Describe the threading of integrated clinical experiences (ICE) throughout the curriculum to assess clinical readiness prior to full time clinical experiences (FCE) in a large PT cohort
Physical therapy education programs (PTEPs) must prepare students for FCE. While on these clinical experiences, students are expected to demonstrate proficient clinical and behavioral skills, while under the supervision of a licensed physical therapist yet most PTEPs do not have established methods of assessing students’ readiness to participate in FCE. ICE is one tool to assess clinical readiness.
In a larger cohort of on average 70 students, ICE are threaded through the curriculum (associated with clinical courses). As students progress along the curriculum, they are expected to demonstrate a progression of competency on rubrics that are based on the clinical performance Instrument (CPI) red flag items. As the students moves through the curriculum the stakes are higher and the red flag items are weighted more heavily. The first ICE is an observational experience that focuses on professional behaviors and communication. The last visit is a demonstration of competency on all red flag items on a patient with complex multisystem involvement. The goal of the ICE assessment is to identify students at risk for poor performance on FCE. At risk students trigger additional visits or remediation.
Identification of struggling students has been successful thus far, however, two cases will demonstrate the need to raise the consequences of poor performance on ICE. One case describes a student who was identified early before an initial FCE. The student had difficulty with a basic clinical decision making regarding performance of a test in a less complex case . The second case describes a student who was identified in an ICE prior to culminating FCE as having difficulties with clinical decision making regarding interpretation of a test in a more complex case. Both students underwent remediation but ultimately failed their FCE.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
ICE is one tool to assess clinical readiness in a larger PT cohort. ICE along with a clinical readiness practical, standardized patient activities and simulation activities in conjunction with lab activities, and didactic course work can assess our students’ preparedness for the diverse world of clinical practice. Multiple opportunities need to be available through the curriculum to assess student progress and readiness for clinic. These opportunities must have mechanisms to not only identify students who are struggling but plans to allow for remediation of skills as needed to maximize success or ultimately prevent the students from being placed on a FCE.
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