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SAN JACINTO COLLEGE SOUTH

PHYSICAL THERAPIST ASSISTANT (PTA) PROGRAM

STUDENT HANDBOOK

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Revised: July 2016

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TABLE OF CONTENTSPage

1. Purpose of Physical Therapist Assistant Student Handbook 32. Introduction 33. Faculty/Staff Directory 54. Mission Statements 65. Vision Statements 66. Values 67. Philosophy 88. Program Goals 99. San Jacinto Community College District Physical Therapist Assistant

Exit Level Competencies (Student Guarantee) 1010. Grievance Procedures for Nondiscrimination 1111. Student Responsibilities 1112. Curriculum Outline 1213. Tuition and Financial Aid 1314. Complaint Process/Grievance Procedure 1315. Physical Therapist Assistant Program Policies 14

I. Class Attendance 14II. Grading 16

III. Clinical Course Grades 22IV. Midterm Counseling Reports 22V. Counseling 23VI. Curriculum Compliance/Failure to complete the PTA Program

in the Designated Time 23VII. Withdrawal Policy 24VIII. Dismissal Policy 25

IX. Clinical Courses 24X. Cellular Phones and Personal Electronics 26

XI. Appearance and Grooming 26XII. Academic Dishonesty 27XIII. Writing Reports and Research Papers 28XIV. Sexual Harassment 28XV. Employment While Enrolled in the PTA Program 28XVI. Course Enrollment 29

XVII. Use of Laboratory Facilities 29XVIII. Use of PTA Library Resources 31

XIX. Patients with Communicable Diseases/HIPAA 32XX. Health Services 32XXI. Physical and Mental Requirements 33

XXII. Disability Assistance 35XXIII. Admissions 35XXIV. Transfer Policy for Students Previously Enrolled in Another PT 37

or PTA Program

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XXV. Readmission 38XXVI. Student Physical Therapist Assistant Club 39

XXVII. Service Learning Projects 40XXVIII. Student and Applicant Files 40

XXIX. Change of Personal Information 41XXX. Notification of Unlawful Behavior 41

XXXI. Suspected Substance Abuse 41XXXII. Summer Skills Checkoffs 42XXXIII. Student Agreement 42XXXIV. PTA Program Policy Statement 42

Student Agreement Form 43 Appendices 44

A. The Minimum Required Skills of a Physical Therapist Assistant Graduate at Entry Level

B. Midterm Counseling formC. Health Science Division Counseling formD. Withdrawal Notice formE. Orientation Agreement formF. Universal Precautions & HIPPA Agreement formG. Safety/Incident ReportH. Supervisor’s Investigation of Accident ReportI. Disability Services ApplicationJ. Criminal History Evaluation formK. Service Learning outlineL. Emergency Contact/Medical Consent FormM. Instructional Authorization Form and Release Agreement for

College Sponsored TravelN. Student Organization Authorization Form and Release Agreement

for College Sponsored TravelO. Activity Registration FormP. Complaints Form

1. PURPOSE OF PHYSICAL THERAPIST ASSISTANT STUDENT HANDBOOK

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This manual states and describes the policies, procedures, and expectations of students enrolled in the Physical Therapist Assistant Program at San Jacinto College. These policies and procedures are extensions of those outlined in the current San Jacinto Community College District Student Handbook.

The PTA program reviews and updates the PTA Student Handbook annually. Throughout the academic year, the faculty and program director keep notes (in the Departmental Meeting Minutes) on policies and procedures that need to be added or changed. Every new policy applied to the Physical Therapist Assistant Program is cross-reference with the institutional policies. Significant additions or changes are presented to the Advisory Board Committee for approval. Changes are then made to the manuals and redistributed at the beginning of the following academic year.

San Jacinto Community College is a public community college in East Harris County, Texas, which serves a district defined by the combined areas of these independent school districts: Channelview, Clear Creek, Deer Park, Galena Park, La Porte, Pasadena, and Sheldon, as well as portions of Clear Creek and Humble. The college is accredited by the Commission on Colleges of Southern Association of Colleges and Schools to award the associate degree.

San Jacinto College District is committed to equal employment opportunity. As provided by this policy and to the extent provided by applicable law, no person including students, faculty, staff, and temporary workers will be excluded from participation in, denied the benefits of, or be subject to discrimination under any program or activity sponsored or conducted by the San Jacinto College District on the basis of sex, disability, race, religion, color, age, national origin, or veteran status.

San Jacinto College District meets the needs of its community through high-quality education. As part of this mission, the Quality Enhancement Plan (QEP) encourages students to read their textbook and course material carefully to succeed in their classes and realize their personal and educational goals.

The Physical Therapist Assistant Program strives to promote congruent mission, vision and values statements with our college. Professionalism is the cornerstone of our program and our vocation. Our philosophy can be reiterated in the American Physical

2. INTRODUCTION

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Therapy Associations’ Code of Ethics for the Physical Therapist, Standards of Ethical Conduct for the Physical Therapist Assistant, Guide for Professional Conduct, and Guide for Conduct of the PTA, at www.apta.org. The PTA program complies with the Executive Council of Physical Therapy and Occupational Therapy Examiners. San Jacinto College is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools. The PTA Program at San Jacinto College is accredited by the Commission on Accreditation in Physical Therapy Education (111 North Fairfax St., Alexandria, VA 22314-1488; telephone: (703) 706-3245); email: accreditation@apta.org; website: http://www.capteonline.org.

American Physical Therapy Association (APTA) 1111 North Fairfax StreetAlexandria, VA 22314-1488(703) 684-APTA (2782)www.apta.org

Executive Council of Physical Therapy and Occupational Therapy Examiners 333 Guadalupe, Suite 2-510Austin, TX 78701-3942(512) 305-6900www.ecptote.state.tx.us/

Commission on Colleges of Southern Association of Colleges and Schools 1886 Southern LaneDecatur, GA 30033-4097(404) 679-4501www.sacscoc.org/

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Core faculty:Susan Hinson, PT, DPT Laura Oppermann, PT, C/NDTProgram Director Academic Coordinator of Clinical EducationPhone: 281-929-4697 Phone: 281-484-1900 ext. 3519Fax: 281-929-4634 Fax: 281-929-4634Susan.Hinson@sjcd.edu Laura.Oppermann@sjcd.edu

Adjunct faculty: Holly Beckman, PTAMartina Quivers, PT, DPT Phone: 281-922-3476 Stephen Edmonds, PT, MPT,MBA Fax: 281-929-4634

Administrative assistant:Anum FatimaPhone: 281-922-3476Fax: 281-929-4634Anum.Fatima@sjcd.edu

Program Information San Jacinto College – South Campus Science/Allied Health (Building 1, room S-1251q) 13735 Beamer RoadHouston, TX 77089281-922-3476www.sanjac.edu/PTA

3. FACUTLY/STAFF DIRECTORY

5. VISION STATEMENTS

6. VALUES

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COLLEGEOur mission is to ensure student success, create seamless transitions, and enrich the quality of life in the communities we serve.

PROGRAMThe mission of the Physical Therapist Assistant Program is to provide successful and competent para-professionals who possess the knowledge, skills, and attitudes necessary to succeed in the profession in a variety of health care settings under the direction of a Physical Therapist. The graduate will have a commitment to self-directed lifelong learning; and be of service to man, the community and society.

COLLEGESan Jacinto College will be the leader in educational excellence and in the achievement of equity among diverse populations. We will empower students to achieve their goals, redefine their expectations, and encourage their exploration of new opportunities. Our passions are people, learning, innovation, and continuous improvement.

PROGRAMThe Physical Therapist Assistant Program will develop educational excellence in physical therapy and bring to the program students from diverse backgrounds, locations and cultures. All students will have the opportunity to explore their unique interests with the support and encouragement of staff and faculty. Our desire is to create an environment to instill critical thinking, ethical behavior, and compassionate treatments in the classroom and on clinical rotations.

COLLEGEIntegrity: Ethical and Professional: “We act in ways which instill confidence and trust.”

Excellence: In Everything We Do : “We achieve quality results in everything we do.”

Accountability: It’s Up to Us: “We take responsibility for our commitments and outcomes.”

Innovation: Lead the Way: “We apply knowledge, skill, insight, and imagination to recognize opportunities, solve problems, and recommend new solutions.”

4. MISSION STATEMENTS

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Sense of Community: Caring for Those We Serve and Ourselves : “We demonstrate genuine concern for the well-being of our students, our community and ourselves.”

Student Success: Our Ultimate Measure: “We enable students to achieve their goals.”

Diversity: Celebrate the Differences: “We celebrate the diversity of ideas and cultures.”

Collaboration: We Work together : “We work together for the benefit of the college.”

PROGRAMIntegrity: In every class and clinical experience students will demonstrate professional behaviors and ethical conduct.

Excellence: We strive to have not only outstanding classes and resources at the college but also at each clinical and healthcare facility.

Accountability: We strive to be accountable to our students, the college, our clinical sites and the community.

Innovation: Our innovated thinking is expressed in the classroom and clinical program by adapting policy of creative clinical placement and imaginative learning experiences.

Sense of Community: Through service learning and the Student Physical Therapist Assistant Society we provide numerous opportunities for the student to develop a sense of community for the betterment of themselves and others.

Student Success: Our student success is ultimately measured by the passage of the National Exam for the PTA, their accumulated knowledge, enriched lives as well as a lifelong service to themselves and others.

Diversity: In all our professional activities we identify, value and act with consideration for all individuals.

Collaboration: Our students work as a team member in class, clinical situations and in the community.

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The Physical Therapist Assistant Program subscribes to and supports the structure of San Jacinto Community College benefiting from and contributing to the mission, values, and goals, the APTA, and the accreditation standards established by CAPTE. The PTA program at SJC is committed to providing the appropriate education necessary to achieve and Associate of Applied Science degree as a PTA.The curriculum reflects sound principles, an expanding body of knowledge, and professional expectations of the health care environment.The PTA faculty is committed to transferring knowledge, providing opportunities for learning and understanding the fundamental principles of physical therapy and the student’s acquisition of clinical skills to current practice expectations. Faculty encourages the students to develop as critical thinkers who are committed to lifelong learning. Faculty roles include educating students, advancing teaching and therapy skills, and provide service to the community and college.

OUTCOMES OF PTA PROGAM GRADUATES:

1. Graduates of the PTA program will perform as entry level physical therapist assistants in a variety of health care settings under the direction and supervision of a physical therapist.

2. Graduates of the PTA program will demonstrate behaviors consistent with lifelong learning.

3. Graduates of the PTA program will function as contributing members of the community and society.

4. Graduates of the PTA program will provide physical therapy treatment in an ethical and culturally competent manner.

5. Graduates of the PTA program will function as an effective member of the healthcare team.

6. Graduates of the PTA program will provide physical therapy treatment based on contemporary standards.

7. PHILOSOPHY

8. PTA PROGRAM OUTCOMES

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In accordance with ensuring the PTA PROGRAM OUTCOMES are achieved, the PTA program and faculty will

o Provide a curriculum of academic and technical courses which will provide the foundation for the graduate to benefit from further study in the profession of physical therapy.

o Provide an atmosphere of technical support that is conducive to student success.

o Provide seamless transitions from technical students to licensed physical therapist assistants.

o Continue to gain knowledge in teaching and the profession of physical therapy.

o Model a commitment to service activities to the community and the profession.

The mission and philosophy of the Physical Therapist Assistant Program are consistent with the mission and overall philosophy of the institution. The PTA program is in harmony and tightly connected in student success and in creating transitions to the workforce, and enriching the quality of life in the communities served by San Jacinto College. The Physical Therapist Assistant Program is committed to an educational environment that will promote students who will possess the knowledge, skills, and attitudes necessary to succeed as a physical therapist assistant in a dynamic health care environment. The PTA program believes that the students should have an educational environment that is led by instructors who are imaginative and competent. The instructors should provide the students with knowledge and skills, but also open channels of interest and occupation. We prepare our students to become active physical therapist assistants in the local workforce and to enrich the lives of patients/ community members that they treat.

For a comprehensive list and description of the skills for an entry level PTA graduate, please refer to The Minimum Required Skills of a Physical Therapist Assistant Graduate at Entry-Level (BOD G11-08-09-18) which can be found in Appendix A and on the APTA’s website at http://www.apta.org/The curriculum of the San Jacinto College PTA program is designed to develop the skills of the programs graduates in accordance with these standards.

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Graduates of the PTA Program will possess a strong base of knowledge of the history of the profession and of the American Physical Therapy Association including the evolution of the role of the physical therapist assistant, legal and ethical standards, and the structure and benefits of the professional organization. Graduates will also possess an understanding of the health care system including the relationship of the physical therapist assistant to others on the health care team, the organization of physical therapy services, and the process and value of continuous quality improvement.

Graduates will recognize an understanding of societal factors such as cultural, economic, psychosocial, ethical, legal and demographic influences as being important in providing effective patient care. They will interact with patients and their families in a manner which provides the desired psychosocial support including the recognition of cultural and socioeconomic differences and the impact of these influences on outcome. They will consider the patient and family as part of the team. Graduates will work in a variety of environments with a diverse population and will understand the need to adapt appropriately. They will understand and respect the roles of others on the health care team. They will understand their roles and responsibilities and interact with others on the health care team appropriately. They will use support staff legally and appropriately.

As health care providers, the graduates will value ethical practice, service to the profession and community, and preservation of the rights and dignity of individuals. They will respect the client’s rights to confidentiality, privacy and choice. They will appreciate learning as a life long process and seek out opportunities to acquire or refine skills and knowledge.

Graduates will be able to perform the functions of an entry level physical therapist assistant in an ethical, legal, safe and effective manner. They will be able to implement a comprehensive treatment plan developed by a physical therapist which may include any of the skills included in the curriculum or for which they have been trained. They will be able to perform appropriate assessments to assist the supervising therapist to monitor patient progress. They will demonstrate effective written, verbal, and nonverbal communication with patients and their families, the supervising physical therapist and other colleagues, other health care providers, and the public. Graduates will use critical thinking and problem solving skills in performing their duties and communicate their observations to the supervising physical therapist in a timely manner. They will document relevant information in a format approved by the facility, participate in discharge planning and teaching others as appropriate.

9. SAN JACINTO COMMUNITY COLLEGE

DISTRICT PHYSICAL THERAPIST ASSISTANT PROGRAM EXIT LEVEL

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It is the policy of San Jacinto College to provide an educational, employment, and business environment free of discrimination based on race, creed, color, national origin, citizenship status, age, disability, pregnancy, religion, gender, sexual orientation, gender expression or identity, genetic information, marital status, or veteran status.Trustees, administrators, faculty, staff, and other agents of the College will not engage in conduct constituting unlawful harassment or discrimination. The College strives to maintain a learning environment free of harassment. The College will promptly investigate all allegations of harassment and take appropriate disciplinary action against individuals who engage in unlawful behavior. Disciplinary action may include dismissal of employees or expulsion of students.As a student at San Jacinto College, you may not be discriminated against on these bases in: Admission to programs of study; Access to enrollment in courses; Career placement services, Counseling and guidance materials, tests, and practices; Technical Education.

Believing that learning is an internal, individual response, dependent on many predictable and unpredictable variables, the faculty see their main role as stimulators, facilitators, and resource persons for the learner. The student, therefore, is seen as having responsibility for his/her own learning, and must be a self directed active learner.

It is important to recognize that the PTA curriculum is carefully designed as a continuum. It is expected that the student will master the material from prerequisite courses and be able to use that material is subsequent courses. Therefore, students should independently review any content as needed to successfully complete other courses.

Students are responsible for adhering to all policies and procedures within the San Jacinto College Student Handbook (www.sanjac.edu), the Physical Therapist Assistant Student Manual, and the Physical Therapist Assistant Clinical Handbook (www.sanjac.edu/PTA). Failure to comply with the policies and procedures of these manuals will result in the student being withdrawn from the PTA program.

