Date of Award
9-1-1989
Document Type
Dissertation - NSU Access Only
Degree Name
Doctor of Education
Department
Center for the Advancement of Education
Abstract
The costs associated with clinical education in physical therapy and other health professions have been debated by educational and hospital administrators in recent years. The assumption has been that these programs incur a cost to the clinical facility. To date, the physical therapy literature has been limited in cost-benefit studies with no definitive conclusions. This study examined the costs of Clinical education in a selective entry-level master's degree program in physical therapy to determine what monetary costs and benefits accrue to clinical affiliation sites and what factors are related to the monetary costs or benefits of clinical education. Study participants included ninety-one first and second year master's degree students and their respective clinical instructors who participated in three progressive levels of clinical education during the academic year 1988-89. Data were obtained from weekly time logs kept by student-instructor pairs for three full-time clinical education experiences. Costs and benefits were calculated varying the amount of time invested by students and instructors in patient care and other affiliation related activities, combined with the salaries paid to the instructors and beginning therapists. The costs and benefits were subtracted to generate a net value that characterized the overall gain or loss that resulted in each week examined in the study. This net value was influenced by the level of the clinical education experience, the relative time within a given clinical rotation, the grade point average of the student, and the type of clinical site to which a strident was assigned. The net value was independent of the student's age and the size of the clinical facility. Clinical Education I yielded an average weekly cost of $54, Clinical Education Il and III yielded average weekly benefits of $85 and $105, respectively (P < .001). Regardless of the level of the affiliation, students incurred a cost to the clinical facility during the first two weeks of a rotation, with the average being a cost of $81 per week. This was offset by the second two weeks of the rotation which yielded an average benefit of $80 per week. In weeks five and six the net value increased to an average of $158 per week and weeks seven and eight yielded an average benefit of $199 per week (p <.001). The net value correlated inversely with the preparedness of the students as reflected by grade point averages (p =.001). This finding might have been artificially induced by differences in the salaries paid to the therapists in respective facilities which caused the higher grade point students to be valued at salaries less than the lower grade point students for the work they contributed. The type of facility to which students were assigned also effected the net value (p <.001). The greatest benefits were found in the rehabilitation centers ($128/week) and in a small miscellaneous group comprised of a military hospital, a hand center, and three mixed rotations of more than one specialty service ($207/week). The average benefit was intermediate for the orthopedic and sports medicine facilities ($57/week) and lowest for the acute care and pediatric sites ($17/week). Combining the net value from all weeks examined in the study resulted in an overall average net benefit of $65 per week to the clinical facilities that participated in the clinical education program. Thus, clinical sites benefited from participating in the clinical education of entry-level master's degree physical therapy students, a benefit that steadily increased with the level of the clinical affiliation experience and through time within each affiliation. This study contributed toward understanding the costs and benefits associated with a clinical education program and as such has implications for effecting change. In order to maximize the benefits of the clinical education experience, and lessen its associated costs, recommendations have been made to foster more cooperative planning between the academic program and its clinical affiliates.