Expectations of Clinical Instructor
1. Orient student regarding safety procedures, status of the clinical site’s organizational structure, and pertinent considerations of practice context.
2. Schedule formal feedback sessions with PTA student, review previous week, and set goals for the coming week.
3. Act as a role model for the proper “socialization” of the PTA while provide opportunities to participate as a member of the PT/PTA team.
4. Continuously assess students’ performance and provide/document feedback of performance in all domains.
5. Contact ACCE with any concerns about student performance.
6. Makes suggestions to ACCE regarding student status and actions to be taken.
7. Design patient schedule to expose the student to a variety of patients/diagnoses and conditions representative of those commonly seen in practice across the life-span and continuum of care and reimbursement models.
8. Expose student to non-patient care activities and other available learning experiences such as observing a surgery, discharge planning, staff meetings, various clinics, such as wound care and prosthetics.
9. Provide opportunities for the students to engage in patient care activities various members of the healthcare teams such as OT, Speech, Nursing, etc.
10. Give student patients that require problem solving and allow the student to problem solve.
11. Coordinate activities that lead to independent functioning in cognitive, psychomotor and affective areas: organize activities to challenge strengths and identify weaknesses and remedies.
12. Provide accurate constructive assessment.
13. Plan opportunities for student to supervise support staff and solicit feedback from support staff on student performance.
14. Structure supervision to level of student ability, encourage problem solving, encourage contact with other members of the health care team.
15. Progressively adjust supervision as student progresses and assist student in achieving objectives.
16. Provide opportunity for (and observe) patient/family education. Also provide opportunity for education of other personnel.
17. Allows for opportunity for electronic technologies and teaches student to use applicable technologies.
18. Allow for a variety of interventions to reach clinical goals as established within a plan of care.
19. Allow for opportunity for assisting the PT in screening activities, outcomes assessment, and discharge planning.
20. Ensure that the student understands billing procedures and review physical therapy charges submitted by the student.
21. Complete the CPI objectively. If needed, contact ACCE for assistance or suggestions.
22. Review and discuss the CPI with the student at the end of the affiliation.
23. Review and discuss the student’s self-assessment utilizing the CPI and the PTA Student Evaluation of the Clinical Affiliation and Clinical Instruction.
23. Ensure that student PTA introduces self as such to each patient, their family, other health care providers, etc.
Objectives of Clinical Experience for Student
1. Demonstrate the following professional standards:
a. Demonstrate behavior consistent with the Standards of Ethical Conduct for the Physical Therapist Assistant and Guide for Conduct of the Physical Therapist Assistant. (7D1)
b. Demonstrate behavior that reflects safe, ethical, and legal physical therapy practice (7D1)
c. Demonstrate behaviors to meet the needs of patients and their family/care givers (7D4)
d. Follow departmental policy
e. Follow appropriate dress code (7D4)
f. Demonstrate professional responsibility and accountability in all clinical interactions, (7D5)
g. Maintain privacy when discussing confidential information with the clinical instructor, patient/client and/or family member. (7D4)
h. Show proper respect to all personnel
i. Exhibit adaptability
j. Show positive attitude and enthusiasm toward the profession (7D4)
k. Exhibit behavior that shows a commitment to meet the expectations of members of the profession and the members of society receiving physical therapy (7D5)
l. Demonstrate altruism by maintaining a balanced relationship with patient between professional and personal aspects of treatment.(7D5)
m. Interact professionally with other members of health care team in patient-care and non-patient care activities (7D28)
n. Demonstrates conflict management/negotiation
i. Recognize potential for conflict and implement strategies to prevent and/or resolve conflict.
ii. Seek resources to resolve conflict when necessary.
