Entry-level Training Research Articles

Protocol for the SELECT study: a sequential mixed methods study of the selection of UK medical students into clinical academic training

BackgroundInternationally, there has been a move towards fostering diverse healthcare workforces that are representative of the patient populations they serve. Selection criteria for academic-clinicians often aim to capture skills and attributes that demonstrate both clinical and academic excellence. Currently, it is not known whether the selection criteria for early academic-clinical careers advantage or disadvantage certain ethnic or socioeconomic groups. The UK has a structured route of integrated clinical academic training with entry level training for newly qualified doctors administered through the ‘Specialised Foundation Programme’ which provides protected time for research within the first two years of postgraduate clinical training. In this study, we aim to identify what selection criteria are used within the UK Specialised Foundation Programme, and how these relate to demographic factors.MethodsWe will perform a mixed methods study consisting of a document analysis of person specifications and selection criteria used in the 2024 UK Specialised Foundation Programme, and a national cross-sectional survey of current medical students in the UK. We will obtain the person specifications, selection criteria, white space (open ended questions used during shortlisting) and interview questions and mark schemes from each Specialised Unit of Applications via information available on their websites or through Freedom of Information requests. Our survey will collect information relating to demographic data, selection criteria, and perceptions of specialised foundation programme selection.DiscussionInternational literature has demonstrated inequity in academic markers used in selection of post-graduate clinicians and that disadvantages caused by selection can compound over time. As such it is important to understand what inequity exists within the selection of early academic-clinicians, as this can help inform more equitable selection practices and help nurture a more diverse academic-clinical workforce.

Entry-Level Training Improves Self-Rating of Interprofessional Competencies & Identification of Teaming Strategies for Early Childhood Practice

Abstract Date Presented 03/21/24 Therapy students in an early childhood training program demonstrated improved self-ratings of teaming competencies and use of teaming strategies and approaches. Entry-level training on collaborative practice enhances the quality of early intervention/early childhood programs. Primary Author and Speaker: Christine T. Myers Additional Authors and Speakers: Kristen Lewandowski, Claudia Senesac, Kim Dunleavy

Recruit Profiles Across the U.S. Armed Forces: Implications for Increasing Gender Integration in Recruit Training.

This article uses recent survey data from a study on gender integration at recruit training across the U.S. Armed Forces to examine service, gender, and training differences in recruit's gender attitudes, beliefs, and cohesion metrics. In addition to providing a descriptive understanding of our recruit sample, this article examines factors germane to gender integration at recruit training such as gender attitudes, sexist beliefs, and unit cohesion. This article uses data from a survey of U.S. Marine Corps (USMC), U.S. Army, U.S. Air Force, U.S. Navy, and U.S. Coast Guard recruits as part of a USMC-commissioned study to develop alternate models and recommendations for increasing gender integration in USMC recruit training. At all sites but the USMC, recruits completed the survey 1 to 2 weeks before graduation. At the Marine Corps Recruit Depots, recruits participated in the survey at the beginning (week 2) and end (week 11) of their 13-week training cycle. A 19-question survey captured sociodemographic information, perspectives and experiences during recruit training, and gender attitudes and beliefs. Analyses were conducted on the sample with complete data on the measures reported, including those USMC recruits observed at both week 2 and week 11 (n = 629). Descriptive statistics (percentage) were calculated for all categorical outcome variables. Outcome variables (cohesion, gender, and sexism attitudes) were compared between groups using chi-squared tests or Fisher's exact tests, as appropriate. Recruits differed significantly across services in perceptions of unit cohesion on 3 of the 4 indicators: Platoon members are cooperative, know they can depend on each other, and really respect each other (P < .05). These differences appear to be driven by female recruit difference across service. They reported significant differences in gender role attitudes across the services, with USMC recruits being most likely to endorse traditional gender roles compared to other service recruits. Male USMC recruits were significantly more likely than their female peers to agree that men should achieve outside the home and women should take care of the home and family (21.3% versus 6.3%, P < .05). The only statistical differences in attitudes about equality of treatment and opportunity among recruits were between male and female USMC recruits. All items capturing sexist attitudes elicited statistically significant differences between male USMC recruits and male recruits in other services (P < .05). There were significant differences in all sexism measures between male and female USMC recruits (P < .05). There is a significant decline in some sexist attitudes between weeks 2 and 11 of training among male USMC recruits (P < .05). Nearly one-half to three-fourths of male USMC recruits hold sexist attitudes, even near the end of recruit training. The disparate gender and sexism attitudes of male USMC recruits compared with their peers in other services, and their fellow female USMC recruits suggest efforts to increase gender integration at entry-level training are needed, but also may be challenging since male USMC recruits report the highest levels of sexist attitudes among all recruits.

