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Published online February 21, 2013PHYS THER. Jill D. Black, Kerstin M. Palombaro and Robin L. DoleQualitative InvestigationStudent-Led Physical Therapy Pro Bono Clinic: A Student Experiences in Creating and Launching a

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Student Experiences in Creating andLaunching a Student-Led PhysicalTherapy Pro Bono Clinic: A QualitativeInvestigationJill D. Black, Kerstin M. Palombaro, Robin L. Dole

Background. The physical therapy profession has called for the provision of probono services. Little is known about the impact on students involved in sustainablepro bono leadership. One physical therapy program established a pro bono physicaltherapy clinic under the direct leadership of a board of students.

Objective. The purpose of this study was to describe the experiences of theinaugural members of the Chester Community Physical Therapy Clinic Student Boardin creating and launching the student-led pro bono physical therapy clinic.

Methods. A purposive sample of the 18 members participated in semistructuredinterviews. Content analysis was conducted using a commercially available softwareprogram. Trustworthiness was enhanced with credibility, transferability, andconfirmability.

Results. The emergent categories were: (1) leadership skill development, (2)competency in hands-on clinical and administrative skills, and (3) commitment toboth the community and the clinic. Pride emerged as a strong and overarching themethroughout the experience.

Conclusions. The student-led pro bono clinic meets several Commission onAccreditation in Physical Therapy Education criteria in a sustainable manner andserves as a means for measuring and meeting program mission and goals. Participa-tion in the program was a meaningful experience and developed ownership, lead-ership skills, and pride among the students. There are also possibilities for expandingaspects of the program so that all physical therapist students can benefit from probono service opportunities.

J.D. Black, PT, DPT, EdD, Institutefor Physical Therapy Education,Widener University, One Univer-sity Place, Chester, PA 19013(USA). Address all correspondenceto Dr Black at: [email protected].

K.M. Palombaro, PT, PhD, CAPS,Institute for Physical Therapy Edu-cation, Widener University.

R.L. Dole, PT, DPT, EdD, PCS, Insti-tute for Physical Therapy Educa-tion, Widener University.

[Black JD, Palombaro KM, Dole RL.Student experiences in creatingand launching a student-led phys-ical therapy pro bono clinic: aqualitative investigation. PhysTher. 2013;93:xxx–xxx.]

© 2013 American Physical TherapyAssociation

Published Ahead of Print:February 21, 2013

Accepted: February 14, 2013Submitted: November 22, 2011

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The physical therapy professionhas increasingly embraced theimportance of addressing

health disparities through pro bonophysical therapy services. The man-date to provide pro bono physicaltherapy services appears in theAmerican Physical Therapy Associa-tion (APTA) Code of Ethics for Phys-ical Therapist,1 APTA House of Del-egates position statements,2 and theCommission on Accreditation inPhysical Therapy Education (CAPTE)criteria.3 Principle 8A of APTA’sCode of Ethics for Physical Thera-pist states, “Physical therapists shallprovide pro bono physical therapyservices or support organizationsthat meet the needs of people whoare economically disadvantaged,uninsured, and underinsured.”1(p2)

The 2010 House of Delegatesdirected the association to developresources that support members inproviding pro bono care in an effortto meet the physical therapy needsof society.2 A House of Delegatesposition statement compelled APTAto publish “Considerations for ProBono Physical Therapy Practice”4

and a list of resources.5 To supportphysical therapists in their efforts toprovide pro bono services, APTA hasestablished an online communityopen to all of its members,6 and theGlobal Health Special Interest Groupof the association’s Section onHealth Policy and Administrationprovides additional networkingopportunities.7

In recent years, individual academicprograms have created pro bonoclinics and provided services as amethod of meeting the profession’sexpectations and fostering studentresponsibility (personal communica-tion: University of Kentucky, Evans-ville University Lebanon Valley Col-lege, and Quinnipiac University).These pro bono services andstudent-run clinics can serve to sup-port CAPTE criteria; they also cansupport the development of the

value of altruism as well as leader-ship skills in administrative and clin-ical practice. However, the physicaltherapy literature regarding studentand faculty experiences in develop-ing and participating in pro bono ser-vices and student-run clinics issparse, and the allied health litera-ture related to leadership develop-ment is limited.

