Influence that Service in a Pro Bono Clinic has on a First Full-Time Physical Therapy Clinical Education Experience

Purpose: Physical therapist education programs strive to prepare their students for full-time clinical experiences in a variety of ways. Experiential and service learning in authentic contexts reportedly help students make connections between the classroom and the clinic. The purpose of this study was to explore the influences that service in a physical therapy pro bono clinic has on a first full-time clinical education experience. Methods: Participants were all third year doctoral physical therapy students at Widener University who were entering their first full-time clinical education experience. Sixteen participants kept journals throughout their first full-time clinical experience regarding the impact of their previous pro bono experience. Upon completion of the 10-week full-time clinical experience, the sixteen participants answered a Likert-scale survey to further delineate the influence of the pro bono experience, and fifteen of the participants participated in focus group discussions to further explore themes that emerged from the journal and survey data. Data from the focus group and journals were analyzed qualitatively. The responses from the surveys provided quantitative data. In addition, the researchers looked at the Clinical Instructors (CI) midterm comments on the APTA’s Clinical Performance Instrument (APTA PT CPI WEB) to further corroborate or disconfirm the findings. Results: Triangulation of the data points revealed 9 categories of positive impact that the pro bono experience had on their first full-time clinical experience. The strongest three categories in order were client interaction, clinical instructor interaction, and professional communication. The next five categories were of relative equal strength and related to specifics areas of competency. They were competency in documentation, evaluation, intervention, clinical reasoning and cultural competency. A final overarching category was increased confidence. CI comments on the midterm CPI corroborated these findings. Participants also shared ways in which the pro bono experience could have better prepared them for their full-time clinical experience. Conclusions: Regular participation in a pro bono clinic throughout the didactic portion of the physical therapy curriculum contributed to student confidence and competence in their first full-time clinical experience. Future research should include interviews with the clinical instructors to further corroborate the student perceptions. The findings of this study also serve to inform how the pro bono clinical experience can be enhanced to further contribute positively to the students’ first full-time clinical experiences

Investigating the Influence that Service in a Pro Bono Clinic has on a First Full-Time Clinical Education Experience from the Perspective of Students and their Clinical Instructors

Purpose: Academic physical therapy programs strive to foster student readiness for full-time clinical education experiences in a variety of ways. This research looks at one program who has students participate in a student-run pro bono clinic for at least 60 hours prior to the first full-time clinic experience. The purpose of the study is to explore the influence that participation in this pro bono clinic has on a first full-time clinical education experience from the perspective of both the student and the clinical instructor (CI). Methods: Qualitative methodology was employed to gain the perspectives of 29 students and their respective CIs. Data collection included student journals and focus groups, and CI Likert-scale rankings and open-ended questions upon midterm calls. Data points were triangulated through iterative data analysis. Results: CIs rated students high in the eight categories that were triangulated to student data. The themes that were strongest among both students and Cis included comfort with client interaction, interaction with CIs, and cultural competency. Additional themes included documentation, interprofessional interaction, examination, clinical reasoning and intervention. An overarching theme was that students were well-prepared and functioning at high levels of competency for a first full-time clinical experience. Conclusions: Participation in a student-run pro bono clinic helps to facilitate student readiness for a first full-time clinical education experience according to both student perceptions and CI ratings

