Physical Therapy Clinical Education Research Articles

Outcome measures in clinical education research

. The Journal of Clinical Education in Physical Therapy (JCEPT) is an open-access journal that disseminates peer-reviewed quantitative and qualitative scholarship to increase the quality evidence available related to clinical education in physical therapy. Since 2021, the number of article downloads has increased by more than 10-fold, with annual increases exceeding 200%. Open-access allows JCEPT readers free access to both read online and download full-text articles. Last year, one article was viewed over 900 times while another was downloaded nearly 1,200 times. The Directory of Open Access Journals (DOAJ) began indexing JCEPT last year and now accounts for 14% of our referral sources. Next year, we expect to obtain indexing in PubMed Central (PMC), which will further increase the discoverability of JCEPT articles. The nature of clinical education raises various challenges to research, with one being how to assess outcomes. Articles published this year in JCEPT reflect the thoughtful application of different approaches to outcome measures. Some questions were assessed with quantitative measures while others used qualitative research methods. Self-efficacy was measured in two different articles exploring the domains of cross-cultural psychological capital and clinical competence. Clinical reasoning was assessed using the physical therapy Clinical Performance Instrument in one article and script concordance tests in another. A more recently established outcome such as inter-professional socialization was assessed with a quantitative scale while emotional and educational adaptability themes were explored with qualitative methods. In past volumes, a SNAPPS model (summarize, narrow, analyse, probe, plan, select) of clinical mentoring was used to help students process initial evaluation findings and longitudinal narrative analyses were used to assess the development of resident clinical reasoning skills. Outcome measures assessing the effectiveness of clinical education are essential.1 Efforts may start with the thoughtful choice of psychometrically supported quantitative measures as well as rigorous description of qualitative measures.2 However, recent JCEPT articles suggest many factors can influence the quality of a clinician,1 including their educational curriculum, pre- clinical training, the clinical environment of their patient exposures, the individual characteristics and stresses of students and their clinical instructors, as well as environmental forces such as the COVID pandemic. Translating the effectiveness of clinical education to improved clinical care and patient outcomes remains a challenge for future researchers. JCEPT publishes scholarly work affecting any aspect of clinical education in physical therapy addressing academic or clinical faculty, entry-level students or residents, curricula or teaching and learning methods. In addition to original research, systematic reviews, and innovative teaching methods, this year JCEPT published our first ‘clinical education case report’ describing remediation methods during clinical training and related outcomes. We look forward to publishing more papers and developing the evidence underpinning physical therapy clinical education.

Use of learner-driven, formative, ad-hoc, prospective assessment of competence in physical therapist clinical education in the United States: a prospective cohort study

The purpose of this project was to implement a process for learner-driven, formative, prospective, ad-hoc, entrustment assessment in Doctor of Physical Therapy clinical education. Our goals were to develop an innovative entrustment assessment tool, and then explore whether the tool detected (1) differences between learners at different stages of development and (2) differences within learners across the course of a clinical education experience. We also investigated whether there was a relationship between the number of assessments and change in performance. A prospective, observational, cohort of clinical instructors (CIs) was recruited to perform learner-driven, formative, ad-hoc, prospective, entrustment assessments. Two entrustable professional activities (EPAs) were used: (1) gather a history and perform an examination and (2) implement and modify the plan of care, as needed. CIs provided a rating on the entrustment scale and provided narrative support for their rating. Forty-nine learners participated across 4 clinical experiences (CEs), resulting in 453 EPA learner-driven assessments. For both EPAs, statistically significant changes were detected both between learners at different stages of development and within learners across the course of a CE. Improvement within each CE was significantly related to the number of feedback opportunities. The results of this pilot study provide preliminary support for the use of learner-driven, formative, ad-hoc assessments of competence based on EPAs with a novel entrustment scale. The number of formative assessments requested correlated with change on the EPA scale, suggesting that formative feedback may augment performance improvement.

The Impact of COVID-19 on Physical Therapy Clinical Education Experiences in Florida.

