Physical Therapist Assistant

Program

Clinical Education Handbook

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INTRODUCTION

Clinical education is an integral part of the education of the physical therapist assistant (PTA) student. While each

clinical affiliation has its own specific objectives, the overall objective of clinical education remains the application

and integration of didactic abilities into the healthcare environment. Carrington College expects that each student

will successfully translate concepts, knowledge, and skills acquired in program specific PTA courses. Clinical

education continues to be the preferred opportunity for PTA students to experience the reality of the clinic. Although

competence can be achieved in the laboratory setting, true mastery can only be developed in clinical practice.

Finally, clinical education provides each student with the opportunity to develop and validate their approach as a

practitioner by having the ability to work directly with patients, supervisors, and in a variety of clinical situations.

This handbook is designed to provide the clinical education faculty and students in the Carrington College PTA

program with important information regarding the policies and procedures specific to clinical education.

Clinical faculty and Carrington PTA students are encouraged to reference the Carrington College Academic

Catalog, Carrington College Student Handbook, Carrington College PTA Policy & Procedure Manual or contact

the Program Academic Coordinator of Clinical Education (ACCE) for further clarification on policies and

procedures that may not be fully covered in this handbook.

FEATURES

The Appendix contains forms and referenced resources relevant to clinical education.

Where applicable, policies and procedures are referenced to related college and/or programmatic

documents.

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Table of Contents COMMON TERMS USED IN CLINICAL EDUCATION ............................................................................... 4

CLINICAL EDUCATION POLICIES & PROCEDURES ................................................................................. 4

STUDENT READINESS FOR CLINICAL EDUCATION............................................................................... 6

BACKGROUND CHECK AND MEDICAL CLEARANCE ............................................................................ 6

SUPERVISION OF STUDENT PHYSICAL THERAPIST ASSISTANTS ..................................................... 8

CRITERIA FOR SELECTION OF CLINICAL INSTRUCTORS .................................................................... 8

ASSIGNMENT OF CLINICAL SITES ............................................................................................................. 9

CLINICAL ATTENDANCE POLICY............................................................................................................. 10

STUDENT LIABILITY.................................................................................................................................... 11

RESPONSIBILITIES OF THE CLINICAL FACULTY & THE CLINICAL INSTRUCTOR ....................... 12

RESPONSIBILITIES OF CARRINGTON COLLEGE ................................................................................... 13

RESPONSIBILITIES OF THE CLINICAL STUDENT .................................................................................. 13

GUIDELINES FOR CLINICAL DRESS CODE ............................................................................................. 14

CONFIDENTIALITY IN CLINICAL EDUCATION ..................................................................................... 15

INFORMED CONSENT IN CLINICAL SETTINGS ..................................................................................... 15

INCIDENTS ..................................................................................................................................................... 16

CLINICAL FACULTY DEVELOPMENT ...................................................................................................... 16

RIGHTS OF THE FACILITY & CLINICAL INSTRUCTOR ........................................................................ 16

EVALUATION OF STUDENTS IN CLINICAL EDUCATION .................................................................... 17

PASSING A CLINICAL EDUCATION COURSE ......................................................................................... 18

CLINICAL EDUCATION DISCIPLINARY POLICY ................................................................................... 19

DISMISSAL FROM A CLINICAL EDUCATION ROTATION .................................................................... 20

COMPLAINTS, GRIEVANCE & DUE PROCESS PROCEDURE ............................................................... 20

FAILURE OF A CLINICAL EDUCATION COURSE ................................................................................... 20

CLINICAL SITE SUGGESTIONS & COMPLAINTS ................................................................................... 21

APPENDICES ..................................................................................................................................................... 22

APPENDIX A: PHYSICAL EXAM FORM .................................................................................................... 22

APPENDIX B: HEPATITIS B DECLINATION FORM ................................................................................. 23

APPENDIX C: CRITERIA FOR SELECTION OF CLINICAL INSTRUCTORS ......................................... 24

APPENDIX D: CONFIDENTIALITY STATEMENT .................................................................................... 25

APPENDIX E: STUDENT EVALUATION OF CI & SITE ........................................................................... 26

APPENDIX F: CLINICAL EDUCATION DISCLOSURE FORM ................................................................ 27

APPENDIX G: CLINICAL SKILLS SCHEDULE .......................................................................................... 28

APPENDIX H: CONSENT FOR RELEASE OF INFORMATION ................................................................ 30

APPENDIX I: ACKNOWLEDGEMENT ........................................................................................................ 31

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COMMON TERMS USED IN CLINICAL EDUCATION Academic Coordinator of Clinical Education (ACCE)/Director of Clinical Education (DCE) - The Core Faculty member who has responsibility in the program for coordinating the clinical education portion of the curriculum. Center Coordinator of Clinical Education (CCCE) – the clinical education manager/ organizer at each clinic for student rotations. Program Director (PD) - The Core Faculty member who is designated as and has responsibility for the management of the PTA program. The Program Director is employed full-time by the institution that houses the PTA program and typically has a faculty appointment. PTA Faculty - The persons employed to instruct courses in the PTA curriculum. Clinical Affiliation – One of three specific clinical education rotations. Students are supervised by a licensed physical therapist or physical therapist assistant and required to travel to the facility where the CI is employed. Clinical Education - the portion of the PTA curriculum where the student develops clinical skills by applying didactic information in a clinical setting. Clinical Instructor (CI) - Licensed Physical Therapist or Physical Therapist Assistant who provides

direct supervision of the PTA student during the clinical learning experience. The CI is responsible for

providing an environment that fosters learning, supervision and constructive feedback.

