Introduction. Integrated clinical education (ICE), defined as clinical learning experiences embedded within the didactic portion of a DPT curriculum, is an integral component of an overall clinical education curriculum. The collaborative supervisory model has been applied to ICE experiences in DPT curricula. Two physical therapist (PT) education programs developed similar ICE experiences incorporating the collaborative model as a component of their clinical education curricula. Benefits for student learning have been described in the literature for both of these models—in isolation, but not combined. The purpose of this study was to determine factors that students felt contributed to successful team function in a collaborative ICE experience. Review of Literature. ICE can provide opportunities for students to develop knowledge, skill, and professional behaviors in preparation for full-time and final clinical experiences. There is a great deal of literature that supports the collaborative model of clinical education to facilitate teamwork and collaboration, deeper level of critical thinking and problem solving, and enhanced clinical competence. Despite the benefits of including ICE in a DPT curriculum, as well as the benefits of the collaborative model of clinical education, the physical therapy literature does not describe factors leading to successful team function when these 2 models of CE are combined. Methods and Subjects. Subjects were 51 PT student teams (3 to 4 people each) from Duke University (2 cohorts) and the University of Colorado (1 cohort) who participated in a collaborative ICE experience. Following their first 2 weeks of ICE, student teams were instructed to create a mind map that depicted how their team functioned together in the clinic. Teams utilized an online mapping tool, "Coggle It," to complete the mapping. The research team employed incident coding processes established in the literature to code the primary concepts of the team mind maps. Chi Square analysis was used to determine numeric differences across all codes among the 3 student team cohorts. Results. Twenty-four distinct codes were assigned to the primary concepts. Chi Square analysis revealed no significant differences between the 3 cohorts (P > .01) across all codes. More than 50% of teams indicated that "group dynamics" and "team communication" were vital to the effective functioning of their team in the clinic. More than 25% of the teams included "individual student qualities," "the learning environment," "practicing skills," "the instructor's teaching strategies," "adult learner characteristics," and the "clinical instructor" of key importance. From the data, 4 themes emerged as being important for effective collaborative learning in an ICE: The Team, the Clinical Environment, the Individual Student, and the Clinical Instructor. Discussion and Conclusion. The 4 themes identified in this study contribute to the literature surrounding student learning in clinical education, specifically a collaborative ICE experience. This study suggests that these characteristics are important for positive experiences and should be factors that are considered by both academic programs and clinical instructors when designing, implementing, and teaching in a collaborative ICE experience.
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.
Introduction/Review of the Literature: Payment for clinical education (CE) experiences is a current topic of discussion within health care professions wherein incidence of payment is described as rare but growing. The American Council of Academic Physical Therapy (ACAPT) Board charged the National Consortium of Clinical Educators (NCCE) to investigate payment for physical therapist (PT) CE experiences. The ACAPT NCCE Task Force (TF) on Payment for Clinical Experience surveyed academic, clinical, and student CE stakeholders to explore perspectives on the current landscape for payment of PT CE experience. Methods: Two surveys were constructed using an exploratory research design: an academic and clinical stakeholder survey and a student survey. For the academic and clinical survey, the TF used member content expertise and literature review to draft questions. Final questions were crafted after conducting 2 validation rounds by an expert panel. For the student survey, student focus groups created and validated final survey questions. Snowball sampling was employed for survey dissemination through ACAPT and NCCE networks. Descriptive statistics were examined and significant differences ( P < .05) between stakeholder groups were analyzed. Analysis of open-text responses was conducted to categorize and identify common concepts. There were 1,883 academic and clinical stakeholder survey respondents, with 84.3% identifying as a clinical-only role; all NCCE regions and practice settings were represented. First-, second-, and third-year doctor of physical therapy student survey respondents (2,815) represented both private and public academic programs. Results: Less than 5% of academic institutions reported paying any portion of full-time CE experiences. A majority of respondents (1,153, 71.9%) were neutral or disagreed that clinical instructors (CIs) should receive direct payment for supervising students and 76.9% indicated that students should not be required to pay for CE experiences. Both intrinsic and extrinsic factors were cited as reasons not to seek payment and as benefits for providing CE experiences. Supervision restrictions and productivity expectations were identified as key barriers to providing CE experiences. Students indicated that prior knowledge of site and CI qualifications would be expected should students be required to pay for CE experiences. Discussion and Conclusion: Most academic, clinical, and student CE stakeholders did not support payment for CE experiences. The stakeholder-identified motivators and nonmonetary incentives to provide CE experiences present an opportunity to explore initiatives that will enhance availability of PT CE experiences aligned with an ACAPT strategic plan on a national level.
Purpose: The placement process is a key contributor to current challenges in health science clinical education. The Director of Clinical Education (DCE) is the central figure in coordinating the placement process in physical therapist education. Despite their central role, there is no research exploring the DCE perspective during this process. The purpose of this study was to explore the DCE’s experience in navigating the placement process to further understand how the DCE role is impacted by barriers and facilitators encountered during this process. Methods: Fourteen DCEs representing private and public institutions from across the country participated in the study. Using a multiple case analysis approach, semi-structured interviews were conducted with each participant. Interview transcripts underwent thematic analysis using a team-based coding approach to identify categories and themes. Results: Five themes with eighteen associated categories represent the interconnectedness between the DCE’s approach to the placement process and their experience throughout. The five themes are: Prolonged Process, Sense of Competition, Leveraging Relationships, Student Centeredness, and Clinical Site Considerations. Conclusions: This is the first study to examine the DCE’s experience in a specific aspect of their faculty role. The placement process is a core component of the DCE’s responsibilities, and its inherent complexities and prolonged nature impact the DCE’s workload and overall experience as a faculty member. Supporting the DCE in this process can have a positive impact on the student experience, and relationships between academic programs and clinical sites, and the DCE’s satisfaction in their role, Findings from this study can be used to address challenges faced by DCEs and other faculty in other health sciences professions that are involved in the clinical placement process.
