Notebook - Whitworth University · athletic trainer as a health care provider within the larger...
Transcript of Notebook - Whitworth University · athletic trainer as a health care provider within the larger...
Whitworth University
2013-2014
Preceptor Notebook
Athletic Training Faculty and Staff 2013-2014
Cynthia Wright, ATC
Program Director
Assistant Professor
Robinson Science Hall 108
(509)777-3244
Melinda Larson, ATC
Interim Athletic Director
Associate Professor
Westminster 200
(509)777-4389
Cheree Sauer, ATC
Assistant Athletic Trainer
Fieldhouse 138
(509)777-3464
Jon Bosh, ATC
Interim Head Athletic Trainer
Associate Athletic Trainer
Fieldhouse 132
(509)777-3728
Shane Wibel, ATC
Assistant Athletic Trainer
Assistant Professor
Fieldhouse 131
(509)777-3478
Sarah Cummings, ATC
Assistant Athletic Trainer
Fieldhouse 134
(509)777-3216
Stacey Nauman, ATC
Visiting Faculty Instructor
Robinson Science Hall
(509)777-3247
Mike Ediger, ATC
Health Sciences Department Chair
Associate Professor
Robinson Science Hall 207
(509)777-4624
Athletic Training Team Physicians
Ed Reisman, MD Medical Director, Team Physician
Barb Brandon, DO Team Physician
Tycho Kersten, MD Team Physician/Orthopedic Surgeon
Andy Lawson, DO Sports Medicine Fellow
Table of Contents
A. Orientation to WU AT Program Clinical Experience 4
1. Mission and Objectives 5
2. Academic and Clinical Foundations of the Program 7
3. Clinical Experience Sequence and Course Content 9
4. Athletic Training Major Course Sequence 11
B. Affiliate Clinical Site Information 12
1. Clinical Site Characteristics and Requirements 13
2. Sample Affiliation Agreement 14
3. Therapeutic Equipment Safety Policy (Modalities) 18
C. Clinical Proficiency Journals 20
1. Introduction and Instructions 21
2. Sample Journal page (see Appendices for full version) 23
D. ATEP Policies and Procedures 24
1. Supervision Policy 25
2. Clinical Hours 27
3. Communicable Disease 28
4. Confidentiality 29
5. Bloodborne pathogen policies 30
Appendices 33
A. Student Evaluation Form 33
B. General Medical Competency Journal 39
C. Physical Therapy Competency Journal 46
D. Athletic Training Competency Journal 57
E. Sample Clinical Experience Course Syllabus (AT 383 fall 2013) 68
Orientation to Whitworth University
AT Program Clinical Experience
Mission Statement
The mission of the Athletic Training Program at Whitworth University is to equip students with
the knowledge and skills necessary to become proficient and professional entry-level athletic
trainers. This is accomplished through high quality instruction and experiences that model ethical
practice, effective communication and compassion. The program utilizes a holistic approach in
developing multi-dimensional healthcare professionals and servant-leaders within the context of
a Christian liberal-arts environment.
Program and Student Learning Outcomes
1. Outcome #1: Whitworth University athletic training students will incorporate spiritual,
ethical, moral and legal behavior into the practice of athletic training.
1.1. Objective: Whitworth University athletic training students will appreciate the value and
nature of personal faith and worldview into vocational practice.
1.2. Objective: Students will abide by the Standards of Practice established by the Board of
Certification as well as the NATA Code of Ethics.
2. Outcome #2: Whitworth University athletic training students will understand the role of an
athletic trainer as a health care provider within the larger context of the continually evolving
health care system.
2.1. Objective: Students will work in collaboration with other health care providers
2.2. Objective: Students will communicate effectively with all those involved in health care
of the patient, both in oral and written form
3. Outcome #3: Whitworth University athletic training students will demonstrate entry-level
proficiency through classroom, laboratory and clinical learning experiences in the 5 domains
of athletic training.
A. Injury/Illness prevention and wellness protection
B. Clinical evaluation and diagnosis
C. Immediate and emergency care
D. Treatment and rehabilitation
E. Organizational and professional health and well-being
3.1. Objective: Students will achieve 100% ultimate pass rate on the BOC exam for those
who continue to attempt it.
3.2. Objective: Students will be well prepared to meet the challenges of entry-level
employment positions.
3.3. Objective: Students will demonstrate contemporary knowledge and skill in the
comprehensive examination, assessment, management, treatment and/or rehabilitation of
patients with injuries and illnesses as they pertain to an active lifestyle
3.4. Objective: Students will learn clinical skills under the supervision of high quality
preceptors at quality clinical sites.
3.5. Objective: Students will recognize quality evidence from a variety of sources and
incorporate into practice
4. Outcome #4: Whitworth University athletic training students and alumni will demonstrate
professional behaviors consistent with the athletic training profession and healthcare.
4.1. Objective: Students and alumni will invest in and promote the profession of athletic
training or other chosen vocation
4.2. Objective: Whitworth University athletic training students and alumni will support their
professional community by assuming a service and/or leadership role in an area that
impacts the practice of athletic training or respective vocation.
4.3. Objective: Students will establish habits that will result in life-long learning and
professional development.
Academic and Clinical Foundations
The knowledge and skills to be mastered by students in the entry-level AT Program have been
identified by the National Athletic Trainers’ Association Professional Education Council in the
Athletic Training Educational Competencies, 5th Edition (NATA, 2011). These Competencies
provide the entry-level athletic trainer (AT) with the essential knowledge and skills needed to
provide athletic training services to patients of differing ages, lifestyles and needs. These
Competencies also serve as a guide for the development of educational programs and learning
experiences leading to a student’s eligibility to challenge the Board of Certification, Inc.
examination. The Whitworth University AT Program builds upon these minimal requirements to
provide students with high quality education that connects the classroom, lab and clinical
education settings.
The Competencies are categorized according to eight content areas comprising the knowledge
and skill set of the entry-level athletic trainer. These content areas are:
1. Evidence Based Practice
2. Prevention and Health Promotion
3. Clinical Examination and Diagnosis
4. Acute Care of Injuries and Illnesses
5. Therapeutic Interventions
6. Psychosocial Intervention and Referral
7. Health Care Administration
8. Professional Development and Responsibility
Additionally, Clinical Integration Proficiencies (CIP) represent the integration of knowledge,
skills, and clinical decision-making into actual patient care. They will ideally be assessed over
multiple interactions and with the same patient, but may also necessitate simulated scenarios.
In addition to the Competencies and Clinical Integration Proficiencies, an understanding of the
Foundational Behaviors of Professional Practice (Behaviors) (NATA, 2011) is vital to the
completion of the AT Program. The Behaviors comprise the application of the common values of
the athletic training profession. These Behaviors are:
Primacy of the Patient
Recognize sources of conflict of interest that can impact the client’s/patient’s health.
Know and apply the commonly accepted standards for patient confidentiality.
Provide the best healthcare available for the client/patient.
Advocate for the needs of the client/patient.
Team Approach to Practice
Recognize the unique skills and abilities of other healthcare professionals.
Understand the scope of practice of other healthcare professionals.
Execute duties within the identified scope of practice for athletic trainers.
Include the patient (and family, where appropriate) in the decision-making process.
Work with others in effecting positive patient outcomes.
Legal Practice
Practice athletic training in a legally competent manner.
Identify and conform to the laws that govern athletic training.
Understand the consequences of violating the laws that govern athletic training.
Ethical Practice
Comply with the NATA’s Code of Ethics and the BOC’s Standards of Professional Practice.
Understand the consequences of violating the NATA’s Code of Ethics and BOC’s Standards
of Professional Practice.
Comply with other codes of ethics, as applicable.
Advancing Knowledge
Critically examine the body of knowledge in athletic training and related fields.
Use evidence-based practice as a foundation for the delivery of care.
Appreciate the connection between continuing education and the improvement of athletic
training practice.
Promote the value of research and scholarship in athletic training.
Disseminate new knowledge in athletic training to fellow athletic trainers, clients/patients,
other healthcare professionals, and others as necessary.
Cultural Competence
Demonstrate awareness of the impact that clients’/patients’ cultural differences have on their
attitudes and behaviors toward healthcare.
Demonstrate knowledge, attitudes, behaviors, and skills necessary to achieve optimal health
outcomes for diverse patient populations.
Work respectfully and effectively with diverse populations and in a diverse work
environment.
Professionalism
Advocate for the profession.
Demonstrate honesty and integrity.
Exhibit compassion and empathy.
Demonstrate effective interpersonal communication skills.
These behaviors are infused throughout the AT Program; however some are more easily
recognized and practiced by students. Other behaviors are predominantly exposed to students
through demonstration by clinical educators and not practiced by students due to the nature of
their role. It is most likely that the full measure of a student’s assimilation of these behaviors will
be achieved after they have been practicing as a certified athletic trainer for a number of years.
Clinical Experience Sequence and Course Content
The first term clinical experience (AT 283) will include content from the following areas:
Injury Prevention
Implementation of Emergency Action Plans
Acute Care and Management Athletic Injuries
Integration of the Christian Faith in Athletic Training
During this term, the student will be exposed to general athletic training room operations, non-
contact, contact, and collision sports as well as both male and female athletes at Whitworth
University.
The second term clinical experience (AT 284) immerses the athletic training student (ATS) in
the completion of competencies related to:
Professional Development and Responsibilities
Ethical Professional Practice
Integration of the Christian Faith in Athletic Training
During this term, the student will be exposed to general athletic training room operations, non-
contact, contact, and collision sports as well as both male and female athletes at Whitworth
University.
The third term and fourth term clinical experience (AT 383 and AT384) include 3 clinical
experiences lasting 7-14 weeks each.