Clinical Performance Instrument (CPI) - The APTA’s Clinical Performance Instrument (CPI) will be used to evaluate the student’s performance in PTA259 and PTA289 Clinical Education II and III. The student will complete the Evaluation of Clinical Experience and Clinical Instruction. The CI and the student will complete and review the CPI at midterm and at completion of the clinical affiliation. Competency - The minimum level of knowledge, skills, and behaviors necessary to progress in the PTA program, and to participate in a clinical education affiliation. Proficiencies - Psychomotor skills that are taught and assessed for minimal competency. On Site Supervision: The supervising physical therapist (PT) is on site and is present in the facility or on the campus where assistive personnel or a holder of an interim permit is performing services, is immediately available to assist the person being supervised in the services being performed and maintains continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated.

CLINICAL EDUCATION POLICIES & PROCEDURES The purpose of clinical education is to allow students the opportunity to apply knowledge and skills acquired in the classroom and lab to a hands-on patient situation. The clinical experience is designed to provide student learning experiences with patients, promote coordination with other healthcare providers, develop a better understanding of common healthcare practices, improve communication, and develop time-management skills. These experiences will assist the student in correlating the academic knowledge attained with clinical practice. In summary, clinical education should allow the students to

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practice and apply new skills and concepts, expand the academic knowledge base, develop clinical competencies, and develop communication and interpersonal skills needed to function as a health care team member under the direction and supervision of a licensed physical therapist. Students will participate in three clinical experiences throughout the course of the program. Clinical Education I is sequentially placed within semester 4 of the technical phase of the PTA program and is therefore integrated into the didactic portion of the program. Clinical Education II and III are full-time terminal experiences during the entire final semester of the program. Each student will be supervised by a licensed physical therapist at a facility affiliated with Carrington College. In order to assure a variety of work environments and exposure to different facilities, it is the policy that students are assigned to two different settings for the terminal clinical experiences, based on clinical site availability. The ACCE will track the student placement to outpatient and inpatient facility via Assignment Tracker. Students are responsible for their own transportation to attend all assigned courses and clinical rotations. Due to standards set by The Joint Commission, students with criminal histories may not be able to complete their clinical rotations. Carrington College cannot be responsible for finding an alternate clinical placement for a student who fails to pass the background check or drug screen. A student who is unable to complete the required clinical experience will be unable to complete the requirements for the PTA program and will be withdrawn. Clinical education experiences will not be scheduled in physical therapy departments in which a student is or was employed, volunteered, or completed pre-admission observation hours. Because clinical education experiences are a learning experience, the facility may not compensate the student in any way. Goals of Clinical Education

Allow the student to practice and apply new skills and concepts.

Expand the student’s academic knowledge base.

Provide the student the opportunity to gain confidence with clinical skills and interpersonal communication.

Develop effective communication, collaboration, and interpersonal skills needed to function as a professional educator and health care team member.

Develop and refine the student’s clinical proficiency within the scope of physical therapy practice.

Promote development of professional behaviors.

Develop critical thinking and problem solving skills.

Identify role models and an understanding of working under the supervision of a physical therapist.

Identify personal areas of interest and/or need.

Afford the student a wide variety of clinical environments and patient experiences so that the student may become a well-rounded, generalist health care provider.

PROGRAM CONTACT INFORMATION ACCE Program Director Laura Cerame, PTA, BS Danielle Mills, PT, DPT 702-688-4142 702-688-4317 lcerame@carrington.edu dmills@carrington.edu

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Clinical education assignments will be arranged by the ACCE from Carrington College in conjunction with the affiliating clinical site. While the student is in the clinical department he/she must observe the regulations imposed by the affiliating clinical facility with regards to patient safety and welfare. The student must read the Clinical Education Handbook and Course Syllabus prior to clinical internship to become familiar with responsibilities, expectations, and other policies and procedures.

STUDENT READINESS FOR CLINICAL EDUCATION The course of study follows a hierarchical progression from rudimentary to complex academic and clinical experiences with the primary goal of graduating an entry-level PTA that is well educated, ethical, professional, and compassionate. Students must have successfully completed all PTA program didactic coursework, with the exception of PTA 230 and PTA 223 for Clinical Education I, and be in good standing in the PTA program in order to be scheduled for clinical education courses. The student must be functioning at the developing level of academic professional behaviors prior to beginning all full-time clinical coursework. The faculty reserves the right to require additional learning experiences as deemed necessary to promote a successful clinical learning experience. Skills competencies checklists and practical examinations are incorporated into the PTA program to ensure that students have achieved entry level skill and knowledge base for all therapeutic interventions, and that they are consistently practicing all critical safety and communication elements. A student may only participate in a clinical experience once he/she has achieved a level of skills proficiency commensurate with the objectives established in the program curriculum. The skills competencies checklists and practical examinations scores will be used to assess those levels of proficiency. Additionally, a student may only participate in clinical experiences after successfully completing and passing all course grading assignments and activities required to pass courses that are scheduled prior to the clinical education experience. Students are required to score 100% on all critical s a f e t y elements and 80% on all skills components of each competency prior to attending Clinical Education courses. All skills competencies for a particular course must be met before a student is issued a grade for that course.

BACKGROUND CHECK AND MEDICAL CLEARANCE Located in the Carrington College Academic Catalog, BackgroundCheck http://carrington.edu/carrington-college/catalog/ In addition to the institution’s Background Check Policy, students of the Carrington College PTA program are advised that hospitals and outpatient clinics typically require that students submit to a background check and receive appropriate clearance before they will be permitted to participate in clinical rotations at those institutions. Students who do not receive appropriate clearance may be unable to fulfill their academic requirements at Carrington College, and may not be able to complete their educational program.

