Examining the Impact of an Integrated Clinical Experience (ICE) on Interpersonal Skills Prior to the First, Full-Time Clinical Internship: Cool as ICE

Abstract

Introduction. Appropriate interpersonal skills between physical therapists and patients/clients are critical for successful physical therapy clinical outcomes. The purpose of this study was to examine whether the inclusion of integrated clinical experiences (ICEs) in physical therapist education curricula helped students develop appropriate interpersonal skills prior to entering into the first full-time clinical experiences compared to students without the experience. Subjects. This 2-part study consisted of 162 student subjects participating in a survey that was a self-assessment of readiness, and 36 student subjects were observed and rated. Methods. Academic coordinators of clinical education/directors of clinical education (ACCE/DCE) teams and students from 4 accredited physical therapist education programs participated. The study subjects were considered trained or untrained. Trained subjects had participated in an ICE prior to their first, full-time clinical internship as part of an entry-level physical therapist education program. The untrained group had no or minimal formal clinical experience. All subjects completed the Interpersonal Communication Questionnaire (ICQ),1 which measures self-perceived communication confidence and anxiety (both subscales of the tool) prior to the first full-time internship. An adapted form of the Medical Communication Behavior System (MCBS)2 was used to observe the subjects' interpersonal skills in the clinic for the first 15 minutes of an intervention session. This occurred during a preplanned site visit by the ACCE/DCE between day 5 and day 15 of the internship. Descriptive statistics were used for demographic data, and comparisons between groups were analyzed through the 1-way analysis of covariance (ANCOVA) and the Mann-Whitney U test. Results. A statistically significant difference was found on the ICQ between students with work experience as a physical therapist aide or technician, and those without this experience (F = 6.877, P = .010). Students in the trained group scored significantly higher on the confidence subscale of the ICQ (F = 4.269, P = .041), the Student Physical Therapist Content Behaviors category (U = 86.5, P = .018), and the Affective Behaviors category (U = 67.0, P = .002) measured by the MCBS. Discussion and Conclusion. Study findings provide evidence that participating in an ICE may improve interpersonal skills among students during the first, full-time clinical internship. Limitations include training for data collection at different times, data collectors choosing which students would be observed based on travel schedules, the narrow timeframe of observations, and the potential for Hawthorne effect. Further research is indicated regarding the development of interpersonal skills in physical therapist students, including the development of a tool that can be easily used in the clinic to objectively measure interpersonal skills. As outcome measurement is necessary for accreditation purposes, development of a practical instrument to measure interpersonal skills in real time is suggested.