One 7 week experience will be completed at a general medical health care facility instructing and
evaluating competencies related to:
Pharmacology
General Medical Conditions
Patient History
Vital Signs
Skin Conditions
Respiratory Conditions
Neurological Conditions
Endocrine Conditions
Genitourinary Conditions
Gynecological Concerns
Viral Conditions
Systemic Conditions
Eyes, Ears, Nose, & Throat Conditions
Gastrointestinal Conditions
Sexually Transmitted Diseases
Disordered Eating
One 7-14 week experience will be completed at a physical therapy clinic or off-campus athletics
setting (area high school, college or professional sports team). Typically, this will be a 7 week
rotation at a physical therapy clinic. The purpose is to immerse the ATS in instruction and
assessment related to:
Therapeutic Modalities
Clinical Evaluation, Treatment and Prevention of Injuries (Lower or Upper Extremity
depending on fall or spring)
Evidence based practice
One 7-14 week experience will be completed at a physical therapy clinic, orthopedist office, or
off-campus athletics setting (area high school, college or professional sports team) . Typically,
this will be a 14 week rotation in a traditional athletics setting. The purpose is to immerse the
ATS in instruction and assessment related to:
Clinical Evaluation, Treatment and Prevention of Injuries (Lower or Upper Extremity
depending on fall or spring)
Professional development and administration
Evidence based practice
The fifth term clinical experience (AT 483) will be completed at Whitworth University and the
student may be assigned a team. This experience includes instruction and assessment related to:
o Clinical Evaluation, Treatment and Prevention of Injuries
o Head and Spinal Injury assessment and management
o Recognition and intervention for psychosocial disorders.
o Interviewing and Employment Preparation
o Health Care Administration
The sixth term clinical experience (AT 484) will be completed at Whitworth University and the
student may be assigned a team. This course provides a capstone experience for seniors to
prepare for the BOC exam. Additionally, it includes instruction and assessment related to:
o Therapeutic Rehabilitation
o Principles of Conditioning and Nutrition
o Professional development and philosophy
Course Progression and Sequence for 4 Year Traditional Student
This is the general course sequence for Athletic Training majors. Students should consult with
their advisor regularly for updates and personalization. Students should be aware that the
majority of courses within the Athletic Training major are sequenced and must be taken in a
specific order due to pre-requisites. Courses in italics are recommended, not required.
Semester 1 Cr. Jan 1 Semester 2 Cr
AT 270 Emergency Response 2 HS179 Foundations
of HS
3 AT 270 Emergency Response (if
not completed in fall)
2
BI 140 General Biology I & Lab 4 AT 271 Intro to Athletic Training 2
CH161/101 General chemistry 4 CH181/101 General Chemistry 2
GE125 Freshman seminar 1 GE Gen Ed Requirements
GE Gen Ed Requirements
Total Total
Semester 3 Jan 2 Semester 4
HS 220 A&P 4 AT396 Topics in AT 1 HS 221 A&P II 4
HS 363 Personal Health &
Nutrition
3 AT 332 Modalities 2
AT 283 Clinical Experience 2 AT 284 Clinical Experience II 2
GE Gen Ed Requirements AT 336 Medical Issues in AT 3
GE Gen Ed Requirements
Total Total
Semester 5 Jan 3 Semester 6
HS 365W Evidence Based Health
Science
3 AT396 Topics in AT 1 HS 320 Structural & Mechanical
Kinesiology
4
HS 326 Exercise Physiology 3 OR, study abroad! AT 333 Org & Admin in AT 3
AT 334 Lower Extremities in AT 3 AT 335 Upper Extremities in AT 3
AT 383 Clinical Experience III 2 AT 384 Clinical Experience IV 2
GE Gen Ed Requirements GE Gen Ed Requirements
Total Total
Semester 7 Jan 2 Semester 8
AT 432 Therapeutic Exercise 2 AT396 Topics in
AT
1 AT 484 Clinical Experience VI 2
HS 433 Principles of Conditioning
and Nutrition
3 MA256 Stats 3 HS 361 Community Health 3
AT 483 Clinical Experience V 2 GE Gen Ed Requirements
GE Gen Ed Requirements
Total Total
Affiliated Clinical Site Information
Clinical Affiliate Selection Criteria Whitworth University
Athletic Training Program
Below are the criteria for inclusion of a site as an Approved Clinical Affiliate for the AT
Program.
Related to the Clinical Site:
1. Commitment to Athletic Training Student education as evidenced an environment
focused on teaching and learning. Not an environment that uses students as “workers”.
2. Provision of multiple opportunities for directed clinical instruction
3. Exposure to environments/practices not readily available Whitworth University Athletic
Training Setting
4. Availability of a variety of clinicians with multiple perspectives, exposing students to
intellectual breadth of experiences and opportunities
5. Affiliated site provides a safe environment, as evidenced by appropriate policies
regarding BBP, EAP, modalities calibration, and electrical safeguards (as appropriate).
6. Affiliated site is willing to enter into a written affiliation agreement with the Whitworth
University AT Program to allow for the placement of athletic training students.
Related to the Preceptor:
7. Sound, evidence based, ethical clinicians
8. Clinicians committed to providing an academic stimulating and challenging learning
experience
9. Environment employs clinicians that are qualified and appropriately licensed
10. Clinicians with expertise/experience in Athletic Training student development and
progression
11. Preceptor is willing to provide regular planned evaluation of athletic training student
performance and proficiency.
Sample of Approved Clinical Affiliate Agreement
Whitworth University
Athletic Training Program
This agreement is between Whitworth University and Sample High School, hereafter referred to
as the affiliated site, and is established to provide a program of supervised clinical experiences
for the Athletic Training students of Whitworth University under the following terms and
conditions.
I. Both Parties agree as follows:
1. Whitworth University and the affiliated site enter into this agreement whereby
undergraduate instruction will be offered at the affiliated site under the auspices of
Whitworth University.
2. It is mutually agreed that no person shall be subject to unlawful discrimination of
race, color, religion, sex, national origin, age, veteran status, and/or disability in
connection with the program.
3. This agreement may be modified by written amendment signed by duly authorized
representatives of each party.
4. This agreement may be terminated by either party. Such termination shall not take
effect until the students already accepted for placement in the program have
completed their scheduled clinical experience. Either party may also terminate this
agreement at any time by mutual written consent.
II. Responsibilities of Whitworth University
1. Whitworth University shall be responsible for selecting and assigning only those
students who have successfully completed appropriate coursework and clinical
experiences. Whitworth University shall retain general responsibility for the content
and methods of instruction, supervision, evaluation, and structure of the clinical
experience.
2. Whitworth University shall inform the affiliated site of the level of experience of the
student prior to their placement. Whitworth University shall provide information
about the mission, curricular, and clinical experience to the affiliated site.
3. Whitworth University will maintain liability insurance (a minimum of $1 million
limit each occurrence, $3 million limit general aggregate) for each student assigned to
the Affiliated Site and will provide the Affiliated Site with information regarding
such liability insurance upon request.
4. Whitworth University will provide a Preceptor Training Workshop and orientation to
the program for all preceptors supervising Athletic Training Students.
5. Whitworth University will notify the student of the following responsibilities:
i. Technical Standards
ii. Immunizations and records
iii. Code of Confidentiality
iv. Expectations for professional practice
v. Dress code
vi. Course proficiencies and expectations for progression
vii. Affiliated site contact information
viii. Communicable Disease Policy
6. Whitworth University will provide the affiliate site with evaluative feedback on
students perceptions of the clinical experience
7. Whitworth University will certify that each student has training in:
i. Bloodborne Pathogens
ii. Universal Precautions
iii. CPR for the Professional Rescuer
iv. Emergency Response
III. Responsibilities of the affiliated site:
1. The affiliated site will provide a planned, supervised program of clinical instruction,
allowing the student to use its physical facilities, clinical equipment and materials as
appropriate and in accordance with the clinical experience objectives agreed upon by
the affiliated site and the University.
2. The affiliated site will provide each assigned student with an orientation to the
affiliated site, including a copy of pertinent rules and regulations of the affiliate site.
3. The affiliated site will provide a site coordinator (in the case of a site with multiple
preceptors) to work with the Whitworth University Athletic Training Program
Director and Clinical Education Coordinator to coordinate and direct the clinical
experience. In the event that the site only has one preceptor, that person will also
serve as the site coordinator.
4. The affiliated site will provide both the student and Whitworth University with
information concerning the students:
i. Professional development
ii. Clinical competency
iii. Perceived ability to progress in the program
5. The affiliated site will allow periodic inspection by Whitworth University and
accrediting agencies of its facilities, athletic training students’ records, or other
records that pertain to the Athletic Training Program.
6. The affiliated site agrees to not use Athletic Training students in the place of regular
employees.
7. The affiliate site will abide by applicable laws, regulations and site policies regarding
the provision of healthcare services by student trainees. Specifically, the affiliated
will not allow provision of healthcare services by student trainees except under the
direct supervision of a licensed healthcare provider. The licensed healthcare provider
will be responsible for clinical decision making, supervision and instruction.
8. The affiliated site will agree to provide practitioners that adhere to the Foundational
Behaviors of Professional Practice including:
i. Primacy of the Patient
ii. Team Approach to Practice
iii. Legal Practice
iv. Ethical Practice
v. Advancing Knowledge
vi. Cultural Competence
vii. Professionalism
IV. Benefits for Whitworth University preceptors typically include:
1. Both business and individual recognition on the Whitworth University Athletic
Training website
2. Whitworth University All Sports Family Pass
3. CEU opportunities through the Whitworth AT Program
4. Access to CPR recertification courses by Whitworth instructional faculty
V. Any notice required or permitted in this agreement shall be in writing to the following:
1. For the University notice shall be given to the Athletic Training Program Director:
Contact Person: Dr. Cynthia Wright
Site: Whitworth University
Address 1: 300 W. Hawthorne Rd
Address 2: Spokane, WA 99251
Email: [email protected]
2. For the affiliated site notice shall be given to the preceptor at the address noted on the
signature page unless otherwise designated below:
Contact Person:
Site:
Address 1:
Address 2:
Email:
Affiliate Agreement
Signature Page
Sample High School
and
Whitworth University
Athletic Training Program
This agreement shall become effective immediately for the 2013-2014 fiscal year at Whitworth
University (July 1st through June 30
th). This agreement will automatically renew on July 1
st of
each year for a maximum of five (5) years unless written notice of termination is given by either
party as provided in Section I4.
By: __________________________
Caroline Simon, PhD Whitworth University
Provost & Executive VP 300 W. Hawthorne Rd.
Academic Affairs Spokane, WA 99251
By: _________________________
Cynthia Wright, PhD, ATC Whitworth University
Athletic Training Program Director 300 W. Hawthorne Rd.
Assistant Professor of Health Sciences Spokane, WA 99251
By: _________________________
Edward Sample Sample High School
Principal 0000 N. Sample St
Sample High School Spokane, WA 99200
By: _________________________
Sally Sample, MS, ATC Sample High School
Athletic Trainer 0000 N. Sample St
Sample High School Spokane, WA 99200
Whitworth AT Program
Therapeutic Equipment Safety Policy
All physical medicine devices, as defined by the US Code of Federal Regulations Title 21 part
890, will be maintained and calibrated according to the FDA Medical Device Quality Systems
Manual Section 7: Equipment and Calibration. These documents refer largely to manufacturer’s
recommendations.
In developing this policy, manufacturer’s recommendations were sought regarding therapeutic
equipment calibration and/or safety checks for devices commonly utilized by athletic trainers.
Overall, each manufacturer recommended annual calibrations and safety checks for their devices
(see Table 1 below for a summary of findings).
