Perspective for change: establishing the need for clinical instructor competencies in physical therapist education
Main Article Content
Abstract
Current issue: Clinical instructors (CIs) are instrumental in the development of competent, entry-level physical therapist graduates. Despite this key role, CIs are often deficient in formal knowledge of the learning sciences that influence quality of clinical education experiences. Clinical education stakeholders also lack a standardized and consistent approach to defining and assessing clinical teaching skills, resulting in an inability to provide adequate feedback and growth opportunities for CIs.
Perspective: A gap exists between qualitative descriptions of clinical teaching behaviors and the ability to objectively assess those behaviors in CIs. Grounded in the Model of Excellence in Physical Therapist Education, this perspective calls attention to and proposes steps toward excellence in clinical education. Defining essential competencies of clinical teaching in the physical therapy profession requires a systematic approach. The competencies established through this approach then become the foundation for creating a meaningful assessment tool of CI performance.
Implications for clinical education: Developing educator competencies and a related assessment tool for CIs allows for the provision of meaningful feedback, the creation of targeted professional development programs, and opportunities for recognition of clinical teaching excellence. Without effective CIs, new graduates may be inadequately equipped to contribute to the profession’s vision of educational excellence.
References
- Jensen GM, Hack LM, Nordstrom T, et al. National study of excellence and innovation in physical therapist education: part 2-a call to reform. Phys Ther (2017) 97: 875–88. doi: 10.1093/ptj/pzx062
- Commision on Accreditation in Physical Therapy Education. Aggregate program data: 2018–2019 Physical therapist education programs fact sheet. Available from: http://www.capteonline.org/uploadedFiles/CAPTEorg/About_CAPTE/Resources/Aggregate_Program_Data/AggregateProgramData_PTPrograms.pdf [cited 18 Mar 2020].
- Recker-Hughes C, Wetherbee E, Buccieri KM, et al. Essential characteristics of quality clinical education experiences: standards to facilitate student learning. J Phys Ther Educ (2014) 28: 48–55. doi: 10.1097/00001416-201400001-00009
- McCallum CA, Reed R, Bachman S, et al. A systematic review of physical therapist clinical instructor demographics and key characteristics: impact on student clinical education experiences. J Phys Ther Educ (2016) 30: 11–20. doi: 10.1097/00001416-201630030-00004
- Mostrom E. What makes a good clinical teacher? In: Jensen GM, Mostrom E, eds. Handbook of teaching and learning for physical therapists, 3rd ed. St. Louis, MO: Elsevier/Butterworth-Heinemann; 2013, pp. 159–82.
- Jensen GM, Nordstrom T, Mostrom E, et al. National study of excellence and innovation in physical therapist education: part 1-design, method, and results. Phys Ther (2017) 97: 857–74. doi: 10.1093/ptj/pzx061
- Merriam SB, Bierema LL. Adult learning: linking theory and practice. 1 ed. San Francisco, CA: Jossey-Bass; 2014.
- Coleman-Ferreira K, Tovin M, Rone-Adams S, et al. Achieving clinical instructor competence. J Phys Ther Educ (2019) 33: 224–35. doi: 10.1097/jte.0000000000000106
- Recker-Hughes C, Brooks G, Mowder-Tinney JJ, et al. Clinical instructors’ perspectives on professional development opportunities: availability, preferences, barriers, and supports. J Phys Ther Educ (2010) 24: 19–25. doi: 10.1097/00001416-201001000-00003
- Buccieri KM, Pivko SE, Olzenak DL. How does a physical therapist acquire the skills of an expert clinical instructor? J Phys Ther Educ (2011) 25: 17–23. doi: 10.1097/00001416-201101000-00005
- Housel N, Gandy J. Clinical instructor credentialing and its effect on student clinical performance outcomes. J Phys Ther Educ (2008) 22: 43–51. doi: 10.1097/00001416-200810000-00006
- Morren KK, Gordon SP, Sawyer BA. The relationship between clinical instructor characteristics and student perceptions of clinical instructor effectiveness. J Phys Ther Educ (2008) 22: 52–63. doi: 10.1097/00001416-200810000-00007
- Wetherbee E, Nordrum JT, Giles S. Effective teaching behaviors of apta-credentialed versus noncredentialed clinical instructors. J Phys Ther Educ (2008) 22: 65–74. doi: 10.1097/00001416-200801000-00010
- American Physical Therapy Association. APTA learning center. Available from: https://learningcenter.apta.org/ [cited 3 January 2021].
- Steinert Y, Mann K, Anderson B, et al. A systematic review of faculty development initiatives designed to enhance teaching effectiveness: a 10-year update. Med Teach (2016) 38: 769–86. doi: 10.1080/0142159X.2016.1181851
- Jensen GM. Educating physical therapists. Thorofare, NJ: Slack Incorporated; 2019.
