The study examined differences between military students enrolled in an accelerated bachelor of s... more The study examined differences between military students enrolled in an accelerated bachelor of science in nursing (BSN) program with and without medical experience and/or a previous bachelor’s degree on graduation grade point average (GPA) and NCLEX®-RN first-time pass rates. Significant differences were found between groups with/without military medical experience on NCLEX-RN, but not graduation GPA. Significant differences were found between groups with/without prior degree on GPA, but not on NCLEX-RN. Having both medical experience and a prior degree did not make a difference on GPA or NCLEX-RN. Findings offer guidance on admission criteria to accelerated programs for this unique group of students.
Aims: Constraint induced movement therapy improves upper extremity (UE) function in children with... more Aims: Constraint induced movement therapy improves upper extremity (UE) function in children with unilateral cerebral palsy (CP). Impact of intervention setting is unknown. The current investigation aimed to determine impact of therapy setting on UE function in children with unilateral CP. Methods: Children were assigned to either center-based (CB) or home-based (HB) interventions using a single-blind cross-over design. Results: UE function improved significantly in all children; greater improvements were found in the CB group. After the HB group received 10 additional weeks of CB intervention, between-group scores were not different but within-group changes were also not significant. Conclusions: Dose may be more important than setting but CB may be more effective than HB in the short term.
Introduction: Academic dishonesty of health profession students may negatively impact the clinica... more Introduction: Academic dishonesty of health profession students may negatively impact the clinical environment. This study examined the attitudes, experiences, and behaviors of nursing, physician assistant, and physical therapist students towards academic dishonesty and explored differences based on demographic variables. Methods: A survey was administered to health profession students in their last semester of the program. Results: 120 students responded. Most reported never observing or participating in activities of academic dishonesty. Collaborating on assignments when instructed not to and falsifying aspects of patient encounters were the two most frequent activities reported. Conclusions: Teamwork and peers may negatively influence academic integrity in some circumstances. Educators should consider strategies to promote individual accountability as well as integrity when reporting clinical findings.
Introduction. Anxiety, depression, and burnout are being discussed across health professions. Des... more Introduction. Anxiety, depression, and burnout are being discussed across health professions. Despite rising concern, studies investigating stress in students enrolled in Doctor of Physical Therapy (DPT) programs remain limited. Only recently have studies exploring stress in DPT students surfaced with any consistency. In this study, our aim was to elucidate the self-identified challenges first-year DPT students faced, how they reacted, and what they did to manage them. Review of the Literature. Evidence suggests that DPT students, like other health professional students, report high levels of anxiety. Despite rising concern, studies investigating the impact of stress on DPT students remain limited. This concern also raises the question of the role of health professions educators in helping students develop the coping strategies needed to manage stress. Programs across the health professions have been proffered to address student stress; however, limited data exist to effectively guide educators. From the insights gained, we offer recommendations linked to the emic or student perspective that may help educators facilitate adaptive coping skills in their learners. Subjects. Participants included first-year DPT students from 3 private universities. Methods. A critical incident questionnaire was used to capture the student experience. Narratives were submitted electronically. Responses were deidentified, and researchers were blinded to participation. An inductive interpretivist approach was used to analyze the data. Strategies to ensure trustworthiness included prolonged engagement, triangulation of investigators, and peer review. Results. Eighty-two first-year DPT students responded; 70 complete responses were analyzed. Three major themes were identified: 1) first-year DPT students faced academic, personal, and mixed challenges; 2) challenges evoked a range of negatively charged emotions; and 3) students relied on adaptive and some potentially maladaptive personal characteristics, behaviors, and strategies to manage their challenges. Discussion and Conclusion. First-year DPT students face many of the same challenges as other health professional students. Most successfully navigated their challenges, however, not without some degree of emotion. As educators, we must prepare students to develop the coping strategies needed to manage not only current academic stressors but ultimately the stressors inherent in clinical practice. Toward that end, we offer recommendations, linked to the emic perspective obtained, that may help educators facilitate adaptive coping skills in their learners.
