The use of complex cases to facilitate and assess curricular integration

Purpose: The purpose of this research was to assess how the use of complex, integrative case studies facilitated synthesis of clinical decision-making from courses within a Doctor of Physical Therapy (DPT). ÊMethods/Description: Faculty developed an Integrated Longitudinal Case-Based Learning (ILCBL) model that uses a multi-generational family for student learning within an entry-level DPT curriculum.Ê Six integrated cases were implemented longitudinally throughout the curriculum emphasizing changes in age, health condition, and psychosocial aspects. From those 6 cases, 4 were implemented as complex cases in the final semester. The focus of this activity was to assess the studentsÕ clinical decision-making using knowledge gained throughout the program. The complex cases were: (1) collaboratively developed by 2 core faculty and involved multiple systems; (2) composed of 5 progressive parts and (3) linked to a specific lecture in an advanced course. The complex cases were used as a small group in-class activity completed in progressive parts. Student responses were then compared to a faculty developed best practice rubric. The responses were independently analyzed by 2 lead faculty to determine the integration of content. The 2 faculty then compared their initial independent analyses and derived themes based on clinical reasoning and curricular integration.Ê Additionally, the students were surveyed using a 5 point Likert aimed at soliciting feedback on the integrative learning opportunity. Ê ÊResults/Outcomes: The analysis demonstrated the studentsÕ ability to apply clinical decision-making effectively in the following areas: PTA delegation, scope of practice and referral, objective measurement application, the identification of home and social roles, and safe practice. Students had difficulty identifying the patientÕs multiple roles, body image as a psychosocial factor and the immune systemÕs involvement in complex cases.Ê The students were inconsistent with their use of standardized tests, risk factor identification, co-morbidity integration in complex clinical decision-making and accurate differential diagnosis in complex cases. Applying these findings to the ICF framework suggested students had integrated body structure and function, activity, and environmental concepts but have limited incorporation of personal factors and health condition comorbidities. Survey results indicated that students felt the learning approach challenged their clinical decision-making skills. ÊConclusions/Relevance to the conference theme: Shaping the Future of Physical Therapy Education: Our goal was to create a learning environment that facilitated an integrative approach through complex case analysis. Findings indicated a positive educational outcome for students and an effective curricular assessment tool for faculty. The future of physical therapy education needs to incorporate an integrative and comprehensive clinical decision-making approach fostering student application of knowledge from all curricular content. ÊReferences: 1.ÊÊÊÊÊÊÊÊÊÊÊ American Physical Therapy Association. Guide to Physical Therapist Practice. 2nd ed. Alexandria, VA: American Physical Therapy Association; 2001. 2.ÊÊÊÊÊÊÊÊÊÊÊ American Physical Therapy Association. A Normative Model of Physical Therapy Professional Education: Version 2004. Alexandria, VA: American Physical Therapy Association; 2004. 3.ÊÊÊÊÊÊÊÊÊÊÊ Jette AM. Physical disablement concepts for physical therapy research and practice. Phys Ther. May 1994;74(5):380-386. 4.ÊÊÊÊÊÊÊÊÊÊÊ Rothstein JM, Echternach JL, Riddle DL. The Hypothesis-Oriented Algorithm for Clinicians II (HOAC II): a guide for patient management. Phys Ther. May 2003;83(5):455-470. 5.ÊÊÊÊÊÊÊÊÊÊÊ Riddle DL, Rothstein JM, Echternach JL. Application of the HOAC II: an episode of care for a patient with low back pain. Phys Ther. May 2003;83(5):471-485. 6.