Sawyer and Lopopolo8 described stu-dent physical therapy pro bono ser-vices in Jamaica. They conducted afocus group with 8 students whoparticipated in a week-long interna-tional service-learning experience.According to those students, theexperience expanded their world-view and enhanced their understand-ing of physical therapist practice. In2003, Village et al9 found that 24United States physical therapy pro-grams reported student participationin pro bono physical therapy ser-vices (the authors did not documentfurther information). Johnson et al10

described a pro bono service modelwhereby physical therapy studentstreat clients at a pro bono clinicunder supervision of a licensed phys-ical therapist, but are not active inthe administration or operation ofthe clinic.

With regard to leadership develop-ment, participation in student pro-fessional nursing associations hasbeen shown to foster the develop-ment of leadership skills,11,12 as hasparticipation in campus studentorganizations that involve commu-nity service.13 Wilson and Collins14

documented a learning experiencewhere physical therapist studentsserved as both student clinicians andservice managers in 3 not-for-profitlearning experiences. Studentsreported learning about leadership,administration, and teamwork.

A charge to “incorporate pro bonoservices into practice”3(p44) appearsin CAPTE criterion CC-5.7; it is a pro-

fessional practice expectationrelated to the APTA core value ofaltruism.15 Many physical therapisteducation programs have started orhave considered starting a student-led pro bono clinic; however, thereis little published about the out-comes or the impact on students orcommunity to guide those efforts. Inorder to consistently and positivelyinfluence the student experienceand provide meaningful support tothe community, pro bono servicesalso must be sustainable. The litera-ture regarding sustainability offersframeworks for assessing sustainabil-ity of community programming,such as the student-led pro bonoclinic. Achieving student buy-in isnoted as an essential element of sus-tainability,16 but little is knownabout whether this is true of thephysical therapy pro bono clinicexperiences.

After assessing the need within thelocal community, program facultychose to create and launch a physicaltherapy clinic under student leader-ship.17 The clinic’s student boardconsisted of 8 to 10 students fromeach doctoral degree in physicaltherapy (DPT) class (Fig. 1). Inter-ested students applied for the volun-teer leadership experience andranked board roles in order of pref-erence. From the applicant pool, thefaculty appointed the inauguralboard members to their specific posi-tions, overseeing all aspects of cliniccreation and administration. Descrip-tions of the responsibilities for eachstudent board position are presentedin Table 1. The purpose of this studywas to describe the inaugural stu-dent board members’ experiences increating and launching the student-led pro bono physical therapy clinicand to determine its usefulness andsustainability for the meeting of bothCAPTE criteria and our programmission.

Student-Led Physical Therapy Pro Bono Clinic

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MethodParticipantsThe participants were the 18 inaugu-ral members of the Chester Commu-nity Physical Therapy Clinic StudentBoard, representing a purposive sam-ple. Ten of the participants werefrom the Institute for Physical Ther-apy Education of Widener Universi-ty’s Class of 2010, and 8 were fromthe institute’s Class of 2011. The par-ticipants were between the ages of22 and 36 years (median age�25years). Fourteen of the participantswere women, and 4 were men. All18 participants were consideredinaugural members as they commit-ted to clinic leadership before theclinic was created; all worked toenvision, create, and launch theclinic. All agreed to participate in thestudy and signed informed consentforms.

ProcedureThe researchers chose qualitativecontent analysis to evaluate theexperiences of the board members.Hsieh and Shannon defined qualita-tive content analysis as “a research

method for the subjective interpreta-tion of the content of text datathrough the systematic classificationprocess and identifying themes orpatterns.”18(p1278) The text data camefrom transcriptions of semistruc-tured interviews that averaged 45minutes in length and were con-ducted and audiotaped by 1 of the 3researchers. Interviews occurredindividually with the participants 1year following the creation andlaunch of the clinic and were con-ducted within a 2-month time frame.Participants received a copy of aninterview guide (Appendix 1) priorto the start of the interview, whichallowed them time for reflectionprior to the interview. Interviewquestions were mainly on the partic-ipants’ experiences workingtogether as a student board, servingin the clinic under supervision of thealumni supervisors, and growing intheir individual board roles. Tworesearch assistants transcribed theinterviews, and the interviewersreviewed each transcription foraccuracy.

