Facilitators and Barriers to Providing Clinical Education Experiences Through the Lens of Clinical Stakeholders
Tawna Wilkinson1,2,3,4,5,6,7,8,9, Katherine Myers1,2,3,4,5,6,7,8,9, Jamie Bayliss1,2,3,4,5,6,7,8,9
1Tawna Wilkinson is a clinical associate professor and director of Curriculum and Assessment at Division of Physical Therapy, Department of Public Health and Community Medicine, Tufts University School of Medicine, 101E Washington Street, Suite 950, Phoenix, AZ 85004, and is the former associate professor and director of Clinical Education at A.T. Still University of Health Sciences, Mesa, AZ ( tawna.wilkinson@tufts.edu ). Please address all correspondence to Tawna Wilkinson.
Introduction:
Although the provision of clinical education (CE) experiences affords many benefits to clinical stakeholders, little published literature exists regarding the factors influencing decisions of site coordinators of CE (SCCE), clinical administrators, and clinical instructors (CI) to provide CE.
Review Of Literature:
Site coordinators of CE and CIs navigate workplace expectations while making decisions about their engagement in CE experiences. The purpose of this study was to determine clinical stakeholders' perceptions of facilitators and barriers to the provision of CE experiences for entry-level Doctor of Physical Therapy students.
Subjects:
This study used survey data from a previous study on perspectives related to payment for CE experiences. The survey questions analyzed included responses provided by 501 clinical administrators, 445 SCCEs, and 657 CIs.
Methods:
Retrospective analysis of survey data included frequencies and percentages of responses for nominal and categorical data. Open-ended survey questions underwent content analysis to identify overarching concepts and subordinate categories.
Results:
Clinicians are most motivated to serve as CIs by "enjoyment of teaching" (274, 49.4%) and a sense of "professional responsibility" (147, 26.5%). Site coordinators of CEs indicated that the top challenges faced in soliciting CIs were the ability to manage challenging students (347, 69.0%), lack of experience serving as a CI (227, 63.4%), ability to maintain productivity standards (220, 61.5%), and clinician burnout (219, 61.2%). Although all participants agreed that their organization promotes a culture of teaching, clinical administrators agreed at a higher percentage than SCCEs (97.8% vs 94.3%, respectively).
Discussion And Conclusion:
Clinical instructors identified values and benefits that were, at times, in contrast to the organizational culture. The discrepancies in perceptions among stakeholders that were uncovered by this research provide a unique lens that has not been addressed in the literature to date. To provide meaningful support for CIs, it is imperative that directors of CEs, clinical administrators, and SCCEs clearly understand the perceptions of the CI.
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