ÊÊÊÊÊÊÊÊÊÊÊ Edwards I, Jones M, Carr J, Braunack-Mayer A, Jensen GM. Clinical reasoning strategies in physical therapy. Phys Ther. Apr 2004;84(4):312-330; discussion 331-315. 7.ÊÊÊÊÊÊÊÊÊÊÊ Foord-May L. A faculty's experience in changing instructional methods in a professional physical therapist education program. Phys Ther. Feb 2006;86(2):223-235. 8.ÊÊÊÊÊÊÊÊÊÊÊ Burnett CN, Pierson FM. Developing problem-solving skills in the classroom. Physical Therapy. 1988;68(9):1381-1385. 9.ÊÊÊÊÊÊÊÊÊÊÊ Baldwin JA, Schaffer S. The continuing case study. Nurse Educ. Sep-Oct 1990;15(5):6-9. 10.ÊÊÊÊÊÊÊÊÊ Talmage DA. Teaching with Cases to Enhance the Clinical Problem-Solving Skills and Integration Skills of Fourth-Term Chiropractic Students. The Journal of Chiropractic Education. 2001;15(2):53-60. 11.ÊÊÊÊÊÊÊÊÊ Struck BD, Teasdale TA. Development and evaluation of a longitudinal Case Based Learning (CBL) experience for a geriatric medicine rotation. Gerontol Geriatr Educ. 2008;28(3):105-114. 12.ÊÊÊÊÊÊÊÊÊ Hayward LM, Blackmer B, Markowski A. Standardized Patients and Communities of Practice: A realistic strategy for integrating the core values in a Physical Therapist Education Program. JPTE. 2006;20(2):29-37. 13.ÊÊÊÊÊÊÊÊÊ Wood DF. Problem based learning. BMJ. Feb 8 2003;326(7384):328-330. 14.ÊÊÊÊÊÊÊÊÊ Donner RS, BIckley H. Problem-based learning in American Medical education: an overview. Bull Med Libr Assoc. 1993;81(3):294-298. 15.ÊÊÊÊÊÊÊÊÊ DeMarco R, Hayward LM, Lynch M. Nursing students' experiences with and strategic approaches to case-based instruction: a replication and comparison study between two disciplines. Journal of Nursing Education. 2002;41(4):165-174. 16.ÊÊÊÊÊÊÊÊÊ Thomas MD, O'Connor FW, Albert ML, Boutain D, Brandt PA. Case-based teaching and learning experiences. Issues Ment Health Nurs. Jul-Aug 2001;22(5):517-531. 17.ÊÊÊÊÊÊÊÊÊ Herrier RN, Jackson TR, Consroe PF. The Use of Student-Centered, Problem-Based, Clinical Case Discussions to Enhance Learning in Pharmacology and Medicinal Chemistry. American Journal of Pharmaceutical Education. 1997;61(Winter):441-446. 18.ÊÊÊÊÊÊÊÊÊ Kim S, Phillips WR, Pinsky L, Brock D, Phillips K, Keary J. A conceptual framework for developing teaching cases: a review and synthesis of the literature across disciplines. Med Educ. Sep 2006;40(9):867-876. 19.ÊÊÊÊÊÊÊÊÊ Schwartz PL, Egan AG, Heath CJ. Students' Perceptions of Course Outcomes and Learning Styles in Case-based Courses in a Traditional Medical School. Academic Medicine. 1994;69(6):507. 20.ÊÊÊÊÊÊÊÊÊ Rein M, Walker F, Ravdin J. Evaluation of a case-oriented curriculum for an introduction to clinical medical course. Acad Med. 1990;65(7):484. 21.ÊÊÊÊÊÊÊÊÊ Hudson JN, Buckley P. An evaluation of case-based teaching: evidence for continuing benefit and realization of aims. Adv Physiol Educ. Dec 2004;28(1-4):15-22. 22.ÊÊÊÊÊÊÊÊÊ Hansen JT, Krackov SK. The use of small group case-based exercises in human gross anatomy: a method for introducing active learning in a traditional course format. Medical Education. 1994;7:357-366. 23.ÊÊÊÊÊÊÊÊÊ McCannon R, Robertson D, Caldwell J, Juwah C, Elfessi A. Students' Perceptions of Their Acquired Knowledge During a Problem Based Learning Case Study. Occupational Therapy in Health Care. 2004;18(4):13-28. 24.ÊÊÊÊÊÊÊÊÊ Irby DM. Three exemplary models of case-based teaching. Acad Med. Dec 1994;69(12):947-953. 25.ÊÊÊÊÊÊÊÊÊ Richards PS, Inglehart MR. An interdisciplinary approach to case-based teaching: does it create patient-centered and culturally sensitive providers? J Dent Educ. Mar 2006;70(3):284-291. 26.ÊÊÊÊÊÊÊÊÊ May WW, Morgan BJ, Lemke JC, Karst GM, Stone HL. Model for ability-based assessment in physical therapy education. J Phys Ther Ed. 1995;9(1):3-6. Ê Ê

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  • Control #: 1990798
  • Type: Poster
  • Event/Year: ELC2014
  • Authors: Peter Altenburger, Amy Bayliss, Terry Loghmani, Valerie A. Strunk, Amy Watson
  • Keywords:

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