Therefore, the Whitworth AT Program will contract with a licensed professional to annually
inspect and certify non-exempt therapeutic equipment used in on-campus instruction or clinical
experience. Additionally, all approved clinical sites will contract with a licensed professional to
annually inspect and certify non-exempt therapeutic equipment on an annual basis. If a clinical
site can provide evidence that the manufacturer guidelines for their equipment are less frequent
than Whitworth’s generic policy (annual), the manufacturers guidelines will prevail.
Non-exempt therapeutic equipment includes those categories outlined in Table 1 below (e.g.
ultrasound, whirlpools, hydrocollators, and electrotherapy machines). In general, any therapeutic
modality with an internal power source, or that combines electricity and water is considered non-
exempt. Exempted devices include items such as the Gameready, and battery operated TENS
and Iontophoresis units. The Gameready is exempted because it has an external power source,
battery operated TENS and Iontophoresis units are exempt due to the low risk associated with
battery power (G. Sargent, personal communication, March 15, 2013*).
References:
http://www.ecfr.gov/cgi-bin/text-
idx?c=ecfr&SID=64dd1b2e5f5fe1965c910c6c0fa295de&rgn=div5&view=text&node=21%3A8.
0.1.1.31&idno=21#21:8.0.1.1.31.2.1.9
http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/PostmarketRequirements/Q
ualitySystemsRegulations/MedicalDeviceQualitySystemsManual/default.htm
*Greg Sargent works for TheraTek USA LLC, and is the licensed professional contracted to
perform annual inspections and calibrations of therapeutic equipment by most clinical sites in the
region.
Table 1. Overview of Manufacturer Recommendations for Specific Products
Manufacturer Modality Category
Recommended
Frequency
User Manual
Page
Dynatronics Dynatron 150+ Ultrasound Annually 41
Dynatronics Dynatron 850+ Electrotherapy Ultrasound
Combination
Annually 107
Dynatronics Dynatron 950+ &
Dynatron 650+
Electrotherapy Ultrasound
Combination
Annually 107
Chattanooga
Group
Vectra Genisys,
Intelect Legend XT, &
Intelect Vet
Therapy System Annually 79
Dynatronics Dynatron Solaris 700
Series
Electrotherapy, Direct
Current Therapy, Ultrasound
Therapy, Light Therapy
Annually 129
Chattanooga
Group
Intelect Model 225P/
230P Ultrasound
Ultrasound Annually 11
Whitehall
Manufacturing
Thermalator Hydrocollator Annually 16
Clinical Proficiency Journals
Whitworth University Athletic Training Program
Clinical Proficiencies to be completed during Off-Campus Clinical Rotations
Purpose The 5th edition of the Athletic Training Education Competencies (Competencies) provides
educational program personnel and others with the knowledge, skills, and clinical abilities to be
mastered by students enrolled in professional athletic training education programs. Mastery of
these Competencies provides the entry–level athletic trainer with the capacity to provide athletic
training services to clients and patients of varying ages, lifestyles, and needs. The Commission
on Accreditation of Athletic Training Education (CAATE) requires that the Competencies be
instructed and evaluated in each accredited professional athletic training education program.
The competencies are divided into eight content areas:
Evidence-Based Practice (EBP)
Prevention and Health Promotion (PHP)
Clinical Examination and Diagnosis (CE)
Acute Care of Injury and Illness (AC)
Therapeutic Interventions (TI)
Psychosocial Strategies and Referral (PS)
Healthcare Administration (HA
Professional Development and Responsibility (PD)
In addition, clinical integration proficiencies (CIPs) represent the synthesis and integration of
knowledge, skills, and clinical decision-making and its global nature into actual client/patient
care. In most cases the CIPs will be assessed over multiple interactions with the same
client/patient and incorporate evidence-based practice principles.
Instructions for the student: All of the Clinical Proficiencies associated with each clinical rotation must be evaluated and
assigned a grade “Proficient” in order to successfully complete the course. Receiving an
evaluation of “Not proficient” for any skill indicates a need to study and practice, then re-attempt
the Clinical Proficiency until a level of “Proficient” is indicated. It is the student’s responsibility
to schedule time with their preceptor for Clinical Proficiency completion.
Some Clinical Proficiencies will require the student to provide a description of how the Clinical
Proficiency was demonstrated. It is the responsibility of the student to write this description,
accurately and completely, prior to presenting it to the preceptor for signature.
Instructions for the Preceptor: After supervising the completion of a Clinical Proficiency, the preceptor should assign a mastery
level (described below), initial and date the attempt. Any Clinical Proficiency marked as “Not
Proficient” will need to be repeated and re-assessed prior to the conclusion of the clinical
rotation. The form allows space to document 2 attempts, although fewer or more attempts may
be necessary.
Evaluation of the student’s mastery level of clinical proficiencies will be completed using a 3-
level scale.
“Not proficient-X” or “NP-X” indicates that the student needs significant
improvement to be able to perform this skill at an acceptable entry-level. The student is
unable to apply his/her knowledge or skills in a manner that suggests he/she could
perform the skill safely, effectively and independently (without prompting or assistance).
o Example 1: The student needed significant prompting or assistance to complete
the task.
o Example 2: The student was unable to recognize the situation and required skills,
let alone perform them.
o Example 3: Without supervision and correction, the actions of the student could
have resulted in harm to the patient.
“Not proficient-Close” or “NP-C” indicates that the student needs minor improvement
to be able to perform this skill at an acceptable entry-level. The student is unable to
apply his/her knowledge or skills in a manner that suggests he/she could perform the skill
safely, effectively and independently (without prompting or assistance).
o Example 1: The student needed minimal prompting or assistance to complete the
task.
o Example 2: The student was able to recognize the situation and required skills, but
struggled to perform them correctly.
o Example 3: The actions of the student would not have resulted in optimal patient
care (but would not have caused harm).
“Proficient” or “Pass” indicates that the student is able to perform the skill
independently at an acceptable entry-level. The “proficient” student should have the
ability to apply the clinical skills safely, effectively, and efficiently in the absence of a
supervisor (although direct supervision of clinical experiences is still required as part of
CAATE standards).
The evaluation of clinical proficiencies can occur in two ways.
1. Performance on an actual patient. The student, under direct supervision may use this
time to demonstrate his/her clinical proficiency by aiding the patient.
2. Performance using a scenario. The student sets up an appointment with a preceptor, at
which time the preceptor provides a mock situation for the student. The student will act
as if the preceptor or a subject is the patient, demonstrating their skill under the
preceptor’s direct supervision.
SAMPLE PROFICIENCY WORKSHEET (See Appendices for full proficiency sheets)
AT Program Policies and Procedures
Athletic Training Students receive an AT Program Policies and Procedures Manual, updated
annually and posted electronically on the AT Program website
(http://www.whitworth.edu/athletictraining/). The following policies and procedures relevant to
off campus clinical experiences, are include for preceptor reference.
WHITWORTH UNIVERSITY AT PROGRAM
Supervision Policy and Emergency Responder Clarification
As a student in an educational program for a health profession it is important to understand and
comply with appropriate boundaries in the practice of athletic training clinical skills. These
boundaries protect the student, the patient and the profession.
In compliance with the Commission on the Accreditation of Athletic Training Education
(CAATE), Whitworth AT Program Supervision Policy is that “Students must be directly
supervised by a preceptor during the delivery of athletic training services. The preceptor
must be physically present and have the ability to intervene on behalf of the athletic
training student and the patient.”
Preceptor
A preceptor is a licensed healthcare professional who is affiliated with the Whitworth AT
Program and provides professional supervision and education to program students. Students will
be assigned to a preceptor by the AT Program.
Direct supervision
Direct supervision means that the preceptor is physically present and has the ability to intervene
on behalf of the athletic training student and the patient. Direct supervision does not preclude a
student’s ability to learn and exercise key skills such as critical thinking or clinical decision-
making. Preceptors should allow students appropriate freedom to engage in critical thinking and
decision-making in a suitable environment. Supervision must be adequate to ensure that each
patient receives competent and quality care, as well as to ensure compliance with relevant state
practice acts (practicing independently without a license is illegal).
Clinical experience
Clinical experiences are educational experiences for the ATS that involve patient care and the
application of athletic training skills under the supervision of your assigned preceptor. Clinical
experiences generally occur at practices, games or during clinical coverage. When in a
supervised clinical experience situation, the student can, at the discretion of the preceptor,
perform all skills that have been previously instructed and evaluated.
During the delivery of athletic training services…
Direct supervision is required during the delivery of athletic training services. This does not
mean that the student and preceptor are physically inseparable every instant--only during patient
care. The preceptor may need to step outside the facility (e.g. to answer a call or respond to an
injury), and likewise a student may need to leave the facility (e.g. to prepare water coolers). If an
injury/emergency occurs during a clinical experience while the preceptor is not physically
present to directly supervise, the student should notify (call/radio) the preceptor immediately,
and may provide basic first aid until the preceptor arrives. The student may not make evaluation,
treatment or return to play decisions without direct supervision.
Use of skills outside of supervised clinical experience (Emergency Responder Clarification)
When not engaged in a supervised clinical experience, the ATS should not participate in the
delivery of athletic training services or provide patient care. For example, an ATS may not
travel with a team without supervision even in the role of “first aider”, or open up the Athletic
Training Room to provide treatment to a patient when a preceptor is not present. To do so is a
violation of professional standards and Washington State law.
In circumstances not affiliated with a university clinical experience, the student assumes the role
of a voluntary citizen with emergency responder (first aid and CPR) training. If a situation arises
in a student’s private life that necessitates the use of emergency responder skills, the student’s
decision to act (or not act) is completely voluntary and the student is responsible to stay within
the scope of practice of an emergency responder.
Examples of acceptable skills performed by a voluntary emergency responder include: first aid
for the treatment of acute injuries (e.g. controlling bleeding, RICE, splinting), monitoring
ABC’s, performing rescue breathing and/or CPR as necessary, and activating the emergency
medical system (call 911).
Examples of unacceptable skills for a student acting as a voluntary emergency responder include:
application of modalities (other than ice/heat), performing an orthopedic evaluation, performing
any rehabilitation procedures, and making decisions about return to play for an athlete. Any
situation where the student’s presence takes the place of a licensed healthcare professional is
unacceptable (e.g. a soccer camp doesn’t want to hire a licensed athletic trainer, so instead they
hire the student to provide first aid services).
In Summary
When in doubt about their role or responsibility, the student should request clarification from an
AT Program faculty member. If faced with an emergency situation where clarification cannot be
sought, the student should first abide by all applicable state laws, then consider the ethical and
moral principles of both the athletic training profession and Christian faith. Afterward, the
student should document the incident and report it to the Program Director a.s.a.p.