Design Considerations for a Multidisciplinary Approach to Provide Policy Recommendations on Gender-Integrated Recruit Training in the Marine Corps.

Recruit training is designed to transform civilians into physically fit military service members, who embody their service's core values and possess military discipline and skills. At the time this research began, the U.S. Marine Corps (USMC) remained the only service that segregated recruits by gender at the lowest unit level (e.g., platoon) and employed gender-segregated drill instructor teams. USMC's Marine Corps Recruit Depots (MCRD) must comply with a 2020 Congressional Mandate to not segregate training by gender in Parris Island by 2025 and San Diego by 2028. In turn, USMC requested an independent scientific study to analyze current approaches to gender integration at recruit training to propose alternate models and other policy recommendations that increase gender integration while maintaining current USMC standards. The Marine Corps is currently evaluating alternate models and recommendations to optimize entry-level training. This article outlines considerations for choosing the optimal research study design, research methods, and types of data collected in a study intended to provide policy recommendations on gender-integrated recruit training for the USMC. Research data were collected during visits to the MCRDs and selected recruit training locations for the Army, Air Force, Navy, and Coast Guard. Data collection on USMC recruits from three cohorts involved social science assessments (focus groups and surveys) and human performance testing (countermovement jumps and isometric mid-thigh pulls, sleep and activity wearables, and cortisol data) at multiple points in the training cycle. Data on recruits from the sister services were limited to social science assessments. Approximately 600 recruits between the two MCRDs and 160 recruits from the sister services participated in the study during a 7-month timeframe in 2021. The research team conducted extensive ethnographic observations of recruit training at all selected research sites and interviewed training cadre, drill instructors, and service leadership responsible for recruit training (∼90 interviews). Additionally, the research team interviewed 20 experts on gender integration or recruit training who possessed alternate viewpoints from the current USMC practice. The mixed methods study was designed to assess the current gender integration practices at recruit training across the services to generate alternative models of gender integration for USMC. The research team developed a set of multidisciplinary objectives and research questions serving as the foundation of the research study design and data collection process. The study was designed to collect qualitative, quantitative, and administrative data informed by social science and human performance disciplines. To ensure that all aspects and implications relevant to gender integration were considered, select data were collected across services and with stakeholders at all levels. This multidisciplinary research approach provided a comprehensive picture of the current USMC recruit training models. The research team captured multiple perspectives and data points for analysis through an expansive view on gender integration across all services, by interacting with participants at all levels of the institutions in varied ways. The information and data gathered enabled the research team to establish objective, data-driven alternate models, and recommendations for enhancing gender integration at recruit training for the USMC.

Decreasing alcohol use among young adults presenting for service in the U.S. Air Force: An epidemiological surveillance study

