All PT schools seem to have a similar structured didactic curriculum. Generally the first year consists of Anatomy, basic sciences, and some basic examination courses to frame the mind around the human body as well as get our hands used to touching the body of another person. Then the structured integration of first year knowledge into more clinical knowledge with orthopaedic and neuromuscular conditions. There's a rhyme and reason for the placement of each course within the curricula. Some schools are slightly different, but from as a whole their course placement is the same.
Now, we PT students are ready to be interns and take on true application of knowledge in a clinical setting. We all pay a god-awful amount of money for our schooling (well except for Army-Baylor), but why is that some of us will walk away from our clinical internships ready and equipped while some won't feel ready to enter the professional world? I would be pissed if I walked away from three years of training and $100,000-$250,000 deeper in debt (dependent on school) and I didn't feel I got enough training. A student's clinical education is most important part of professional education, whether it is medicine, nursing, PA, or PT. If the clinical education is the most important, then why are PT students given such intricate didactic structure then thrown to the "clinical wolves" to fend for themselves to literally get the most for their money? Some of us travel internationally, some across multiple states, and some just travel down the road to our respective clinical sites. Most of us have never met our Clinical Instructor (CI) before and have no idea what to expect from our CI.
The kicker is that our clinical education faculty has never met our CI either, so it is completely unknown what the learning experience is going to be; well it is known what type of setting, but that is about it. Clinical education faculty don't have time to visit every 200+ sites that many schools "boast" about.
The 1 on 1 model is a failing model. The model especially fails with the much longer clinical internships for Doctor of Physical Therapy students. It doesn't take much time until the student gets "their own" caseload while their CI also has their own caseload. The intern is now a source of revenue for the clinic and the CI is getting nearly double the billable units (this is a whole other bag of worms). How is the PT intern supposed to learn critical clinical reasoning when the intern and CI's mind is too preoccupied with paperwork and each seeing their own patients. Don't get me wrong, learning to juggle patients and paperwork is an important real world aspect of PT, but it doesn't take a year long internship to learn this aspect. Additionally the model fails because the standardization process is a joke; the clinical performance instrument (CPI) basically determines if the PT intern is safe and communicates with patients through a series of very repetitive questions. Also, many can agree that there are PT's that vary on the spectrum of greatness; Shockingly, there are CI's that vary on the spectrum of greatness. Where's the standardization in this?
The PT clinical education model across the nation is due for an overhaul. A doctor level degree deserves a doctor level of education from beginning to end. The wheel does not need to be reinvented, just give it some studs.