learning phase describes learning new knowledge and skills as well as educational strategies to use in practice. Following the learning phase, the learner will use the new knowledge or skills in clinical practice and assess the effectiveness of these skills. Self-assessment is a critical component of this phase along with input from peers. Finally, during the adjusting phase, the learner implements these skills, when appropriate, in routine practice and determines if an individual or system change is needed to improve patient care (Cutrer et al., 2017). The “master adaptive learner” concept in medicine is easily applied to both physical and occupational therapy as we
evolve with a continuously changing environment and patient population. Perhaps the most important take-home points from this topic is that students and therapists need to be reflective, demonstrate self- assessment, engage in innovation, and apply new learning to current practice with an understanding that change may occur at the individual level and/or the systems level to produce effective care for patients. Educators will have the challenge of teaching students to develop characteristics of adaptive learning to effectively and optimally treat patients now and in the future.
PREPARATION FOR TEACHING IN THE CLINICAL SETTING AND WORKPLACE
The workplace, or in the case of physical therapy, the clinical practice site, is a rich environment in which optimal learning can occur. This setting provides dynamic opportunities for learners to grapple with and make decisions about patients with complex health conditions and other factors including family dynamics, Collaboration between academic and clinical education The professional or entry-level physical therapist and physical therapist assistant curriculum consists of both a didactic and clinical component, each of which is important in the educational process of the physical therapist (CAPTE, 2018). The clinical education or clinical practice environment allows the learner to apply theory to clinical practice, bridging the gap between knowledge learned in the classroom and the real-world environment (CAPTE, 2018). In this collaborative relationship, the academic faculty begins the foundational knowledge and skills learning process in the didactic curriculum and then the clinical faculty provides the application of this process in the practice environment. Communication between the academic and clinical faculty, including the clinical instructor or mentor, is critical in ensuring optimal learning. The clinical instructor needs to have a good understanding of the learner’s content knowledge based upon his or her progression in the didactic curriculum (Frost, 2013). For example, has the learner been exposed to foundational knowledge in the neuromuscular system so he or she has content knowledge about a patient with a stroke, traumatic brain injury, or spinal cord injury? If the answer to this question is yes, then the clinical faculty member can assist the student in translating this knowledge of Academic education The academic institution by definition is a structured continuum with a well-planned and designed curriculum that has a finite beginning and ending point. The classroom environment is well contained and typically predictable in terms of who will be present, the format of teaching and learning that will occur (lecture format, small group discussion, problem-based discussions, patient simulation, or laboratory setting), and the mostly positive learning environment that exists since both the academic educator and the student are engaged in the learning Clinical education In direct contrast to the structured environment of the academic setting, the clinical setting is full of variation, unpredictable circumstances, and patients who may not want to participate in physical therapy. Essentially, the clinical instructor works in an environment that offers many challenges to a novice learner who is uncomfortable with the complex and unpredictable situations of practice. However, this setting provides a rich learning opportunity above and beyond the foundational knowledge that a textbook or classroom can provide and allows the learner to explore his or her adaptability in this dynamic environment, which is required for success in the clinical practice setting (Frost, 2013). Role of the student/learner In the clinical environment, the student/learner is responsible for developing goals for the learning experience, engaging in ongoing self-assessment, and gaining additional content
social factors, and environmental challenges. A static setting such as the classroom can help a learner develop foundational skills and abilities, however, the multifaceted environment of the practice setting puts learning to the real test (Cutrer et al., 2017; Schumacher, Englander, & Carraccio, 2013). a clinical presentation into a real-life situation and expect the student to begin to convert this information into the patient management model to perform aspects of the physical therapy examination or intervention with the patient. If the student has not had this content knowledge in the didactic curriculum, then the clinical instructor may need to provide the student with an expected clinical presentation or ask the student to gain a better understanding of a cerebrovascular accident as a health condition via researching the health condition or video interaction before interacting with the patient. In this case, the clinical instructor will need to provide more instruction, advisement, and handling skills to the student when working with such a patient. On the other hand, the academic faculty seeks to understand how the preparation of the learner in the classroom setting translated into clinical practice. The student’s performance in the clinical setting is directly correlated to how well the academic faculty members prepared the student for workplace learning. Thus, communication between the clinical instructor and academic faculty allows this exchange of knowledge to improve learning for the student (American Physical Therapy Association [APTA], 2012). process. The assessments, including multiple choice quizzes, written examinations, practical examinations, assignments, or clinical narratives, are also structured events that take place in a “closed environment” with little distraction or disruption so optimal learning and performance can occur (Jensen, Mostrom, & Shepard, 2013). While this type of structured learning environment may lead to improved learning in foundational skills, it lacks the ability to replicate the variability of clinical practice and the real issues therapists and patients face. knowledge in areas where he or she may be lacking in patient care abilities. In addition, the learner must provide constructive feedback to the clinical instructor or mentor to guide the learning experience and ensure an optimal learning opportunity (Higgs, 1992). These are high expectations for a novice learner; however, the ability to clearly articulate and communicate goals, reflect upon the experience to create change if needed, and determine the effectiveness of the teaching style is imperative to a positive and effective learning experience (Mostrom, 2013). Role of the clinical instructor The clinical instructor plays a vital role in the success of the clinical learning experience as the instructor manages the daily responsibilities and supervision of the learner. The complex clinical environment includes the interaction of the learner, clinical instructor, patient, and learning environment. The management of the interaction among all of these individuals
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