<p><strong>ABSTRACT:</strong></p><... more <p><strong>ABSTRACT:</strong></p><p>One of three older adults age 65+ fall each year, and every 20 minutes an older adult dies due to injuries sustained during a fall. Yet, most patients do not report falls to their physician. Primary care practitioners (PCPs) are well positioned to screen for fall risk and add proactive referral patterns to both well-selected practitioners and evidence-based fall prevention (EBFP) programs designed to help older patients stay healthy, active, and independent.</p><p>The purposes of this review are to summarize the data related to the impact of falls; review efficient and reliable screening tools that identify individuals at high fall risk; describe appropriate referrals that facilitate a match between individual specific risk factors and interventions; and, highlight evidence-based fall prevention (EBFP) programs available to significantly decrease fall risk with outstanding return on investment.</p><p>Simple administrative changes in a PCP’s practice accompanied by appropriate referrals will result in proactive fall prevention including lower rates of falls and fall injuries and fewer hospitalizations and/or hospital readmissions. Fall risk screening can be built into practice to seamlessly add services without impacting practitioner productivity. Additionally, reporting fall risk screening and prevention activities in the Physician Quality Reporting System will positively impact practice Medicare reimbursement rates.</p>
Journal of acute care physical therapy, Apr 1, 2018
The Academy of Acute Care Physical Therapy recently established core competencies for entry-level... more The Academy of Acute Care Physical Therapy recently established core competencies for entry-level practice in acute care settings. The purpose of this article is to describe and evaluate a model that embeds the competencies throughout an entry-level curriculum, emphasizes active learning strategies, and facilitates student proficiency in clinical decision making in the acute care setting. Faculty-mapped course objectives, learning activities, and assessment methods to the competencies and identified redundancies and gaps. Student learning was assessed using a variety of activities including computerized modules and authentic simulations. The mapping process led to enhanced coordination and documentation of the competencies throughout the curriculum. Course feedback indicated high levels of student satisfaction with active and authentic learning strategies. Learning outcomes substantiated student attainment of the newly established entry-level competencies. Curricular mapping is an effective strategy to ensure that acute care competencies are embedded, reinforced, and integrated. Active and authentic learning assists students to make the transition from the classroom to the demands of acute care settings. Enhanced student self-efficacy and performance in simulated scenarios provided evidence of their attainment of clinical reasoning skills required for the complex and changing demands of the acute care environment.
Background and Purpose. Standardized patient (SP) encounters are used to teach and assess various... more Background and Purpose. Standardized patient (SP) encounters are used to teach and assess various professional skills. Although well established in medical education, the validity of assessing student performance during SP encounters has not been adequately addressed in physical therapist education. This paper presents a method for validating an SP assessment tool for use in a high‐stakes exam within a Doctor of Physical Therapy program using published professional standards. Method Description and Evaluation. Faculty in a physical therapist education program developed an assessment tool for the first of 4 SP encounters students must pass to progress in the curriculum. Criteria were matched to specific statements in the Guide to Physical Therapist Practice, A Normative Model of Physical Therapist Professional Education, and Minimum Required Skills of Physical Therapists Graduates at Entry‐Level. A survey was developed listing each assessment criteria with its corresponding statements from the 3 professional documents. Respondents' levels of agreement were assessed using a 4‐point Likert scale. The chi‐square (X2) goodness of fit was used to determine the level of agreement between the assessment criteria and the practice expectation statements. Additional comments were analyzed using qualitative methods. Outcomes. Thirty academic and clinical educators completed the survey. Ninetysix percent (22/23) of the SP assessment criteria reached statistically significant levels of agreement, with matching statements from at least one of the professional documents. Respondents indicated that the SP assessment tool was either more detailed or specific than the published professional documents; however, it was generally less comprehensive. Discussion. Faculty concluded that the SP assessment criteria were generally consistent with practice expectations and thus a valid form of measurement. Differences can be attributed to the purposes of professional publications and the specific SP encounter. Conclusion. SP encounters can help to ensure the safety of aspiring clinicians prior to clinical practice. The method presented uses published professional expectations to validate a high‐stake assessment of student clinical competence during SP encounters. Using published professional documents to validate classroom assessment tools has the added benefit of connecting classroom teaching and assessment to practice.
