Physical Therapist Students’ Perceptions of Effective Clinical Instructor Behaviors: A Pilot Study

Abstract

INTRODUCTIONIn the United States (US), professional physical therapist (PT) education is presently conducted at the graduate level, with the Doctor of Physical Therapy (DPT) degree being the required degree as of December 31, 2015.1,2 Although curricular sequences and specifics vary, per the Standards and Required Elements for Accreditation of Physical Therapist Education Programs from the Commission on Accreditation in Physical Therapy Education (CAPTE),2 professional PT education consists of 2 curricular components: a didactic component and a clinical component. The didactic component includes classroom and laboratory experiences involving the foundational sciences, the clinical sciences, and the physical therapy sciences.2 The clinical component provides students with opportunities to apply the knowledge, attitudes, behaviors, and skills acquired during the didactic component of the curriculum to the real-life context of the clinical environment. The structure and timing of clinical education experiences varies by program but must include a minimum of 30 weeks of full-time clinical education through both integrated and terminal experiences.2 Although these experiences typically occur under the direction of a clinical instructor (CI) at clinical sites outside of the academic institution, the academic program maintains full responsibility for the clinical education program.2Clinical education experiences are conducted in complex, unpredictable, and authentic practice environments, thereby affording learning opportunities that cannot be reproduced in the classroom or laboratory setting. Whereas didactic teaching and learning strategies can only attempt to simulate real-life clinical situations, clinical education allows the concepts, theories, and ideas from the relatively protected world of the classroom to come to life in a purposeful and meaningful manner. Given the importance of clinical education, CIs are essential in preparing PT students to assume the roles and responsibilities of contemporary PT practice. CAPTE requirements to serve as a CI include licensure as a PT, 1 year of full-time post-licensure clinical experience, and being an effective role model and clinical teacher.2Several researchers have explored the characteristics and behaviors of effective CIs.3-5 Kelly3 conducted a qualitative case study that described the instructional reasoning and teaching strategies used in PT clinical education from the viewpoint of a single, exemplary CI. Data in the study were gathered via 2 semistructured interviews with the CI and a review of artifacts provided by the CI. Triangulation of data was achieved through separate interviews with a former student and with a coworker who had observed the CI supervising and interacting with students. Five main themes related to the instructional reasoning and teaching strategies of the exemplary CI were identified in the data and included: (1) creating and maintaining an open, collegial relationship; (2) adapting the clinical experience to the specific student; (3) facilitating clinical reasoning skills; (4) making time for the student; and (5) receiving environmental support.A 1990 study by Jarski et al4 explored the perceptions of CIs and PT students from both bachelor's and master's degree-level professional education programs to identify CI teaching behaviors perceived as most helpful and most hindering during clinical education experiences. Using a questionnaire that listed 58 CI behaviors, respondents indicated their perceptions of each CI behavior on a 7-point Likert scale ranging from 1 (very helpful) to 7 (very hindering). Findings indicated that the most highly rated perceived helpful behaviors related to the teaching process included answering and discussing questions, providing constructive feedback, and facilitating practice and problem solving. Interpersonal behaviors, including those such as Deals with students in a friendly, outgoing manner were the next most highly rated category. …