Data AnalysisAll researchers independently codedall transcripts, keeping reflectivememos to guide their thought pro-cesses, and then met to discuss sim-ilarities in findings and resolve anydiscrepancies among their individualanalyses. Discrepancies were few,and the researchers easily reachedagreement on an initial coding andcategory list (Fig. 2). After reanalyz-ing the data independently, theresearchers again discussed the orga-nization of codes that seemed to beemerging. Once they reached agree-ment on coding and category organi-zation, they uploaded the frameworkto NVivo8 software (QSR Interna-tional Pty Ltd, Doncaster, Victoria,Australia) for ease of data manage-ment and analysis. Two of theresearchers (J.D.B. and K.M.P.), bothwith qualitative research experi-ence, independently analyzed a des-ignated transcript within NVivo8.Upon completion, they comparedcoding patterns and identified miss-ing elements and redundancies.They subsequently revised the cate-gory framework (Fig. 2) and pro-

Figure 1.Clinic organizational chart. PT�physical therapy.




ceeded to code all 18 transcriptsindependently, keeping analyticmemos throughout the coding pro-cedure. The 2 researchers met againand, using NVivo8 software fre-quency counts, identified the mostprominent categories and ensuredthat all categories were mutuallyexclusive. They found that 3 catego-

ries were best collapsed and 2 addi-tional categories that had beenlabeled “other” warranted furtherexamination. These findings resultedin 1 additional coding category: teamcollaboration (Fig. 2).

All 3 researchers convened to exam-ine the coding categories that

emerged most strongly and began todiscuss their relationships. They cre-ated a conceptual framework thatdepicted the findings and debatedmodifications until the depictioncaptured what they all found to berepresented in the data. They sentthe draft of the conceptual frame-work along with an explanation ofthe categories and their relationships(Appendix 2) to the 18 participantsfor member checking. Twelve out ofthe 18 participants responded. Allexcept 1 out of the 18 participantsagreed that the proposed depictioncaptured their experience. The rep-resentation did not conflict with theexperience of the disagreeing partic-ipant; however, it did not com-pletely capture it. He felt that hisexperience was more than themodel was conveying. The research-ers had debated the category of prideand, after revisiting the data and fur-ther discussion, posed extending thepride arrow through the entire expe-rience as a theme rather than pre-senting it simply as an outcome ofthe experience. The participant whohad earlier disagreed verified thatthis revision better captured hisexperience. The revised conceptualframework then was sent out formember checking again, and 8 par-ticipants responded. All concurredwith the change to extend pride as atheme throughout the experience.

TrustworthinessAccording to Lincoln and Guba,19

the determinants of trustworthinessof qualitative findings are: credibil-ity, confirmability, transferability, anddependability. Prolonged engage-ment, triangulation, and memberchecking enhance credibility. Pro-longed engagement entails that theresearchers spend enough time inthe setting and with the participantsto best understand the phenomenonof interest.20 All 3 researchers wit-nessed the student-led creation andlaunch of the pro bono clinic,which added to their ability to probe

Table 1.Student Board Positions and Responsibilitiesa

Position Responsibilities

Student Scheduler ● Ensure adequate student staffing for clinic operating hours● Create and conduct student volunteer orientations● Maintain student records (eg, PPD, CPR)● Coordinate with IPTE faculty for class-related activities

involving the clinic

Supervisor/Alumni PT Scheduler ● Ensure adequate staffing of supervising PT professionalvolunteers

● Conduct alumni volunteer orientation● Maintain supervising PT records (copy of updated license,

malpractice insurance, CPR, and first aid)● Ensure expression of appreciation to supervising PT

volunteers (such as recognition on webpage, recognitiondinner, continuing education benefit)

● Update alumni supervisor recognition website● Maintain log of volunteer hours on Google Docs (Google

Inc, Mountain View, California)● Maintain log of volunteer contact info on Google Docs

Client Scheduler ● Maintain a schedule of clients● Maintain communication with clients● Maintain adequate client records● Ensure updated referrals● Help clinic coordinator oversee receptionist

Community Relations Officer ● Promote positive relationships with the Chestercommunity

● Promote positive relationships with alumni● Promote positive relationships with Widener University

Outcomes Coordinator ● Track patient outcomes statistics● Track clinic operation statistics● Maintain/update all clinic forms/paperwork● Maintain alumni webpage