Background and Purpose. An important program outcome for physical therapist assistant (PTA) educa... more Background and Purpose. An important program outcome for physical therapist assistant (PTA) education programs is the pass rates of PTA graduates on the National Physical Therapy Examination (NPTE). The purposes of this study were to: (1) examine the relationship between PTA student education program characteristics and PTA graduate pass rates on the NPTE; and (2) develop a model which includes student and programmatic characteristics to predict success on the NPTE. Subjects. Program directors from 50 accredited PTA education programs completed surveys about their program. Methods. Program survey responses were coded and matched with first time and ultimate pass rates on the NPTE obtained from the Federation of State Boards of Physical Therapy (FSBPT). Correlation analyses and regression analyses were performed examining the relationships between NPTE pass rates and survey variables describing student and program characteristics and the role of the variables in predicting program pass rates. Results. Pass rates of PTA graduates were positively correlated with newer, public programs, more clinical education credits, and less general education credits as a percentage of the total credits required for program completion. The model best predicting first time pass rates included the year of program inception, and clinical education credits expressed as a percentage of the total credits. The model best predicting ultimate pass rates included the year of program inception, and whether the institution was public or private. Discussion and Conclusion. Updated curricula that include adequate time for required PTA competencies and the recruitment of qualified students are some factors that may contribute to PTA graduate success on the NPTE. All factors examined in this study need further investigation with a larger sample size.
Background and Purpose. Distance learning is a growing trend in physical therapy education; littl... more Background and Purpose. Distance learning is a growing trend in physical therapy education; little is known about its impact on learning outcomes. The purposes of this study were to: 1) compare student performance based on mode of delivery (distance education versus traditional classroom presentation); 2) investigate the relationship between students' previous academic performance and difference in performance based on mode of delivery; and 3) explore students' perceptions of, and preferences for, distance education and traditional classroom instruction. Subjects. Ninety‐six physical therapist students, enrolled in 2 successive pathophysiology courses, were included in this study. Methods. Each student received half of the course instruction in a traditional classroom mode and half in a distance mode. Student learning was measured by multiple‐choice exams. The percent correct was calculated for questions relating to the content presented in classroom versus distance modes of instruction. Matched pair t‐tests were used to compare the means. Pearson product moment correlations were used to examine the strength of the association between student cumulative GPA (grade point average) and differences in scores based on mode of presentation. A survey was conducted to obtain the students' perceptions of the learning experience based on format of delivery. Qualitative and quantitative methods were used to analyze the survey responses. Results. Students performed significantly better on questions based on material presented in the distance format (t = 5.16, P < .001); however, students expressed a strong preference for the traditional classroom format. Increases in exam scores based on distance learning were inversely correlated to cumulative GPAs. Themes emerged that describe the students' perceptions of, and preferences for, distance versus classroom learning formats. Student recommendations also raised questions that warrant future investigation. Discussion and Conclusion. Although students preferred traditional classroom instruction, they performed significantly better on questions related to material that was presented in a distance format. Students with less academic ability may benefit from the self‐paced learning and internet resources to master coursework requiring factual recall of information.
Reflection enables learners to analyze their experiences and capture the wisdom that lies within.... more Reflection enables learners to analyze their experiences and capture the wisdom that lies within. Effective teaching requires reliable methods of assessment. Several methods of assessing reflective writing have been described; however, they often require significant training, and reliability has seldom been assessed. This study was designed to determine the interrater reliability of a method of assessing reflective writing by using a modified Bloom&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Taxonomy. Twenty-one third-year medical students maintained reflective journals throughout their pediatric clerkship. A coding schema based on Bloom&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Taxonomy was developed to assess the level of cognitive processing evident in the journals. Journals were independently assessed by 3 raters. Percent agreement, kappa statistics, and intraclass correlation coefficients (ICC [2,1]) were used to assess interrater reliability. Three hundred eight entries from 21 journals were assessed. Percent agreement ranged from 78.2% to 100%. Kappa statistic for each level ranged from 0.57 +/- 0.04 to 0.73 +/- 0.04, and for the highest level of processing evident it ranged from 0.52 +/- .04 to 0.58 +/- 0.04. ICC (2,1) for each level of cognitive processing ranged from 0.62 (F = 6.20; P = .000) to 1.00, and for the highest level of cognitive processing evident, it was 0.79 (F = 12.42; P = .000). Substantial to almost perfect agreement was attained. Reflective journals allow learners to revisit their experiences for critical analysis and deeper learning. This study describes a reliable method, based on Bloom&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Taxonomy, of determining whether learners have achieved higher order thinking through reflective journal writing. This method can provide a baseline for facilitating higher order processing, critical thinking, and reflective practice.
