Lane Community CollegeClinical Education Conference

June 18, 2012

Beth Ann Thorpe, LPTA, BS, CSCS – ACCEChristina Howard, MPT – Program Coordinator

Marc Duyck, PT, MsEd - Instructor

Schedule 9:00 - Introduction and Welcome9:15 - Physical Therapy Clinical Outcome Objectives10:00 – Clinical Student Case Scenarios10:30 – Break10:45 – Scenario Discussion 11:45 – Walking Tour of Health and Wellness Building12:00 – Buffet Lunch1:00 – CI of the Year Award, Program Updates1:15 - Characteristics of Effective Clinical Instructors1:30 – Student Panel2:15 – Fostering Student Professionalism 3:00 – Disability Resources and ADA Compliance3:45 – Take Home Messages and Closing

Courtesy AnnouncementsPlease turn phones to vibrate or silent modeWater and coffee available through the dayRestrooms are out in the hall – LOCATEGet up and move around as needed

AM break time, walking tour before lunch

Certificates with be e-mailed within 1-2 days along with links to documents discussed and survey

Wi-Fi is available on campus through SAN1 LOGIN: L88888888, PIN: jackjane2012

Conference ObjectivesUnderstand clinical outcome objectives including

Clinical Performance Instrument performance levels.Create and discuss student clinical case scenarios

and identify strategies for successful resolution.Know when to contact the ACCE/DCE with clinical

concerns.Recognize characteristics of an effective clinical

instructor and successful clinical student.Fostering professionalism in physical therapy

studentsUnderstand student rights for disability

accommodations in the clinical setting.

Survey – Show of HandsHow many of you are or will be:

Clinical InstructorsCenter Coordinators of Clinical InstructionClinic/Department Managers/Rehab DirectorsAcademic Faculty – Instructors or ACCE/DCEWork with Pacific SPTsWork with Mount Hood SPTAsWork with Lane SPTAsWork with students from other schools or

disciplines

Clinical Outcome ObjectivesBeth Ann Thorpe, LPTA, BS, CSCS – ACCE

•What is “Entry Level” for PT/PTA?• Clinical Performance Instrument (CPI) • Review of Bloom’s Taxonomy

What is “Entry Level?”PT Minimum Skills – Doctorate Degree

LinkPTA Minimum Skills – Associate Degree

Link We teach general foundational knowledge for ALL

settings, not specialties or in depth manual techniques for PTAs.

Remember these are students, not experienced clinicians.

A little humor – So You Want to Be a PT Student

Clinical Performance Instrument Paper or online assessment tool created by the

APTA for student clinical performance.PTA CPI Web: LINK

Schools pay to use the online versionOnline version has required FREE training

module through APTA Learning Center for all usersCPI Indicators: 18 for SPTs, 14 for SPTAsPerformance Dimensions and Rating Anchors:

LINK Definition of Entry Level on handout

Clinical OutcomesLCC PTA Students complete 3 clinical rotations

during 2nd year; PTA 280A, B, and C (6 weeks for 216 hours)

Outcome expectations are progressively increased

PTA 280A: CPI 1-6 approaching I level, 8-14 approaching AB level PTA 280B: CPI 1-7 approaching AI level, 8-14 approaching I level PTA 280C: CPI 1-7 approaching E level, 8-14 approaching AI level

Bloom’s Taxonomy3 Domains

1. Cognitive - knowledge, definition (see image below)2. Psychomotor – skill, do it3. Affective – attitude, value

Bloom’s Taxonomy LinksBig Dog and Little Dog’s Performance

Juxtapositionhttp://www.nwlink.com/~donclark/hrd/bloom.

htmlIowa State University Center for Excellence in

Learning and Teaching- A Model of Learning Objectives

http://www.celt.iastate.edu/teaching/RevisedBlooms1.html

Bloom’s Taxonomy with an iPhonehttp://www.youtube.com/watch?v=sdkT7nQ0

WGQ&feature=related

Bloom’s Cognitive PTA Example Remembering – Recite stages of gait cycleUnderstanding – Explain what happens at

each stageApplying – Classify RLA vs Traditional

descriptionsAnalyzing – Differentiate normal vs abnormal

gaitEvaluating – Correct abnormal form,

weaknessesCreating – Prescribe exercise program to

address gait deviations

Student Clinical Case StudiesWrite Individual Case - 10 minutesUse the worksheet givenThis can be CI-Student, Student-Patient

Color paper = ChallengeColor paper = Success

Think about the CPI Indicators around the room

Case Study ExamplesChallenge – PT student in middle rotation in OP ortho completing

an evaluation omitted taking vital signs but later made up values in documentation.Professional and behavioral issue. DCE was called by CI. Critical

Incident report was completed. Lesson on VS and given practice in case the skill was a problem. Student ultimately continued questionable ethical behavior and failed clinical. CI was more aware of ethics and began discussing it with students.