ABSTRACT U.S. surveys demonstrate recent decreases in the prevalence of alcohol use and binge drinking among young adults. The current study aims to determine whether similar trends are evident in a similarly aged cohort of service members in the US Air Force to inform ongoing prevention efforts. Participants were 103,240 Air Force personnel in entry-level training between 2016 and 2019. Participants anonymously completed the AUDIT (Alcohol Use Disorder Identification Test) regarding their pre-service drinking. Logistic regression analyses and the Cochran-Armitage test were conducted to measure population trends over the study duration with stratification by age (<21 vs. ≥21) and evaluation of specific alcohol behaviors. Between 2016 and 2019, the proportion of young service members endorsing any alcohol use significantly decreased for both the <21 group (i.e. from 38.9% to 32.6%) and the ≥21 group (i.e. from 80.6% to 77.5%). Among those who endorsed drinking, a decrease over time in binge use was also observed from 46.6% to 37.8% for the <21 group and from 34.2% to 27.5% for the ≥21 group. Responses to other specific alcohol risk items and total AUDIT scores also demonstrated decreases. Binge use and risky drinking remained disproportionately common among those under the legal drinking age. It is encouraging to observe a shift toward abstinence and decreased binge use among this population of young military recruits. However, given the risk for many adverse health and legal consequences in this population, more work is needed to prevent problematic drinking, especially among those under the legal drinking age.

Musculoskeletal physiotherapists reasons for treatment selection and continuous professional development practices in the United Kingdom: A cross-sectional survey

PURPOSE: The aims of the study were two-fold 1) to explore the treatment modalities musculoskeletal physiotherapists are utilising and the underlying reasons why and 2) report current continuing professional development (CPD) practises and their perceived effectiveness. METHODS: Using a cross-sectional questionnaire, musculoskeletal physiotherapists in the United Kingdom (UK) were invited to complete an online survey. The survey captured respondents’ professional characteristics and their main reason for selecting a range of treatments sub-grouped into three broad categories; Manual Therapy, Treatment Modalities and Education Based Approaches. Respondents were asked to report their CPD practises and their perceived effectiveness. Data was converted into proportions with lower and upper limits of the 95% confidence interval (CI). Likert scale questions were treated as numeric variables with the mean and standard deviation (SD) calculated for combined responses. RESULTS: Of the 414 responders, 408 were eligible for analyses. The most common reason for treatment selection, based upon a combined total of 9792 responses across all treatment modalities, was content taught in ‘entry-level training’ (n = 2010, 20.5%, 85% CI 20 to 21), followed by ‘practice related courses or CPD events’ (n = 1241, 12.7%, 95% CI 12 to 13). ‘Self-reflection’ was the most common form of CPD (n = 404). All forms of CPD were considered ‘effective’ for developing knowledge and skills except ‘clinical audit’ and ‘journal clubs’ which were rated as ‘indifferent’ by respondents. CONCLUSIONS: Treatment technique depends heavily on skills taught in entry-level training. Despite research articles amongst the most utilised forms of CPD, a disconnect exists in its implementation as the main driver of treatment selection. A wide range of CPD activities were undertaken by participants and rated as ‘effective’ for acquiring and applying physiotherapy related skills.

"A New Page in the ROTC Concept": ROTC Entry-Level Training and Fort Knox, 1965–2014

"A New Page in the ROTC Concept": ROTC Entry-Level Training and Fort Knox, 1965–2014

End of an era or a moment of reshuffling: fragmentation of entry-level training in China's psycho-boom.

This article examines the fragmentation of entry-level training in China's psycho-boom since the state terminated its certification for psychological counsellors in 2017. Initially, the policy change was perceived as the end of an era marked by rapid yet disorderly development. The stringent state regulation that many people anticipated, however, did not occur. The certification's ending turned out to be a moment of reshuffling that gave existing key players - including the Registry System under the Chinese Psychological Society, other quasi-official organizations and their partners in the training industry, and digital start-up companies - a new chance to vie for growth and dominance in the space it left behind. The heat of the psycho-boom continues, as do the chaos and struggles within it.