The study examined differences between military students enrolled in an accelerated bachelor of s... more The study examined differences between military students enrolled in an accelerated bachelor of science in nursing (BSN) program with and without medical experience and/or a previous bachelor’s degree on graduation grade point average (GPA) and NCLEX®-RN first-time pass rates. Significant differences were found between groups with/without military medical experience on NCLEX-RN, but not graduation GPA. Significant differences were found between groups with/without prior degree on GPA, but not on NCLEX-RN. Having both medical experience and a prior degree did not make a difference on GPA or NCLEX-RN. Findings offer guidance on admission criteria to accelerated programs for this unique group of students.
Aims: Constraint induced movement therapy improves upper extremity (UE) function in children with... more Aims: Constraint induced movement therapy improves upper extremity (UE) function in children with unilateral cerebral palsy (CP). Impact of intervention setting is unknown. The current investigation aimed to determine impact of therapy setting on UE function in children with unilateral CP. Methods: Children were assigned to either center-based (CB) or home-based (HB) interventions using a single-blind cross-over design. Results: UE function improved significantly in all children; greater improvements were found in the CB group. After the HB group received 10 additional weeks of CB intervention, between-group scores were not different but within-group changes were also not significant. Conclusions: Dose may be more important than setting but CB may be more effective than HB in the short term.
Introduction: Academic dishonesty of health profession students may negatively impact the clinica... more Introduction: Academic dishonesty of health profession students may negatively impact the clinical environment. This study examined the attitudes, experiences, and behaviors of nursing, physician assistant, and physical therapist students towards academic dishonesty and explored differences based on demographic variables. Methods: A survey was administered to health profession students in their last semester of the program. Results: 120 students responded. Most reported never observing or participating in activities of academic dishonesty. Collaborating on assignments when instructed not to and falsifying aspects of patient encounters were the two most frequent activities reported. Conclusions: Teamwork and peers may negatively influence academic integrity in some circumstances. Educators should consider strategies to promote individual accountability as well as integrity when reporting clinical findings.
Introduction. Anxiety, depression, and burnout are being discussed across health professions. Des... more Introduction. Anxiety, depression, and burnout are being discussed across health professions. Despite rising concern, studies investigating stress in students enrolled in Doctor of Physical Therapy (DPT) programs remain limited. Only recently have studies exploring stress in DPT students surfaced with any consistency. In this study, our aim was to elucidate the self-identified challenges first-year DPT students faced, how they reacted, and what they did to manage them. Review of the Literature. Evidence suggests that DPT students, like other health professional students, report high levels of anxiety. Despite rising concern, studies investigating the impact of stress on DPT students remain limited. This concern also raises the question of the role of health professions educators in helping students develop the coping strategies needed to manage stress. Programs across the health professions have been proffered to address student stress; however, limited data exist to effectively guide educators. From the insights gained, we offer recommendations linked to the emic or student perspective that may help educators facilitate adaptive coping skills in their learners. Subjects. Participants included first-year DPT students from 3 private universities. Methods. A critical incident questionnaire was used to capture the student experience. Narratives were submitted electronically. Responses were deidentified, and researchers were blinded to participation. An inductive interpretivist approach was used to analyze the data. Strategies to ensure trustworthiness included prolonged engagement, triangulation of investigators, and peer review. Results. Eighty-two first-year DPT students responded; 70 complete responses were analyzed. Three major themes were identified: 1) first-year DPT students faced academic, personal, and mixed challenges; 2) challenges evoked a range of negatively charged emotions; and 3) students relied on adaptive and some potentially maladaptive personal characteristics, behaviors, and strategies to manage their challenges. Discussion and Conclusion. First-year DPT students face many of the same challenges as other health professional students. Most successfully navigated their challenges, however, not without some degree of emotion. As educators, we must prepare students to develop the coping strategies needed to manage not only current academic stressors but ultimately the stressors inherent in clinical practice. Toward that end, we offer recommendations, linked to the emic perspective obtained, that may help educators facilitate adaptive coping skills in their learners.