Current issue: Clinical instructors (CIs) are instrumental in the development of competent, entry-level physical therapist graduates. Despite this key role, CIs are often deficient in formal knowledge of the learning sciences that influence quality of clinical education experiences. Clinical education stakeholders also lack a standardized and consistent approach to defining and assessing clinical teaching skills, resulting in an inability to provide adequate feedback and growth opportunities for CIs. Perspective: A gap exists between qualitative descriptions of clinical teaching behaviors and the ability to objectively assess those behaviors in CIs. Grounded in the Model of Excellence in Physical Therapist Education, this perspective calls attention to and proposes steps toward excellence in clinical education. Defining essential competencies of clinical teaching in the physical therapy profession requires a systematic approach. The competencies established through this approach then become the foundation for creating a meaningful assessment tool of CI performance. Implications for clinical education: Developing educator competencies and a related assessment tool for CIs allows for the provision of meaningful feedback, the creation of targeted professional development programs, and opportunities for recognition of clinical teaching excellence. Without effective CIs, new graduates may be inadequately equipped to contribute to the profession’s vision of educational excellence.
Doctor of physical therapy preparation requires extensive time in precepted clinical education, which involves multiple stakeholders. Student outcomes in clinical education are impacted by many factors, and, in the case of failure, it can be challenging to determine which factors played a primary role in the poor result. Using existing root-cause analysis processes, the authors developed and implemented a framework designed to identify the causes of student failure in clinical education. This framework, when applied to a specific student failure event, can be used to identify the factors that contributed to the situation and to reveal opportunities for improvement in both the clinical and academic environments. A root-cause analysis framework can help to drive change at the programmatic level, and future studies should focus on the framework’s application to a variety of clinical and didactic settings.
Purpose: There is a potential link between the clinical education phase of a physical therapist’s education and increased incidence of student mental health challenges. The Director of Clinical Education (DCE) has a complex role in supporting students and clinical sites during clinical education experiences (CEEs.) The purposes of this study were to explore DCE’s experiences and perceptions with supporting students with mental health challenges during CEEs. Methods: Two-hundred-twenty DCEs from accredited Doctor of Physical Therapy programs were invited to participate in an electronic survey. Survey questions included demographics, institutional and curricular characteristics, and current perceptions/experiences with student mental health challenges. DCEs (n = 106; 48.2%) responded and were included in the analyses. Analyses included descriptive statistics, simple frequencies, and binary logistic regression. Incident coding processes analyzed responses of open-ended questions. Results: Seventy-four percent of respondents indicated awareness of a student(s) experiencing a mental health concern during a full-time clinical experience in the past 3 years. Regression analyses showed that length of terminal clinical experience, out-of-state placement, cohort size, and availability of online/video counseling were related to prevalence of DCE’s experience. Forty-six percent of DCEs indicated feeling prepared to deal with these issues, while 35% were ‘unsure’. DCEs indicated experience, training, and workload support as contributors to successfully supporting students. Conclusion: Results contribute to the emerging understanding of the prevalence of student mental health challenges in physical therapist education from the DCE’s perspective. Our findings suggest that institutional and curricular characteristics are potential contributors to the prevalence of this issue. We recommend training and institutional support for the DCE in these situations.
A competency framework for clinical teaching in physical therapy was established in a recent study. Validation of competency frameworks requires multiple steps, including consideration of end-user perceptions of value and utility. The purpose of this study was to further validate the Clinical Teaching Competency Framework by gathering input specifically from clinical education faculty.
Abstract Objective Clinical instructors play a key role in physical therapist professional education but may serve with minimal preparation and without clearly defined expectations for their teaching performance. The objective of this study was to utilize a consensus-building process to establish core competencies of clinical teaching within physical therapist education. Methods A modified Delphi approach was used to identify core competencies of clinical teaching. An expert panel consisted of clinical instructors, site coordinators of clinical education, and directors of clinical education, representing multiple geographic regions in the United States. The panel assessed the relevance of 30 original competencies. Criteria for consensus included 75% of participants perceiving the competency as very or extremely relevant and a median score of 2 (very relevant) on a 5-point Likert scale. Consistent with a Modified Delphi approach, quantitative and qualitative data analysis were completed for each of the 3 rounds. Revised surveys were used in Rounds 2 and 3 based on the results from previous data analysis. Results Twenty-four competencies achieved final consensus. The competencies were categorized within 3 domains: learner-centered educator (n = 8), assessor/evaluator (n = 7), and professional role model (n = 9). Conclusion The 24 competencies and 3 domains provide the foundation for a competency framework for clinical teaching in physical therapy. This framework provides clarity for the expected knowledge, skills, and attitudes of clinical instructors in physical therapist professional education. Impact This is the first study, to our knowledge, to utilize a consensus-building strategy to clearly define competencies of clinical teaching in physical therapist professional education. Like efforts in nursing and medical education, adoption of these competencies could promote consistency in clinical instructor teaching behaviors and contribute to the creation of assessment and professional development mechanisms for clinical instructors, positively impacting the preparation of the next generation of excellent physical therapist clinicians.
