R. Wellmon, MS, PT College of Allied Health Professions, Department of Physical Therapy, Temple University, Philadelphia, PA.
Purpose: One challenge facing physical therapy educators is designing learning experiences that foster the acquisition of clinical decision making skills among students who have limited clinical experience. The learning experience must closely simulate what commonly occurs in the clinic so that the student has an opportunity to engage in problem solving activities under conditions which are comparable to those in which they will be practicing. The purpose of this presentation is to describe a teaching method that was used to prepare first year students for their first clinical experience.
Description: During the final weeks of class, three two-hour lab sessions are devoted to clinical case studies. Practicing clinicians are invited to submit case studies which are based on patients that they are or have been actively involved in treating. Students are divided into groups of four and work on a single problem within a lab session. The lab instructors play the role of the patient. The students are given a copy of the referral and a medical history. They have 80 minutes to review the patient’s medical record and make decisions about what to evaluate, collect a subjective history, perform an initial evaluation, and document their findings. At the end of the 80 minutes, the group reassembles and the patient is presented by the expert treating clinician. Videotapes of the actual patient are used to enhance the students’ understanding of clinical concepts and to facilitate group discussion. Students can compare their findings with those of the expert clinician. Over the course of the three labs, each group of four students receives at least one opportunity to work with a lab instructor. Lab instructors can step out of the patient role to assist the students with clinical decision making and can provide feedback regarding the psychomotor performance of specific evaluative techniques.
Observation: The clinical case presentations are universally well received by the students. Feedback has been positive with students remarking that the clinical case studies and presentations were helpful in linking concepts covered throughout the academic year.
Conclusions: Expert clinical case studies seem to be an effective method to enhance clinical decision making skills for first year physical therapy students. Case presentations helped the students integrate concepts discussed during the semester and afforded the students with an opportunity to practice skills learned throughout the first academic year. The students were also presented with a model for peer interaction and their sense of confidence regarding their present level of clinical skills was enhanced in days leading up the first clinical affiliation.
Poster presented at the 1997 American Physical Therapy Assoication Scientific Meeting, San Diego, CA.