The Art of Connection: A Model for Teaching Therapeutic Alliance to Doctoral Physical Therapy Students Within an Acute Care Course

Abstract

Background and Purpose. The connection and collaborative relationship, or therapeutic alliance, between clinician and patient reflects physical therapy's core values and serves as a vehicle for the essential goal of patient-centered care. The purpose of this study was to assess the effectiveness of integrating therapeutic alliance education into an entry-level doctoral physical therapy acute care course. Method/Model Description and Evaluation. Sixty-seven students completed an 11-week acute care course that integrated therapeutic alliance through lecture, simulation, self-assessment, peer and faculty feedback, debriefing, standardized patient written feedback, and written reflection. Surveys were completed before and on completion of the course. Outcomes. Quantitative results indicated that there was a significant increase in median (minimum, maximum) students' knowledge (8[2,10] vs 0 [0,9], effect size r = 0.86, P < .001), and perception of importance (10 [6,10] vs 10 [1,10], z = −3.6, r = 0.44, P < .001), of therapeutic alliance. Qualitative analysis of student reflections revealed the following perceptions of therapeutic alliance: high-quality health care, a strong relationship, awareness of self, awareness of others, communication (nonverbal and verbal), and emotional responsiveness. Qualitative analysis also revealed spontaneous, strong verbal language to describe the importance of therapeutic alliance indicating high impact and value to students. Conclusion. It is imperative that skills facilitating connection and patient-centered care become embedded within the physical therapy curriculum. By educating students in the affective domain of learning, tools are provided to facilitate the crucial therapist–patient connection. Including therapeutic alliance in entry-level doctoral physical therapy curriculum supports an academic culture promoting patient-centered care.