Clinical Education Experiences Research Articles

Language Discordance Between Students and Patients: Impact on Clinical Learning

Background The clinical education of medical students relies on having direct patient experiences, which can be challenging when the patient population speaks multiple languages. In Singapore, students regularly encounter patients with whom they do not speak the same language. Objective The purpose of this study was to examine the role of student–patient language discordance (SPLD) on students’ clinical education experience. Methods In this sequential mixed-methods study, medical students who have completed at least 1 year of clinical education at the Duke-NUS Medical School in Singapore were asked to complete an online survey to obtain their self-reported language proficiency in local languages, experiences interacting with patients who do not speak English, and perceptions of the impact on clinical learning. A follow-up interview with selected participants was conducted. Results Overall, 35.9% of eligible students responded to the survey. Demographic analysis of respondents adequately represented the school’s overall student population. Non-Mandarin-speaking respondents reported that learning medicine in a multilingual environment negatively impacts clinical learning due to significantly more frequent challenges to clerking patients and feeling hindered from learning from doctors due to language barriers. However, no difference was observed in the performance on clinical exams of the three groups. Qualitative interviews uncovered possible reasons for the confounding results and two interrelated themes that highlight clinical learning experiences and challenges in a multilingual environment. Conclusion Students perceive SPLD as a hindrance toward their clinical education experience. Follow-up interviews uncovered the quandary of using translators and how language discordance impacts student’s professional identity formation.

Attitudes of Filipino health profession students toward interprofessional education: a descriptive study

ABSTRACT The thrust of interprofessional education is to prepare health professions students to deliberately learn and work together with a common goal of providing better and safer care for service users. This study sought to describe the attitudes of health profession students toward interprofessional education and to identify which among the variables (i.e., sex, programme, year level, prior clinical and interprofessional education experiences, and level of moral development) are determinants of their attitudes toward interprofessional education. A total of 485 participants were surveyed using a validated, three-part Interprofessional Education-Attitude Scale (IPE-AS). No statistically significant difference was found between the attitudes toward interprofessional education and variables such as sex, prior clinical and interprofessional education experiences among medical, nursing, and pharmacy students. Our findings found that those with more agreeable attitudes toward interprofessional education were students in the medical programme, those from the lower year levels and those with higher stages of morality (based on Kohlberg’s stages of moral development). This suggests that IPE must be introduced across health science curricula with an intentional profiling of students about their experiences related to learning and working with students from different programmes. Moral development, as a variable in the study, also provides information as to how it can improve IPE programmes, competencies, and experiences of students in the fields of health sciences.

The experience of baccalaureate clinical nursing faculty transitioning to emergency remote clinical teaching during the COVID-19 pandemic: Lessons for the future

BackgroundExperiential clinical learning in undergraduate nursing education allows for fusion of nursing knowledge with practice to ensure the development of competent graduate nurses. The global COVID-19 pandemic necessitated an abrupt transition from in-person clinical educational experiences to emergency remote clinical teaching. ObjectivesThe purpose of this study was to describe the experiences of baccalaureate nursing clinical faculty who transitioned from in-person clinical to emergency remote clinical teaching during the COVID-19 pandemic in spring 2020. DesignA qualitative descriptive design was used. SettingThe study took place in the United States. ParticipantsNineteen baccalaureate nursing clinical faculty participated in the study. MethodsParticipants engaged in semi-structured, in-depth, online interviews. ResultsFive themes emerged from the data: transition, collaboration and support, the joy of teaching, authentic professional experience, and the overarching primary theme, stress of the moment. ConclusionsThe transition to emergency remote clinical teaching during the COVID-19 pandemic caused stress and anxiety. However, there were important lessons learned about how to best support students and faculty while providing a robust online learning experience. Understanding the experiences of clinical nursing faculty during this abrupt transition can support recommendations for best practices in the future.

Transformational education: exploring the lasting impact of students’ clinical pastoral education experiences

“Thank you for that experience and for the ways it continues to shape who I am and how I interact in all of my life.” (S20). There has been limited research validating Clinical Pastoral Education (CPE) as a learning approach to date, however, the anecdotal evidence supporting the transformative value of CPE is abundant, as demonstrated by this student response. This quality improvement project engages a thematic cross-sectional analysis of 34 students’ self-evaluative responses reporting the lasting impact of their CPE training. From the survey responses a thematic map was developed highlighting six themes of lasting impact: Spirituality, Psychotherapy, Agency, Self-Inter, Self-Intra, and Story/Narrative. These six themes overlap and intersect to provide a point of what we call “SPE alchemy”–the perfect conditions for lasting impact and transformation.

