Factors Affecting Success of the 2:1 Student: Clinical Instructor Model in Acute Care Settings: A Case Study Analysis

Background & Purpose : Placing students in acute care clinical experiences has become increasingly difficult for many physical therapy (PT) programs. One possible solution is to adopt a 2:1 student to clinical instructor (CI) collaborative clinical education model, thus decreasing the number of acute care CIs and placements needed. Previously reported benefits of the 2:1 model in PT and other health professions include increased productivity, collaborative learning, and critical thinking. Reported concerns include potential of personality conflicts and issues if students have varied levels of clinical skills and confidence. The aim of this study was to describe factors that influence the success of a 2:1 model in acute care settings.Case Description : Five triads (2 Doctor of Physical Therapy students: one clinical instructor, N =15) were studied over 2 years in 2 large metropolitan hospitals. Prior to starting a long-term experience, CIs and students completed a 2:1 model perception survey, Kolb Learning Style Inventory, DISC Profile, and Cognitive Style Inventory. The students and CIs shared their learning style and personality types with triad members. CIs and students wrote weekly journals and completed daily the Clinical Education Quality Audit Part A (CEQAA), which measures time involved with student and CI patient care, CI student supervision and other CI administrative duties. After the experience, students and CIs completed the 2:1 model perception survey again.Outcomes : CIsÕ and studentsÕ overall perceptions regarding the 2:1 model improved at the end of the experiences when compared to baseline measures. Student perceptions increased in terms of time spent with patients and clinical instructors. CIs perceptions regarding time spent with students also improved at the end of the experience. Journal entries supported these perceptions. Other benefits noted were increased productivity, student collaboration, and student independence and confidence. Challenges included potential of comparison of student performance by both CIs and students, CIÕs concern of meeting the needs of students of differing confidence and clinical skill levels, and increased CI paperwork. The CEQAA data supported increased student time with patients and more student supervision by CIs. Personality types and learning styles were mixed within each triad and did not appear to affect the outcome of the experience. All participants believed that knowledge of personality and learning styles was valuable. All the students successfully completed the rotations and both clinics continued to use the 2: 1 model after study conclusion.Discussion : Overall, both CIs and students believed that the benefits of the 2:1 model outweighed the challenges. Strategies used to overcome the challenges included use of clear communication strategies as well as tailoring of patient load, learning experiences and supervisions based on individual student needs. The results of this study provide evidence that the 2:1 model is a viable model in acute care settings.

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  • Control #: 2021219
  • Type: Poster
  • Event/Year: CSM2015
  • Authors: Donald H. Lein, Cecilia Graham, Linda Freeman
  • Keywords: Collborative models|Clinical Education |peer learning

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