If the student experiences violations of this policy within their clinical experience site (e.g. their
preceptor leaves them unattended) the student MUST report the incidence to the Clinical
Coordinator and/or Program Director immediately. Students will not be disciplined for reporting
violations.
I, ____________________________________, have read and understand the Whitworth AT
Program supervision policy and emergency responder clarification. I agree to abide by this
policy, and to only provide athletic training services and patient care under the direct supervision
of university-assigned preceptor.
__________________________________________date:______ (Student signature)
__________________________________________date:______ (Program Director signature)
Hours Policy
Students will be available an average of 15 hours per week, typically in the afternoons. In order
to ensure a quality learning experience and appropriate workload, a maximum hours policy will
be in effect any time regular University classes are in session. During university breaks when
regular classes are not in session hour maxes are not applicable. The maximum number of
clinical hours that may be logged for students enrolled in 283, 284, 383, or 384 is 20 hours a
week, averaged over a 2 week period. To allow for the in-depth nature of senior year
experiences, and in accordance with the lighter academic load of the senior year, the maximal
number of hours for students enrolled in 483 or 484 is 30 hours a week. This heightened
maximum is designed to allow students to take advantage of brief (4-8 week) periods of intense
clinical experience opportunity, however students may not average 30 hours a week over the
entire course of the semester. Additionally, at all times of the year students will receive a
minimum of 1 day off in every 7 day period. Students are responsible for tracking their own
hours and notifying their preceptor in advance if they anticipate an overage of clinical experience
hours. In general, the CE should follow the academic calendar of Whitworth University.
Students will generally receive all long university breaks (e.g. spring break, Christmas break) but
may be required to participate in clinical experiences over short minor breaks (e.g. Labor Day).”
Students are expected to complete 1200 hours of clinical experience during the required 6
semesters. A minimum of 1000 of those hours are to be directly supervised by a certified athletic
trainer with the remaining hours supervised by other appropriate health care professionals. At no
time should the ATS be allowed to serve as replacement for regular clinical staff.
Whitworth University Athletic Training Program
Communicable Disease Policy
A Communicable Disease is a disease that may be transmitted directly or indirectly from one
individual to another.
Students in the AT Program must demonstrate protection against communicable diseases before
being allowed to participate in patient care. This includes the completion of a comprehensive
vaccination and completion of a physical examination to verify that the student is able to meet
the technical standards of the profession. Verification of appropriate vaccinations must be
completed upon admission to the program. The vaccination records will be reviewed by the
Medical Director (or their designee) of the AT Program and maintained in the ATS confidential
file in the office of the Program Director. In addition, ATS must complete annual training on the
recognition and management of blood-borne pathogens and infectious agents as specified by the
Occupational Safety Health Administration (OSHA) and the AT Program.
The Whitworth University AT Program desires to ensure a healthy and safe environment for all
students, faculty members, ACE/CI’s, and their respective patients/athletes. Therefore in the
event that a student contracts a communicable disease the student must:
1. Seek immediate medical attention by an appropriate qualified health care provider. The
clinician, in collaboration with the ATS will discuss restrictions from clinical (and if
appropriate didactic) learning experiences.
2. The ATS must provide written documentation from the clinician in regards to their ability
to continue with classes and/or clinical experiences.
3. The ATS must notify the Clinical Instruction Coordinator (CIC) and their Approved
Clinical Instructor (ACI) about their health status and any restrictions for their clinical
experiences.
4. In the event that the illness results in prolonged inability to attend classes and/or clinical
experiences, the AT Program Director must be notified in order to appropriately
document and remediate the situation.
5. As long as the ATS is deemed to be contagious, they will not be allowed to attend clinical
experiences.
6. The ATS must be cleared in writing by an appropriately licensed health care provider
prior to being allowed to return to their clinical experience.
I have read and understand the Whitworth University Communicable Disease Policy. I agree to
abide by the requirements described in the document.
____________________________________ _______________________________
Athletic Training Student Date
OATH OF CONFIDENTIALITY
I, ________________________________, understand that as part of required clinical experience
courses in the Athletic Training major I will see, hear and/or otherwise have access to
confidential health care information and other privileged documents. As such, I understand that I
have a legal and ethical responsibility to maintain the privacy and respect of each patient
encountered as part of clinical experiences in the Whitworth Athletic Training Program.
As a general rule, patient information should only be accessed by authorized personnel when the
information is needed to perform health care operations. Confidential information includes any
information found in a patient’s medical record as well as personal information. All information
relating to a patient’s care, treatment, or condition constitutes confidential information. Patient
information should be protected to the maximum extent possible. This includes avoiding
discussing confidential maters in areas where the discussion might be overheard.
I agree that, except as directed by my preceptor, I will not at any time during or after this clinical
experience, disclose any information to any person whatsoever, or permit any person to examine
or make copies of any reports or other documents that have in any way to do with patients of the
clinical site.
Additionally, I understand that depending on the nature of the clinical site the Federal
Educational Rights and Privacy Act (FERPA) and or Health Insurance Portability and
Accountability Act (HIPPA), may govern the release of information. I understand it is my
responsibility to be familiar and maintain compliance with the policies of each assigned clinical
site.
Student Signature Date
AT Program Faculty Witness Signature Date
Bloodborne Pathogens Policies & Documentation POST-EXPOSURE EVALUATION AND FOLLOW-UP FOR ATHLETIC TRAINING STUDENTS
Should an exposure incident occur: 1. Wash the wound/area thoroughly with soap and water 2. Contact/Notify:
a. Notify your immediate supervisor or preceptor b. Notify the Interim Head Athletic Trainer, Jon Bosh IMMEDIATELY as a report must be
filed with the appropriate authorities within 24 hours (509-777-3728, [email protected]) If unable to contact Jon Bosh, contact Marisha Hamm (509-777-4494, [email protected])
c. Make an appointment at the on-campus health center for possible treatment and counseling (509-777-3259). If the health center is closed, Jon Bosh or Marisha Hamm will direct you where to seek treatment.
An immediately available confidential medical evaluation and follow-up will be conducted by the Student Health Center or other designated healthcare facility. Following initial first aid (clean the wound, flush eyes or other mucous membrane, etc.), the following activities will be performed:
Document the routes of exposure and how the exposure occurred.
Identify and document the source individual (unless the employer can establish that identification is infeasible or prohibited by state or local law).
Obtain consent and make arrangements to have the source individual tested as soon as possible to determine HIV, HCV, and HBV infectivity; document that the source individual’s test results were conveyed to the employee’s health care provider.
If the source individual is already known to be HIV, HCV and/or HBV positive, new testing need not be performed.
Assure that the exposed individual is provided with the source individual’s test results and with information about applicable disclosure laws and regulations concerning the identity and infectious status of the source individual (e.g., laws protecting confidentiality).
After obtaining consent, collect exposed individual’s blood as soon as feasible after exposure incident, and test blood for HBV and HIV serological status
If the individual does not give consent for HIV serological testing during collection of blood for baseline testing, preserve the baseline blood sample for at least 90 days; if the exposed individual elects to have the baseline sample tested during this waiting period, perform testing as soon as feasible.
Post-exposure plan developed from: OSHA 3186-06R 2003 “Model Plans and Programs for the OSHA Bloodborne Pathogens and Hazard Communications Standards”
Appendix A
Student Evaluation Form
To be completed at the end of each clinical rotation
Whitworth University
AT 383/384 Clinical Experience Evaluations
Name:
Level: Junior
Date:
5: indicates very outstanding/excellent performance qualifications
4: indicates above average/good performance or qualifications
3: indicates average performance or qualifications
2: indicates below average/poor performance or qualifications
1: indicates unacceptable/deficient performance or qualifications
N/A: indicates not applicable/unable to observe
Academic Application
Psychomotor skills
5 4 3 2 1 N/A
Ability to apply skills and knowledge in comprehensive
examination, assessment, management, and
treatment/rehabilitation of injuries as well as illnesses
appropriate to educational level.
Inability to apply knowledge and skills appropriate to level.
Comments:
Curiosity
5 4 3 2 1 N/A
Demonstration of intellectual curiosity regarding the
profession of athletic training, philosophical
considerations of healthcare, and specific athletic
training topics as they arise
Minimal engagement with material and setting. Does not
seek additional information about profession or specific
issues that arise.
Comments:
Evidence based practice
5 4 3 2 1 N/A
Utilization of evidence based practice to seek out
information to assist with providing optimal healthcare
for the patient. Recognition of quality evidence from a
variety of sources and incorporate that into practice.
Minimal understanding and use of evidence based practice.
Inability to form clinical questions or locate quality sources
and apply to provision of care
Comments:
Clinical Thinking
5 4 3 2 1 N/A
Demonstrates skills toward independent thinking/clinical
thinking, and problem solving, student is able to think
for self. Developing ability to critically exam the body of
knowledge in athletic training and related fields.
Unable to initiate clinical tasks such as evaluation or
treatment. Does not offer suggestions or ideas regarding
diagnoses or interventions. Needs excessive guidance or
supervision regarding application of skills and knowledge.
Comments:
Behavior
Professionalism
5 4 3 2 1 N/A
Student is invested in and promotes the profession of
athletic training through interest in NATA involvement,
application laws, regulations, standards and guidelines
that affect athletic training. Support of athletic training
community through service and/or leadership roles.
Student shows no interest in the professional aspects of
athletic training.
Comments:
Compassion and empathy
5 4 3 2 1 N/A
Compassion and empathy are demonstrated toward
fellow students and athletes. This is shown through
effective and honest communication and positive
interpersonal communication skills.
Lack of compassion or empathy is evident. Minimal or
indifferent communication.
Comments:
Reliability and Flexibility
5 4 3 2 1 N/A
Always on time and performs well while present;
completes assigned tasks promptly and willingly.
Responds to the changing nature of clinical assignments
with appropriate actions and openness to learning.
Arrives late, has had absences or has not called in;
sometimes does not complete tasks or demonstrates
unwillingness to accept instruction. Inappropriate of
closed-minded response to change in assignments.
Comments:
Team Approach to Practice
Role of the athletic trainer
5 4 3 2 1 N/A
Understanding of the role of an athletic trainer as a
health care provider within the larger context of the
healthcare system. Ability to work with other healthcare
providers such as team physicians including effective
communication both in oral and written form. Ability to
recognize when referral of the patient to another
healthcare provider is warranted and aid in that referral.
Unfamiliarity or unawareness of other healthcare
providers. Ineffective communication with other members
of the healthcare team. Inability to recognize when referral
of a patient is warranted.
Comments:
Collaboration within the healthcare team
5 4 3 2 1 N/A
Ability to work with others in effecting positive patient
outcomes, including the patient and family when
appropriate. This may also include other healthcare
professionals and recognizing their scope of practice.
