Implementation of the 2:1 Model of Student Supervision in Acute Care

Background & Purpose : Cooperative clinical education (CE) models, where two or more students are assigned to one clinical instructor (CI), have the potential to increase productivity, enhance student learning, and effectively increase the availability of student placements. However, why do the majority of CE placements continue to reflect the traditional 1:1 student-CI model? Anecdotal evidence suggests that we pattern from tradition. With increasing demand for acute care placements, academic programs must explore alternative models in order to meet the needs of student learning. The purpose of this case report is to describe the efforts of one Doctor of Physical Therapy (DPT) program in working with a clinical partner to effectively Òbreak traditionÓ and implement the 2:1 model of clinical student supervision within the acute care setting.Case Description : This DPT Program requires each student to complete a terminal internship in a hospital-based, acute care practice. The Hospital is a long-term partner in CE; historically, the site accepted two students for terminal internships per year, placing students in a 1:1 supervisory model. Upon request, the site agreed to pilot the 2:1 model of student supervision. In the process of securing the agreement, the program provided literature resources and onsite consultation in support of cooperative CE learning models. The site identified CIs who are flexible, open, and experienced. The program selectively assigned students who had no prior history of remediation and who demonstrated compatibility. Site agreed to lower productivity expectations for the CI during the first half of the internship, offset by productivity gains during the latter half of the internship. Also agreed were shared expectations for the CI to provide direct line-of-site supervision for each student until such point that the CI was able to establish student competency with respect to patient safety; in-house supervision was required at all times. Site manager agreed to a coordinated effort to keep daily patient assignments within the same unit/area of the hospital. CCCE assisted in strategies for student instruction, student supervision, and caseload management.Outcomes : Placement availability within this setting effectively doubled. Overall productivity averaged 79% over the internship period, which was higher than average productivity for the CI alone. Supervisory time during the second half of the internship decreased due to studentsÕ problem-solving between themselves prior to going to the CI for assistance. Post-internship site and CI evaluations indicated highest levels of satisfaction, and all students met internship goals for entry-level performance.Discussion : Evidence suggests that the 2:1 model is a viable alternative to the more traditional 1:1 student supervisory model. The 2:1 model of student supervision can be effectively implemented in acute care practice; however, programs must engage in a Ògrass rootsÓ effort to advocate for this model of supervision which yields benefits for both the site and the program.

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  • Control #: 1726277
  • Type: Poster
  • Event/Year: CSM2014
  • Authors: Peri J. Jacobson, Beth Quinn, Sarah Bormann
  • Keywords: clinical education|student supervision|acute care

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