Full-time clinical education experiences (CEEs) constitute a significant component of entry-level physical therapy education. COVID-19 challenged clinical education throughout the country by affecting the availability of CEEs. Research suggested that the number of clinical education spots available would stay the same. By contrast, the number of students enrolling in physical therapist (PT) and physical therapist assistant (PTA) education programs continues to rise. In response to the COVID-19 pandemic, students and faculty expressed concerns about the lack of student readiness and the availability of CEEs. The purpose of this study was to examine prepandemic factors that influenced the number of CEE slots available in Florida and the impact that the COVID-19 pandemic had on slot availability. Furthermore, researchers sought to identify factors that prevented a return to prepandemic levels of CEE spot offerings and recognize solutions to overcome those barriers. Finally, the researchers aimed to pinpoint suggestions to enhance collaborations between the clinical sites and physical therapy education programs. Forty-eight site coordinators of clinical education (SCCEs) from various settings and regions in Florida completed the survey. An online survey was distributed to Florida SCCEs to ascertain their perceptions on how COVID-19 influenced clinical education. The researchers used descriptive and inferential statistics to analyze the data. Clinical instructor (CI) volunteerism was the primary determinant of CEE spots available before the COVID-19 pandemic. The number of CEE spots was reduced for both PT and PTA education programs during the COVID-19 pandemic. Although the PTA slots returned to their baseline from 2019, the PT placements remained significantly lower in 2021. Social distancing and CI availability had the most considerable impact on CEE offerings. Site coordinators of clinical education also suggested that the greatest supports needed from the academic institutions were educating students on COVID-19 prevention and providing personal protective equipment (PPE) to students for their CEEs. This article also offers suggested incentives that academic sites can provide their clinical partners, such as in-services earning continuing education units, to enhance their participation in clinical education. All clinical education stakeholders must collaborate to provide students with the required clinical educational opportunities. Academic sites should continue to provide support, training, and incentives to CIs to enhance participation from clinical education sites. Educational programs must add content about COVID-19 to their curriculum and consider providing students with PPE during their rotations to restore the number of CEEs post-COVID-19 pandemic.

Assessing Effectiveness of Physical Therapy Clinical Education Site Visits: Clinical Instructor and Student Perspectives.

Video, phone, or in-person site visits are used to assess clinical education in entry-level physical therapy education programs. The perspectives of students and clinical instructors (CIs) related to site visits were examined in this article using 2 consecutive surveys. The first included items related to in-person and phone call site visits. The second added video calls. The research purpose was to assess the CI and student perspectives on the effectiveness of site visits and explore the differences between in-person, video, and phone visits. Published literature about the effectiveness of site visits is scarce. Two recent articles explored the director of clinical education and student perspectives of site visits. Future research concentrating on the clinician perspective of site visits was recommended. A convenience sample of 104 CIs and 97 doctor of physical therapy students were recruited by email for the 2 surveys. A mixed-methods, triangular, validating, quantitative data model was used. Respondents answered open-ended questions and rated items on 5-point Likert scales. Descriptive and chi-square statistics were calculated, and themes were developed using qualitative analysis. No significant difference was found in preference of site visit method between students and CIs. CIs rated the effectiveness of site visits similarly for all methods. Students rated in-person site visits as the most effective in the first survey and video calls as the most effective in the second survey. Qualitative analysis showed that CIs and students preferred in-person visits when the student was struggling. Considering closed-ended and open-ended questions on both surveys, CIs and students would rather meet individually with the faculty member. The results of this study suggest that any type of site visit can be effective; in-person visits should be considered when students are struggling, and the site visitor should meet privately with the student and CI.