Students are expected to promote health and wellness and the field of physical therapy. They are to be committed to the profession and are encouraged to become members of the American Physical Therapy Association and to participate in professional opportunities outside of the classroom (i.e. TPTA Student Conclave)

10.Grievance Procedures for Discrimination

11. STUDENT RESPONSIBILITIES

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12. CURRICULUM OUTLINE

First TermPTHA 1305 – Basic Patient Care Skills

Credits3

PTHA 1313 – Functional Anatomy 3ENGL 1301 – Composition I 3PTHA 1201 – The Profession of Physical Therapy 2BIOL 2301 – Human Anatomy & Physiology I (Lecture) 3BIOL 2101 – Human Anatomy & Physiology I (Lab) 1

Second TermPTHA 2301 – Essentials of Data Collection 3PTHA 1431 – Physical Agents 4PTHA 2409 – Therapeutic Exercise 4BIOL 2302 – Human Anatomy & Physiology II 3BIOL 2102 – Human Anatomy & Physiology II (Lab) 1

Third TermPTHA 2250 – Current Concepts in Physical Therapy 2PTHA 1360 – Clinical I – PTA 3PTHA 1321 – Pathophysiology for the PTA 3MATH 1314 – College Algebra or higher 3

Fourth TermPTHA 2431 – Management of Neurological Disorders 4PTHA 2435 – Rehabilitation Techniques 4PTHA 2239 – Professional Issues 2

Fifth TermPTHA 2460 – Clinical II – PTA 4PTHA 2461 – Clinical III – PTA 4*Humanities or Fine Arts 3PSYC 2301 – General Psychology 3

Associate of Applied Science Degree Total 64

Courses that meet Humanities requirements:*English 2322, 2323, 2327, 2328, 2332, 2333; Philosophy 1301, 2306; Arts 1301, 1303, 1304;Dance 2303; Drama 1310, 2366; Music 1306, 1307, 1310

The program is a total of 64 credit hours and the student is awarded an A.A.S. degree upon completion of the program.

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The cost of the PTA program is the same for any student at San Jacinto College with additional fees for labs, insurance, background checks, drug screen, immunizations, CPR certification, and additional travel expenses for clinical rotations. Uniforms may need to be purchased for some clinical rotations. All costs for the PTA program are at the student’s expense.Tuition information can be found on the college’s website at http://sanjac.edu/future- students/paying-for-college/tuition-fees

Financial aid information may be found on the college’s website at http://sanjac.edu/financial-aid-programs.Students are also encouraged to contact the financial aid office at 281-998-6150 for further information.

All formal complaints regarding the Physical Therapist Assistant Program can be submitted to the department and will be recorded using the “Complaints” form (Appendix P) in the PTA department. This form is also available directly on the program’s website at www.sanjac.edu/PTA. The program director will evaluate all complaints and work towards a resolution for all parties involved.

If the program director is unable to make a resolution, he or she will seek advice from the Health Science department chair and the dean of Natural and Health Sciences.

Students in the PTA program are to follow the Policy and Grievance Procedures as outlined in the San Jacinto Community College District Student Handbook. Grievances must be filed in writing with the dean of student development on the South campus and must describe the actions, policies, or practices which the student believes to be discriminatory. Grievances should be filed no later than 30 days after the occurrence of the alleged discrimination. A student may be asked to meet with those persons who would be involved in correcting the actions, policies, or practice that he or she believes are discriminatory. The dean of student development will notify the student in writing of his or her agreement or disagreement with the grievance and of any corrective actions taken to restore the student’s rights. If the decision of the dean of student development does not satisfactorily resolve the student’s concerns, the student may appeal the grievance to the campus President.

13. TUITION and FINANCIAL AID

14. Complaint Process/Grievance Procedure

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Students are expected to function according to guidelines in the yearly San Jacinto Community College Student Handbook and College Catalog. In addition, specific program policies are as follows:

A. Students are required to attend all lecture and laboratory periods. An accurate record of each student’s attendance is kept by each instructor. An instructor has full authority to drop a student for excessive absences. A student may be asked to drop the course upon the accumulation of 10% absences of the total number of course hours. Students are expected to notify the course instructor in advance that they will be late or will be missing class. Notification does not excuse the student from the consequences of missing class (see B, C, D and E below).

B. When a student is 5 or more minutes late for a scheduled class, it is considered a late arrival. When a student leaves more than 5 minutes prior to the end of the scheduled class, it is considered an early leave. Three late arrivals, 3 early leaves, or 3 combined late arrivals/early leaves is equal to one full absence of that class.

C. For every unexcused absence in a given class (lecture or lab), one full point will be deducted from the student’s final course grade.

For example, if a student’s final course grade is a 91% and he or she has 3 late arrivals and one full absence, the final course grade will be an 89%:

91% - 1 point (for 3 late arrivals) – 1 point (for one full unexcused absence) = 89% = B as the final letter grade.

Excused absences: If the student turns in a physician’s letter of excused absence, the instructor may not deduct points from the student’s final course grade for the absences noted on the physician’s letter.

D. It is the student’s responsibility to make up the missed class work, however the course instructor may make the decision on how the course work will be made up. Make up work must be turned in as soon as the student returns to class. 10% per day will be deducted for late work.

15. PHYSICAL THERAPIST ASSISTANT PROGRAM POLICIES

I. Class Attendance

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E. Make-Up Exams must be taken within one week of the day of the missed scheduled exam and must be taken at the college’s testing center. Failure to follow the guideline will result in a grade of zero, which will be calculated into the average grade for that unit of study. Make-up exams to be taken are the responsibility of the instructor and student. The student must inform the instructor of the need to make up the exam. The instructor must make the test available at the testing center. The student must come prepared with pen/pencil and picture identification to take the make-up exam in the testing center.

F. At the discretion of the instructor, the student may be required to supply a physician’s statement regarding fitness to return to school and assume duties.

G. Clinical Absences: The student is required to notify the affiliating agency and the PTA faculty when unable to attend as assigned. Refer to the Physical Therapist Assistant Clinical Handbook (www.sanjac.edu/PTA) for further detail on the clinical attendance policies.

H. Service Learning: Students are required to attend scheduled service learning arrangements. The student is required to notify the affiliating agency and the PTA faculty when unable to attend as scheduled. The student will be responsible for rescheduling service learning opportunities in order to meet the requirements of the service learning project (and ultimately the course in which the service learning project is a part of).

I. Students are expected to engage in laboratory and clinical experiences, including the role of students as subjects or as patient-simulators in laboratory and clinical experiences as appropriate. Students are explicitly instructed to exclude themselves from engaging as the role of the patient if the student has any precautions or contraindications to the procedure.

J. Students are expected to make themselves aware of any school closings related to weather or disasters. They are encouraged to participate in the SJC AlertMe program which can be found at http://www.sanjac.edu/sjc-alert-me.

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A. The following grade equivalency is established for all PTHA courses:

A = 90 - 100%B = 80 - 89%C = 70 - 79%D = 60 - 69%F = Below 60%

A grade below “C” is not acceptable in the PTA program. Therefore, grades of “D” and “F” are not passing and are not acceptable. Faculty will determine the details of the grading system for the specific course at the beginning of each course. This information will be located on the syllabus of each course under Grading Formula. Each PTHA course must be passed with a minimum of “C” based on the instructor’s Grading Formula. Each semester’s courses must be completed with a satisfactory grade of a “C” or better before progressing to the next level.

B. If a student does receive a grade below “C” in a non-PTHA course, he or she will be required to retake the course and earn a “C” or better prior to graduation. If a student receives a grade below “C” in a PTHA course, they will be removed from the program and given the option to reapply to the program. (See Readmission policy XXIII).

C. Grading will be performed using the Rule of Rounding. Grades will be carried to the first decimal place, using the hundredths place to determine whether to round up or to round down. If the digit in the hundredths place is less than 5, the number will be rounded down; if the digit in the hundredths place is 5 or greater, the number will be rounded up. A number will only be rounded once. Example: 66.56 = 67; 85.33 = 85.

D. Test scores will not be rounded until the final course grade calculation.

E. Questionable test items may be deleted by the instructor and the grade will be based on the remaining items. The course instructor will determine if a question is improperly constructed.

Example: 50 questions - 1 improperly constructed question = 49

F. Extra Credit: The course instructor may provide students with assignments for extra credit to improve a course grade, however extra credit must not be awarded on written exams, lab checkoffs, or lab exams.

II. Grading

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G. The weight of each component of the final course grade can be found in the syllabus of each course under Grading Formula.

H. The grading system for non-PTHA courses will be determined by the specific department responsible for the course. Students must receive a final grade of “C” or better in all non-PTHA courses.

I. Laboratory Skill Check Offs:

The instructor must supply the students with the checkoff list (including grading criteria) of the lab skills within the first two weeks of the lab course.

a. For each lab skill checkoff, there are a given number of skill components. Each component is worth up to 2 points where 2 points = meets expectations without guidance; 1 point = meets expectations with minimal guidance from instructor; 0 points = clearly does not meet expectations, safety or effectiveness of treatment is compromised; further instruction/practice is needed. The grade on each skill will be determined by the percentage of points earned. For example if a skill has 20 components, up to 40 points can be earned. If a student earns 37 points, their grade on the skill will be 37/40 = 92.5.

b. For each course with a laboratory section, (*with the exception of PTHA 1413) students must demonstrate proficiency on a given list of skills where proficiency is defined as fulfillment of the following three criteria:

i. No more than 25 points deducted from starting grade. (i.e. If student starts with 100 points (as he or she will on first attempt), he or she must receive a 75 or higher. If a student starts with 70 points (as he or she will on second attempt), he or she must receive a 55 or higher. If a student starts with 0 points (as he or she will on third attempt), he or she must not have more than 25 points deducted on the grading sheet.)

ii. Student must earn 2 points on all Critical Safety Elements which are marked with * under the 2 points earned box. These skills have been deemed by the PTA faculty as essential for safety for both the patient and the therapist and must be met in order for student to progress safely through the curriculum.

iii. Demonstration of an overall understanding of how to complete the skill. This is at the discretion of the course instructor. If the instructor observes that the student requires significant time or hesitates significantly between steps of the skill and is unable to answer questions related to the skill and/or converse with the instructor about the skill, it may be determined that the student is unable to demonstrate an overall understanding of how to perform the skill.

c. A student is allowed 4 attempts to complete a lab skill with proficiency. For each skill, the student will start with 100 points. Each component of the skill will

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account for a given number of points which will be deducted from if a student does not successfully demonstrate that component. Certain components will be deemed “critical safety elements”. If a student does not demonstrate proficiency (that is if he or she gets >25 points deducted from starting grade, fails to earn 2 points on a critical safety element, or if the instructor determines that the student does not have an overall understanding of how to complete the skill), he or she will fail the 1st

attempt. On the second attempt, the student will begin with 70 points. If a 3rd

attempt or more is needed, the student will be given a 0 for the check off. If on the 4th attempt the student is unable to complete the skill checkoff with proficiency, he or she will receive an F for the course and will be removed from the program and given the option to reapply to the program (See Readmission policy XXIII).

d. The student may not take a midterm lab exam or final lab exam until all laboratory skills checkoffs associated with that lab exam are completed with proficiency.

e. All check offs must be completed with a level of proficiency by the 4th attempt in order to pass the course.

f. Grading of all skill check offs will be documented and signed by the course instructor and the student.

g. The average of all skill check offs will be used in the calculation of the final score which will be worth 5% of the total grade.

J. Laboratory Exams

(The instructor must supply the students with the grading sheet for the lab exam at least one week prior to the lab exam.)

a. For each lab exam, there are a given number of skills. Each skill is worth up to 2 points where 2 points = meets expectations without guidance; 1 point = meets expectations with minimal guidance from instructor; 0 points= clearly does not meet expectations, safety or effectiveness of treatment is compromised; further instruction/practice is needed. The grade on each exam will be determined by the percentage of points earned. For example if an exam has 20 components, up to 40 points can be earned. If a student earns 37 points, their grade on the exam will be 37/40 = 92.5.

b. Each course with a laboratory section (*with the exception of PTHA 1413) will have a patient scenario midterm lab exam and a final lab exam that must be completed with proficiency where proficiency is defined as fulfillment of the following 3 criteria:

i. No more than 25 points deducted from starting grade. (i.e. If student starts with 100 points (as he or she will on first attempt), he or she must receive a 75 or higher. If a student starts with 70 points (as he or she will on second attempt), he or she must receive a 55 or higher. If a student starts with 0 points (as he or

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she will on third attempt), he or she must not have more than 25 points deducted on the grading sheet.)

ii. Student must earn 2 points on all Critical Safety Elements which are marked with * under the 2 points earned box. These skills have been deemed by the PTA faculty as essential for safety for both the patient and the therapist and must be met in order for student to progress safely through the curriculum.

iii. Demonstration of an overall understanding of the exam material and skills required for the exam. This is at the discretion of the course instructor. If the instructor observes that the student requires significant hesitation between steps of the exam and is unable to answer questions related to the exam material and/or converse with the instructor about the exam material, it may be determined that the student is unable to demonstrate an overall understanding of the exam material and skills required for the exam.

(*The lab exams for PTHA 1413 (Functional Anatomy) are not case based. They will consist of answering written questions associated with labeled anatomical models. Therefore, the grading criteria for lab exams do not apply to these exams. These exams will be graded by the instructor at his or her discretion.)

c. A student is allowed 3 attempts to complete a lab exam with proficiency. Each exam will be worth 100 points. Each component of the exam will account for a given number of points which will be deducted from if a student does not successfully demonstrate that component. The scoring of many of these criteria will be standardized for all lab exams. Certain components that have been deemed vital to the safety of the student and patient are marked as “critical safety elements”. If a student does not demonstrate proficiency (that is if he or she gets >25 points deducted from the starting grade, fails to earn 2 points on a critical safety element, or if the instructor determines that the student does not demonstrate an overall understanding of the exam material), he or she will fail the 1st attempt on the exam. On the second attempt, the student will begin with 70 points and be graded using the same standards as if it was the 1st attempt. However, the maximum points earned will be 70. If a 3rd

attempt is needed, a student will receive a 0 for the exam. This 0 will be averaged into the Total Class Grade (according the instructor’s grading formula) as well as the Exam Average. If on the 3rd attempt, the student is unable to complete the lab exam with proficiency (as described in Kb), he or she will receive an F in the course, will be removed from the program, and be given the option to reapply to the program (See Readmission Policy XXII).

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d. The weight of the laboratory exams for the student’s final course grade is determined by the course instructor and can be found in each course syllabus under the Grading Formula.

K. PROCTORING Lab Checkoffs and Lab Exams

a. The instructor proctoring a lab checkoff or lab exam has an obligation to utilize the scoring rubrics fairly for each student and complete all information on the scoring rubrics.

b. Critical Skills (marked with * on the grading rubrics for lab checkoffs and exams):

i. If the student does not earn 2 points for a critical skill (by meeting the expectations of the critical skill without guidance), the instructor is to stop the checkoff or lab exam before the student moves on in an unsafe manner. The instructor is to inform the student what critical skill is missing or demonstrated incorrectly and ensure the student verbalizes an understanding of the importance of and the correct way to demonstrate the critical skill.

ii. The instructor must make a written comment on the grading rubric explaining why the student did not earn full credit (2 points) for the critical skill.

iii. The instructor must also document (with a signature) on the scoring paper that the student has been informed of the need to repeat the lab checkoff or lab exam secondary to not demonstrating competency in the skill (see Jb and Kb under Policy II Grading.)

c. Non-Critical Skillsi. If the student does not earn 2 points a non-critical skill (by not

meeting the expectations of the skill without guidance), the instructor is to interrupt the checkoff or exam and inform the student that an aspect of the skill is missing or demonstrated incorrectly. If the student is able to make the appropriate change in the implementation of the skill or exam without further instruction, the student will earn 1 point (meets expectations with minimal guidance from instructor). If the student is NOT able to make the appropriate change in the implementation of the skill or requires further instruction to do so, the student will earn 0 points (clearly does not meet expectations, safety or effectiveness of treatment is compromised, further instruction/practice is needed).

ii. The instructor must make a written comment on the grading rubric explaining why the student did not earn full credit (2 points) for any skill in which 2 points is not earned.

d. Complete grade/signature of proficiency:

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i. Lab Checkoffs: The instructor is to tally the total points earned by the student and document the final grade. If the final grade is a 75% or higher and all critical skills were demonstrated with 2 points, the instructor is to date and initial that the student has demonstrated proficiency in the skill. The student must also initial. If the grade is less than 75%, the instructor must document (with a signature) on the scoring paper that the student has been informed of the need to repeat the lab checkoff secondary to not demonstrating competency in the skill (see Jb under Policy II Grading.)

ii. Lab Exams: The instructor is to tally the total points earned by the student and document the final grade on the scoring rubric. If the final grade is a 75% or higher and all critical skills were demonstrated with 2 points, the instructor is to record the grade in their grade book. If the grade is less than 75%, the instructor must document (with a signature) on the scoring paper that the student has been informed of the need to repeat the lab exam secondary to not demonstrating competency in the skill (see Kb under Policy II Grading.)