Operations Coordinator ● Maintain clinic supplies● Oversee durable medical equipment program● Maintain clinic space● Oversee services related to clinic operation● Propose an annual budget● Oversee opening/closing procedures and laundry service

Fund Officer ● Oversee fundraising efforts● Optimize and pursue relationships with donors● Provide oversight of the budget

Clinic Coordinator ● Conduct and oversee all student board business● Oversee receptionist position● Serve as liaison between the faculty board and student

board● Serve as a representative to the school, university, and

community

a IPTE�Institute for Physical Therapy Education, PT�Physical Therapy, PPD�purified protein derivative,CPR�cardiopulmonary resuscitation.




and contextualize the experiences ofthe participants. Patton21 described4 types of triangulation (ie, methodstriangulation, triangulation of sources,analyst triangulation, and theory/per-spective triangulation). In this proj-ect, we used triangulation of sourcesto compare 18 transcripts and usedanalyst triangulation as 2 of theresearchers conducted detailed anal-ysis. Member checking for concep-tual framework validity occurred asdescribed previously.

A detailed audit trail, triangulation,and reflexivity contribute to confirm-ability. Reflexivity is the practice ofmaking personal biases and rolesknown.19 All 3 researchers were fac-ulty members at the same universityand were strong promoters of stu-dent leadership. In addition, theresearchers kept a detailed audit trailthroughout the analysis includingcoding frameworks, analytic memos,and iterations of emergent concep-tual models. Triangulation was con-ducted as described above.

Transferability is enhanced by thickdescription to allow readers to eval-uate relatedness to their individualcontexts.19 The below account of

our results include many descriptivequotes and a conceptual frameworkin an attempt to provide rich descrip-tion of the participant experience.Dependability was not evaluated (eg,no external audit was conducted),which serves as a limitation of thestudy.19

ResultsData analysis identified specific ele-ments that equipped the students forthe experience of creating andlaunching the clinic, and 2 compo-nents of the experience itselfemerged as significant. Three addi-tional categories were strong out-comes of the experience, and prideemerged as a central, overarchingtheme.

Conceptual FrameworkDescriptionFigure 3 depicts the experiences ofthe board throughout the study asderived from the data analysis. Theoutcomes of leadership skills, com-petency, and commitment werefueled by components of the experi-ence itself as well as preparticipatoryelements. The 2 preparticipatory ele-ments that were critical to the expe-rience of creating and launching the

student-led pro bono clinic were cur-riculum and individual strengths.The leadership opportunities andmentorship from alumni supervisingtherapists were an important partof the experience. The outcomesrelated to leadership skills, compe-tency, and commitment (ie, clinicaland administrative skills, problemsolving and team collaboration, andcommitment to the community andclinic) also were in the experience.Pride was an overarching themethroughout the experience and theoutcomes.

PreparationThe 2 main components that pre-pared the students for the task ofcreating and launching a pro bonoclinic were the doctor of physicaltherapy curriculum and their ownindividual strengths. Components ofthe curriculum included the coursecontent and lab experiences thatequipped them with clinical skillsand the community engagementactivities and cultural content thatprepared them for interaction withthe community. The response of oneparticipant captured both the clini-cal and community engagementpieces well.

Figure 2.Coding and category development.




I guess most students look at [coursesin areas such as cultural competency]and [say], “Oh, common sense. That’sso easy.” and “That’s not a big deal.”But I feel like that really has impactedthe way we’ve set up the clinic [and]the way we approach the people thatcome to our clinic. I think that’s beenreally beneficial. [Also beneficialwere] some of the foundationalclasses . . . getting your hands on peo-ple and working with people. (P1)

In addition, many of the studentsfound that they were able to bringtheir individual strengths to theboard experience. When one of thestudent schedulers was asked whyshe chose to pursue this board posi-tion, she responded: “I like itbecause I am a very quiet andreserved person. It did not have any-thing to do with a lot of outside con-tact, but I am very close with myclass, so I thought it would be best.”One of the fund officers alsoanswered the question by saying,“I’ve done fundraising before. . . .I’m not afraid to talk to people, sothat made it easy. . . . And I likenumbers so I thought it would be agood spot for me.”

