APTA Combined Sections Meeting

Positive, Possible, and Productive: Innovations in Clinical Education

New Orleans, Louisiana

February, 2018

Presenters:

Eric Stewart, PT, DPT

University of Delaware, Newark, DE

Jessica Denny, PT,DPT

University of Maryland Shore Regional Health System

Teresa Blem, PT

University of Maryland Shore Regional Health System

Ellen Wruble Hakim, PT, DScPT, MS, CWS, FACCWS

University of Delaware, Newark, DE

Disclosures

No relevant conflicts of interest or financial relationships exist.

Learning objectives

Upon completion of this presentation the audience will be able to:

  1. Discuss the evidence to support the utilization of the 2:1 model of clinical education, including the evidence on productivity.
  2. Identify commonly perceived barriers to implementation of the 2:1 model outside the academic medical center.
  3. Conceptualize how the 2:1 model of clinical education can be implemented in specialty and/or rural regional health centers.
  4. Identify outcomes associated with the 2:1 clinical education model in non-academic medical centers.

NOTE: Outline provides an overview of the presentation. Enhanced slides will be availableduring and after the conference. Slides can be obtained by emailing Eric Stewart at

Content Outline

  1. Current state of clinical education
  2. Fewer clinical education sites
  3. Less slots per clinical education site
  4. Expanded student cohorts
  5. Increased number of PT programs
  6. Evidence supporting utilization of the collaborative model of clinical education
  7. Clinical education site
  8. Improved productivity
  9. Increased student volumes with reduced clinician utilization
  10. Student
  11. Enhanced opportunities for collaborative learning
  12. Increased clinical education experience opportunities
  13. Academic Institution
  14. Increased clinical education experience opportunities
  15. “Making the sell” to clinical education sites
  16. Establish partnership prior to going “live” with collaborative model
  17. Recognize resource requirements
  18. Determine facility and university resources
  19. Identify potential barriers and concerns and work collaboratively to overcome
  20. Deliver education and training
  21. Provide ongoing support
  22. Collect outcome data on successes and challenges
  23. Use data to debunk common misconceptions about the collaborative model
  24. Workloads do not double as students double
  25. Individualized feedback can be provided
  26. Appropriate supervision is possible
  27. Utilization of the collaborative model of clinical education in a pediatric hospital
  28. Internal vetting and buy-in
  29. Built upon prior relationship
  30. Create culture of change (for betterment)
  31. Assign clinical leader to champion change
  32. Identify “key” stakeholders
  33. External training
  34. CCIP
  35. University of Maryland Rehab Networks training program
  36. Online modules produced by Philadelphia Area Clinical Education Consortium
  37. Internal planning to minimize implementation difficulties
  38. Engage personnel and promote appreciation, understanding, and involvement
  39. Prepare in advance with academic institution (UD)
  40. Address unique concerns of pediatric hospital
  41. Strong focus on family-centered care
  42. Need to integrate two students into this culture
  43. Reliance upon inter-professional team functioning
  44. Need to ensure two students can seamlessly integrate into team
  45. Layout of the children’s hospital
  46. Need to facilitate student integration into space
  47. Outcomes
  48. Productivity data
  49. Data currently under analysis; outcomes to be discussed during presentation.
  50. CI and student satisfaction
  51. Data currently under analysis; outcomes to be discussed during presentation
  52. Lessons learned
  53. Utilization of the collaborative modelof clinical education within a regional health network
  54. Internal vetting and buy-in
  55. Built upon previously established foundation of trust
  56. Observation of collaborative model in action within UD’s clinic
  57. External training
  58. CCIP
  59. University of Maryland Rehab Networks training program
  60. Online modules produced by Philadelphia Area Clinical Education Consortium
  61. Internal planning to minimize implementation difficulties
  62. Prepare in advance with academic institution (UD)
  63. Attend to logistical details (desk, computer, etc.)
  64. Address unique concerns of rural hospital system
  65. Fluctuating numbers of FTEspending patient volumes
  66. Need to restructure staff responsibilities
  67. Reduced census on smaller units
  68. Need to ensure adequate patient volumes to support two full caseloads
  69. Reliance upon inter-professional team functioning
  70. Need to ensure two students can seamlessly integrate into team
  71. Outcomes
  72. Productivity data
  73. Increased in rehab setting
  74. Decreased in acute care setting
  75. Census driven (hospital had lower census during time period of collaborative model of clinical education)
  76. CI and student satisfaction
  77. Positive experience reported by all students
  78. Entry level standards achieved by all students
  79. Positive experience reported by CIs
  80. Adequate supervision was feasible
  81. Workload did not increase (able to complete paperwork during work day)
  82. Global departmental benefits recognized (rehab techs available to other staff, staff floated to other areas of the hospital, more time for QI)
  83. CIs noted studentindependence occurred sooner than in traditional models and with improved clinical decision making
  84. Lessons learned
  85. Plan for fluctuating census
  86. Consider learning opportunities outside of typical patient care
  87. Community health
  88. Question and answer

References

Deusinger, S., Crowner, B., Burlis, T., & Stith, J. (2013). Meeting Contemporary Expectations for Physical Therapists: Imperatives, Challenges, and Proposed Solutions for Professional Education. Journal of Physical Therapy Education 28(1), 56-61.

Jette, D., Nelson, L., Palaima, M., & Wetherbee, E. (2013). How do we Improve Quality in Clinical Education? Examination of Structures, Processes, and Outcomes. Journal of Physical Therapy Education 28(1), 6-12.

Rindflesch, A. B., Dunfee, H. J., Cieslak, K. R., Eischen, S. L., Trenary, T., Calley, D. Q., & Heinle, D. K. (2009). Collaborative model of clinical education in physical and occupational therapy at the mayo clinic. Journal of Allied Health, 38(3), 132-142. Retrieved from

Recker-Hughes, C., Wetherbee, E., Buccieri, K., Timmerberg, J., & Stolfi, A. (2013). Essential Characteristics of Quality Clinical Education Experiences: Standards to Facilitate Student Learning. Journal of Physical Therapy Education 28(1), 48-55.

Tigani, L. Funk,C., Palmieri, T., Stewart, E., Neeley,L., & Wruble-Hakim, E. Outcomes of Clinical Instructor (CI) Effort and Productivity with Implementation of the 2 Students: 1 CI (2:1) Clinical Education Model in the Acute Care Setting. APTA Combined Section Meeting, Anaheim CA, 2016.

Wruble-Hakim, E., Johnson, D., & Stewart, E. Visioning and Implementing a Sustainable Clinical Education Program within a Large Health Network. Education Leadership Conference of the American Physical Therapy Association, Phoenix AZ, 2016.

Positive, Possible, and Productive: Innovations in Clinical Education

Presentation materials should not be distributed or otherwise used without express written permission from Eric Stewart () on behalf of the author group.