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Facilitating effective methods of physical therapy student learning during shadowing experiences Bennett, Jami; Aiers, Jen; Chicoine, Anna; Gagne, Erin; Gardiner, Susan; Bainbridge, Lesley 2012-08-10

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Facilitating effective methods of physical therapy student learning during shadow experiences Jennifer Aiers1, Jami Bennett1, Anna Chicoine1, Erin Gagne1, Susan Gardiner1, Lesley Bainbridge1,2  A. R., et al. "Student Involvement on Teaching Rounds." Academic medicine : journal of the Association of American Medical Colleges 82.10 Suppl (2007): S19-21. Print. Eades, J., K. Hill, and J. Craig. "The Shadowing Experience for Nursing Students." Nursing standard (Royal College of Nursing (Great Britain) : 1987) 20.12 (2005): 48-51. Print. 3 Eddy, M.E., and Schermer, J. “Shadowing: A Strategy to Strengthen the Negotiating Style of Baccalaureate Nursing Students.” Journal of Nursing Education 38.8 (1999): 364 - 367. Print. 4 Alford CL, Currie DM. Introducing first-year medical students to clinical practice by having them "shadow" third-year clerks. Teach Learn Med. 2004;16(3):260-3. Print. 5 Bates T, Cohan M, Bragg DS, and Bedinghaus J. The Medical College of Wisconsin Senior Mentor Program: Experience of a Lifetime. (2006) Gerontology & Geriatrics Education, Vol. 27(2):93-103. Print. 6 Cole, B., and J. Wessel. "How Clinical Instructors can Enhance the Learning Experience of Physical Therapy Students in an Introductory Clinical Placement." Advances in health sciences education : theory and practice 13.2 (2008): 163-79. Print. 7 Skøien AK, gstøl UV, and Raaheim R. Learning physiotherapy in clinical practice: Student interaction in a professional context. (2009) Physiotherapy Theory and Practice, 25(4):268–278. Print.  20 10  60 50 40  No  20 10 Rotation between clinical areas  Other  Stay with same preceptor  More than one student  Curriculum Delivery  60 Percent of Respondents  40 30  Very Satisfied  20  Satisfied  10  Neutral  Degree & Duration of Program  Shadow Experience & Description  Medical Genetics Counselling  • Masters • 2 years duration  • Not formal • First days of placement considered shadow  Pharmacy  • Bachelor • 4 years duration  • Completed before classes or in first month • 4 hours  • Bachelor • 2 years duration, accelerated program  • Not formal • First day of placement considered shadow  • Masters • 2 years duration  • 3 shadow placements • One interview, one shadow, one transfer  Nursing  Occupational Therapy  • Masters • 2 years duration  • Part of admissions process  Admissions Process  • Letter of intent • Volunteer experience in the profession  ts  io ct ru st  LACK OF KNOWLEDGE 4%  9%  LIMITED EXPOSURE TO PATIENTS 13% HOSPITAL SETTING 9%  TIMING 19% LACK OF VARIETY 23%  INAPPROPRIATE  • Shadow experience must be completed prior to admissions  Figure 3. Faculty Interviews. Summary of Shadow Experiences as represented by interviews with UBC health professional program faculty who facilitate clinical curriculum delivery.  Acknowledgements  In an attempt to standardize the experience, structure is created through site selection, duration, assignments and debriefing approaches There is a critically important role for the assignment or debriefing approach in the learning process which directs both the level of cognitive challenge and amount of personal reflection for the learner Shadowing experience structure must necessarily reflect the goals of all stakeholders (students, preceptors and faculty) and enable completion of assignments to facilitate success  RECOMMENDATIONS  TRAVEL DISTANCE 13% • Unspecific volunteer experience needed  Enabling all students to have a similar experience is difficult, as the learning occurs in a variable and uncontrolled clinical environment  in of Q  PRECEPTOR ASSIGNMENT DUE 4% DATE 2% LACK OF CONTROL 2% NONE  Observation and reflection are low risk ways to be exposed to the clinical setting and reinforce skills like interviewing, clinical reasoning and communication 4,5,6,7  en  nc sig as n  ad sh g in ld  fu U se  Very Unsatisfied  on  ow  to tiv e la re g in  Tim  Unsatisfied  nm  rie  m pla  ex pe  ce  ct le of e nc va  R ele  e  t en  e  s  ur  te no ss cla of  s es ln fu  nd U &  U se  ed  er  uli  st  ng  an  of  da  or  ble  ie  le  nt  ct  at  ur  io  e  n  0  What did you like least about your shadow placement? Faculty  DISCUSSION Goals of shadow experiences have been described as exposure to clinical practice, communication styles and roles, socialization to the profession, and interprofessional learning 2,4,5  50  Sc h  Figure 1. Study Design. Student participants were recruited from a pool of 79 first year students in the 2011 cohort of the MPT program at UBC. Participants received the classroom instruction about shadowing and attended 16 hours of shadowing experience. 