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To be considered eligible to attend any clinical education rotations for the PTA program at Carrington College, all students are required to show documentation of the following: Background Check The background check must be completed at the time of the admission process. Failure to do so will result in an

incomplete admissions packet and the applicant will be ineligible for entrance into the PTA program. A second background check may also be required to be completed prior to the start of a Clinical Affiliation assignment per the specific affiliation agreement requirements for each site. Failure to do so will result in and the student being ineligible for enrollment in Clinical Education courses. Each student will be given a background check information packet that he/she must complete on their own and submit to Carrington College. The background check website can be accessed at www.mystudentcheck.com. Each applicant is responsible for the cost which is $49.50. ** There may be an additional requirement for a DES fingerprint clearance card, depending upon clinical site requirements in semesters four and five. Proof of immunization must be completed prior to beginning the technical phase of the program in semester three. Students are responsible for costs associated with this requirement. Medical Clearance Requirements Immunizations:

Mumps, Measles and Rubella: This requires two vaccinations or a titer showing immunity.

Varicella (chicken pox): Must have a varicella vaccine or a titer showing immunity. The titer results will typically take up to seven days.

Hepatitis B: This requires three vaccinations over six months or a waiver may be signed. The student must have completed at least two of the three vaccines in the series prior to starting clinical education.

TB Screen: Two-step PPD/Tests will be completed on an annual basis prior to clinical placement at the student’s expense.

Tdap or Diphtheria, Tetanus, and Pertussis

Additional medical documentation, immunizations, and requirements may be required based on clinical facility requirements. Drug screen: Negative results from a urine sample for the follow substances.

Amphetamine (AMP)

Barbiturate (BAR)

Benzodiazepines (BZD)

Cocaine (COC)

Marijuana (THC)

Methadone (MAD)

Methamphetamine (MET)

Oxycodone (OXY)

Phencyclidine (PCP)

Propoxyphene (PPX)

CPR: BLS American Heart Association Healthcare Provider certification. CPR must be completed as a requirement for admission into the PTA program. Proof of Health Insurance: Students are required to maintain their own health care coverage, at their own cost. Students may be required by some clinical facilities to have proof of health insurance prior to beginning a clinical rotation.

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Physical Examination by a physician (SEE APPENDIX A) APTA POLICY ON

SUPERVISION OF STUDENT PHYSICAL THERAPIST ASSISTANTS http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/HOD/Practice/Supervision.pdf On-site supervision is required for all clinical education experiences. Specific requirements include:

When the student PTA is participating in the delivery of physical therapy services while being supervised by the physical therapist alone or the PT and PTA working as a team, the PT or the PTA is physically present and immediately available at all times.

PTA students must be supervised via on-site supervision at all times during patient care. The PT or the PTA will have direct contact with the patient/client during each visit as visit is defined in the

Guide to Physical Therapist Practice. The supervising PT may supervise any combination of graduates of physical therapy, students of physical

therapy, physical therapist’s assistants and physical therapist’s technicians, a combined total of three such

persons at the same time. The supervising physical therapist may not supervise more than:

o Two physical therapist’s assistants at the same time.

o Two physical therapist’s technicians at the same time.

o Two students of physical therapy at the same time.

o Two graduates of physical therapy at the same time. All patient treatment notes should be read, approved, and countersigned by the CI. All treatment notes

should be signed by the student with the words “Student Physical Therapist Assistant.”

CRITERIA FOR SELECTION OF CLINICAL INSTRUCTORS In order to ensure that students are receiving the best possible education, the Carrington College PTA

program has developed minimum standards required for CIs supervising students in clinical experience

(SEE APPENDIX C).

1. Hold current Physical Therapist license or Physical Therapist Assistant licensure/certification in the state

he/she is practicing Physical Therapy services without reservation from the Nevada Board of Physical

Therapy.

2. Physical Therapist Assistants as clinical instructors will require supervision from a Physical Therapist

and work collaboratively with the Physical Therapist

3. Have at least one year’s clinical experience prior to assuming the role of the CI.

4. Use and abide by the APTA document, “Guidelines and Self-Assessments for Clinical Education.”

5. Have a regular patient load sufficient to provide the student(s) with an opportunity to apply knowledge

and increase skill in patient treatment.

6. Be committed to high quality Physical Therapist Assistant student education and support the Carrington

College- Las Vegas Campus Physical Therapist Assistant Program.

7. Express positive attitudes and willingness to work with the student(s) and faculty of Carrington College-

Las Vegas Campus.

8. Provide adequate supervision of patient interaction, treatment, and record keeping procedures performed

by the student(s).

9. Follow facilities system for maintaining records of patient evaluation, treatment, and progression.

10. Express willingness to follow written agreement between the clinical facility and Carrington College-

Las Vegas Campus.

11. Abide by all applicable state and federal laws and appropriate professional codes of ethics.

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12. Follow Policies and Procedures of the Physical Therapist Assistant Program at Carrington College-Las

Vegas campus, the policies and procedures of the clinical site and the APTA Standards for Ethical

Conduct for Physical Therapist Assistant and Code of Ethics.

13. Agree to use the APTA document the Clinical Performance Instrument (CPI) as a student evaluation tool. (Training will be provided to the CI if he/she is unfamiliar or inexperienced with using the CPI.)

Each CI will be given a copy of the CI Selection Form outlining the minimal standards list. A signed copy

of the form indicating the CI’s agreement with the standards will be maintained by the ACCE in the

clinical faculty file.