Early Identification of Barriers to Student Success in Physical Therapy Clinical Education: Utilization of a Week One Clinical Survey Tool

Purpose: The purpose of this study was to evaluate the use of a week-one clinical survey tool for early identification of student perceived barriers, including personal and environmental safety, that may impact success during full-time clinical education experiences (CEE) in physical therapy. Methods: DPT students (n= 81) engaged in full-time CEE in their second and third years were required to complete an online self-designed survey tool regarding perceptions of safety, clinical instructor (CI) satisfaction, and clinical challenges. Students in their third year completed the survey for both experiences. Data were assessed to compare second versus third-year student responses overall using a Mann-Whitney U test. Qualitative data was analyzed using an incident coding process. Results: Most students (65.1%) indicated high satisfaction with their CI (≥ 9 on a 10-pt scale). Two students (1.8%) indicated feeling unsafe. There were no differences between cohorts for perception of personal safety or completion of orientation, but there was a difference in rating of their experience with the CI (p = .008). Narrative responses revealed that students’ perceptions of CI personality characteristics were related to their overall CI satisfaction. There were no differences between cohorts or levels of CEE in overall qualitative themes from the open-ended questions, but there was a difference in the impact of each qualitative theme and associated subcategories. Conclusion: During the first week of a CEE, students reported high CI satisfaction and low personal and environmental safety concerns. Further research is needed to examine the perspective of other stakeholders with the utilization of this week-one clinical survey tool. The results of this study are the first to contribute an understanding of the barriers to success during the first week of a CEE from the students’ perspective.

Clinical education across the physical therapy professional continuum

The Journal of Clinical Education in Physical Therapy (JCEPT) is a peer-reviewed open-access journal that aims to develop and disseminate quality evidence related to clinical education in physical therapy. Over the first 3 years of publishing, the number of article downloads has increased quickly with 2021 downloads more than tripling the previous year. Two articles were downloaded over 200 times in just the last year. This year, JCEPT has been indexed by the Directory of Open Access Journals, and we are on track to meet our goal of PubMed Central indexing within our first 5 years. COVID-19 continues to affect society and education. In this volume, two papers explore the impact of changes imposed on physical therapy education by the ongoing COVID-19 pandemic. Many programs had to make changes to their clinical education routines due to COVID-19 restrictions and sudden limitations in clinical placements. One article explored the effect of fewer preparatory integrated clinical experiences on interpersonal communication skills and confidence in the acute care setting. Another explored the financial impact of COVID-19 on doctor of physical therapy students. JCEPT publishes scholarly work related to physical therapy education affecting any aspect of clinical practice at all levels of the professional continuum.1 The 2022 JCEPT volume, for instance, includes a model of physical therapist assistant learning in an intra-professional pro bono clinical environment with entry-level physical therapy students. For physical therapist education, articles address readiness for telehealth, the effect of integrated clinical experiences on interpersonal communication, decision making, and clinical reasoning. Post-professional topics include developing residents’ clinical reasoning and clinical instructors’ mentoring skills. Physical therapy as a profession requires a commitment to lifelong learning to ensure the profession evolves to best serve the public purpose.2 Lifelong learning is sometimes thought of as simply individual clinicians continually gaining additional knowledge and skill. Moving the profession forward, however, demands more structure.2 A more detailed formulation of lifelong learning includes activities that demonstrate the voluntary participation in professional activities that expand learning and the pursuit of opportunities to develop professionally.3 Examples within this volume include the pro bono clinics, residency training, and clinical instructors participating in simulated learning experiences within the didactic portion of physical therapy training. Advanced degrees and continuing education are also parts of the continuum for future volumes to explore.4 As the journal continues to grow, we expect to publish more papers on topics important to physical therapy clinical education in various forms. JCEPT accepts manuscript types such as original research, narrative and systematic reviews, innovative teaching methods or educational models, clinical education or clinical case reports, and critically appraised topics. Christopher Kevin Wong and Jean Fitzpatrick TimmerbergEditors in Chief

Innovation in Pediatric Clinical Education: The Development of a Clinical Instructor Toolkit

