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Altenburger P1, Strunk V1, Loghmani M1, Bayliss A1
1Indiana University, Physical Therapy, Indianapolis, United States
Background: Faculty developed an Integrated Longitudinal Case-Based Learning (ILCBL) model that uses a multi-generational family to foster synthesis, analysis, and application of knowledge within an entry-level Doctor of Physical Therapy (DPT) curriculum. Six integrated cases were implemented longitudinally throughout the curriculum emphasizing changes in age, health condition, and psychosocial domains. From these six integrated cases, four were chosen to be developed as complex case signature assignments to assess the students' ability to integrate knowledge across courses and the curriculum.
Purpose: The purpose of this qualitative research study was to assess whether the use of complex, integrative case as a signature curricular assignment were affective at achieving the following:
1) facilitating synthesis of clinical decision-making with learned material across courses and
2) enhanced integration of knowledge across the curriculum, within a DPT program.
Methods: The complex cases were:
(1) collaboratively developed by 2 core faculty and involved multiple systems;
(2) composed of 3-4 progressive parts and
(3) linked to a specific lecture in an advanced course.
The complex cases were used as a small group in-class activity completed in progressive parts. Student responses were then compared to a faculty developed best practice rubric. The responses were independently analyzed by 2 lead faculty to determine the integration of content. The 2 faculty then compared their initial independent analyses and derived themes based on clinical reasoning and curricular integration. Additionally, the students were surveyed using a 5 point Likert aimed at soliciting feedback on the integrative learning opportunity.
Results: The qualitative analysis revealed the students' ability to apply clinical decision-making effectively in the following areas: delegation of care, scope of practice and referral, objective measurement application, the identification of home and social roles, and safe practice. Students had difficulty identifying the patient's multiple roles, body image as a psychosocial factor and the immune system's involvement in complex cases. The students were inconsistent with their use of standardized tests, risk factor identification, co-morbidity integration in complex clinical decision-making and accurate differential diagnosis in complex cases. Applying these findings to the ICF framework suggested students had integrated body structure and function, activity, and environmental concepts but have limited incorporation of personal factors and health condition comorbidities. Survey results indicated that 94% of students felt the learning approach challenged their clinical decision-making skills and 91% felt the process required knowledge synthesis.
Conclusion(s): Our goal was to create a case-based learning model to facilitate an integrative learning approach. The findings from the complex case signature assignments indicated a positive educational outcome for students and an effective curricular assessment tool for faculty. The future of physical therapy education needs to incorporate an integrative and comprehensive clinical decision-making approach fostering student application of knowledge from all curricular content.
Implications: The use of complex cases with the ILCBL curricular structure was a useful tool to facilitate critical thinking and problem solving in DPT students but also to perform assessment of curricular integration within a DPT program. The findings support the use of the complex case approach as a curricular signature assignment.
Keywords: Complex case analysis, Signature assignments, Student learning outcomes
Funding acknowledgements: Internal grant: Curriculum Enhancement Grant from the Center of Teaching of Learning at Indiana Uniiverity Purdue University Indianapolis.
Purpose: The purpose of this qualitative research study was to assess whether the use of complex, integrative case as a signature curricular assignment were affective at achieving the following:
1) facilitating synthesis of clinical decision-making with learned material across courses and
2) enhanced integration of knowledge across the curriculum, within a DPT program.
Methods: The complex cases were:
(1) collaboratively developed by 2 core faculty and involved multiple systems;
(2) composed of 3-4 progressive parts and
(3) linked to a specific lecture in an advanced course.
The complex cases were used as a small group in-class activity completed in progressive parts. Student responses were then compared to a faculty developed best practice rubric. The responses were independently analyzed by 2 lead faculty to determine the integration of content. The 2 faculty then compared their initial independent analyses and derived themes based on clinical reasoning and curricular integration. Additionally, the students were surveyed using a 5 point Likert aimed at soliciting feedback on the integrative learning opportunity.
Results: The qualitative analysis revealed the students' ability to apply clinical decision-making effectively in the following areas: delegation of care, scope of practice and referral, objective measurement application, the identification of home and social roles, and safe practice. Students had difficulty identifying the patient's multiple roles, body image as a psychosocial factor and the immune system's involvement in complex cases. The students were inconsistent with their use of standardized tests, risk factor identification, co-morbidity integration in complex clinical decision-making and accurate differential diagnosis in complex cases. Applying these findings to the ICF framework suggested students had integrated body structure and function, activity, and environmental concepts but have limited incorporation of personal factors and health condition comorbidities. Survey results indicated that 94% of students felt the learning approach challenged their clinical decision-making skills and 91% felt the process required knowledge synthesis.
Conclusion(s): Our goal was to create a case-based learning model to facilitate an integrative learning approach. The findings from the complex case signature assignments indicated a positive educational outcome for students and an effective curricular assessment tool for faculty. The future of physical therapy education needs to incorporate an integrative and comprehensive clinical decision-making approach fostering student application of knowledge from all curricular content.
Implications: The use of complex cases with the ILCBL curricular structure was a useful tool to facilitate critical thinking and problem solving in DPT students but also to perform assessment of curricular integration within a DPT program. The findings support the use of the complex case approach as a curricular signature assignment.
Keywords: Complex case analysis, Signature assignments, Student learning outcomes
Funding acknowledgements: Internal grant: Curriculum Enhancement Grant from the Center of Teaching of Learning at Indiana Uniiverity Purdue University Indianapolis.
Topic: Education; Outcome measurement
Ethics approval required: Yes
Institution: Indiana University
Ethics committee: Office of Research Compliance
Ethics number: 1111007341
All authors, affiliations and abstracts have been published as submitted.
