Glynn T1, Kirk-Sanchez N1
1University of Miami, Department of Physical Therapy, Miami, United States
Background: With a need for increased integration of experiential learning into entry-level PT education curricula, it is important to understand whether patients are benefitting under these models of care. Utilizing common patient self-reported functional outcomes measures is one way to illustrate efficacy of care delivered by students. Pro-bono clinics create opportunities to promote access to care for indigent patients while contributing to skill development in PT students.
Purpose: The purpose of this study is to describe the outcomes of patients treated in a pro-bono PT clinic delivered through a student and faculty developed service-learning program. The program treats uninsured patients who have income less than 200% of the federal poverty line. Students spend six two-hour sessions providing care in the pro-bono clinic as part of an elective course.
Methods: Treatment was provided by student physical therapists under the supervision of clinical faculty and staff within an academic medical center in the outpatient physical therapy clinic. Patients receive care two times per week during evening pro-bono clinic hours. Interventions included manual therapy, therapeutic exercise, and neuromuscular re-education. Data were retrospectively extracted from the medical records of 30 patients who completed an episode of care in the pro bono clinic from 2015-2016. Patient outcome measures were reported at initial evaluation to establish a baseline and repeated at the conclusion of the episode of care. Outcome measures included: Limitation in Mobility Activities Test (LIMAT), Verbal Analog Scale (VAS) of Pain 1-10 and Lower Extremity Functional Scale (LEFS). Dependent one sample t-tests examined the difference between pre and post outcome measures. Student therapists participated in a focus group after the completion of the elective course to elicit feedback on their learning and skill development.
Results: For the VAS, 23 subjects reported current pain level, 20 reported pain level at best and 20 reported pain at worst. The mean changes in VAS pre to post intervention were 2.17±3.19 for current, 2.20±2.40 for best, and 1.90±2.65 for worst. All differences for VAS measurements of pain were statistically significant (p .005). Fifteen subjects completed the LIMAT with a statistically significant mean difference of 16.7±29.3 (p .05). Thirteen subjects completed the LEFS with a statistically significant mean difference of 14.2±14.9 (p .005). For the LEFS, the change in post treatment scores was greater than the minimal clinically important difference. 60% of patients completing the LIMAT and 76.9% of patient completing the LEFS had positive outcomes.
Conclusion(s): The majority of patients showed improvement in self-reported functional outcome measures after an episode of care in the pro-bono clinic. Mean changes were statistically and clinically significant. Student focus group feedback consistently rate the experiential of pro-bono clinic as highly valuable in building clinical and professional skills.
Implications: This data provides evidence to support the value of a student run pro bono clinic and demonstrates a possible venue for the delivery of essential services to uninsured patients. If incorporated through physical therapy academic institutions, effective access solutions for rehabilitation are created for underserved individuals in their respective communities.
Keywords: Pro-bono clinic, experiential learning, patient outcomes
Funding acknowledgements: There was no funding agency.
Purpose: The purpose of this study is to describe the outcomes of patients treated in a pro-bono PT clinic delivered through a student and faculty developed service-learning program. The program treats uninsured patients who have income less than 200% of the federal poverty line. Students spend six two-hour sessions providing care in the pro-bono clinic as part of an elective course.
Methods: Treatment was provided by student physical therapists under the supervision of clinical faculty and staff within an academic medical center in the outpatient physical therapy clinic. Patients receive care two times per week during evening pro-bono clinic hours. Interventions included manual therapy, therapeutic exercise, and neuromuscular re-education. Data were retrospectively extracted from the medical records of 30 patients who completed an episode of care in the pro bono clinic from 2015-2016. Patient outcome measures were reported at initial evaluation to establish a baseline and repeated at the conclusion of the episode of care. Outcome measures included: Limitation in Mobility Activities Test (LIMAT), Verbal Analog Scale (VAS) of Pain 1-10 and Lower Extremity Functional Scale (LEFS). Dependent one sample t-tests examined the difference between pre and post outcome measures. Student therapists participated in a focus group after the completion of the elective course to elicit feedback on their learning and skill development.
Results: For the VAS, 23 subjects reported current pain level, 20 reported pain level at best and 20 reported pain at worst. The mean changes in VAS pre to post intervention were 2.17±3.19 for current, 2.20±2.40 for best, and 1.90±2.65 for worst. All differences for VAS measurements of pain were statistically significant (p .005). Fifteen subjects completed the LIMAT with a statistically significant mean difference of 16.7±29.3 (p .05). Thirteen subjects completed the LEFS with a statistically significant mean difference of 14.2±14.9 (p .005). For the LEFS, the change in post treatment scores was greater than the minimal clinically important difference. 60% of patients completing the LIMAT and 76.9% of patient completing the LEFS had positive outcomes.
Conclusion(s): The majority of patients showed improvement in self-reported functional outcome measures after an episode of care in the pro-bono clinic. Mean changes were statistically and clinically significant. Student focus group feedback consistently rate the experiential of pro-bono clinic as highly valuable in building clinical and professional skills.
Implications: This data provides evidence to support the value of a student run pro bono clinic and demonstrates a possible venue for the delivery of essential services to uninsured patients. If incorporated through physical therapy academic institutions, effective access solutions for rehabilitation are created for underserved individuals in their respective communities.
Keywords: Pro-bono clinic, experiential learning, patient outcomes
Funding acknowledgements: There was no funding agency.
Topic: Education: clinical; Education: clinical; Outcome measurement
Ethics approval required: No
Institution: University of Miami
Ethics committee: Department of Physical Therapy
Reason not required: This data is part of a quality assurance initiative.
All authors, affiliations and abstracts have been published as submitted.
