Biggest Complaint from PT Clinicians

[aggie777]

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I've heard over and over from clinicians that new-hires are "not ready" for the workforce after graduating from PT school. Now, this isn't the students fault, but rather its the educational model that isn't preparing students for real-world experiences.

My question for current students or those who've graduated...

• Do you feel confident and prepared to enter a clinic upon graduation?

 

[markelmarcel]

I've actually never heard that opinion. I feel more than ready to go into the workforce after going through school. In fact, I felt extremely well-prepared for every clinical experience I had.

 

[truthseeker]

as a clinical supervisor and clinical educator, the student/new PT is responsible for integrating the information learned in PT school. the school, in order to remain accredited, has to provide the basic information. It is up to the one learning it to integrate and apply it to "life". I have had good, average, and poor students from every school I am a CI for. It is not a reflection on the school, but on the individual. BTW, that is the case now that I am in MN and see students from this area, and it was the same when I was in KC and I had students from that area.

 

[Azimuthal]

The funny thing is that the same things were probably said of these 'complaining' clinicians.

 

[callmecrazy]

I also haven't really heard that opinion expressed. If it were, I'd lean toward putting the onus on the student and not the program. I felt very well-prepared and confident post-graduation.

 

[NewTestament]

How many weeks should a student physical therapist spend in the clinic before working independently? Should PT schools move towards one-year residencies?

 

[Azimuthal]

How many weeks should a student physical therapist spend in the clinic before working independently? Should PT schools move towards one-year residencies?

I heard some talk about that through my profession development course. Apparently, it's under consideration.

 

[markelmarcel]

Well, some schools do a one-year clinical rotation as its last year of schooling and starting with the incoming class this year the school I went to changed their curriculum so that it is 26 weeks of clinical at the end of the program.

Personally, I was independent and was given entry-level at the end of each of my clinical affiliations (which were either 8 or 10 weeks long) and for me, I felt that this was enough... But, I also think the more time you are in the clinic, the better your skills (although the better chance to learn bad habits too...), so I think a push for longer clinical affiliations is a positive move.

 

[callmecrazy]

How many weeks should a student physical therapist spend in the clinic before working independently? Should PT schools move towards one-year residencies?

Pitt's program finishes with a 1 year 'internship', following 2 years of classes. There are 3 part-time and 1 shorter full-time affiliations during the first two years. It's not a perfect setup, but I certainly credit a full year in the clinic for making me a well-prepared clinician. For what it's worth, having a full year experience in my specialty appeared to really help my marketability, but it may mean less if all students are getting that. The challenges for a student are that you may not get a placement in the area you desire (limited peds affiliations for example) or you may feel stuck in a less than stellar situation (CI, facility, etc). I think the bigger issue may be having enough willing facilities/CIs to accommodate that number of students for a year. Taking on students is work.

 

[NewTestament]

I think the bigger issue may be having enough willing facilities/CIs to accommodate that number of students for a year. Taking on students is work.

And yet more and more PT programs open every year, without figuring out how they're going to place these students. I predict the number of available CIs is going to be a big limiter in the next few years.

 

[markelmarcel]

And yet more and more PT programs open every year, without figuring out how they're going to place these students. I predict the number of available CIs is going to be a big limiter in the next few years.

I agree... especially because my school changed their clinical experiences because of lack of clinical placements; they are hoping if they can say the student will be available for a longer period of time, it will be easier to place them... not sure I agree with that, but I can understand it may be easier to persuade someone to take on 1 student for 10-16 weeks rather than trying to get a place to take 2-3 students for 8 week chunks... It will be interesting to see what happens. Meanwhile, I'll impatiently wait until I have "enough experience" to become a CI 😉

 

[jesspt]

And yet more and more PT programs open every year, without figuring out how they're going to place these students. I predict the number of available CIs is going to be a big limiter in the next few years.

