Impact of Service Learning on Physical Therapist Students' Knowledge of and Attitudes Toward Older Adults and on Their Critical Thinking Ability

Journal of Physical Therapy Education, Spring 2004 by Beling, Janna

Background and Purpose. The increased use of health care services by older adults has prompted an interest in preparing physical therapists to better deal with the special needs of this population. The purpose of this study was to determine the impact of service learning on physical therapist students' knowledge of and attitudes about the older adult and on their critical thinking ability. Subjects. A cohort of 40 students in a Master of Physical Therapy (MPT) degree program was divided into either an experimental (service-learning) group or a control (no service learning) group in the last semester of a 3-year curriculum while enrolled in a geriatric rehabilitation course. Methods. General knowledge and attitudes about aging were measured by Palmore's Facts on Aging Quiz I (FAQ). Critical thinking skills were measured by the Watson-Glaser Critical Thinking Appraisal (WGCTA). Both tests are reported to be valid and reliable and have been used in many studies for at least 25 years. The FAQ and the WGCTA were administered to students at the first and last class meetings. Results. Two-way analyses of variance for repeated measures revealed that all students, regardless of pedagogical method, increased their knowledge about aging (P

Key Words: Aging, Attitudes, Critical thinking, Physical therapist education, Service learning.

INTRODUCTION

As the number and proportion of elderly people rapidly increase in the next few decades, there will be increased demands for physical therapists to work with older clients. Although the availability of physical therapists to work with elderly people will be determined, in part, by their personal preferences,1 most physical therapists will be routinely required to work with elderly clients and clients' aging family members.2 In order to provide effective services, it is imperative that physical therapist students possess adequate knowledge about the aging process and recognize the individuality of older clients, as well as their capacity for growth.

Service learning is a pedagogical method that combines community service with explicit academic learning objectives, preparation, and reflection.3 One of the primary goals of service learning is to provide service to the community. Another goal of service learning is for students to apply what they have learned to real-life settings and to use these community-based experiences during classroom discussions. Another key component of the service-learning experience is to provide opportunities for students to reflect upon their service activities and to learn from these experiences.

Critical thinking is an outcome expected of all physical therapist graduates.4,5 Watson and Glaser defined critical thinking as a compilation of attitudes, knowledge, and skill that encompasses five areas: inferences, assumptions, conclusions, interpretations, and arguments.6 Physical therapist educators are faced with the task of promoting educational strategies to develop the abilities of physical therapist students to think critically in all health care settings.

The purpose of this study was to determine the impact of service learning on physical therapist students' knowledge and attitudes about the older adult and on their critical thinking ability.

The following hypotheses were generated:

1. Physical therapist students' knowledge, misconceptions, and bias regarding aging will be improved following a service-learning experience in a geriatric rehabilitation course.

2. Physical therapist students' critical thinking skills will be improved following a service-learning experience in a geriatric rehabilitation course.

This study was implemented to determine the importance of service learning on possibly increasing both physical therapist students' knowledge of and attitudes toward elderly people and their critical thinking skills. As America ages, the future demand for physical therapists working with the geriatric population will increase.7 The development of critical thinking (the ability to solve problems by assessing evidence using valid inferences, abstractions, and generalizations) is one of the global goals advocated In both the Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists4 and A Normative Model of Physical Therapist Professional Education.5 No available studies have examined the impact of service learning on physical therapist students' knowledge and attitudes about elderly people or its impact on the development of critical thinking.

REVIEW OF THE LITERATURE

Demographics

In 2000, approximately 35 million American citizens, or 12.4% of the total population, were over 65 years of age.7 By the year 2030, it is predicted that 70.3 million people, or approximately 20% of the total population, will be in tills age group.7 This is an Increase of more than twice their number from today's figures.

As individuals age, they frequently experience illness and utilize health care services. For example, most older people have at least one chronic condition, and many have multiple conditions.7 People aged 65 years and over use health care at a rate more than three times higher than that of younger cohorts.7 Elderly people use more of the acute care hospital beds and the nation's nursing home beds than any other population group. They also use 68.7% of home health care services.7