Success – PTA student in first rotation in acute was intimidated by transferring patient with multiple lines in small room. Some behavior but mostly skill issue. CI simulated catheter, O2 and

IV lines in open room to have student practice. CI told ACCE at site visit about student lack of skill in this area. Line management practice in mock hospital room added the next term prior to clinical. This sharing helped entire class and CI practiced IV with students prior to multi-line patient handling.

Student Clinical Case StudiesSmall group discussions at your table – 15 minutesSeek/offer feedbackHave any of you experienced similar?

Break Time - 10:30AMWrite on the easels on your way out: 1-2• Characteristics of an effective Clinical Instructor• Characteristics of a successful clinical student

Student Clinical Case ScenariosLarge Group DiscussionShare 1 Success and 1 Challenge

per tableHow often was the ACCE/DCE

involved?Suggestions/Feedback

ACCE/DCE ResourcesUse us! When in doubt, check in.

Keep phone number and e-mail handy during clinicalRed Flags/Behavioral issues – sooner than later

Set up a successful environment before student arrivalAPTA Credentialed Clinical Instructor ProgramAPTA Guidelines and Self-Assessment for Clinical

Instruction – CI LINK, CCCE LINKHave site policies, goals, manual, mentoringWelcome letter and contact prior to student arrivalPossible shadow or meeting prior to start date

ACCE/DCE Resources cont’dDuring Clinical

Thorough student orientation on day 1 - LINKSet communication style/tone early on

Kolb Learning Style Inventory - LINKWeekly Goal Setting Meeting – LINK (sample)End of the day reflections – Ask the student for 3

things that went well today and 3 things to work onProblem-Solving Algorithm - LINKCritical Incident Report – LINK (sample), also onlineSample Weekly Progressions – LCCMid-term CPI springboard for final goal setting

Student Humor

Tour of Health and WellnessBuilding 30 – PTA Lab 122 and SIM Lab – 15

minutes

Lunch Time 12-1PM• Mediterranean Buffet • Moodle demo if interested

Program Announcements

2011-2012 CI of the Year

Characteristics of Effective Clinical Instructor and Successful Clinical Student•Attendee response today vs. student response

Characteristics of an Effective CIPatienceAllow hands on

practiceDemonstrate

techniquesAllow (safe)

mistakesGear toward student

learning styleGood communicatorEBPRole model

Give feedbackSupportive and

encouragingSeek feedbackGive appropriate but

not unreasonable challenges

Build confidence by allowing student to lead

Be nice.

Successful Clinical StudentDrive and

determinationDo not be too hard on

yourself – allow/forgive mistakes

PatienceAsk questionsConfidence in

knowledge learnedAdaptable/flexible

Take feedback/criticism

Write clear and concise notes

Good listenerArrive early and be

prepared for the dayStudy at homeRespectful,

accountableTime management

PTA Student Panel• Share feedback• Q & A

Promoting Professionalism Among Students in the Clinic• Marc Duyck, PTA, MsEd

ProfessionalismWhat is considered Professional Behavior?What type of professional behaviors are

expected of students? PT vs PTA? Autonomous vs semi-autonomous?

How do CIs orient students who are challenged in the professional domain?

APTA Guide to Professional Conduct for the PT APTA Guide to Professional Conduct for the PTA Example of conduct observed Review of Guides in small groups

Professionalism cont’dCoaching students on professional

communicationVerbalNon-verbalWritten

E-mail communications

Challenges faced by programsHow challenges are addressed by programs

Explicit coachingProgram standards

Disability Resources• Americans with Disabilities Act Compliance• Students’ Rights • Disability Resources Department Procedures•Increase in student requests for accommodations at the community college level•Most common request is for text anxiety, time and a half for exams•LCC PTA clinical outcome objectives have built in extra time that progressively lessens by final rotation.

