Physical Therapy Clinical Educatorsʼ Perspectives on Students Achieving Entry-Level Clinical Performance

Abstract

Background and Purpose. The move to a doctorate in physical therapy education has led to changes in the expectations for entry-level student performance. Members of the Iowa Clinical Education Consortium were interested in how clinical educators in their region would respond to this change in expectations. The purpose of this study was to explore the range of opinions among clinical educators regarding the educational implications of an enhanced definition of entry-level physical therapist performance. Participants. Thirty-four clinicians from the Midwest were invited to participate in regional focus groups. Methods. Each focus group was asked the same 3 questions considering a proposed entry-level definition: what ideal clinical education would look like; what obstacles would need to be overcome; and what support would be needed to achieve ideal clinical education based on the definition. Results. A multi-step process of thematic analysis was used to determine the core themes identified by the participants. These themes related to various academic and administrative issues that need to be addressed to implement the proposed definition in the clinical setting. These issues were diverse in nature and varied across and within practice settings. Discussion and Conclusion. This research contributes to the literature by identifying key concepts and concerns of clinical instructors in relation to implementation of the proposed definition of entry-level performance. This research provides a foundation for further exploration of this issue in terms of clinical educators' expectations of what would be necessary to implement the new definition and the potential impact on their current practices. Key Words: Clinical education, Entry-level education, Qualitative research. BACKGROUND AND PURPOSE Entry-level education in physical therapy has changed markedly in the past 20 years, not only in numbers of education programs and degrees awarded, but in curricular content. Eighty- six percent of the accredited physical therapy programs awarded a doctorate level degree in 2007, as compared to only 9.4% in 2000, and zero in 1987.1 Clinical education, or learning in the context of patient care, has always been a significant component in all physical therapist professional education programs, and now accounts for an average of 31.3% of the time spent in a physical therapist programs professional curriculum. The average total length of full-time clinical education has increased from 29.2 weeks in 2001 to 33.6 weeks in 2007. However, there is wide variation in total length of clinical education between programs, with a range of 20 to 55 weeks.1 As the clinical education portion of the curriculum has expanded, more has been asked of the facilities providing clinical education and their clinical instructors (CIs). Coupled with the increased length of clinical education experiences is the expectation that graduates will enter the profession with a higher level of competency, requiring less guidance or supervision when addressing patient problems, and demonstrating competent time-management skills.2'3 For physical therapist education programs to be accredited by the Commission on Accreditation of Physical Therapist Education (CAPTE), they must meet stringent evaluative criteria. The criteria state that schools must document that their clinical education experiences encompass: (a) management of patients/clients representative of those commonly seen in practice across the lifespan and the continuum of care, (b) practice in settings representative of those in which physical therapy is commonly practiced, (c) interaction with physical therapist role models whose practice is consistent with the program's philosophy of practice, (d) opportunities for involvement in interdisciplinary care; and (e) other experiences that lead to the achievement of expected student outcomes.4 The first goal of the Education Strategic Plan from the American Physical Therapy Association (APTA) emphasizes the importance that the profession has placed on quality clinical education. …