Clinical Experience from the DPT Student Point of View

Thank you to everyone who responded to the survey I put forth on social media about your clinical experiences.  I apologize again for the sheer length and amount of open ended questions the survey included.  I really do appreciate your honest feedback.  It is my hope that it will help students who are about to embark on their next clinical affiliation.  Just remember, you are not alone in this endeavor!

These are direct quotations from the survey.  Some changes and edits were made such as spelling corrections or shortened to reduce redundancy.

What we look for in a clinical instructor

wanting to be a CI for the student to learn not just for the student to do all the work”

“Someone who is genuinely interested in teaching because he/she wants to better the PT profession.”

Approachable”

Positive, encouraging”

A CI that will tell me what they expect from me, demonstrate new skills, give me space to treat my own patients but still be available if I have questions”

reasonable caseload to allow teaching time”

I like it when they take time to regularly talk with me about how I am doing and my goals and what they would like to see me doing better with as a student. I like it when we work together to gradually increase my independence as a clinician instead of just throwing me in there when I don’t feel comfortable. I also like it when they respond to clinical questions with other questions that help to guide my thinking”

A good CI is one that has the ability to let go of their patients and allow the student to take a forward role as appropriate for the student’s education to that point. The CI should always be available for questions, and should regularly question why they student treats the way they choose to.”

Flexible on teaching style”

willingness to let me jump in and discuss treatment options with me.”

Good communication”

setting mini goals with the student so that both are on the same page with the student’s performance, strengths, weaknesses”

Flexible on teaching style. . . also willing to let you learn from them and not rely solely on what you are bringing to the clinical”

Someone who challenges me as a student in order for me to develop my clinical decision making skills”

“Someone who takes time to give the student feedback, both positive and negative.”

Someone who keeps eye contact with their patients, and remembers they are human beings in need of expert healthcare.”

Someone who is a lifelong learner.”

What we look for in a clinical experience

Interdisciplinary exposure”

Opportunities specific to the setting”

Being in a setting that is not high pressure for productivity”

“Good work environment: approachable and helpful coworkers, an aim for learning not just productivity, application of evidence based practice”

other therapists that I can work in close proximity with so I can learn from multiple styles.”

Variety in case load, independence to choose treatments”

I think that the CI can make or break the clinical experience”

“Good CIs are hard to come by, from what I hear.”

Having good communication and the site appreciating the student and vice versa. – Feedback and communication are key.”

What we liked about our clinical instructors

day one we discussed how I best learn”

Went above and beyond and spent extra time with me”

“. . . honest yet respectful feedback”

My last CI found my weak spots and pushed me to improve them”

helped me become me as a clinician rather than a carbon copy of themselves”

We also set weekly goals and had a quick mini-meeting every week to discuss progress thus far, what to work on, etc.”

Gauges my skill and comfort levels before exposing me to new situations”

What we didn’t like about our clinical instructors

No feedback.”

I learned close to nothing, never observed her treat, had to base my sessions on what I knew coming in and what I found through research”

Her feedback is inconsistent, one day she says she wants one thing and the next day it’s completely opposite”

I did not like it when my CI did not have a plan or clear expectations for me or had difficulty allowing me to participate fully.”

“. . . not being organized”

“. . . my way or the highway type”

What we liked about our clinical experience

It was so nice to get into the field, talk with patients, use critical thinking skills.”

I learned about things in the clinic that I have yet to learn in the classroom, which will set me up for success in the classroom later.”

Humility of staff to acknowledge that we do our best but that we are always … Always. Learning”

Variety of patient population, ability to shadow other clinicians or disciplines, earned independence”

Because of the high patient volume, I learned time management and efficiency, as well as how to treat acute injuries,”

What we didn’t like about our clinical experience

Having my CI look over my shoulder all the time.”

Overly concerned with productivity”

I just wish I had a better CI. My expectations were too high going in, which made it a worse experience.”

Didn’t learn much”

sometimes the hours have been difficult or what seemed to me to be excessively long (52+ hours/week)”

If you could go back in time and give yourself advice for clinic, what would you say?

Be more vocal about the extra opportunities you would like to see.”