Health Promotion and Disease Prevention in the Elderly: The Perspective of Nursing Students.

Health promotion and disease prevention are closely linked to health literacy. Therefore, intervention to increase individuals’ knowledge is essential if action is to be taken to promote a healthy lifestyle with support from health professionals for decision making on choices leading to behavioral change. Taking into account the growing aging population, nurses and nursing students have to develop interventions to promote health and prevent disease in these people, in order to keep them healthy and with quality of life. This study aims to understand how nursing students’ experiences in a clinical teaching context contributed to the development of their competencies in the promotion of health and prevention of disease in the elderly. Method: Qualitative, exploratory, and descriptive study carried out with ten students about to finish a graduate nursing course in a higher education institution in the South of Portugal. This study was carried out through narratives, one of the most common data collection procedures in social and health investigations. The content analysis technique, more specifically the thematic categorical analysis, was used for data analysis. The study received authorization from the Ethics Committee of the institution where it took place. Results: Three categories were found: “Strategies to promote health and prevent disease in the elderly”, “Health improvements from the implementation of the strategies to promote health and prevent disease in the elderly”, and “The impact your participation in these strategies to promote health and prevent disease in the elderly had on your formative process”. Conclusion: The students developed competencies during their clinical teaching experiences through the implementation of strategies of health promotion and disease prevention adapted to/focused on the needs of the elderly.

Collaborating to Integrate Education and Practice: A Model of a Physical Therapy Academic–Clinical Partnership

Background and Purpose. Strong academic–clinical partnerships have been advocated to optimize the training of the next generation of health professionals and to best meet the needs of patients and society. Despite the benefits of partnerships, there is a lack of literature describing successful models for collaboration between physical therapist (PT) schools and academic medical center hospitals. The purpose of this article was to describe the formal partnership between the Northwestern University, Feinberg School of Medicine, Department of Physical Therapy and Human Movement Sciences (DPTHMS) and Shirley Ryan AbilityLab in Chicago, Illinois. Method/Model Description and Evaluation. The partnership is presented through the lens of D'Amour's 4-dimensional model of collaboration highlighting 4 critical dimensions of collaboration: shared goals and activities, internalization, formalization, and governance. Outcomes. The establishment of this partnership has fostered the institutions' achievement of mutual goals supporting their interconnected visions and missions. Examples of the collaboration's shared goal and activities include: the tripling of clinical education experiences for professional Doctor of Physical Therapy (DPT) students; establishment of 2 post professional PT residency programs; proliferation of DPT teaching opportunities for Shirley Ryan AbiltyLab clinical PTs with formal university academic appointments for 6 Shirley Ryan Ability Lab PTs; and clinical appointments for 7 of 34 eligible DPTHMS faculty members. The internalization dimension is evidenced by regularly scheduled communications; promotion of opportunities for mutual acquaintanceship through shared boards and teams; socialization opportunities; and trust-building across institutions. The primary example of formalization is the legal collaboration agreement signed in 2013 and amended in 2019. Partnership governance is achieved through a structure of designated liaisons, shared boards, and regular interinstitutional leadership meetings. Discussion and Conclusion. D'Amour's structuration model describes predictors for successful interinstitutional clinical–academic partnerships. The model's 4 collaboration dimensions facilitate the assessment of partnership success for both established partnerships and for institutions in the planning stage of such collaborations.

Room for Improvement? Mentor Teachers and the Evolution of Teacher Preservice Clinical Evaluations

The clinical teaching experience is one of the most important components of teacher preparation. Prior observational research has found that more effective mentors and schools with better professional climates are associated with better preparation for teacher candidates. We test these findings using an experimental assignment of teacher candidates to placement sites in two states. Candidates who were randomly assigned to higher quality placement sites experienced larger improvements in performance over the course of the clinical experience, as evaluated by field instructors (a.k.a university instructors). The findings suggest that improving clinical placement procedures can improve the teaching quality of candidates.

Implementing a virtual placement scheme for physiotherapy students in the UK: The experiences of clinical educators

Implementing a virtual placement scheme for physiotherapy students in the UK: The experiences of clinical educators

Clinical instruction in mental health nursing: students' perceptions of best practices.