The ExperienceTwo major components of the expe-rience itself emerged that shapedoutcomes. The first was leadershipdevelopment opportunities; the fac-ulty specifically sought out leader-ship opportunities for the boardsuch as formal in-servicing and pro-gramming, as well as presentationopportunities locally, regionally, andnationally. Formal leadership devel-opment opportunities facilitated theenhancement of leadership skills.

When I went to the LAMP [Leader-ship, Administration, Management,and Professionalism] Conference, the1 thing that was very insightful wasthat you can be a leader and not beoutspoken. I tend to be quieter anddon’t really state what I am feelingvery often, and in past experiencesand leadership roles, I was more of aquiet leader. . . . So that made mefeel good to hear that. (P6)

It was really good because he [DrMorrison] talked about transforma-tional versus transactional lead-ers. . . . And [it] allowed me to thinkabout how you would go aboutmaking change and the things thatyou would do with being a

leader . . . rather than being theprime decision maker. You can stillinspire everyone to have ideas andwork those ideas in a certain way.You get a much better product. Thatwas inspiring. (P11)

The second was mentorship fromalumni supervising therapists. Stu-dents noted the value of having expe-rienced therapists guiding and teach-ing as they applied their clinical skillsin the clinic. The mentorship phe-nomenon occurred between theolder class of students and theyounger class of students as well.This phenomenon was mentionedby the majority of participants.

I gained a lot of knowledge, not onlyin my skill sets, but also in the knowl-edge of the curriculum and programfrom their experiences and what [thealumni supervising therapists] foundbeneficial and what has worked forthem. Also I can ask them about anytechnique I am using and how Icould better do it for the patient,and. . .how to progress a patient.(P13)

Because the mentorship experiencecannot fully be explored by only thestudents’ perception, the research-ers are engaged in an additionalstudy to understand the mentorshipexperience from both the supervis-ing therapists’ and students’perspectives.

Outcomes of the ExperienceThree major categories presented asoutcomes of the board experience:leadership, competency, and com-mitment. Subcategories emergedwithin each of the major categories.The development of leadership skillsand collaboration were the 2 subcat-egories of leadership that emergedfrom the data.

Leadership. Students attributedthe development of their leadershipskills to the supplemental leadershipdevelopment activities describedabove, as well as the inaugural board

Figure 3.Conceptual model.




experience itself. They discussed theleadership skills developed withinthe experience itself.

I think one of the major things I’mtaking from it is the management andthe organization that you had to haveto do it, because I’m not a very detail-oriented person. . . . So it made mefocus on that, which is somethingthat I needed to work on. (P8)

Well, this is a unique leadershipopportunity, and it gives you more ofthe business side, which I didn’t thinkI was that interested in. But I think Ihave opened my eyes to it. I like beingbehind the scenes and seeing whatworks. (P15)

In particular, they noted an appreci-ation of team collaboration thatemerged from the experience.

I think that as we have grown as aboard, we’ve evolved. . . . We haveour roles, but at times, wejust . . . shove those roles to the sideand just work as a group. Everybodydoes everybody else’s jobor . . . puts their ideas in. So [it’s] ateam collaboration. (P2)

Competency. The students identi-fied improved competence in bothclinical and administrative skills.Clinical hands-on skills included: theopportunity to practice tests andmeasures, manual techniques, evalu-ative techniques, administration oftherapeutic exercise, client and fam-ily teaching, and documentationskills.

The other day, we had learned cervi-cal moves, and I was able to go downthat day and, with the supervisingphysical therapist, able to try it,which is really cool because [myclassmates are free of impairments].So when you get to feel it on a patientit is kind of enlightening. (P16)

Participants also noted the develop-ment of their administrative skills. P1stated, “Our paperwork is com-pletely different now. [We’re] taking

ideas from other clinics and seeingwhat they ask their patients and howthey look at quality assurance typesof things.”

Commitment. The board mem-bers expressed strong commitmentto both the community and to theclinic.

[The patients] come in to us becausethey have nowhere else to go, and forus to be able to take them under ourwing and help them out by alleviatingtheir pain and increasing [range ofmotion] is very heart warming. It justgives you a great sense of accomplish-ment to be able to reach out to peo-ple who are in need. (P3)

They expressed their commitmentto the clinic in both immediate andfuture terms.