Not seeking or including other input or opinions from the
patient, family or other healthcare provides as appropriate.
Comments:
Communication skills
5 4 3 2 1 N/A
Effective communication with patients, with the sports
medicine team and with coaches both in oral and written form.
Poor quality or quantity of communication.
Comments:
Interactions with supervisors and peers
5 4 3 2 1 N/A
Cooperative with all levels of staff as well as peers. Can
give and receive instruction and feedback positively and
constructively. Works well through conflict and adjusts
to stressful circumstances.
Inability to interact effectively with supervisors and/or
peers. Does not take or give instruction or feedback well.
Inappropriate reaction in conflict or under stress
Comments:
Legal and Ethical Practice
Scope of practice
5 4 3 2 1 N/A
Provision of care that falls within an appropriate scope
of practice and level of educational experience. Inappropriate care provided or attempt at skills or tasks
outside of educational experience.
Comments:
Ethical, moral and legal behavior
5 4 3 2 1 N/A
Provision of care following the NATA code of ethics
and BOC standards of practice. Also practices with
integrity and honesty.
Unawareness or non-compliance with code of ethics or
standards of practice. Lack of integrity or honesty.
Comments:
Cultural and Faith Awareness
Faith Awareness
5 4 3 2 1 N/A
Understanding and appreciation of the value and nature
of a patients’ faith during the provision of care. (Not an
assessment of students’ faith or expression of faith)
Deficient awareness of the role of faith in healthcare
provision.
Comments:
Cultural competence
5 4 3 2 1 N/A
Demonstration of awareness of the impact that patients’
cultural differences have on their attitudes and behaviors
toward healthcare. Possession of skills necessary to
achieve optimal health outcomes of diverse patient
populations (age, sex, beliefs, etc) and cultural
differences. Respectful interactions.
Lack of awareness of differences and/or ability to work
with diverse patients. Ineffective or disrespectful
interactions.
Comments:
Overall Rating
5 4 3 2 1 N/A
Strengths:
Areas in need of improvement:
Demonstrated Performance Level Of Present Duties (Select only 1)
Performance of duties is equaled by very few students at this level.
Performs duties better than most athletic training students at this level.
Performs duties as well as most athletic training students at this level.
Performance of duties meets minimum standards.
Performs duties in unsatisfactory manner.
Advancement Recommendation (Select only 1)
Potential to accept additional responsibility. Recommended for advancement.
Evidence of potential to accept additional responsibility is lacking. Recommended for
probationary advancement in program. (Probation dropped when satisfactory improvement achieved.)
Not suitable for present level. Recommended discontinuing program.
Preceptor signatures Student signature
Appendix B
Proficiency Journal for the General Medical
Rotation
Clinical Proficiencies to be completed during the General Medical Rotation
Instructions for the student:
All of the Clinical Proficiencies associated with each clinical rotation must be evaluated and assigned a grade “Proficient” in order to successfully
complete the course. Receiving an evaluation of “Not proficient” for any skill indicates a need to study and practice, then re-attempt the Clinical
Proficiency until a level of “Proficient” or “Pass” is indicated. It is the student’s responsibility to schedule time with their preceptor for Clinical
Proficiency completion. Some Clinical Proficiencies will require the student to provide a description of how the Clinical Proficiency was
demonstrated. It is the responsibility of the student to write this description, accurately and completely, prior to presenting it to the preceptor for
signature.
Instructions for the Preceptor:
After supervising the completion of a Clinical Proficiency, the preceptor should assign a mastery level (described below), initial and date the
attempt. Any Clinical Proficiency marked as “Not Proficient” will need to be repeated and re-assessed prior to the conclusion of the clinical
rotation. The form allows space to document 2 attempts, although fewer or more attempts may be necessary.
Evaluation of the student’s mastery level of clinical proficiencies will be completed using a 3-level scale.
“Not proficient-X” or “NP-X” indicates that the student needs significant improvement to be able to perform this skill at an acceptable
entry-level. The student is unable to apply his/her knowledge or skills in a manner that suggests he/she could perform the skill safely,
effectively and independently (without prompting or assistance).
o Example 1: The student needed significant prompting or assistance to complete the task.
o Example 2: The student was unable to recognize the situation and required skills, let alone perform them.
o Example 3: Without supervision and correction, the actions of the student could have resulted in harm to the patient.
“Not proficient-Close” or “NP-C” indicates that the student needs minor improvement to be able to perform this skill at an acceptable
entry-level. The student is unable to apply his/her knowledge or skills in a manner that suggests he/she could perform the skill safely,
effectively and independently (without prompting or assistance).
o Example 1: The student needed minimal prompting or assistance to complete the task.
o Example 2: The student was able to recognize the situation and required skills, but struggled to perform them correctly.
o Example 3: The actions of the student would not have resulted in optimal patient care (but would not have caused harm).
“Proficient” or “Pass” indicates that the student is able to perform the skill independently at an acceptable entry-level. The “proficient”
student should have the ability to apply the clinical skills safely, effectively, and efficiently in the absence of a supervisor (although direct
supervision of clinical experiences is still required as part of CAATE standards).
The evaluation of clinical proficiencies can occur in two ways.
3. Performance on an actual patient. The student, under direct supervision may use this time to demonstrate his/her clinical proficiency by
aiding the patient.
4. Performance using a scenario. The student sets up an appointment with a preceptor, at which time the preceptor provides a mock
situation for the student. The student will act as if the preceptor or a subject is the patient, demonstrating their skill under the preceptor’s
direct supervision.
Clinical Proficiencies for the General Medical clinical rotation
**If you lack the equipment necessary to adequately assess the Clinical Proficiency please write “Unable to assess” next to the
specific item on this form. The student will then be required to complete that specific Clinical Proficiency at Whitworth University.**
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Obtain a medical history appropriate for the patient's ability to
respond. (AC-5) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Select and use appropriate procedures for the cleaning,
closure, and dressing of wounds, identifying when referral is
necessary. (AC-22)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Assist the patient in the use of a nebulizer treatment for an
asthmatic attack. (AC-31) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Instruct the patient in home care and self-treatment plans for
acute conditions. (AC-43) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Use an electronic drug resource to locate and identify
indications, contraindications, precautions, and adverse
reactions for common prescription and nonprescription
medications. (TI-23)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Properly assist and/or instruct the patient in the proper use,
cleaning, and storage of drugs commonly delivered by
metered dose inhalers, nebulizers, insulin pumps, or other
parenteral routes as prescribed by the physician. (TI-28)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Optimize therapeutic outcomes by communicating with
patients and/or appropriate healthcare professionals regarding
compliance issues, drug interactions, adverse drug reactions,
and sub-optimal therapy. (TI-31)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Use standard techniques and procedures for the clinical examination of common injuries,
conditions, illnesses, and diseases including, but not limited to:
Respiratory assessments (auscultation, percussion, respirations, peak-flow) (CE-20g)
circulatory assessments (pulse, blood pressure, auscultation) (CE-20h)
abdominal assessments (percussion, palpation, auscultation) (CE-20i)
other clinical assessments (otoscope, urinalysis, glucometer, temperature, opthalmoscope)
(CE-20j)
Assess and interpret findings from a physical examination that is based on the patient’s clinical
presentation. This exam can include:
Cardiovascular function (including differentiation between normal and abnormal heart
sounds, blood pressure, and heart rate) (CE-21i)
Pulmonary function (including differentiation between normal breath sounds, percussion
sounds, number and characteristics of respirations, peak expiratory flow) (CE-21j)
Gastrointestinal function (including differentiation between normal and abnormal bowel
sounds) (CE-21k)
Genitourinary function (urinalysis) (CE-21l)
Ocular function (vision, ophthalmoscope) (CE-21m)
Function of the ear, nose, and throat (including otoscopic evaluation) (CE-21n)
Dermatological assessment (CE-21o)
Other assessments (glucometer, temperature) (CE-21p)
Differentiate between normal and abnormal physical findings (e.g. pulse, blood pressure, heart and
lung sounds, oxygen saturation, pain, core temperature) and the associated pathophysiology. (AC-
7)
To complete this Clinical
Proficiency, please evaluate the
individual skills listed below.
Use a stethoscope to auscultate heart and lung sounds.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Record respiratory rate, heart rate and blood pressure
using appropriate methods and equipment. _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Perform an abdominal assessment including percussion,
palpation, auscultation. _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Assess vision using an eye chart.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Assess oxygen saturation and interpret findings.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Assess the ear, nose and throat using an otoscope.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Assess blood sugar using a glucometer.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Assess body temperature using appropriate methods and
equipment. _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Interpret the results of a urinalysis.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Perform a dermatological assessment to identify skin
conditions (e.g. MRSA, fungal infection, etc.) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Use a comprehensive patient-file management system for
appropriate chart documentation, risk management, outcomes,
and billing. (HA-12)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Identify the risk management plan and associated policies and
procedures at a healthcare facility or the need for one. (HA-
20) e.g. Discuss with your preceptor health and safety policies
at your site (BBP, fire, adverse weather, chemical storage,
security, etc.). Are any missing?
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Rehearse the EAP for a specific venue. (HA-21)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Rehearse the specific plans of care for common potential
emergent conditions (eg, asthma attack, diabetic emergency).
(HA-22)
To complete this Clinical Proficiency, please evaluate the individual
skills listed below.
Rehearse the plan of care for an asthma attack. (What
is the site specific protocol?) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Rehearse the plan of care for a diabetic emergency.
(What is the site specific protocol?) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Rehearse the plan of care for a cardiac emergency.
(What is the site specific protocol?) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Use a glucometer to monitor blood glucose levels, determine
participation status, and make referral decisions. (PHP-15) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Use a peak-flow meter to monitor a patient's asthma
symptoms, determine participation status, and make referral
decisions. (PHP-16)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
CLINICAL ASSESSMENT & DIAGNOSIS / ACUTE CARE / THERAPEUTIC INTERVENTION CIP-6
Clinically evaluate and manage a patient with an emergency injury or condition to include the assessment of vital signs and level of
consciousness, activation of emergency action plan, secondary assessment, diagnosis, and provision of the appropriate emergency care
(eg, CPR, AED, supplemental oxygen, airway adjunct, splinting, spinal stabilization, control of bleeding).
Sources of Evidence/Comments
Please provide a THOROUGH description of how this proficiency was demonstrated. Format using SOAP note style when possible.