ASSIGNMENT OF CLINICAL SITES Located in Catalog, Externships, Clinical Rotation, and Fieldwork, http://carrington.edu/carrington-

college/catalog/

Carrington College is committed to following the APTA Uniform Mailing Date, when possible, to inquire

about the availability of clinical sites for the upcoming student cohort. The ACCE will send the Clinical

Requests Form to affiliating clinical sites. When a completed form is received, the status of the written

agreement and CI criteria will be reviewed. Students are assigned to a clinical site at least six weeks prior

to the start of the affiliation. Under special circumstances, such as cancelled site availability, students will

be assigned as early as possible for continuity of the clinical experience.

Clinical sites are chosen in the PTA program to meet the student’s need for a comprehensive education and to meet the mission and goals of the program. In order to provide the variety, depth, and breadth expected for the clinical experiences, students will typically be placed in at least two different settings. However, the determining factor for clinical placement is to ensure that the student is able to meet all clinical educational goals through the clinical education experience. Student preferences will be considered during the placement process; however, the final determination rests with the ACCE. The ACCE will only place a student at a clinical site where:

The college has a current affiliation agreement with the site.

The CI meets all criteria for selection as a CI.

The site is able to provide adequate supervision within the laws and regulations of supervision of a student PTA.

The ACCE is responsible for determining the clinical assignments for each student. Clinical placement is

designed to provide the student with a variety of physical therapy experiences and facilitate the

attainment of the basic skills needed for the practice of a physical therapist assistant. The program is

committed to providing a clinical experience with the breadth and depth expected to ensure

opportunities for the PTA student to graduate as a generalist in entry level PTA competency.

Any questions or comments should be directed to the ACCE. Any refusal to take an assignment without

just cause will put the student at risk of being withdrawn from the PTA program. Student placements are

reserved months in advance of a scheduled clinical experience. A student’s request for a change in

assignments will be considered only if a situation warrants, which will be determined by the ACCE and

the Program Director. The student needs to understand that finding alternative placements are not

always possible once assignments have been made, and request for change may be denied. Once a clinical

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site has been confirmed, changes to the assignment will not be made other than in an emergent situation.

Students will only be sent to facilities that have a current and valid contract with Carrington College.

Clinical affiliations are available in the Las Vegas Metropolitan area as well as throughout the state of Nevada; however, a student may also request a clinical site in another location. Should one of the clinical facilities cancel their affiliation slot, the student who is involved in the

cancellation will be notified and the ACCE will call additional facilities and request a slot. Graduation

could be delayed based on availability of clinical sites/placements.

Each student is assigned to a specific clinical site. The student must contact the clinical site contact person two weeks prior to the start of the internship. The purpose of the call is to introduce the student confirm the clinic hours and expected arrival time on the first day, dress code, directions to the department, any specific parking requirements, etc. The student is required to adhere to his or her assigned clinical schedule. Any adjustment to expected clinical schedule will be made between the ACCE and the CI. No personal adjustments may be made without notification and approval by the ACCE.

CLINICAL ATTENDANCE POLICY Located in the Carrington College Student Handbook, Clinical Hours & Externship, http://docs.carrington.edu/forms/hand-books/2014/2014-CC-student-handbook.pdf In addition to the institution policy, PTA students are expected to be present for all clinical experiences and to abide by the hours and policies of the assigned clinical facility. Students are responsible for reviewing the Attendance Policy and abiding all items in the Code of Conduct section of the Catalog. Clinical hours are full-time, 40 hours per week. Students are expected to be in their assigned clinical area at the clinical facility prepared to engage in patient care a minimum of 10 minutes before the start of their “shift.” Failure to meet this requirement constitute tardiness. Chronic tardiness will affect the student’s performance evaluation for the rotation and may result in disciplinary action. If a student is unable to attend, the clinical facility and ACCE must be notified each day of an absence by 8:00 a.m. or upon opening. Absences must be documented as being due to illness or emergency. The student will submit a “Clinical Affiliation Absence/Tardy Form” with the timesheet indicating the date, total hours missed, and reason for absence. Absences must be due to illness or emergency. Clinical attendance will be documented in the student's record. Changes in the clinical schedule, including make-up days must be coordinated and approved by the ACCE, CCCE, and CI. If a student does not report for a clinical experience as scheduled, the CI and the ACCE will counsel the student and this absence will be considered unexcused. Students will be allowed one sick day of clinical absence during Clinical Education I and three sick days of absence during Clinical Education II and III. Making up missed clinical education hours will be determined at the discretion of the ACCE, CI, and/or CCCE.

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All holidays observed by Carrington College may be considered holidays for students. Clinical sites that observe holidays that coincide with scheduled clinical days will also be regarded as holidays by those students assigned to that facility. Students failing to comply with attendance requirements may receive a grade of ‘No Credit’ for the clinical experience and may be recommended for dismissal from the program. A release from a physician will be required to return to clinical following three (3) or more consecutive days of absence due to illness/injury. Children may not attend the clinical experience with the parent. Before leaving the clinical site, the student must report to the CI. Clinical Attendance Process

1. Timesheets are required to be submitted on Thursday before 5pm for that work week.

Student’s hours are to reflect any breaks or lunch and the hours are to be totaled for each day. 2. Students failing to comply with attendance requirements may be recommended for dismissal

from the program. 3. Any changes in the clinical schedule, including make-up days must be coordinated and

approved by the ACCE, CCCE and CI. TRANSPORTATION Students are responsible for their own transportation including all expenses incurred for transportation, parking, and living arrangements related to clinical affiliations.

STUDENT LIABILITY All students are covered by Carrington College’s umbrella liability insurance while on their clinical affiliations.