Introduction/Literature Review: Clinical education (CE) experiences are essential components of physical therapist assistant (PTA) and professional physical therapist education requiring qualified clinical instructors (CIs). The 2014 CE Summit recognized the need for CI development. The Academy of Pediatric Physical Therapy Academic and Clinical Educators special interest group assembled a task force to address the need for pediatric CI resources. The purposes of this study are to describe the process used to create a pediatric CI Toolkit and describe the results of the task force's work as a mechanism to meet the needs of CIs to facilitate clinical teaching. Participants: Pediatric PTAs and physical therapists (PTs) engaged in physical therapy CE were included in the needs assessment survey. The target population of the survey also represented the intended users of the created CI Toolkit. Method: A task force composed of individuals with diverse pediatric subspecialties, geographic regions, and roles in CE convened to create the CI Toolkit. The task force completed a literature search and online CE resources search to assist with survey development and with guidance in the development of the CI Toolkit. A needs assessment survey was created and deployed to gather information from pediatric PTAs and PTs. The task force developed the structure of the CI Toolkit and collected resources to populate the online tool. Results: An online CI Toolkit was created and contained 160 resources organized into topics, settings, and descriptors. Tools include resources for clinical reasoning, student assignments, general resources, weekly objectives, and CI development. A four-person committee was created to review proposed additions to the CI Toolkit. Discussion and Conclusion: The CI Toolkit is a model for accessible CI professional development for clinical teaching and learning. Health professions educators interested in creating resources for clinical educators will benefit from the lessons learned in the creation of the CI Toolkit.

The Collaborative Clinical Learning Experience in Physical Therapy: Student and Instructor Perspectives

Introduction. A clinical collaborative learning experience (CCLE) is a viable clinical education model in physical therapy (PT). The purposes of this study were to 1) examine factors perceived to influence a successful CCLE, and 2) examine processes that make it successful. Review of Literature. Factors contributing to a successful CCLE, including teaching strategies, student characteristics, and environment, have been reported. The processes that occur during a CCLE that influence its success have not been studied. Subjects. Twenty-nine students and 18 clinical instructors (CIs) involved in CCLEs. Methods. Using a grounded theory approach, phase 1 examined perceived factors contributing to efficacy of the CCLE through surveys and focus groups. Phase 2 examined the processes involved in team building, leading to an effective CCLE through journals and focus groups. Results. Student and clinic factors were perceived to affect the success of the CCLE. The evolution of an effective team that depended on effective communication was deemed the cornerstone of a successful CCLE. The student strategies of self-reflection, idea sharing, and active observation along with clinic-driven strategies of role assignment and a positive learning environment fostered team development. All students in the CCLE were successful as measured by the Clinical Performance Instrument (full-time experiences) and the integrated clinical experience evaluation supporting the trustworthiness of the qualitative findings. Discussion and Conclusion. These findings expand the considerations for an effective CCLE and provide a basis for understanding the processes involved in a successful CCLE. This process is focused on developing an effective student–CI team. Preparation and training of students and CIs in the importance of team development and strategies to achieve this are warranted. The CCLE may address the shortage of clinical placements in PT and enhance the learning that occurs in PT clinical education.

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

Educational Research Priorities for Pediatric Physical Therapy: A Consensus Study.

This study engaged stakeholders internal and external to pediatric physical therapy education in a consensus exercise toward determining and refining priorities and considerations for educational research for pediatric physical therapy. The Delphi method was used to survey 54 physical therapists from 5 stakeholder groups drawn from experts in the field of physical therapy education and from Academy of Pediatric Physical Therapy members invested in educational leadership, research, and/or pediatric physical therapy clinical and residency education. A 4-round survey process revealed 12 educational research priorities and 13 educational research considerations that reached 80% consensus, with clear and consistent top ranking of 4 of these priorities and 4 considerations across all stakeholder groups. As the Academy of Pediatric Physical Therapy continues to develop and advance its capacity and support for educational research, knowledge of these priorities and considerations might be used to guide an educational research agenda.

Clinical Instructors' Experiences Working with and Assessing Students Who Perform below Expectations in Physical Therapy Clinical Internships.

