Are physical therapy clinical instructors teaching the Institute of Medicine core competencies? An exploratory...

The Institute of Medicine (IOM) has recommended instituting clinical education reforms to ensure all health profession graduates acquire five core competencies; providing patient-centered care, working in interdisciplinary teams, employing evidence-based practice, applying quality improvement and utilizing informatics. The IOM has identified 28 specific skills associated with these competencies. This qualitative, exploratory study was conducted to begin to examine the extent to which physical therapy clinical instructors provide students with instruction the students perceived as promoting the acquisition of these skills.

Two groups of physical therapy students enrolled in a 3-year DPT program (7 on a first-year clinical education experience and 17 on a final year experience) maintained journals describing the types of learning activities used by clinical instructors to promote the acquisition of the competencies. The authors employed NVivo qualitative data analysis software to code the journal entries using 28 codes derived from the skills associated with the five core competencies.

Of the 327 coded learning activities, just over 50% were related to skills associated with providing patient-centered care (21.4%) and working in interdisciplinary teams (30.0%). The remaining 49.6% of the learning activities cited by students were related to skills associated with employing evidence-based practice (18.3%), applying quality improvement (16.5%) and utilizing informatics (13.8%).

Based on student perceptions, physical therapy clinical instructors are providing learning activities that allow students to acquire skills associated with all five of the IOM competencies. However, students reported the least emphasis on instruction pertaining to the competencies of applying quality improvement and utilizing informatics.

This study supports the need for the profession of physical therapy to delineate formal and explicit clinical education instructional content and strategies to promote students' acquisition of the IOM core competency skills.