L. Notification of Grading Policy for Lab Checkoffs and Lab Exams:a. Lab Checkoffs:

i. The course instructor is to post the lab checkoffs on Blackboard and have students print out the entire packet (including the cover page which includes the grading policy) for the chekcoffs (or provide the students with a printed packet) within the first two weeks of any lab course.

ii. Prior to the first lab checkoff, the instructor must verbally review the grading policy found in this manaul for lab checkoffs.

iii. The grading policy for lab checkoffs will also be reviewed during Orientation to the program.

b. Lab Examsi. The course instructor is to post the lab exam (midterm and final)

scoring rubrics at least 2 weeks prior to the scheduled date of the lab exam. The student is to come to the exam with a printed copy of the lab exam rubric.

ii. Prior to any lab exam, the course instructor must verbally review the grading policy found in this manual with the class.

iii. The grading policy for lab exams will also be reviewed during Orientation to the program.

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A. Students will be evaluated in the following clinical courses:

PTHA 1360 - Clinical I PTHA 2460 - Clinical II PTHA 2461 - Clinical III

B. Clinical evaluations will consider the student’s ability to apply theory to practice, conduct, appearance, interpersonal relationships and demonstrated competence in clinical performance via use of the PTA MACS.

C. See PTA Clinical Handbook for detailed information on clinical course grades. The PTA Clinical Handbook can be found on the programs website at www.sanjac.edu/PTA

A. A Midterm Counseling Report form (Appendix B) will be filled out by the course instructor for each student for each PTHA course at the middle of each semester. If the student is NOT in danger of failing, both the student and instructor must sign the form. If the student is in danger of failing, the student and instructor must schedule a meeting to determine a written action plan to improve the student’s status in the course. Both the student and instructor must sign the written action plan. A student’s signature on the conference form does not indicate that the student agrees with statements made on the form, only that the student has had an opportunity to read the form and to make comments.

B. The student or instructor may also request a scheduled meeting if he or she has any concerns regarding the student’s status in the course, even if the student is not in danger of failing.

C. An action plan may include, but is not limited to: tutoring, assigning a mentor, locating resources to assist with study habits and learning style assessment, making modifications to outside responsibilities, and initiating formal counseling (which may include reference to the counseling center).

D. Students will not be required to fill out Midterm Counseling form for clinical courses as they will follow the procedures outline in the Clinical Manual for counseling and grading.

III. Clinical Course Grades

IV. Midterm Counseling Reports

23

A. All students are free to seek counsel at any time throughout the program for personal, academic, and/or professional matters. They may contact any faculty member, the program director, or the San Jacinto College Counseling services at the J.D. Bruce Student Center (281-998-6150).

B. The program director and any course instructor may determine if academic counseling is appropriate for a student at any time. If this decision is made, counseling for the student will be initiated.

C. Whenever counseling regarding program performance is initiated, the Health Science Division Counseling form (Appendix C) is completed. This includes a written planned corrective action (which may include reference to the counseling center). It is completed by the appropriate faculty member and is signed by the program director. Students will be aware of such documents, and asked to acknowledge them by signature. This applies to any situation that influences the student’s continuance in school. One copy of this document is held in the student’s file in the PTA department, one copy is given to the student, and another copy is given to the course instructor.

D. Except for dismissal reasons, students will receive documented counseling with time to correct the deficiency prior to notice of the need to withdraw.

A. Students must take courses as sequenced in the curriculum. They may take non-PTHA courses prior to when scheduled in the curriculum, but no later than in the planned curriculum.

B. Students must be eligible to graduate from the PTA program by the end of Summer of the anticipated graduation year of their cohort. If the student cannot finish their clinical rotations by that time, the student must retake and pass with a minimum of 70% the final exams of all PTHA classes prior to being placed in their clinical rotation.

V. Counseling

VI. Curriculum Compliance/Failure to Complete the

PTA Program in the Designated Time.

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A. The Physical Therapist Assistant Program Director has the right to initiate the administrative withdrawal of any student whose attendance, conduct, scholastic standing, or lack of aptitude for the profession of physical therapy makes it inadvisable for the student to continue in the program. This right exists regardless of grades. The primary concern of the program and the college shall be patient safety and competence of practice.

B. A Withdrawal Notice form (Appendix D) will be completed on all students who leave the program, regardless of the reason for the student leaving. Students considering withdrawal from the program should talk to the program director for withdrawal and readmission information. It is the responsibility of the student to process withdrawal forms in the registrar’s office prior to the college’s established withdrawal deadline.

C. In order for a student to be eligible for readmission into the program, he or she must meet with the program director upon withdrawal from the program (regardless of reason for withdrawal). This meeting will include documentation on the Health Science Division Counseling form (Appendix C)) of what he/she will do to help insure a passing grade if readmitted and/or what he or she will do in order to rectify the situation that caused the withdrawal. The Withdrawal Notice form (Appendix D) must also be complete in order for the student to be eligible for readmission.

D. Students who withdraw from the program that are eligible for readmission into the program must re-enter the program by the next academic year. Students who are withdrawn longer than one academic year must repeat all PTHA courses. Any student who withdraws must re-apply and will be held under the programs admissions standard criteria with all applicants.

E. Students returning to the program will pay college fees and liability insurance as appropriate.

F. Students may only fail or withdraw from academic based PTHA courses during one academic semester. Failure or withdrawal of academic based PTHA courses in more than one academic semester will result in removal from the PTA program unless otherwise determined by the program director. Situations that may be considered by the program director include but are not limited to illness, family hardship, and natural disasters.

G. Students may only fail or withdraw from one clinical based PTHA course (PTHA 1360, PTHA 2460, and PTHA 2461). Failure or withdrawal from more than one clinical based PTHA course will result in removal from the PTA program unless otherwise determined by the program director. Situations that may be considered

VII. Withdrawal Policies

25

by the program director include but are not limited to illness, family hardship, and natural disasters.

H. If a student withdraws from an academic course or courses, but not the entire program, he or she must re-apply and will be held under the programs admissions standard criteria with all applicants. (See Readmissions policy XXIII).

A. Immediate dismissal from the program may follow documented evidence of:1. Willful lying or deceit.2. Verbal or physical abuse of patients, classmates, faculty, or staff.3. Falsification of records.4. Cheating, plagiarism, stealing.5. Patient neglect of any kind.6. Failure to acknowledge and honor patient’s rights.7. Failure to submit written clinical requirements when due.8. Misuse of drugs and/or alcoholic beverages.9. Unprofessional conduct. Unprofessional conduct may include but is not

limited to use of abusive or profane language or gesture; sexual, social, or ethnic slurs; loud, boisterous or disruptive behavior.

10. Lack of aptitude for physical therapy.11. Inability to render safe competent patient care.12. Refusal of a clinical agency to allow a student to affiliate in that agency.13. Any fighting/physical or verbal confrontation with faculty, peers, or hospital

staff.14. Breach of confidentiality.

C. A course instructor must report any of the above documented evidence to the program director. If action to dismiss the student is taken, the dean of Sciences and Health Sciences must be notified.

A. Students are to abide by all policies and procedures as outlined in the PTA Clinical Handbook which can be found on our website at www.sanjac.edu/PTA

VIII. Dismissal Policy

IX. Clinical Courses

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A. The use of cellular phones and personal electronics during scheduled classes (in the classroom or laboratory) is not tolerated. If a student is to bring his or her cellular phone to class or lab, it is to be turned off or on silent mode and put away.

B. Students may not make phone calls, answer the phone, or receive or send text messages or emails during instructional time in the classroom or lab.

C. If a student is expecting a very important contact, he or she must notify the instructor before class regarding the nature of the situation. The phone must be kept on vibrate or silent mode and the student must quietly step out of the classroom to handle the call.

D. All cell phones and personal electronics must be put away and on silent mode/turned off during testing. If a student is expecting a very important contact during a test, he or she may ask permission of the course instructor to hold his or her phone and notify him or her if a call or message comes in. The course instructor has the right to deny a student this privilege.

E. The use of portable laptop computers is tolerated during instructional time in the classroom and lab settings for the purposes of note taking only. The use of email and the internet are not tolerated during instructional time. Portable laptop computers must be turned off and put away during testing.

A. PTA students are expected to present themselves in a professional manner in the classroom, laboratory, and clinical settings. Personal cleanliness and hygiene are essential for engagement with others in the healthcare setting. Students should follow the guidelines below and the PTA faculty will counsel students in these areas when necessary. Failure of the student to follow these guidelines after counseling may result in dismissal from the PTA program.

a. Hygiene should include daily bathing and brushing teeth. No fragrances or perfumes are to be worn. Offensive body odors will not be tolerated, including the lingering smell of tobacco on skin, hair, breath or clothing.

b. Moustaches/beards must be neatly trimmed.c. Hair must be clean and trimmed. Students with long hair must be able to

tie hair back so that it does not fall loosely over shoulders and face.d. Fingernails must be clean and filed smoothly. The fingernails must not

X. Cellular Phones and Personal Electronics

XI. Appearance and Grooming

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extend beyond the fingertips.e. Simple jewelry such as wedding bands/rings, watch, small chain necklace,

and small stud earrings are acceptable. Oversized jewelry is not acceptable. Piercings anywhere other than the ear are not acceptable.

B. While on clinical rotations, students are expected to follow these guidelines, the guidelines written in the PTA Clinical Handbook (which can be found on our website at www.sanjac.edu/PTA), and the policies of the clinical site.

A. Students are expected to refrain from academic dishonesty including:

a. Cheating: Includes but is not limited toi. Copying from another student’s test paperii. Using any unauthorized assistant in taking quizzes, test, or

examinationsiii. Possession during a test of materials which are not authorized by

the person giving the test, such as class notes or specifically designed “crib notes”

iv. Dependence upon the aide of sources beyond those authorized by the instructor in writing papers, preparing reports, solving problems, or carrying out assignments

v. The acquisition, without permission, of tests or other academic material belonging to a member for the San Jacinto College faculty or staff.

b. Plagiarism: Offering the work of another as one’s own without proper acknowledgment

c. Collaborating with others if contrary to stated guidelines for course/assignment.

d. Providing students who have not yet completed assignment/exam with information related to the assignment/exam.

e. Abiding or abetting another person in committing any form of academic dishonesty.

B. The course instructor controls the options of seating arrangement, movement, leaving the room, and stopping an exam for violation of the honesty policy.

C. All books, papers, notebooks, and personal belongings will be placed at the front of the classroom or other designated area (but not on the table top or desktop where the test is being taken) before entering a testing situation.

XII. Academic Dishonesty

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D. Identification of any evidence of information found on, or in the immediate vicinity of the individual during a testing situation that is suggestive of academic dishonesty will be collected by the course instructor. Identification of such materials may provide grounds for dismissal of the individuals involved from the PTA program.

E. If a course instructor identifies evidence of information suggestive of academic dishonesty, he or she must report it to the program director. The student will receive a grade of zero on the given assignment or exam. The PTA faculty will meet to determine appropriate disciplinary action for the individual student. This may result in termination from the program.

A. Students write many reports and papers in the PTA program. Students are expected to utilize the APA format. Students may utilize the APA Style website (http://www.apastyle.org/) and/or contact the on campus librarians if they require assistance to format a paper in the APA style.

A. It is the policy of the San Jacinto Community College District to provide an educational, employment, and business environment free of sexual harassment. Sexual harassment in any situation is reprehensible and, in many situations, it is illegal. It subverts the mission of the College and threatens the careers of students, staff, and faculty. Sexual harassment will not be tolerated.

B. The College will take appropriate preventative, corrective, and/or disciplinary action for any condition or behavior that violates this policy or the rights and privileges it is intended to protect. (Please refer to the San Jacinto Community College District Student Handbook located on the college’s website at www.sanjac.edu.)

A. The student has the right to work while enrolled in the Physical Therapist Assistant Program, although students are discouraged from working full time.

B. Working students are expected to maintain grades and clinical performance and no allowances will be made for failure to maintain program criteria.

XIII. Writing Reports and Research Papers

XIV. Sexual Harassment

XV. Employment While Enrolled in PTA Program

29

C. Students must not display their school identification at any time while working in any setting (as volunteers or for monetary remuneration).

A. Students are expected to enroll and pay for all classes prior to the start of classes. Failure to do so may result in the student being unable to participate in the given course which will result from failure to progress in the program/a need to withdrawal from the program.

B. PTHA class enrollment will be limited to 24 students for lecture courses and 12 students for laboratory courses.

A. Laboratory Safety Rules are posted in the PTA laboratory.

B. When in the laboratory for scheduled labs or independent practice, students must abide by the following rules:

1. A faculty member or authorized, licensed physical therapist or physical therapist assistant must be present in the department. Independent laboratory practice outside of class must be scheduled with the appropriate instructor.

2. Students will refrain from practicing laboratory activities until after they have received the appropriate instruction.

3. Students will observe all safety precautions for each laboratory procedure as instructed in class.

4. Containers of liquid shall not be placed on top of any electrical equipment at any time.

5. Spills must be cleaned up immediately.

6. Students who have questions regarding the functioning of any piece of equipment shall immediately contact the faculty member in charge.

XVI. Course Enrollment

XVII. Use of Laboratory Facilities

30

7. All injuries and unsafe practices must be reported to the instructor immediately.

8. Students with a pre-existing condition in which performing a laboratory procedure could be potentially harmful shall assume the responsibility of informing the laboratory instructor immediately so that proper accommodations can be made.

9. Students must clean up their area before they leave for the day. No drink containers or food wrappers should be left behind.

10. All plinths should be cleaned before and after class. Two chairs and one rolling stool should be placed by each plinth at the end of class.

11. All San Jacinto College policies must be followed.

C. Students are expected to engage in laboratory and clinical experiences, including the role of students as subjects or as patient-simulators in laboratory and clinical experiences as appropriate. Students are explicitly instructed to exclude themselves from engaging as the role of the patient if the student has any precautions or contraindications to the procedure.

D. If the student is injured or exposed to a communicable disease while engaged in activities or procedures in the laboratory setting, the student must notify the course instructor immediately. A Safety/Incident Report (Appendix G) will be completed and sent to the District Safety Department. A copy will be made and placed in the student’s file. The instructor must also complete the Supervisor’s Investigation of Accident Report (Appendix H) and send it to the District Safety Department.

E. The student’s signature on the Orientation Agreement form (Appendix E) will be required as documentation of providing consent to serve as a “patient” for demonstration by the faculty and for classmates in laboratory practice.

F. Laboratory Equipment Inspection: Inspection and calibration of all modalities are performed on an annual basis and records of results of tests and calibrations are kept in the PTA department. Tags are placed on each piece of equipment tested by a qualified vendor. Any faulty equipment will be fixed and tested and calibrated prior to being used in the lab.

G. When available by the manufacturer, manuals for appropriate laboratory equipment are kept in a notebook that is available to all students and faculty in the PTA department (or in the lab).

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H. Open Lab: Open lab hours are posted in the laboratory. Students must have supervision during open lab. They must not practice any procedure they have not already been taught in prior classes.

I. Laboratory supervisor/student ratio will be no greater than 1 instructor per 16 students at any time.

J. Students are to inform a faculty member of any potential hazard in the lab area such as a wet floor, frayed electrical wires, broken equipment, etc. This also includes any exposure of body substances.

K. Attire in the laboratory: Students are expected to dress appropriately for lab. Shorts with elastic waistband and t-shirts are appropriate. Shorts must not be excessively short and must be loose enough to allow palpation of hip musculature. Women should also wear a halter top or swimsuit in order to provide adequate exposure to the shoulders and back. If lab clothing is deemed inappropriate by the lab instructor, the student will be notified and required to have appropriate lab clothing in order to participate in the next lab period.

