How Service-Learning Experiences Benefit Physical Therapist Students' Professional Development: A Grounded Theory Study

Journal of Physical Therapy Education, Spring 2005 by Reynolds, Pamela J

Background and Purpose. Service learning is a pedagogical method that combines academic learning objectives with community-based needs and priorities. The purpose of this study was to discover the educational outcomes and benefits that student physical therapists realize through participation in a service learning-based course. The primary project of this course was for the student to assist a community organization or agency that provided services to an underserved, disadvantaged, or cross-cultural population. The general objectives associated with this course included understanding individual and cultural differences, and development of social responsibility, education, communication, professional behavior, and professional development skills. At the time of the study, service learning was not typically found in physical therapy educational programs. In reviewing the students' written reflection reports, it was obvious that they were getting much more out of this course than the stated objectives. Since potential efficacy of this pedagogical method in physical therapy and all of the actual educational outcomes were unknown, the study suggested the classical qualitative research question, "What's going on here?" Subjects. The participants included 85 graduates who received their Master of Physical Therapy degree from the study's program between 1996 and 1999 and returned a signed informed consent allowing their written work to be part of this qualitative study. Methods. Grounded theory qualitative inquiry methodology was applied to the development and analysis of this study. Data sources included textual reports written by participants, participant observer data, memos and diagrams generated throughout the analysis, and summative quantitative data from the Physical Therapist Clinical Performance Instrument (CPI) for the complete cycle of one physical therapy class. Two independent researchers assisted with the verification of the category themes. Results. Qualitative data analysis resulted in identification and verification of academic course outcomes representing 14 CAPTE evaluative criteria. Summative quantitative data from CPIs demonstrated that students in the study's program had limited opportunities to meet clinical competencies in: consultation; prevention and wellness; addressing needs for services other than physical therapy; and social responsibility. Exploring the relationship between these two results yielded the summary model and substantive or explanatory theory. Discussion and Conclusions. The summary model suggests that service-learning experiences set within the context of the community organizations enhanced opportunities for physical therapist students in the study to develop and demonstrate the required competencies that were more limited in traditional clinical education. The significance of this study is the potential benefit to future practice that service-learning pedagogy offers for the educational preparation of physical therapist practitioners.

Key Words: Service learning, Grounded theory, Experiential learning, Clinical education, Community-based learning.

INTRODUCTION

The physical therapy profession has several core documents that delineate expectations for educational preparation and professional behavior of the physical therapist practitioner.1-5 In order to meet these expectations, educational preparation of a physical therapist must include extensive didactic and experiential clinical education in the examination and evaluation of movement dysfunctions and "clinical applications in the preservation, development, and restoration of optimal physical function."1(p7) It is also essential that physical therapists be able to participate in the health care delivery system. Physical therapists must be prepared "to assume leadership roles in the rehabilitation services, prevention and health maintenance programs, and professional and community organizations.. . . [They] also play important roles in developing health care policy and appropriate standards for the various elements of physical therapist practice. . . ."'(p7) Principle 10 of the Code of Ethics2 supports these tenets and states: "A physical therapist shall endeavor to address the health needs of society."2 The Standards of Practice for Physical Therapy3 define a physical therapist's community responsibility as "participating in community and community agency activities, educating the public, formulating public policy, or providing pro bono physical therapy services."3

Objectives from Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists4 and competencies from the Physical Therapist Clinical Performance Instrument (CPI)5 included the following expectations for physical therapist graduates entering the profession: 1) participate in community and human services organizations; 2) demonstrate social responsibility, citizenship, and advocacy; 3) address the prevention, health, and wellness needs of the public; and 4) provide consultation to individuals, businesses, schools, and government agencies4,5 When the program in this study was developed, it was observed that there were limited opportunities for physical therapist students to develop in these areas. Clinical education is a significant experiential learning component of physical therapy education through which students develop their clinical, technical, and professional skills. However, opportunities to achieve the particular aforementioned expectations often appear limited in the traditional clinical education experience. Service-learning experiences offer another potential experiential learning opportunity to meeting these objectives through community-based educational experiences.