Influence of the Hidden Curriculum on Physical Therapy Students’ Perceptions of Interprofessional Collaborative Practice During a Terminal Clinical Experience

The influence of the hidden curriculum within healthcare education impacts students’ perception of Interprofessional Collaborative Practice (IPCP). However, information regarding IPCP within physical therapy requires further investigation, particularly during clinical experiences. IPCP improves healthcare quality, patient experience, and medical error rates. Therefore, the aim of this study is to identify the influence of the hidden curriculum on entry-level Doctor of Physical Therapy (DPT) students’ perception of IPCP and progression toward the IPEC Core Competencies during their terminal clinical experience.

Students completed a 12-week terminal clinical experience (CE) in either an inpatient or outpatient setting. Outcomes included student completion of the Interprofessional Socialization and Valuing Scale-9 (ISVS-9) pre- and post-CE, the Interprofessional Collaborative Competency Attainment Survey (ICCAS) as a retrospective pre-/post-, and the clinical instructor (CI) assessment of students’ performance using the Clinical Performance Instrument (CPI) in 18 areas, including communication and plan of care, which includes IPCP components.

Twenty-two DPT students completed the CE, seven students in an inpatient and 15 in an outpatient setting. Using a paired t-test, we compared ISVS-9 and ICCAS scores and found a significant difference in ISVS-9 scores from pre- (M=2.28 , SE=0.133) to post-CE (M=1.65, SE=0.126; t(6.67)=0.631, p < 0.0001), total ICCAS scores from pre- (M=6.11 , SE=0.135) to post-CE (M=6.74, SE=0.086; t(-6.26)=-0.625, p < 0.0001), and in each of the six sub-categories of the ICCAS between pre- and post-CE (p < 0.001). Post hoc analyses between inpatient and outpatient groups were found, and correlations between CI’s rating of student clinical performance and students’ self-rated interprofessional (IP) socialization, valuation, and competencies are pending.

Students’ self-identified a decline in their ability to adopt a dual professional and IP identity, in which they value roles of others and function as collaborative team members. However, their self-reported behaviors associated with patient-centered, team-based, and collaborative care improved. Results suggest mixed influence of the hidden curriculum, with declines in IS and improvements in IP competencies.

Further efforts are necessary to provide IP learning to students and established healthcare providers to improve practice within intra- and interprofessional cultures, and minimize the negative impact of the hidden curriculum.