To Treat or Not to Treat: The Use of Computer Assisted Learning to Enhance Clinical Decision Making and Self‐Efficacy of Student Physical Therapists in the Acute Care Setting. Issue 3 (2017)

• Record Type: Journal Article
• Authors: Costello, Ellen; Ruckert, Elizabeth; Lyons, Laurie; Cotton, Linda; Birkmeier, Marisa
• Is Part Of: Journal of physical therapy education. Volume 31:Issue 3(2018)
• Publication Date: 2017
• Subjects: Computer assisted learning -- Acute care -- Clinical decision making -- Selfefficacy.; Physical therapy -- Study and teaching -- Periodicals; Physical therapy -- Study and teaching; Physical Therapy (Specialty) -- education -- Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 615.82071
• Languages: English
• ISSNs: 0899-1855

Abstract

Abstract : Background. : The acute care environment has become increasingly complex, raising practice expectations for student physical therapists (PTs) during clinical internships. Computer assisted learning (CAL) has gained popularity as an innovative method to teach and learn; however, there is little research to support its use to improve student preparedness to practice in a particular setting. The purpose of the study is to determine if integrating CAL modules into a PT educational curriculum will improve students' clinical decision making and self‐efficacy to practice in the acute care environment. Methods. : This is a quasi‐experimental, 2 group design. The experimental group participated in a series of 4 acute care‐based CAL modules during their second year of study and the control group did not. Outcome measures included a complex acute care clinical reasoning case, selected Clinical Performance Instrument (CPI) measures (clinical reasoning, safety), a student self‐efficacy survey to determine preparedness to practice in the acute care setting, and qualitative student responses. Results. : Thirty‐five students in the experimental group and 33 students in the control group agreed to participate. Students who engaged in the modules demonstrated a significant difference in overall self‐efficacy to practice in the acute care setting as compared to students who did not ( P = .01); however, self‐efficacy constructs that involved psychomotor skill performance or direct face‐to‐face communication showed no group differences. The experimental group also demonstrated improved outcome performance on a culminating clinical reasoning case ( P = .024). CPI data revealed no group differences in student self‐assessment or clinical instructor (CI) assessment of student safety or clinical reasoning during the acute internship. Discussion/Conclusions. : The addition of CAL modules into an existing PT education curriculum provides student PTs additional opportunities to immerse themselves in the complex world of acute care prior to internship. Perceived selfefficacy to practice in the acute care setting was greater in the cohort with CAL module training, as was their clinical decision making skills in a classroom setting. Transfer of these constructs was not evident in student performance during their acute care internship. CAL module instruction is limited in its ability to affect constructs, which rely in part on psychomotor performance or face‐to‐face communication; however, additional exposure to this practice setting using CAL module instruction provided a framework for students from which to approach patient management decisions.