The development of clinical reasoning and interprofessional behaviors: service-learning at a student-run free clinic

Abstract

This article examines the benefits of a student run free clinic (SRFC) as a service learning experience for students in medicine, pharmacy, occupational therapy, physical therapy and physician assistant programs. We hypothesized that students who participate in an interprofessional service learning course and volunteer at a SRFC would demonstrate significant increases in perceptions and attitudes for working in interprofessional health care teams and clinical reasoning skills compared to students who did not participate. Three assessments were administered to an experimental and control group of pre-clinical students from medical, occupational therapy, physical therapy, pharmacy and physician assistant programs before and after participation in an interprofessional service-learning course and volunteering at the SRFC. The tools were the Interdisciplinary Education Perception Scale (IEPS), Readiness for Interprofessional Learning Scale (RIPLS) and the Self-Assessment of Clinical Reflection and Reasoning (SACRR). Students who completed the course had improvements in interprofessional perceptions and attitudes (p = 0.03) and perceptions of clinical reasoning skills when compared to the control group (p = 0.002). This study is novel as it examined students' perceptions of interprofessional attitudes and clinical reasoning following participation in an interprofessional service-learning course and participation in a SRFC.

Experiential Learning to Advance Student Readiness for Level II Fieldwork

“…Experiential learning has been found to enhance confidence levels of occupational therapy students (Giles et al, 2014;Knecht-Sabres, 2010;Seif et al, 2014). Students showed more competent clinical skills such as assessment and intervention planning, therapeutic use of self and awareness of client resources when provided with an opportunity to deliver occupational therapy services to clients in the community with guided supervision, as determined by Knecht-Sabres (2010).…”

“…Other reasons some students failed their Level II fieldwork was due to difficulty accepting feedback and seeing the global impact of their actions. Seif et al (2014) reported that hands-on experience with clients was necessary to develop entry-level clinical reasoning skills.…”

Designing and Evaluating an Interprofessional Experiential Course Series Involving Medical and Pharmacy Students

“…25 We observed that a high percentage of medical and pharmacy students agreed that working with students from another profession enhances student education and future abilities to work on an interprofessional team, and that all health profession students should be educated to establish collaborative relationships with members from other professions, which is similar to the findings of many other studies. 7,[18][19][20]23 The majority of students agreed that physicians and pharmacists should collaborate in teams and that medical and pharmacy students should be involved in teamwork during their education in order to understand their respective roles. These perceptions were measured towards the end of the spring semester, just before the standardized objective behavioral assessment.…”

“…[7][8][9][10][11]17,20,23 Shrader and colleagues demonstrated that student perceptions, collected with an attitudinal survey instrument, were not a significant predictor of clinical outcome scores, whereas teamwork scores, rated by trained observers using a checklist, were a significant predictor of clinical outcome scores. 11 Our standardized objective behavior assessment followed a similar model and involved trained observers evaluating student team behaviors using a checklist.…”

“…Overall, student perceptions of IPE were predominantly positive, which is similar to previously published literature. 8,11,[17][18][19][20][21][22][23] Out of the 156 students who completed the standardized objective behavioral assessment, 45 students subsequently completed the voluntary student evaluation survey for a response rate of 29%. Overall, the responses were positive (Table 1).…”