ABSTRACT
AIMS: The purpose of this mixed-methods study was to investigate the effect of a first clinical experience on student perception of the importance of obtaining and assessing blood pressure (BP). METHODS: Fifty-eight students preparing for their first clinical experiences were recruited from three New York State physical therapy programs. Student experience obtaining BP during a first clinical experience was investigated using online anonymous surveys and focus groups. The pre survey was administered at 2 weeks before the first clinical experience, and a post survey and focus group were complete 3 weeks after. RESULTS: Statistically significant decline was found in student perceptions of the importance and likelihood of obtaining and assessing BP following a first clinical experience. Qualitatively, three themes emerged (1) Being a student and agency including reluctance to independently initiate practices; (2) influence of clinic norms such as availability of equipment and consistency of BP monitoring; and (3) personal confidence obtaining, assessing, and interpreting BP influenced by exposure to obtaining, assessing, and interpreting BP. CONCLUSION: Clinical education appears to have significant influence on students' perception of the importance of BP assessment. If students encounter and adopt practices deviating from didactic instruction reflecting professional standards, it can expose patients and practitioners to unnecessary risk. Faculty can use these results to better appreciate students' first clinical experiences and foster agency by discussing practice norms.
Subject(s)
Perception , Students , Humans , Blood Pressure , Surveys and Questionnaires , Focus GroupsABSTRACT
Phenotyping and the characterization of chronic obstructive pulmonary disease (COPD) is currently an active area of interest. The perspectives gleaned from evaluating COPD in the context of exercise lend new insights into this endeavor. Pulmonary rehabilitation centers are uniquely positioned to generate such clinical observations and have enhanced an understanding of the disease processes that are involved in COPD. This review and commentary discusses the various patterns of exercise intolerance and characterizes COPD from the perspectives of clinicians caring for persons with COPD.
Subject(s)
Exercise Therapy/methods , Exercise Tolerance/physiology , Pulmonary Disease, Chronic Obstructive/rehabilitation , Humans , Phenotype , Pulmonary Disease, Chronic Obstructive/physiopathologyABSTRACT
A retrospective analysis of 23 patients was undertaken to evaluate the outcome of pulmonary rehabilitation (PR) in patients with pulmonary hypertension (PH) over a preceding 6-year time frame. Chart review and data analyses were undertaken evaluating pulmonary arterial hypertension pharmacotherapy versus the same therapy with the addition of PR. Analysis included 23 patients who had a mean pulmonary artery pressure of 36.6 while on therapy and who had initial six-minute walk tests (6MWTs) ranging between 54 and 396 meters. Outcomes included 6MWTs and Saint George's Respiratory Questionnaire. There was no improvement in 6MWT postpharmacotherapy. Patients with low 6MWT <250 meters had substantial gains in 6MWT postrehabilitation (average of 86 meters). As well, those with initial 6MWT >250 meters had a significant improvement of 52.55 meters, documenting the utility of PR in patients with PH. PH patients are increasingly seen in PR clinics as they share many characteristics present in chronic respiratory disease states. There is increasing literature supporting the utility of PR in this population. We have found that patients with 6MWTs as low as <250 meters are also candidates for PR and can demonstrate substantial benefits as measured using the 6MWTs.