DISABILITY ACCOMMODATION – CLINICAL EDUCATION Carrington College adheres to the Americans with Disabilities Act, and will work with clinical facilities to make every effort to provide reasonable accommodations for those students with disabilities. Documentation by a physician of a student’s physical performance limitations may be required to accommodate requests. Students who are aware or suspect there is a situation that may interfere with their ability to complete the requirements of the clinical education courses and affiliation duties/responsibilities, must contact the ACCE or Program Director. Appropriate actions are facilitated by timely requests. Reasonable requests for appropriate accommodations will be attempted and all requests will be held in confidence. Carrington College prohibits retaliation towards anyone who files a complaint of discrimination against the administration, faculty, or staff.

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EXPECTATIONS The Clinical Education courses have been designed to provide the student with a variety of patient experiences. These experiences are coordinated with the didactic portion of the curriculum. This should ensure that each student has a well-rounded exposure to physical therapy practice. Each Clinical Education course has course objectives, which will be disseminated to students and clinical education facilities as part of the course syllabus. Students are expected to generate individualized learning objectives and goals. Each clinical site is encouraged to develop learning experiences for students rotating through their department. These objectives can address experiences and/or techniques unique to the facility. Structured learning experiences can then be developed to address the facility’s learning objectives.

RESPONSIBILITIES OF THE CLINICAL FACULTY & THE CLINICAL INSTRUCTOR A clinical educator has many roles. A key responsibility is to create and structure a safe and rich learning environment. A clinical educator is also a teacher, a role in which the clinician assesses the student’s skills and presents information to the student. A clinical educator is also an influential role model from which the student molds his attributes and behaviors to build a professional image. An important responsibility of the clinical site and CI is the evaluation of the student’s performance and accomplishment of the goals and objectives of the clinical education course:

The facility shall designate a staff member to coordinate student’s schedules and activities at the facility, and act as a liaison with the College. The names of the clinical facility’s CCCE and CI shall be provided to the ACCE.

The facility shall provide students with field experience and o b s e r v a t i o n a l opportunities at the facility. Students will be assigned to a department(s) that is able to offer students appropriate experiences that are commensurate with their training and that will allow the student to meet the objectives of the clinical experience.

The facility shall accommodate reasonable requests for students with documented disabilities. Students shall be supervised by a designated CI at all times while at the facility. The CI shall be a licensed

PT or PTA. The CI will co-sign all clinical documentation written by the student. The facility agrees not to decrease the normal complement of its staff as a result of the assignment of

students. The facility will limit the number of students participating in clinical externships to a level that allows the

student to gain adequate and appropriate clinical experience. The CI shall engage in frequent, informal evaluations of each student. This can be daily or weekly,

and is at the discretion of the CI, based upon the performance of the student. The CI shall engage in periodic evaluations of each student. Formal evaluations of each student shall

occur at mid-term and at the terminus of the clinical experience. The CI shall utilize the CPI for evaluations of students. If the CI is not familiar with the use of the CPI,

he/she shall request an in-service from the ACCE. The CI agrees to communicate with the ACCE should a student be performing below the expected level of

competency, or if it appears that the student will not be able to meet expected course objectives. The CI shall submit student attendance logs to the ACCE at the conclusion of the clinical experience. The facility shall allow inspection by appropriate accrediting, registration, and licensing agencies,

insofar as such inspection is necessary for approval or certification of the PTA program.

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The facility will provide to students an educational environment that minimizes the risk of injury, and that adheres to generally accepted industry and legal standards of safety.

The facility shall allow students to wear the Carrington College identification badge, and/or will provide an identification badge if one of their own is required.

The facility shall require students to provide their own transportation, meals, uniforms, and accommodation at their own expense.

The facility shall provide students appropriate orientation to rules, regulations, policies, and emergency procedures.

The facility shall assign students to training activities that will provide experiences consistent with the purposes and objectives of the PTA program and the clinical experience.

RESPONSIBILITIES OF CARRINGTON COLLEGE

Carrington will designate a staff member (ACCE) to coordinate students’ schedules and activities at the facility and to act as a liaison with the facility.

Carrington will provide the names and contact information of students to be assigned to the facility sufficiently in advance of the start of the clinical experience.

Student schedules shall be mutually determined by the ACCE and the CCCE. Carrington shall assign only properly prepared and qualified students to the facility. Carrington shall provide certification that each student has been immunized against those

communicable diseases as determined by the facility’s employment requirements including, but not limited to: Measles, Rubella; Rubella; Hepatitis B, and Tuberculosis.

Carrington will require its students to conform to all established policies and procedures of the facility, maintain confidentiality, conform to any established dress policy, and be responsible for their own laundry.

Carrington shall inform students that they are responsible for their own meals, transportation to and from the facility, and accommodations while on clinical experience.

Carrington shall furnish evidence of liability insurance to the facility, if requested. Carrington shall provide instruction in the use of the CPI , as requested, to the CI. The ACCE will communicate with the CI during the mid-term and before the final week of the student’s

clinical experience to assess student’s progress toward objectives, and to determine any additional needs the student or the CI might have.

The ACCE will be responsible for coordinating student remediation should it be determined that the student’s clinical skills are not at a level appropriate for the clinical experience.

The ACCE will be responsible for issuing the student’s grade for the clinical experience based upon the feedback received from the CI.

RESPONSIBILITIES OF THE CLINICAL STUDENT

The student may not initiate contact with a prospective or established clinical site. The ACCE negotiates clinical contracts and determines the appropriateness of the clinical site for students.

The student will follow all rules and regulations of the facility provided by the CCCE and/or the CI, and follow the schedule provided by the CCCE.

The student may not alter their daily schedule without approval of both the ACCE and the CCCE. The student will maintain confidentiality and adhere to all HIPAA and facility guidelines. The student shall identify themselves to patients and facility staff using the appropriate credentials (PTA

Student). The student shall perform only those procedures/interventions for which the student has been

trained and displayed competency in the lab setting or with the CI. The student will recognize when an intervention or procedure is beyond the scope of practice of a

PTA, or beyond the student’s level of skill or knowledge, and defer to the CI.

