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Mercer County Community College

Physical Therapist Assistant Program

PTA 235

PTA Clinical Education II

Clinical Performance Instrument

Student/learner

Dates of Clinical Experience

Clinical Education Site Information:

Name of Clinical Site:

Address:

Telephone:

Fax:

Clinical Instructor’s Name:

Center Coordinator of Clinical Education’s Name:

Holly Beinert Academic Coordinator of Clinical Education

609-570-3478 [email protected]

Mercer County Community College/P.O.Box 17202 /Trenton/NJ/08690

**The students are required to hand deliver either the original (or a copy) of this Clinical Performance Instrument to the ACCE upon return to the college.**

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Course Description:

This is the second clinical experience within the Physical Therapist Assistant Program curriculum. Student/learners will be investing 40 hours per week for 5 weeks in a physical therapy clinical setting within the local geographic area. Students will have the opportunity to practice and apply skills learned in other classes. Students will also have the opportunity to become integrated into a physical therapy department by working with a clinical instructor.

Course Outline:

Week 1 Orientation and integration to the clinical setting: The student/learner is expected to observe the physical therapy department and personnel utilization until the student/learner and the clinical instructor (CI) determine that the student/learner is sufficiently acclimated to this setting. The CI will be interacting with the student/learner and working with him or her to set up observations as needed. The student/learner needs to initiate interaction with patients, and seek out the components of departmental organization and documentation style. During this week the student/learner should gain an understanding of the role and responsibilities of all staff in the PT department. An introduction to who handles patient scheduling and how effectiveness is maximized via appropriate scheduling should also occur during the first week. Weeks 2-4 Integration into the clinical setting: Once the student/learner has been oriented to the department, the Clinical Instructor can begin to have the student work on the course goal objectives listed below. The student can be expected to perform the following activities within the department: MMT, ROM, vital signs, measurement for assistive devices, gait training, transfers, massage, wound care dressing, hydrotherapy, physical agents, bed mobility, therapeutic exercise, and treatment documentation. This is not an all-inclusive list and providing opportunities for student/learners to reach their highest potential is encouraged. Additional experience with techniques is encouraged, as deemed appropriate by the CI and the student.

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Email [email protected] if at any time the student/learner is considered unsafe with patients

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Course Goals:

At a minimum, each student/learner will achieve the following goals by the end of the second clinical affiliation (Clinical Affiliation II): 1. By the end of the second clinical affiliation, the student/learner will treat a complex (or lower

functioning) patient one-on-one from start to finish with distant supervision in an appropriate time frame, which includes the following:

a. performing a chart review to identify relevant data pertinent to the treatment session b. bringing the patient into the clinic, gathering subjective information, and completing the

entire treatment session in a safe, effective and competent manner. c. writing an accurate SOAP note in a timely manner (which is to be handed in by the end of the treatment day, at the latest) d. identifying the appropriate billing codes that correspond with the interventions provided (the student/learner does not necessarily need to identify the # of units per code, but should be

able to identify which CPT codes are appropriate) e. providing a clinically meaningful verbal report to the supervising CI or PT regarding the patient.

2. By the end of the second clinical affiliation, the student/learner will treat multiple non-complex patients from start to finish at the same time, with distant supervision in an appropriate timeframe, which includes the following: a. performing chart reviews to identify relevant data pertinent to the treatment session for the patients

b. bringing the patients into the clinic, gathering subjective information, and completing the entire treatment sessions in a safe, effective and competent manner. c. managing his/her time effectively to minimize having patients wait and maximize the session for all patients c. writing an accurate SOAP note in a timely manner (which is to be handed in by the end of the treatment day, at the latest) for each patient d. identifying the appropriate billing codes that correspond with the interventions provided (the student/learner does not necessarily need to identify the # of units per code, but should be

able to identify which CPT codes are appropriate) e. providing a clinically meaningful verbal report to the supervising CI or PT regarding the patients

What has the student/learner learned so far within the PTA curriculum?

This section has been provided to inform the Clinical Instructor of the didactic material that the student/learner has already covered within the PTA curriculum. If the Clinical Instructor chooses to instruct the student/learner in skills not included in this list or the PTA 224 course objectives, the Clinical Instructor is then responsible for teaching the student/learner the new skill and ensuring the student/learner’s competency and safety with that skill prior to patient care. Pre-requisite courses Student/learners have successfully completed all pre-requisite courses including PTA 101: Introduction to PTA and PTA 105: Kinesiology.