Purpose: Clinical education is an integral component of the curriculum of all physical therapy (PT) entry-to-practice programmes in Canada. The literature indicates that working with and assessing students performing below expectations (SPBE) can be procedurally and emotionally difficult. Our study aimed to explore the experiences of clinical instructors (CIs) and the decision-making process involved when supervising SPBE in PT. Method: A total of 19 in-depth, semi-structured interviews were conducted with CIs, transcribed, and coded using qualitative thematic analysis. Results: Four factors appeared to be important for CIs when they were deciding how to assess SPBE: (1) features of student performance, (2) factors related to the CIs, (3) academic and clinical facility influencers, and (4) strategies and available resources. Concerns about safety and professional behaviour, a student's clinical reasoning skills, and a lack of progression were key factors that CIs considered in recommending a final grade. CIs were more likely to recommend a failing grade if there was a series of repeated incidents rather than an isolated incident. Conclusions: We make several recommendations for the student, CI, and facilities to consider to better support and facilitate the process of working with SPBE in PT clinical education.

Clinical Instructor Perceptions of the Collaborative Clinical Education Model: Providing Solutions for Success in Physical Therapy Education

Purpose: The most common approach to physical therapy clinical education is the one-to-one (1:1) model. The collaborative clinical education model (CCEM) offers an alternative and beneficial approach to education but is not widely utilized within physical therapy. The primary aim of this study was to explore the experiences and perceptions of clinical instructors (CIs) teaching within the CCEM while also receiving structured support from an academic program. Methods: This study used semi-structured interviews before and after the CCEM experience to explore CI perceptions. CIs received formalized support that included pre-experience meetings, a CCEM Toolkit resource, scheduled follow-ups during the experience, and a post-clinical debriefing. Interview transcripts were analyzed using a qualitative data analysis program and collaborative coding process. Results: CIs’ perceptions of the CCEM shifted following participation. Participants noted a need to be prepared with appropriate teaching strategies, have frequent communication with the academic program, and have a supportive clinical environment. Conclusion: CI participation in the CCEM is challenged by negative perceptions and lack of experience with collaborative learning. CI perceptions of the CCEM can become more positive after actually teaching in the CCEM; therefore, perceived challenges need to be addressed to increase CI participation. The CCEM may be more widely accepted if CIs’ perceived challenges are addressed in partnership with an academic program with intentional CCEM training and support strategies.

Influence that Service in a Pro Bono Clinic has on a First Full-Time Physical Therapy Clinical Education Experience

Purpose: Physical therapist education programs strive to prepare their students for full-time clinical experiences in a variety of ways. Experiential and service learning in authentic contexts reportedly help students make connections between the classroom and the clinic. The purpose of this study was to explore the influences that service in a physical therapy pro bono clinic has on a first full-time clinical education experience. Methods: Participants were all third year doctoral physical therapy students at Widener University who were entering their first full-time clinical education experience. Sixteen participants kept journals throughout their first full-time clinical experience regarding the impact of their previous pro bono experience. Upon completion of the 10-week full-time clinical experience, the sixteen participants answered a Likert-scale survey to further delineate the influence of the pro bono experience, and fifteen of the participants participated in focus group discussions to further explore themes that emerged from the journal and survey data. Data from the focus group and journals were analyzed qualitatively. The responses from the surveys provided quantitative data. In addition, the researchers looked at the Clinical Instructors (CI) midterm comments on the APTA’s Clinical Performance Instrument (APTA PT CPI WEB) to further corroborate or disconfirm the findings. Results: Triangulation of the data points revealed 9 categories of positive impact that the pro bono experience had on their first full-time clinical experience. The strongest three categories in order were client interaction, clinical instructor interaction, and professional communication. The next five categories were of relative equal strength and related to specifics areas of competency. They were competency in documentation, evaluation, intervention, clinical reasoning and cultural competency. A final overarching category was increased confidence. CI comments on the midterm CPI corroborated these findings. Participants also shared ways in which the pro bono experience could have better prepared them for their full-time clinical experience. Conclusions: Regular participation in a pro bono clinic throughout the didactic portion of the physical therapy curriculum contributed to student confidence and competence in their first full-time clinical experience. Future research should include interviews with the clinical instructors to further corroborate the student perceptions. The findings of this study also serve to inform how the pro bono clinical experience can be enhanced to further contribute positively to the students’ first full-time clinical experiences.

