Proposed Guidelines for International Clinical Education in US-Based Physical Therapist Education Programs: Results of a Focus Group and Delphi Study

Abstract

Physical therapist students are increasingly engaging in international clinical education (ICE). The growth of international engagement has been accompanied by appeals to ensure that these experiences are conducted in an ethical manner. Although detailed guidelines have been developed to guide global health training in general, they do not specifically address all aspects relevant to ICE in physical therapist education. The purpose of this study was to systematically develop recommendations for the implementation of ICE in physical therapist education to promote ethical practice. An initial virtual focus group of 5 physical therapist faculty with expertise in ICE provided input to review and revise global health training guidelines previously developed by non-physical therapists. The revised guidelines were distributed to a pool of 19 physical therapist faculty with ICE experience for additional review and revision through 3 online Delphi survey rounds. The participants accepted 31 of the original guidelines with or without revisions, rejected 2 guidelines, and developed 10 new guidelines or subguidelines. Most notably, they rejected a guideline related to students pursuing training outside of a structured program, stressing that ICE should never be done outside of a formal program. The primary limitation is that the study included only faculty from sending institutions and thus lacked the voices of the host institutions, students, partner organizations, or funders. This study systematically produced guidelines for ICE in physical therapist education using a range of ICE experts from sending institutions. The recommendations may be used by educators and other decision makers to optimally design new ICE opportunities or to improve existing ones. Additional validation should be done to ensure relevance for all stakeholders.