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Professional Phase Courses

Semester Course Psychomotor Skills (Hands On Skills) Tested to Competency

Content Not Tested to Competency

Summer PTA 112: Pathology

- -Diseases and disorders by system

PTA 106: Therapeutic Measurement

-Goniometry -Manual muscle testing

-Postural assessment

Fall PTA 210: PTA Techniques

-Vital signs -Aseptic technique -Wound measurement -Patient positioning and draping -Body mechanics -Bed mobility -Transfers -Wheelchair mobility -Choosing and measuring assistive devices -Gait training on level and elevated surfaces using assistive devices, gait belt and proper guarding -Soft tissue massage -Scar massage

-Wheelchair components and fit -Normal and abnormal gait -Trigger point release -Deep friction massage -Edema management -CPM machines -Intermittent Compression -Lymphedema -Chest PT -Radiography -Pharmacology -Lab Tests and medical equipment

PTA 211: Physical Agents

-Hot packs -Paraffin -Therapeutic ultrasound -Neuromuscular e-stim -Interferential e-stim -Documentation

-Cold packs -Mechanical traction -Hydrotherapy -Therapeutic use of light

PTA 226: PTA Seminar I

- -HIPAA -Insurances -Billing and Reimbursement -Regulatory Bodies -Cultural Competence -Communication -Psychosocial Aspects of Disability

Spring PTA 205: Motor Development

- -Motor development -Motor Learning & motor control -Reflexes -General Treatment Approaches -Adaptive equipment and patient handling -Development and aging

PTA 213: PTA Clinic -total hip and total knee replacements -residual limb wrapping after amputation

-Amputation -Prosthetics and orthotics -CVA, SCI, TBI & other neurologic disroders -ADA accessibility issues -Postural re-education interventions -Outcome measurement tools

PTA 216: Orthopedics -Orthopedic conditions and treatment organized by joint/body segment -Special tests

PTA 236: PTA Seminar II

-Patient evaluation process -Learning styles -Teaching and learning -Reading professional literature -Home care equipment -Observation of inpatient rehab and prosthetics fabrication

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Course Objectives:

Following the successful completion of this course, the student/learner will possess skills in the following domains to:

Cognitive/Knowledge

1. verbalize an understanding of the interventions provided by reporting why interventions are chosen, how they are properly performed, when it would be appropriate to use them and when it would be inappropriate to use them

2. approach the CI with observations regarding which interventions should be progressed with a patient, why progression is indicated and how the progression should take place

3. verbalize an understanding of how each PT intervention provided relates to the patient’s functional goals

4. observe an initial PT examination performed by a physical therapist, and participate in the development of an initial treatment session for that patient

5. describe the sequence from the initial examination of a patient forward 6. discuss the differences between patient populations and communication styles that are utilized

Psychomotor

1. ensure patient safety by utilizing universal precautions, proper body mechanics, proper guarding techniques, maintaining a safe environment, and utilizing proper intervention techniques

2. identify situations in which patient assessment is indicated and then competently and safely perform manual muscle tests (MMT), range of motion (ROM) using a goniometer, and vital signs measurements on patients

3. modify ROM and MMT techniques based on varying patient circumstances while utilizing sound foundational concepts

4. interpret the results of changes in the patient’s objective measures and identify its impact on the treatment plan

5. performs physical therapy interventions in a competent and safe manner including therapeutic exercise, therapeutic activities, neuromuscular re-education, gait training, stair training, transfers, bed mobility, and modalities as appropriate for the clinical site

6. modify the performance of PT interventions to meet the varying needs of patients 7. recognize when an intervention should not be provided due to changes in the patient’s

status and report this back to the supervising CI or PT 8. review patient data prior to treatment interventions, demonstrating the ability to identify data

which is pertinent and its importance for that patient 9. document all relevant information in the format used by the PT department, in a method

that is accurate, concise, legible, grammatically correct and timely 10. document a progress note or summative weekly note (whichever summative note format is

utilized in the clinical setting) 11. identify accurate billing codes (CPT codes) in a timely manner 12. instruct a patient in a therapeutic exercise program for the first time 13. delegate appropriate tasks to support staff as a demonstration of time and resource

management 14. contribute to discharge planning with the assistance of a supervising PT 15. recognize individual and cultural differences and respond appropriately in all aspects of

physical therapy services 16. take appropriate action in an emergency situation (or discuss the steps to take during an

emergency situation)

