ABSTRACT
Introduction: The COVID-19 pandemic saw physical therapist (PT) education programs in 2020 add virtual options to prepare students for hands-on clinical skills. The purpose of this research was to investigate student confidence, preparation, and clinical performance based on their choice of virtual or in-person laboratory immersion. Secondary analysis compared 2020 cohort outcomes with the previous cohort in 2019 (prepandemic). Review of literature: Virtual skill acquisition has been studied with support for effectiveness in didactic and psychomotor skill acquisition. The impact on clinical education performance is unknown. Subjects: Student records from an accelerated hybrid, PT education program in 2020 (n = 91) and 2019 (n = 86). Methods: :In this mixed-method observational study, researchers analyzed a Qualtrics survey and the PT Clinical Performance Instrument (CPI) to compare student outcomes. Statistical analyses included chi-square, two-way multivariate analysis of variance (MANOVA), and Mann-Whitney U test. MAXQDA software was used to code student and clinical instructor narrative responses from the CPI related to strengths and areas for further development. Results: All students in 2020 attended laboratory virtually for 9 full days, and 24% of students chose virtual laboratory for the remaining 8.5 days;97% of students reported feeling confident going into their clinical experience (66% inpatient). No statistically significant differences were found based on instructional method (virtual or in-person) or clinical practice setting (inpatient or outpatient) for confidence, preparation, or CPI performance. Themes of wanting more time to prepare and more confidence in clinical decision making emerged from the qualitative analysis. Discussion: and Conclusion: Results indicate no statistically significant difference for virtual versus in-person laboratory and no difference compared with the 2019 cohort. Virtual instruction effectively prepared students for their clinical experiences across all settings. Although an in-person laboratory experience may be preferred, it is possible to deliver effective experiences in a virtual setting without compromising student performance. Further research is needed to confirm findings. Copyright © 2023 Academy of Physical Therapy Education, APTA.
ABSTRACT
Background: Dialysis patients are at high risk for severe complications related to COVID-19. The present study examined perception of risk of COVID-19 and its impact on behavior modification and emotional well-being among in-center hemodialysis (ICHD) patients during the recent COVID-19 pandemic. Methods: In-depth, semi-structured telephone interviews were conducted between May and July 2020 with adult ICHD patients dialyzing at a large dialysis organization (LDO). Responses were analyzed using inductive thematic analysis. The reliability of categories was examined by an independent coder. Results: A total of 41 LDO patients were interviewed. The median age was 63 years and 54% were female. Satisfactory inter-rater reliability was achieved for all identified themes (kappa = 0.70 -0.99). We found that the COVID-19 pandemic caused a high level of worry among ICHD study subjects;78% of those interviewed felt that they are at high risk of COVID-19. Consequently, subjects reported a high level of compliance with appropriate protective behaviors during the pandemic, such as wearing a mask, sheltering at home, social distancing, and frequent handwashing. The perception of the actual likelihood of contracting the virus during a hemodialysis session was relatively low (M = 3.38 on a 0 to 10 risk scale). The pandemic had no impact on self-reported adherence to dialysis treatment schedules, medications, or diet. However, subjects reported dominating emotions of frustration, fear, stress, depression, and anxiety. Conclusions: The study subjects were aware of the risk of COVID-19 and seemingly increased compliance with protective behaviors as a consequence. It appears that the pandemic had a strong negative impact on the study subjects' emotional well-being and that additional support in this area might be beneficial.