L. Off-campus Lab Activities: Prior to attending an off-campus lab, students must complete the Emergency Contact/Medical Consent Form (Appendix L). He or she must also sign the Instructional Authorization Form and Release Agreement for College Sponsored Travel (Appendix M).

A. Students have access to The Parker Williams Library which provides access to current books and journals in physical therapy and other allied health fields. The PTA program ensures that all course text books used in classes are available on reserve in the library. In addition, students have access to over 60 databases, including CINAHL (Cumulative Index to Nursing and Allied Health Literature), Health Source: Nursing/Academic Edition, Health Reference - Academic, MEDLINE, and other health science-related databases. These databases provide full-text access to thousands of journals, and indexing for many thousands more. Databases are accessible anywhere students can connect to the Internet The library subscribes in hard-copy to journals that support the studies of the students, including JOSPT (Journal of Orthopaedic and Sports Physical Therapy; PT (the magazine of the American Physical Therapy Association), Physical Therapy, and Physiotherapy. (PT and Physical Therapy are two separate publications). The library regularly adds and updates its collection of books supporting our program and has sufficient physical therapy specific textbooks and manuals to meet the needs of the students.

XVIII. Use of PTA Library Resources

32

B. PTA students will receive an orientation to the library in the first semester of the program in PTHA 1305 Basic Patient Care Skills.

C. Students also have access to specific texts in the laboratory for immediate use during lab and open lab hours. These resources must not be removed from the lab.

D. Students may also utilize the faculty library texts in the PTA lab and offices if they request further information. Students must have faculty obtain these texts from the faculty library.

A. Caring for patients with a communicable disease is an occupational/professional challenge in health care. Students will be instructed in protocols and procedures to reduce their risk for acquiring an infection or communicable disease. However, all areas of health care practice have inherent risks and no area is completely risk free. Students will be trained in Universal Precautions and will be required to sign documentation (Appendix F) that they have received training prior to the start of their clinical course.

B. All patients have the right to confidentiality of all records and all communications, written or oral, between patients and health care providers. Students will not reveal (to anyone other than their instructors) any confidential information that may come to their knowledge in the course of their work/studies. Students will hold in confidence all personal matters committed to confidentiality and all family affairs coming to their knowledge in the practice of their profession. Students will be dismissed from the program for breach of confidentiality.

C. Students will be trained in HIPAA policies and will sign documentation (Appendix F) that they have received training prior to the start of their clinical course.

A. Students are responsible for their own medical needs regardless of injury or exposure to communicable disease occurring in the laboratory or on clinical experience.

XIX. Patients with

Communicable

XX. Health Services

33

B. Students with a pre-existing condition in which performing a laboratory procedure could be potentially harmful shall assume the responsibility of informing the laboratory instructor immediately so that proper accommodations can be made.

C. The student’s signature on Orientation Agreement Form (Appendix E) will be required as documentation of providing consent to serve as a “patient” for demonstration by the faculty and for classmates in laboratory practice.

D. If students need to make appointments for physician care, they are expected to schedule such appointments so that they do not conflict with class or clinical experience hours.

E. If the student is injured or exposed to a communicable disease while engaged in activities or procedures in the laboratory setting, the student must notify the course instructor immediately. A Safety/Incident Report (Appendix G) will be completed and sent to the District Safety Department. A copy will be made and placed in the student’s file. The instructor must also complete the Supervisor’s Investigation of Accident Report (Appendix H) and send it to the District Safety Department.

F. If the student is injured or exposed to a communicable disease while on clinical experience assignment, the clinical instructor and PTA faculty will be notified immediately. The student will follow the policy and procedure of the affiliating agency.

G. Pregnancy: Pregnant students will need written approval from their physician which will include the amount of weight a student can lift before going out on clinical rotation. They are responsible for notifying the instructor of any lab components in order to maintain safe lab practice.

H. Students are NOT to discuss personal medical problems with physicians while on duty in their clinical courses.

A. The following skills are required in the Physical Therapist Assistant program. If a student is unable to meet these skills secondary to a disability, the PTA faculty will meet to determine if adaptations can be made to ensure successful completion of the program. A student may need to withdraw from the PTA program if the following physical and mental requirements cannot be met with or without appropriate modifications.

a. Adequate verbal, reading, and writing skills to communicate in English in an effective and prompt manner.

b. Adequate eyesight to be able to:

XXI. Physical and Mental Requirements

34

i. Read paper, computer generated materials, and instrument panels.ii. Monitor patients adverse reactions to treatment.iii. Make visual observations regarding patient’s posture,

exercise performance, and functional abilities.iv. Make adjustments to equipment.

c. Adequate hearing to communicate with human beings and to monitor signals and alarms of instruments.

d. Adequate smell to assess status of patient and to maintain a safe practice environment.

e. Adequate fine touch discrimination to palpate anatomical sites and to determine pathological changes in soft tissue.

f. Adequate motor coordination to operate equipment and perform manual treatment and assessment techniques.

g. Maintain and assume a variety of positions including sitting for up to 2 hours continuously, frequent standing, walking, bending, squatting, kneeling, stair climbing, reaching forward, reaching overhead, turning, and movement of the trunk and neck in all directions.

h. Adequate strength to transport, move, or lift, and guard patients requiring all levels of assistance during transfers, gait training (including stair training) and other appropriate activities. Specifically, a student must be able to:

i. Safely lift up to 50 lbs. independentlyii. Safely lift up to 200 pounds with assistanceiii. Safely push and pull up to 200 lbs.iv. Demonstrate strong bilateral grasp during joint

mobilization/manipulation and manually resisted exercise, bilateral gross and fine motor control and strength to perform therapeutic massage, find motor control to manipulate testing instruments/equipment/writing instruments/computers

v. Manually palpate various structures during data collection and intervention procedures.

vi. Balance self and provide support and balance to patients on a variety of surfaces including level and uneven ground, ramp, curbs, and stairs.

vii. Have sufficient endurance to continue performing a variety of exertional activities for up to 8-12 hours with occasional rest breaks.

viii. Respond quickly to emergency situations by lifting/pushing/pulling patients, applying force to perform CPR, assist with transporting patients.

i. Adequate intellectual, emotional, and interpersonal skills to ensure patient safety, to exercise appropriate and independent judgment in rendering of patient care, and to interact with peers, patients, families, and health care workers.

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A. Students with learning disabilities, physical impairments, psychiatric disorders, and attention deficit hyperactivity disorder may be eligible for accommodations in the classroom. In order for a student to be eligible for accommodations, he or she must obtain documentation of the disability and complete the Disability Service Application (Appendix I). This application must be submitted to Disability Services (located in the Educational Planning and Counseling office in room 4218).

B. The Disability Services counselors will meet to determine approval (or disapproval) of the students requests for accommodations and provide the student with a letter of approval.

C. It is the responsibility of the student to obtain the letter of approval and give a copy to the course instructor for each course (even if the student has previously been taught by the instructor). The course instructor will keep the letter of approval secured in the student’s file for the given course.

D. It is the responsibility of the course instructor to provide the approved accommodations.

E. If a student is approved to have increased time to take a written test, the student is to report to the testing center for the test.

F. It is the responsibility of the course instructor to make the test available at the testing center.

G. Students should report to the testing center prepared with pen, necessary paper, and student identification.

A. All application forms and further details are available on-line at www.sanjac.edu/PTA.

B. Acceptance into the PTA program is competitive with enrollment limited to 24 students

C. Applicants must meet the College’s general admission requirements. Complete applications must be submitted by March 1 for enrollment in the following Fall semester. Admission to the program is based on a points system. A breakdown

XXI. Disability Assistance

XXII. Admissions

36

of the point system can be found on the website. The top 50 or so students will be invited for an interview (which includes a written essay) and students with the greatest number of points will be offered acceptance.

D. Applicants must complete a total of at least 40 hours of observation in physical therapy from at least two settings (one must be an in-patient setting) and submit three forms of recommendation (with at least one from a licensed PT or PTA).

E. Meeting the criteria does not guarantee admission to the PTA program.

F. Accepted students are required to have a criminal background and urine drug screen prior to admission into the program. They will go to https://portal.castlebranch.com/SV20 to access both the criminal background and urine drug screen. Students are responsible for associated fees. Any student who receives unsatisfactory results on these tests will complete the Criminal History Evaluation Form (Appendix J) available on the ECPTOTE’s website at www.ecptote.state.tx.us and submit it to the Board for review. As mandated by the Legislature, it will cost the individual with the criminal history$50.00 for this review.

G. Steps to complete admission:

1. Apply for admission into San Jacinto College at www.sanjac.edu/apply2. Submit all official transcripts from colleges/universities other than San Jacinto to

the Office of Enrollment Services at San Jacinto South. Request a transcript evaluation be completed to determine prior course equivalency. (This must be completed prior to the admission application deadline. This can take up to 10 business days). Upon completion of the transcript evaluation you must provide a copy of your San Jacinto College transcript to the PTA program with your PTA program application and other required materials.

3. Submit all transcripts (unofficial copies are acceptable) in your PTA application packet.

4. Complete PTA Program application form and submit after January 15th. The deadline for all application documents is March 1st. All program application forms are available at www.sanjac.edu/PTA .

5. Submit Hours of Observation Form. A total of 40 hours is required from at least two of the following settings: out-patient, in-patient rehabilitation, acute care hospital, pediatrics or home health. Twenty hours in-patient or acute hospital setting is strongly required as one of the options.

6. Submit 3 recommendation forms (only 3). It is required that one of the letters be from a PT or PTA. Each form must be completed and placed in a separate envelope. The person completing the form must sign the seal of the envelope. All 3 sealed and signed envelopes must be included in the PTA program application packet.

7. All required forms must be submitted in one envelope via mail or hand delivery by March 1st.

37

8. If eligible, complete the interview process.9. If eligible, complete criminal background and drug screen.

H. Deferral of Admission: Accepted students who would like to apply for deferral must make an appointment and meet with the Program Director stating their reason for requesting deferral. Granting a deferral is not guaranteed, but such requests that involve medical conditions affecting the student and military commitments are supported by the admissions committee. If approved, the applicant will need to inform the program by March 31st of the next application period their intent to remain a candidate for the incoming fall class. If deferred matriculation is declined, a new application would be required for any subsequent terms of entry. Only one deferral will be considered per applicant.

I. If a student is denied acceptance into the PTA program, he or she has the right to request a conference call with a member of the PTA department in order to review his or her application to determine appropriate actions to develop a stronger application. These calls will be limited to a 10 minute block. Information regarding essay and interview points is to be held confidential by the PTA department. If the student’s application consists of weakness in the area of forms of recommendation, the student will be notified; however the student will not be allowed to see the forms.

Students who wish to transfer from a physical therapist program or another physical therapist assistant program must meet the following criteria:

A. A student requesting to transfer must meet all of the admission requirements of San Jacinto College and the San Jacinto College PTA program.

B. There must be space available in the Physical Therapist Assistant Program at San Jacinto College. Enrollment is limited to 24 students.

C. The student must submit two current letters of reference. One letter must be from the Director of the program the student is transferring from and must state that the student is in good standing and is eligible to return to the program. The other letter must provide a statement of good character and be from a professional.

XXIII. Transfer Policy for Students Previously Enrolled

in Another PT or PTA Program.

38

D. The student must be transferring from a CAPTE accredited program or from a program that has CAPTE candidate status.

E. The student must complete 30 hours of course work at San Jacinto College prior to graduation. The student must be eligible to graduate on the expected date of graduation for the class he or she is applying to be a part of.

F. The San Jacinto College PTA faculty will review the curriculum of the previously attended PT or PTA program to determine compatibility with the curriculum of the San Jacinto College PTA program. If it is determined that the programs are not compatible, the student may be denied transfer acceptance.

G. The San Jacinto College PTA faculty will review the grades of the coursework (including clinical experiences) completed at the previously attended PT or PTA program to determine which courses in the San Jacinto College PTA curriculum that the student will need to complete. PT and PTA program curriculums vary significantly and the student may be required to take courses that cover content they have previously taken in another course.

H. If a student is accepted and has been approved for completion of coursework from the prior PT or PTA program, the student must pass a written exam and lab exam (if applicable) with a grade of 75% or greater for each PTHA course that is approved for completion. The most recent written final and final lab examination will be used for each course. These tests must be taken prior to registration in future PTHA courses.

A. If a student is not allowed to continue in the program because of unacceptable grades or if the student voluntarily withdraws, the student must wait until the next application period to re-apply. Admittance into the program will be dependent on all readmission policies and will be on a competitive basis with new applicants.

B. A student is only allowed to be admitted 2 times unless extenuating circumstances are applicable. Extenuating circumstances are at the discretion of the program director.

C. In order for a student to apply for readmission, he or she must submit a written request for readmission and include documentation of what he/she did to help insure a passing grade next admittance or rectify the situation that caused the withdrawal. This documentation should reflect completion of the actions discussed with the program director on the Health Science Division Counseling form (Appendix C). This written request must be approved by the program director in order for the student to continue with the readmissions process. The

XXIV. Readmission

39

program director will notify the student in writing whether or not the student has permission to continue with the readmissions process.

D. If at any time, space becomes available in the program, the program director has the right to make the decision to allow students to apply for re-admission. (Space is limited to 24 students.) The student must inquire with the programdirector if space is available and proceed with writing a written request as defined above in section C.

E. If a student is granted permission to proceed with the readmissions process, the PTA admissions committee will meet to determine if the student will be readmitted into the program. The student will be notified in writing of the decision of the PTA admissions committee.

F. If multiple qualified students are applying for readmission simultaneously and space is limited, they will apply on a competitive basis. The PTA admission team will meet to determine the best qualified applicants who will be chosen to be readmitted into the program. Documentation of plan to insure future passing grades, prior class participation and performance, grades, and character will be considered.

G. If an applicant is granted readmission, they must repeat any PTHA course that he/she received a grade of a D or lower.

H. An applicant that is granted readmission, must pass a written exam and lab exam (if applicable) with a grade of 75% or greater for each PTHA course that was completed with a grade of C or better in order to be exempt from repeating that course. The most recent written final and final lab examination will be used for each course. These tests must be taken prior to registration in future PTHA courses.

NOTE: These requirements are subject to change according to the requirements of the Physical Therapist Assistant Student Handbook applicable during the academic year when readmission is sought.

STUDENTS MUST COMPLETE THE READMISSION PROCESS IN COORDINATION WITH THE PROGRAM’S STANDARD ADMISSIONS DEADLINES.

A. All students enrolled in the Physical Therapist Assistant Program are required to be members of the SPTA club and abide by the bylaws of the SPTA club.

XXV. Student Physical Therapist Assistant Club

(SPTA club)

40

B. Students are expected to be actively involved in the SPTA club including participation in fund raisers and club activities.

C. For each activity the club does, an Activity Registration Form (Appendix) must be completed and submitted to student life. Prior to participating in any student activity, each participant must complete the Emergency Contact/Medical Consent Form (Appendix L). He or she must complete and sign the Student Organization Authorization Form and Release Agreement for College Sponsored Travel (Appendix N).

A. Students are expected to participate in a service learning project each year as described in the Service Learning Project Outline (Appendix K).

B. Students are expected to volunteer 20 hours of their time during the first year coursework portion of the program (throughout the Fall and Spring semesters) at one location and 10 hours of their time during the second year coursework portion of the program (throughout the Fall semester) at location different from the one they volunteer at the first year.

C. During each semester, one course will be designated to include a paper and presentation related to the service learning project. This paper/presentation will account for 5% of the grade.

D. Details of the project will be reviewed by each course instructor.

A. All applicants files are kept in locked file cabinets held within the offices of the PTA Department and Health Science Division with access limited to PTA faculty and PTA Administrative Assistant.

B. All tests, quizzes, papers and other graded work of every student will be kept in the students’ files. These files are kept in locked file cabinets held within the offices of the PTA Department and Health Science Division with access limited to PTA faculty and PTA Administrative Assistant.