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17. prepare and perform an in-service for colleagues 18. recognize when the performance of an intervention is beyond the scope of practice for a

PTA student/learner 19. demonstrate an awareness of one’s own limits by asking for assistance when necessary

and asking appropriate questions 20. provide patient related instruction to patients, family members, and caregivers to

achieve patient outcomes based on the POC established by the PT 21. adjust interventions within the POC established by the PT in response to patient

clinical indications and report this to the supervising PT 22. maintain patient confidentiality, dignity, and modesty in the clinical environment 23. establish realistic weekly goals in an effort to improve clinical skills 24. arrive prepared to the midterm and final assessment meetings with a fully filled out Self-

Performance Evaluation

Affective 1. demonstrates initiative by arriving early each day and arriving prepared 2. exhibit conduct that reflects practice standards that are legal, ethical, and safe 3. interact and communicate appropriately verbally and non-verbally with the patient, the

physical therapist (PT), health care delivery personnel and others in an effective, appropriate and respectful manner

4. develop a strategy for maintaining an open line of communication with the supervising PT to discuss patient and practice concerns

5. demonstrates time management skills 6. uses “downtime” appropriately and professionally 7. accept feedback without becoming angry or defensive and use it to strengthen future

performance as a PTA in the clinical setting

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Email [email protected] if at any time the student/learner is considered unsafe with patients

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Using this Clinical Performance Instrument:

The Physical Therapist Assistant Program at Mercer County Community College uses its own Clinical Performance Instrument (CPI) for the assessment of student/learner performance in the clinical setting. For Clinical Instructors who are familiar with the APTA’s CPI, that document does not change from clinical to clinical. What changes with regards to the APTA’s CPI is the expectation of where the student/learners’ performance should be at the end of each clinical affiliation. Unlike the APTA CPI, our CPIs are different for each of the three clinical affiliations and the goals reflect the exact expectations of student/learner performance for each of the three clinical affiliations. The goals change and become more complex as the student/learners progress through the clinical education component of the program. It is expected that the student/learners meet all goals by the end of the clinical affiliation. However, just as with the APTA CPI, expectations are not always met. The PTA Program at Mercer does not utilize a pass/fail approach to clinical education and it is the Academic Coordinator of Clinical Education (ACCE) at Mercer who is ultimately responsible for the academic grade. It is in the student/learner’s best interest to provide accurate and honest feedback during the midterm assessment, so that the student/learner has the opportunity to demonstrate improvement prior to the final assessment. While some skills will be progressed and continue in future clinical affiliations (i.e. documentation, billing, communication, etc), others are specific to certain PT settings. This may be the only clinical affiliation the student/learner will have in this particular PT setting. Therefore, student/learners should become competent in the foundational skills that are unique to this setting. For instance, there are certain exercises and manual techniques that are “typical” of an outpatient setting. In the subacute setting, there are transfers that may be foundational to that setting. In the acute care setting, reading and interpreting lab results may be foundational to that setting. When assessing student/learner performance, please make a mark along the 0-10 line which indicates to the best of your ability, the current performance level of the student/learner. Please differentiate the midterm assessment from the final assessment by utilizing “M” and “F” as indicators.

Additional Learning Experiences are Encouraged:

There are many aspects of clinical practice in addition to direct patient care. The PTA program highly encourages student/learners to observe and practice additional areas of clinical practice when provided the opportunity. These additional experiences may include but are not limited to billing and coding, scheduling, quality assurance review, ordering supplies, vendor relationships, grand rounds, in-services and productivity standards.

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Call 609-570- 3478 if at any time the student/learner is considered unsafe with patient

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C1. The student/learner verbalizes an understanding of the interventions provided by reporting why interventions are chosen, how they are properly performed, when it would be appropriate to use them and when it would be inappropriate to use them.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)

Midterm Feedback Final Feedback

If the score is <5, what can the student/learner do to improve in this area?


