Manuela Deodato (Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy )
Raffaele Sabot (Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy )
Francesca Zelesnich (Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy )
Giulia Sgubin (Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy )
Alex Buiote Stella (Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy )
Alessandra Galmonte (Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy )
Luigi Murena (Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy )
An optimal clinical environment represents an excellent place to develop clinical reasoning and clinical practice, which provide optimal decision making and, as a consequence, optimal patient management 1. Student led-clinics represent an innovative practical experience for physiotherapist students2. The aim of student-led-clinic is the development of clinical reasoning and professional skills through a teaching methodology by health care professional supervisors that could lead to an optimal patient management1–3. In fact, this model could provide benefits both in the student education and in health care systems2. Currently, there is few data on the impact of these models on the development of students clinical reasoning, nor on the patients satisfaction 2,4. Therefore, the aim of the present study is to evaluate the impact of an Italian Student-led clinic in the clinical reasoning of the physiotherapy students. The second aim is to evaluate the patients satisfaction in this model.
A quantitative cross-sectional survey was conducted on 102 university students and on 101 patients (Institutional review board of University of Trieste n. 70268; 8.05.2024) in accordance with the STrengthening the Reporting of OBservational Studies in Epidemiology. Concerning students, the questionnaire “Evaluation of Clinical reasoning during internship” was developed with the following domains: medical history, physiotherapy evaluation, the selection of rehabilitation goals, progression of treatment, patient education, discussion of clinical cases with the tutors/students. As regard to patients, the validated “Physical Therapy Satisfaction Survey (PTOPS)”5 was used and the questionnaire “Patients experience in Palestra Didattica” was developed that assess: Student–supervisor relationship, Quality of physiotherapy care, Style of supervision and Student qualities. The Guidelines for developing and validating questionnaire were respected 6 for the two developed questionnaires.
The first interesting finding was that the impact of clinical reasoning of the physiotherapy students was statistically significantly improved in the PD student-led clinic with respect to other traditional models in 7 of 8 items take in to consideration. Another important finding was that the patients satisfaction assessed with the PTOPS survey was statistically significantly higher in the PD model compared with traditional models in 20 of 34 items: in 5 of 12 items of Depersonalization domain, in 4 of 6 items of Inaccessibility domain, in 7 of 10 items of Ambience domain and in 4 of 10 items of Cost domain. Finally, the “Patients experience in Palestra Didattica” questionnaire highlighted high rate of positive answers concerning, Student–supervisor relationship, Quality of physiotherapy care, Style of supervision and Student qualities.
The student-led physiotherapy clinic Palestra Didattica represents an innovative clinical-learning environment that allow to meet both the health care systems and University needs, but also the student clinical education and patient care needs. Three main factors improve the patients and students experience in this model with respect to traditional models: 1) the collaborative interaction among students/patients/academic tutors that lead to patient-centered care and to student-centered learning experience; 2) the learning experience based on active learning methodology and on a real clinical experience with patients that promote clinical reasoning; 3) a dedicated environment in which education, service and research join together that enhance the relationship between health care systems and Universities, which, in turn, bridge the gap between theory and practice in order to promote both best practice for health service and an excellent quality of students learning experience.