Simulated Patients in Physical Therapy Education: Systematic Review and Meta-Analysis.

Traditional models of physical therapy clinical education are experiencing unprecedented pressures. Simulation-based education with simulated (standardized) patients (SPs) is one alternative that has significant potential value, and implementation is increasing globally. However, no review evaluating the effects of SPs on professional (entry-level) physical therapy education is available. The purpose of this study was to synthesize and critically appraise the findings of empirical studies evaluating the contribution of SPs to entry-level physical therapy education, compared with no SP interaction or an alternative education strategy, on any outcome relevant to learning. A systematic search was conducted of Ovid MEDLINE, PubMed, AMED, ERIC, and CINAHL Plus databases and reference lists of included articles, relevant reviews, and gray literature up to May 2015. Articles reporting quantitative or qualitative data evaluating the contribution of SPs to entry-level physical therapy education were included. Two reviewers independently extracted study characteristics, intervention details, and quantitative and qualitative evaluation data from the 14 articles that met the eligibility criteria. Pooled random-effects meta-analysis indicated that replacing up to 25% of authentic patient-based physical therapist practice with SP-based education results in comparable competency (mean difference=1.55/100; 95% confidence interval=-1.08, 4.18; P=.25). Thematic analysis of qualitative data indicated that students value learning with SPs. Assumptions were made to enable pooling of data, and the search strategy was limited to English. Simulated patients appear to have an effect comparable to that of alternative educational strategies on development of physical therapy clinical practice competencies and serve a valuable role in entry-level physical therapy education. However, available research lacks the rigor required for confidence in findings. Given the potential advantages for students, high-quality studies that include an economic analysis should be conducted.

Development of an optimised, multi-disciplinary intervention for chronic fatigue states

Results: Fifteen students have participated in clinical education experiences in Belize, four students in Chile. Students experienced a 4–21 score increase on the IAPCC-SV© and from 7 to 62% positive change on the PAT, indicating positive growth in cultural competency and professionalism. Students effectively used blogging as a reflection tool. Qualitative analysis found that professional growth resulted from exposure to a variety of patient-care settings, outreach and service, modification of educational methods, and managing personal responses during the experience. Delivering holistic care required adaptability, cultural mindfulness and professional proficiency. Site hosts reported that students were well prepared academically and demonstrated effective clinical management. Conclusion(s): Institutional support is essential to plan a program of this scope. In line with the University’s goals and strategic plan, students and faculty demonstrated a need for global health experiences. This project was successful in implementing global clinical education opportunities based on an established framework. The quantitative and qualitative results demonstrate growth for these students in the delivery of cross-cultural care. Implications: This project presents a reproducible model for the emergence and sustained presence of physical therapy clinical education in the growing field of global health.

A Description of Current Curricular Design Models Used In Physical Therapy Clinical Education and Their Relationship to Pass Rates on the National Physical Therapy Examination

Purpose. The purpose of this study was to develop descriptions and identify commonalities of current clinical education models used in physical therapy programs; then, using this information, to examine differences in first-time and ultimate pass rates among the derived formula from Commission on Accreditation in Physical Therapy Education (CAPTE) accredited programs in 2011-2013. Methods. This mixed methods study captured qualitative and quantitative data from the 204 PT programs located in the United States and Puerto Rico from 2011 to 2013. The data were coded into 11 different clinical education models which represented all programs. The models were then linked to first time and ultimate pass rates. Results. Twenty out of 204 (9.8%) PT programs reported first-time pass rates and 201/204 (98.5%) reported ultimate pass rates in the cited three-year cycle period stated in this study. The three most commonly occurring models make up 84% of all current existing models. All three frequently occurring models include both full time and clinical internship clinical experiences. Additionally, these models outperformed the national pass rate average by at least 3%. Conclusions. Our results are the first to provide an analysis of the various models in use in physical therapist education, as well as a preliminary outlook on how clinical education design is matched against a program’s pass rate on the national exam. Since pass rate is one of the few standardized, modifiable outcomes for CAPTE approved programs, it was selected as the outcome to allow comparison of clinical education models. One of the driving forces behind this study was to illustrate clearly the tremendous variety of clinical education models and a better understanding of the scope of the variances that is occurring.

