Lane Community College Clinical Education Conference

1. Lane Community CollegeClinical Education Conference June 18, 2012 Beth Ann Thorpe, LPTA, BS, CSCS – ACCE Christina Howard, MPT – Program Coordinator Marc Duyck, PT, MsEd - Instructor

2. Schedule • 9:00 - Introduction and Welcome • 9:15 - Physical Therapy Clinical Outcome Objectives • 10:00 – Clinical Student Case Scenarios • 10:30 – Break • 10:45 – Scenario Discussion • 11:45 – Walking Tour of Health and Wellness Building • 12:00 – Buffet Lunch • 1:00 – CI of the Year Award, Program Updates • 1:15 - Characteristics of Effective Clinical Instructors • 1:30 – Student Panel • 2:15 – Fostering Student Professionalism • 3:00 – Disability Resources and ADA Compliance • 3:45 – Take Home Messages and Closing

3. Courtesy Announcements • Please turn phones to vibrate or silent mode • Water and coffee available through the day • Restrooms are out in the hall – LOCATE • Get up and move around as needed • AM break time, walking tour before lunch • Certificates with be e-mailed within 1-2 days along with links to documents discussed and survey • Wi-Fi is available on campus through SAN1 • LOGIN: L88888888, PIN: jackjane2012

4. Conference Objectives • Understand clinical outcome objectives including Clinical Performance Instrument performance levels. • Create and discuss student clinical case scenarios and identify strategies for successful resolution. • Know when to contact the ACCE/DCE with clinical concerns. • Recognize characteristics of an effective clinical instructor and successful clinical student. • Fostering professionalism in physical therapy students • Understand student rights for disability accommodations in the clinical setting.

5. Survey – Show of Hands • How many of you are or will be: • Clinical Instructors • Center Coordinators of Clinical Instruction • Clinic/Department Managers/Rehab Directors • Academic Faculty – Instructors or ACCE/DCE • Work with Pacific SPTs • Work with Mount Hood SPTAs • Work with Lane SPTAs • Work with students from other schools or disciplines

6. Clinical Outcome Objectives Beth Ann Thorpe, LPTA, BS, CSCS – ACCE What is “Entry Level” for PT/PTA? Clinical Performance Instrument (CPI) Review of Bloom’s Taxonomy

7. What is “Entry Level?” • PT Minimum Skills – Doctorate Degree • Link • PTA Minimum Skills – Associate Degree • Link • We teach general foundational knowledge for ALL settings, not specialties or in depth manual techniques for PTAs. • Remember these are students, not experienced clinicians. • A little humor – So You Want to Be a PT Student

8. Clinical Performance Instrument • Paper or online assessment tool created by the APTA for student clinical performance. • PTA CPI Web: LINK • Schools pay to use the online version • Online version has required FREE training module through APTA Learning Center for all users • CPI Indicators: 18 for SPTs, 14 for SPTAs • Performance Dimensions and Rating Anchors: LINK • Definition of Entry Level on handout

9. Clinical Outcomes • LCC PTA Students complete 3 clinical rotations during 2nd year; PTA 280A, B, and C (6 weeks for 216 hours) • Outcome expectations are progressively increased • PTA 280A: CPI 1-6 approaching I level, 8-14 approaching AB level • PTA 280B: CPI 1-7 approaching AI level, 8-14 approaching I level • PTA 280C: CPI 1-7 approaching E level, 8-14 approaching AI level

10. Bloom’s Taxonomy • 3 Domains • Cognitive - knowledge, definition (see image below) • Psychomotor – skill, do it • Affective – attitude, value

11. Bloom’s Taxonomy Links Big Dog and Little Dog’s Performance Juxtaposition • http://www.nwlink.com/~donclark/hrd/bloom.html Iowa State University Center for Excellence in Learning and Teaching- A Model of Learning Objectives • http://www.celt.iastate.edu/teaching/RevisedBlooms1.html Bloom’s Taxonomy with an iPhone • http://www.youtube.com/watch?v=sdkT7nQ0WGQ&feature=related