o. Report to the appropriate authorities suspected cases of abuse of vulnerable populations. (7D2)
p. Implement, in response to an ethical situation, a plan of action that demonstrates sound moral reasoning congruent with core professional ethics and values. (7D6)
2. Accept responsibility for professional growth
a. Ask appropriate questions
b. Differentiate level of assistance needed as situation indicates
c. Analyze work performance and behaviors and seek assistance for improvements as needed (7D5)
d. Demonstrate self-confidence in following the physical therapist plan of care
e. Accept criticism and adapt accordingly
f. Utilize any free clinic time in an appropriate manner (patient chart review, review of a modality, seek out additional learning opportunities, etc.)(7D14)
g. Demonstrate a commitment to meeting the needs of patients and consumers (7D5)
h. Demonstrate an awareness of social responsibility, citizenship, and advocacy, including participation in community and service organizations and activities (7D14)
i. Identify career development and lifelong learning opportunities (7D14)
j. Identify learning needs to enhance role in the profession (7D14)
k. Identify and obtain resources to increase knowledge and skill (7D14)
3. Understand and interpret for others the scope and function of a PTA
a. Recognize when an intervention is outside the scope of practice of a physical therapist assistant and communicate to the supervising physical therapist. (7D21)
b. Recognize the role of the physical therapist assistant in the clinical education of physical therapist assistant students.(7D14)
c. Independently educate colleagues and other health care professionals about the role, responsibilities, and academic preparation and scope of work of physical therapist assistant. (7D12)
4. Understand basic concepts related to the health care system
a. Participate in interprofessional practice by appropriately interacting with other members of the health care team in patient care and non-patient care activities including but not limited to: co-treatments, staff meetings, discharge planning, and instruction (7D28, 6J3)
b. Provide accurate, timely information for billing and reimbursement purposes (7D31)
c. Report to the appropriate authorities suspected cases of fraud and abuse related to utilization of and payment for physical therapy and other health care services (7D3)
d. Describe aspects of organizational planning and operation of the physical therapy service (7D30)
e. Participate in performance improvement activities including quality assurance (7D29)
5. Demonstrate appropriate verbal skills at entry –level performance (general supervision of the physical therapist)
a. Communicate clearly in an effective, appropriate and capable manner congruent with situational needs (7D7)
b. Demonstrate congruence between verbal and non-verbal messages (7D7)
c. Interview patients/clients, caregivers, and family to obtain current information related to prior and current level of functioning and general health independently (7D15)
d. Develop a rapport with patients and others to promote confidence
e. Participates in educating patients and caregivers as directed by the supervising physical therapist (7D23g, 7D12)
f. Recognize individual and cultural differences and respond appropriately in all aspects of physical therapy services. (7D8)
g. Consistently give clear, effective instructions to patient, family members and caregivers in the course of treatment to achieve patient outcomes established by the physical therapist’s plan of care (7D7)
h. Explain the rationale for selected interventions to achieve patient goals as identified in the plan of care. (7D17)
i. Determine patient response/understanding of instruction. (7D23g)
j. Give patient feedback and encouragement during treatment (7D23g)
k. Demonstrate effective motivation strategies in to provision of patient/client interventions.(7D12)
l. Communicate effectively with clinical supervisors on patient care and performance issues (7D7)
m. Determine the effectiveness of communication with patients, family, caregivers, physical therapists and other health care providers (7D7)
n. Recognize role and participate appropriately in communicating patient status and progress with the health care team (7D7)
o. Modify communication to meet the needs and demonstrate respect for the knowledge and experience of others(7D7)
6. Demonstrate effective written communication
a. Complete documentation of patient care using language that is accurate, complete, legible, timely and consistent with institutional, legal and billing requirements. (7D25)
b. Follow documentation format of clinic, state practice acts and other regulatory agencies. (7D25)
c. Compose documentation in an organized and logical framework. (7D25)
d. Compose documentation that incorporates appropriate medical terminology and institutionally approved abbreviations
e. Provide information in the assessment section based on information gathered from subjective and objective data that will be useful to the physical therapist in evaluating the patient/client’s progression. (7D25)
f. Instruct a patient on a home program effectively that is consist with the supervising physical therapist plan of care (7D23g)
7. Demonstrate appropriate non-verbal skills
a. Recognize, respond to, and utilize non-verbal communication signals from the patient (7D7)
b. Recognize own reactions to illness and disability; be aware of information being directed to patient
c. Communicate using body language consistent with the intended message (7D7)
8. Perform the following preparation procedures
a. Review information in the medical record at each visit and differentiate pertinent information from the patient’s chart, including the plan of care, prior to initiating treatment.(7D18)
i. Collect data on patient’s current condition, compare results to previously collected data and safety parameters established by the physical therapist and determine if the safety parameters have been met.