XXVI. Service Learning Projects

XXVII. Student and Applicant Files

41

C. Students may only access these files under the direct supervision of the course instructor (or by another instructor or faculty member as determined by the primary course instructor).

D. Students may not photocopy, take pictures, or in any way rewrite any items from their files.

E. Student files will be kept on record for a minimum of 3 years after withdrawal or graduation from the PTA program. Files are shredded prior to purging.

A. It is the responsibility of the student to inform the PTA department concerning all changes in personal information at any point throughout the program. This should be done immediately after any change occurs. Name change requires notifying enrollment services and showing proof of either driver’s license or marriage certificate.

A. If a student has any encounter with the police or law or is committed of a misdemeanor or any level of crime while in attendance of the PTA program, it is his or her responsibility to notify the program director immediately. The PTA faculty will meet and determine the appropriate actions that will be taken regarding the situation on an individual basis.

B. Failure to notify the program director within 5 days may result in dismissal from the PTA program.

A. If a student is suspected of being under the influence of any substance during any school related activities including but not limited to class, laboratory, field trips, the student must be immediately sent home. It is the responsibility of the instructor who is in charge to assist the student in finding safe transportation home (i.e. classmate, family, friend, or taxi cab). The instructor in charge must then notify the Program Director.

XXVIII. Change of Personal Information

XXIX. Notification of Unlawful Behavior

XXX. Suspected Substance Abuse

42

B. If the student is suspected of being under the influence of any substance during a clinical experience, it is the responsibility of the clinical instructor to contact the ACCE. The student is to be sent home immediately and the clinical instructor and ACCE are responsible to assist the student in finding safe transportation home (i.e. family member, friend, or taxi cab).

C. The student will then meet with the Program Director. If it is determined that the student has participated in school related activities while under the influence of any substance, he or she will be removed from the program. He or she may be asked to complete a drug screen.

D. Refusal to take a drug screen or a positive drug screen will result in dismissal from the PTA program.

A. Prior to the start of PTHA 1360 (Clinical I), all students must demonstrate competency in skills deemed necessary by the PTA faculty and the Program Assessment. These skills may include, but are not limited to, guarding with transfers, gait training, and use of electrical stimulation and ultrasound.

A. Students will be held accountable for the policies and procedures as outlined in the most current copy of the Physical Therapist Assistant Student Handbook. Students must sign the attached agreement form in order to participate in the Physical Therapist Assistant Program.

A. All unusual or unique circumstances not identified in the previous pages, will be addressed by the program director.

XXXI. Summer Skills Checkoffs

XXXII. Student Agreement

XXXIII. PTA Program Policy Statement

43

SAN JACINTO COLLEGE DISTRICT PHYSICAL THERAPIST ASSISTANT PROGRAM

STUDENT AGREEMENT

I have received a copy of the guidelines as outlined in the Physical Therapist Assistant Program Student Handbook and recognize that it contains pertinent information regarding my retention and progress in the program.

It is my responsibility to read the handbook and be accountable for its content. I agree to abide by the policies and procedures. I am also aware that this handbook is intended as a guide and policies and procedures described in this handbook may be changed without notice.

STUDENT NAME (printed)

STUDENT SIGNATURE DATE

THIS SIGNED FORM SHOULD BE FILED IN STUDENT’S PERMANENT FILE.

44

A. The Minimum Required Skills of a Physical Therapist Assistant Graduate at Entry Level

B. Midterm Counseling formC. Health Science Division Counseling formD. Withdrawal Notice formE. Orientation Agreement formF. Universal Precautions & HIPPA Agreement formG. Safety/Incident ReportH. Supervisor’s Investigation of Accident ReportI. Disability Services ApplicationJ. Criminal History Evaluation formK. Service Learning outlineL. Emergency Contact Medical Consent FormM. Instructional Authorization Form and Release Agreement for College

Sponsored TravelN. Student Organization Authorization Form and Release Agreement

for College Sponsored TravelO. Activity Registration FormP. Complaints Form

Appendices

Appendix A:

Last Updated: 10/1/13 Contact: nationalgovernance@apta.org

MINIMUM REQUIRED SKILLS OF PHYSICAL THERAPIST GRADUATES AT ENTRY-LEVEL BOD G11-05-20-49 [Guideline]

BackgroundIn August 2004, 28 member consultants convened in Alexandria, VA for a consensus conference on “Clinical Education in a Doctoring Profession.” One of the specific purposes of this conference was to achieve consensus on minimum skills for every graduate from a physical therapist professional program that include, but are not limited to, the skill set required by the physical therapist licensure examination. Assumptions that framed the boundaries for the discussion during this conference included:

(1) A minimum set of required skills will be identified that every graduate from a professional physical therapist program can competently perform in clinical practice.

(2) Physical therapist programs can prepare graduates to be competent in the performance of skills that exceed the minimum skills based on institutional and program prerogatives.

(3) Development of the minimum required skills will include, but not be limited to, the content blueprint for the physical therapist licensure examination; put differently, no skills on the physical therapist licensure blueprint will be excluded from the minimum skill set.

(4) To achieve consensus on minimum skills, 90% or more of the member consultants must be in agreement.

Minimum skills were defined as foundational skills that are indispensable for a new graduate physical therapist to perform on patients/clients in a competent and coordinated manner. Skills considered essential for any physical therapist graduate include those addressing all systems (ie, musculoskeletal, neurological, cardiovascular pulmonary, integumentary, GI, and GU) and the continuum of patient/client care throughout the lifespan.Definitions for terms used in this document are based on the Guide to Physical Therapist Practice. An asterisk (*) denotes a skill identified on the Physical Therapist Licensure Examination Content Outline. Given that consensus on this document was achieved by a small group of member consultants, it was agreed that the conference outcome document would be disseminated to a wider audience comprised of stakeholder groups that would be invested in and affected by this document.

The consensus-based draft document of Essential Skills of the Physical Therapist (previous title) was placed on APTA’s website and stakeholder groups, including APTA Board of Directors, all physical therapist academic program directors, Academic Coordinators/Directors of Clinical Education, and their faculties, physical therapists on CAPTE, component leaders, and a selected list of clinical educators, were invited to vote on whether or not to include/exclude specific essential skills that every physical therapist graduate should be competent in performing on patients. A total of 624 invitations to vote e-mails were sent out and 212 responses (34%) were received.Given the length of this document and the time required to complete the process, a 34% return rate was deemed acceptable for the purpose of this investigation. The “yes” and “no” votes were tabulated and analyzed.

The final “vote” was provided in a report to the Board of Directors in November 2005 for their review, deliberation, and action. The Board of Directors adopted the document Minimum Required Skills of Physical Therapist Graduates at Entry-level (revised title) as a core document to be made available to stakeholders including the Commission on Accreditation in Physical Therapy Education, physical therapist academic programs and their faculties, clinical education sites, students, and employers. The final document that follows defines Minimum Required Skills of Physical Therapist Graduates At Entry-level.

Skill Category Description of Minimum Skills

Screening Systems review

for referral Recognize scope

of limitations

1. Perform review of systems to determine the need for referral or for physical therapy services.

2. Systems review screening includes the following:A. General Health Condition (GHC)

(1) Fatigue(2) Malaise(3) Fever/chills/sweats(4) Nausea/vomiting(5) Dizziness/lightheadedness(6) Unexplained weight change(7) Numbness/Paresthesia(8) Weakness(9) Mentation/cognition

B. Cardiovascular System (CVS)*(1) Dyspnea(2) Orthopnea(3) Palpitations(4) Pain/sweats(5) Syncope(6) Peripheral edema(7) Cough

C. Pulmonary System (PS)*(1) Dyspnea(2) Onset of cough(3) Change in cough(4) Sputum(5) Hemoptysis(6) Clubbing of nails(7) Stridor(8) Wheezing

D. Gastrointestinal System (GIS)(1) Difficulty with swallowing(2) Heartburn, indigestion(3) Change in appetite(4) Change in bowel function

E. Urinary System (US)(1) Frequency(2) Urgency(3) Incontinence

F. Genital Reproductive System (GRS)Male(1) Describe any sexual dysfunction, difficulties, or concerns

Female(1) Describe any sexual or menstrual dysfunction, difficulties, or

problems

Skill Category Description of Minimum Skills

Screening(cont.)

3. Initiate referral when positive signs and symptoms identified in the review of systems are beyond the specific skills or expertise of the physical therapist or beyond the scope of physical therapist practice.

4. Consult additional resources, as needed, including other physical therapists, evidence-based literature, other health care professionals, and community resources.

5. Screen for physical, sexual, and psychological

abuse. Cardiovascular and Pulmonary Systems* 1. Conduct a systems review for screening of the cardiovascular and pulmonary

system (heart rate and rhythm, respiratory rate, blood pressure, edema).2. Read a single lead EKG.

Integumentary System* 1. Conduct a systems review for screening of the integumentary system, the

assessment of pliability (texture), presence of scar formation, skin color, and skin integrity.

Musculoskeletal System* 1. Conduct a systems review for screening of musculoskeletal system, the

assessment of gross symmetry, gross range of motion, gross strength, height and weight.

Neurological System* 1. Conduct a systems review for screening of the neuromuscular system, a

general assessment of gross coordinated movement (eg, balance, gait, locomotion, transfers, and transitions) and motor function (motor control and motor learning).

Examination/ Reexamination History Tests and Measures

(refer to Licensure Examination Outline, Guide to Physical Therapist Practice, PT Normative Model: Version 2004)

Systems Review for Examination

1. Review pertinent medical records and conduct an interview which collects the following data:

A. Past and current patient/client historyB. DemographicsC. General health statusD. Chief complaintE. MedicationsF. Medical/surgical historyG. Social historyH. Present and premorbid functional status/activityI. Social/health habitsJ. Living environmentK. EmploymentL. Growth and developmentM. Lab valuesN. ImagingO. Consultations

2. Based on best available evidence select examination tests and measures that are appropriate for the patient/client.

3. Perform posture tests and measures of postural alignment and positioning.*

Skill Category Description of Minimum Skills

Examination/ Reexamination (cont.)

4. Perform gait, locomotion and balance tests including quantitative and qualitative measures such as*:

A. Balance during functional activities with or without the use of assistive, adaptive, orthotic, protective, supportive, or prosthetic devices or equipment

B. Balance (dynamic and static) with or without the use of assistive, adaptive, orthotic, protective, supportive, or prosthetic devices or equipment

C. Gait and locomotion during functional activities with or without the use of assistive, adaptive, orthotic, protective, supportive, or prosthetic devices or equipment to include:(1) Bed mobility(2) Transfers (level surfaces and floor)*(3) Wheelchair management(4) Uneven surfaces(5) Safety during gait, locomotion, and balance

D. Perform gait assessment including step length, speed, characteristics of gait, and abnormal gait patterns.

5. Characterize or quantify body mechanics during self-care, home management, work, community, tasks, or leisure activities.

6. Characterize or quantify ergonomic performance during work (job/school/play)*:

A. Dexterity and coordination during workB. Safety in work environmentC. Specific work conditions or activitiesD. Tools, devices, equipment, and workstations related to work

actions, tasks, or activities7. Characterize or quantify environmental home and work

(job/school/play) barriers:A. Current and potential barriersB. Physical space and environmentC. Community access

8. Observe self-care and home management (including ADL and IADL)*

9. Measure and characterize pain* to include:A. Pain, soreness, and nocioceptionB. Specific body parts

10. Recognize and characterize signs and symptoms of

inflammation. Cardiovascular and Pulmonary Systems 1. Perform cardiovascular/pulmonary tests and measures including:

A. Heart rateB. Respiratory rate, pattern and quality*C. Blood pressureD. Aerobic capacity test* (functional or standardized) such as the 6-minute

walk testE. Pulse OximetryF. Breath sounds – normal/abnormalG. Response to exercise (RPE)

Skill Category Description of Minimum Skills

Examination/ Reexamination (cont.)

H. Signs and symptoms of hypoxiaI. Peripheral circulation (deep vein thrombosis, pulse, venous

stasis, lymphedema)*

Integumentary System 1. Perform integumentary integrity tests and measures including*:

A. Activities, positioning, and postures that produce or relieve trauma to the skin.

B. Assistive, adaptive, orthotic, protective, supportive, or prosthetic devices and equipment that may produce or relieve trauma to the skin.

C. Skin characteristics, including blistering, continuity of skin color, dermatitis, hair growth, mobility, nail growth, sensation, temperature, texture and turgor.

D. Activities, positioning, and postures that aggravate the wound or scar or that produce or relieve trauma.

E. Signs of infection.F. Wound characteristics: bleeding, depth, drainage, location, odor,

size, and color.G. Wound scar tissue characteristics including banding,

pliability, sensation, and texture.

Musculoskeletal System 1. Perform musculoskeletal system tests and measures including:

A. Accessory movement testsB. Anthropometrics

(1) Limb length(2) Limb girth(3) Body composition

C. Functional strength testingD. Joint integrity*E. Joint mobility*F. Ligament laxity testsG. Muscle length*H. Muscle strength* including manual muscle testing, dynamometry, one

repetition maxI. PalpationJ. Range of motion* including goniometric measurements

2. Perform orthotic tests and measures including*:A. Components, alignment, fit, and ability to care for orthotic,

protective, and supportive devices and equipment.B. Evaluate the need for orthotic, protective, and supportive devices

used during functional activities.C. Remediation of impairments in body function and structure, activity

limitations, and participation restrictions with use of orthotic, protective, and supportive device.

D. Residual limb or adjacent segment, including edema, range of motion, skin integrity and strength.

E. Safety during use of orthotic, protective, and supportive device.

3. Perform prosthetic tests and measures including*:A. Alignment, fit, and ability to care for prosthetic device.B. Prosthetic device use during functional activities.

Skill Category Description of Minimum Skills

Examination/ Reexamination (cont.)

C. Remediation of impairments in body function and structure, activity limitations, and participation restrictions, with use of prosthetic device.

D. Evaluation of residual limb or adjacent segment, including edema, range of motion, skin integrity, and strength.

E. Safety during use of the prosthetic device.

4. Perform tests and measures for assistive and adaptive devices including*:A. Assistive or adaptive devices and equipment use during

functional activities.B. Components, alignment, fit, and ability to care for the assistive

or adaptive devices and equipment.C. Remediation of impairments in body function and structure, activity

limitations, and participation restrictions with use of assistive or adaptive devices and equipment.

D. Safety during use of assistive or adaptive equipment.

Neurological System 1. Perform arousal, attention and cognition tests and measures to

characterize or quantify (including standardized tests and measures)*:A. ArousalB. AttentionC. OrientationD. Processing and registration of informationE. Retention and recallF. Communication/language

2. Perform cranial and peripheral nerve integrity tests and measures*:A. Motor distribution of the cranial nerves (eg, muscle tests, observations)B. Motor distribution of the peripheral nerves (eg, dynamometry, muscle

tests, observations, thoracic outlet tests)C. Response to neural provocation (e.g. tension test, vertebral artery

compression tests)D. Response to stimuli, including auditory, gustatory, olfactory,

pharyngeal, vestibular, and visual (eg, observations, provocation tests

3. Perform motor function tests and measures to include*:A. Dexterity, coordination, and agilityB. Initiation, execution, modulation and termination of movement

patterns and voluntary postures

4. Perform neuromotor development and sensory integration tests and measures to characterize or quantify*:

A. Acquisition and evolution of motor skills, including age-appropriate development

B. Sensorimotor integration, including postural responses, equilibrium, and righting reactions

5. Perform tests and measures for reflex integrity including*:A. Deep reflexes (eg, myotatic reflex scale, observations, reflex tests)B. Postural reflexes and reactions, including righting, equilibrium

and protective reactionsC. Primitive reflexes and reactions, including developmental

Skill Category Description of Minimum Skills

Examination/ Reexamination (cont.)

F. Resistance to velocity dependent movement

6. Perform sensory integrity tests and measures that characterize or quantify including*:

A. Light touchB. Sharp/dullC. TemperatureD. Deep pressureE. LocalizationF. VibrationG. Deep sensationH. StereognosisI. Graphesthesia

Evaluation Clinical reasoning Clinical decision making

1. Synthesize available data on a patient/client expressed in terms of the International Classification of Function, Disability and Health (ICF) model to include body functions and structures, activities, and participation.