Exploring teacher educators’ post-pandemic intention to teach online in mainland China: the social cognitive career theory perspective

ABSTRACT The outbreak of COVID-19 has compelled teacher educators to move their teaching online. On the positive side, teacher educators may become more willing to continue integrating online teaching as part of their practice post-pandemic due to frequent usage of digital tools and platforms during pandemic. The social cognitive career theory (SCCT) was used to investigate how this intention was related to the tandem of self-efficacy and expected outcomes, as well as their sources (i.e. identity commitment to student teacher learning and the supportive environment at the institution). The results of partial least squares structural equation modelling (PLS-PM) revealed the following: first, self-efficacy did not affect intention directly, but through the chain mediation of expected outcomes and interests. It mirrored the effectiveness-oriented instructional mindset of teacher educators. Second, identity commitment to student teacher learning and a supportive environment at the institution affected self-efficacy but did not affect expected outcomes directly. The multigroup analysis revealed that for those who had attended pre-pandemic online teaching training, a supportive environment significantly affected their expected outcomes when using online teaching. This study argued for the importance of entry-level training to facilitate peer support and mentoring for teacher educators working with online teaching strategies.

Interprofessional Collaborative Practice and Education in Oncology: Practical Applications and Experiences, From Physical Therapy Classroom to Clinic

Oncology is a complex clinical domain that requires physical therapists (PTs) to engage in multidisciplinary collaboration to achieve optimal patient outcomes. The emerging role of PT in oncology highlights the need to include interprofessional education (IPE) and interprofessional collaborative practice (IPCP) during entry-level training, yet few curricular models, which integrate IPE and IPCP, exist. New clinical opportunities in oncology within our Doctor of Physical Therapist (DPT) program create a multidimensional platform for students to engage with the entire health care team to address the complex needs of this population, and to demonstrate the value of the PT as a member. Such opportunities not only meet the standards and required elements of DPT education, but are initiatives supported by the World Health Organization, and the American Physical Therapy Association. The purpose of this article is to highlight opportunities and practical strategies employed by one academic institution to integrate IPE and IPCP into their entry-level program, share lessons learned, and ideas for future development of this important topic. In our integrated curricular model, physical therapist students learn about the roles and responsibilities of each interprofessional team member, learn to share information, and collaborate during a dynamic and practical clinical environment under the supervision of faculty. Knowledge from previous didactic coursework is applied to pediatric and adult oncology survivors participating in a wellness program or group exercise class. All activities and exercises are modified based on the patients' needs and responses.

Self-Perceived Resilience In U.S. Service Members During Entry-level Training

PURPOSE: To describe self-perceived resilience (SPR) in recently enlisted service members (SM) upon entry into a three-month secondary training (ST) course and to investigate the associations between SPR and graduation from ST. METHODS: Male enlisted SM (N = 858, age = 19.7 ± 1.75 years) were surveyed upon entry into ST. SPR was assessed with the question: “Do you consider yourself a resilient person (able to bounce back after stressful events)?” Subjects selected one of four responses: rarely, sometimes, very often and almost always. To simplify responses we collapsed responses into two categories: low SPR (rarely and sometimes) and high SPR (very often and almost always). Graduation outcomes, assessed via existing training records, were considered on-time if training was completed without any delays on the first attempt. Counts and percentages were evaluated with contingency tables. Fisher’s exact and Pearson Chi-squared tests with odds ratios (OR) and 95% confidence intervals (95% CIs) were used to assess associations between SPR and both overall graduation and on-time graduation, respectively. RESULTS: The majority of subjects reported high SPR (92%; n = 792/858); 8% (n = 66/858) reported low SPR. There was a significant association between SPR and overall graduation (Fisher’s exact test p = 0.02; High SPR: Graduated = 98% [n = 775/792], Did Not Graduate = 2% [n = 17/792]; Low SPR: Graduated = 92% [n = 61/66], Did Not Graduate = 8% [n = 5/66]). Subjects who had low SPR were at greater odds of not graduating (OR = 3.7, 95%CI = 1.33-10.47) compared to those with high SPR. There was a significant association between SPR and on-time graduation (X2 = 9.8, p = 0.002; High SPR: On-time graduation = 86% [n = 663/775], Delayed graduation = 14% [n = 112/775], Low SPR: On-time graduation = 70% [n = 43/61]; Delayed graduation = 30% [n = 18/61]). Those with low SPR were also at greater odds of delayed graduation (OR = 2.5, 95%CI = 1.4-4.5) compared to those with high SPR. CONCLUSIONS: Our findings show SM entering ST with low SPR have nearly 4 times greater odds of not graduating from ST overall and 2.5 times greater odds of delayed graduation compared to those entering with high SPR. Future studies should incorporate how resilience along with additional factors such as injury, race, marital status and education affect graduation from secondary training.

