A Shared Vision for Clinical Education: The Year-Long Internship

Background and Purpose. There has been much concern and discussion about the lack of standardization in clinical education as an integral component of physical therapist entry-level education. Despite efforts by the American Physical Therapy Association (APTA) to promote greater standardization in clinical education across programs, there continues to be great variability in the delivery of clinical education. Currently, there is not sufficient evidence demonstrating that 1 model is better or more effective than another, nor is there consensus on a preferred model. Aside from lengthening the total time in clinical education, the infrastructure of clinical education has not changed significantly with the transition to the physical therapy clinical doctorate, the Doctor of Physical Therapy (DPT) degree, and integrated clinical education continues to be the dominant model of education in the United States. However, health care delivery and health care systems have changed, and this has led to additional challenges for clinical education sites and concerns around sustainability of the current models of clinical education that support DPT students. The purpose of this paper is to describe the need for, and the proposed benefits of, a clinical education model where the terminal or culminating clinical education experience is a year-long internship. We believe that this is the preferred model necessary to optimally prepare future physical therapists to enter the work force. This extended experience would push students to achieve performance expectations beyond entry level, and students would be supported in their initial transition to new professional. Other stakeholders, including the clinical facility, academic program, physical therapy profession, and health care profession at large will also benefit from the year-long internship. Ideally, the structure of the internship would consist of a pregraduation phase and a postgraduation phase, perhaps of varying lengths. To maximize the benefit for all stakeholders, a longer postgraduation phase and a postlicensure phase is recommended. We believe that the year-long internship should be the shared vision for all physical therapist education programs in developing our future physical therapist colleagues.