Learning styles of allied health students using Kolb's LSI-IIa

The purpose of this study was to assess the learning style preferences of students enrolled in various allied health professional programs. Five professions were examined: nursing, physician assistant (PA), occupational therapy (OT), physical therapy (PT), and speech-language pathology (SLP). The assessment instrument used was the Kolb Learning Style Inventory LSI-IIa. The study included 89 subjects from the various allied health care programs enrolled at a small midwestern university. Findings indicated similar learning style preferences between nursing, OT, PA, and SLP student groups. Students from these groups exhibited a close balance between all four learning styles. The nursing and SLP groups showed a slight preference for concrete experimentation, whereas the OT and PA groups preferred abstract conceptualization. The learning style of the PT students was that of converger, with a strong tendency toward active experimentation versus reflective observation. An emphasis needs to be placed on student learning styles and its impact in the educational process. An understanding and incorporation of learning styles in the education of health care providers could have a positive impact not only on the teaching and learning process but also on the effectiveness of interdisciplinary team interactions and the patient educational process.     

Attitudes and knowledge of students in the allied health professions toward their future professional team members

The investigators wished to explore final-year allied health students' knowledge of their future colleagues. A survey developed by Felsher and Ross (1994) was adapted and administered to 35 occupational therapy (OT), 35 physical therapy (PT), and 35 speech-language pathology (SLP) students. Findings suggested that all students had a good understanding and knowledge of their own professions. Differences were found among the three groups of students regarding their understanding of other disciplines and the overlap in OT and SLP roles. Specifically, OT and SLP students perceived their own professions as the primary providers of cognitive treatment. Ways to foster student understanding and collaboration are suggested.     

An office or a bedroom? Challenges for family-centered care in the pediatric intensive care unit

Although the modern pediatric intensive care unit (PICU) has followed general pediatrics and adopted the family-centered care model, little is known about how families prospectively experience PICU care. The authors' goal was to better understand the experiences of families whose child was hospitalized in a PICU. They conducted a 12-month prospective ethnographic study in a PICU in a tertiary care hospital in a large North American urban center. Data were obtained via participant-observation and formal and informal interviews with 18 families and staff key informants. Findings revealed a disconnect between the espoused model of family-centered care and quotidian professional practices. This divergence emerged in the authors' analysis as a heuristic that contrasts a professional "office" to a sick child's "bedroom." PICU practices and protocols transformed the child into a patient and parents into visitors; issues such as noise, visitation, turf, and privacy could favor staff comfort and convenience over that of the child and family. The authors' discussion highlights suggestions to overcome this divergence in order to truly make the PICU family centered.     

A working around "it": the experience of occupational therapy students with a disability

The purpose of this qualitative study was to gain an understanding of the experiences of students with disabilities in occupational therapy (OT) programs. Telephone and email interviews were conducted with five students from different universities who volunteered to participate in the study. Interviews were transcribed, and researchers used the constant comparison method for data analysis. Trustworthiness was assured by using an audit trail, triangulation of data analysis, and member checking. Results revealed that students with disabilities (1) have a strong desire to "work around it," (2) desire support and understanding both within and outside the academic environment, (3) understand that disability is an essential part of who they are as people, and (4) believe that having a disability will enhance their own practice. The discussion includes ways to optimize the experience of being an OT student with a disability.     

After the Intensive Care Nursery Experience: Families' Perceptions of Their Well Being

This article describes family well being after a child's intensive care nursery experience. Thirty families of children who were graduates of intensive care nurseries participated in the study. Fifteen families of children with identifiable disabilities and 15 families of children with no identifiable disabilities were interviewed and completed standardized questionnaires. A comparison of family well being was done across three dimensions: the child's characteristics and caregiving needs, the family's support resources and needs, and the family's values and beliefs regarding their child's hospitalization and resulting special needs. Both groups of families had realized a renewed sense of meaning concerning family, children, and life itself due to their child's medical crises or disability. Families of children with disabilities, however, noted their financial concerns, burdens with their child's caregiving, and their difficulty in locating services for their child. These families' experiences underscore the need for a coordinated transition from the hospital to the community for the family and child.     