Negative clinical educational experiences for student nurses are predictors of negative attitudes and perceptions towards mental health. In clinical education, instructors take on this important role often with little to no formal training. This study explored nursing students' perceptions of instructional best practices in mental health clinical education. A qualitative descriptive design was used, and 10 Canadian baccalaureate nursing (BN) students were interviewed. These students had completed a six-week practicum on an acute inpatient psychiatric unit in either their second, third or fourth year of study. Through thematic analysis, three themes were identified: (1) Students valued feeling prepared at the beginning of the clinical placement. (2) Students felt empowered when instructors encouraged self-direction. (3) Students appreciated positive role modeling by their instructors. Suggestions for clinical teaching strategies are made to mitigate student stress, increase confidence, and address the influence of mental health stigma on learning.

A web-based clinical pedagogy program to promote professional development for nurse preceptors: A quasi-experimental study

ObjectiveTo examine the effectiveness of a web-based clinical pedagogy program on nurse preceptors’ clinical teaching competency, self-efficacy, and attitudes toward web-based learning in comparison to face-to-face course. BackgroundPreceptorship is a dynamic educational process that requires designing, and implementing various teaching strategies, evaluation, assessment and feedback. Web-based learning has been recognized as an effective learning approach for nursing professional development. DesignA prospective quasi-experimental approach with two-group pre-test and post-test repeated measures was adopted. MethodsThe web-based clinical pedagogy program was provided to the preceptors in the experimental group, while control group received the face-to-face preceptorship course. Clinical Teaching Competence Inventory (CTCI), Preceptor Self-efficacy Assessment Instrument (PSEQ), and Attitudes toward Web-based Continuing Learning Survey (AWCLS) were used to evaluate preceptors’ learning outcomes. Data were collected at three time points – before, immediately after the learning program, and after 6 months of the clinical teaching experience. ResultsA total of 150 nurses (75 participants/group) were recruited from a tertiary hospital in Singapore from July 2018 to June 2020. The results from the repeated measures analysis of covariance showed that there was a significant interaction effect (group x time) on the overall CTCI score after adjusting for covariate (F = 5.390, p = 0.005). However, there were no significant interaction effect (group x time) on PSEQ (F = 2.693, p = 0.070) and overall AWCLS score (F = 1.341, p = 0.264) between the two groups across the three time points. ConclusionThe web-based clinical pedagogy program produced outcomes comparable to the face-to-face program in terms of preceptors’ clinical teaching competence and self-efficacy. The innovative and cost-effective web-based clinical pedagogy program provided professional development and the flexibility to accommodate preceptors’ busy work schedules. Online learning has become increasingly popular during the COVID-19 pandemic and the web-based clinical pedagogy program was implemented when face-to-face workshop was not feasible.

Influence of Clinical Instructor Experience on Assessing Doctor of Physical Therapist Student Clinical Performance: A Mixed-Methods Study

Introduction. Formative and summative feedback are essential for physical therapist students' professional growth. Achieving objectivity in student clinical assessment has been a longstanding concern for health care educators and ambiguity surrounds what is meant by competent clinical practice. According to a sociocultural perspective, clinical performance is socially constructed and based on an individual's perception of what is taking place, which may explain differences identified in the literature between novice and experienced assessors of student clinical performance. However, it is not known whether novice clinical instructors (CIs) differ from experienced CIs in their assessment practices of student physical therapists. The purposes of this study were to examine whether novice and experienced CIs' assessment practice differ and explore the reasons for these differences (if any). Methods. Novice and experienced CIs for physical therapist students' 3 full-time clinical education experiences served as participants for this study. A mixed-methods research design was used. In the quantitative phase, novice and experienced CI-assigned midterm and final student ratings of the Clinical Performance Instrument (CPI) were compared. In the qualitative phase, semi-structured interviews, document review, and participant observation were conducted. Results. Experienced CIs awarded higher ratings on the CPI than novice CIs, but ratings on only a few of the performance criteria were significantly different. Qualitatively, both novice and experienced CIs were similar in terms of the importance assigned to professional behavior and safety. However, novice CIs were more literal and concrete and experienced CIs were more flexible and varied. Three CI roles (CI as student, CI as clinician, and CI as assessor), CI self-confidence, reflection, context, assessor approach, and assessor agreement emerged as strong themes throughout. Discussion and Conclusion. The low number of statistically significant differences between novice and experienced CIs' awarding CPI ratings suggests that there were few true quantitative disparities between the assessors. Both study cohorts' backgrounds as former students and as current clinicians as well as their stage of CI professional development seem to have influenced their approach to clinical assessment.