I don't think that there is a lack of therapists willing to be a student's clinical instructor. Rather, there is likely going to be a lack of institutions and private clinics that are willing to take on a student for a year whose treatments cannot be submitted to Medicare for reimbursement. I have already seen this beginning to happen, and as reimbursement rates continue to decline, it will likely become more common.

 

[ptisfun2]

I don't think that there is a lack of therapists willing to be a student's clinical instructor. Rather, there is likely going to be a lack of institutions and private clinics that are willing to take on a student for a year whose treatments cannot be submitted to Medicare for reimbursement. I have already seen this beginning to happen, and as reimbursement rates continue to decline, it will likely become more common.

I think that is one of the big issue. Not only Medicare, but some lost productivity with a student, especially early on rotations (1st year for example) limits the desire for a clinic to take on a 'money loser.' I am not the ACCE/DCE at my institution, but I know our ACCE is having a hard time placing students (and also we have had 2 schools open in our [relatively] small population state in the past 5 years as well as expansion of existing programs). I think that is why the 2-1 model is expanding now. Our ACCE was told that some sites are being offered money by some PT schools to take students. That really puts state institutions at a disadvantage to get clinical sites. The other issue is the option of choice. ACCEs across the country try to place students where they want to go rather than assigning them (closed systems excluded of course). Students try to find sites on their own, which means schools cannot ensure quality, and it becomes a mess. I think most ACCEs (our ACCE was talking about this at CSM) are now advocating a smaller number of rotation sites with a closer relationship with them.

 

[NewTestament]

The other issue is the option of choice. ACCEs across the country try to place students where they want to go rather than assigning them (closed systems excluded of course). Students try to find sites on their own, which means schools cannot ensure quality, and it becomes a mess.

My classmates often complain they cannot find their own sites, and this is why.

 

[markelmarcel]

I don't think that there is a lack of therapists willing to be a student's clinical instructor. Rather, there is likely going to be a lack of institutions and private clinics that are willing to take on a student for a year whose treatments cannot be submitted to Medicare for reimbursement. I have already seen this beginning to happen, and as reimbursement rates continue to decline, it will likely become more common.

This is a good point, and definitely something that needs to be considered. I suppose the only clinic I was in where this made a difference (lucky for me and my placements) it was worth it because I was only there for 8 weeks and my CI just continued to see the Medicare patients solely herself when I took on the rest of her patient case. But, I couldn't imagine having to worry about that for one year... Definitely a big part of the picture.

 

[truthseeker]

speaking as a long time CI, it always seems odd to me that on those final internships that last 8 weeks or so that the school is still receiving tuition money and the CI gets a thank you and maybe access to the schools medical library. All for supervising a student who may be awesome, average, or a nightmare. If the student is awesome, they may be treating patients relatively independently within 2-3 weeks. if they are a nightmare, they never get to that point and the CI has to work twice as hard with no tangible reward.

 

[callmecrazy]

speaking as a long time CI, it always seems odd to me that on those final internships that last 8 weeks or so that the school is still receiving tuition money and the CI gets a thank you and maybe access to the schools medical library. All for supervising a student who may be awesome, average, or a nightmare. If the student is awesome, they may be treating patients relatively independently within 2-3 weeks. if they are a nightmare, they never get to that point and the CI has to work twice as hard with no tangible reward.

In my final placement (a full year) the clinic actually paid the university. In turn, PT students get a monthly stipend payout. Which would be awesome if it weren't a fraction of the tuition being paid for the same timeframe. So the all-around opposite of your suggestion, hah.

I wonder if PT programs would ever follow suit with education programs, where cooperating teachers typically do receive pay for taking a student teacher. It varies by program and is generally a modest$ amount, but it's something.

Edited: hit post too soon

 

[markelmarcel]

I wonder if PT programs would ever follow suit with education programs, where cooperating teachers typically do receive pay for taking a student teacher.

Especially when other professions, like education (in most situations), do give at least small stipends to teachers for taking on a student teacher. Same principle... It'd be nice to see a benefit.