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Students must use caution when working with potentially hazardous materials and all safety procedures and universal precautions set forth by Carrington and OSHA must be followed.

The student will document all patient interventions in which they participated, as appropriate, in a timely fashion and using the accepted mode of documentation of the clinical facility. All documentation must be signed and followed by “Student Physical Therapist Assistant” or, if within state regulations, the abbreviated credentials “SPTA.”

The student will maintain and/or submit weekly reflection logs to demonstrate self-reflection of the learning and experiences occurring in clinical education and patient care.

The student will participate in the evaluation process and be open to suggestions and constructive criticism.

The student shall complete and return the APTA Clinical Instructor Evaluation form and the CPI no later than one week after the conclusion of the clinical experience.

The student will be responsible for any non-Worker’s Compensation related medical health care costs he/she may incur during the internship, including emergency services.

The student will provide immunization records to the ACCE and ensure that immunizations and titers are up-to-date prior to participating in clinical experience.

The student will earn and maintain Healthcare Provider BLS/CPR throughout the course of the PTA program.

The student shall contact the clinical facility at least two weeks prior to beginning the clinical experience to receive any pertinent information/instructions regarding the facility and/or the clinical experience.

The student shall locate his/her own housing during the clinical experience, if applicable. The student is responsible for his/her transportation to and from the clinical facility. The student is

responsible for all costs (including gas, tolls, auto maintenance, etc.) associated with travel for clinical experience.

The student shall notify the college and facility of any changes in address and/or contact information. The student shall notify the ACCE and facility of any changes in health status, or other circumstances that

may interfere with timely completion of the internship. The student will conduct him/herself in a professional manner as outlined by the APTA’s Standards of

Ethical Conduct for the PTA. The student shall adhere to attendance policies for clinical experience (listed below). The student may not terminate their clinical experience without approval of the ACCE. The student is advised of their rights as a student extern as outlined in the Carrington College PTA Clinical

Education Handbook. The student shall communicate with the CI, the CCCE, the ACCE, and/or the PTA Program Director should

situations arise that may adversely affect their safety, wellbeing, and/or ability to successfully meet their course/program objectives.

GUIDELINES FOR CLINICAL DRESS CODE Professional appearance and hygiene standards are required when working in a healthcare profession. Each clinical facility will have a specific dress code. The student is expected to follow that code. Some of the areas that are common in the facilities are:

A student identification badge issued by the College or by the facility shall be worn at all times. The badge shall identify the student as a ‘Student PTA.’

The student will wear uniform requi red by the clinical facility (typically slacks & polo) or the Carrington College PTA program uniform, which m a y include a college issued polo shirt and slacks.

Clothes will be clean, neatly pressed, and free of odor. Students will be clean and free of body odor. Makeup will be conservative in nature. Nails will be trimmed short. Acrylic nails and nail art are prohibited.

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Long hair will be pulled back. Hair may be dyed, but it should be of a natural color. Beards and mustaches will be neatly trimmed.

Jewelry will be kept to a minimum and consistent with the clinic’s expectations. Appropriate undergarments will be worn, and will not be visible. Shoes must be closed toed with non-slip soles. Shoes should be in good condition, and laces should be

tied, if applicable. Athletic shoes may only be worn if approved by the clinical site.

Any student who disregards the dress code policy will be issued a verbal warning and may be sent home at the discretion of the clinical facility and/or CI. The second infraction will result in suspension from the clinical site until a conference is held with the PTA Program Director or ACCE and the CI.

CONFIDENTIALITY IN CLINICAL EDUCATION It is the responsibility of the CI to ensure that students adhere to standards of confidentiality when interacting with all persons while participating in clinical education experiences. The CI should report any violations of confidentiality to the ACCE and/or the Program Director. To protect the right to privacy and confidentiality of patients throughout the PTA curriculum, students are obligated to:

Understand the regulations and implications of the HIPAA. Abide by all facility policies and procedures regarding confidentiality and access to computer

information. Protect all personally identifiable medical information from being observed by unauthorized personnel or

bystanders. Refrain from discussing a patient’s medical, social, financial, or emotional condition outside the context of

providing appropriate physical therapy interventions. Use good judgment and discretion to maintain patients right to privacy when discussing specific

patients with clinical staff. Refrain from discussing any confidential information relating to clinical facilities, employees, volunteers, or

other students. Never remove original patient records or identifiable copies from the clinic site. Be certain that personal notes, journals, case studies, etc. do not contain personally identifiable

information.

Students sign a “Confidentiality Policy” form during orientation at the beginning of the program. (SEE APPENDIX D Confidentiality Policy). Violations of this code will result in disciplinary action up to and including expulsion from the Carrington College PTA program.

INFORMED CONSENT IN CLINICAL SETTINGS Students begin to introduce themselves as “Student Physical Therapist Assistants” in lab practice and practical examinations in semester three. Students are made aware that patients have the right to refuse to participate in their clinical education, without repercussion. It is the responsibility of the student to inform the CI of the patient’s request. Students must wear their Carrington College identification badge or badge issued by the clinical site at all times while on clinical experience. Students are to verbally identify themselves as a student to all patients and health care workers in the facility prior to any direct contact with a patient, giving the patient the opportunity to refuse treatment by a student.

