A Comparison of Student Outcomes in 4-week and 6-week Initial Clinical Experiences

Purpose/Hypothesis : Academic programs tend to rely on student and clinical instructor (CI) feedback when defining or altering the length of clinical education experiences. While studies have measured perceptions of CIs and Center Coordinators of Clinical Education (CCCEs) regarding optimal length of experiences, there is inconclusive evidence which constitutes best practice in clinical education. The primary purpose of this study was to examine and compare student outcomes between a 4-week initial clinical experience and a 6-week initial clinical experience following a curriculum change. The hypothesis proposed that students in a 6-week initial experience would achieve higher performance ratings.Number of Subjects : Eight-eight (88) second-year Doctor of Physical Therapy students participating in their first full-time clinical experience.Materials/Methods : Cohort 1 (n=41; Class of 2012) students participated in a 4-week initial experience. Cohort 2 (n=47; Class of 2013) participated in a 6-week initial experience. Both cohorts had completed four didactic semesters, although Cohort 2 had not yet completed courses in gross anatomy and examination and evaluation of the extremities due to curricular restructuring. Assessment of student competency during the clinical experience was measured using the Physical Therapist Clinical Performance Instrument (PT-CPI). Average midterm and final PT-CPI ratings were downloaded into an Excel spreadsheet for comparison between groups. Group differences were analyzed for each of the 18 PT-CPI performance criteria; averages were analyzed in summation relative to PT-CPI performance criteria in total, and in subcategories for professional practice (Items 1-6), patient management (Items 7-15), and practice management (Items 16-18).Results : Without exception, average CI final ratings for each 18 performance criterion were higher for students in the 6-week experience by an average of one interval rating on the PT-CPI, although the differences between groups for each criterion were not statistically significant. There were significant differences found when comparing the aggregate mean scores of all 18 final student ratings (t=11.295, P<0.00001) and the subcategories of professional practice (t=6.900, P=0.001) and patient management (t=11.350, P<0.00001); the difference between means for the subcategory of practice management was not statistically significant. Aggregate CI midterm ratings between the two groups were also not statistically significant.Conclusions : Despite not yet having a key orthopedic course, students benefit from a longer initial rotation as demonstrated by the students achieving higher performance scores from their CIs. Given that site productivity increases with longer clinical rotations, the decision to expand the initial clinical experience from 4-weeks to 6-weeks resulted in a favorable outcome.Clinical Relevance : Increasing the length of initial clinical experiences serves to enhance student performance with the potential to increase site productivity.

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  • Control #: 1726269
  • Type: Poster
  • Event/Year: CSM2014
  • Authors: Peri J. Jacobson
  • Keywords: clinical education|length of experience |student performance

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