CI Training for CE III: Final Clinical Experience

Objectives for the Training By the end of this training session, participants will be prepared to: Appreciate the role of the Clinical Instructor during a final clinical education experience Develop skills in facilitating clinical reasoning Enhance clinical teaching skills using tools to encourage self-reflection and professional growth

What is your role as a clinical instructor in a final clinical education experience?

Role of Clinical Instructor Develop Entry Level Clinician Set Goals & Plan Design Learning Experiences Determine Learning Needs & Continue to Challenge Evaluate Performance & Provide Feedback

CPI Definition: Entry Level Without guidance or clinical supervision for simple or complex conditions Proficient and skilled in simple and complex pt care Consults with others for unfamiliar or ambiguous situations Capable of maintaining 100% caseload

Prepare Graduates to: Provide Patient-centered Care Utilize Evidence for Clinical Reasoning at a High Level (Moral & Ethical) Be Reflective Practitioners Be Life-long Learners Seek Mentoring

First Year of Practice: Article Highlights Professional Identity and Role Transitions Learning Through Experience Growing Confidence / Self Efficacy Clinical Environment Community of Practice (Black L, et al, 2010)

Novice to Expert Development: Learning within a Community of Practice Engagement Observation Reflection Discussion  Leads to shared understanding / shared meaning (Plack, 2006)

Necessary Skill Set: Focused Development Clinical Skills Clinical Reasoning Professionalism Self-Reflection & Assessment Lifelong Learning

Necessary Ingredient… Patients Self-Reflection TIME Colleagues

Essential Characteristics of CIs Interpersonal Skills / Communication Professionalism Instruction / Teaching Evaluation / Performance Assessment (Recker-Hughes C, et al, 2014)

Tools to Facilitate Professional Development Clinical Reasoning Professionalism Reflection Clinical Instructor articulates own reasoning Role Model Guiding Questions ICF Worksheet Generic Professional Abilities Planning forms Mind Mapping APTA Core Values Journal / Narrative

Expert Practice in Physical Therapy Expert’s Reasoning Process Patient is central to reasoning process; collaborative problem-solving Intuitive reasoning process Reflection on reasoning (Jensen G, et al, 1999)

ICF Reasoning Worksheet

Clinical Reasoning Mind Mapping

Facilitating Growth in Professionalism: “Generic” Professional Behaviors Critical Thinking Communication Problem Solving Interpersonal Skills Responsibility Professionalism Use of Constructive Feedback Effective Use of Time and Resources Stress Management Commitment to Learning (May, Kontney, Iglarsh, 2009)

Facilitating Growth in Professionalism

Facilitating Growth in Professionalism

Facilitating Growth in Professionalism (APTA, 2007)

Types of Reflection Reflection – on – Action Reflection – in – Action Reflection – for – Action (Schon, 1983, 1987)

Guiding Questions: Judger vs. Learner What went wrong? What did you do wrong? How will this be a problem? Why was that a stupid thing to do? Why did you do it that way? How are you going to fix this? Haven’t I told you this before? Should we bother to discuss it? LEARNER What worked? What can you have an impact on? What did you want to happen? What can you learn? What’s useful about this? What’s the big picture? What’s possible from here? What do you think this pt needs? (Adapted from Adams , Change Your Questions Change Your Life, 2009)

Mechanisms for Reflection

Staying on Track: Performance Measures Performance Measures for CE III Planning Forms Monthly Benchmarks Clinical Performance Instrument (Mid-term and Final)

Summary / Questions Resources available on the CI Community Website www.cuphysicaltherapy.org/clined Password: ClinEd