Reasonable accommodations in higher education are being more frequently requested by graduate occupational and physical therapy students within didactic and clinical contexts. Researchers aimed to describe the experiences of clinical educators in occupational and physical therapy mentoring graduate students with a disclosed accommodation during terminal clinical education, employing a qualitative design. Semi-structured interviews and one-time electronic survey were completed. Reflexive thematic analysis was conducted following the approach described by Braun and Clarke. Twelve occupational or physical therapy clinical educators participated in semi-structured interviews, each having mentored 1–2 students with a disclosed disability accommodation during a terminal clinical education experience. Four major thematic categories regarding accommodation use in terminal clinical emerged: 1) accommodation process, 2) team approach to accommodating, 3) fostering accommodations, and 4) ambiguity in facilitating accommodations. Clinical educators emphasized the importance of being informed about accommodations well in advance, adapting teaching methods, and maintaining regular communication between academic institutions, clinical sites, and students. Training for clinical educators on the disclosure process, legal obligations, and strategies for effective mentorship to ensure alignment of accommodation, academic requirements, and site expectations is essential.
What students say to be ready for acute care: Implications for preceptors
Abstract Background Student readiness for clinical education experiences is an important variable for clinical preceptors. Readiness has been reported from the viewpoints of clinicians, academic faculty, clinical preceptors, employers and novice graduate physical therapists. Perspectives from physical and occupational therapy students could better prepare preceptors in the acute care setting. Approach Thematic analysis was conducted following the approach described by Braun and Clarke. The purpose of this study was to describe physical and occupational therapy student perceptions of readiness for full‐time acute care clinical education experiences. Twenty‐one physical and occupational therapy students in process of completing full‐time clinical education experiences at a large academic medical centre were qualitatively interviewed in small groups. A two‐stage iterative process of thematic inquiry was used to induce themes about student readiness for full‐time acute care clinical experiences. Transcription, coding and thematic analysis were completed. Students also completed a one‐time questionnaire with demographic and learner characteristic scales. Findings Participants were on average 26.4 years old, predominantly female and White, and had completed one full‐time clinical education experience prior to participation. Four major thematic categories of student readiness for acute care clinical experiences emerged: (1) mindset and willingness; (2) knowledge and experience; (3) communication and collaboration; and (4) planning and prioritising. Implications Students report their readiness is facilitated by preceptors who can model flexibility, foster communication that promotes clinical reasoning, implement an orientation to the acute care culture and learning resources and scaffold roles and responsibilities to aid professional authority.
Identifying Fall Risk of Patients Receiving Hematopoietic Cell Transplant
Background and Purpose/Objective: Few studies have examined the efficacy of fall risk assessment tools for patients undergoing hematopoietic cell transplant (HCT). The purpose of this study was to determine whether the Hendrich II Fall Risk Model (HFRM II) can distinguish patients who fell from those who did not fall in the inpatient HCT population. Methods: Observational study. Design: Retrospective chart review. Setting: Academic medical center. Patients: Patients undergoing HCT who fell during the first 100 days posttransplant. Intervention: None. Measurements: Independent-sample t tests were performed to determine differences in HFRM II score, age, pulse, systolic and diastolic blood pressure, platelet count, hemoglobin concentration, and hematocrit for fallers compared with nonfallers. Chi-square tests of independence determined differences regarding sex, assistive device used on the day of fall, transplant type, and physical therapy. Logistic regression analysis detected odds of falling dependent on transplant type, pulse rate, and HFRM II score. Results: Forty-seven patients who fell within 100 days after HCT were control matched by transplant date with 2 nonfallers each. Significant differences included HFRM II mean score (5.36 for fallers vs 3.41 for nonfallers; t = 4.510, P < .001) and mean pulse rates (100.09 vs 88.70 bpm; t = 3.398, P = .001). Patients with allogeneic HCT were 3.46 times more likely to have fallen than those with autologous HCT (P = .007). Limitations: Potential selection bias of retrospective review. Conclusions: HCT patients with higher HFRM II scores, greater pulse rate, or allogeneic transplant were more likely to fall.