The Influence of Instructional Media on Achievement in Physical Therapy Teaching

The primary learning outcome for physical therapy programs is to prepare graduates who will be effective contemporary practitioners of physical therapy (Commission on Accreditation in Physical Therapy Education, 2014). It is still not clear what the best instructional strategies, instructional methods, and instructional materials are to achieve this goal of physical therapy education. As educational technology continues to evolve it may become harder for the instructor to sort through the available media to design the best learning experience for the student. As an instructor considers which instructional methods and materials to use to design a learning experience, it is important to consider the work of Richard E. Clark on educational technology and achievement, and to consider the current evidence related to education technology and physical therapy education.

In 1983, Clark wrote,

In a 1994 paper titled “Media Will Never Influence Learning,” Clark reiterated his argument, “Media and their attributes have important influences on the cost or speed of learning but only the use of adequate instructional methods will influence learning” (Clark, 1994, p. 27). Physical therapy educators must recognize Clark’s message that what influences learning is the instructional method underlying the instructional technology (Artino & Durning, 2012; Clark, 1983, 1994).

Clark defined an instructional method as any way to shape information that activates, supplants, or compensates for the cognitive processes necessary for achievement or motivation (Clark, 1994, p. 23). Fitzgerald defined an instructional method as the way information is taught that brings the learner into contact with what is to be learned (Fitzgerald, 2011). Examples of instructional methods are lecture, group discussion, one-to-one instruction, demonstration and return demonstration, gaming, simulation, role-playing, role modeling, and self-instruction modules (Fitzgerald, 2011). “Educational technology is the study and ethical practice of facilitating learning and improving performance by creating, using, and managing appropriate technology process and resources” (Januszewski & Molenda, 2008, p. 1).

As physical therapy instructors organize and present material to prepare graduates who will be effective contemporary practitioners of physical therapy, the instructor should consider the instructional methods and instructional media that will be used (Jensen, Mostrom, & Shepherd, 2013). Multiple investigations have been completed in the last 10 years looking at the use of media in physical therapy education.

Moore and Smith (2012) compared the effectiveness of video podcasting to live instructor demonstration in teaching of the basic psychomotor skills to a cohort of first year doctor of physical therapy students. Moore and Smith (2012) found no difference between video podcasts and live demonstration on the students’ exam scores and concluded that the results of their pilot study indicate that delivering information to students via podcasts was as effective as live demonstration for teaching transfer and gait training skills to a cohort of first-year doctor of physical therapy students.

Learning management systems are a type of media available to physical therapy educators for developing learning activities. Seif, Brown, and Annan-Coultas (2013) described the development of an interactive, online activity in a learning management system to promote the development of clinical reasoning in physical therapy students. The online learning activity was designed to lead the student through a series of clinical-reasoning activities related to a simulated patient with an orthopedic condition as preparation for a clinical practicum. The learning activity was completed by students independently outside of class time within the online learning management system. The Self-Assessment of Clinical Reflection and Reasoning (SACRR) was used to assess the student’s perception of his or her clinical reasoning before and after the semester during which the online learning activity took place. The SACRR scores for 17 of the 26 items demonstrated statistically significant change from pre-to postassessment. Survey responses from the students also demonstrated satisfaction with the online learning activity. Limitations of this study include the lack of a comparison group and the potential for confounding variables that influenced the results of the SACRR (Seif et al., 2013).

Sole, Schneiders, Hebert-Losier, and Perry (2013) described the development and use of a DVD resource for learning manual skills that was provided to second year physical therapy students. The DVD, containing audio-video clips of standardized manual physical therapy techniques, was used during the second half of a 13-week semester. The authors used a questionnaire, student focus group interview, and faculty focus group interview to learn about their perceptions of the DVD resource. Students responded favorably to the DVD on the questionnaire and focus group. Despite the students’ favorable response, faculty responded that they did not observe improvements in practical skills during clinical placements (Sole et al., 2013).

Greenberger and Dispensa (2015) reported survey results on physical therapist students’ usage and perceived value of using video podcasts to learn and teach orthopedic special tests. They found that 99% of students accessed the video clips, with 79% using them extensively. The majority of the students watched the video clips on their computer but there was a trend towards watching them on a mobile device. Student used the video clips to prepare for labs and practical exams.

This is not an exhaustive review of the literature on instructional media and physical therapy education. However, this sample from the literature does show that there are many types of media that could be used in physical therapy education, including learning management systems, audio-visual media, and podcasts. As Clark has argued, this sample from the physical therapy education literature does not definitively show that instructional media improves student achievement. Moore and Smith did report that student achievement was not different when instructional media was compared to a traditional instructional method (Moore & Smith, 2012).

A limitation of these studies is that the majority of them did not measure student achievement directly. Another limitation is that the studies did not have a comparison group or control group. These limitations replicate patterns in instructional media research that were identified by Clark. Clark (1983) concluded, “It seems that existing research is vulnerable to rival hypotheses concerning the uncontrolled effects of instructional method and novelty” (p. 457). It should also be noted that there were potential confounding variables that may have influenced the results of these physical therapy education studies.

Physical therapy educators must prioritize evidence-based instructional methods when designing learning experiences to influence student achievement. Instructional media may be used as an aid to instructional methods in designing learning experiences. Educators should remember that entry level physical therapy students have a positive perception of instructional media in physical therapy education. Future research should move beyond survey methods reporting the students’ perception of instructional media to using experimental methods to study student achievement.