Clinical Education Coordinators' Selection and Deselection Criteria of Clinical Education Experiences

Context Athletic training students have identified clinical education as the most important aspect of their education when transitioning to practice. However, athletic training students have been frustrated with a lack of engagement, mentorship, and diversity within their clinical education experiences. As such, the selection and deselection of clinical sites is critical to creating effective learning experiences. Objective To explore how clinical education coordinators (CECs) select and deselect clinical education experiences (sites and preceptors) for clinical integration and immersion. Design Consensual qualitative research. Setting Individual teleconference interviews. Patients or Other Participants Thirteen CECs (age = 42 ± 8 years, experience in current role = 8 ± 8 years) from accredited professional master's programs who were in their position for at least 1 year and had at least 1 immersive rotation. Data Collection and Analysis All interviews were audio recorded and transcribed. A 3-person data analysis team used a multiphase process to identify the emerging domains and categories. Trustworthiness was established through member checking, multiple researcher triangulation, and auditing. Results Two themes emerged from the participant responses: accreditation compliance and strategic choices. We found participants expressed the theme of accreditation compliance as a major facilitator when selecting or deselecting clinical education placements. Strategic choices, such as student aspirations and focus on the quantity over the quality, were used by CECs to select clinical education placements which develop student autonomy and provide diverse experiences. However, the CECs engaged in convenient preceptor selection based on geographical location and previous relationships. Conclusion(s) Our findings suggest CECs leverage convenient clinical education opportunities that comply with accreditation expectations. CECs should be strategically selecting clinical education opportunities that move beyond accreditation minimum standards and focus on high-quality experiential learning, which leads to autonomous practice and embraces the diversity of the profession.

Impact of an Interprofessional Student-Led Concussion Clinic

This article describes the impact on the learners and health care institution of the OnTRACK-Concussion program, an innovative student-led clinic at a children’s rehabilitation hospital. The clinic, developed and operated by occupational therapists, serves the community full-time year-round. Interprofessional health care learners work together to provide education and intervention for youth with concussion and their families and to support research and community outreach initiatives. To determine the program’s impact on student learning, a post-placement questionnaire was used to capture feedback about their clinical education experience. To determine the program impact more broadly, the most significant change method was used to analyze data from in-depth qualitative interviews with stakeholders across and beyond the organization. Three Program Impact Pathways were identified that support the program’s success within and beyond the organization: 1) Having a clear message/vision of integration; 2) Enabling learners to work directly with patients; and 3) Enabling learners to work autonomously. Debriefing with peers and clinical supervisors was identified as an important learning experience by interprofessional learners. This student-led clinic, developed and operationalized by occupational therapists, supports the integration of patient care, research, and clinical education in pediatric concussion through clearly identified Program Impact Pathways.

Professional Master's Athletic Training Students' Career Influences Part I: Perceptions of Athletic Training

ContextAs athletic training education transitions to a professional master's degree, understanding the perceptions professional master's athletic training students have of athletic training is important.ObjectiveTo examine second-year professional master's students' perceptions of the athletic training profession, a career in the profession, and identify the factors that influence their perceptions.DesignConvergent mixed methods.SettingOnline surveys and individual phone interviews.Patients or Other ParticipantsA total of 80 second-year professional master's students (63 female, 13 male, 4 no response, age = 24.63 ± 2.29 years), who were enrolled in the final semester of their program in the spring of 2019, completed the online survey. Ten survey respondents completed the follow-up phone interviews.Data Collection and AnalysisA survey instrument and a semistructured interview guide were developed to answer the research questions. Both were validated externally by 3 independent researchers using a content-validity indexing tool. The data from the survey and interviews were woven together and merged to provide 1 comprehensive results section. Trustworthiness was established using triangulation, member checks, memos, and peer debriefing.ResultsThree higher-order themes emerged from the data: (1) perceptions of the athletic training profession: lack of appreciation and awareness for the profession from others, rewarding profession, and dynamic profession; (2) perceptions of a career in athletic training: low pay, long hours and inconsistent schedules, and inability to have work-life balance; (3) factors influencing perceptions: clinical experiences and interactions with athletic trainers.ConclusionsSecond-year professional master's athletic training students developed positive and negative perceptions about the profession and a career in the profession during their professional education experiences. The factors identified were professional socializing agents and should be considered when designing clinical education experiences.

