Student Attitudes Toward Using Community Volunteers Enhance Clinical Reasoning Skills as Part of Laboratory Coursework

PURPOSE: The occupational therapy refereed literature is sparse as it relates to the use of simulation, student-run clinics, and community volunteers as pedagogical components as a part of laboratory experiences for entry-level occupational therapy education (Liu, Schneider, & Miyazaki, 1997). Anecdotally, students and fieldwork educators are needing and demanding that students have more clinical experience and exposure prior to their Level II fieldwork rotations. Idaho State University uses an interprofessional education clinical model (Gee et al., 2016) in which evaluation protocols were adapted to a single discipline and a course laboratory. The clinical model includes client intake (community volunteers), evaluation, home evaluation, and consultation and follow-up. Students work in pairs with clients and are supervised and mentored by two faculty members. When not engaged with their assigned client, students are then required to observe the evaluation and follow-up of the clients their classmates are working with. The purpose of this pilot study was to evaluate student attitudes and perceptions of a structured, laboratory-based, student participatory model to facilitate engagement in the occupational therapy process with community volunteers living with chronic neurological conditions.

DESIGN AND METHOD: A 12-question descriptive survey was developed that included 10 Likert-type questions and two open-ended questions. The survey was administered to 2nd-year MOT students who had recently completed an intervention lecture and laboratory-based course focused on adult neurological conditions and interventions. The survey was voluntary and anonymous, and eight students completed it. Descriptive statistics were calculated to synthesize the raw survey data, and narrative qualitative coding was used to manage the textual portions of the survey tool.

RESULTS: Analyses of the raw survey data revealed the following quantitative key findings related to student perceptions of the clinical participatory model: One hundred percent of the respondents indicated that the overall pedagogical activities increased their understanding of individuals with chronic neurological conditions. More than 50% of the respondents indicated that the process increased their understanding of the evaluation process. Approximately 80% of the respondents indicated that they valued being able to observe and review (videotaped) sessions of their peers engaging in the evaluation and consultative process of the laboratory activity. One hundred percent of the respondents indicated that they were able to integrate content from other intervention-based preparatory courses. Additionally, consistent thematic elements emerged from students’ attitudes regarding the strengths and opportunities of the laboratory delivery method: (1) evaluating and treating real clients and seeing the observable aspects of their neurological condition, (2) hearing the clients’ stories, (3) applying recently acquired skills (evaluation, intervention, therapeutic use of self), and (4) developing and enhancing clinical reasoning (procedural and conditional).

CONCLUSION: Overall, students had highly favorable perceptions of the realistic clinical experiences as part of their neurological rehabilitation laboratory experiences. The findings support the desire and need for students to have more clinical experiences to assist them with acquiring clinical knowledge and developing clinical reasoning prior to fieldwork and practice. The community volunteer evaluation process provides occupational therapy education programs with a simple yet innovative approach to instructing students and meeting the needs of individuals in the community with chronic neurological conditions.

References

Gee, B., Holst, J., Baron, K., Kendall, E., Knudsen, S., McKnight, L. & Streagle, K. (2016). Interprofessional education in occupational therapy: The Idaho State University model. Open Journal of Occupational Therapy, 4(2), Article 11. https://doi.org/10.15453/2168-6408.1226

Liu, L., Schneider, P., & Miyazaki, M. (1997). The effectiveness of using simulated patients versus videotapes of simulated patients to teach clinical skills to occupational and physical therapy students. OTJR: Occupation, Participation and Health, 17, 159–172.