1. Click to edit Master title style Click to edit Master text styles – Second level Third level – Fourth level » Fifth level 6/13/20161 - Outcomes associated with American and Canadian Student-Directed Physical Therapy Clinics: Student and Patient Perspectives Bostick GP 1* ; Maritz CA 2* ; Martin B 1 ; Campolo M 2 1. University of Alberta, Edmonton AB, CAN; 2. Samson College of Health Sciences, University of the Sciences, Philadelphia PA, USA UA & USciences Student Clinics METHODS Acknowledgements INTRODUCTION DISCUSSION Figure 1. Graph of patient satisfaction in a Philadelphia community PT clinic and the student clinics Traditionally, part of clinical education occurred concurrently within the didactic curriculum This concurrence provided direct transfer of knowledge and skills from classroom to clinic but are increasingly difficult to provide, necessitating innovation. Student-led clinics are one such innovation and have numerous potential benefits: 1)Personalized education empower students leading to greater engagement 2)Students develop positive values and learn how to become valued members of society 1 3)Access to physical therapy services for underserved populations 2 4)Peer mentorship: development of self-confidence and communication skills 5)Learning about systems-based practice 3 In addition to providing valuable learning experiences, student-led clinics have comparable, and in some cases better, outcomes relative to community clinics 4-8 Despite growing literature on the benefits of student-led clinics, information specific to a physical therapy context is limited Study Aim: To evaluate learning and patient satisfaction in two student physical therapy clinic models from the perspectives of students and patients. Secondarily, patient satisfaction data are compared to satisfaction data from a community clinic. University of the Sciences clinic (Philadelphia, USA): Pro-Bono clinic providing PT to uninsured Structured experiential learning opportunities are integrated into the curriculum in a step- wise progression 60 hours required throughout the 3-year program run concurrently Senior students mentor junior students Care is provided by students under faculty and volunteer clinician supervision Caseload consists of ethnically diverse adult population with primarily musculoskeletal conditions Funding: nominal patient user fee, currently not funded Participants: The sampling frame included 146 students and 282 patients participating in the University of the Sciences, PA, USA (USciences) and the University of Alberta in Edmonton, AB, CAN (UA) student clinics from January – December 2009. In addition, 420 patients in a community clinic in Philadelphia were surveyed. Design: A multi-method study using qualitative and quantitative data Data collection: Student data were collected qualitatively from reflection papers completed after student clinic experiences. Patient data were collected using a written satisfaction survey. Items were scored on a 5-point agreement scale (0=strongly disagree, 5=strongly agree). Higher scores indicate higher levels of satisfaction. Analysis: Qualitative Description was used to summarize the student data as the intent was to describe student experiences within the clinics. These data were analyzed using latent content analysis where primary patterns within the data were identified, coded and categorized. Based on these patterns, themes were generated. Descriptive statistics were used to summarize the patient satisfaction survey data University of Alberta (UA) clinic : Focused on student-learning while providing PT to underserviced populations 15-hour 1 credit elective When possible, senior students are paired with junior students PT provided by students under the supervision of a members of faculty The clinic is offered twice weekly Caseload consists of older adult wellness and mixed neurological and musculoskeletal rehabilitation Funding: nominal patient user fee, not externally funded Patient experience: A total of 95 (33.7%) patients responded to the satisfaction survey in both clinics 94/95 would recommend the clinic to a friend or family member Specific items related to the overall and rehabilitation experiences were also reported with high levels of satisfaction and comparable to a community clinic Student experience: Thematic saturation was achieved after analysis of 18 student reflections from UA and USciences. Based on these reflections, the student clinic experience shared two common themes related to ‘confidence’ and ‘acclimatization’. Students consistently reflected on improved levels of confidence as well as adapting to the clinical environment through exposure to learning opportunities in a ‘real-world’ context. The USciences student reflections included a mentorship component which identified themes related to ‘safety in learning’ as a result of the mentorship experience. Table 1. Summary of themes of the students’ experience in the UA and USciences clinics Data from two student clinics from different contexts suggest the student clinic experience is positive for students and patients. Student data support anecdotal evidence that experiential learning results in improved confidence with patient interactions and acclimatization to the clinical environment. In addition, mentorship opportunities further enhance confidence in both mentors and mentees. The USciences and UA clinics provide low cost physical therapy in a learning environment. While the clinic experiences reported here are positive, it is unknown whether they enhance clinical skills, content knowledge, or patient outcomes. Further study is required to quantify the benefits of physical therapy student clinic experiences for both students and patients. RESULTS (cont.) We would like to acknowledge the students and patients attending the USciences and UA student clinics for their valuable contribution to this research RESULTS UA student clinicUSP student clinic ThemeExemplarThemeExemplar Confidence “In addition to getting a lot more hands on practice that first day I started to get the feeling I knew more than I thought I did…” Confidence "I left my first night at the clinic feeling a new found confidence.” Acclimatization “I learnt that assessments are not as straight forward as I once hoped. Practicing on other students in class is great for understanding the basics, but when I am working with “real” patients, it may not be so cut and dry...” Acclimatization “Instead of just being able to do goniometry and MMT like I have done with my classmates... I had to interact with the patient in such a way that she would understand how to position her body appropriately.” Mentorship: Safety in learning "Teaching the junior students gave me more confidence in myself that I know more than I thought. It gave me a chance to see how far I've come in the past year"