A Hybrid Model of Student-Centered Instruction Improves Physical Therapist Student Performance in Cardiopulmonary Practice Patterns by Enhancing Performance in Higher Cognitive Domains

Background and Purpose. Studentcentered instruction is prevalent in professional (entry-level) physical therapist education programs. Previous studies in health care professions have suggested student performance may be enhanced with a student-centered approach when compared to traditional lecture-based instruction. The purpose of this study was to compare overall student test performance, test question performance in different cognitive domains, and preference to mode of instruction between a hybrid model of student-centered and traditional lecture-based instruction. Subjects. A total of 65 students in their third semester of a Doctor of Physical Therapy (DPT) degree program and who were enrolled in a 3-credit cardiopulmonary practice patterns course participated in this study. Model Description. Subjects attended 6 classes during the first module of the cardiopulmonary practice patterns course. Three classes were taught using traditional lecture-based instruction and 3 via a hybrid model of student-centered instruction consisting of electronic lectures and small-group, problem-solving activities. After completion of the 6 classes, students were given a written test consisting of multiple choice and short answer questions within the knowledge, comprehension, analysis, and evaluation cognitive domains, and a survey regarding preferred mode of instruction. Outcomes. Student performance was 10.4% (95% confidence interval [CI], 6.5%-14.3%) higher on test questions relating to the content taught via hybrid student-centered instruction compared to traditional lecture-based instruction (P < 0.001). More detailed analysis demonstrated that hybrid student-centered instruction improved test performance over traditional lecture-based instruction on questions within the higher cognitive domains of comprehension, analysis, and evaluation, but not on questions assessing knowledge (all P < 0.05). There were no differences in student preference for mode of instruction, with 43.1%, 24.6%, and 32.3% preferring traditional lecture-based instruction, hybrid student-centered instruction, and having no preference, respectively (P = 0.19). Discussion and Conclusion. The results of the study suggest that the hybrid model of student-centered instruction improves the professional physical therapist student's test performance in a cardiopulmonary practice patterns course over traditional lecture-based instruction. In particular, the hybrid student-centered approach improved performance on higherorder level of questions, which fits with professional practice expectations. Students showed no preference for mode of instruction, confirming that learning style is very individual.