Knowledge Bank

Background: Pediatric content has been an accreditation standard for professional physical therapy (PT) programs since the early 1970s. Entry-level PTs are trained to treat patients across the lifespan. Essential competencies, curriculum components (didactic, lab, and experiential), and recommended hours are established to promote consistency across pediatric PT education. Despite guidelines for consistency, wide variability in curriculum components and hours exists. Few options exist for measuring outcomes to inform pediatric curricular enhancement.

One possible measure is self-efficacy (SE). Perceived SE is individual belief in the ability to be successful in a behavior. SE is domain-specific, so efficacy beliefs in one area of clinical practice (e.g., orthopedics) is not related to efficacy beliefs in another area of clinical practice (e.g., pediatrics). Based on the idea that efficacy beliefs of students have the potential to enhance learning outcomes, researchers developed a measure of SE related to pediatric experiential learning opportunities. The Pediatric Communication and Handling Self-Efficacy Scale (PCHSES) is a domain-specific, self-report tool. Items relate to confidence in communication and direct handling of children and caregivers. There is evidence that gains in SE result after as few as 8 hours of community-based pediatric experiential learning. Given that SE is domain-specific, variability in PCHSES scores may be related to previous associated experiences.

The purpose of this study is to (1) quantify relationships between prior pediatric experience and pediatric-specific SE among DPT students, and (2) measure growth in SE after completing pediatric PT curriculum requirements, including an integrated pediatric clinical experience.

Methods: 48 students starting the second year of an accredited DPT program completed the PCHSES and a questionnaire about prior pediatric experiences. Average scores for communication skills, handling skills and overall SE were calculated from PCHSES responses. "Experience" included time spent with children ages 0-11 years, parents, and pediatric patients. Spearman rho was calculated for prior pediatric experience and average baseline PCHSES scores. A Kruskal-Wallis Test was used to compare prior experience with children to (1) level of interest in pediatrics, and (2) intent to specialize in pediatrics. Paired sample t-tests used to compare baseline and follow-up PCHSES scores.

Results: There is a statistically significant correlation between prior experience with children and average baseline SE (Spearman rho = 0.603, p<0.0001), average baseline communication SE (Spearman rho = 0.652, p<0.0001), and average baseline handling SE (Spearman rho = 0.357, p<0.05). A statistically significant relationship exists between prior pediatric experience and commitment to pediatric specialization within the DPT program. A significant difference in level of prior pediatric experience exists for students who have no or uncertain interest in pediatric practice compared with students who are considering or are sure of an interest in pediatric practice. When comparing baseline SE scores to score following the completion of the pediatrics curriculum, there was a statistically significant increase in overall SE (mean difference = 2.03), communication SE (mean difference = 2.02), and handling SE (mean difference = 2.10) from baseline to follow-up (p<0.0001, see Figure 3).

Conclusion: SE is related to domain-specific experience. The PCHSES appears to capture SE related to prior pediatric-domain experience. Pediatric PT curriculum could focus on domain-specific, experiential learning opportunities to promote confidence in entry-level communication and handling skills with a pediatric population. These findings highlight that domain-specific experience appears to relate to learner confidence in that domain. This concept could be applied broadly across PT education.