Incidence of Shared Clinical Instruction in Physical Therapy Clinical Education in the United States.

Abstract

Introduction: Physical therapy clinical education experiences (CEE) typically involve a 1:1 or 2:1 student:instructor ratio. Students may also be supervised by more than 1 clinical instructor (CI), referred to as shared clinical instruction. The purpose of this study was to examine the incidence and implementation of shared clinical instruction in the United States.

Review of literature: Burnout and moral distress, along with the growing number of physical therapist (PT) education programs, contribute to limitations in clinical education capacity. Shared clinical instruction may benefit both educators and students, warranting further investigation.

Subjects: Deidentified data were extracted from 178 PT education programs using Exxat in September 2023.

Methods: This study analyzed CEE data between January 2014 and September 2023 (placement setting, state, dates, length of the CEE, number of assigned CIs, CI years of clinical experience and as a CI, credentialed instructor status, and specialization status) using descriptive and inferential statistics.

Results: Almost all, 175 (98.3%) of the 178 programs, and 16,356 (12.5%) of the 131,184 CEEs in the data set had students who participated in shared clinical instruction, representing all 50 states, and every clinical setting. Shared clinical instruction occurred in longer CEEs compared with 1:1 experiences; binary logistic regression indicated that longer CEEs predicted higher rates of shared clinical instruction. Independent t-tests indicate that primary CIs in shared clinical instruction had slightly more years of clinical and instructional experience.

Discussion and conclusion: Shared clinical instruction is occurring in most PT education programs and clinical settings in the United States. Further investigation should explore the rationale behind the use of shared clinical instruction in various practice settings, and the selection and pairing of CIs in this model, along with the efficacy of shared clinical instruction, including benefits, challenges, and best practices.