b. Utilize indications and contraindications to guide physical therapy treatments
c. Communicate an understanding of the plan of care developed by the physical therapist to achieve short and long term goals and intended outcomes (7D17)
d. Prepare and maintain a safe working environment for performing interventions (e.g. clear walkways, equipment checks) (7D27)
e. Obtain patient/client permission prior to initiating procedural intervention.
f. Position and drape patients appropriately
g. Explain the rationale for selected patient/client interventions as related to the goals in plan of care (7D17)
h. Instruct patient and/or family members as to rationale for selected patient/client interventions as related to the goals in the plan of care (7d23g)
9. Demonstrate knowledge and entry-level performance (general supervision of physical therapist when working with patients with simple and complex conditions) in the following interventions identified in the plan of care established by the physical therapist to include some or all of the following based on the clinical site setting/opportunities:
a. Functional training to including ADLs, bed mobility, transfers developmental activities, and prosthetics and orthotics(7D23d, 7D23h,7D23b)
b. Proper selection, fitting, use and instruction of assistive devices including wheelchairs (7B,7D23b, 7D23d)
c. Gait and locomotion training (7D23f)
d. Therapeutic exercise to include aerobic conditioning, balance and coordination training, breathing exercises and coughing techniques, conditioning and reconditioning, posture awareness training, ROM exercises, stretching exercises, and strengthening exercises (7B,7D23h; 7D23a; 7D24f)
e. Physical agents and mechanical agents to include athermal agents, biofeedback, compression therapies, cryotherapy, electrotherapeutic agents, hydrotherapy, superficial and deep thermal agents, traction (7D23c)
f. Manual therapy techniques to include PROM and therapeutic massage(7D23e)
g. Wound management to include application of dressing or agents, identification of precautions for dressing removal and removal of dressing or agents (7D23i)
10. Demonstrate knowledge and entry-level performance (general supervision of physical therapist when working with patients with simple and complex conditions) in performing components of data collection skills essential for carrying out the plan of care established by the physical therapist to include some or all of the following based on the clinical site setting/opportunities:
a. Measurement of standard vital signs and other anthropometrical characteristics such as: height, weight, length and girth (7D24a,7D24b)
b. Performance of manual muscle testing and recognition of abnormal and normal muscle length and tone (7D24g, 7D24h)
c. Observation and description of the presence or absence of muscle mass (7D24h)
d. Performance of goniometric measurement of joint range of motion and functional range of motion; with recognition of normal and abnormal joint movement (7D24g; 7D24k; 7D24l)
e. Inspection of physical environments including inspection and measuring space if applicable (7D23d, 7D24m)
f. Recognition of safety and barriers in home, community and environments. (7D23d, 7d24m)
g. Recognition of patient/client functional status (7D23d, D24m)
h. Administration of standardized questionnaires to patients (7D24m)
i. Utilization of proper body mechanics on self and demonstration of proper body mechanics to patients/caregivers (7D27, 7D23g))
j. Observation and description of patient postural alignment at rest and during activities (7D24j; 7D24k)
k. Recognition of responses to positional changes and activities and monitoring throughout treatment (7D24)
l. Observation of signs and symptoms of cyanosis, thoracoabdominal movements and breathing patterns at rest and with functional activity and monitoring throughout treatment (7B,7D24n,7D24m)
m. Observation and description of cough and sputum characteristics (7B,7D24n)
n. Recognition of the s changes in the direction and magnitude of patient’s state of arousal, mentation and cognition(7D24c)
o. Observation and description of safety factors, skin condition and patient/caregivers ability to care for assistive, adaptive, orthotic, protective, supportive and prosthetic devices (7D24d)
p. Observation and description of the safety, status, and progression of patients while engaged in gait, locomotion, balance, wheelchair management and mobility (7D24e)
q. Observation and description of the skin condition including sensation, activities, positioning and postures that can contribute to skin trauma (7B,7D24f)
r. Identification of viable versus nonviable tissue (7D24f)
s. Recognition of neuromotor development such as: gross motor milestones, fine motor milestones, righting and equilibrium reactions (7B,7D24i)
t. Administration of standardized questionnaires, graphs, behavioral scales, verbal pain scale or visual analog scales to patients or others(7D24j)
u. Recognition of changes in pain or sensation, activities, positioning, and posture that aggravate or relieve pain or altered sensation and adjust treatment accordingly (7D24j)
v. Recognition of normal and abnormal integumentary changes and reports abnormal changes to the supervising physical therapist (7D24f)
w. Recognition of absent or altered sensation and modifies intervention as needed (7D24f)
11. Provide accurate, reproducible, safe, valid, and timely collection to measure the patient’s medical status and/or progress within the interventions.