Transdisciplinary assignments in graduate health education as a model for future collaboration

Transdisciplinary health care continues to be at the forefront of patient treatment in the medical arena, in part due to escalating health care costs, an increasing aging population, and the development of multiple chronic diseases. Gaining the knowledge, experience, and principles associated with transdisciplinary teamwork to successfully prepare for modern-day practice is therefore essential for individuals of various health care professions. This report describes an assignment developed and implemented to facilitate professional interaction between graduate physical therapy, nutrition, and nursing students. The objectives of this assignment were to determine through student evaluation the effects of a transdisciplinary experience on students' understanding of the role of another discipline and students' communication skills across disciplines. When evaluating the assignment, students most often remarked that they developed a greater understanding of the roles of the included disciplines and reported a significant increase in communication skills. However, some students did not concur that this assignment was effective due to the scheduling conflicts and lack of teamwork that can occur during a collaborative project. The students' reports of their experiences in completing the assignment provide valuable insights for implementing and/or updating a preparatory transdisciplinary education component in other settings. Additional research can focus on the challenges faced by the majority of the students venturing into actual health care or "real-world" settings for comparative studies.     

A home visit programme to teach medical students about children with special needs

OBJECTIVES: During an 8-week clinical rotation in paediatrics and child health, fifth-year medical students at the University of Cape Town are required to visit children with special needs in their homes. The home visit allows students to learn, first-hand, from children with special needs and their families about living with chronic disease and disability. DESIGN: During 1998 students anonymously completed home visit evaluation questionnaires (90% response rate, 160/177). Through verbal presentations, students are assessed on their ability to make a comprehensive evaluation of the impact of chronic disease and disability on a child and family. SETTING: University of Cape Town Medical School. SUBJECTS: Fifth-year medical students. RESULTS: A content analysis of verbal presentations found students were more likely to identify medical, psychosocial and economic than spiritual and ethical issues. As a learning experience, 37% (n=57) of students rated the home visit as 'extremely worthwhile', 62% (n=100) found it 'worthwhile' and only 2% (n=3) felt it was 'a waste of time'. Most (97%, n=155) students felt the programme should continue in the future. CONCLUSIONS: As an educational tool, home visiting grounds learning in families' experience and encourages reflection beyond the medical aspects of care for children with special needs.     

Family mentoring: a life experience

The purpose of this study was to determine the effectiveness of a preservice education family mentor experience on the development of family-centered attitudes expressed by 84 nursing, occupational therapy, physical therapy, and social work students from a private Midwestern university. The instrument, Issues in Early Intervention, was administered to students before and after participation in a field experience that included a minimum of 8 hours with assigned families. The instrument measured changes in attitude regarding family-centered care expressed by students in response to 24 statements reflective of family-centered concepts and approaches. A Wilcoxon signed rank test was used to analyze data from pretests and posttests using the Issues in Early Intervention instrument. Eight items reflected significant positive changes in family-centered attitudes. When total scores were examined using a paired t-test, students demonstrated a significant increase (p < or = 0.001) in family centered attitudes after the family mentor experience according to the instrument. The family mentor experience evaluation of outcome objectives was administered to students at the conclusion of the project. Results from student feedback on the family mentor experience evaluation of experience outcomes also indicated a positive impact in family-centered attitudes as a result of the family mentor experience.     

Facilitating transdisciplinary teamwork in dietetics education: a case study approach

Teamwork, emphasized by the transdisciplinary approach, has been strongly linked to the development of a culture of patient safety. However, the vast majority of health care education is one-dimensional, ie, focused on one discipline, taught by practitioners of the same discipline, with students of the same discipline. In an effort to address this one-dimensional view of health care education, a case-study assignment was developed to facilitate professional interaction between graduate physical therapy and graduate nutrition students. The objectives were threefold: (a). to increase student understanding of the role of another discipline, (b). to increase student ability to obtain and analyze information from a consultant relative to a patient case, and (c). to increase student communication skills across disciplines. For the assignment, physical therapy students were assigned one case scenario and one nutrition student to interview individually. The nutrition students acted as consultants in a clinical setting. The interactive assignment was considered an effective learning tool for facilitating interprofessional learning by the faculty based on student comments reporting increased understanding of the role of the other discipline, increased communication skills, and an understanding of the barriers to transdisciplinary interaction. Future studies, both quantitative and qualitative, may further identify effects of instructional activities designed to facilitate transdisciplinary health care.     

Interaction experience for families who live with their child's disease and hospitalization

Starting from the research question about the meanings the family attributes to interactions experienced during their child's hospitalization, this study tried to understand the interaction experience of families in pediatric hospitals, as well to identify the interventions considered effective the family's perspective. Symbolic Interactionism was the theoretical framework that supported the data analysis process, and Grounded Theory was the methodological framework. Six families with hospitalized children participated. The results allowed us to identify the phenomena "feeling secure to assume risks" and "feeling insecure to assume risks", representing the symbolic meanings attributed to relational contexts that emerge from interaction between families and health professionals. The identified concepts significantly contribute to achieve a better understanding of the family-centered care approach and provide a way to reflect on interaction and intervention with families in pediatric clinical care practice.     

