Perceived Impact on Physical Therapist Students of an International Pro Bono Clinical Education Experience in a Developing Country

Journal of Physical Therapy Education, Fall 2004 by Sawyer, Karen L, Lopopolo, Rosalie

I was just shocked to see the living conditions...he was in, and then even more shocked to see him saying, "Praise God. . .!" through it all. . . . I'm complaining because I'm hot.... It was very shocking. [It] gave me a much different perspective to go on. And it really made me. . .try to re-evaluate the way I approach things. . . . It was life changing. It did force me to kind of take a step back. (M:192-196)

Not only was the difference in worldwide noted, but also it served as a springboard for personal learning and growth, as the following comment indicates:

I was so moved by the power of their faith and their positive thinking in the face of what I thought were really rough conditions and rough disabilities. Their adjustments to things is a learning experience for me. (F:200-206)

Jamaica, known as a tourist destination, has a striking contrast between the more materialistic tourist areas and the poorer part of the country in which they lived. It was this latter context that the students experienced, and it was stark and eye-opening. Students who had a preconceived view of Jamaica came away with a very different perspective on the country. For example:

And then [there was] the difference between doing the physical therapy and the poorer parts and spending the weekend in Montego Bay. It was really hard to be in Montego Bay, I thought. It was nice to be at the beach and just relax and sleep..., but it was so different. I just couldn't imagine going there for a vacation.... What we saw was so totally different. (A:324-332)

Changes in Self in Role of PT Student

The majority of the comments made by the students addressed their perception of what happened within themselves In their role of PT student. The experiential learning specific to the practice of physical therapy required students to apply and modify their professional knowledge acquired In the United States to another culture. Because of the breadth and depth of the input, the comments are categorized in the following two groups: (1) what changed from the beginning to the end of the week, and (2) what effect the experience had on the students upon returning to the United States.

Changes in self during the week. Students described the difference between the first and last patient experiences over the course of the week with vivid descriptors and gripping metaphors. One student summarized the change over the course of the week in this way:

In the beginning all the little things threw you, but by the end they didn't throw you as much. (N:111-113)

Metaphors such as drowning, being shell-shocked, and a deer caught in headlights are among the descriptors they used concerning their clinical competence during the first day practicing physical therapy in Jamaica. Feeling horrible, overwhelmed, disorganized, lost, awkward, and disappointed were emotions verbalized by and shared among the student participants. By the end of the week, expressions such as "more comfortable," "completely different," and "more organized" conveyed the sentiments of the students.