Survey of International Clinical Education in Physical Therapist Education

Abstract

Background and Purpose. International opportunities, including international clinical education (ICE), appear to be increasingly offered in education of physical therapist students. ICE encompasses experiences designed primarily for student learning at a site outside of country where physical therapist program is located. Little research exists regarding use of ICE in physical therapist education. The specific purposes of this study were to (1) explore potential program differences between those with and without ICE; (2) discover current use, locations, and durations of ICE opportunities; (3) gather general information about ICE models, including their development, implementation, and evaluation; and (4) examine faculty perceptions of barriers and benefits regarding ICE. Subjects. The participants were directors of clinical education/academic coordinators of clinical education (DCEs/ACCEs) from US-based physical therapist education programs (n = 110). Methods. Direct mailing and listserv postings were used to recruit participants who then completed an Internet-based survey. Results. Of 110 respondents, 40.9% reported that they offered ICE. Of those programs that did not offer ICE, 18.8% (12 out of 64) planned to develop such opportunities in subsequent 2 years. Most ICE programs were 6 to 8 weeks in length, and were located in high-, upper-, or middle-income countries. The majority of ICE opportunities were in outpatient and hospital settings, and most clinical instructors were non-US citizens whose education was commensurate with US-level training. Commonly perceived barriers to ICE included expense, lack of faculty time and knowledge, and difficulty with site coordination. Perceived benefits were positive impact on cross-cultural competency, student personal development, and global awareness. Discussion and Conclusion. This study was first to explore broad use of ICE in US-based physical therapist education programs. Further research and professional dialogue are warranted to explore its present use and perhaps shape future application of ICE. Key Words: International, Clinical education, Global health. BACKGROUND AND PURPOSE Many factors, including rapidly developing technology and greater ease of travel, have contributed to an increasingly connected world. In this changing environment, impact of internationalization is becoming more evident across higher education.1 Knight2 defines internationalization as the process of integrating an international, intercultural or global dimension into purpose, functions or delivery of post-secondary education.(P2) As a reflection of this integration, international opportunities appear to be more prevalent in curricula of many health care profession programs located inside and outside of United States, including medicine,3-9 nursing,1015 and physical therapist education.16-21 A wide range of models are described in this literature. While overlap occurs among them, they may be grouped into 3 broad categories: community service; (2) service and learning, often termed international service-learning (ISL); and (3) student learning. Various terms are found in literature to describe experiences developed primarily for student learning at international locations: study abroad, global or global health training/education/electives/experiences, and international or international health electives/ clinical placements/ clinical rotations/internships/clinical education.3-11,15,19 Global health education also may refer to coursework that addresses health care systems and/or common health problems in countries outside United States, but may or may not include an international experience for student.3 In discussion that follows, term international clinical education (ICE) will be used to encompass all activities focused on student learning at international sites. …