12. Bloom’s Cognitive PTA Example • Remembering – Recite stages of gait cycle • Understanding – Explain what happens at each stage • Applying – Classify RLA vs Traditional descriptions • Analyzing – Differentiate normal vs abnormal gait • Evaluating – Correct abnormal form, weaknesses • Creating – Prescribe exercise program to address gait deviations

13. Student Clinical Case Studies • Write Individual Case - 10 minutes • Use the worksheet given • This can be CI-Student, Student-Patient • Color paper = Challenge • Color paper = Success • Think about the CPI Indicators around the room

14. Case Study Examples • Challenge – PT student in middle rotation in OP ortho completing an evaluation omitted taking vital signs but later made up values in documentation. • Professional and behavioral issue. DCE was called by CI. Critical Incident report was completed. Lesson on VS and given practice in case the skill was a problem. Student ultimately continued questionable ethical behavior and failed clinical. CI was more aware of ethics and began discussing it with students. • Success – PTA student in first rotation in acute was intimidated by transferring patient with multiple lines in small room. • Some behavior but mostly skill issue. CI simulated catheter, O2 and IV lines in open room to have student practice. CI told ACCE at site visit about student lack of skill in this area. Line management practice in mock hospital room added the next term prior to clinical. This sharing helped entire class and CI practiced IV with students prior to multi-line patient handling.

15. Student Clinical Case Studies • Small group discussions at your table – 15 minutes • Seek/offer feedback • Have any of you experienced similar?

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

17. Student Clinical Case Scenarios • Large Group Discussion • Share 1 Success and 1 Challenge per table • How often was the ACCE/DCE involved? • Suggestions/Feedback

18. ACCE/DCE Resources • Use us! When in doubt, check in. • Keep phone number and e-mail handy during clinical • Red Flags/Behavioral issues – sooner than later • Set up a successful environment before student arrival • APTA Credentialed Clinical Instructor Program • APTA Guidelines and Self-Assessment for Clinical Instruction – CI LINK, CCCE LINK • Have site policies, goals, manual, mentoring • Welcome letter and contact prior to student arrival • Possible shadow or meeting prior to start date

19. ACCE/DCE Resources cont’d • During Clinical • Thorough student orientation on day 1 - LINK • Set communication style/tone early on • Kolb Learning Style Inventory - LINK • Weekly Goal Setting Meeting – LINK (sample) • End of the day reflections – Ask the student for 3 things that went well today and 3 things to work on • Problem-Solving Algorithm - LINK • Critical Incident Report – LINK (sample), also online • Sample Weekly Progressions – LCC • Mid-term CPI springboard for final goal setting

20. Student Humor

21. Tour of Health and Wellness • Building 30 – PTA Lab 122 and SIM Lab – 15 minutes

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

23. Program Announcements

24. 2011-2012 CI of the Year

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

26. Characteristics of an Effective CI • Patience • Allow hands on practice • Demonstrate techniques • Allow (safe) mistakes • Gear toward student learning style • Good communicator • EBP • Role model • Give feedback • Supportive and encouraging • Seek feedback • Give appropriate but not unreasonable challenges • Build confidence by allowing student to lead • Be nice. 

27. Successful Clinical Student • Drive and determination • Do not be too hard on yourself – allow/forgive mistakes • Patience • Ask questions • Confidence in knowledge learned • Adaptable/flexible • Take feedback/criticism • Write clear and concise notes • Good listener • Arrive early and be prepared for the day • Study at home • Respectful, accountable • Time management

28. PTA Student Panel Share feedback Q & A

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

30. Professionalism • What is considered Professional Behavior? • What type of professional behaviors are expected of students? • PT vs PTA? • Autonomous vs semi-autonomous? • How do CIs orient students who are challenged in the professional domain? • APTA Guide to Professional Conduct for the PT • APTA Guide to Professional Conduct for the PTA • Example of conduct observed • Review of Guides in small groups

