Clinical Decision Making and Clinical Skills in DPT Graduates Following a Yearlong Internship: A Pilot Study

Purpose/Hypothesis : Clinical decision making and clinical skills are the keystones to the development of competent autonomous practitioners. The DPT program at the MGH Institute of Health Professions established a yearlong internship to develop graduates who are equipped to be autonomous practitioners with sound clinical decision making skills. Although the program has been very successful, further research is required to determine if these graduates are indeed functioning as autonomous practitioners at the conclusion of their internship. The purpose of this study was to measure and compare DPT internsÕ and clinical instructorsÕ (CIs) perceptions of the internsÕ clinical skills and decision making after completing a yearlong internship.Number of Subjects : 20Materials/Methods : A sample of convenience was selected to participate in this study, consisting of 19 CIs from area clinics and 12 DPT interns from MGH Institute of Health Professions. Surveys for each the CIs and the interns were constructed based on elements from the Physical Therapist Clinical Performance Instrument and then disseminated using Survey Monkey. Participants were asked to rate themselves or their interns on a 6-point Likert scale. A Wilcoxon signed rank test was used to compare the responses of the matched pairs of interns and CIs. A general linear model was used to compare the aggregate responses of the interns and CIs. Descriptive statistics were used to describe the sample.Results : A total of 13 CIs and 7 interns responded, yielding response rates of 72.22% and 53.84% respectively. The average rating score for both CIs and interns was above 5 (on a scale of 6), ranging from 5.08-5.85 and 5.14-6.0 respectively. There was a significant difference between the perceptions of CIs and interns in 4 of 5 matched pairs. Although the results of the general linear model were not significant, a few significant trends were noted.Conclusions : The response rate was above the average response rate for academic studies. The average rating score above 5 for both interns and CIs suggests that the perceptions of CIs and interns about the internsÕ skills and clinical decision making are quite good, implying that the DPT program is preparing graduates well. Four out of five CI-intern pairs demonstrated a significant difference between their ratings. Previous literature suggests that students tend to underrate themselves. This may explain this difference in rating. The CIsÕ perceptions were different from internsÕ perceptions with respect to the internsÕ skills in the area of interventions and safety of the patient. This warrants reevaluation in a larger sample given its curricular implications.Clinical Relevance : The results of this pilot study indicate that graduates completing a full year internship have very good clinical decision making and clinical skills. Based on these results, further study is indicated with a larger sample and triangulation of data to validate the survey tool and generalize the results to a larger population.

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  • Control #: 1714423
  • Type: Poster
  • Event/Year: CSM2014
  • Authors: Tracy Brudvig, Kelly Macauley, Harsha Dhingra
  • Keywords: clinical decision making|clinical skills|yearlong internship model

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