2. Use available evidence in interpreting the examination findings.3. Verbalize possible alternatives when interpreting the examination findings.4. Cite the evidence (patient/client history, lab diagnostics, tests and

measures and scientific literature) to support a clinical decision.

Diagnosis 1. Integrate the examination findings to classify the patient/client problem in terms of body functions and structures, and activities and participation (ie, practice patterns in the Guide)

2. Identify and prioritize impairments in body functions and structures, and activity limitations and participation restrictions to determine specific body function and structure, and activities and participation towards which the intervention will be directed.*

Prognosis 1. Determine the predicted level of optimal functioning and the amount of time required to achieve that level.*

2. Recognize barriers that may impact the achievement of optimal functioning within a predicted time frame including*:

A. AgeB. Medication(s)C. Socioeconomic statusD. Co-morbiditiesE. Cognitive statusF. NutritionG. Social SupportH. Environment

Plan of Care Goal setting Coordination of Care Progression of care Discharge

Design a Plan of Care 1. Write measurable functional goals (short-term and long-term) that are time

referenced with expected outcomes.2. Consult patient/client and/or caregivers to develop a mutually agreed to plan

of care.*3. Identify patient/client goals and expectations.*4. Identify indications for consultation with other professionals.*5. Make referral to resources needed by the patient/client (assumes knowledge

of referral sources).*

Skill Category Description of Minimum Skills

Plan of care (cont.)

6. Select and prioritize the essential interventions that are safe and meet the specified functional goals and outcomes in the plan of care* (ie, (a) identify precautions and contraindications, (b) provide evidence for patient-centered interventions that are identified and selected, (c) define the specificity of the intervention (time, intensity, duration, and frequency), and (d) set realistic priorities that consider relative time duration in conjunction with family, caregivers, and other health care professionals).

7. Establish criteria for discharge based on patient goals and current functioning and disablity.*

Coordination of Care 1. Identify who needs to collaborate in the plan of care.2. Identify additional patient/client needs that are beyond the scope of

physical therapist practice, level of experience and expertise, and warrant referral.*

3. Refer and discuss coordination of care with other health care professionals.*4. Articulate a specific rational for a referral.5. Advocate for patient/client access to services.

Progression of Care 1. Identify outcome measures of progress relative to when to progress the

patient further.*2. Measure patient/client response to intervention.*3. Monitor patient/client response to intervention.4. Modify elements of the plan of care and goals in response to

changing patient/client status, as needed.*5. Make on-going adjustments to interventions according to outcomes

including environmental factors and personal factors and, medical therapeutic interventions.

6. Make accurate decisions regarding intensity and frequency when adjusting interventions in the plan of care.

Discharge Plan 1. Re-examine patient/client if not meeting established criteria for discharge

based on the plan of care.2. Differentiate between discharge of the patient/client, discontinuation of

service, and transfer of care with re-evaluation.*3. Prepare needed resources for patient/client to ensure timely

discharge, including follow-up care.4. Include patient/client and family/caregiver as a partner in discharge.*5. Discontinue care when services are no longer indicated.6. When services are still needed, seek resources and/or consult with others

to identify alternative resources that may be available.7. Determine the need for equipment and initiate requests to obtain.

Skill Category Description of Minimum Skills

Interventions Safety, Emergency

Care, CPR and First Aid

Standard Precautions Body Mechanics

and Positioning Categories of

Interventions (See NPTE List and Guide)

Safety, Cardiopulmonary Resuscitation Emergency Care, First Aid 1. Ensure patient safety and safe application of patient/client care.*2. Perform first aid.*3. Perform emergency procedures.*4. Perform Cardiopulmonary Resuscitation (CPR).*

Precautions1. Demonstrate appropriate sequencing of events related to universal

precautions.*2. Use Universal Precautions.3. Determine equipment to be used and assemble all sterile and non-sterile

materials.*4. Use transmission-based precautions.5. Demonstrate aseptic techniques.*6. Apply sterile procedures.*7. Properly discard soiled items.*

Body Mechanics and Positioning 1. Apply proper body mechanics (utilize, teach, reinforce, and observe).*2. Properly position, drape, and stabilize a patient/client when providing physical

therapy.*

Interventions1. Coordination, communication, and documentation may include:

A. Addressing required functions:(1) Establish and maintain an ongoing collaborative process of

decision-making with patients/clients, families, or caregivers prior to initiating care and throughout the provision of services.*

(2) Discern the need to perform mandatory communication and reporting (eg, incident reports, patient advocacy and abuse reporting).

(3) Follow advance directives.B. Admission and discharge planning.C. Case management.D. Collaboration and coordination with agencies, including:

(1) Home care agencies(2) Equipment suppliers(3) Schools(4) Transportation agencies(5) Payer groups

E. Communication across settings, including:(1) Case conferences(2) Documentation(3) Education plans

F. Cost-effective resource utilization.G. Data collection, analysis, and reporting of:

(1) Outcome data(2) Peer review findings(3) Record reviews

H. Documentation across settings, following APTA’s Guidelines for Physical Therapy Documentation, including:(1) Elements of examination, evaluation, diagnosis, prognosis,

and intervention

Skill Category Description of Minimum Skills

Interventions (cont.)

(2) Changes in body structure and function, activities and participation.

(3) Changes in interventions(4) Outcomes of intervention

I. Interdisciplinary teamwork:(1) Patient/client family meetings(2) Patient care rounds(3) Case conferences

J. Referrals to other professionals or resources.*

2. Patient/client-related instruction may include:A. Instruction, education, and training of patients/clients and

caregivers regarding:(1) Current condition, health condition, impairments in body structure

and function, and activity limitations, and participation restrictions)*

(2) Enhancement of performance(3) Plan of care:

a. Risk factors for health condition, impairments in body structure and function, and activity limitations, and participation restrictions.

b. Preferred interventions, alternative interventions, and alternative modes of delivery

c. Expected outcomes(4) Health, wellness, and fitness programs (management of

risk factors)(5) Transitions across settings

3. Therapeutic exercise may include performing:A. Aerobic capacity/endurance conditioning or reconditioning*:

(1) Gait and locomotor training*(2) Increased workload over time (modify workload progression)(3) Movement efficiency and energy conservation training(4) Walking and wheelchair propulsion programs(5) Cardiovascular conditioning programs

B. Balance*, coordination*, and agility training:(1) Developmental activities training*(2) Motor function (motor control and motor learning) training

or retraining(3) Neuromuscular education or reeducation*(4) Perceptual training(5) Posture awareness training*(6) Sensory training or retraining(7) Standardized, programmatic approaches(8) Task-specific performance training

C. Body mechanics and postural stabilization:(1) Body mechanics training*(2) Postural control training*(3) Postural stabilization activities*(4) Posture awareness training*

Skill Category Description of Minimum Skills

Interventions (continued) D. Flexibility exercises:(1) Muscle lengthening*(2) Range of motion*(3) Stretching*

E. Gait and locomotion training*:(1) Developmental activities training*(2) Gait training*(3) Device training*(4) Perceptual training*(5) Basic wheelchair training*

F. Neuromotor development training:(1) Developmental activities training*(2) Motor training(3) Movement pattern training(4) Neuromuscular education or reeducation*

G. Relaxation:(1) Breathing strategies*(2) Movement strategies(3) Relaxation techniques

H. Strength, power, and endurance training for head, neck, limb, and trunk*:(1) Active assistive, active, and resistive exercises (including

concentric, dynamic/isotonic, eccentric, isokinetic, isometric, and plyometric exercises)

(2) Aquatic programs*(3) Task-specific performance training

I. Strength, power, and endurance training for pelvic floor:(1) Active (Kegel)

J. Strength, power, and endurance training for ventilatory muscles:(1) Active and resistive

4. Functional training in self-care and home management may include*:

A. Activities of daily living (ADL) training:(1) Bed mobility and transfer training*(2) Age appropriate functional skills

B. Barrier accommodations or modifications*

C. Device and equipment use and training:(1) Assistive and adaptive device or equipment training during

ADL (specifically for bed mobility and transfer training, gait and locomotion, and dressing)*

(2) Orthotic, protective, or supportive device or equipment training during self-care and home management*

(3) Prosthetic device or equipment training during ADL (specifically for bed mobility and transfer training, gait and locomotion, and dressing)*

Skill Category Description of Minimum Skills

Interventions (cont.)

D. Functional training programs*:(1) Simulated environments and tasks*(2) Task adaptation

E. Injury prevention or reduction:(1) Safety awareness training during self-care and home

management*(2) Injury prevention education during self-care and home

management(3) Injury prevention or reduction with use of devices and equipment

5. Functional training in work (job/school/play), community, and leisure integration or reintegration may include*:

A. Barrier accommodations or modifications*

B. Device and equipment use and training*:(1) Assistive and adaptive device or equipment training

during instrumental activities of daily living (IADL)*(2) Orthotic, protective, or supportive device or equipment

training during IADL for work*(3) Prosthetic device or equipment training during IADL *

C. Functional training programs:(1) Simulated environments and tasks(2) Task adaptation(3) Task training

D. Injury prevention or reduction:(1) Injury prevention education during work

(job/school/play), community, and leisure integration or reintegration

(2) Injury prevention education with use of devices and equipment(3) Safety awareness training during work (job/school/play),

community, and leisure integration or reintegration(4) Training for leisure and play activities

6. Manual therapy techniques may include:

A. Passive range of motion

B. Massage:(1) Connective tissue massage(2) Therapeutic massage

C. Manual traction*

D. Mobilization/manipulation:(1) Soft tissue* (thrust and nonthrust*)(2) Spinal and peripheral joints* (thrust and nonthrust*)

7. Prescription, application, and, as appropriate, fabrication of devices and equipment may include*:

Skill Category Description of Minimum Skills

Interventions (cont.)

(1) Hospital beds(2) Raised toilet seats(3) Seating systems – prefabricated

B. Assistive devices*:(1) Canes(2) Crutches(3) Long-handled reachers(4) Static and dynamic splints – prefabricated(5) Walkers(6) Wheelchairs

C. Orthotic devices*:(1) Prefabricated braces(2) Prefabricated shoe inserts(3) Prefabricated splints

D. Prosthetic devices (lower-extremity)*

E. Protective devices*:(1) Braces(2) Cushions(3) Helmets(4) Protective taping

F. Supportive devices*:(1) Prefabricated compression garments(2) Corsets(3) Elastic wraps(4) Neck collars(5) Slings(6) Supplemental oxygen - apply and adjust(7) Supportive taping

8. Airway clearance techniques may include*:

A. Breathing strategies*:(1) Active cycle of breathing or forced expiratory techniques*(2) Assisted cough/huff techniques*(3) Paced breathing*(4) Pursed lip breathing(5) Techniques to maximize ventilation (eg, maximum inspiratory

hold, breath stacking, manual hyperinflation)

B. Manual/mechanical techniques*:(1) Assistive devices

C. Positioning*:(1) Positioning to alter work of breathing(2) Positioning to maximize ventilation and perfusion

9. Integumentary repair and protection techniques may include*:

A. Debridement*—nonselective:

Skill Category Description of Minimum Skills

Interventions (continued) (1) Enzymatic debridement(2) Wet dressings(3) Wet-to-dry dressings(4) Wet-to-moist dressings

B. Dressings*:(1) Hydrogels(2) Wound coverings

C. Topical agents*:(1) Cleansers(2) Creams(3) Moisturizers(4) Ointments(5) Sealants

10. Electrotherapeutic modalities may include:

A. Biofeedback*

B. Electrotherapeutic delivery of medications (eg, iontophoresis)*

C. Electrical stimulation*:(1) Electrical muscle stimulation (EMS)*(2) Functional electrical stimulation (FES)(3) High voltage pulsed current (HVPC)(4) Neuromuscular electrical stimulation (NMES)(5) Transcutaneous electrical nerve stimulation (TENS)

11. Physical agents and mechanical modalities may include:Physical agents:

A. Cryotherapy*:(1) Cold packs(2) Ice massage(3) Vapocoolant spray

B. Hydrotherapy*:(1) Contrast bath(2) Pools(3) Whirlpool tanks*

C. Sound agents*:(1) Phonophoresis*(2) Ultrasound*

D. Thermotherapy*:(1) Dry heat(2) Hot packs*(3) Paraffin baths*

Mechanical modalities:A. Compression therapies (prefabricated)*

(1) Compression garments

Skill Category Description of Minimum Skills

Interventions (continued) (2) Vasopneumatic compression devices*(3) Taping(4) Compression bandaging (excluding lymphedema)

B. Gravity-assisted compression devices:(1) Standing frame*(2) Tilt table*

C. Mechanical motion devices*:(1) Continuous passive motion (CPM)*

D. Traction devices*:(1) Intermittent(2) Positional(3) Sustained

Outcomes Assessment 1. Perform chart review/audit with respect to documenting components of patient/client management and facility procedures and regulatory requirements.

2. Collect relevant evidenced-based outcome measures that relate to patient/client goals and/or prior level of functioning.*

3. Select outcome measures for levels of impairments in body function and structure, activity limitations, and participation restrictions with respect for psychometric properties of the outcomes.

4. Aggregate data across patients/clients and analyze results as it relates to the effectiveness of clinical performance (intervention).*

Education Patients/clients,

families, and caregivers

Colleagues, other healthcare professionals, and students

Patient/Client1. Determine patient/client variables that affect learning.*2. Educate the patient/client and caregiver about the patient’s/client’s current

health condition/examination findings, plan of care and expected outcomes, utilizing their feedback to modify the plan of care and expected outcomes as needed.*

3. Assess prior levels of learning for patient/client and family/caregiver to ensure clarity of education.

4. Educate patients/clients and caregivers to recognize normal and abnormal response to interventions that warrant follow-up.*

5. Provide patient/client and caregiver clear and concise home/independent program instruction at their levels of learning and ensure the patient’s /client’s understanding of home/independent program.*

6. Educate patient/client and caregiver to enable them to articulate and demonstrate the nature of the impairments in body function and structure, activity limitations, and participation restrictions and how to safely and effectively manage the impairments in body function and structure, activity limitations, and participation restrictions (eg, identify symptoms, alter the program, and contact the therapist).*

Colleagues1. Identify patient/client related questions and systematically locate and

critically appraise evidence that addresses the question.2. Educate colleagues and other health care professionals about the role,

responsibilities, and academic preparation of the physical therapist and scope

Skill Category Description of Minimum Skills

of physical therapist practice.3. Address relevant learning needs, convey information, and assess outcomes of

learning.4. Present contemporary topics/issues using current evidence and sound

teaching principles (ie, case studies, in-service, journal article review, etc.).

Practice Management Billing/Reimbursement Documentation Quality Improvement Direction and

Supervision Marketing and

Public Relations Patient Rights, Patient

Consent, Confidentiality, and HIPPA

Billing/Reimbursement1. Describe the legal/ethical ramifications of billing and act accordingly.2. Correlate/distinguish between billing and reimbursement.3. Include consideration of billing/ reimbursement in the plan of care.4. Choose correct and accurate ICD-9 and CPT codes.5. Contact insurance company to follow-up on a denial or ask for additional

services including Durable Medical Equipment (DME).6. Describe the implications of insurers’ use of the Guide on

billing/reimbursement.

Documentation of Care 1. Document patient/client care in writing that is accurate and complete

using institutional processes.*2. Use appropriate grammar, syntax, spelling, and punctuation in written

communication.3. Use appropriate terminology and institutionally approved abbreviations.4. Use an organized and logical framework to document care (eg, refer to the

Guide to Physical Therapist Practice, Appendix 5).*5. Conform to documentation requirements of the practice setting and

the reimbursement system.6. Accurately interpret documentation from other health care professionals.

Quality Improvement 1. Participate in quality improvement program of self, peers, and

setting/institution.2. Describe the relevance and impact of institutional accreditation (eg,

Joint Commision or CARF) on the delivery of physical therapy services.

Direction and Supervision of Physical Therapist Assistants (PTAs) and Other Support Personnel 1. Follow legal and ethical requirements for direction and supervision.2. Supervise the physical therapist assistant and/or other support personnel.3. Select appropriate patients/clients for whom care can be directed to

physical therapist assistants based on patient complexity and acuity, reimbursement, PTA knowledge/skill, jurisdictional law, etc.