&lt;p&gt;&lt;strong&gt;ABSTRACT:&lt;/strong&gt;&lt;/p&gt;&lt;... more &lt;p&gt;&lt;strong&gt;ABSTRACT:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;One of three older adults age 65+ fall each year, and every 20 minutes an older adult dies due to injuries sustained during a fall. Yet, most patients do not report falls to their physician. Primary care practitioners (PCPs) are well positioned to screen for fall risk and add proactive referral patterns to both well-selected practitioners and evidence-based fall prevention (EBFP) programs designed to help older patients stay healthy, active, and independent.&lt;/p&gt;&lt;p&gt;The purposes of this review are to summarize the data related to the impact of falls; review efficient and reliable screening tools that identify individuals at high fall risk; describe appropriate referrals that facilitate a match between individual specific risk factors and interventions; and, highlight evidence-based fall prevention (EBFP) programs available to significantly decrease fall risk with outstanding return on investment.&lt;/p&gt;&lt;p&gt;Simple administrative changes in a PCP’s practice accompanied by appropriate referrals will result in proactive fall prevention including lower rates of falls and fall injuries and fewer hospitalizations and/or hospital readmissions. Fall risk screening can be built into practice to seamlessly add services without impacting practitioner productivity. Additionally, reporting fall risk screening and prevention activities in the Physician Quality Reporting System will positively impact practice Medicare reimbursement rates.&lt;/p&gt;
Journal of acute care physical therapy, Apr 1, 2018
The Academy of Acute Care Physical Therapy recently established core competencies for entry-level... more The Academy of Acute Care Physical Therapy recently established core competencies for entry-level practice in acute care settings. The purpose of this article is to describe and evaluate a model that embeds the competencies throughout an entry-level curriculum, emphasizes active learning strategies, and facilitates student proficiency in clinical decision making in the acute care setting. Faculty-mapped course objectives, learning activities, and assessment methods to the competencies and identified redundancies and gaps. Student learning was assessed using a variety of activities including computerized modules and authentic simulations. The mapping process led to enhanced coordination and documentation of the competencies throughout the curriculum. Course feedback indicated high levels of student satisfaction with active and authentic learning strategies. Learning outcomes substantiated student attainment of the newly established entry-level competencies. Curricular mapping is an effective strategy to ensure that acute care competencies are embedded, reinforced, and integrated. Active and authentic learning assists students to make the transition from the classroom to the demands of acute care settings. Enhanced student self-efficacy and performance in simulated scenarios provided evidence of their attainment of clinical reasoning skills required for the complex and changing demands of the acute care environment.
Background and Purpose. Standardized patient (SP) encounters are used to teach and assess various... more Background and Purpose. Standardized patient (SP) encounters are used to teach and assess various professional skills. Although well established in medical education, the validity of assessing student performance during SP encounters has not been adequately addressed in physical therapist education. This paper presents a method for validating an SP assessment tool for use in a high‐stakes exam within a Doctor of Physical Therapy program using published professional standards. Method Description and Evaluation. Faculty in a physical therapist education program developed an assessment tool for the first of 4 SP encounters students must pass to progress in the curriculum. Criteria were matched to specific statements in the Guide to Physical Therapist Practice, A Normative Model of Physical Therapist Professional Education, and Minimum Required Skills of Physical Therapists Graduates at Entry‐Level. A survey was developed listing each assessment criteria with its corresponding statements from the 3 professional documents. Respondents' levels of agreement were assessed using a 4‐point Likert scale. The chi‐square (X2) goodness of fit was used to determine the level of agreement between the assessment criteria and the practice expectation statements. Additional comments were analyzed using qualitative methods. Outcomes. Thirty academic and clinical educators completed the survey. Ninetysix percent (22/23) of the SP assessment criteria reached statistically significant levels of agreement, with matching statements from at least one of the professional documents. Respondents indicated that the SP assessment tool was either more detailed or specific than the published professional documents; however, it was generally less comprehensive. Discussion. Faculty concluded that the SP assessment criteria were generally consistent with practice expectations and thus a valid form of measurement. Differences can be attributed to the purposes of professional publications and the specific SP encounter. Conclusion. SP encounters can help to ensure the safety of aspiring clinicians prior to clinical practice. The method presented uses published professional expectations to validate a high‐stake assessment of student clinical competence during SP encounters. Using published professional documents to validate classroom assessment tools has the added benefit of connecting classroom teaching and assessment to practice.