Prison Officer Training and Education: A Scoping Review of the Published Literature

The role of the prison officer is complex and challenging. In order to discharge their duties effectively, prison officers require relevant and comprehensive training and education upon recruitment and throughout their working career. The following paper presents the findings of a scoping review of the published literature as it relates to the training and education of prison officers. Employing a descriptive-analytical approach, we stratified this literature into three overarching themes; namely entry-level training and education programs, emerging issues and developments in prison officer training, and specialist health and well-being training programs. Findings are discussed with reference to significant current trends in the literature and potential areas of future research and practice.

Accuracy of the Tuning Fork Test for Determination of Presence and Location of Tibial Stress Fractures in a Military Training Population.

Stress fractures or bone stress injuries arise from trauma or overuse, often as a result of rapid increase in training. This rapid increase in training occurs frequently as military recruits begin their entry-level training, as many individuals are not accustomed to the level of activity required during boot camp. Tibial stress fractures are the most common bone stress injuries in the military setting. MRI is the gold standard test for identification of stress fractures, but MRI may not be available in field settings. Although limited evidence has suggested that a vibrating tuning fork may be beneficial in determining the presence of a stress fracture, the tuning fork has become a frequent tool used to detect or diagnose stress fractures. Military personnel with suspected unilateral tibial stress fractures were asked to participate in evaluation of tuning forks as a diagnostic tool, in addition to receiving standard diagnostics and treatment. Points of maximal shin tenderness to palpation and vibration, followed by the application of a tuning fork, were evaluated. Each service member also underwent an abbreviated MRI evaluation with a 1.5T magnet consisting of coronal and sagittal STIR (Short Tau Inversion Recovery) and T1 (weighted longitudinal relaxation time) sequences. The results of tuning fork testing were compared to the MRI findings, considering grade 1 changes on MRI to represent a true stress fracture. A two-by-two table was used to determine the performance of tuning fork testing, relative to MRI findings, applying conventional definitions of sensitivity, specificity, positive predictive value, and negative predictive value. Among 63 male active duty members with suspected tibial stress fractures, 39 had MRI-confirmed stress fractures. Tuning fork testing, relative to MRI, demonstrated overall sensitivity of 61.5%, specificity of 25.0%, positive predictive value of 57.1%, and negative predictive value of 28.6%. A sub-analysis restricting to grade 3 and grade 4 MRI findings did not improve the diagnostic performance of tuning forks. The tuning fork is an ineffective tool for diagnosing tibial stress fractures.

New-graduate physiotherapists' perceptions of their preparedness for rural practice.

Providing health care in a rural or remote setting requires physiotherapists to adapt to a number of unique challenges. New-graduates working in rural or remote settings must respond to these challenges in addition to those of being a novice practitioner. This study investigated the perceived preparedness of new-graduate physiotherapists for work in rural or remote settings. A qualitative general inductive approach. Rural and remote Queensland. New-graduate physiotherapists working in rural or remote locations were contacted via a snowballing recruitment strategy. Semi-structured interviews. Four key themes emerged from the data: (a) adjusting to rural life, (b) embracing opportunities, (c) stepping up to the plate and (d) preparing through authentic experiences. New-graduate physiotherapists perceived rural and remote practice to be a challenging but valuable opportunity with many social and professional rewards. The complex clinical demands and unique cultural factors inherent in rural and remote locations were experienced as additional obstacles to the transition from student to clinician. New-graduate physiotherapists were satisfied that their entry-level training provided the necessary skills required to practise rurally and remotely; however, they expressed 'shock' at the rapid adaptations needed to provide effective service in these settings. New-graduates are confident that exposure to authentic rural and remote clinical practice during their training was integral to their preparedness.

Long-Haul Truck Driver Training Does Not Meet Driver Needs in Canada.