Professional Socialization: A Retrospective View From Graduation to Full-Time Employment

Context It is assumed that after the transition to practice, athletic trainers will have developed stronger decision-making strategies, will have become comfortable within their role, and will be able to reflect on how their employer assisted them through the transition-to-practice process. Objective The goal of this study was to gain an understanding of how athletic trainers have gone through the transition-to-practice process and what resources they relied on during and after the transition. Design Qualitative study, phenomenological design. Setting Semistructured interviews. Patients or Other Participants Twelve athletic trainers (10 women, 2 men; 4.0 ± 2 years certified) agreed to participate. Data saturation guided the total number of participants for this study. Data Collection and Analysis Videoconference interviews were recorded and transcribed verbatim using Zoom. Credibility of the study was maintained using several mechanisms, including expert/peer review, member checks, and researcher triangulation. Results Two themes emerged as different points in time of the athletic trainer's transition to practice. The first theme was pre–entrance into the workforce, and within this theme, athletic trainers were able to reflect on the strategies and resources that were provided to them by their professional master of athletic training program. Within the second theme, post–entrance into the workforce, athletic trainers were able to recall the resources that were provided to them by their employers and those additional resources that were sought out individually. Conclusions Athletic trainers recognized how their master of athletic training programs prepared them for the transition-to-practice process based on the didactic coursework and intentional clinical education experiences. Athletic trainers also recognized the resources that were and were not provided to them to assist them in fulfilling their roles and responsibilities, as well as realizing the additional resources they needed to enhance their own clinical practice.

Clinical Legal Education in Belarus: Practice-Oriented Pedagogy for Socially Engaged Law Students

The paper analyzes the evolution and changes involving clinical legal education (CLE) in Belarus. The author tends to create a historical overview of the 22 years’ experience of clinical legal education in Belarus. It will be possible to answer some questions mostly based on the inside view and 12 years of clinical experience with goals to bring some inspiration in a global context and to leave a mark on history. It focused on the new role embraced by legal clinics in Belarus and contribution to the creation of a new formation of legal practitioners. Additionally, the author shares the technological insights about clinical legal education. Thinking about the future it is important to make an overview of achievements and opportunities of going forwards. There is a great number of opportunities to implement clinical methodology to both academic studies and professional training. The research problem addressed in this paper is to substantiate the most effective forms and methods of teaching law disciplines both in Russian and in English in a law school in the context of introduction of digital forms of learning into traditional educational environment of a law school. The author carries out an analytical review of law clinics in historical perspective and how the work of law clinics is implemented in both academic curricula and professional training in Belarus.

Educational Benefits of an International Service-Learning Course in Honduras for Doctor of Physical Therapy Students

International service-learning (ISL) activities are academic experiences that encompass participation in organized service activities, practical experiences, and critical reflection. The assessment of physical therapy clinical education is primarily achieved through student performance on the clinical performance instrument (CPI) during clinical education. The CPI assesses a student’s performance in all subdomains of professional practice and patient management and is completed during each clinical education experience

