Academic performance of physical therapy students participating in a student-led pro bono clinic: a quasi-experimental, cohort study across two orthopedic courses

Abstract

Purpose: Prior studies have explored the influence of student-run pro bono clinics on attitudes, empathy, and professional development; however, limited research has examined the potential academic impact. The TSU Tiger Rehabilitation Clinic is a student-led clinic offering physical therapy services to underserved populations. The purpose of this study was to investigate whether involvement impacted the performance on written examinations and practical scores of second-year Doctor of Physical Therapy (DPT) students enrolled in two consecutive orthopedic courses.

Methods: A quasi-experimental crossover design was employed to investigate the effect of student-led pro bono clinic participation on the academic performance of second-year DPT students across two consecutive cohorts. Students were randomly assigned to either the experimental group (clinic participation) or the control group (fundraising) during the fall semester and switched roles in the spring. Academic performance was assessed using standardized quizzes, written exams, and practical assessments in Orthopedics I and II. Written evaluations were administered through an electronic management system with NPTE-style questions from a consistent question bank; item reliability was confirmed using platform analytics. Practical exams evaluated both clinical skill performance and theoretical knowledge, with structured remediation and safety protocols in place. A paired sample t-test and MANOVA were performed to analyze differences in academic outcomes between groups.

Results: No statistically significant differences were found between groups on any written or practical assessments. Score differences were minimal, correlations were weak, and effect sizes were consistently small, indicating a minimal to negligible measurable impact on academic outcomes from clinic participation.

Conclusion: Although clinic participation did not significantly impact academic performance, pro bono experiences may promote interpersonal and professional development that is not captured by traditional assessments. Future research should employ mixed-method designs to explore broader educational impacts and long-term outcomes of early clinical exposure.