Gut bacteria require neutrophils to promote mammary tumorigenesis

Recent studies suggest that gastrointestinal tract microbiota modulate cancer development in distant non-intestinal tissues. Here we tested mechanistic hypotheses using a targeted pathogenic gut microbial infection animal model with a predilection to breast cancer. FVB-Tg(C3-1-TAg)cJeg/JegJ female mice were infected by gastric gavage with Helicobacter hepaticus at three-months-of-age putting them at increased risk for mammary tumor development. Tumorigenesis was multifocal and characterized by extensive infiltrates of myeloperoxidase-positive neutrophils otherwise implicated in cancer progression in humans and animal models. To test whether neutrophils were important in etiopathogenesis in this bacteria-triggered model system, we next systemically depleted mice of neutrophils using thrice weekly intraperitoneal injections with anti-Ly-6G antibody. We found that antibody depletion entirely inhibited tumor development in this H. hepaticus-infected model. These data demonstrate that host neutrophil-associated immune responses to intestinal tract microbes significantly impact cancer progression in distal tissues such as mammary glands, and identify gut microbes as novel targets for extra-intestinal cancer therapy.National Institutes of Health (U.S.) (Grant U01 CA164337)National Institutes of Health (U.S.) (Grant T32 OD011141

Persistent infection of rhesus monkeys with ‘Helicobacter macacae’ and its isolation from an animal with intestinal adenocarcinoma

A novel helicobacter, ‘Helicobacter macacae’, was previously isolated from a colony of rhesus and cynomolgus monkeys in which diarrhoea from chronic idiopathic colitis was enzootic. A survey performed in a second colony of rhesus monkeys without a history of chronic diarrhoea determined that 57 % were faecal-culture positive for Helicobacter species. Ten years after the survey, one of the animals from which ‘H. macacae’ had been isolated, a 23-year-old, intact male rhesus monkey (Macaca mulatta), presented with partial inappetence and progressive weight loss. Subsequent evaluation of the monkey revealed anaemia, hypoproteinaemia, hypoalbuminaemia and a palpable abdominal mass. Contrast radiography suggested partial intestinal obstruction. The animal was euthanized and a diagnosis was made of intestinal adenocarcinoma of the ileocaecocolic junction with metastasis to regional lymph nodes and liver. Microaerobic culture of caecal tissue yielded a helicobacter organism identified as ‘H. macacae’ by 16S rRNA gene sequencing – the same species of bacteria isolated 10 years previously. The liver, small intestine and colon were also positive by PCR for Helicobacter species. Intestinal adenocarcinoma is the most common malignancy of aged macaques. Faeces or caecal tissue from five out of five monkeys that remained from the original cohort and that were colonized with ‘H. macacae’ in the initial survey were positive for the organism. The apparent persistence of ‘H. macacae’ in these animals, the isolation of the bacterium from animals with colitis and the recognition of the importance of inflammation in carcinogenesis raise the possibility of an aetiological role in the genesis of intestinal adenocarcinoma in aged rhesus monkeys

Civic-Mindedness and Core Values Ratings across Three Cohorts of DPT Students: Impact of Covid19

Purpose: The American Physical Therapy Association (APTA) defines expected professional behaviors beyond legal and ethical expectations in the Core Values document. Civic mindedness may be related to core values. Civic-minded professionals have strong ethics and work cooperatively to promote the general welfare of others. Doctor of Physical Therapy (DPT) education programs use a variety of methods to develop professional behaviors, Core Values, and civic mindedness in students, including experiential service-learning. The purpose of this study was to describe the trajectory of civic mindedness and core values over the course of a three-year DPT program in three cohorts of graduate students. Methods: Three cohorts of DPT students were surveyed using two established tools at the beginning and completion of the didactic portion of the curriculum. The Civic-minded Professional Scale (CMP) provides an overall score as well as 5-subscale scores measuring constructs of consensus building, voluntary action, identity and calling, and being a social trustee; higher scores indicating greater levels of civic-mindedness. The APTA Professionalism in Physical Therapy: Core Values self-assessment (PPTCV) measures accountability, altruism, compassion/caring, excellence, integrity, professional duty, and social responsibility. Results: The classes of 2021 and 2022 had scores increase or remain stable across the CMP and PPTCV but the class of 2023 total and subscale scores either significantly decreased or remained stable from pre-test to post-test. Conclusions: The shift to indirect and electronic service-learning during the pandemic may have negatively impacted the development of civic mindedness and physical therapist core values in the class of 2023. These deficits could impact graduates in early clinical practice in both professional behaviors and civic-mindedness