C2. The student/learner approaches the CI with observations regarding which interventions should be progressed with a patient, why progression is indicated and how the progression should take place.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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C3. The student/learner verbalizes an understanding of how each PT intervention provided relates to the patient’s functional goals.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




C4. The student/learner observes an initial PT examination performed by a physical therapist, and participates in the development of an initial treatment session for that patient.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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C5. The student/learner describes the sequence from the initial examination of a patient forward.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




C6. The student/learner discusses the differences between patient populations and communication styles that are utilized.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P1. The student/learner ensures patient safety by utilizing universal precautions, proper body mechanics, proper guarding techniques, maintaining a safe environment, and utilizing proper intervention techniques.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P2. The student/learner identifies situations in which patient assessment is indicated and then competently and safely performs the assessment (manual muscle tests (MMT), range of motion (ROM) using a goniometer, and vital signs measurements) on patients.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P3. The student/learner modifies ROM and MMT techniques based on varying patient circumstances while utilizing sound foundational concepts.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P4. The student/learner interprets the results of changes in the patient’s objective measures and identifies its impact on the treatment plan.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P5. The student/learner performs physical therapy interventions in a competent and safe manner including therapeutic exercise, therapeutic activities, neuromuscular re-education, gait training, stair training, transfers, bed mobility, and modalities as appropriate for the clinical site.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P6. The student/learner modifies the performance of PT interventions to meet the varying needs of patients.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P7. The student/learner recognizes when an intervention should not be provided due to changes in the patient’s status and reports this back to the supervising CI or PT.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P8. The student/learner reviews patient data prior to treatment interventions, demonstrating the ability to identify data which is pertinent and its importance for that patient.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P9. The student/learner documents all relevant information in the format used by the PT department, in a method that is accurate, concise, legible, grammatically correct and timely.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P10. The student/learner documents a progress note or summative weekly note (whichever summative note format is utilized in the clinical setting).

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P11. The student/learner identifies accurate billing codes (CPT codes) in a timely manner. (It is not a requirement that the student/learner identify the # of units per CPT code, but it is expected that the student/learner understands which CPT codes cover the specific interventions provided.)

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P12. The student/learner instructs a patient in a therapeutic exercise program for the first time. (It is much easier for a student/learner to supervise a patient in a therapeutic exercise program when the patient had been doing it for 2 weeks prior to the student’s arrival. Being able to demonstrate and verbalize a therapeutic exercise program typical and appropriate for the setting to a patient who has not yet performed them, provides feedback regarding the student/learners true ability to instruct therex.)

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P13. The student/learner delegates appropriate tasks to support staff as a demonstration of time and resource management.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P14. The student/learner contributes to discharge planning with the assistance of a supervising PT.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P15. The student/learner recognizes individual and cultural differences and responds appropriately in all aspects of physical therapy services.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P16. The student/learner takes appropriate action in an emergency situation (or discusses the steps to take during an emergency situation).

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P18. The student/learner recognizes when the performance of an intervention is beyond the scope of practice for a PTA student/learner.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P19. The student/learner demonstrates an awareness of one’s own limits by asking for assistance when necessary and asking appropriate questions.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P20. The student/learner provides patient related instruction to patients, family members, and caregivers to achieve patient outcomes based on the POC established by the PT.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P21. The student/learner adjusts interventions within the POC established by the PT in response to patient clinical indications and reports this to the supervising PT.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P22. The student/learner maintains patient confidentiality, dignity, and modesty in the clinical environment.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




P23. The student/learner establishes realistic weekly goals in an effort to improve clinical skills. (It is expected that the student/learner utilize the “Weekly Summary” sheet by taking the initiative to fill out the left column, identifying their challenges and improvements as well as appropriate goals for the coming week and asking for feedback and input from the CI.)

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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P24. The student/learner arrives prepared to the midterm and final assessment meetings with a fully filled out Self-Performance Evaluation.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




A1. The student/learner demonstrates initiative by arriving early each day and arriving prepared. (Student/learners are aware that they should be arriving 10-15 minutes prior to the start of the schedule, so that they can take their coats off, put their lunch away and review the schedule. This enables them to be ready to treat a patient at the start time.)