Take Home Points•Familiarize yourself with clinical outcome objectives, CPI indicators, student level before student arrival•Meet the student where he/she is in the learning process•Self-assess your performance as a site/CI/CCCE/instructor and ask for student feedback for improvement•Consult with resources and ACCE/DCE for support sooner than later, especially on red flags/behaviors•Create a rich learning environment with welcome letter, orientation, and communication strategies early on

Take Home Points cont’d•Be direct with students – do not wait until mid-term to provide feedback •When having discussions regarding professionalism with students, use core documents as references•When it comes to professionalism, we are all works in progress•Students with disabilities have rights to seek accommodations but must be able to perform essential skills.•It is the responsibility of the student and the school to provide possible accommodations.

Thank You for Attending!Questions?

References APTA Minimum Required Skills of Physical Therapist Graduates at Entry-Level BOD G-11-05-20-48.

http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/BOD/Education/MinReqSkillsPTGrad.pdf. Accessed June 15, 2012. APTA Minimum Required Skills of Physical Therapist Assistant Graduates at Entry-Level. BOD G11-08-09-18.

http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/BOD/Education/MinReqSkillsPTGrad.pdf. Accessed June 15, 2012. So You Want to Be a PT Student video. You Tube. http://www.youtube.com/watch?v=vgt1Gl4pir4. Accessed June 15, 2012. PTA CPI Web. Academic Software Plus. https://cpi2.amsapps.com/user_session/new. Accessed June 15, 2012. PTA Clinical Performance Instrument. APTA, 2008. PT Clinical Performance Instrument. APTA, 2008 Bloom’s Taxonomy Cognitive Domain image. http://projects.coe.uga.edu/epltt/index.php?title=Bloom%27s_Taxonomy. Accessed June

15, 2012. Big Dog and Little Dog’s Performance Juxtaposition. http://www.nwlink.com/~donclark/hrd/bloom.html. Accessed June 16, 2012. A Model of Learning Objectives. Iowa State University Center for Excellence in Learning and Teaching.

http://www.celt.iastate.edu/teaching/RevisedBlooms1.html. Accessed June 15, 2012. Bloom’s Taxonomy with the iPhone. You Tube, Video. http://www.youtube.com/watch?v=sdkT7nQ0WGQ. Accessed June 15, 2012. APTA Credentialed Clinical Instructor Program. http://www.apta.org/CCIP/. Accessed June 15, 2012. Guidelines for Self-Assessment for Clinical Instruction. APTA. 2004 Edition. Kolb Learning Style Inventory. Image retrieved from

http://www.google.com/imgres?imgurl=http://www.businessballs.com/images/kolb%27s_learning_styles_businessballs.jpg&imgrefurl=http://www.businessballs.com/kolblearningstyles.htm&h=675&w=859&sz=138&tbnid=VxAjWuMz-MtusM:&tbnh=90&tbnw=115&zoom=1&usg=__BTY9kRRVc8EG5lZT7fXONIgryxg=&docid=xeuHq50qaha0fM&sa=X&ei=-vLeT4OTOsLu2gW04OTgAQ&ved=0CHMQ9QEwAA&dur=214. Accessed June 15, 2012.

American Physical Therapy Association. Problem solving algorithm utilized by PTAs in patient/client intervention. In: A Normative Model

of Physical Therapist Assistant Education: Version 2007. Alexandria, VA: American Physical Therapy Association; 2007:84‐85. Lane Community College Health and Wellness Building image. Building User Introduction. SRG Partnership, Inc.

www.lanecc.edu/sustainability/documents/B30book.pdf. Accessed June 15, 2012. APTA Guide to Professional Conduct for the PTA. APTA Ethics and Judicial Committee. November 2010.

http://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Ethics/GuideforConductofthePTA.pdf. Accessed June 15, 2012.

APTA Guide to Professional Conduct for the PT. APTA Ethics and Judicial Committee. November 2010. http://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Ethics/GuideforProfessionalConduct.pdf. Accessed June 15, 2012.

American With Disabilities Act of 1990. Department of Justice. http://www.ada.gov/pubs/ada.htm. Accessed June 15, 2012. Shepard, K and Jensen, G. Handbook of Teaching For Physical Therapists. Second Edition. Philadelphia, PA. Butterworth and

Heinemann and imprint of Elsevier. 2002