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INCIDENTS Students will be participating in activities in clinical education courses which have potential for exposure to infectious diseases including but not limited to Hepatitis B and HIV. Students must take all necessary precautions to minimize the risk of exposure. Students who fail to comply with the blood borne pathogen and HIV training may be asked to withdraw from the PTA program. All incidents that are inconsistent with routine care or the patient’s plan of care must be reported to the CI immediately. If a medical emergency occurs, the policies of the facility will be followed. The condition of the involved person(s) will be evaluated and the necessary emergency care will be provided. A written report describing the incident should be completed according to facility policy. In addition, the ACCE and Program Director are to be notified of the incident by the CI and the PTA student. Follow-up evaluation will be required consistent with federal regulations. This may involve going to their personal physician or the emergency room. Students are responsible for the cost of their own medical care.

CLINICAL FACULTY DEVELOPMENT The clinical sites, along with the CCCEs and the CIs, are key partners in clinical education. The ACCE engages in regular communications with these partners to deliver effective clinical education. The ACCE, with assistance from the Program Director, conduct yearly (or more regularly, if needed) assessments of the clinical faculty and clinical sites and provide resources for development activities which will improve clinical faculty effectiveness. The following tools are utilized to perform these assessments:

Review of the CSIF.

The ACCE will review the Student Evaluation of Clinical Instructor and Clinical Site form and the APTA: Physical Therapist Assistant Student Evaluation: Clinical Experience and Clinical Instruction form at the completion of each clinical affiliation, noting any needs identified by students.

Review of clinical faculty requests/suggestions provided to the ACCE and/or Program Director.

Review of the Clinical Affiliation Surveys distributed to clinical faculty at the end of each affiliation.

Needs that are identified in any of the assessment methods will be addressed using any combination of the following methods: one-on-one training, in-services provided by program faculty, and formal continuing education courses offered through the PTA program. The institution will provide resources for ongoing faculty development activities for clinical education faculty/CIs utilized by the program.

RIGHTS OF THE FACILITY & CLINICAL INSTRUCTOR Carrington College offers specific rights and privileges to CIs and facilities for providing clinical education to the PTA students and helping achieve the program’s mission and goals.

Clinical facilities are under no financial obligation to the college or the program.

Clinical facilities assume no liability as a result of injuries or damages that arise from students traveling to and from the facility.

Clinical facilities are responsible only for the actions of their employees, officers, and agents.

Clinical facilities are not obligated to designate students of the PTA program as employees.

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CIs are encouraged to become members of the PTA Program Advisory Committee, w h i c h meets every six months to discuss program assessment and how to incorporate changes for continued improvement in PTA program to achieve our mission and learning objectives. The meetings occur in the evening and meals are provided.

CIs have access to the PTA program’s library and reference material used for didactic education, including EBSCO. The clinical faculty may phone the academic faculty for access to the computer lab.

CIs will have access to seminars and educational functions, including the web-based PTA CPI and the APTA Credentialing Courses, sponsored by the PTA program.

EVALUATION OF STUDENTS IN CLINICAL EDUCATION The evaluation tools used in clinical education evaluate the student’s skills, professionalism, clinical problem solving, and PT/PTA relationship. The tools are a means of keeping a record of a student’s clinical performance and professional development. They also assist the student in recognition of their growth as a PTA and assist in planning future clinical education experiences. The evaluation tools assist the CI in determining strengths and weaknesses of the student's clinical performance while planning new learning experiences. Additionally, the tools assist the ACCE in determining strengths and weaknesses in the overall academic curriculum, and in determining ways in which the individual student may be assisted in achieving individual clinical education objectives. The APTA’s CPI will be used to evaluate the student’s performance in Clinical Education I (PTA 199). The CI and the student will complete and review the CPI at the completion of the clinical experience. The APTA’s CPI will be used to evaluate the student’s performance in Clinical Education II (PT 259) and III (PTA 289). The CI and the student will complete and review the CPI at midterm and at the completion of the clinical experience. The completed form should be submitted to the ACCE at Carrington College w i t h i n one week of completion of the clinical experience. During Clinical Education II and III, the student will present an in-service to peers and other health care professionals in the clinic. This in-service must be a topic of interest to the clinicians who will attend the in-service and must be agreed upon by the student and the student’s CI. The student will not only provide information about the topic, but will explain what the PTAs role is related to the topic presented. Students are expected to conduct an in-service presentation to the clinical staff. The student must submit copies of the materials presented. (Refer to the PTA 259 and PTA 289 Course Syllabi). The ACCE will communicate with the CI via phone, email, or clinical visit during the mid-term of the student’s affiliation to assess student’s progress and needs, and again before the final week of clinical affiliation. This communication is intended to facilitate discussion between the student, CI/CCCE and ACCE. These visits provide a professional atmosphere for the discussion of the student performance, curriculum concerns, practice issues, and topics of general concern for all of the participants. In addition to formal student evaluations, the PTA program encourages daily and weekly feedback sessions between the CI and the student to promote communication, a sense of teamwork, and emphasis of learning objectives. These sessions may be structured or unstructured, depending on the needs and learning styles of the student.

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PASSING A CLINICAL EDUCATION COURSE A grade of “Pass/Fail” will be issued for all Clinical Education courses. The ACCE is responsible for determining the student’s final grade in the Clinical Education course. The process for determining the grade involves a review of the CPI completed by the CI as well as a review of additional grading criteria established below. A grade of “Pass” for any Clinical Education course is based upon:

On-time attendance to all scheduled clinical education days (A student may be absent due to illness one day during Clinical Education I and three days during Clinical Education II and III) Absences may require make up days and/or remediation.

Submission of the following: o Completed PTA CPI o Completed APTA: Physical Therapist Assistant Student Evaluation: Clinical Experience and Clinical

Instruction form o Carrington College Student Evaluation of Clinical Instructor and Clinical Site form (SEE

APPENDIX E) o Any additional surveys within three business days of the conclusion of the clinical education

experience

No “Significant Concern” or “Critical Incidents” boxes may be checked at the final evaluation on the CPI.