Journal of Clinical Education in Physical Therapy – Growth during COVID

The Journal of Clinical Education in Physical Therapy (JCEPT) mission emphasizes facilitating development of and disseminating evidence related to clinical education in physical therapy. Our distinguished editorial board members continue to provide guidance as we develop, while representing various clinical specialties, research interests, and roles in physical therapy education. The coronavirus (COVID) pandemic has posed serious challenges for everyone including personal health and financial crises, educational adaptation to online learning, and professional research challenges. Interest in JCEPT has continued to grow, nevertheless. Submissions and published papers for the 2021 volume have doubled. As an open-access journal, JCEPT is developing an international reach; papers last year were downloaded about 1,000 times with >15% of users located beyond the United States. In the current volume, we look forward to papers with timely topics: impact of integrated clinical experiences on physical therapy student clinical performance, student mental health during clinical education, competency of clinical instructors, entry level caseload expectations during terminal clinical experiences, and student physical therapist burnout and grit during terminal clinical education experiences. Many of the opportunities and challenges we face along the continuum of learning is not unique to physical therapy. In an effort to integrate the views of other professions, we are pleased to publish our first resident case study in our Inter-Professional Corner. Physical therapy education programs create learning experiences in a controlled environment to approximate authentic clinical situations. There is, however, no substitute for clinical education where learners apply knowledge and skills in real clinical practice. Clinical instructors (CIs) are the primary educators during entry level Doctor of Physical Therapy (DPT) clinical education experiences which account for approximately one third of the DPT curriculum.1 While typical characteristics and qualities of CIs have been identified,2–4 there is wide variation in the quality of clinical education that DPT students experience. One reason for variations in clinical education quality appears to be CIs clinical teaching skills.2 The National Study of Excellence and Innovation in Physical Therapy Education has suggested the establishment of a standard comprehensive, longitudinal approach for performance-based learning outcomes across the learner continuum.5 Competencies, or characteristics of an individual, are an example of a defined outcome. In the current volume, Bilyeu et al. describe a path to the stepwise development of competencies for CIs to help prepare them to teach. This information can help develop personalized professional development for CIs that could reduce the variation in clinical teaching. The increase in new and expanding DPT programs has increased demand for clinical education placements. Bayliss introduces a re-designed clinical education curricular model that emphasizes in-class patient experiences along with integrated clinical experiences as an alternate solution to meet this growing challenge. In addition, increased productivity pressures add to the challenges of CIs and students. Sherman et al. examine expected student caseloads across and within clinical settings, while Kish et al. explore student burnout and grit within clinical settings. Finally, Eubanks et al. explores the experiences of the Director of Clinical Education (DCE) that often expand beyond the recommended roles6 to include supporting the student during mental health challenges.7 The growth of JCEPT has been exciting to see and we look forward to developing further as other manuscripts progress through the publication pathway. JCEPT accepts original research, narrative and systematic reviews, innovative teaching methods or educational models relevant to clinical training, clinical education or clinical case reports, and exceptional critically appraised topics all of which can address any element of physical therapy education related to clinical practice. Christopher Kevin Wong and Jean Fitzpatrick TimmerbergEditors in Chief

Clinical educator’s experiences of the decentralised training platform for Occupational Therapy students in KwaZulu-Natal, South Africa

In piloting a shift from traditional practice-based placements to decentralised clinical training (DCT), there was a need to explore the factors that influenced the placement as part of monitoring and evaluation. DCT involves placement to clinical sites away from the higher education institution necessitating changes to supervision strategies utilised. This study explored the experiences of clinical educators supervising occupational therapy students within this new model during a pilot phase of the DCT programme at one institution in South Africa. The study was located in KwaZulu-Natal province and followed an explorative qualitative design with semi-structured interviews and focus groups with purposively sampled clinical educators (n=11). Data were audio-recorded and d thematically analysed. Two central themes emerged and included the clinical educators' expectations (organisation factors, role and scope of partners in decentralised training and communication) and experiences (perspectives and value of decentralised training). Decentralised training has considerable potential to contribute to authentic student learning. Improved communication between all stakeholders would assist in enhancing the quality of the learning experiences on such platforms. Students need to be more prepared prior to commencing DCT, and there is a need for more rural placements with a primary health care focus.

Burnout and grit in student physical therapists before and after terminal clinical education experiences: a prospective longitudinal study of a single class-year cohort

Rationale: Burnout has been reported by graduate healthcare students during several phases of preprofessional education. The purpose of this study was to explore changes in levels of Doctor of Physical Therapy (DPT) student burnout and grit before and after clinical education. Additional aims included exploring how burnout and grit might differ based on student gender and over time and what relationships might exist between burnout and grit in this population. Methods: All enrolled third year DPT students (n = 50) at a single physical therapist education program participated in this study. Participants were surveyed using the Maslach Burnout Inventory Human Services Survey and the 12-Item Grit Scale at the end of curricular Year 3 and at graduation after terminal clinical education experiences. Descriptive, exploratory, and comparative statistical methods were used. Results: Male participants reported significantly decreased emotional exhaustion (EE) from Year 3 to graduation, p ≤ 0.0001. Overall, the cohort reported significantly decreased EE, F(1,48) = 12.35, p = 0.001, d = 0.44 and increased personal accomplishment, F(1,48) = 13.322, p = 0.001, d = 0.58 after terminal clinical experiences. The main effect of time on grit scores was also significant, p = 0.035. A moderate inverse relationship existed between student grit levels at Year 3 and EE levels at graduation, r = –0.447, p = 0.01. Conclusions: Cohort burnout scores did not meet the Maslach Burnout Inventory criteria definition for burnout; mean EE and personal accomplishment subscale scores significantly changed over time. Male DPT students reported moderate levels of EE at the start of terminal clinical experiences that dropped significantly to low levels compared to female students. Student grit levels in this study were high compared to recent investigations of other DPT cohorts. Grit may have a protective effect against DPT students experiencing burnout. Meshterms: Burnout, Professional; Physical Therapists/education; Achievement.