Augmented behavioral medicine competencies in physical therapy students’ clinical reasoning with a targeted curriculum: a final-semester cohort-comparison study

Purpose: To describe the perceptions of peer evaluation as an instructional method when used by entry-level doctor of physical therapy (DPT) students as preparation for practical examinations within a clinically oriented course. Methods/Description: Forty first year, entry-level doctor of physical therapy students participated in structured peer-skills checks prior to practical exams as part a clinically based course. Each student was required to observe and provide critical feedback for at least four other students as they performed simulated patient care activities. Peer-evaluators rated the students on their level of competency with the skills using a Visual Analog Scale and provided written feedback specifying areas of strength and areas needing improvement. Following the conclusion of the course, students completed a questionnaire using online survey software. The questionnaire was designed to investigate student perceptions related to skill acquisition, giving and accepting feedback, and the overall value of peer-feedback. Results: Themes emerged regarding the value of practice and repetition, emerging reflective practice skills, emerging critical thinking and problem solving skills, and the use of peer feedback for improved performance. The value of practice and repetition was reflected in statements such as the skills checks “helped me organize my interviews…and get over my fear of the unknown.” Emerging reflective practice was demonstrated by comments such as "made me self-reflect on my abilities to perform skills.” The development of clinical reasoning and problem solving skills were evidenced by comments of “the skills check helped me think through what to do when things did not go as planned...” The value of feedback was reflected in comments such as “It helped me refine my skills and develop the areas that aren't as strong,” “I embraced the feedback...I could work on my weaknesses.” Conclusions: Literature supports peer evaluation as an instructional tool within allied health education; however, minimal research has been completed within the profession of physical therapy education. Based on the results of this study, entry-level doctor of physical therapy students perceive peer-evaluation as an effective instructional method to assist in developing psychomotor skills necessary for patient care, as well as, affective skills necessary for reflective practice and cognitive skills related to clinical reasoning.

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Implementation of Objective structured clinical examination (OSCE) as a tool to evaluate the development of clinical reasoning in physical therapy students and level of satisfaction with its use

Revista de la Facultad de Medicina ◽

10.15446/revfacmed.v70n2.90746 ◽

2021 ◽

Vol 70 (2) ◽

pp. e90746

Author(s):

Nicole Figueroa-Arce ◽

Paola Figueroa-González ◽

Luis Gómez-Miranda ◽

Ruvistay Gútierrez-Arias ◽

Viviana Contreras-Pizarro

Keyword(s):

Physical Therapy ◽

Clinical Examination ◽

Clinical Reasoning ◽

Clinical Skills ◽

Objective Structured Clinical Examination ◽

Satisfaction Survey ◽

Physical Therapy Students ◽

Cross Sectional ◽

Level Of Satisfaction ◽

Passing Score

Introduction: Clinical reasoning involves critical thinking and decision-making in clinical situations. It can be evaluated using Objective structured clinical examination (OSCE), which measures clinical skills associated with the development of clinical reasoning. Objective: To describe the implementation of an OSCE to evaluate the clinical skills associated with the development of clinical reasoning in physical therapy students, and to determine their level of satisfaction with this strategy. Materials and methods: Cross-sectional descriptive study carried out in 159 physiotherapy students from Universidad Andres Bello, Chile, enrolled in the Reasoning in Physical therapy course. The OSCE had 11 stations and a student satisfaction survey was administered. Data normality was determined using the Shapiro-Wilk test. Descriptive statistics (percentages, medians, and interquartile ranges (IQR)) were used for data analysis. Results: The median global score was 142 points (IQR:132-150) and 61.1% of the students obtained a passing score (≥ 134 points). Stations in which most students had a passing score were S3, S5 and S7 (with standardized patients): 78.62%, 96.85% and 85.53%, respectively. Regarding the satisfaction survey, 36.48% and 59.12% of the students agreed and strongly agreed with using tools that assess their clinical skills. Conclusions: The OSCE was successfully designed and implemented to evaluate the clinical skills associated with the the development of clinical reasoning in the study population, and most of them reported a high level of satisfaction with its use; this confirms OSCE is an excellent methodology to train and evaluate physical therapy students.

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