OUTCOMES OF A PHYSICAL ACTIVITY SERVICE LEARNING PROGRAM INVOLVING PHYSICAL THERAPIST ASSISTANT

STUDENTS AND OLDER ADULTS IN A TECHNICAL COLLEGE SETTING

By: Julie Siefert PT, MHSNortheast Wisconsin Technical CollegePhysical Therapist Assistant Program

OBJECTIVESService Learning

OverviewHealth and Wellness

TrendsLiterature GapsPurposeKeep Stepping ProgramMethodology ResultsFindingsConcluding Remarks

SERVICE LEARNING

Participation of students

Activities address human and community needs

Involved community partner

Reflection and Reciprocity key components

Experiential education

Designed to promote student learning and development

Symbiotic relationship between the service and the learning

Jacoby (1996)

COLLABORATIONCommunity needs often

exist in the area of health and wellness

Academic institutions have available resources as well as a desire to serve and enhance their community

Coordinated partnership to address specific needs

REFLECTION REQUIRED….

Bringle (2003)

RECIPROCITY:

ALL Participants are teachers and learners!!!

8

PROFESSIONAL PRACTICE EXPECTATIONS

Respectful Communication

ResponsibleActions

EthicalPractice

LegalPractice

SafePractice

Reynolds (2006)

SERVICE LEARNING IN PHYSICAL THERAPY EDUCATION

50% US Physical therapist education programs Village (2004)

30% US Physical therapist assistant education programs

85% of programs considered a program requirementEffective qualities: Village (2006)

Institutional commitment Collaboration Meaningful service Reflection

Program of study: Service provided:

Pharmacy Sauer (2006)

Nursing Reising (2006)

Exercise Science Williams (2001)

OT Haber (1997)

PT Romani, Brown (2007)

Medication reviewsBlood pressure checksBalance and mobility

training

Group exercises

Health education presentations and screens

HEALTH & WELLNESS SERVICE LEARNING

SERVICE LEARNING COMMON THREADS

Improved student learningBaccalaureate or graduate level studentsTravel to provide the serviceEvaluation of the service learning is often

collected from the students and community partners

TREND TOWARD A GRAYING AMERICA

Fastest growing age group

Experience physiological changes

Chronic conditions prevalent

Lifestyle behaviors Smoking Poor diet Obesity Physical inactivity

TREND TOWARD PHYSICAL INACTIVITY

Surgeon General ReportHealthy People 2010 ObjectivesHealth People 2020 ObjectiveAmerican College of Sport Medicine (ASCM) and

American Heart Association (AHA)Guidelines for Older Adults Nelson (2007) Aerobic Muscular strength and endurance Flexibility Balance

COMMUNITY PHYSICAL ACTIVITY PROGRAM TRENDS

Offered at different facilities

Successful at bringing in older adults

Standardized classesBalance accessibility

with affordabilityChallenge to find

qualified instructors

78% INCREASE IN PHYSICAL ACTIVITY PROGRAMS OFFERED

TO OLDER ADULTS TO MEET THE POPULATION DEMAND!!!

H U G H E S ( 2 0 0 5 )

A COMMUNITY NEED

IS IT POSSIBLE TO MEET THE NEED WITH SERVICE LEARNING??

GAPS IN THE LITERAURE

1. Service provided by students enrolled in two-year degree programs

2. Service provided within the walls of the academic institution

3. Service inclusive of individualized physical activity programming

4. Participant perspective of the service experience

PURPOSES1. Describe the Keep

Stepping Program2. Students’ perceptions of

service learning, community involvement, and future professional application

3. Participants’ perceptions of the program as an educational activity and source of personal benefit

KEEP STEPPING PROGRAM

KEEP STEPPING PROGRAM

Partnership Northeast Wisconsin Technical College (NWTC) Aging and Disability Resource Center of Brown County (ADRC)

Need Balance Strengthening Walking

Grant Opportunity Wisconsin ADRC Prevention Grant

Continue Living Well With Chronic Conditions Continue Stepping On Create Keep Stepping

KEEP STEPPING PROGRAM

Meets for 1 hour, twice a week, for 8 weeksHosted on campus in the PTA labOlder adult is paired with a PTA studentEntails:

Pre- and post-program Senior Fitness Test Group exercise

Warm up and cool down Flexibility, strength, balance, and aerobic

Individual exercise Education

KEEP STEPPING PROGRAM

Educational components Commission on Accreditation in Physical Therapy

Education (CAPTE) Physical therapy practice roles College core abilities Program outcomes Program course competencies and learning objectives

PTA Therapeutic Exercise PTA Kinesiology 2 PTA Management of Cardiopulmonary & Integumentary

Conditions

STUDENT RESPONSIBILITIES

Develop and organize Senior Fitness Test

data collection Partner with older

adultExercise instruction &

modificationEducationLeadershipDocumentationDiscussion forums

EXPECTED STUDENT OUTCOMES

Greater appreciation for the healthy older adult

Enhanced clinical skills Data collection Exercise instruction and

progression Documentation Communication

METHODOLOGY

Five-point ordinal (Likert) survey Brosky, Gelson (2006) Student Survey Items

Service Learning Community Involvement Future Professional Application

Community Participant Survey Items Program Evaluation Perceived Personal Benefit

Student reflection papersParticipant comments

STUDENT SURVEY RESULTS: SERVICE LEARNING (N=29)

Real life le

arnin

g

Add serv

ice acti

vities

Better u

ndersta

nding

Enhanced le

arnin

g*

Challengin

g task

s0

10

20

30

40

50

60% Strongly Agree

% Agree

% Neutral

% Disagree

% Strongly Disagree

Percent indicates combined positive responses*Scoring reversed for survey question presented negatively

