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Raising the Bar in Rehab

2:1 Student Model

Published June 10, 2011 8:55 AM by

I have another student starting with me next week; she will be with me for a whopping 12 weeks! I'm looking forward to a longer clinical experience because I think it takes that long to truly understand the diagnoses and physical therapy interventions in an ICU setting. I loved my acute-care rotation when I was a student, and part of my experience there was enhanced because I was able to work with other students in the same setting. We bounced ideas off each other and laughed about all the mistakes we made and the funny things our patients said. Although we each had our own clinical instructor, because we were around other students the learning environment seemed less like a superior-inferior relationship and more like a teamwork approach.

So, I got to thinking - maybe having more than one student is more conducive to learning and offers more autonomous practice opportunities than a traditional one-student-to-one-clinical-instructor model.

There was an article written a whopping 15 years ago in the Physical Therapy Journal, and although it is fairly old (in terms of research), many of the findings still apply. Titled "Physical Therapy Clinical Education in a 2:1 Student-Instructor Education Model," the article offers advice to implement a two-student-to-one-clinical-instructor setup.

Some of the benefits of the 2:1 model include: increased note-writing experience, increased autonomy and more opportunities for peer collaboration. Students in this model are less reliant on their supervisor and are challenged to work independently. Students leave the clinical experience having successfully gained each outcome to the highest degree. Part of the article includes feedback provided by students who participated in a 2:1 model, and the benefits of working with another student are fairly substantial.

However, not every combination of students is an appropriate pairing for a 2:1 model, as the article describes. The only 2:1 model that was terminated early included two students who required different levels of supervision and were at different stages of their schooling. The clinical instructor for two students also faces challenges in terms of separating the students' goals, providing equal attention to both students' needs, monitoring and organizing opportunities for both students to interact with patients and other caregivers. Initially, those responsibilities can subtract from productivity standards, but can later exceed productivity standards when a daily schedule/rhythm is established.

Have you ever been a clinical instructor to two students? How can we facilitate this learning model in our physical therapy settings?

Reference: Nemshick, M.T. (1996). Physical Therapy Clinical Education in a 2:1 Student-Instructor Education Model. Physical Therapy Journal, 76, 968-981.


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