The educational interaction between physical therapy and occupational therapy students

The objectives of this study were to identify the prevalence of shared learning in U.S. physical therapy (PT) and occupational therapy (OT) education programs; determine what terminology is used for these courses; and identify perceived barriers, benefits, and challenges of the educational interactions. A survey, designed to collect information about the educational interaction between PT and OT students, was mailed to all program directors (n = 206) at each of the academic institutions (N = 103) in the United States with accredited or developing entry-level programs in PT and OT. A census study was conducted, and the entire study population received a survey. A total of 206 surveys were mailed, and 123 were retured (59.7% response rate). Of program directors, 40 (67.8%) of the PT and 42 (65.6%) of the OT program directors reported that their students shared courses with each other. None of the PT and only 8 (12.5%) of the OT directors reported that students shared clinical experiences. The term interdisciplinary was used most frequently to refer to shared educational experiences. Benefits of shared learning included sharing resources, collaboration, learning about the other profession, and gaining respect for the other profession. Challenges to shared learning included resource constraints, curricular differences, competition and differences between disciplines, relevance of course work, and different faculty expectations. Barriers reported by program directors whose students did not engage in interdisciplinary education were resource constraints, curricular differences, faculty attitude, and failure of past attempts. A model of interdisciplinary education that seeks to instill collaboration and understanding among professions is difficult to implement without shared clinical experiences. Most students in entry-level PT and OT programs in the United States do not currently have the opportunity to practice the teamwork that will be essential when they enter their respective professions.     

Attitudes of physical therapist students toward physical therapist assistants before and after full-time clinical internships

Development of attitudes of physical therapists (PTs) toward physical therapist assistants (PTAs) begins during their professional education, and attitudes are influenced further by clinical experiences. The purpose of this study was to understand attitudes of student PTs toward PTAs. We surveyed 66 clinical intern students enrolled in an entry-level master of physical therapy program. PT students received the same survey before and after their full-time clinical internship. Eleven Likert scale items were used to assess students' attitudes toward PTAs in the areas of competence, financial remuneration, and job security. One item was designed to determine whether PT students' level of contact with PTAs influenced attitudes. A random sample of 13 (20.9%) students who returned surveys were asked to participate in a telephone interview designed to enrich the quantitative data. After item analysis, five of the scale items were eliminated from the analyses due to poor internal consistency. Cronbach's alpha of the remaining six scale items was 0.75. Survey results reveal that PT students maintain an overall positive attitude toward PTAs before and after full-time clinical internship. Qualitative interview data support this finding. Students' attitudes in specific areas of PTA competence were negative and positive, however. The negative attitude may have been based on the students' beliefs that PTAs are not competent to perform physical therapy in situations that are changing or unpredictable. Positive attitudes may have been reflective of the students' beliefs that PTAs are competent to implement established plans of care. Student ranking of four professional issues showed a significant difference before and after full-time clinical internships.     

Ethical decision-making by students in physical and occupational therapy

The professions of physical therapy (PT) and occupational therapy (OT) progressively have expanded their scope of responsibility, and practitioners often are placed in positions in which ethical decisions must be made. Few studies have reported the level of moral development and the effects of education on ethical decision making in PT or OT students. This research study was designed to determine the impact of the educational programs at the University of New Mexico (UNM) in PT and OT on the moral reasoning of the students as measured by the Defining Issues Test (DIT). The longitudinal design of this study followed two consecutive classes in each program (N = 94; 58 PT students and 36 OT students) from entry until graduation approximately 2 years later. The subjects completed a demographic survey and the DIT on the first day of class and again during their final semester (OT) or at graduation (PT). A factorial analysis of covariance was used to examine the effects of a professional degree program (PT and OT) and time (ENTRY and EXIT), after adjusting for the effects of age. The mean P score for this sample was between 45 and 46, which is within range for college and professional students. There was a significant relationship between age and the P score of the DIT. There were no significant differences between PT and OT students or between the entering and the exiting scores for either group of students. Based on the results of this study, these educational programs do not seem to be facilitating moral development in these students. The baseline level of moral development and the skills that PT and OT students use when making ethical decisions need to be established. Additional research is recommended with a larger sample size, including students in other locations. To optimize clinical practice, students must be taught how to make ethical as well as clinical judgments. Therapists must be capable of functioning in the changing health care environment, now and in the future. If the disciplines of PT and OT expect to graduate students who meet this challenge, the educational programs must take the responsibility for evaluating students and implementing curricula that facilitate ethical decision making.     