- Buccieri KM, Pivko SE, Olzenak DL. Development of an expert clinical instructor: a theoretical model for clinical teaching in physical therapy. J Phys Ther Educ (2013) 27: 48–57. doi: 10.1097/00001416-201310000-00007
- Jette DU, Nelson L, Palaima M, et al. How do we improve quality in clinical education? Examination of structures, processes, and outcomes. J Phys Ther Educ (2014) 28: 6–12. doi: 10.1097/00001416-201400001-00004
- McCallum CA, Mosher PD, Jacobson PJ, et al. Quality in physical therapist clinical education: a systematic review. Phys Ther (2013) 93: 1298–311. doi: 10.2522/ptj.20120410
- Chen HC, Fogh S, Kobashi B, et al. An interview study of how clinical teachers develop skills to attend to different level learners. Med Teach (2016) 38: 578–84. doi: 10.3109/0142159X.2015.1073238
- American Physical Therapy Association. Guidelines and self-assessments for clinical education. Available from: http://www.apta.org/Educators/Assessments/ACCE/DCE/GuidelinesandAssessmentsforClinEd/ [cited 1 March 2020].
- American Physical Therapy Association. Physical therapist student evaluation: clinical experience and clinical instruction. Available from: http://www.apta.org/uploadedFiles/APTAorg/Educators/Assessments/StudentPTEvaluationForm [cited 12 January 2020].
- Wormley ME, Romney W, Schweizer K, et al. Using a valid and reliable measure to assess clinical instructor self-perception of teaching behaviors. J Phys Ther Educ (2018) 32: 344–54. doi: 10.1097/jte.000000000000006324
- Gallivan SP. Construct validity and internal consistency of the physical therapist student evaluation of clinical experience and clinical instruction. University of Dayton OhioLINK Electronic Theses and Dissertations Center (2019). Available from: https://etd.ohiolink.edu/pg_10?0::NO:10:P10_ACCESSION_NUM:dayton155497630642095 [cited 14 May 2020].
- Galbraith RM, Hawkins RE, Holmboe ES. Making self-assessment more effective. J Contin Educ Health Prof (2008) 28: 20–4. doi: 10.1002/chp.151
- Verma S, Paterson M, Medves J. Core competencies for health care professionals: what medicine, nursing, occupational therapy, and physiotherapy share. J Allied Health (2006) 35: 109–15. doi: 10.3233/WOR-2012-1299
- Batt AM, Tavares W, Williams B. The development of competency frameworks in healthcare professions: a scoping review. Adv Health Sci Educ Theory Pract (2020) 25: 913–87. doi: 10.1007/s10459-019-09946-w
- Ramsburg L, Childress R. An initial investigation of the applicability of the Dreyfus skill acquisition model to the professional development of nurse educators. Nurs Educ Perspect (2012) 33: 312–6. doi: 10.5480/1536-5026-33.5.312
- Srinivasan M, Li ST, Meyers FJ, et al. Teaching as a competency: competencies for medical educators. Acad Med (2011) 86: 1211–20. doi: 10.1097/ACM.0b013e31822c5b9a
- Brink D, Simpson D, Crouse B, et al. Teaching competencies for community preceptors. Fam Med (2018) 50: 359–63. doi: 10.22454/FamMed.2018.578747
- Promoting Teacher Effectiveness. Adult education teacher competencies. American Institues for Research. United States Department of Education. Available from: https://lincs.ed.gov/state-resources/federal-initiatives/teacher-effectiveness/competencies [cited 19 January 2020].
- Frank JR, Danoff D. The CanMEDS initiative: implementing an outcomes-based framework of physician competencies. Med Teach (2007) 29: 642–7. doi: 10.1080/01421590701746983
- Kassis K, Wallihan R, Hurtubise L, et al. Milestone-based tool for learner evaluation of faculty clinical teaching. MedEdPORTAL (2017) 13: 10626. doi: 10.15766/mep_2374-8265.10626
- Nguyen VNB, Forbes H, Mohebbi M, et al. Development and validation of an instrument to measure nurse educator perceived confidence in clinical teaching. Nurs Health Sci (2017) 19: 498–508. doi: 10.1111/nhs.12373
- Rosenbaum M. Competencies in medical education. Soc Gen Intern Med Forum (2012) 35: 1–2.
- American Physical Therapy Association. Education leadership partnership. Available from: https://www.apta.org/ELP/ [cited 20 January 2020].
- Lyon LJ. Development of teaching expertise viewed through the dreyfus model of skill acquisition. J Schol Teach Learn (2015) 15: 88–105. doi: 10.14434/josotl.v15i1.12866
- Ericcson K, Krampe R, Tesch-Romer C. The role of deliberate practice in the acquisition of expert performances. Psychol Rev (1993) 100: 363–406. doi: 10.1037/0033-295X.100.3.363
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.