IntroductionTraining standards for long-haul truck drivers (LHTD) are rapidly evolving in Canada, yet the opinions of the drivers themselves have not been adequately considered. The purpose was to survey LHTD on their work training history and to examine LHTD perceptions of driver training and licensing protocols.MethodsLHTD were recruited across two Western Canadian provinces from seven different truck stops. The sample completed 207 surveys and 67 semi-structured interviews.ResultsThe average age of the participants was 52.5 ± 11.5 years (range 24–79); 96% were men. Approximately 33% of the LHTD had at least one crash. Those who did not receive formal driver training were significantly more likely to crash than those who had received training. Participants stated that current training standards are inadequate for the industry, particularly for new drivers. According to participants, entry-level curriculums should consist of both classroom and practical training, as well as on-road observation with a senior mentor. LHTD reported that many new drivers are not equipped to drive in various contexts and settings (e.g., mountains, slippery roads).ConclusionsLHTD are not confident in the current training guidelines for novice truck drivers. Revisions to the training curriculum and standardization across Canada should be considered.Practical ApplicationA federal mandatory entry-level training program is needed in Canada to ensure that all new LHTD ascertain the necessary skills to drive safely. Such a program requires government involvement and input from LHTD to facilitate appropriate licensure and consistent training for all drivers.

Attaining and assessing the Australian interprofessional learning competencies

ABSTRACT Interprofessional collaboration is critical for optimal healthcare. Preparing for a collaborative, practice-ready workforce, the Interprofessional Learning Competencies (IPLCs) were adopted for accreditation of Australian entry-level health, nursing and medical tertiary training programs. In order to meet new accreditation standards, activities which facilitate and assess IPLC attainment must be identified. Interprofessional education programs have not evaluated student interprofessional learning activities using the Australian IPLCs. This project evaluates students’ experiences of the IPLCs during ‘Inspiring Health,’ a community-based interprofessional placement, and determines whether reflections can effectively assess IPLC attainment. Forty-nine students from seven Flinders University health and social science programs completed written reflections about four self-selected IPLCs. The results indicated that students had opportunities to attain all the IPLCs. Their reflections were analyzed using thematic analysis. Three themes were identified: the processes by which students learned, the outcomes of their learning, and the factors that influenced their learning. Ultimately, these findings describe a beneficial community-based interprofessional learning activity for attainment of the Australian IPLCs and provide evidence that student reflections can be used to assess the Australian IPLCs.

Every person is an individual: physical therapist clinical reasoning used in inpatient rehabilitation for walking assistive device prescription in patients with stroke and brain injury

Purpose A complete description of the process of physical therapy clinical reasoning for walking assistive devices in patients with stroke and brain injury has never been undertaken. Describing the clinical reasoning process used in post-acute inpatient rehabilitation is important to shed light on the clinical activities and factors used in practice, prevent device abandonment, and, inform entry-level clinical training. The two purposes were first, to describe the clinical reasoning process used during inpatient rehabilitation for walking assistive devices in patients with stroke and brain injury, and second, to determine whether clinical reasoning differed by two facility types and by diagnosis. Methods A mixed methods study of 67 participants in either an online survey or focus groups. Results A consistent and comprehensive method to determine the need and justification for a walking assistive device regardless of diagnosis or facility type was found. The clinical reasoning process included five primary factors, considered throughout the rehabilitation stay (safety, balance, cognition, strength, and function). The three therapist-related factors (experience/preference, training parameters, and use of objective tools), and seven patient-related factors (experience/preference, fluctuations, fear, age, diagnosis/comorbidities, discharge environment, and payer) individualized care. Definitions of the five primary factors were derived from participants’ responses. Conclusions Results from this study revealed complexity in the clinical reasoning process used in physical therapy practice to determine the best walking assistive device for patients with stroke and brain injury during inpatient rehabilitation. Information from this study can inform post-acute physical therapy practice and education, and may reduce device abandonment. Implications for rehabilitation Clinical reasoning (CR) is a complex process in which a clinician must consider multiple factors, which requires non-linear and iterative thinking, and involves many people, making it shared among the patient, caregivers, and the healthcare team. Describing the actual CR process used by physiotherapists when prescribing a walking assistive device (WAD) will identify the factors considered, thus more accurately explain the process of care. Such a description could lead to better justification of rehabilitation for patients with stroke and brain injury, and furthermore, determine whether treatments are rendered consistently and when, if ever, divergent approaches occur. Better understanding of the CR process of WAD prescription may also reduce the possibility of device abandonment.