For ACI use only:
Scenario Mastery Level Date Preceptor Signature
Live
Mock
Not proficient (needs improvement, not able to perform safe & effectively)
Proficient (able to perform safely & effectively)
Mastery (able to perform with excellence)
_ _ / _ _ / _ _
Appendix C
Proficiency Journal for the Physical Therapy
Rotation
Clinical Proficiencies to be completed during the Physical Therapy/Clinic Rotation
Instructions for the student:
All of the Clinical Proficiencies associated with each clinical rotation must be evaluated and assigned a grade “Proficient” in order to successfully
complete the course. Receiving an evaluation of “Not proficient” for any skill indicates a need to study and practice, then re-attempt the Clinical
Proficiency until a level of “Proficient” or “Pass” is indicated. It is the student’s responsibility to schedule time with their preceptor for Clinical
Proficiency completion. Some Clinical Proficiencies will require the student to provide a description of how the Clinical Proficiency was
demonstrated. It is the responsibility of the student to write this description, accurately and completely, prior to presenting it to the preceptor for
signature.
Instructions for the Preceptor:
After supervising the completion of a Clinical Proficiency, the preceptor should assign a mastery level (described below), initial and date the
attempt. Any Clinical Proficiency marked as “Not Proficient” will need to be repeated and re-assessed prior to the conclusion of the clinical
rotation. The form allows space to document 2 attempts, although fewer or more attempts may be necessary.
Evaluation of the student’s mastery level of clinical proficiencies will be completed using a 3-level scale.
“Not proficient-X” or “NP-X” indicates that the student needs significant improvement to be able to perform this skill at an acceptable
entry-level. The student is unable to apply his/her knowledge or skills in a manner that suggests he/she could perform the skill safely,
effectively and independently (without prompting or assistance).
o Example 1: The student needed significant prompting or assistance to complete the task.
o Example 2: The student was unable to recognize the situation and required skills, let alone perform them.
o Example 3: Without supervision and correction, the actions of the student could have resulted in harm to the patient.
“Not proficient-Close” or “NP-C” indicates that the student needs minor improvement to be able to perform this skill at an acceptable
entry-level. The student is unable to apply his/her knowledge or skills in a manner that suggests he/she could perform the skill safely,
effectively and independently (without prompting or assistance).
o Example 1: The student needed minimal prompting or assistance to complete the task.
o Example 2: The student was able to recognize the situation and required skills, but struggled to perform them correctly.
o Example 3: The actions of the student would not have resulted in optimal patient care (but would not have caused harm).
“Proficient” or “Pass” indicates that the student is able to perform the skill independently at an acceptable entry-level. The “proficient”
student should have the ability to apply the clinical skills safely, effectively, and efficiently in the absence of a supervisor (although direct
supervision of clinical experiences is still required as part of CAATE standards).
The evaluation of clinical proficiencies can occur in two ways.
1. Performance on an actual patient. The student, under direct supervision may use this time to demonstrate his/her clinical proficiency by
aiding the patient.
2. Performance using a scenario. The student sets up an appointment with a preceptor, at which time the preceptor provides a mock
situation for the student. The student will act as if the preceptor or a subject is the patient, demonstrating their skill under the preceptor’s
direct supervision.
Clinical Proficiencies for the Physical Therapy clinical rotation
**If you lack the equipment necessary to adequately assess the Clinical Proficiency please write “Unable to assess” next to the
specific item on this form. The student will then be required to complete that specific Clinical Proficiency at Whitworth University.**
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Instruct the patient in home care and self-treatment plans for
acute conditions. (AC-43) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Use contemporary documentation strategies to effectively
communicate with patients, physicians, insurers, colleagues,
administrators, and parents or family members. Use a
comprehensive patient-file management system for
appropriate chart documentation, risk management, outcomes,
and billing. (HA-11 & HA-12)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Identify the risk management plan and associated policies and
procedures at a healthcare facility or the need for one. (HA-
20) e.g. Discuss with your preceptor health and safety policies
at your site (BBP, fire, adverse weather, chemical storage,
security, etc.). Are any missing?
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Rehearse the EAP for a specific venue. (HA-21)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Instruct clients/patients in the basic principles of
ergodynamics and their relationship to the prevention of
illness and injury. (PHP-19) Student: Please describe how
you demonstrated this skill.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Instruct a client/patient regarding fitness exercises and the use
of muscle strengthening equipment to include correction or
modification of inappropriate, unsafe, or dangerous lifting
techniques. (PHP-31) Student: Please describe how you
demonstrated this skill.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Integrate self-treatment into a therapeutic intervention when
appropriate, including instructing the patient regarding self-
treatment plans. (TI-10)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Use the results of on-going clinical examinations to determine
when a therapeutic intervention should be progressed,
regressed or discontinued. (TI-12)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Analyze gait and select appropriate instruction and correction
strategies to facilitate safe progression to functional gait
pattern. (TI-17) Student: please describe how you
demonstrated this proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Inspect therapeutic equipment and the treatment environment
for potential safety hazards. (TI-20) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
The following Clinical Proficiencies are incorporated into a modality application.
Design therapeutic interventions to meet specified treatment goals. (TI-11)
Assess the patient to identify indications, contraindications, and precautions applicable to
the intended intervention. (TI-11a)
Position and prepare the patient for various therapeutic interventions. (TI-11b)
Describe the expected effects and potential adverse reactions to the patient. (TI-11c)
Apply the intervention, using parameters appropriate to the intended outcome. (TI-11e)
Reassess the patient to determine the immediate impact of the intervention. (TI-11f)
To complete this Clinical
Proficiency, please evaluate the
individual skills listed below.
Goal: reduce/control acute inflammation
Student: please describe how you demonstrated this
proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Goal: heat tissue to promote healing or increase tissue
extensibility (e.g. moist heat pack, diathermy, warm
whirlpool, paraffin) Student: please describe how you
demonstrated this proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Goal: heat tissue to promote healing or increase tissue
extensibility (ultrasound) Student: please describe how
you demonstrated this proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Goal: reduce pain (electrical modality) Student: please
describe how you demonstrated this proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Goal: increase strength or muscle re-education (electrical
modality) Student: please describe how you
demonstrated this proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Goal: decrease edema (electrical modality) Student:
please describe how you demonstrated this proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Goal: decrease edema (intermittent compression)
Student: please describe how you demonstrated this
proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Goal: Utilize massage to promote tissue healing Student:
please describe how you demonstrated this proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
AT and PT clinical rotations: Proficiencies related to evidence based practice.
Preceptors: These are included for your information only—for each of these skills the student will be evaluated by the clinical course
instructor. However, feel free to suggest a relevant clinical question for the student to research.
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Develop a relevant clinical question using a pre-defined
question format (eg, PICO= Patients, Intervention,
Comparison, Outcomes; PIO = Patients, Intervention,
Outcomes) (EBP-5)
Student: please describe the clinical question you asked.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Conduct a literature search using a clinical question relevant
to athletic training practice using search techniques (eg,
Boolean search, Medical Subject Headings) and resources
appropriate for a specific clinical question. (EBP-7)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Determine the effectiveness and efficacy of an athletic
training intervention utilizing evidence-based practice
concepts. (EBP-10)
Student: How did you demonstrate this?
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Apply and interpret clinical outcomes to assess patient status,
progress, and change using psychometrically sound outcome
instruments. (EBP-14)
Student: How did you demonstrate this?
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Fall Physical Therapy / Athletic Training (circle one) rotation clinical evaluation skills
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
The following Clinical Proficiencies are incorporated into an injury/illness evaluation.
Demonstrate the ability to modify the diagnostic examination process according to the demands of the situation and
patient responses. (CE-15)
Use clinical reasoning skills to formulate an appropriate clinical diagnosis for common illness/disease and orthopedic
injuries/conditions. (CE-17)
Incorporate the concept of differential diagnosis into the examination process. (CE-18)
Use standard techniques and procedures for the clinical examination of common injuries, conditions, illnesses, and
diseases including, but not limited to: history taking, inspection/observation, palpation, functional assessment,
selective tissue testing techniques/special tests, neurological assessments (sensory, motor, reflexes, balance, cognitive
function) (CE-20a-f)
Assess and interpret findings from a physical examination that is based on the patient’s clinical presentation. This
exam can include: Assessment of posture, gait, and movement patterns, Palpation, Muscle function assessment,
Assessment of quantity and quality of osteokinematic joint motion, Capsular and ligamentous stress testing, Joint
play (arthrokinematics), Selective tissue examination techniques/special tests, Neurologic function (sensory, motor,
reflexes, balance, cognition) (CE-21a-h)
To complete
this Clinical
Proficiency,
please
evaluate the
individual
skills listed
below.
Foot/Ankle/Lower leg injury evaluation and assessment.
Student: please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Knee injury evaluation and assessment. Student: please
describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Thigh, hip or pelvic injury evaluation and assessment.
Student: please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Determine criteria and make decisions regarding return to
activity and/or sports participation based on the patient’s
current status. (CE-19)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Spring Physical Therapy / Athletic Training (circle one) rotation clinical evaluation skills
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
The following Clinical Proficiencies are incorporated into an injury/illness evaluation.
Demonstrate the ability to modify the diagnostic examination process according to the demands of the situation and
patient responses. (CE-15)
Use clinical reasoning skills to formulate an appropriate clinical diagnosis for common illness/disease and
orthopedic injuries/conditions. (CE-17)
Incorporate the concept of differential diagnosis into the examination process. (CE-18)
Use standard techniques and procedures for the clinical examination of common injuries, conditions, illnesses, and
diseases including, but not limited to: history taking, inspection/observation, palpation, functional assessment,
selective tissue testing techniques/special tests, neurological assessments (sensory, motor, reflexes, balance,
cognitive function) (CE-20a-f)
Assess and interpret findings from a physical examination that is based on the patient’s clinical presentation. This
exam can include: Assessment of posture, gait, and movement patterns, Palpation, Muscle function assessment,
Assessment of quantity and quality of osteokinematic joint motion, Capsular and ligamentous stress testing, Joint
play (arthrokinematics), Selective tissue examination techniques/special tests, Neurologic function (sensory, motor,
reflexes, balance, cognition) (CE-21a-h)
To complete
this Clinical
Proficiency,
please evaluate
the individual
skills listed
below.
Head/Neck/Face injury evaluation and assessment.
Student: please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Spine/Trunk injury evaluation and assessment. Student:
please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Shoulder injury evaluation and assessment. Student:
please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Elbow injury evaluation and assessment. Student: please
describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Wrist/Hand/Finger injury evaluation and assessment.