49 students participated in the survey, and 8 students participated in the focus group. Preceptors at sites throughout Vancouver were invited to participate in a focus group to provide their perceptions of the themes identified in the student survey. Invitations were distributed by a 3rd party email to clinical practice leaders; 1 clinical site responded and 4 preceptors participated in a focus group. Faculty coordinators of clinical experiences in Faculty of Medicine programs at UBC were invited by a 3rd party email to participate in interviews during the spring of 2012. Interviews with faculty members who oversee clinical education in 5 other healthcare disciplines at UBC focused on the structure of their programs and explored the themes identified in the student survey. Participant invitation, in the College of Health Disciplines at UBC. Names of participants and clinical sites are confidential to the co-investigators.  Outpatient  ar  Conclusions  Medical Genetics Pharmacy Nursing OT SLP  Yes  30  THEMES IDENTIFIED Structure of the experience Curriculum & assignments Preceptor Socialization Inter-professional practice  0 Acute/Medical Rehabilitation  Themes  Speech Language Pathology/Audiology  2  30  0  SELECTED REFERENCES 1 Hoellein,  40  70  ur  Student Focus Group  80  y  Faculty Interviews  Experience Structure  90  lit  Preceptor Interviews  Clinical Practice Area  50  ua  Student surveys  PURPOSE The purpose of this study was to identify essential characteristics of effective shadow placements from students, preceptors, and faculty members at the University of British Columbia, in order to develop recommendations to optimize this educational opportunity for all stakeholders.  60  Shadow Experiences  Percent of Respondents  FINDINGS  le  Shadow placements have been identified as valuable learning experiences that help students become more comfortable in the clinical setting, and subsequently more effective learners in the classroom1. Shadowing for the purpose of learning provides students with the opportunity to access and observe leadership behaviours and characteristics demonstrated by practicing therapists2. For many students this shadowing experience represents their first exposure to the clinical setting3. A highly effective and satisfying shadow placement that socializes the student to the profession, and increases comfort in the clinical environment is currently not well defined. In this study, student perspectives were evaluated using post- shadow experience surveys and focus groups to explore attitudes towards, and satisfaction with, the shadowing experience. Preceptors contributed their perspectives in a focus group addressing themes identified through student surveys, and faculty members involved in facilitating clinical practice experiences for health profession students at UBC participated in interviews.  C  INTRODUCTION & RATIONALE  Contact:  Therapy Department, Faculty of Medicine, University of British Columbia, Vancouver BC, College of Health Disciplines, Faculty of Medicine, University of British Columbia, Vancouver BC  Percent of respondents  1Physical  PROFESSIONAL CONDUCT 2%  Figure 2. Student Survey Simple, random, convenience sampling was used in the survey portion of this study. All MPT1 students were emailed a link to the online survey for completion, which included a consent form in the introduction, if they chose to participate. The 18-item survey administered using SurveyMonkey™ Students completed the survey anywhere from one to three months following their shadow experience. We used a 5-point Likert scale to obtain quantitative data for 11 closed-ended survey questions; 4 yes-no questions, 1 numerical question, 1 categorical question, and 8 open ended questions were also included. Survey data were downloaded onto a secure, password-protected database within the College of Health Disciplines. Questions were developed for both student and preceptor focus groups based on the responses from the surveys.  Use guided reflection around specific topics as a means of personal exploration, development, and transformative learning Encourage students to focus on being present and to absorb information in the new environment Direct student attention to different aspects of interprofessional practice Use shadow placements as opportunities to increase exposure to different practice areas for physical therapists Team up students to maximize discussion and comfort in the new environment  The authors would like to thank Victoria Wood and Valerie Ball for project support, proposal review, and assistance with the ethics approval process. This study is part of a group student research project for the Masters of Physical Therapy program.  This study was approved by the Institutional Review Board at the University of British Columbia (UBC) in Vancouver, British Columbia. All participants signed an informed consent prior to involvement.  


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