A Comparison of Two Strategies for Teaching Medical Screening and Patient Referral in a Physical Therapist Professional Degree Program

Journal of Physical Therapy Education, Spring 2006 by Boissonnault, William, Morgan, Barbara, Buelow, Jill

Data Analysis

Data for the 2 student groups were entered into a Microsoft Excel spreadsheet by the third author, who was blinded to the identity of the respondent and their group assignment. To establish homogeneity of the 2 student groups, we compared demographic and academic performance information (undergraduate grade point average, Graduate Record Examination score, PT education program cumulative grade point average) by unpaired ß test. Additionally, a chi-square analysis was performed to compare the distribution of learning styles (auditory, visual, or kinesthetic37,38) between the 2 groups. For the written examination, unpaired t tests were used to detect between-group differences in total (composite) scores and also in Bloom's level-specific (partitioned) scores. For multiple comparisons of composite and partitioned scores, α was adjusted according to the Bonferroni correction," so that for these comparisons, P values less than .01 were considered statistically significant. Unpaired t tests were also used to compare scores on the CEQ. Although caution has been advised in the use of parametric statistical tests for ordinal measurements such as our CEQ, this concern mainly applies to tools with less than 4 ordinal indicators.40 Additionally, a Mann-Whitney U test was conducted on the Visual Analogue Scale (VAS) data to determine if the level of confidence differed between the 2 groups.39 The level of significance was set at α = .05 because the hypothesis was directional. Accordingly, P values less than .05 were considered statistically significant.

OUTCOMES

Fifty-one of 67 (76%) first-year PT students volunteered to participate in the unit evaluation. The demographic characteristics of the entire group of 67 students, divided into the 2 instructional methods groups, are presented in Table 1. There were no betweengroup differences in: (1) GRE total scores (1358 ± 375 vs 1400 359, P = .64), (2) GPA of the last 60 credits in their undergraduate career (3.46 ± 0.32 vs 3.41 ± 0.36, P= .61), or (3) GPA attained in the first semester of the PT curriculum (3.77 ± 0.33 vs 3.78 ± 0.30, P = .91). In addition, learning styles (visual, auditory, and kinesthetic) were evenly distributed between the 2 groups (P > .05).

Medical Screening Written Examination

Significant differences were noted between the TL and RP groups (P = .01 in the combined scores from all 3 taxonomic categories (knowledge, application, and synthesis) (Figure 1). When groups of questions representing the 3 taxonomic categories were analyzed separately for differences across the 2 student groups, the RP student group performed significantly better than the TL group in scores and performance on the application-level questions ( 59% ± 0.24% vs 74% ± 0.24%, P = .01). In contrast, there were no differences between groups in scores representing the knowledge-level questions (36% ± 0.16% vs 45% ± 0.18%, P = .05) or synthesis level of Bloom's Taxonomy (58% ± 0.25% vs 62% ± 0.25%, P = .28) (Figure 2).

Student Confidence With Medical Screening and Patient Referral Abilities

Based on Visual Analogue Scale values for self-confidence in medical screening skills and to initiate a referral to a physician, the RP group reported higher self-confidence for medical screening and patient referral abilities than the TL group (53mm ± 0.17 vs 45mm ± 0.17, P

Student Assessment of Learning Experience

Analysis of the Likert scale data from the CEQ revealed that the TL group was less satisfied with their educational experience than the RP group (P = .0001 ). Furthermore, the RP group rated their ability to think critically and independently and apply their knowledge of PT higher than the TL group (Figure 4). For example, the RP group reported that the educational experience allowed them to better integrate facts and develop generalizations than the TL group. There were no differences in the students' perceptions of the instructor's behavior or interest in the teaching material (P = .29).