Student: please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Determine criteria and make decisions regarding return to
activity and/or sports participation based on the patient’s
current status. (CE-19)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Appendix D
Proficiency Journal for the Athletic Training
Rotation
Clinical Proficiencies to be completed during the Athletic Training Rotation
Instructions for the student:
All of the Clinical Proficiencies associated with each clinical rotation must be evaluated and assigned a grade “Proficient” in order to successfully
complete the course. Receiving an evaluation of “Not proficient” for any skill indicates a need to study and practice, then re-attempt the Clinical
Proficiency until a level of “Proficient” or “Pass” is indicated. It is the student’s responsibility to schedule time with their preceptor for Clinical
Proficiency completion. Some Clinical Proficiencies will require the student to provide a description of how the Clinical Proficiency was
demonstrated. It is the responsibility of the student to write this description, accurately and completely, prior to presenting it to the preceptor for
signature.
Instructions for the Preceptor:
After supervising the completion of a Clinical Proficiency, the preceptor should assign a mastery level (described below), initial and date the
attempt. Any Clinical Proficiency marked as “Not Proficient” will need to be repeated and re-assessed prior to the conclusion of the clinical
rotation. The form allows space to document 2 attempts, although fewer or more attempts may be necessary.
Evaluation of the student’s mastery level of clinical proficiencies will be completed using a 3-level scale.
“Not proficient-X” or “NP-X” indicates that the student needs significant improvement to be able to perform this skill at an acceptable
entry-level. The student is unable to apply his/her knowledge or skills in a manner that suggests he/she could perform the skill safely,
effectively and independently (without prompting or assistance).
o Example 1: The student needed significant prompting or assistance to complete the task.
o Example 2: The student was unable to recognize the situation and required skills, let alone perform them.
o Example 3: Without supervision and correction, the actions of the student could have resulted in harm to the patient.
“Not proficient-Close” or “NP-C” indicates that the student needs minor improvement to be able to perform this skill at an acceptable
entry-level. The student is unable to apply his/her knowledge or skills in a manner that suggests he/she could perform the skill safely,
effectively and independently (without prompting or assistance).
o Example 1: The student needed minimal prompting or assistance to complete the task.
o Example 2: The student was able to recognize the situation and required skills, but struggled to perform them correctly.
o Example 3: The actions of the student would not have resulted in optimal patient care (but would not have caused harm).
“Proficient” or “Pass” indicates that the student is able to perform the skill independently at an acceptable entry-level. The “proficient”
student should have the ability to apply the clinical skills safely, effectively, and efficiently in the absence of a supervisor (although direct
supervision of clinical experiences is still required as part of CAATE standards).
The evaluation of clinical proficiencies can occur in two ways.
1. Performance on an actual patient. The student, under direct supervision may use this time to demonstrate his/her clinical proficiency by
aiding the patient.
2. Performance using a scenario. The student sets up an appointment with a preceptor, at which time the preceptor provides a mock
situation for the student. The student will act as if the preceptor or a subject is the patient, demonstrating their skill under the preceptor’s
direct supervision.
Clinical Proficiencies for the Athletic Training clinical rotation
**If you lack the equipment necessary to adequately assess the Clinical Proficiency please write “Unable to assess” next to the
specific item on this form. The student will then be required to complete that specific Clinical Proficiency at Whitworth University.**
Clinical Proficiency
Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Obtain a medical history appropriate for the patient's ability to
respond. (AC-5) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Select and use appropriate procedures for the cleaning,
closure, and dressing of wounds, identifying when referral is
necessary. (AC-22)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Apply appropriate immediate treatment to protect the injured
area and minimize the effects of hypoxic and enzymatic
injury. (AC-38)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Instruct the patient in home care and self-treatment plans for
acute conditions. (AC-43) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Use contemporary documentation strategies to effectively
communicate with patients, physicians, insurers, colleagues,
administrators, and parents or family members. (HA-11)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Identify the risk management plan and associated policies and
procedures at a healthcare facility or the need for one. (HA-
20) e.g. Discuss with your preceptor health and safety policies
at your site (BBP, fire, adverse weather, chemical storage,
security, etc.). Are any missing?
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Rehearse the EAP for a specific venue. (HA-21)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Rehearse the specific plans of care for common potential
emergent conditions (eg, asthma attack, diabetic emergency).
(HA-22)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Implement strategies to facilitate referral of patients to other
healthcare providers. (PD-9)
_ _/_ _/_ _
NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
PREVENTION & HEALTH PROMOTION CIP-2
Select, apply, evaluate, and modify appropriate standard protective equipment, taping, wrapping, bracing, padding, and other custom
devices for the client/patient in order to prevent and/or minimize the risk of injury to the head, torso, spine, and extremities for safe
participation in sport or other physical activity.
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Fit standard protective equipment following manufacturers’
guidelines. (PHP-22)
To complete this Clinical Proficiency, please evaluate the individual
skills listed below.
Helmet, shoulder pads or other sports specific protective
equipment _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Brace: Knee, ankle, shoulder or other joint specific brace
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Fabricate and apply taping, wrapping, supportive, and
protective devices to facilitate return to function. (TI-16)
Apply preventive taping and wrapping procedures, splints,
braces, and other special protective devices. (PHP-23)
To complete this Clinical Proficiency, please evaluate the individual
skills listed below.
Taping for turf toe
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Taping/padding for foot pathology (e.g. morton’s
neuroma, arch pads, heel pads) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Taping/padding for shin pathology (e.g. shin splints,
contusion) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Taping for wrist hyperextension/hyperflexion
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Taping for thumb sprain
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Taping for elbow instability (e.g. hyperextension, UCL
sprain) _ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
The following Clinical Proficiencies are incorporated into a modality application.
Design therapeutic interventions to meet specified treatment goals. (TI-11)
Assess the patient to identify indications, contraindications, and precautions applicable to
the intended intervention. (TI-11a)
Position and prepare the patient for various therapeutic interventions. (TI-11b)
Describe the expected effects and potential adverse reactions to the patient. (TI-11c)
Apply the intervention, using parameters appropriate to the intended outcome. (TI-11e)
Reassess the patient to determine the immediate impact of the intervention. (TI-11f)
To complete this Clinical
Proficiency, please evaluate the
individual skills listed below.
Goal: reduce/control acute inflammation
Student: please describe how you demonstrated this
proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Goal: heat tissue to promote healing or increase tissue
extensibility (e.g. moist heat pack, diathermy, warm
whirlpool, paraffin) Student: please describe how you
demonstrated this proficiency.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Integrate self-treatment into a therapeutic intervention when
appropriate, including instructing the patient regarding self-
treatment plans. (TI-10)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Use the results of on-going clinical examinations to determine
when a therapeutic intervention should be progressed,
regressed or discontinued. (TI-12)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
AT and PT clinical rotations: Proficiencies related to evidence based practice.
Preceptors: These are included for your information only—for each of these skills the student will be evaluated by the clinical course
instructor. However, feel free to suggest a relevant clinical question for the student to research.
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Develop a relevant clinical question using a pre-defined
question format (eg, PICO= Patients, Intervention,
Comparison, Outcomes; PIO = Patients, Intervention,
Outcomes) (EBP-5)
Student: please describe the clinical question you asked.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Conduct a literature search using a clinical question relevant
to athletic training practice using search techniques (eg,
Boolean search, Medical Subject Headings) and resources
appropriate for a specific clinical question. (EBP-7)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Determine the effectiveness and efficacy of an athletic
training intervention utilizing evidence-based practice
concepts. (EBP-10)
Student: How did you demonstrate this?
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Apply and interpret clinical outcomes to assess patient status,
progress, and change using psychometrically sound outcome
instruments. (EBP-14)
Student: How did you demonstrate this?
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Fall Physical Therapy / Athletic Training (circle one) rotation clinical evaluation skills
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
The following Clinical Proficiencies are incorporated into an injury/illness evaluation.
Demonstrate the ability to modify the diagnostic examination process according to the demands of the situation and
patient responses. (CE-15)
Use clinical reasoning skills to formulate an appropriate clinical diagnosis for common illness/disease and orthopedic
injuries/conditions. (CE-17)
Incorporate the concept of differential diagnosis into the examination process. (CE-18)
Use standard techniques and procedures for the clinical examination of common injuries, conditions, illnesses, and
diseases including, but not limited to: history taking, inspection/observation, palpation, functional assessment,
selective tissue testing techniques/special tests, neurological assessments (sensory, motor, reflexes, balance, cognitive
function) (CE-20a-f)
Assess and interpret findings from a physical examination that is based on the patient’s clinical presentation. This
exam can include: Assessment of posture, gait, and movement patterns, Palpation, Muscle function assessment,
Assessment of quantity and quality of osteokinematic joint motion, Capsular and ligamentous stress testing, Joint
play (arthrokinematics), Selective tissue examination techniques/special tests, Neurologic function (sensory, motor,
reflexes, balance, cognition) (CE-21a-h)
To complete
this Clinical
Proficiency,
please
evaluate the
individual
skills listed
below.
Foot/Ankle/Lower leg injury evaluation and assessment.
Student: please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Knee injury evaluation and assessment. Student: please
describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Thigh, hip or pelvic injury evaluation and assessment.
Student: please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Determine criteria and make decisions regarding return to
activity and/or sports participation based on the patient’s
current status. (CE-19)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Spring Physical Therapy / Athletic Training (circle one) rotation clinical evaluation skills
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
The following Clinical Proficiencies are incorporated into an injury/illness evaluation.
Demonstrate the ability to modify the diagnostic examination process according to the demands of the situation and
patient responses. (CE-15)
Use clinical reasoning skills to formulate an appropriate clinical diagnosis for common illness/disease and
orthopedic injuries/conditions. (CE-17)
Incorporate the concept of differential diagnosis into the examination process. (CE-18)
Use standard techniques and procedures for the clinical examination of common injuries, conditions, illnesses, and
diseases including, but not limited to: history taking, inspection/observation, palpation, functional assessment,
selective tissue testing techniques/special tests, neurological assessments (sensory, motor, reflexes, balance,
cognitive function) (CE-20a-f)
Assess and interpret findings from a physical examination that is based on the patient’s clinical presentation. This
exam can include: Assessment of posture, gait, and movement patterns, Palpation, Muscle function assessment,
Assessment of quantity and quality of osteokinematic joint motion, Capsular and ligamentous stress testing, Joint
play (arthrokinematics), Selective tissue examination techniques/special tests, Neurologic function (sensory, motor,
reflexes, balance, cognition) (CE-21a-h)
To complete
this Clinical
Proficiency,
please evaluate
the individual
skills listed
below.
Head/Neck/Face injury evaluation and assessment.
Student: please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Spine/Trunk injury evaluation and assessment. Student:
please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Clinical Proficiency Date 1st
assessed
Mastery
level
Preceptor
initials
Date
proficient
Mastery
level
Preceptor
initials
Shoulder injury evaluation and assessment. Student:
please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Elbow injury evaluation and assessment. Student: please
describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Wrist/Hand/Finger injury evaluation and assessment.
Student: please describe situation/scenario.
