Global Health Perspectives in Physical Therapy Education: A Qualitative Report on a Service Learning Experience in Guatemala

Authors: Winter F Wildt-Bailey, SPT; Adriana Sandoval, SPT; Holly J Roberts, PT, DPT, GCS, NCS Global Health Perspectives in Physical Therapy Education: A Qualitative Report on a Service Learning Experience in Guatemala Purpose: Doctor of physical therapy (DPT) students at the University of Puget Sound traveled to Zacapa, Guatemala to deliver physical therapy services for 5 days as part of an elective course introducing students to physical therapy and health care delivery from a global health perspective. Participants journaled about their experiences, responding to prompts provided by the course professor/clinical instructor. The purpose of this research was to explore the impact of the experience by identifying common themes among the journal entries. Methods: Ten student physical therapists (SPT), 9 females, 1 male, mean age 29yrs (range 25-40) at the end of their second year of a three-year DPT program consented to allow their journals to be included in this report. Two SPTs noted recurring themes that emerged in the de-identified journal entries. Results: Five common themes emerged among the journal entries: 1) Cultural Bias: recognizing cultural biases, the impact they have on patient care, and identifying strategies for addressing them; 2) Healthcare Disparities: recognizing disparities in access to healthcare, patient education, and resources between the U.S. and Guatemala; 3) Confidence and Competency: overcoming feelings of inadequacy as novice clinicians and appreciating the extent of knowledge and skill gained through didactic coursework; 4) Identity: reaffirming one\u27s decision to pursue a physical therapy career and that it aligns with one\u27s values and identity; and 5) Skills Development: adapting to working with limited resources, and developing effective communication skills with a language barrier. Conclusions: Reflection is a central tenet of service learning. The personal reflections of DPT students participating in a short-term service learning trip to Guatemala as part of an elective course in global health perspectives revealed the experience allowed students to recognize and address cultural biases, recognize healthcare disparities, build professional confidence and competence, reaffirm professional goals, and develop important skills in communication and healthcare delivery. Clinical Relevance: The results of this qualitative report are consistent with literature examining the benefits of experiential learning in healthcare education. They demonstrate the potential for an international service learning experience to facilitate development of cultural competence, clinical reasoning skills, communication skills, and confidence in one\u27s knowledge and abilities. Keywords: global health, service learning, experiential learning References: Benson JD, Provident I, Szucs KA. An experiential learning lab embedded in a didactic course: outcomes from a pediatric intervention course. Occ Ther Health Care. 2013; 27:46-57. Knecht-Sabres LJ. Experiential learning in occupational therapy: can it enhance readiness for clinical practice? J Exp Educ. 2013; 36:22-36. Paterson C, Chapman J. Enhancing skills of critical reflection to evidence learning in professional practice. Phys Ther Sport. 2013; 14:133-138. Seif G, Coker-Bolt P, Kraft S, Gonsalves W, Simpson K, Johnson E. The development of clinical reasoning and interprofessional behaviors: service-learning at a student-run free clinic. J Interprof Care. 2014; 28(6):559-564. Smith S, Crocker A. Experiential learning in physical therapy education. Adv Med Educ Pract. 2017; 8:427-433. Village D, Clouten N, Millar AL, Geigle A, et al. Comparison of the use of service learning, volunteer, and pro bono activities in physical therapy curricula. J Phys Ther Educ St Louis. 2004;18(1):22-28