Schwarz B.1, Hightower C.2
1University of North Texas Health Science Center, Physical Therapy, Fort Worth, United States, 2Texas Christian University, Institutional Effectivness, Fort Worth, United States
Background: While improvements in cultural competence have been demonstrated through various experiences available to physical therapist (PT) students, many are one-time events available only to self-selected groups as opposed to integration throughout the curriculum for all students. To meet the needs of our diverse society, all students need to develop skills in providing culturally competent and effective care. To improve the opportunities for all students, baseline levels of and changes in intercultural competence during the educational process must first be established.
Purpose: The purpose of this study was to examine development of intercultural effectiveness during each year of a doctor of physical therapy (DPT) program.
Methods: Data collection occurred through the Intercultural Effectiveness Scale (IES), a validated self-assessment tool. A cross sectional design was utilized to establish IES scores of PT students at various points in their curriculum. Paired-samples t-tests were run on overall IES scores as well as each dimension and construct within the IES. Cohort one was assessed pre- and post-year one of the educational program, cohort two pre- and post-year two, and cohort three pre- and post-year three, which is comprised of all clinical rotations.
Results: For cohort three, overall IES scores reflected a significant difference pre(M=3.54, SD=.27) and post(M=3.64, SD=.31) clinical rotations t(40)=2.146, p=.038, with scores improving post-rotation. Global Mindset construct demonstrated significant change pre(M=2.63, SD=.65) and post(M=2.86, SD=.74) rotations; t(40)=2.034, p=.049. A significant difference existed on the Hardiness dimension pre(M=3.25, SD=.45) and post(M=3.42, SD=.45) rotations t(40)=2.48, p=.018, and on the Positive Regard construct within that dimension, pre(M=3.18, SD=.55) and post(M=3.38, SD=.45) rotations; t(40)=2.55, p=.015. For Cohort 1, a significant decline existed on three constructs: Exploration, t(40)=2.495, p=.017; Relationship Interest, t(40)=2.074, p=.045; and Positive Regard, t(40)=3.017, p=.004, and on the Continuous Learning dimension t(40)=2.047, p=.047. For Cohort 2, the only significant difference existed in Positive Regard t(38)=2.442, p=.019, with a decline after year two of the curriculum.
Conclusion(s): Students in cohort one and two showed no improvement or significant decline on certain constructs and dimensions. Students in cohort three developed skills related to intercultural effectiveness during clinical rotations, as demonstrated by overall improvements in IES scores. Lack of growth in year one and two could be attributed to characteristics of the cohorts, to curricular characteristics, or to a combination of the two. During the program, students may become more aware of opportunities for growth and therefore score themselves at lower levels or may experience culture shock moments and retreat to a moratorium status until they become comfortable with the challenges experienced and are able to progress forward. Following multiple cohorts longitudinally through the program would be helpful in order to further examine the factors impacting student development in this area.
Implications: Additional exploration of experiences contributing to cultural competence development is needed to determine how both academic and clinical educators can better shape and prepare students to provide culturally competent and effective care. In order to assist in the development of all students, not only a self-selected group, educators must strike a balance amidst the dynamic interaction of challenge and support.
Funding acknowledgements: This research is supported by the Texas Physical Therapy Foundation
Topic: Education
Ethics approval: This project was approved by the Institutional Board of the University of North Texas Health Science Center.
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