Recognizing Innate Transformational Traits in Public Administrative Services: Are We Doing Right?

ABSTRACTWith shifting paradigm, public administration needs even more transformational leaders. A large part of an individual’s leadership potential refers to innate personality traits which are brought out by relevant nurturing processes. Environment, favorable or unfavorable, interacts with these processes and impacts the flourishing of natural potential. Experience promotes the positive growth of innate potential that one possesses. Using data from India, this article looks into the systematic impact of public administrative training institutes on the development of top-tier civil servants. By comparing the performance of officers in public administration training academy possessing innate personality traits suitable for transformational leadership vis-à-vis innate personality traits suitable for transactional leadership, we test whether current training evaluation promotes transformational innate personality traits and suggests the implications. Interestingly, our mix-method study evaluating the entry-level induction training of public administrative leaders reveals that there is a gap between theory and praxis.

What Should a Baccalaureate Curriculum in Conservation Law Enforcement Emphasize in Wisconsin?

The job duties of a conservation law enforcement (CLE) officer have been expanding and getting more complex. Many baccalaureate programs are now offered in conservation law enforcement, but it has been 30 years since research has examined what curricular components to emphasize in such a program. This study surveyed CLE officers in the Wisconsin Department of Natural Resources to determine their opinions on probationary officer strengths & weaknesses, preparedness for entry-level training, relative importance of academic subject areas, relative importance of modes of instruction, and officer demographics. Results (65% response rate; n = 108) indicated that the top three skills to develop in a baccalaureate program were CLE field techniques, natural resource sciences, and basic law enforcement skills. Specific courses rated extremely/very important included oral/written communication, CLE fundamentals/field skills, criminal justice investigation, law enforcement academy, resource policy and law, English, human dimensions, internship, and natural resource field skills. Courses rated relatively low in importance included philosophy, economics, arts, history, and math/statistics. The top three instructional methods were practical exercises/application, role playing/scenarios, and case studies. Observations about how to incorporate the results into a CLE baccalaureate curriculum are made as are recommendations for future research.

Integrated clinical experience with concurrent problem-based learning is associated with increased clinical reasoning of physical therapy students in the United States.

Clinical reasoning (CR) is a key learning domain for physical therapy educators and a core skill for entry-level practitioners. Integrated clinical experience (ICE) and problem-based learning (PBL) have each been reported to improve interpersonal and social domains, while promoting knowledge acquisition and CR. Unfortunately, studies monitoring CR during ICE with concurrent PBL in physical therapy education are sparse. We hypothesized that ICE with concurrent PBL would be associated with improved self-reported CR in third-year student physical therapists (PTs) in the United States. The Self-Assessment of Clinical Reflection and Reasoning (SACRR) survey was administered to 42 student PTs at the beginning and end of their third and final year of didactic training. Between the pretest and posttest analyses, the participants completed faculty-led ICE and PBL coursework for 16 weeks. The overall SACRR score and 26 individual item scores were examined. The Wilcoxon rank-sum test and paired t-test were used, with statistical significance accepted at P< 0.05. Significant improvements were observed in the overall SACRR score (P< 0.001), including 6 of the 26 survey items centered around decision-making based on experience and evidence, as well as self-reflection and reasoning. ICE with PBL was associated with improved self-assessed CR and reflection in third-year student PTs in the United States. Monitoring the impact of curricular design on CR may improve educators’ ability to enhance cognitive and psychomotor skills, which underscores the importance of increasing the explicit use of theoretical frameworks and teaching techniques for coping with uncertainty as a way of enhancing entry-level training.