Development of an Expert Clinical Instructor: A Theoretical Model for Clinical Teaching in Physical Therapy

Introduction. The characteristics of effective and of exemplary clinical instructors (CIs) have been described in physical therapy clinical education literature. However, little is known about how CIs acquire expert skills as clinical teachers or how expert CIs interact with students. The primary purpose at the start of this investigation was to answer the question: “How do physical therapist CIs attain expertise as clinical teachers?” To do so, first “expert CI” had to be defined. Next, a subset of 3 participants were interviewed and data were analyzed as a pilot study. Then, in this phase, 6 additional participants were interviewed to confirm, refute, and expand on the initial findings. A secondary phenomenon, the expert CIs' approach to teaching students, was identified and examined. Methods. A qualitative study using thematic analysis was developed to investigate CI expertise. Three investigators conducted semi-structured interviews with a purposive sample of 9 participants. Based on literature, the investigators defined the phrase “expert CI” and developed an interview guide. Constant comparative technique refined the interview guide, codes, and emerging concepts. Theoretical models depicting our findings were developed and member checked. Results. The participants acquired expert CI teaching skills by applying a reflective process of identifying needs and integrating relevant teaching strategies from the themes of professional development, teaching and learning, and relationships. Furthermore, the expert CIs applied a problem-solving approach to the episode of teaching; analyzing and facilitating teacher and learner needs in 6 areas: examination, evaluation, diagnosis, prognosis, intervention, and outcome. Discussion and Conclusion. The CI Expertise in Action Model presented is an interpretation of the data that reveals a complex and multifaceted approach to clinical instruction that may be used to facilitate clinical teaching skills.