Clinical Decision Making and Clinical Skills in DPT Graduates Following a Year-long Internship

Purpose/Hypothesis : Although the MGH Institute of Health Profession Institute year-long internship is considered to be successful, a formal evaluation of internsÕ clinical decision making (CDM) and clinical skills (CS) has not been done. The purposes of this study were to: 1. Measure clinical instructorsÕ perception of Doctor of Physical Therapy (DPT) graduates CS and CDM after completing a year-long internship. 2. Measure DPT graduateÕs perceptions of their own CS and CDM after completing a year-long internship. 3. Compare the perceptions between clinical instructors and DPT graduates completing a year-long internship with respect to CS and CDM. 4. Validate the survey toolNumber of Subjects : Forty-two interns, their 42 clinical instructors (CIs) and 194 DPT students were asked to participate.Materials/Methods : This is a cross-sectional descriptive study, using a survey tool for data collection. Surveys were sent to 42 Interns at the end of their internship, their 42 clinical instructors (CIs) and 194 DPT students. Twenty-five items addressing CDM and CS were chosen, each was assessed by participants on a 6-point Likert scale to indicate level of agreement. Participants also described their (or their internsÕ) CDM and CS in an open ended question. Both descriptive and inferential statistics were utilized for data analysis. Comparison was made between and within groups and between matching pairs of interns and CIs. Narrative sections were analyzed by a qualitative review of the answers and a final themes list was established.Results : In matched pairs of interns and CIs there was a statistically significant difference between the scores of the intern and their CI, with the CIs entering higher values than the intern. When comparing between classes, the interns achieved the highest scores in both domains and presented with the narrowest ranges. Significant differences were found between the interns and all other groups, and between the classes of 2015 and 2016. In most matching cases there was significant difference between the intern and their CI, with the CI rating the intern higher. Three out of 4 themes identied in each group were identical and consistent with the survey items.Conclusions : For the matched pairs, the interns showed a tendency to under rate themselves. Previous studies in health professional students support this finding. There was a gradual increase in the median ratings throughout the groups indicating an ability of the survey to discriminate well between groups in an order consistent to their level of training. Narrative statements supported the score achieved on the survey and three themes were consistent with the survey items, suggesting that the major aspects of our constructs were covered. The results support further use of this survey tool to assess DPT students throughout their training.Clinical Relevance : This survey tool can be used to assess students' CDM and CS at different levels of their clinical education.

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  • Control #: 2021061
  • Type: Poster
  • Event/Year: CSM2015
  • Authors: Tracy J. Brudvig, Kelly Macauley, Noam Segal
  • Keywords: Clinical Decisionmaking|Clinical Skills|Internship

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