Take advantage of every learning opportunity and have confidence in the skills and knowledge I received in PT school.”

Communication with your CI is key to having a good clinical experience, no matter the CI’s level of expertise.”

Stay flexible, ask more questions, and don’t be scared when I get asked questions. If you’re using x technique to treat you should know why.”

Be confident!”

Talk to my school clin Ed advisor about problematic relationship issue with CI. Early. Don’t wait and think it will sort out”

Seek feedback from your CI regularly about what you could have done differently or better.”

Have more confidence. You know more than you think you do.”

“Relax. Always try to learn from each day. Reflect on paper”

“Relax and ask questions when you have them, remember this is your time to learn not to just show what you know”

What strategies did you use in clinical? 

Talking with CI, making sure there is open communication and trust”

Daily meeting/discussion about patients and plan for sessions, weekly checkpoints on good, bad and need for improvement and setting weekly goals”

We [CI and student] also discuss documentation before locking notes”

Goal settings weekly, strengths and weaknesses”

How did you manage stress during clinical? 

With CI and other staff”

Exercise!”

made time to hang out with classmates.”

Prioritize as best as I can between clinic and home life”

“. . . prayer”

“Alcohol”

“Reflection/journal writing”

How did you manage setbacks and/or lack of progress in clinic? 

Feedback and communication with my CI

Discuss with my CI on how I can improve.”

Either spent extra time preparing, or readjusted my goals if it was clear they weren’t going to be met in this setting”

Pick something that I’m lacking and make every treatment or whatever about improving one thing.”

Patience knowing that I am learning every day even if I do not realize it at the time”

Goal setting with CI helps.”

Did you feel your didactic coursework prepared you for clinic? 

Yes. We have a great professor who has taught me how to think critically, which is exactly what I needed to be doing in the clinic. Rarely did we have a “textbook patient,” so I had to critically think about what the patient in front of me needed.”

Partially. I had the basic information I needed to start the rotation from my classes. However, for me, the actual hands on experience is way easier to retain all of the information we learn in the classroom.”

Yes and no. I was not prepared for dealing with discharging patients to hospice or losing them to death. My CI was great at helping me cope with the death of patients and helped me realize it is something commonly seen in the skilled setting.”

Yes as best as they could. Nothing is as clear cut as it is in the classroom, and the professors give a bunch of resources and try to have a good discussion about the topic, but you won’t know until they are in front of you.”

Do you feel the CPI adequately evaluates your performance? Why or why not?

“No. CPI is very subjective and not a great evaluation of the whole experience. It is a good tool but should not be the sole evaluator of the clinical experience.”

The CPI is repetitively and lengthy. I think it could be shortened and still do a sufficient job of evaluating performance.”

Yes it is thorough, hits most areas, and has an easy to use grading system”

No. It’s too long and repetitive. The comments are more appropriate for performance than the grading scale”

What could be done to improve the CPI? 

“More free box writing such as strengths, weaknesses and further study needed”

“Get rid of the grading scale, make it shorter”

“The individual PT program should do site calls or visits to thoroughly eval their students.”

A sliding scale just doesn’t seem to work well for some categories. I think it works for things like examination, or diagnosis because it depends on how much help you need in that area but things like “professional behavior” don’t really make sense on the scale. I mean, why would you need help being professional with complex patients but not simple ones? It just doesn’t really work in my opinion.”

Any comments or advice you would give students heading into their next clinical?

Be confident in yourself, you know more than you think! Don’t be afraid to ask questions, that’s why you’re there! Try and experience as many different things as you can”

Reflect! Write a short synopsis for each day”

Prepare beforehand. Ask your CI what you should brush up on before you head out.”

Open communication is key. If don’t have it with CI… Talk with school early and often. Clinical is stressful enough without having a CI who stresses you out.”

Keep an open mind and be prepared to get out of your comfort zone. You may have to change a few adult “briefs” or clean up a patient after an accident– treat every patient as if they were your parents or grandparents :)”

“Good luck! Enjoy it and learn!!”

quote-Theodore-Roosevelt-believe-you-can-and-youre-halfway-there-449

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