level PT students from 2 programs participated in this study. Methods. Semistructured interviews and a modified Q-sort were used to examine the students' perspectives on physical therapy practice. Qualitative analyses focused on the students' conceptualizations of the purpose of the physical therapy patient encounter, the level of participation expected of the patient, and the type of knowledge valued in the interaction. The students' perspectives were then analyzed for their relationship to the students' clinical decision making processes during a standardized patient encounter. Results. The students exhibited a broad range of perspectives on physical therapy practice, ranging from a PT-centered mechanistic view to a patient-centered holistic view. Students who held more mechanical views of practice indicated that the patient's expectations for therapy were not highly important in their work, while those who held patient-centered views highly valued the patient's interests and expectations. Conclusion. Students should be engaged in learning opportunities during entrylevel PT education that support development of patient-centered perspectives, as well as the skills and knowledge necessary for such practice.