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Determine criteria and make decisions regarding return to
activity and/or sports participation based on the patient’s
current status. (CE-19)
_ _/_ _/_ _ NPX
NPC
Pass _ _/_ _/_ _
NPX
NPC
Pass
Appendix E
Sample Syllabus for Clinical Experience
Course
AT 383 Fall 2013
Example
AT 383 Clinical Experience II
Fall 2013 (2 credits)
Eric Johnson Science Hall 220 Tuesday 11:45-12:40
Instructor: Stacey Nauman, MEd, ATC
Office & Phone: Robinson Hall #140, x3247
Email: [email protected]
Office Hours: Tuesdays and Thursdays, 1:00-3:00; feel free to stop by outside of office hours or
make an appointment with me as needed.
General Course Information
Course Description and Objectives
This course will satisfy the requirements for structured clinical experience set forth by CAATE. Objectives include:
The student will engage in meaningful clinical experience opportunities under the direct supervision of
licensed healthcare providers.
Students will integrate didactic knowledge to the clinical setting.
Students will incorporate critical thinking and intentional self-reflection to evaluate their clinical
experiences, what they are learning, and why they do what we do in clinical settings.
Students will develop professional characteristics, attitudes, communication skills.
Students will have opportunities to incorporate holistic, compassionate patient care and demonstrate
servant-leadership within the athletic training profession.
Students will study current events
The third term and fourth term clinical experience (AT 383and AT 384) include clinical experiences in three
different settings. In one term, students will complete two seven-week rotations, one at a general medical healthcare
facility and the other at an outpatient physical therapy clinic. In the other term, they will complete a fourteen-week
rotation in an off-site athletic training setting
The Clinical Experience (CE) contributes to the learning over time concept of instruction. Proficiencies are initially
instructed and evaluated in the curriculum. The CE requires the reintroduction and reassessment of clinical
proficiencies. Preceptors are expected to provide “daily personal/verbal contact at the site of supervision between
the athletic training student and the Preceptor who plans, directs, advises, and evaluates the students athletic training
experience.”
Prerequisites: AT 284
Required Texts:
None
Clinical Experience Hours
Students should refer to the Athletic Training Program Student Policy and Procedure Handbook for maximum and
minimum hours requirements. Brief specifics for this course: the maximum number of clinical experience hours
which may be logged are 20 hours a week, averaged over 2 weeks. The minimum hours to be completed in each 1
week period will vary depending on the type of rotation and unique characteristics of each clinical site. The
minimum expectation will be communicated to each student, and failure to achieve this minimum will result in
disciplinary action within the course and/or within the athletic training program.
Hours must be submitted weekly as outlined in the course schedule. Failure to submit hours within 1 week of
deadline will result in those hours being ineligible to count towards your overall minimum clinical experience hours
in the course and program. Submitting late will result in penalties as defined in the grading section.
Example
Clinical Proficiencies
Students will be expected to demonstrate throughout their six semesters in the Athletic Training Program, proficient
performance in the nine Clinical Integration Proficiencies (CIP) and multiple specific actionable competencies (e.g.
PHP-44.0 Assess body composition by validated techniques) assigned to the course. These will be directly
evaluated by their preceptor and recorded in student competency journals. A list of all assigned competencies for
this course is included at the end of this syllabus. Students must pass 100% of all actionable competencies assigned
to this level of clinical course to successfully complete the course and progress to the next level of clinical
experience. As defined in following sections, if a student fails meet the actionable competencies requirement, they
will receive a penalty of 30% off their overall grade. Specific instructions for journaling CIPs and actionable
competencies are included near the end of this syllabus.
Successfully Completing the Clinical Experience
In order to successfully complete your CE you must (1) earn a passing grade according to the grading scale set forth
in this course, and (2) complete the four specific items below:
1. Demonstrate successful mastery of all assigned clinical integration proficiencies and actionable
competencies.
2. Complete at least the minimum number of hours required.
3. Receive a favorable evaluation for program continuance from all preceptors.
4. Complete all required evaluations of the clinical site, yourself and the preceptor.
In the event that any 1 of these 4 requirements is not met, you may receive a failing grade for the semester and not
be allowed to progress in the Athletic Training Program.
Grading Policies and Procedures
Grading for the Clinical Experience is A – F. The grading scale and further grading detail are given below. All
grades will be updated and posted on Black Board every 2 weeks.
Grading Scale
A 93.0% and above C 73%-76.9%
A- 90.0-92.9% C- 70%-72.9%
B+ 87%-89.9% D+ 67%-69.9%
B 83%-86.9% D 63%-66.9%
B- 80%-82.9% D- 60%-62.9%
C+ 77%-79.9% F Below 60%
Grading for Journals: Students must turn in up to date journals graded by their preceptor once every two weeks,
beginning September 16th
. Preceptors get very busy and can sometimes forget; the student will need to ensure they
notify their preceptor well in advance of the due date. Student should also make every effort to accommodate
preceptor when grading journals.
There are seven (7) total grading periods for journals through the semester. Each journal evaluation will be worth 10
points: 3 points for turning the journal in on time, and 7 points for the quality of work. It is the student’s
responsibility to have journals turned in and hours updated by the end of the grading period. Journals will be due to
my mailbox by 3:00 pm on Mondays. The student’s grade will be reduced by 30% at the end of the semester for
not completing required competencies.
Grading for Hours: Students will be responsible for setting their own schedule with their preceptor throughout the
semester. Students will submit their schedule weekly, recording both hours completed and their upcoming schedule.
An example of this schedule is shown below:
Example
An updated hours log will be e-mailed to the course instructor weekly, by Sunday night. The student’s preceptor
should also be copied on the e-mail. Completion of this process is worth 3 points weekly. Late journals will
result in a 1 point penalty daily, continuous until hour log is submitted. Even though hours logs are only
worth three points, point deductions will be taken off of the total number of possible points for hours logs for
the semester.
Example
GRADING DETAILS Points % of Overall Grade
Competency Journals & Hours
Biweekly Journal: on-time (3 pts)
Biweekly Journal: high quality (7 pts)
Hours log: on time and complete (3 points)
*See “Journal Instructions” section below
7 journals x 10 pts =70 pts
14 weekly hour logs x 3
points = 42 points
50%
Common Clinical Experience Assignments:
Goal-setting Assignment
Self-Evaluation/Reflection
EBP Competency Assignment
20 points
40 points
20 points
~35%
AT 383 Specific Assignments:
Myers-Briggs Personality Assessment
Other at instructor discretion
10 points
25 points
~15%
Failure to complete any of the following 4 items will result in a grading penalty:
1. Does not demonstrate successful mastery of all assigned clinical integration
proficiencies and actionable competencies (50% by fall, 100% by spring).
Automatic penalty of
-30%
2. Does no complete at least the minimum number of hours required.
3. Does not receive a favorable evaluation for program continuance from all
preceptors.
4. Does not complete all required evaluations of the clinical site, yourself and the
preceptor.
Penalty of up to -30%
depending on situation
Total 100%
Assignment Instructions
Goal-setting assignment (20 points)
Evidence-Based Practice Assignment (20 points each) Throughout the course of the semester, students should be
formulating a clinical question based on an experience at their clinical site. They will then complete the following
steps:
1. Develop a relevant clinical question using a pre-defined question format (eg, PICO= Patients, Intervention,
Comparison, Outcomes; PIO = Patients, Intervention, Outcomes) (EBP-5)
2. Conduct a literature search using a clinical question relevant to athletic training practice using search
techniques (eg, Boolean search, Medical Subject Headings) and resources appropriate for a specific clinical
question. (EBP-7)
3. Complete the worksheet for article review (given in class) to determine the effectiveness and efficacy of an
athletic training intervention utilizing evidence-based practice concepts. (EBP-10)
4. Apply and interpret clinical outcomes to assess patient status, progress, and change using psychometrically
sound outcome instruments. (EBP-14)
5. Present your clinical question, the results of your research, and how you applied it in your clinical setting to
the rest of the class.
Reflections (20 points each) Students will complete reflections twice throughout the course of the semester. These
reflections will be based on the following criteria:
High-quality writing
Minimum of three pages, double-spaced
Reflection on goals set at the beginning of the semester
Specific instructions and a grading rubric will be given in class.
Attendance and Participation
Students are required to attend class each week on Tuesday at 11:45 unless otherwise noted on the calendar.
Students are expected to be active and engaged in class discussions. No cell phones in class.
Example
Accommodations for Students with Documented Disabilities:
Special Needs: Whitworth University is committed to providing its students access to education. If you have a
documented special need that affects your learning or performance on exams or papers, you will need to contact the
Educational Support Office (Andrew Pyrc – ext. 4534) to identify accommodations that are appropriate.
Academic Honesty:
Please note that I take extremely seriously the university’s policy on the need for academic honesty in all your work.
I refer you to the Whitworth Catalog, and the current Student Handbook, where guidelines on plagiarism and other
forms of academic dishonesty are spelled out. Any form of dishonesty in an assignment will lead to a zero on the
assignment, and I reserve the right to give a grade of F for the course as well.
Course Schedule
This course schedule is tentative and subject to change. Students should not schedule activities during the course
meeting time on any “off” weeks that cannot be rearranged if the course meeting schedule were to change.
Week Date Topic, Readings, Other Info. Due
TBD Individual meetings prior to beginning at clinical sites
1 9/10 Syllabus and expectations Hours log: bring your
clinical hours schedule to
class – you should know at
least your first week
schedule by the first week of
class. Bring record of any
completed hours as well.
2 9/17 Goal-setting Hours log (by Sunday) and
journal (by Monday)
3 9/24 Myers-Briggs Personality Inventory Hours log (by Sunday)
Goal-setting assignment
due
4 10/1 All AT Program Meeting Hours log (by Sunday) and
journal (by Monday)
5 10/8 First Aid and CPR Review Hours log (by Sunday)
6 10/15 First Aid and CPR Recertification Testing Hours log (by Sunday) and
journal (by Monday)
7 10/22 Midterm individual meetings Hours log (by Sunday)
Midterm reflection due to
my mailbox by Monday,
10/21 at 4:00 pm.
8 10/29 Special topics Hours log (by Sunday) and
journal (by Monday)
9 11/5 All AT Program Meeting Hours log (by Sunday)
10 11/12 Special topics Hours log (by Sunday) and
journal (by Monday)
11 11/19 EBP Assignment presentations Hours log (by Sunday)EBP
Assignment due
12 11/26 Special topics Hours log (by Sunday) and
journal (by Monday)
13 12/3 Final individual meetings Hours log (by Sunday)
14 12/10 No class. Final exams start. Good Luck! Final hours log, journal
and reflection due by 6:00
pm on Thursday, 12/12/13.