Effect of Physical Therapy Students' Clinical Experiences on Clinician Productivity.

BACKGROUND: Physical therapy clinical education experiences (CEEs) are difficult to secure, particularly first-level CEEs. Our purpose was to determine 1) what impact student full-time CEEs have on PT clinician productivity and 2) whether there is a productivity difference between first vs final CEEs. METHODS: Productivity logs, including possible factors impacting productivity, were distributed to clinician-student pairings on first and final CEEs. Two-week baseline data (without a student) were compared to weeks 1 and 6 (with a student) for 31 logs using a 2x4 repeated-measures ANOVA. In a subset of 17 logs for CEEs 8 weeks or longer, a 2x5 repeated-measures ANOVA was performed. RESULTS: There was a significant increase in the number of patients seen and CPT units billed by both levels of CEEs comparing weeks 1 and 6. In the subset of CEEs, 8 weeks or longer, there was a significant increase in the number of patients treated per hour at week 6 and a trend toward a change at week 8 when compared to baseline week A. The factors selected as impacting productivity were census (59%) and staffing (32%). CONCLUSION: Physical therapy clinician-student pairings showed an overall increase in productivity during both full-time first and final level CEEs.

Validity of the stroke rehabilitation assessment of movement scale in acute rehabilitation: a comparison with the functional independence measure and stroke impact scale-16.

OBJECTIVE: To demonstrate sensitivity to change of the Stroke Rehabilitation Assessment of Movement (STREAM) as well as the concurrent and predictive validity of the STREAM in an acute rehabilitation setting. DESIGN: Prospective cohort study. SETTING: Acute, in-patient rehabilitation department within a tertiary-care teaching hospital in the United States. PARTICIPANTS: Thirty adults with a newly diagnosed, first ischemic stroke. METHODS: Clinical assessments were conducted on admission and then again on discharge from the rehabilitation hospital with the STREAM (total STREAM and upper extremity, lower extremity, and mobility subscales), Functional Independence Measure (FIM), and Stroke Impact Scale-16 (SIS-16). Sensitivity to change was determined with the Wilcoxon signed rank test and by the calculation of standardized response means. Spearman correlations were used to assess concurrent validity of the total STREAM and STREAM subscales with the FIM and SIS-16 on admission and discharge. We determined predictive validity for all instruments by correlating admission scores with actual and predicted length of stay and by testing associations between admission scores and discharge destination (home vs subacute facility). MAIN OUTCOMES: Not applicable. RESULTS: For all instruments, there was statistically significant improvement from admission to discharge. The standardized response means for the total STREAM and STREAM subscales were large. Spearman correlations between the total STREAM and STREAM subscales and the FIM and SIS-16 were moderate to excellent, both on admission and discharge. Among change scores, only the SIS-16 correlated with the total STREAM. All 3 instruments were significantly associated with discharge destination; however, the associations were strongest for the total STREAM and STREAM subscales. All instruments showed moderate-to-excellent correlations with predicted and actual length of stay. CONCLUSIONS: The STREAM is sensitive to change and demonstrates good concurrent and predictive validity as compared with the FIM and SIS-16 in the acute inpatient rehabilitation population.

Pedagogical tools to develop clinical reasoning: physical therapy students' perspective.

Physical therapy students' perspective about the development of clinical decision making ability was solicited to determine: 1) if actual clinical and academic learning experiences are consistent with student preferences; and 2) if actual academic learning experiences differ according to subject matter. Program representatives contacted physical therapy students via email with an embedded link to an on-line survey during their final clinical education experiences. Open-ended and forced-choice items addressed reactions to learning experiences to develop clinical reasoning in academic and final clinical education experiences. Data were analyzed with frequency analysis, chi-square and correlations of survey items. Ninety-one respondents completed the survey, yielding a 13% response rate. The frequency of use of pedagogical tools was lower than the preferred use of the tools. Perceptions about clinical reasoning learning tools varied with course content. Course content corresponded to the type of pedagogical tool that students deemed essential for learning clinical reasoning. Participants appeared to experience and prefer more independence at the final clinical experience although they preferred considerable involvement by the clinical instructor.