Circle of Learning at Camp Spirit: An Innovative Model of Student-Directed Teaching, Learning, and Assessment Focused on Activities for Children With Juvenile Arthritis
Authors: Nelson Kelly , Peck Kirk M. , Givens Debby 
Published: December 2017

Background and Purpose.
Service learning can be a powerful tool in shaping future health professionals. The utilization of peer coaches has been explored in health care education, but primarily in professions other than physical therapy and in the classroom, laboratory, and clinic as compared to in service learning settings. There is a need to study the impact and outcomes associated with peer-coaching models embedded in professional physical therapy curricula, especially in service learning settings. Students in physical therapy programs are well equipped to participate in service learning, especially for individuals in the community who have chronic conditions. Physical therapy students can help enhance clients' health literacy, participation, and quality of life. Children with juvenile arthritis (JA) are a particularly vulnerable population at high risk of developing emotional, developmental, or behavioral comorbidities. The purpose of this case report was to describe a teaching approach, incorporating peer coaching with the following goals for students: (1) prepare third-year physical therapy students (PT3 student coaches) to design and implement teaching activities and effective strategies for the assessment of learning in a community-based setting and (2) prepare second-year physical therapy students (PT2 students) to integrate and apply knowledge of exercise, movement control, and motor learning for children with JA to promote healthy lifestyle habits and health literacy.

Case Description.
The teaching method was directed at a unique, community-based activity for children with JA. Camp Spirit is an annual week-long experience for individuals with JA ranging from 8 to 15 years. Third-year physical therapy student coaches participated in Camp Spirit as part of a behavioral strategy course. Students organized and facilitated an instructional experience for PT2 students. Second-year physical therapy students engaged in didactic, laboratory, and experiential service learning activities led by PT3 student coaches to design and conduct exercise programs in yoga, aquatics, and tai chi/martial arts for children with JA at Camp Spirit. Each program incorporated principles of exercise prescription including warm-up, movement-based activities, cool down, and the provision of health literacy education. All student participants completed written reflections after the experience.

Outcomes.
A randomized, representative group of PT2 students from each of the three exercise program days participated in a semistructured focus group interview to elicit more information about their perceptions about involvement of the PT3 student coaches. All responses were coded and themed using a systematic qualitative review process. Third-year physical therapy student coaches learned how to structure teaching experiences to facilitate the education of other physical therapy students. Second-year physical therapy students felt that the involvement of the PT3 student coaches was an essential component of the learning module. Second-year physical therapy students viewed the PT3 student coaches as mentors, coaches, and supporters in a unique and meaningful way. Campers with JA learned how to safely perform enjoyable activities to promote long-term health and fitness.

Discussion and Conclusion.
This model is titled the “circle of learning” involving key players of the PT3 student coaches as peer coaches; PT2 students; faculty facilitators; and the community partner. Concepts of this project are relevant to professional physical therapy programs seeking to promote improved quality of life for community-based populations.