4. In any practice setting, maintain responsibility for patient/client care by regularly monitoring care and patient progression throughout care provided by PTAs and services provided by other support personnel.

Marketing and Public Relations

1. Present self in a professional manner.2. Promote the profession by discussing the benefits of physical therapy in all

interactions, including presentations to the community about physical therapy.

Patient Rights, Patient Consent, Confidentiality, and Health Insurance Portability and Accountability Act (HIPAA)*

Skill Category Description of Minimum Skills

1. Obtain consent from patients/clients and/or caregiver for the provision of all components of physical therapy including*:

A. treatment-related*B. research*C. fiscal

2. Comply with HIPAA/FERPA regulations.*3. Act in concert with institutional “Patient Rights” statements and

advanced directives (eg, Living wills, Do Not Resuscitate (DNR) requests, etc.).

Informatics1. Use current information technology, including word-processing, spreadsheets,

and basic statistical packages.

Risk Management 1. Follow institutional/setting procedures regarding risk management.2. Identify the need to improve risk management practices.

Productivity1. Analyze personal productivity using the clinical facility’s system and implement

strategies to improve when necessary.Professionalism: Core Values Accountability Altruism Compassion/Caring Excellence Integrity Professional Duty Social Responsibility

Core Values 1. Demonstrate all APTA core values associated with professionalism.2. Identify resources to develop core values.3. Seek mentors and learning opportunities to develop and enhance the

degree to which core values are demonstrated.4. Promote core values within a practice setting.

Consultation 1. Provide consultation within the context of patient/client care with physicians, family and caregivers, insurers, and other health care providers, etc.

2. Accurately self-assess the boundaries within which consultation outside of the patient/client care context can be provided.

Evidence-Based Practice Impact of Research

on Practice

1. Discriminate among the levels of evidence (eg, Sackett).2. Access current literature using databases and other resources to answer

clinical/practice questions.3. Read and critically analyze current literature.4. Use current evidence, patient values, and personal experiences in making

clinical decisions.*5. Prepare a written or verbal case report.6. Share expertise related to accessing evidence with colleagues.

Skill Category Description of Minimum Skills

Communication Interpersonal Verbal Written

Interpersonal (including verbal, non-verbal, electronic)

1. Develop rapport with patients/clients and others.2. Display sensitivity to the needs of others.3. Actively listen to others.4. Engender confidence of others.5. Ask questions in a manner that elicits needed responses.6. Modify communication to meet the needs of the audience.7. Demonstrate congruence between verbal and non-verbal messages.8. Use appropriate grammar, syntax, spelling, and punctuation in

written communication.9. Use appropriate, and where available, standard terminology and abbreviations.10. Maintain professional relationships with all persons.11. Adapt communication in ways that recognize and respect the knowledge

and experiences of colleagues and others.

Conflict Management/Negotiation

1. Recognize potential for conflict.2. Implement strategies to prevent and/or resolve conflict.3. Seek resources to resolve conflict when necessary,

Cultural Competence 1. Elicit the “patient’s story” to avoid stereotypical assumptions.2. Utilize information about health disparities during patient/client care.3. Provide care in a non-judgmental manner.4. Acknowledge personal biases, via self-assessment or critical assessment of

feedback from others.5. Recognize individual and cultural differences and adapt behavior

accordingly in all aspects of physical therapy care.*

Promotion of Health, Wellness, and Prevention

1. Identify patient/client health risks during the history and physical via the systems review.

2. Take vital signs of every patient/client during each visit.3. Collaborate with the patient/client to develop and implement a plan to

address health risks.*4. Determine readiness for behavioral change.5. Identify available resources in the community to assist in the achievement

of the plan.6. Identify secondary and tertiary effects of disability.7. Demonstrate healthy behaviors.8. Promote health/wellness in the community.

Relationship to Vision 2020: Doctor of Physical Therapy; (Academic/Clinical Education Affairs Department, ext 3203)

Explanation of Reference Numbers:BOD P 00 - 00 - 00 - 00 stands for Board of Directors/month/year/page/vote in the Board of Directors Minutes; the "P" indicates that it is a position (see below). For example, BOD P11-97-06-18 means that this position can be found in the November 1997 Board of Directors minutes on Page 6 and that it was Vote 18.

P: Position | S: Standard | G: Guideline | Y: Policy | R: Procedure

Appendix B:

San Jacinto College – South

Physical Therapist Assistant Program

Midterm Counseling Report

Student Name:

Semester/Year:

Course: PTHA

Test Average: # of Absences

In Danger of Failing (circle one): Yes No

Action Plan:

Student comments:

Instructor Signature

Course: PTHA

Test Average: # of Absences

In Danger of Failing (circle one): Yes No

Action Plan:

Student comments:

Instructor Signature

Student Name:

Course: PTHA

Test Average: # of Absences

In Danger of Failing (circle one): Yes No

Action Plan:

Student comments:

Instructor Signature

Student Signature:

Instructors should meet with the student and discuss options such as counseling sessions to assist with better study patterns and refer them to the counseling center as a resource if needed. Discuss the student’s use of the instructor’s office hours for more one-on-one time with the instructor to improve comprehension of the material in the course. In the student comments section of the form, ask the student to briefly explain the circumstances resulting in their poor performance.

Have the student sign the form, the instructor sign the form, and give it to the program director.

The program director will review the form and place the original in the student file.

Appendix C:SAN JAC I N TOCOLLEGE---SOUTH--

Health Science Division Counseling Form

Name SS #

Course No. and Title Date

This student has been conferenced regarding:

1. Failing _

Exam No. -----------------------2. Danger of failing Clinical/Theory

3. Excessive Absences/Tardiness

4. Medication/Treatment Error

5. 0ther

Comments and Recommendations: --------------

Student's Comments: _

1) Original to student file

2) Copy to student

3) Copy to instructor

Student Signature

Instructor's Signature

Rev: 05/09

Program Director

Appendix D:SAN JACINTO COLLEGE

PHYSICAL THERAPIST ASSISTANT PROGRAMWITHDRAWAL NOTICE

STUDENT’S NAME:

DATE FIRST ENROLLED:

DATE OF WITHDRAWAL:

TODAY’S DATE: ENTERED INTO COMPUTER:

REASON FOR WITHDRAWAL:

1) ACADEMIC FAILURE

2) FINANCIAL REASONS

3) FAMILY/PERSONAL PROBLEMS (EXCLUDING HEALTH)

4) EXCESSIVE ABSENTEEISM DUE TO ILLNESS

5) EXCESSIVE ABSENTEEISM. REASONS OTHER THAN ILLNESS

6) CHANGE OF RESIDENCE

7) OTHER REASON – SPECIFY:

8) REASON UNKNOWN

WITHDRAWAL PROCESS EXPLAINED: YES NO

IF ELIGIBLE TO REAPPLY WAS PROCESS EXPLAINED?YES NO

COMMENTS:

STUDENT SIGNATURE Program Director, Physical Therapist Assistant Program

1

Appendix E:San Jacinto College

Physical Therapist Assistant ProgramOrientation Agreement

Please read then, if you agree to the statement, initial each statement to the left. Please read the consequence of refusal to each statement. Sign and date at the bottom. (8 statements)

1. I consent that my written work or projects may be showed to other students for the purpose of learning although my grades will remain confidential.(If the student does not agree/initial the statement above, the student will be removed from the program. Sharing of written work and projects is an important part of the learning process in the PTA program.)

2. I consent that the results for my criminal background check may be released to San Jacinto College Physical Therapist Assistant Program.(If the student does not agree/initial the statement above, he or she will be removed from the program. The criminal background check is part of the requirements of the admissions process and may also be required to participate in particular clinical experiences.)

3. I agree to voluntarily participate in lab activities which include being a “patient” and to have palpation activities performed on me by other students or faculty. I am aware that it is my responsibility to notify my instructor of any injury, condition, or cultural/personal beliefs for which I should be excluded from acting as a patient. This is for my safety.(If the student does not agree/initial the statement above, he or she will be removed from the program. Participation in the lab activities as a “patient” is necessary for the learning of hands on skills. With agreement of the statement above it is understood students may refuse particular activities as a result of injury, condition, or cultural/personal beliefs. In such cases, the student must collaborate with the course instructor.)

4. I understand that as a student in the Physical Therapist Assistant Program, I will be videotaped and photographed at times either for school activities. I consent to be videotaped and photographed.(If the student does not agree/initial the statement above, the program will ensure that the student is not videotaped or photographed.)

5. I agree to allow my name, address, phone numbers, and email to be given to my classmates and my instructors.(If the student does not agree/initial the statement above, the program will not put that student’s information on the class contact information sheet that is handed out to all students in the program and will keep the students address, phone numbers and email confidential.)

2

6. I agree that a program representative may release information regarding my academic standing during the time I was a student in the Physical Therapist Assistant Program for the purpose of giving a reference letter by standard mail, email, fax or phone calls for a potential job position. This will only be done if the student requests a reference letter.(If the student does not agree/initial the statement above, the program will not release academic standing of the PTA student to anyone.)

7. In the event that a hospital or clinic that I participate in a clinical experience at requests my Social Security Number, I will allow the PTA program to submit it to them.(If the student does not agree/initial the statement above, it is the responsibility of the student to directly divulge information regarding his or her social security number to the hospital or clinic requesting such information).

8. I will allow the PTA Program to submit my Social Security number to any state board of physical therapy examiners that requests this information. Many states, including the state of Texas, require the program director to submit a letter of program completion that includes the student’s name and social security number in order for the student to be eligible for a physical therapist assistant license in that state.(If the student does not agree/initial the statement above, he or she will be responsible for communicating with the state board of physical therapy examiners and presenting the social security number in the method that the state determines appropriate.)

I have initialed the statements to which I agree and understand the consequences of each of the statements for which I did not agree to/initial. If you did not initial statements #1, 2, and 3, you will be removed from the program. The PTA program seeks to make accommodations to students in order to provide optimal learning experiences. However, in some circumstances we are unable to make complete accommodations and require cooperation of the students.

Print Name Student Signature

Faculty Member Signature

Revised 1/30/12

Appendix F:

San Jacinto CollegePhysical Therapist Assistant Program

Universal Precautions & HIPAA Agreement Form

Please read then initial each statement to the left. Sign and date at the bottom.

1.As a student you will be instructed in protocols to reduce your risk for acquiring an infection or communicable disease. However, all areas of health care practice have inherent risks and no area is completely risk free. I acknowledge I have received instruction on Universal Precautions & blood borne Pathogens and understand the recommended guidelines. I agree to practice the Universal Precaution guidelines in providing patient care in all settings as well as the lab and lecture rooms.

2.All patients have the right to confidentiality of all records and communications. I have read the policy on HIPAA regulations and agree to abide by all standards in the student handbook.

Print Name Signature Date

Faculty Member Signature Date

Safety/Incident ReportThe San Jacinto College Safety, Health and Risk Management Department

Appendix G:

If you were injured or you recognize a hazardous situation, please complete and submit to the Safety, Health and Risk Management Department by clicking on the SUBMIT button located at the bottom of this page.

This report was originated from:Central Campus South Campus North Campus

Date of Report:

District OfficesOff Site

Name of person completing this report: Check one: Faculty/Staff Visitor

Nature of Report:

Minor incident

Major catastrophe or serious incident

Immediate and clear hazard

Potential Hazard

Other

Date and time that incident or hazard was identified:

Specific location of the incident or hazard:

Name of individual(s) involved (if

applicable): Check one: Student Faculty/Staff Visitor

Name of witnesses:

Describe the incident or hazard:

Was College Police notified? Yes No

Who initially reported the situation, and to whom was the report made?

Was assistance provided by outside agencies? Yes No If Yes, indicate agency:

Was medical treatment offered?

Action taken, and if so by

whom?

Yes No

ADDITIONAL COMMENTS:

06.2015 Injured Workers Signature (if applicable)

SUPERVISOR’S Investigation of Accident ReportThe San Jacinto College Safety, Health and Risk Management Office

Appendix H:

Please complete and send this form to Ginger Lambert in the SHRM office via fax to (281) 998-6133 or via intercampus mail as soon as possible.

SECTION 1:

FOR PERSONAL INJURY ACCIDENTS COMPLETE ENTIRE REPORT! – NON-INJURY ACCIDENTS COMPLETE SECTION II AND

TIME OF ACCIDENT a.m. p.m.

DATE OF ACCIDENT CAMPUS

NAME OF INJURED EMPLOYEE

DATE INJURED STOPPED WORKING (Mo., Day, Year)

DOING HIS REGULAR WORK?

YES NO

HAD YOU INSTRUCTED HIM REGARDING HAZARDS OF HIS JOB?

YES NOOCCUPATION WHEN INJURED (Job Title)

WHAT WAS THE APPARENT NATURE OF EMPLOYEE’S INJURIES?

SECTION II: DESCRIPTION OF ACCIDENT

DID YOU SEE THIS ACCIDENT?

YES NO

WHO SAW THIS ACCIDENT?

UNSAFE CONDITIONS:WHAT WAS NOT SAFE CONCERNING THE MACHINE, TOOL, EQUIPMENT, PREMISES OR VEHICLE? WHY DID THE UNSAFE CONDITION EXISTS?

UNSAFE ACTS:WHAT DID ANYONE DO OR FAIL THAT LED TO THIS ACCIDENT? INDICATE REASONS FOR UNSAFE ACTS?

WHAT ACTION HAS BEEN OR SHOULD BE TAKEN TO PREVENT A SIMILAR ACCIDENT?

DATE (Mo., Day, Year) DEPARTMENT SIGNATURE OF SUPERVISOR

Updated 04/2015

Appendix I:

Disability Services Application

Student must complete this application AND provide documentation of a disability . Documentation guidelines are available on the following page. Proper documentation is required before accommodations can be provided.

Return the completed application along with documentation to the Disability Services Counselor on your designated campus.

All documentation will be reviewed by the Disability Services Committee.

An appointment will be scheduled within approximately 10 business days after the application and documentation have been reviewed by the committee.

All requested accommodations must be supported by appropriate documentation.

Disability Services Contact Information

Central Campus 281-998-6150 ext. 1888North Campus 281-998-6150 ext. 7364South Campus 281-998-6150 ext. 3444

Updated 04/2015

Guidelines for DocumentationFor Learning Disabilities:

1. A diagnostic assessment from a licensed psychologist, diagnostician, or other professional knowledgeable in learning disabilities must be provided. The information should include a complete battery with all subtest and standard scores.

2. The documentation must clearly identify a learning disability and should not be more than five years old. ARD information alone WILL NOT BE ACCEPTED.

Physical Impairments:

1. Diagnosis of the disability by a medical doctor whose credentials and experience qualifies him/her to render the diagnosis is required. The documentation must be on letterhead, typed, dated and signed by a doctor or otherwise qualified person to make the diagnosis.

2. The report should include any functional limitations as a result of the disability, specify how they might impact the student in an academic setting, and provide specific recommendations for "reasonable accommodations.

3. If the condition is temporary, an estimate of the expected duration must be included. Documentation should not be more than ~ 5 years old. (This requirement does not apply to physical or sensory disabilities of a permanent or unchanging nature).

For Psychiatric Disorders:

1. Documentation must specifically indicate the diagnosis and should be provided by a licensed psychologist, psychiatrist, or a licensed clinical social worker on his/her letterhead and include the DSM diagnosis and diagnostic code(s).

2. The report should include an explanation of how the disability may affect the student in an academic setting and suggestions for reasonable accommodations.

3. Documentation should not be more than five years old.

For Attention Deficit Hyperactivity Disorder:

A diagnosis of ADHD/ADD must be provided and signed by a licensed and qualified professional on his/her letterhead. The diagnosis must be made in the form of a DSM diagnosis, and include diagnostic codes and specified subtype. A multi-axial diagnostic format is preferred. Functional limitations related to ADHD/ADD must be clearly defined for the individual along with suggested academic accommodations. Documentation should not be more than 2– 3 years old.

