Student perceptions and understanding of client-therapist interactions within the inpatient acute care environment: qualitative study.

BACKGROUND: Physical therapists practicing in inpatient acute care settings in the United States work in a 21st century health care system that requires professional competence in clinical reasoning and decision making. For doctor of physical therapy (DPT) students, the development of confidence in the patient evaluation and the professional skills necessary for managing the inpatient environment can be challenging. OBJECTIVE: The study's purpose was to understand whether the early exposure of students to inpatient settings informed their understanding of the thought processes and actions of experienced clinicians during client interactions. DESIGN: A qualitative design was used. METHODS: Thirty-three DPT students working in inpatient settings were recruited from 15 unique inpatient hospital (acute care and rehabilitation) facilities with a convenience sampling technique. Reflective data were collected for 1 month with clinician-facilitated discussion boards. RESULTS: Four themes emerged: environment, communication, evaluation, and client-therapist interaction. The themes informed a conceptual model depicting the observation by DPT students of factors that influenced interactions between clients and experienced clinicians in inpatient settings. Reflection on the what, the how, and the why that informed clinical decisions enabled students to recognize the situated nature of evaluation and treatment approaches. LIMITATIONS: The use of a sample from 1 year of a DPT program at one university reduced the generalizability of the results. CONCLUSIONS: Limited research has examined student perceptions of the interactions of experienced clinicians with clients in inpatient acute care settings. More research is needed to understand the impact of exposing students to the thoughts and actions of therapists working in such settings earlier within DPT curricula.

Reflective electronic portfolios: a design process for integrating liberal and professional studies and experiential education.

The purpose of this article is to describe the process used to create and pilot-test a customized reflective electronic portfolio (e-portfolio) that integrates learning across three distinct components of an entry-level 6.5 year Doctor of Physical Therapy (DPT) program. During the 2004-2005 academic year, a pilot test was conducted with 10 students, representative of all 6.5 years in the DPT program. Development of our reflective e-portfolio model consisted of four stages: design a paper-based portfolio model to organize and create linkages among the liberal studies, professional, and experiential components of a DPT program; transform the model into an electronic format; create a demonstration e-portfolio tutorial; and evaluate the e-portfolio model via pilot testing. An interdepartmental team of faculty from physical therapy (PT), cooperative education, educational technology, and two PT students developed the e-portfolio model to map, visualize, and create linkages for student learning. Input to assist with the model design process was gathered from PT faculty and students through three focus groups. Data were collected on student experiences with the e-portfolio through written surveys at three points during the project and through face-to-face discussion. Written reflection, integral to the model, required students to reflect on artifacts selected from existing academic and experiential materials. Our project resulted in the generation of a reflective e-portfolio and tutorial customized for DPT students. Evaluation by users indicated that the reflective e-portfolio helped them organize and integrate academic and experiential learning and illuminate developmental transitions. Further research with a larger sample is indicated to examine the impact of e-portfolios on student learning and professional development.