Students' Perceptions of Clinical Education during a Global Pandemic

Introduction Clinical education is an essential component of allied health programs. The coronavirus disease 2019 (COVID-19) global pandemic had significant impacts on clinical education. The central purpose of this research was to recognize student perceptions of the impact of COVID-19 on their face-to-face clinical experiences during the global pandemic. Methods A Qualtrics survey was sent to 80 physical therapist assistant students whose clinical education was affected during the 2019 to 2020 academic year. Subjects were asked about the following: factors that influenced their decision to complete clinical rotations during the pandemic; perceptions of learning, safety, and stress under these conditions as well as perceptions of the effectiveness of clinical preparatory activities. Results Twenty-six responses to the survey were received and analyzed using descriptive statistics and nonpaired t-tests calculated for each scaled survey item to compare groups. A majority (83.3%) of the respondents reported graduation followed by professional experience (58.3%) as extremely important factors of consideration for participation in clinical education. Personal safety (33.3%) ranked the lowest of the extremely important factors. In preparing for the clinical experience, 75% reported that individual or small group meetings with the faculty member were extremely helpful. The majority of students (78.26%) strongly agreed that they learned a great deal from the clinical experiences under global pandemic; however, 52.17% reported they found the clinical experiences to be stressful. Conclusion During the global pandemic, students placed greater value on interpersonal, trusted relationships when seeking information. Even though students felt stressed during their clinical education, they perceived that learning did occur. As the impacts of COVID-19 remain, physical therapy programs can use this data to recognize areas that require increased support and preparation for students' clinical experiences to encourage an impactful and sustainable future in clinical education.

Identifying and Addressing Social Determinants of Learning during the COVID-19 Pandemic

The COVID-19 pandemic has negatively impacted the health of people from communities of color and people of limited socioeconomic means in a disproportionate way due to social determinants of health (SDoH). The Centers for Disease Control defines SDoH as the “conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.” A related construct, social determinants of learning (SDoL), includes contextual conditions and variables that impact students’ ability to optimally participate in their education, including academic and clinical development. SDoL directly impact students’ ability to participate in the educational process. During the COVID-19 pandemic, students struggling with SDoH and, by extension SDoL, may be more likely to have sick family members, caregiving responsibilities, food and housing insecurity, and obligations to supplement lost family wages. SDoL are also influenced by individual experiences within and outside of the classroom. Beyond bringing this matter to the attention of our profession, especially clinical and academic educators, we must take action to reach and support students who are at higher academic risk due to the SDoL. The purpose of this paper is to: (1) define SDoL, (2) explain how SDoL are impacting DPT and physical therapist assistant students, and (3) discuss actions that physical therapists and physical therapist assistants can take to mitigate the effects of SDoL on current DPT and physical therapist assistant students.

The Impact of Level of Physical Therapist Assistant Involvement on Patient Outcomes Following Stroke

Objective This study investigates if higher utilization of physical therapist assistants adversely affects patient outcomes in the acute rehabilitation setting for patients following a cerebrovascular accident (CVA). Methods Participants were admitted to 1 of 5 inpatient rehabilitation facilities following a CVA from 2008 to 2010. High physical therapist assistant use was defined as ≥20% of the physical therapist visits being provided by the physical therapist assistant for an episode of care. Multivariable regression techniques examined differences in functional outcome, discharge location, and length of stay between high and low physical therapist assistant use groups. Propensity scoring methods supplemented findings of the regression analyses. Results Of the 1561 participants, 496 (32%) had high physical therapist assistant involvement. Baseline participant characteristics such as age, sex, baseline motor function, and comorbidities did not differ between high and low physical therapist assistant use groups. After adjusting for patient characteristics, rehabilitation facility, and year, higher physical therapist assistant use did not adversely affect functional outcome or length of stay. Fewer conclusions can be drawn regarding discharge location, although there was no significant difference in discharge location between groups with high and low physical therapist assistant utilization. Propensity scoring methods supported the findings of the regression analyses. Conclusions Higher physical therapist assistant involvement in the rehabilitation of patients following CVA did not adversely affect functional outcome, increase length of stay, or reduce the likelihood of discharge to home from an inpatient rehabilitation facility. Impact The results demonstrate the value of the physical therapist assistant in the provision of physical therapy for patients with stroke in the inpatient rehabilitation setting. Higher involvement of the physical therapist assistant may provide cost savings while maintaining patient outcomes for this setting and population.