It’s like I said before, “After a long dayof class, going to the clinic revitalizesyou”—the camaraderie among us asthe boards and the patients and super-vising therapists. . . . It is just a funenvironment to be in. (P17)

I wouldn’t mind coming back [to helpvolunteer] because I think it is a goodopportunity. And since we . . .started it, we know what works andwhat doesn’t. . . . I think it would be agood learning experience for me.(P7)

Pride. Pride was an overarchingand pervasive theme that emergedfrom the data analysis. The boardmembers expressed tremendouspride in the creation and launch ofthe clinic. When asked what theywould most remember about theexperience, they had positivecomments.

It has been exciting, especially goingto Jacksonville [for the Student-RunFree Clinic Conference sponsored bythe Society for Student-Run Free Clin-ics] and seeing how lucky we are tohave such an operational clinic andseeing the other schools that desirewhat we have and would love to be inour shoes. (P18)

[It was having] the open house andhaving everyone see our space. It is abeautiful space. . . . I don’t think peo-ple were expecting that . . . and alsoour first couple of patients and seeinghow satisfied they were with thenew, up-and-running clinic. (P17)

I think another big thing with beingpart of the inaugural board isthat . . . we did this. [The clinic] issomething that didn’t exist, so this issomething that years from now whenwe look back it is still going to behere functioning [and] helping peo-ple. (P5)

DiscussionThis qualitative study examined theexperiences of students in a DPTprogram who were part of the cre-ation and launch of a student-led probono physical therapy clinic. Uponreflection on the qualitative analysisof student interviews, we realized, atleast for those students involved inthe creation and launch of the probono clinic, that this experiencecontributed to the achievement ofseveral CAPTE criteria (Fig. 4) inaddition to the expectation toengage in pro bono practice found inCC-5.7. The additional criteriainclude: attention to administrativeand practice management pieces, cli-ent advocacy, and compassion/car-ing. The participants repeatedlynoted the attainment of leadershipand administration skills. Theydescribed a commitment to the cli-ents they served and demonstratedadvocacy, compassion, caring, andsocial responsibility. This finding isconsistent with those of Groh et al22

who surveyed 306 nursing studentsbefore and after a service-learningexperience. They found significantchanges in the constructs of leader-ship skills and social justice.22

Although theirs was not a clinicexperience and the measure was aself-assessment tool, the constructsare similar.

Throughout the interviews, the par-ticipants provided many examples of




opportunities to obtain practicemanagement and professional prac-tice experience. These are expecta-tions that may sometimes be chal-lenging, given the potential difficultyof finding meaningful experienceswithin the didactic portion of theprogram that address issues ofadministration, advocacy, and socialresponsibility. The clinic serves assupport to the didactic portion ofthe curriculum because of its inclu-sion of these elements, which oftenare more difficult to incorporate andassess.23,24

In addition, the results of this studyare relevant to CAPTE criterion P-4:Program Assessment and Planning.Program assessment in these criteriais specific to the meeting of programmission. This physical therapy pro-gram’s mission is built upon devel-opment in 3 areas: competency,character, and citizenship. All 3tenets are reflected in the results ofthe study. The participants notedenhanced competency in both clini-cal skills and administrative skills.

Their character growth is demon-strated in their learned leadershipskills and ability to collaborate withone another. Citizenship is mani-fested in their commitment to boththe community members and to thepro bono clinic. The findings con-firm that the board experienceserved to meet the program’s mis-sion and thus serves as evidencewhen evaluating achievement ofCAPTE criterion P-4. In addition, theboard experience relied on programplanning for the enhancement of theproject and experience. Programplanning requires strategies toattract students beyond the inaugu-ral board members to participate asfuture leaders of the clinic.

Given that only a portion of theentire student body experienced thisunique opportunity to meet theexpectations related to skills andabilities required by CAPTE, we rec-ognize the need to create the oppor-tunity for all students to engage inactivities that foster these skills. Tothat end, we have expanded both

voluntary and curriculum-based par-ticipation at the student-run clinic toallow for the inclusion of all studentsacross all 3 years. Although every stu-dent will not have the experience ofserving on the student board, all stu-dents will have the opportunity to beinvolved in key aspects of clinic ser-vice; clinic experience will be part ofthe didactic curriculum. The growthof the clinic over the past 3 years hasfacilitated this process (Tab. 2).

