The Impact of Virtual Laboratories on Student Clinical Education Preparedness: A Mixed-Method Analysis : Journal of Physical Therapy Education

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The Impact of Virtual Laboratories on Student Clinical Education Preparedness: A Mixed-Method Analysis

Kothe, Caitlin PT, DPT, MS, CSCS; Reynolds, Breanna PT, DPT, PhD, FAAOMPT; Eaton, Kareaion PT, DPT, CWS; Harrison, Sarah PT, DPT, CCS; Kozsalinski, Alex DPT PhD; Krogmann, Monica PT, DPT, MA; Norton, Hannah PT, DPT, FAAOMPT; Pharr, Ann PT, ScD, GCS; Sabbahi, Ahmad PT, PhD, MA, CCS; Volansky, Kerry PT, DSc, EdD, MBA, OCS

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Journal of Physical Therapy Education 37(2):p 94-101, June 2023. | DOI: 10.1097/JTE.0000000000000270



The COVID-19 pandemic saw physical therapist (PT) education programs in 2020 add virtual options to prepare students for hands-on clinical skills. The purpose of this research was to investigate student confidence, preparation, and clinical performance based on their choice of virtual or in-person laboratory immersion. Secondary analysis compared 2020 cohort outcomes with the previous cohort in 2019 (prepandemic).

Review of literature: 

Virtual skill acquisition has been studied with support for effectiveness in didactic and psychomotor skill acquisition. The impact on clinical education performance is unknown.


Student records from an accelerated hybrid, PT education program in 2020 (n = 91) and 2019 (n = 86).


In this mixed-method observational study, researchers analyzed a Qualtrics survey and the PT Clinical Performance Instrument (CPI) to compare student outcomes. Statistical analyses included chi-square, two-way multivariate analysis of variance (MANOVA), and Mann–Whitney U test. MAXQDA software was used to code student and clinical instructor narrative responses from the CPI related to strengths and areas for further development.


All students in 2020 attended laboratory virtually for 9 full days, and 24% of students chose virtual laboratory for the remaining 8.5 days; 97% of students reported feeling confident going into their clinical experience (66% inpatient). No statistically significant differences were found based on instructional method (virtual or in-person) or clinical practice setting (inpatient or outpatient) for confidence, preparation, or CPI performance. Themes of wanting more time to prepare and more confidence in clinical decision making emerged from the qualitative analysis.

Discussion and Conclusion: 

Results indicate no statistically significant difference for virtual versus in-person laboratory and no difference compared with the 2019 cohort. Virtual instruction effectively prepared students for their clinical experiences across all settings. Although an in-person laboratory experience may be preferred, it is possible to deliver effective experiences in a virtual setting without compromising student performance. Further research is needed to confirm findings.

© 2023 Academy of Physical Therapy Education, APTA

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