31. Professionalism cont’d • Coaching students on professional communication • Verbal • Non-verbal • Written • E-mail communications • Challenges faced by programs • How challenges are addressed by programs • Explicit coaching • Program standards

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

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

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

35. Thank You for Attending! Questions?

36. References • APTA Minimum Required Skills of Physical Therapist Graduates at Entry-Level BOD G-11-05-20-48. http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/BOD/Education/MinReqSkillsPTGrad.pdf. Accessed June 15, 2012. • APTA Minimum Required Skills of Physical Therapist Assistant Graduates at Entry-Level. BOD G11-08-09-18. http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/BOD/Education/MinReqSkillsPTGrad.pdf. Accessed June 15, 2012. • So You Want to Be a PT Student video. You Tube. http://www.youtube.com/watch?v=vgt1Gl4pir4. Accessed June 15, 2012. • PTA CPI Web. Academic Software Plus. https://cpi2.amsapps.com/user_session/new. Accessed June 15, 2012. • PTA Clinical Performance Instrument. APTA, 2008. • PT Clinical Performance Instrument. APTA, 2008 • Bloom’s Taxonomy Cognitive Domain image. http://projects.coe.uga.edu/epltt/index.php?title=Bloom%27s_Taxonomy. Accessed June 15, 2012. • Big Dog and Little Dog’s Performance Juxtaposition. http://www.nwlink.com/~donclark/hrd/bloom.html. Accessed June 16, 2012. • A Model of Learning Objectives. Iowa State University Center for Excellence in Learning and Teaching. http://www.celt.iastate.edu/teaching/RevisedBlooms1.html. Accessed June 15, 2012. • Bloom’s Taxonomy with the iPhone. You Tube, Video. http://www.youtube.com/watch?v=sdkT7nQ0WGQ. Accessed June 15, 2012. • APTA Credentialed Clinical Instructor Program. http://www.apta.org/CCIP/. Accessed June 15, 2012. • Guidelines for Self-Assessment for Clinical Instruction. APTA. 2004 Edition. • Kolb Learning Style Inventory. Image retrieved from http://www.google.com/imgres?imgurl=http://www.businessballs.com/images/kolb%27s_learning_styles_businessballs.jpg&imgrefurl=http://www.businessballs.com/kolblearningstyles.htm&h=675&w=859&sz=138&tbnid=VxAjWuMz-MtusM:&tbnh=90&tbnw=115&zoom=1&usg=__BTY9kRRVc8EG5lZT7fXONIgryxg=&docid=xeuHq50qaha0fM&sa=X&ei=-vLeT4OTOsLu2gW04OTgAQ&ved=0CHMQ9QEwAA&dur=214. Accessed June 15, 2012. • American Physical Therapy Association. Problem solving algorithm utilized by PTAs in patient/client intervention. In: A Normative Model • of Physical Therapist Assistant Education: Version 2007. Alexandria, VA: American Physical Therapy Association; 2007:84‐85. • Lane Community College Health and Wellness Building image. Building User Introduction. SRG Partnership, Inc. www.lanecc.edu/sustainability/documents/B30book.pdf. Accessed June 15, 2012. • APTA Guide to Professional Conduct for the PTA. APTA Ethics and Judicial Committee. November 2010. http://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Ethics/GuideforConductofthePTA.pdf. Accessed June 15, 2012. • APTA Guide to Professional Conduct for the PT. APTA Ethics and Judicial Committee. November 2010. http://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Ethics/GuideforProfessionalConduct.pdf. Accessed June 15, 2012. • American With Disabilities Act of 1990. Department of Justice. http://www.ada.gov/pubs/ada.htm. Accessed June 15, 2012. • Shepard, K and Jensen, G. Handbook of Teaching For Physical Therapists. Second Edition. Philadelphia, PA. Butterworth and Heinemann and imprint of Elsevier. 2002