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BACKGROUND AND PURPOSEAll doctoring professions recognize the important connection between practice and the academy.1-4 The concepts of academic medicine,5 academic dentistry,6 academic pharmacy,7 and now academic physical therapy,8 all refer to the essential relationship between the didactic and clinical components of professional education, including curriculum, faculty, and practice. For the concept of academic physical therapy to be fully realized, clinical sites and physical therapist education programs must embrace a common educational mission and work together to develop a model that will serve everyone in the quest for quality care and cost containment.The sustainability of physical therapist education depends on the ability of programs to provide comprehensive and quality learning experiences across the spectrum of academic and clinical settings. The limited availability of clinical placements is often cited as 1 of the most influential factors in being able to provide quality professional education. With mounting constraints related to cost and availability of clinical educator resources, all health care professions are challenged to provide appropriate opportunities for experiential learning and practice while meeting the service demands of patient and client care.9 This creates a difficult tension for clinics that must focus on cost reduction where there is no clear educational mission.10 Unfortunately, the profession's system for securing placements is inefficient, requiring annual negotiations, often in a spirit of competition among programs.The last 10 years have seen a steady rise in enrollment as well as an increase in the length of fulland part-time clinical experiences (Figure 1), placing ever-increasing demands on clinical educators. To meet these demands, programs have contracted with increasing numbers of clinical sites, now averaging 458 per program, even though they typically only use one quarter of these in any given year.u(pl3) This, in turn, is burdensome for clinical institutions, as there are evermore Clinical Site Information Forms to update, contracts for legal departments to initiate and renew, and responses to generate to an ever-growing number of schools requesting student placements. Alternative systems are needed that will save time and resources for all those involved in clinical education management.Delitto12 has suggested that the physical therapy profession faces serious vulnerabil ity in the clinical component of professional education because of an overreliance on volunteerism to provide this portion of the curriculum and a lack of control over what happens in the clinic. When students are assigned to clinics, the academic program may not know who the clinical instructor (Cl) will be, and the Cl may be given only minimal information about the student. When clinics affiliate with multiple programs, as is the norm, CIs may not be familiar with the curriculum or how students are taught to make clinical decisions. We frequently hear about a "disconnect" between academic and clinical experiences that contributes to variations in practice, with students claiming that what they learned in class is not what they see in the "real world."13 Clinical educators find it extremely challenging to learn the nuances of each program, which not only impacts their efficiency but also detracts from the focus of the clinical experience. If the Cl already understood the programs curriculum, time could be better spent learning students' strengths and weaknesses and subsequently tailoring the experience to the individual instead of the program.Clinics often develop their own clinical education program to structure the student's experience based on their own strengths and resources, but this may or may not fit well with the academic curriculum. In fact, when a clinic affiliates with many schools, it may not be able to focus its program to fit readily with any single school's philosophy or curriculum. … |