Future planning also requires atten-tion to sustainability. Smith et al25

found that one way to achieve sus-tainability of community engage-ment programs is to involve studentsin the planning and implementationprocess. The process of creating andlaunching the clinic, which created asense of pride in the inaugural board,can support clinic sustainability. Theclinic’s sustainability also can be sup-ported by continued involvement ofstudents beyond graduation. The stu-dents who served on the inauguralboard expressed commitment to theclinic both during their academic

CC-5.57–5.61 Practice Management Expectation: Practice ManagementHuman resources, fiscal management, business plan, marketing and public relations, manage practice in accordance with regulatory and legal

requirements.

CC-5.64–5.65 Practice Management Expectation: Social Responsibility and AdvocacyAdvocate for the health and wellness needs of society. Participate and show leadership in community organizations and volunteer service.

CC-5.7 Practice Management Expectation: AltruismIncorporate pro bono services into practice.

CC-5.8 Professional Practice Expectation: Compassion/CaringExhibit caring, compassion, and empathy in providing services to patients/clients.

P-4 Program Assessment and PlanningThere is an ongoing, formal program assessment process that determines the extent to which the program meets its stated mission. The

assessment process: (1) uses information from professional standards and guidelines and institutional mission and policies; (2) uses data

related to program mission, goals, and expected program outcomes, program policies and procedures, individual core faculty, collective core

faculty, clinical education faculty, associated faculty, communication, resources, admissions criteria and prerequisites, curriculum plan, clinical

education program, and expected student outcomes; (3) identifies program strengths and weaknesses; (4) includes considered judgments

regarding need for change; and (5) includes steps to achieve the changes, with anticipated dates of completion.

Figure 4.Relevant Commission on Accreditation in Physical Therapy Education criteria.3




career and in their future careers.Students indicated that they wouldbe interested in serving as alumnisupervising therapists or donatingmoney and equipment in the future.This commitment is vital to thefuture of the clinic.

Another way to achieve sustainabil-ity is to evaluate the impact that theprogram is having on students andthe community.25 The studentsdeveloped leadership, clinical, andadministrative skills as inauguralboard members. Continued develop-ment of these skills in both futureboard members and physical thera-pist student volunteers is one way toensure clinic sustainability, demon-strating its value in the physical ther-apy education process. These stu-dents can potentially becomecommunity partners if they remainin the area after achieving licensureand thus will become key stakehold-ers as local clinicians.16 Future inves-tigation should focus on the profes-sional development of students whowere involved in the clinic as bothboard members and volunteers inorder to determine whether involve-ment in a student-led physical ther-apy pro bono clinic makes a positiveimpact in their early careers. Anypotential contribution of the clinicto the early professional life of ouralumni will help ensure that there isa constituency of physical therapistswho support the clinic throughpatient referrals and as supervisingtherapists.

LimitationsThe researchers did not conduct anexternal audit of their findings.Other than member checking withthe participants, the researchers didnot confirm additional dependabil-ity. With respect to generalizability,the results of this study are specificto this group of inaugural boardmembers. However, the findingshave the potential to be informativeto other DPT programs seeking to

establish student-led pro bono clin-ics. An additional limitation to thestudy was a smaller response rate onthe second round of member check-ing, although the data fully supportthe decision to change pride from acategory to a theme. The boardmembers experienced a sense ofownership and pride as they lookedback on their experiences. It isincumbent upon the program andthe faculty board to extend thisexperience and sense of pride to thenext generation of student boardmembers and to all students involvedin the clinic. Further research shouldinvestigate whether creating oppor-tunities of ownership and pride forfuture student groups will foster theleadership, competency, and com-mitment outcomes that were experi-enced by the students interviewedfor this study. Additional researchalso should look at the experiencesof the community members, alumnisupervisors, and the students whovolunteer in the clinic but do notspecifically serve on the board. Afinal limitation was the absence ofobjective measures for the enhance-ment of students’ clinical and admin-istrative skills as well as their devel-opment of social responsibility.Future research should seek to con-firm student perceptions of skill andprofessional development withquantitative measures.

