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Abstract

Purpose: The physical therapy literature has explored the cost and affordability of a Doctor of Physical Therapy (DPT) education; however, academic and clinical educators may lack a nuanced understanding of the costs students incur to complete their full-time Clinical Education (CE) experiences. This study explored expenses beyond course credits during a full-time CE experience. As this was the first exploratory study on this topic, the aim was to gather information from a diverse sample of participants about the costs associated with a CE experience and the perceived financial burden. Method: A survey was developed and administered to collect quantitative and qualitative data on transportation, living expenses, and site requirements incurred by students during their CE experiences. The survey was distributed to Directors of Clinical Education at all accredited DPT programs, with a request to forward the invitation to students who have completed at least one full-time CE experience. Results: The majority of respondents (77.0%, n=396) agreed that they experienced increased financial debt stress related to CE costs, with 47.2% (n=187) strongly agree and 29.8% (n=118) somewhat agree. Participants requiring additional housing (35.1%, n = 139) reported significantly higher financial stress than those who did not (U = 23,625.5, p < .001). Costs to travel to the site (n=377) averaged $450.85 (SD = $923.58) and daily total commute expenses (n=386) averaged $437.43 (SD = $519.45). Site-specific requirements (n=370) and attire (n=384) averaged $217.00 (SD = $483.50) and $113.56 (SD = $117.36), respectively, with costs significantly higher in acute care (p ≤ .01). Three qualitative themes emerged: anticipated and hidden costs of CE created financial stress, participants would not make different decisions about their CE placements; and a plea for financial help and systemic change. Conclusions: The financial burden associated with full-time CE experiences is a reality for DPT students. DCEs should share cost information early in the placement process to plan for expenses. Academic and clinical partners who recognize the stress and debt burden of CE experiences may be more effective at minimizing associated costs and developing resources to defray them and support students.

Author Bio(s)

Michelle L. Donahue, PT, DPT, EdD, PCS, is a Clinical Professor, Undergraduate Program Director of Physical Therapy, and Director of Clinical Education of Physical Therapy in the College of Interprofessional Health and Human Services at Nazareth University in Rochester, NY. 

Acknowledgements

The author thanks the student researchers for their contributions to survey development, data collection, and preliminary data analysis as part of a faculty-mentored research project. The author also thanks the Directors of Clinical Education who assisted with survey distribution and the physical therapy students who participated in this study.

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