Background and Purpose. An important program outcome for physical therapist assistant (PTA) educa... more Background and Purpose. An important program outcome for physical therapist assistant (PTA) education programs is the pass rates of PTA graduates on the National Physical Therapy Examination (NPTE). The purposes of this study were to: (1) examine the relationship between PTA student education program characteristics and PTA graduate pass rates on the NPTE; and (2) develop a model which includes student and programmatic characteristics to predict success on the NPTE. Subjects. Program directors from 50 accredited PTA education programs completed surveys about their program. Methods. Program survey responses were coded and matched with first time and ultimate pass rates on the NPTE obtained from the Federation of State Boards of Physical Therapy (FSBPT). Correlation analyses and regression analyses were performed examining the relationships between NPTE pass rates and survey variables describing student and program characteristics and the role of the variables in predicting program pass rates. Results. Pass rates of PTA graduates were positively correlated with newer, public programs, more clinical education credits, and less general education credits as a percentage of the total credits required for program completion. The model best predicting first time pass rates included the year of program inception, and clinical education credits expressed as a percentage of the total credits. The model best predicting ultimate pass rates included the year of program inception, and whether the institution was public or private. Discussion and Conclusion. Updated curricula that include adequate time for required PTA competencies and the recruitment of qualified students are some factors that may contribute to PTA graduate success on the NPTE. All factors examined in this study need further investigation with a larger sample size.
Background and Purpose. Distance learning is a growing trend in physical therapy education; littl... more Background and Purpose. Distance learning is a growing trend in physical therapy education; little is known about its impact on learning outcomes. The purposes of this study were to: 1) compare student performance based on mode of delivery (distance education versus traditional classroom presentation); 2) investigate the relationship between students' previous academic performance and difference in performance based on mode of delivery; and 3) explore students' perceptions of, and preferences for, distance education and traditional classroom instruction. Subjects. Ninety‐six physical therapist students, enrolled in 2 successive pathophysiology courses, were included in this study. Methods. Each student received half of the course instruction in a traditional classroom mode and half in a distance mode. Student learning was measured by multiple‐choice exams. The percent correct was calculated for questions relating to the content presented in classroom versus distance modes of instruction. Matched pair t‐tests were used to compare the means. Pearson product moment correlations were used to examine the strength of the association between student cumulative GPA (grade point average) and differences in scores based on mode of presentation. A survey was conducted to obtain the students' perceptions of the learning experience based on format of delivery. Qualitative and quantitative methods were used to analyze the survey responses. Results. Students performed significantly better on questions based on material presented in the distance format (t = 5.16, P < .001); however, students expressed a strong preference for the traditional classroom format. Increases in exam scores based on distance learning were inversely correlated to cumulative GPAs. Themes emerged that describe the students' perceptions of, and preferences for, distance versus classroom learning formats. Student recommendations also raised questions that warrant future investigation. Discussion and Conclusion. Although students preferred traditional classroom instruction, they performed significantly better on questions related to material that was presented in a distance format. Students with less academic ability may benefit from the self‐paced learning and internet resources to master coursework requiring factual recall of information.
Reflection enables learners to analyze their experiences and capture the wisdom that lies within.... more Reflection enables learners to analyze their experiences and capture the wisdom that lies within. Effective teaching requires reliable methods of assessment. Several methods of assessing reflective writing have been described; however, they often require significant training, and reliability has seldom been assessed. This study was designed to determine the interrater reliability of a method of assessing reflective writing by using a modified Bloom&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Taxonomy. Twenty-one third-year medical students maintained reflective journals throughout their pediatric clerkship. A coding schema based on Bloom&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Taxonomy was developed to assess the level of cognitive processing evident in the journals. Journals were independently assessed by 3 raters. Percent agreement, kappa statistics, and intraclass correlation coefficients (ICC [2,1]) were used to assess interrater reliability. Three hundred eight entries from 21 journals were assessed. Percent agreement ranged from 78.2% to 100%. Kappa statistic for each level ranged from 0.57 +/- 0.04 to 0.73 +/- 0.04, and for the highest level of processing evident it ranged from 0.52 +/- .04 to 0.58 +/- 0.04. ICC (2,1) for each level of cognitive processing ranged from 0.62 (F = 6.20; P = .000) to 1.00, and for the highest level of cognitive processing evident, it was 0.79 (F = 12.42; P = .000). Substantial to almost perfect agreement was attained. Reflective journals allow learners to revisit their experiences for critical analysis and deeper learning. This study describes a reliable method, based on Bloom&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Taxonomy, of determining whether learners have achieved higher order thinking through reflective journal writing. This method can provide a baseline for facilitating higher order processing, critical thinking, and reflective practice.
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