ConclusionsThis study sought to examine theperspective of DPT students

involved in the creation and launchof a student-led physical therapy probono clinic. Interviews and subse-quent content analysis identified ele-ments that equipped the students forthe experience, components thatwere integral to the experience, andoutcomes of the experience. Theresultant conceptual framework cap-tures those pieces and includes“pride” as a theme evident through-out the experience. The findingsdemonstrate how the experiencehelped meet CAPTE criteria for somestudents and informs how we mightextend the experience to all stu-dents. The findings also informfuture growth and development ofthe clinic and point to additionalareas of research. This study offersinsight into the creation and imple-mentation of student-led pro bonophysical therapy clinics and similarprojects.

Dr Black and Dr Palombaro provided con-cept/idea/research design and project man-agement. All authors provided writing, datacollection, and analysis. The authors thankthe members of the inaugural student boardfor their participation.

DOI: 10.2522/ptj.20110430

References1 Code of Ethics for the Physical Therapist.

American Physical Therapy Associationwebsite. Available at: http://www.apta.org/uploadedFiles/APTAorg/About_US/policies/HOD/Ethics/CodeofEthics.pdf. Accessed October 11, 2011.

Table 2.3 Years of Data on the Chester Community Physical Therapy Clinic

SchoolYeara

No. ofClientVisits

No. ofNew

Clients

No. ofStudentBoard

Positions

% ofStudentsInvolved

2009–2010 297 18 8 25%

2010–2011 422 26 9 70%

2011–2012 845 70 10 100%

a Ranges are from September to September.




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Appendix 1.Inaugural Student Board Interview Guide

1. Why did you pursue membership on the student board? What motivated or led you to apply?

2. What is your role on the student board? What class are you in?

3. What interested you about this particular position?

4. What duties have you done? What things does this encompass? What things have you done since assuming theposition?

5. What has your experience as a member of the inaugural student board been like?

● What have been the highlights and benefits?

● What have been the challenges?

● What would you like to have been different?

● What recommendations do you have?

6. What has been your experience to date participating in the treatment of clients in the clinic?

● How has that experience been?

● What has gone well?

● What has not gone so well?

● What has been surprising?

● In what ways could you have been better prepared?

7. What has been your experience with working with the alumni supervisors?

● What have you gained/learned?

● What have you found difficult?

● What has been surprising?

8. What aspects (if any) of your experience here at IPTEa have prepared or contributed to your experience hereat the Chester Community Physical Therapy Clinic? What other aspects of IPTE have played a part? How and inwhat way?

9. Would you recommend student board membership and participation to other physical therapist students? Whyor why not?

10. What will you most remember/value about your experience as a student board member of the ChesterCommunity Physical Therapy Clinic?

11. How do you think that your participation as a student board member will help shape your professional career?

12. What role (if any) do you think that you will have in the Chester Community Physical Therapy Clinic as analumnus?

a IPTE�Institute for Physical Therapy Education.




Appendix 2.Member-Checking Materials

Inaugural Board Experience Emergent Model

The Experience of Creating and Running the Student-Run Physical Therapy Pro Bono Clinic

1. The first small wheel on the left depicts 2 key elements that you brought into the experience or helped prepareyou for the experience:

● Components of the physical therapy curriculum

● Your individual strengths, gifts, backgrounds

2. The larger wheel in the middle represents the experience itself. Two components seemed to further shape youas you experienced the creation and running of the clinic. These components were:

● Mentorship from the supervisors

● Leadership training experiences, both the formal training experiences and the opportunities to present atprofessional conferences and marketing fairs, etc.

3. The 3 arrows spinning off the wheel represent outcomes of the experience. We found 4 key outcomes, butdecided to depict the fourth one in a slightly different manner. The 3 outcome arrows are:

● Increased competency in both clinical and in administrative skills

● Improved leadership skills, particularly relevant to problem-solving skills and team collaboration skills

● A strong commitment to both the clinic itself and to the community members you served

4. The fourth outcome that came through loud and clear was pride. All of you spoke of the pride that you have asa result of being part of this project. We decided that pride encompassed all of the outcomes and chose to depictit as such.




doi: 10.2522/ptj.20110430Originally published online February 21, 2013

Published online February 21, 2013PHYS THER. Jill D. Black, Kerstin M. Palombaro and Robin L. DoleQualitative InvestigationStudent-Led Physical Therapy Pro Bono Clinic: A Student Experiences in Creating and Launching a

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