1. Physical Therapy Clinical Instructor Training Harriet Lewis, PT, MS Assistant Clinical Professor, Co ACCE

2. Objectives At the end of this unit, the participant will be able to: –Define the minimum requirements to be a clinical instructor. –Discuss the duties of a clinical instructor. –Discuss the legal issues regarding clinical instructors and student physical therapists.

3. Stop and think 1. Why do I need training to be a clinical instructor (CI)? 2. What do I already know about being a CI and teaching in the clinical environment? 3. What tools do I already have that will assist me to be an effective CI?

4. Background How is being a CI to a student like being a physical therapist for a patient? Stop and think What are the characteristics of a CI that I really like? What is the most important characteristic?

5. Expectations of a CI Here are characteristics that prior PT students desired in a CI –Fairness and objectivity –Honesty –Integrity –Creativity –Understanding of the evaluation tool –Approachability –Appropriate feedback offered frequently based on observed behavior

6. Expectations of a CI Do you agree with research that says that the most important characteristic/skill is effective communication? Why or why not? An effective communicator –Listens well –Remains honest –Employs non-inflammatory language –Avoids anger buttons –Keeps a level-head –Displays a good sense of humor –Uses effective communication techniques (restatement, reflection, clarification)

7. Expectations of a CI What are characteristics of effective communication ? –Clarity –Brevity –Accuracy –Focus

8. CI Characteristics Practices in an ethical and legal manner Follows federal and state laws as well as safe practice and risk management guidelines to determine the appropriate level of supervision Encourages self-directed learning

9. Stop and Think Forms a meaningful relationship with the student where dialog is valued Could you substitute patient, colleague, physician, caregiver, case manager, family member in the above statement? Being a good CI is being a good physical therapist.

10. CI Characteristics CI is involved in other aspects of healthcare besides patient care –Administration –Peer review –Utilization review –Continuing education –Marketing –Employee training –Committee meetings Could these be good learning experiences for a student?

11. CI Training/Qualifications We have looked at the desirable characteristics of a CI. What about the training and/or requirements to be a CI? Clinical Education Handbook –Minimum expectations are listed in handbook –http://www.angelo.edu/content/files/19023- graduating-2015-dpt-clin-ed-handbook (see page 7)http://www.angelo.edu/content/files/19023- graduating-2015-dpt-clin-ed-handbook – Stop and think –Is this enough to be a good CI? –If not, what else do you desire in a CI?

12. Duties of a CI What does the CI do? http://www.angelo.edu/content/files/19023- graduating-2015-dpt-clin-ed-handbookhttp://www.angelo.edu/content/files/19023- graduating-2015-dpt-clin-ed-handbook See page 8

13. CI Duties – Preparing for students Things to know before the student arrives –Expectations and goals Academic program Clinical site Student physical therapist –Legal requirements Contract between facility and academic program Practice Act and Rules regarding students Policies and procedures of the clinical site

14. CI Duties – Preparing for Students More things to know –What is the level of the student? Is this the first, last, or mid-program rotation? What academic courses has the student had? What skills and knowledge does the student have? How does ASU’s program provide this information?

15. CI Duties – Preparing for students –Other information to consider What learning opportunities are available at my site? What tool will be used to assess student performance? Does the CI need special training to use the tool? What resources are available to assist the CI at the university? At the site?

16. CI Duties – Beginning of the rotation Introductions –Key personnel in the department –Key personnel in the facility Orientation –Facility –Department –Expectations of the CI, department and facility

17. CI Duties – Beginning of the rotation Get to know student and assess the student’s learning needs –Knowledge base –Skills –Comfort level with patients –Expectations Learning needs Learning style Feedback preferences

18. CI Duties – Planning learning experiences Use your assessment of your student’s learning needs to answer these questions –Do you need to confirm what your student already knows? –Do you need to challenge your student to grow? –How can you include learning in all the domains? Cognitive (knowledge) Psychomotor (skills) Affective (attitude)

19. CI Duties – Planning Learning Experiences Refer to presentation on Writing and Using Objectives in Clinical Education Determine the resources and learning opportunities available in your site

20. CI Duties – Planning learning experiences Planning and implementing learning experiences Before you start –What are you trying to teach? –What is the best method to teach this material? –How will I know if the student has mastered this material?

21. CI Duties – Planning Learning Experiences Good learning experiences –Contain clear objectives with measurable outcomes –Fall within scope of facilities resources –Employ a variety of teaching methods to touch variety of learning styles –Meet the student’s and facility’s learning objectives –Facilitate the evaluation of the effectiveness of the learning experience with measurable outcomes See Writing and Using Objectives module for more information.

22. CI Duties – Planning Learning Experiences What are you trying to teach? –Write an objective or several objectives –Determine student readiness –Verify that the necessary resources are available Patients Equipment Personnel –Choose the appropriate teaching method(s)

23. CI Duties – Planning Learning Experiences Possible teaching methods Patient/client care Written assignments Observation experiences Presentations Demonstrations Lecture “Paper patients” Role play Reflection/Self assessment/Journaling “Go look it up”

24. CI Duties – Planning Learning Experiences Evaluate teaching effectiveness –Were the objectives met? –Were the teaching methods effective? –How could this learning experience be improved? –Did the student learn, i.e., change his/her performance?

25. CI Duties – Evaluating Student Performance http://youtu.be/IvoLfcrkKNs Was this a successful learning experience for the student?

26. CI “Musts” Keep up with current knowledge and skills in practice area Supervise the student Keep up with current legal, ethical and reimbursements issues Model excellent patient-centered care using the latest evidence to support clinical decisions

27. Legal Issues for the CI Supervision –Federal and state law (Practice Act & Rules) –APTA recommendations Reimbursement (Medicare, Medicaid, other) Safety Policies of institution (academic and clinical site) regarding acceptable behavior –Clinical Education Handbook –Texas Practice Act Rule 322.3, 322.4 –Policy and Procedure manual for clinical site

28. Summary Students have high expectations of clinical instructors Clinical instructors have many duties along with teaching and supervising students Clinical instructors are the student’s supervisor. Clinical instructors plan learning experiences for students Clinical instructors should be aware of legal issues regarding students

29. References Physical Therapy Clinical Instructor Educator Credentialing Manual. Alexandria, VA: American Physical Therapy Association; 1997 (rev 2005). A Normative Model of Physical Therapist Professional Education: Version 2000. Alexandria, VA: American Physical Therapy Association; 2000: 43-44,105-106. Texas Practice Act. Austin, TX: Texas Board of PT/OT Examiners; 2004: 1-6. Clinical Education Handbook. San Angelo, TX: Angelo State University; 2015: II-3,4. Teaching and Learning in Physical Therapy. New York: Slack Incorporated; 2011: 159-195.