a. Communicate the results of data collection to the physical therapist
12. Demonstrate compliance with isolation protocols, standard precautions and sterile technique
13. Provide interventions (as directed in the plan of care and supervised by the physical therapist) compliant with federal and state licensing requirements, APTA standards documents and facility policies and procedures.
a. Adjust interventions within the established plan of care set forth by the supervising physical therapist appropriately in response to patient clinical indications (7B,7D19)
b. Assess patients/client’s safety and response to the intervention and communicate concerns and/or results to the intervention with the supervising physical therapist (7D20)
c. Recognize when change in patient status should result in deletion of intervention and communicates this to the supervising physical therapist (7D7, 7D21)
d. Organize the components of interventions so that the task can be performed within a specified time frame.
e. Assure safety of patient and health care provider throughout patient care(7D27)
i. Identify the need for and take action when safety of patient or health care provider may be at risk or has been compromised (7D27)
ii. Utilize risk management strategies (e.g. universal precautions, body mechanics) (7D27)
iii. Respond effectively to patient/client and environmental emergencies in the clinical setting (7D26)
14. Through application of current knowledge, theory and clinical judgement progress the patient/client within the established plan of care.(7D9)
a. Make and implement modifications in selected interventions to progress patient/client as directed by physical therapist (7D9)
b. Identify when changes in the medical status of the patient/client occur by reviewing the medical record (7D9)
c. Compare results of intervention to previously collected data and determine if there is progress toward the goals established by the physical therapist or if the goals have been met (79D)
d. Communicate with physical therapist when modifications are outside the scope of work of physical therapist assistant(7D9, 7D21)
e. Recognize when other variables (psychological, social, cultural, etc.) appear to be affecting the patient’s progression with the intervention (7D8)
f. Identify and integrate appropriate evidence based resources to support clinical decision making for progression of the patient within the plan of care established by the physical therapist (7D11)
g. Participate in discharge planning and follow up as directed by the supervising physical therapist (7D22)
h. Identify the need to progress via data collection
i. Determine what progression can be made within the plan of care
j. Identify possible progressions that will continue to advance the patient response
k. Utilize the International Classification of Functioning, disability, and health (ICF) to describe a patient’s and/or client’s impairments, activity, and participation limitations (7D16)
15. Instruct other members of the health care team, using established techniques, programs and instructional materials commensurate with the learning characteristics of the audience. (7D12)
a. Modify communication to meet the needs of the audience demonstrating respect for the knowledge and experience of others
b. Present in-service to peers, practitioners and supervisors during clinical experiences utilizing professional literature and solicit feedback from the audience (7D10, 7D12)
16. Demonstrates efficient management of resources.
a. Follow legal and ethical requirements for direction and supervision of other support personnel. (7D4)
b. Select appropriate non-patient care activities to be directed to support personnel (7D4)
c. Demonstrate efficient time management
d. Maintain and use physical therapy equipment effectively
17. Utilize the online Clinical Performance Instrument for self-assessment of the six week clinical experience
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