Critical thinking experiences for students of child development: outcomes in values and attitudes

Early childhood professionals are likely to benefit from critical thinking skills as they explore problems facing children and evaluate policy issues related to those problems. To facilitate their critical thinking, students in child development classes were assigned two types of learning activities: general exploration of problems that involved critical thinking only implicitly and specific activities that guided students explicitly through steps of critical thinking in the context of exploring problems facing children. Regardless of the type of assignment, students increased their self-ratings of personal attributes related to public policy and helping others, understanding other cultures, and developing methods for human services. Also, students increased their value of both breadth and depth of postsecondary education. Nevertheless, the type of assignment appeared to have differential effects, with general experiences providing more changes in educational values and self-confidence and specific experiences providing more change in knowledge and self-awareness.     

A community-based approach to the medical humanities

BACKGROUND: This paper discusses the rationale behind, and an approach to, the development of a graduate level interdisciplinary curriculum in literature and health care that incorporates community-based learning. Such an innovative approach emerges from the recognition that professional training in both health care and humanities programmes often does not model the kinds of collaborative relationships and professional values desired by contemporary health care students, providers and patients. METHOD: Recent trends in literary study and the medical humanities are described, along with the function (and benefits to students) of interdisciplinary classrooms and the role of community-based learning in higher education. The authors discuss their experiences teaching, and offer students' responses to medical humanities courses from which the concept for such a curriculum evolved. The paper offers advice on developing, evaluating and disseminating such a model curriculum for medical, nursing and graduate literature students. PROPOSAL: By linking health care with graduate English literature students, such a course would promote dialogue and understanding among health professionals, enhance student awareness of the effects of illness on patients, their caregivers and families, and encourage student activism and community service. A common set of literary works would provide a shared vocabulary and opportunities for ethical, critical and personal response. Working together in a community-based project, students from different programmes would learn to appreciate alternative professional and lay perspectives on common experiences.     

Parent Perceptions of the Impact of Chronic Pain in Children and Adolescents

In this exploratory study we describe the impact of chronic pain in children and adolescents. Information was gathered from the parents of 43 children (ages 7 to 16 years) referred for psychological management of chronic pain in a tertiary care setting. Parents completed a questionnaire about their child's experience of pain over the past year, its impact on child and family day-to-day activities, and treatments sought. Their responses depict clinically significant levels of pain and associated disability, requiring multiple contacts with health care providers. Although these data are preliminary, they suggest that complex pain problems in children and adolescents can be associated with both personal costs to families and economic costs to the health care system. There is a compelling need for effective treatments for children and adolescents with chronic pain that specifically target prevention or reduction of disability.     

Humanized care in the teaching of nursing

This 'teaching experience' report addresses contents related to the humanized care given to children/adolescents and to their family. It was made in collaboration with students of the Undergraduate Course in Nursing. The Creativity and Awareness workshops proposed by Cabra I (1999) have been used as methodology because they proved adequate to approaching complex themes such as prevention of violence against children/adolescents and assistance to families that experience child sickness. During the workshops, the aim is to create an environment for reflection on humanized care on the basis of students' experiences. We found out that it is important to introduce alternative methodologies into the teaching/learning process of students, seeking the construction of knowledge and giving priority to their experiences.     

Impact of an interprofessional community-based educational experience on students' perceptions of other health professions and older adults

Caring for older adults has become increasingly complex due to multiple health and societal factors. The purpose of this study was to evaluate the impact of an interprofessional community-based educational project on students' attitudes toward other health care professions and older adults. A pretest and posttest quasi-experimental research design was implemented with 64 participating students from four health care professions (nursing, occupational therapy, physical therapy, and pharmacy). These students completed the Interdisciplinary Education Perception Scale (IEPS) and Survey of Attitudes on Aging Scale (SAAS) before and following an educational experience with older adults. Qualitative data were collected through student reflection journals and focus groups with participating students. The results of the study showed that interprofessional community-based learning had a significant impact on some students' attitudes toward older adults. The difference between pretest and posttest reached a statistically significant level on the SAAS in occupational therapy (p = 0.013) and physical therapy students (p = 0.044). No significant differences, however, were found between the pretest and posttest in pharmacy (p = 0.097) or nursing students (p = 0.144). Similarly, the experience also had a positive impact on some students' perceptions of other health care professions as measured by the IEPS. A significant difference was found between the pretest and posttest in occupational therapy (p = 0.000) and physical therapy students (p = 0.028). This study indicates that interprofessional community-based learning can be an effective method for some students to increase their understanding and respect toward other health professionals and older adults.