Exploring the experiences of novice clinical instructors in physical therapy clinical education: a phenomenological study

ObjectiveTo explore the perceptions of novice physical therapy clinical instructors (CIs) about their interactions and teaching behaviours with physical therapy students. DesignA phenomenological approach using semi-structured interviews and a focus group. ParticipantsSix novice physical therapy CIs (less than two years as a CI and supervised fewer than three students) were recruited purposefully from a large metropolitan area in the USA. All participants were credentialed by the American Physical Therapy Association as CIs. Main outcome measuresTranscripts of interview data and focus group data were analysed using interpretative analysis for themes and subthemes. ResultsParticipants viewed the transition of students from the classroom to the clinic as their primary role, using strategies of ‘providing a way in’, ‘fostering critical thinking’, ‘finding a balance’, ‘overcoming barriers’ and ‘letting go’. ConclusionWhile novice CIs showed skill in fostering student reflection and providing orientation, they struggled with student autonomy and balancing the competing obligations of patient care and clinical instruction. They expressed issues related to anxiety and lack of confidence. In the future, novice CIs could benefit from training and support in these areas.

Questions and Answers

The Journal of Physical Therapy Education advances the scholarship of physical therapy education in all its dimensions by disseminating scholarly works of discovery, application, and integration and enriches physical therapy academic and clinical education environments by using evidence into the educational decision-making process to effectively prepare students, support faculty and clinicians, and inform administrators. Vision Within 5 years, the Journal of Physical Therapy Education will be recognized both internationally and interprofessionally as the premier forum for disseminating scholarly works in physical therapy educational theory and practice; it will be easily accessible to a wide audience of healthcare practitioners for use in making evidence –based educational decisions to enhance the efficacy of academic and clinical education.

Integrated Clinical Experiences in a Campus Onsite Clinic: A Self-Contained Model of Physical Therapy Clinical Education

Purpose: This paper describes a self-contained model of integrated clinical experiences (ICEs) that take place during the academic portion of an entry-level physical therapist education program in a campus onsite clinic. Description of Model: Students participate in ICEs for three consecutive semesters. Students provide pro bono physical therapy services to individuals with impairments, functional limitations, or changes in physical function resulting from a variety of health conditions. In addition, students participate in an exercise/wellness program for individuals who wish to improve or maintain their current levels of fitness. The first ICE consists of second-year students observing/assisting third-year students in the onsite clinic with basic patient care skills and participation in an exercise/wellness program. Students in the second and third ICEs provide ongoing one-on-one skilled therapy for individuals with neurological or musculoskeletal diagnoses. Results: Feedback obtained from onsite clinical instructors, core academic faculty, students, and patients receiving care in the onsite clinic through group debriefings, questionnaires, and interviews is used to assess students’ readiness for full-time internships and effectiveness of the ICEs. The feedback reveals that the ICEs are meeting their intended goals. Category ratings in the “red flag” areas of the Clinical Performance Instrument (CPI) are consistently above expected levels for students completing their first full-time clinical internship. In addition, patients receiving care in the onsite clinic report a high level of satisfaction with the care provided. Conclusion/Possible Recommendations: This model provides students with an opportunity to gain clinical confidence in a realistic setting while reinforcing concepts presented in academic coursework. Providing ICEs on campus decreases reliance on clinical facilities and allows for academic program oversight of the quality of the learning experiences and early identification of students who have deficits in clinical skills and/or academic knowledge. The learning experiences provided in the onsite clinic give students a transitional experience that helps them benefit more fully from full-time internships. A potential challenge to this model is finding the space and financial resources needed to make it viable.