Benefits, Challenges, and Strategies for Implementing Shared Clinical Instruction in the United States: A Qualitative Study.

Abstract

Introduction: Doctor of Physical Therapy (DPT) students participate in clinical education experiences (CEEs) with varying structure regarding student-to-clinical instructor (CI) ratios. No clinical education model has been identified as superior.

Review of literature: The literature discusses 1:1 or 2:1 student-to-CI ratios, with limited research on shared clinical instruction (1 student to 2 CIs). Placement capacity is the greatest challenge in clinical education, and despite calls for reform, change to clinical education remains an ongoing endeavor. The purpose of this study was to explore the perspectives of interested parties in clinical education on CEEs with shared clinical instruction.

Subjects: Site coordinators of clinical education, CIs, directors of clinical education, and DPT students across the United States with shared clinical instruction experience participated in the study.

Methods: A phenomenological inquiry following an inductive approach explored participants' perspectives on shared clinical instruction using semi-structured interviews. A peer review established credibility, trustworthiness, and confirmability of the findings.

Results: Twelve participants completed the study, revealing 5 main themes: sharing and collaboration decreases CI burnout, increased opportunities for clinicians to be CIs, expands learning opportunities for students, potential challenges with multiple CIs, and ingredients for successful shared clinical instruction.

Discussion and conclusion: Shared clinical instruction cultivates a supportive environment, enabling CIs to distribute responsibilities, thereby decreasing stress and burnout. This model potentially increases the CI pool by involving part-time and specialized professionals in clinical education. Shared clinical instruction exposes students to diverse clinical cases and teaching styles. Challenges include inconsistent feedback and assessment from divergent CI expectations, causing stress. Strategies for successful shared clinical instruction are presented. Future research should explore its impact on clinical education capacity and develop best practice guidelines. Benefits of shared clinical instruction may outweigh the potential challenges. With effective strategies, shared clinical instruction can create positive and productive CEEs for all parties.