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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A2. The student/learner exhibits conduct that reflects practice standards that are legal, ethical, and safe. (i.e. obeys statutory and regulatory rules that govern the practice of physical therapy)

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




A3. The student/learner interacts and communicates appropriately verbally and non-verbally with the patient, the physical therapist (PT), health care delivery personnel and others in an effective, appropriate and respectful manner. (This includes verbal and non-verbal communication, appropriate use of medical terminology vs. layman’s terminology, personal appearance, body language, eye contact, etc)

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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A4. The student/learner develops a strategy for maintaining an open line of communication with the supervising PT to discuss patient and practice concerns. (When a student/learner has questions, it is expected that the student/learner will take the initiative to look up or think about the answer to the question. The student should then present both the question and their answer to the CI, with their rationale. The CI can give the student feedback and a rationale at that point. This is an opportunity for the student/learner to demonstrate initiative, responsibility for their own learning, and critical thinking skills.)

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




A5. The student/learner demonstrates time management skills. (This includes completing written documentation in a timely manner, improving on the length of time that is takes to review a patient chart, treating a complex patient one-on-one in an appropriate length of time for the setting, and treating multiple non-complex patients at the same time.)

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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A6. The student/learner uses “downtime” appropriately and professionally. (Occasionally a patient will cancel or no show. The student/learner is expected to utilizes this time appropriately. Examples would be following another clinician, reading PT literature, preparing a case study, working on SOAP notes, reviewing patient charts, etc.)

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




A7. The student/learner accepts feedback without becoming angry or defensive and uses it to strengthen future performance as a PTA in the clinical setting. (NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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Course Goals: At a minimum, each student/learner will achieve the following goals by the end of the second clinical affiliation (Clinical Affiliation II): 1. By the end of the second clinical affiliation, the student/learner will treat a complex (or lower

functioning) patient one-on-one from start to finish with distant supervision in an appropriate time frame, which includes the following:

a. performing a chart review to identify relevant data pertinent to the treatment session b. bringing the patient into the clinic, gathering subjective information, and completing the

entire treatment session in a safe, effective and competent manner. c. writing an accurate SOAP note in a timely manner (which is to be handed in by the end of the treatment day, at the latest) d. identifying the appropriate billing codes that correspond with the interventions provided (the student/learner does not necessarily need to identify the # of units per code, but should be

able to identify which CPT codes are appropriate) e. providing a clinically meaningful verbal report to the supervising CI or PT regarding the patient.

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




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Course Goals: At a minimum, each student/learner will achieve the following goals by the end of the second clinical affiliation (Clinical Affiliation II): 2. By the end of the second clinical affiliation, the student/learner will treat multiple non-complex

patients from start to finish at the same time, with distant supervision in an appropriate timeframe, which includes the following: a. performing chart reviews to identify relevant data pertinent to the treatment session for the patients

b. bringing the patients into the clinic, gathering subjective information, and completing the entire treatment sessions in a safe, effective and competent manner. c. managing his/her time effectively to minimize having patients wait and maximize the session for all patients c. writing an accurate SOAP note in a timely manner (which is to be handed in by the end of the treatment day, at the latest) for each patient d. identifying the appropriate billing codes that correspond with the interventions provided (the student/learner does not necessarily need to identify the # of units per code, but should be

able to identify which CPT codes are appropriate) e. providing a clinically meaningful verbal report to the supervising CI or PT regarding the patients

(NOT MET) 0 1 2 3 4 5 6 7 8 9 10 (MET)




**If the student/learner is marked at <5/10 for ≥ 9 items, please email the ACCE so that a visit or phone call can be scheduled to maximize the resources available to help the student succeed.

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Midterm Evaluation Findings

Strengths at Midterm: Challenges at Midterm:

Did the student bring a completed Self Performance Evaluation Instrument in preparation for the midterm meeting? Please circle: YES NO Do you feel that the student/learner was academically prepared to meet your expectations for a PTA student/learner experiencing a second clinical affiliation? YES / NO Please Comment: Midterm Comments:

Midterm Evaluation Signatures: ______________________________ Student/learner Clinical Instructor Name (Print) __ Date Clinical Instructor Signature/Date

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Final Evaluation Findings

Strengths at Final Areas for continued improvement

Did the student bring a completed Self Performance Evaluation Instrument in preparation for the final meeting? Please circle: YES / NO

Did the student provide an in-service for the PT department? Yes / No Final Comments:

Final Evaluation Signatures: ______________________________ Student/learner Clinical Instructor Name (Print) __ Date Clinical Instructor Signature/Date

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