93%

90%

76%

61% 75%

STUDENT SURVEY RESULTS: COMMUNITY INVOLVEMENT (N=29)

Understand Community

Needs

Solve Society's Problems

Responsibility to Serve

Community

> Community Involvement

Role as Citizen Beneficial to Community*

0

10

20

30

40

50

60

70% Strongly Agree

% Agree

% Neutral

% Disagree

% Strongly Disagree

• Percent indicates combined positive responses

• *Scoring reversed for survey question presented negatively

93%

83%

88%

82%

86%100%

STUDENT SURVEY RESULTS: FUTURE APPLICATION (N=29)

Future

Service

*

Daily lif

e applicatio

n

> Aware

ness of b

ias

Enroll a

gain

Encoura

ge others

0

10

20

30

40

50

60

% Strongly Agree

% Agree

% Neutral

% Disagree

% Strongly Disagree

• Percent indicates combined positive responses

• *Scoring reversed for survey question presented negatively

86% 93%

48%57%

79%

STUDENT INVOLVEMENT

COMMON THEMES FROM STUDENT REFLECTIONS

Impression of Participants

Self-Reflection

Program Assignments & Assessment

Student Journals

STUDENTS’ IMPRESSIONS OF PARTICIPANTS

Clients seemed to have fun

Possible to be

functional but not healthy

Thrilled with the progress

made

Gave his “all”

everydayAppreciative of our help not certain they realize how grateful we are of

them

STUDENT PERCEPTIONS OF PTA RESPONSIBILTIES

Focused on posture, balance,

and flexibility

Apply kinesiology and ther ex to real

people

Confident in writing daily patient notes

Improved “bedside”

skills

Frustration with client absences and

exercise compliance

Helped identify gait patterns

and deviations

STUDENT SELF REFLECTION

More comfortable around clients

Initially not confident but have had a major boost

Helped me to think in different ways to

meet needs

Surprised at how much I actually

knew

Exciting to see improvement

STUDENT SELF REFLECTION

I felt very inadequate to be guiding someone else, however, by feeling inadequate, I think it pushed me harder to think and utilize all the information I had already acquired.

ASSIGNMENTS ASSESSMENT

Better than a class lectureFelt like a lot of work, but

I am looking forward to next year

Better instructions needed

Faculty provided students opportunity to lead

Best experience to dateOpportunity to work

with people other than our classmates

Lifeline for the older adults

Grateful for the opportunity

Had fun!

STUDENT ASSESSMENT OF PROGRAM

PARTICIPANT SURVEY RESULTS: PROGRAM EVALUATION (N=22)

Educatio

nal task

s

Students

benefitte

d

Student a

ttitu

des

Effecti

ve com

munica

tion

Progra

m co

ntinuatio

n 0

20

40

60

80

100

% Strongly Agree

% Agreee

% Neutral

% Disagree

% Strongly Disagree

• Percent indicates combined positive responses

100% 100%100%100%

90%

PARTICIPANT SURVEY RESULTS: PERSONAL BENEFIT (N=22)

Student a

n asset

Educatio

nal enviro

nment

Needs met

Positive im

pact

1:1 tim

e appropria

te0

20

40

60

80

100

% Strongly Agree

% Agree

% Neutral

% Disagree

% Strongly Disagree

100% 100% 100% 100%100%

• Percent indicates combined positive responses

PARTICIPANT INVOLVEMENT

PARTICIPANT EVALUATION OF PROGRAM

Great class, not only for school but for the

communityVery educational & helpful

Comfortable in the environment

Definitely enroll again

Enjoyed the students

Best class attended

PARTICIPANT’S PERCEIVED BENEFIT

Feel improved

Modified to meet my needs

Identified my weaknesses

More aware of posture

Loved having a student work with me

PROGRAM FINDINGSBenefit to communityWell worth the workContinue Value real-life learning Application Challenging & meaningful

tasks Learn more in the

classroom versus community?

Uncertain if students gained a greater awareness of personal biases

Organization requiredWorkload complaintsUncertain if enroll in

additional service learning courses

PTA STUDENTS LITERATURE FINDINGS

Skill application & development

Improve documentation Increase confidenceBetter critical thinking skillsNot enough knowledge to

participateMore organization with

assignmentsMore time and workload

required

Made a differenceGain skillGain confidenceDevelop professionallyPerform in a real life

settingFeel unpreparedNeed additional time to

commit to the experience

STUDENT PERCEPTIONS OF SERVICE LEARNING

FINDINGS

Service Learning in a PTA Program Student perceptions consistent with baccalaureate and

graduate students >75% reported enhanced learning >90% reported an understanding of community needs

Academic Institution as the Location Additional steps taken by the College to encourage

participation Benefits of “on campus” experience Older adults reported the environment as “comfortable” and

“positive”

FINDINGS

Individualized Programming 100% reported students were an asset to their participation 100% reported sufficient 1:1 time Loved having a student work with me Appreciated the modifications made to meet limitations

Participant Experience Similar to community partners perceptions Overwhelming support for the program >90% positive survey responses 100% support for program continuation

FUTURE STUDIES

Objective performance of participant fitness levels pre- and post-program

Assess student feedback following full integration of Keep Stepping Program into the PTA curriculum

Continued assessment of service learning at the associate degree level

Additional service learning participant feedbackPhysical activity service learning model implemented

at other academic institutions with different health-related programs

CONCLUSIONS

Vital component of the PTA Program

Valued by the PTA students

Valued by the older adults

Vital to receive participant input for evaluation

ACKNOWLEDGEMENTS

Dr. Julie GahimerDr. Elizabeth DomholdtDr. Martha HinmanADRC of Brown County NWTCPTA Program FacultyPTA Class 2010Spring 2009 Keep

Stepping ParticipantsWI ADRC Prevention

Grant