Updated 04/2015

Disability Services Application

Date of Request: DOB Gender

Name: (please print)

Student ID Number: G

Home Address:

Home Phone:

Cell Phone:

E-mail:

Emergency Contact Name:

Telephone Number:

Relationship:

Are you a dual credit student? Yes No Major:

What semester do you plan on attending San Jacinto College? Spring Summer Fall

1. Please check off any disabilities you have.

Learning Disability/ADD Emotional/Psychiatric Disability Mobility Blind or Low Vision Other

_Deaf or Hard of Hearing Health Issues

State the specific diagnosis

2. Please describe any limitations you have that are related to your disability.

3. Please describe any accommodation(s) being requested. This does not mean all accommodations will be approved. Accommodations will be based on the disability and documentation provided.

All of the information above has been provided on a voluntary basis. I understand that this information will be kept confidential and serves as a request for services only. Upon review and approval of my documentation for accommodations, it will be my responsibility to request direct services.

If the student does not agree with the decision of the Disability Services Counselor due to either (a) being denied services or (b) disagreement on the approved accommodations, the student may initiate a formal appeal.Information on the appeal process can be obtained from the Disability Services Counselor.

STUDENT SIGNATURE

DATE

Updated 04/2015

Are you a client of DARS (formally TRC) or any other agency Yes / No

Updated 04/2015

San Jacinto College Authorization for Release of Information

I give permission to The Department of Educational Planning and Counseling-Disability Services Office to discuss my accommodation needs with San Jacinto College faculty and/or staff who request such information.

The Office of Disability Services has permission to discuss my disability, accommodations, and/or academic record with .

(family/agency/advocate)

I understand that I may revoke my consent at any time by informing San Jacinto College Disability Services Office in writing, or if I am physically unable by oral permission.

Student Signature Date

OR

I do not give permission to The Department of Educational Planning and Counseling- Disability Services Office to discuss my accommodation needs with San Jacinto College faculty and/or staff who request such information.

Student Signature Date

Updated 04/2015

Differences Between High School and College for Students with Disabilities

High School CollegeThe applicable law is the Individuals with Disabilities Education Act or IDEA

The applicable law is the Americans with Disabilities Act (ADA) and Section 504 and 508 of the Rehabilitation Act

IDEA is about success The ADA is about accessFundamental modifications of programs and curricula are required

No fundamental modifications are required - only accommodations

Education is a right and must be provided in an appropriate environment to all individuals

Education is not a right - students must meet certain admission criteria

The school district is responsible for identifying a student's disability

Students must self-identify

The school district develops Individualized Education Plans (IEPs) to define educational services

Student must identify needs and request services - no IEP exists and is not considered sufficient documentation

The school district provides free evaluations The student must obtain evaluations at his/her own expense

Student is supported by parents and teachers Student is responsible for seeking assistance from the Disability Services Office

Primary responsibility for arranging modifications belongs to the school

Primary responsibility for self- advocacy and arranging accommodations belongs to the student (who may seek assistance from Disability Services)

Personal services for medical and physical disabilities are required (i.e., Personal Care Attendant)

No personal services are required - however, the Disability Services Office may assist the student in advertising for such services

Parent has access to student records and can participate in the IEP process

Parent does not have access to student records without student's written consent

Updated 04/2015

Parent advocates for student Student must advocate for self

School year runs from September - June School year is divided into 2 semesters: from September to December and from January to May

Classes meet daily Classes meet 1, 2, or 3 times a weekClasses are generally held in the same building

Classes are held in many different sites on campus

The average length of a class is 35-45 minutes

Classes vary in length from 50 min to 3 hours

Daily contact with teachers Classes meet less frequently which will impact on access to instructors and assistance

The student needs the parent's permission in most instances

The student is an adult and parent permission is not required

Guidance counselors or other staff schedule support services for students

The student must make arrangements for support services

A main office exists as the center of activity for the building

The student is responsible for knowing where to go to obtain information and assistance

Classes consist of about 30 students Classes consist of about 100 studentsTeachers often take time to remind you of assignments and due dates

Professors expect you to read, save and consult the course syllabus (outline); this tells the student exactly what is expected of him/her, when it is due and how it will be graded

High school is paid for by tax dollars that go to the school district

The student is responsible for applying for financial aid or arranging some type of payment

Criminal History Letter & Form 2014_07

Appendix J:

Executive Council ofPhysical Therapy and Occupational Therapy Examiners

Texas Board of Physical Therapy Examiners www.ptot.texas.gov 333 Guadalupe, Suite 2-510 Texas Board of Occupational Therapy Examiners Austin, Texas 78701-3942

Voice 512/305-6900 Fax 512-305-6951

Criminal History Evaluation Letter

Prior to applying for licensure, an individual seeking licensure may request that the board review the person’s criminal history to determine if the person is eligible for licensure based solely on the person’s criminal background up to that point in time.

Requestors must submit their requests in writing to the board and include:(1) A statement by the petitioner or applicant detailing the event(s) that led to the conviction/deferment;(2) Copies of any court documents including (but not limited to): indictments, orders of deferred adjudication; judgments; convictions; probation/parole records and evidence of completion of probation/parole; and(3) The fee required by the board, which is not refundable. The fee is currently $50, but is subject to change.

The board may require additional information including fingerprint cards before issuing a criminal history evaluation letter.

The board shall provide a criminal history evaluation letter that includes the basis for ineligibility if grounds for ineligibility exist to all requestors, no later than the 120th day after the board receives all required documentation. The 120 day time period is needed to allow the agency sufficient time to respond to a request. If the requestor does not provide all requesteddocumentation within one year of submitting the original request, the requestor must submit a new request along with appropriate fees.

All requestors remain subject to the requirements for licensure at the time of application and may be determined ineligible under existing law at the time of application. If a requestor fails to provide complete and accurate information to the agency, the board may invalidate the criminal history evaluation letter. Additional criminal history after the submission of the Petition for Criminal History Evaluation Letter may invalidate the Criminal History Evaluation Letter.

An individual may always apply for licensure, regardless of the board’s decision provided in the criminal history evaluation letter.

Criminal History Letter & Form 2014_07

Criminal History Evaluation Form

This form is used to request a criminal background check by the board of an individual’s past criminal history in order to receive a letter of eligibility for future licensure from the board. This form should be accompanied by a check for $50, along with all court and relevant documentsLast Name:

First Name:

Previous Names, if applicable: Address:

Day time contact number:

For which profession are you seeking licensure? Circle one: OT or OTA PT for PTA Explanation of Criminal History:

List of Supporting Documentation (Attached)

Date of Receipt

Accounting Dept.

Revised 7/15/2014

Appendix K:

SERVICE LEARNING OUTLINEPHYSICAL THERAPIST ASSISTANT PROGRAM

In Basic Patient Care Skills, PTHA 1305, service learning will be introduced. The student will research community partners in the area of health and fitness or in areas in which they are interested and hopefully close to where the student lives. The community partner must be approved by the PTHA 1305 instructor (for the first year project) and the PTHA 2239 instructor (for the second year project) and the student will then design their project. (The program director may also approve the community partner/site where the student will do their service. The project will include: skills learned during the first year of the PTA Program, professional behaviors, and helping in the community. Each project will be developed in the fall with 2-4 students working on each project which will add team work to the component. Over the first year the student will spend a total of 20 hours volunteering. At the end of the first and second semesters, the student will present their organization, what they did including their opinions about what they did, and the professional behaviors they developed. They will also write a reflection paper. Each semester the project will be 5% of the total grade. During clinical I the student will write a reflection paper about how the 5 behaviors they researched, observed, practiced during the first year were seen or not seen in the first clinical. The second year students will spend 10 hours volunteering at a different facility. During the first few weeks the student will name the community partner, the history, type of facility, and why the facility was chosen and identify 3 different professional behaviors. Preferably 2-4 students will go to the same place. A reflection paper and presentation will be 5% of the total grade and given at the end of the class.In clinical II and III the student will address, in the reflection paper, the professional behavior they examined in the fall.

The paper for PTHA 1305 will include the name of the community partner, the history, type of facility, why the student choose that organization and 5 professional

behaviors the student will work on when at the facility.

Procedures to follow for service learning project (for first and second years):1. Determine site to complete service learning project.

Revised 7/15/2014

2. Get site approved by instructor of the course in which the service learning project is a part of for that semester (or the program director)

3. Complete/have facility complete the following documents prior to completing any service at the facility where you will provide service and turn in to course instructor:

a. Service Learning Project – Information Sheet (1st or 2nd year as appropriate)

b. Service Learning Contract and Liability Waiver Form – Student Responsibilities

c. Service Learning Contract and Liability Waiver Form – Community Agency or Organization

4. If at any time, you change facilities, the above forms must be recompleted. 5. Utilize Time Log form every time you visit the site for service. 6. Turn in Time Log with reflection paper/presentation.

All forms described above are attached to the Service Learning Project Outline

Revised 7/15/2014

Service Learning Project Paper and PresentationCriteria and Grading

Paper: Each student will write a brief paper (about 4 paragraphs) answering/describing the following: First semester (PTHA 1305 Basic Patient Care):

1. Why did you choose this site? 2. Describe this site. 3. Describe one experience that you found particularly unique, rewarding, challenging etc. 4. Describe the professional behavior of accountability and how it related to you on this project.

Second semester (PTHA 2409 Therapeutic Exercise):1. Describe how you developed Cultural Competence and Altruism on for this project. 2. Describe how the psychological and emotional needs of the clients were addressed. 3. As a “volunteer” how did you adapt to the limitations placed on you (i.e. unable to perform a task,

limited resources)?

Fourth semester (PTHA 2309):1. Describe how you developed Integrity, Social Responsibility, and Compassion and Caring at this

site. 2. Provide an overview reflection of your experience participating in Service Learning while in the PTA

program.

Presentation: You will also give a very brief presentation to the class. You should do this as a group (with the other classmates you worked with). The presentation must include a description of the site and each person should share an experience that was particularly unique, rewarding, challenging, etc.

Grading for Service Learning ProjectPaper (75%) Points

Content covered 30Organization 20Grammar/spelling/punctuation 25

Presentation (25%)Content covered 5Organization 5Oral presentation skills (eye contact, voice projection, etc) 15

Total 100

Revised 7/15/2014

Revised 6/16/2016San Jacinto College

Physical Therapist Assistant Program SERVICE LEARNING PROJECT

Information Sheet (1st year students)

Student’s Name:_______________________________

Group members: _________________________ ________________________________ _________________________ ________________________________

Name of facility: _____________________________________________________Contact information at facility – Name: _______________________; phone:________________

Email:______________________________

Brief description of facility: _________________________________________________________________________________________________________________________________________________________________________________________________________________

Professional Behaviors: Your service learning project will focus on these 3 professional behaviors during your 1st year in the program.

1. Accountability Fall semester with PTHA 1305

2. Cultural Competence -Spring semester in PTHA 24093. Altruism – Spring semester in PTHA 2409

Revised 7/15/2014

San Jacinto CollegePhysical Therapist Assistant Program

SERVICE LEARNING PROJECTInformation Sheet

(2nd year students)

Student’s Name:_______________________________

Group members: _________________________ ________________________________ _________________________ ________________________________

Name of facility: _____________________________________________________Contact information at facility – Name: _______________________; phone:________________

Email:______________________________

Brief description of facility: _________________________________________________________________________________________________________________________________________________________________________________________________________________

Professional Behaviors: 3 professional behaviors to focus on the 2nd year of service learning in the fall with PTHA 2239

1. Integrity 2. Social Responsibility 3. Compassion and Caring

Student Signature Date

Emergency Contact/Medical Consent FormAppendix L:

Organization Date(s) of Activity

Student Information

Location of Activity

Name (Last, First, MI) Date of Birth Address City State/Zip

Emergency Contact (list at least one)

Telephone (home) Telephone (work/other) Telephone (mobile)

NameContact #1 Contact #2

Telephone Home Work Mobile

Address City/State/Zip

Relationship to Student(circle one)

Spouse Relative

Parent/Guardian Spouse Parent/GuardianFriend Relative Friend

Medical Information (attach extra pages if necessary) 1. Describe all prescription medications or special medical care you require. If none, write NONE.

2. Describe all medications to which you are allergic. If none, write NONE.

3. Describe all other allergies (including food) or special medical conditions. If none, write NONE.

4. Provide Name, City and Telephone number to your physician.

5. Are you covered under a medical/hospitalization insurance plan? If no, write NONE. If yes, provide the following information:

Insurance Company Policy Number Name of Insured Employer/Group Name

In the event of a serious medical emergency, I authorize San Jacinto College, its employees, and/or other agents (collectively the College) to secure medical transportation or treatment on my behalf. I understand that the College is not required to obtain medical transportation or care for me. I understand that the College will attempt to contact one of the individuals I have designated as an emergency contact. I authorize the College to release the information on this form to health care providers for the purpose of securing health care services for me. I understand and agree that I am responsible for all expenses, fees, or costs incurred as a result of the medical transportation or care secured for me by the College. I understand and agree that the College is not liable for any injury or damages that may occur as a result of medical treatment that I may receive.

Dean of Student Development Date

Instru ctio nal Authorization Form and Release Agreement for College Sponsored TravelAppendix M:

Date Submitted: Campus: Central North South

PARTICIPANTS: Class Class Name/Number/Section

Faculty/Staff Member who will supervise trip:

If class field trip will other classes be missed? Yes No

PURPOSE OF TRIP:

Destination City State Place Staying (if overnight) Phone #

Departure: Date Time

Return: Date Time

Release Agreement: It is understood that neither San Jacinto College, nor any of its trustees, officers or employees are liable for any accident of injuries that may occur to the below-named students as a result of any aspect of his/her participation in this activity.

I agree to indemnify and hold San Jacinto College harmless from all claims made by third parties which result from the below-named student’s actions while participating in this activity. I, the undersigned, have read this student acknowlegement and release and understand all of its terms. I have executed it voluntarily.

I agree to abide by the Code of Student Conduct including but not limited to Section 3.9 stating: Alcohol usage, regardless of age, is strictly prohibited at any off-campus, college authorized activity or travel.

Trip Approved Trip Not Approved

Instructor Date

Department Chair Date

Instructional Dean Date

Students Making TripPlease sign name legibly.

Student Name (Printed) Signature G#

Dean of Student Development Date

Student Organization Authorization Form andRelease Agreement for College Sponsored Travel

Appendix N:

Date Submitted: Campus: Central North South

PARTICIPANTS: Student Organization

Faculty/Staff Member who will supervise trip:

If class field trip will other classes be missed? Yes No

PURPOSE OF TRIP:

Destination City State Place Staying (if overnight) Phone #

Departure: Date Time

Return: Date Time

Release Agreement: It is understood that neither San Jacinto College, nor any of its trustees, officers or employees are liable for any accident of injuries that may occur to the below-named students as a result of any aspect of his/her participation in this activity.

I agree to indemnify and hold San Jacinto College harmless from all claims made by third parties which result from the below-named student’s actions while participating in this activity. I, the undersigned, have read this student acknowlegement and release and understand all of its terms. I have exectuted it voluntarily. (Students under 18 years of age are to obtain the signature of his/her parent or gardian on this form).

I agree to abide by the Code of Student Conduct including but not limited to Section 3.8.2 stating: Alcohol usage, regardless of age, is strictly prohibited at any off-campus, college authorized activity or travel.

Student Organization Advisor Date

Student Life Coordinator Date Trip Approved Trip Not Approved

Students Making TripPlease sign name legibly.

Student Name (Printed) Signature G#

■

Revised 1.30.13

Appendix P:

Complaints FormIf you feel any of the students, staff, or faculty of the San Jacinto College Physical Therapist Assistant program has behaved in an unsafe or inappropriate manner, please complete the form and return it to the PTA department at 13735 Beamer Road, Houston TX 77089. Upon receipt of this form, the program director will evaluate the complaint and work towards a resolution for all parties involved. If the program director is unable to make a resolution, he or she will seek advice from the Health Science department chair and the Dean of Natural Sciences and Health Sciences.

Date:_

Complaint issued by:

Physical Therapist Assistant Program Director signature:

Health Sciences Department Chair signature:

Dean of Natural Sciences and Health Sciences signature:_ _

Incident:

Nature of Complaint:

Disposition (to be completed by Program Director, Health Science department chair, or Dean of Natural Sciences and Health Sciences):