Submission of all assignments (e.g. in-service, study guide) in the clinic to the ACCE by the established due date.

For Clinical Education I (PTA 199), the student must achieve: 1. Students must be at 25% (Advanced Beginner Performance) or higher for criteria #6-14 (or #4,

5, 7, 9, 11-20 paper CPI). 2. Students must be at 50% (Intermediate Performance) or higher for criteria #1-5 (or #1-3, 6, 8, 10

paper CPI). 3. No “significant concern” boxes checked on any performance criteria identified at final evaluation.

For Clinical Education II (PTA 259), a student must achieve:

1. Students must be at Entry-level Performance for Foundational Elements #1, 2, 3, 5, 7 (#1-6 for paper CPI)

2. Students must be at 50% (Intermediate Performance) or higher for criteria #4, 6, 8-14 (or #7-20 for paper CPI)

3. No “Significant Concern” boxes checked on any performance criteria identified at final evaluation. For Clinical Education III (PTA 289), a student should achieve:

1. Students must be rated at Entry-level Performance on all criteria #1-14 (#1-20 paper CPI) 2. No “Significant Concern” boxes checked on any performance criteria identified at final evaluation.

For Clinical Education II and III the student is required to provide an in-service to the physical therapy team. The presentation will be submitted at the end of the clinical rotation. In instances when the CI’s comments do not align with the rating percentage of the CPI Criterion, the ACCE will communicate with the CI for clarification before issuing the student a grade.

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Determination of the final grade for Clinical Education courses is the sole responsibility of the ACCE. If it is determined through consultation with the CI that student performance is unsatisfactory, and the student can verify that there were extenuating circumstances leading to their inability to be successful within the allotted time, the ACCE may offer the student an incomplete grade with terms for removal from the clinical experience. The ACCE will construct an action plan, with input from the student, to address the terms for removal of the incomplete grade. The ACCE may seek input from academic faculty and the CI when constructing remedial action plans. Incomplete clinical coursework may interrupt the student’s ability to proceed with subsequently scheduled didactic or clinical courses, and may delay graduation from the PTA program.

CLINICAL EDUCATION DISCIPLINARY POLICY Located in the Catalog, Code of Conduct, http://carrington.edu/carrington-college/catalog/ In addition to the institution’s Code of Conduct Policy, it is presumed that PTA students exercise maturity and sound judgment in the process of becoming productive members of the healthcare community; there are occasions when it becomes necessary to address matters of conduct and discipline. In the event that disciplinary action becomes necessary, the ACCE and Program Director will exercise fairness, utilizing progressive discipline when possible. The type of disciplinary action taken will depend on the seriousness and nature of the offense, and the student’s history of problems. Students are also advised to refer to the following resource for clarification on acceptable behavior while on clinical experience: APTA’s Standards of Ethical Conduct for the PTA Located http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/Ethics/StandardsEthicalConductPTA.pdf?navID=10737423626 DISCIPLINARY ACTION Located in the Catalog, Disciplinary Action, http://carrington.edu/carrington-college/catalog/ In addition to the College’s Disciplinary Action Policy, the following steps may be involved:

Verbal counseling: when the infraction is relatively minor or is a first offense.

The CI will consult with the student, and if deemed necessary, the ACCE.

Written warning: when verbal counseling fails to achieve the desired change in behavior. The CI will consult with the student and the ACCE. A conference will be held between the student, the CI, the ACCE, and/or the PTA Program Director to discuss the inappropriate behavior. This will become part of the student’s permanent student record.

Removal from the clinical site: when previous disciplinary actions fail to produce the desired changes in behavior, or conduct presents a danger to self and others. The CCCE, CI and clinical facility have the right to request the student not return until the conference with the ACCE. The student will be given a grade of ‘No Credit’ for the course. Certain behaviors may result in the student being dismissed from the PTA program.

The aim of clinical education is to promote behaviors that best serve the needs of patients, the health care institution, and the community.

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DISMISSAL FROM A CLINICAL EDUCATION ROTATION The following actions are considered just cause for dismissal from the clinical experience and/or the PTA program:

Unprofessional or unethical behavior on the part of the student in accordance with professional guidelines or Code of Ethics as defined by the Physical Therapy profession.

Criminal activity within the clinical facility.

Action which knowingly endangers the health or wellbeing of a patient, fellow student, facility personnel, or visitor.

Being under the influence of alcohol, drugs, or foreign substances while present at the clinical facility or while participating in any patient care activity.

Any behavior which violates a clinical site regulation that results in denial by the clinical site of Carrington College’s clinical privileges.

Vandalism or abuse of clinical equipment and/or property.

Violation of patient privacy.

Failing to meet course objectives and evaluative criteria as outlined in each clinical education course syllabus.

COMPLAINTS, GRIEVANCE & DUE PROCESS PROCEDURE Located in the Catalog, Grievance Procedure, http://carrington.edu/carrington-college/catalog/

FAILURE OF A CLINICAL EDUCATION COURSE If a student fails a Clinical Education course, for reasons other than a critical incident or red flag concerns per the CPI, remediation and re-scheduling another clinical education course may be considered. It is the CI’s responsibility to contact the ACCE with any concerns regarding the student’s clinical performance prior to any mid-term or final performance evaluations especially when safety issues are involved. In the case of irreparable issues at that clinical site, the PTA Program Director, in collaboration with the ACCE, CCCE, and CI, may make the determination that the student requires a remedial experience (procedure described below) or fails the Clinical Education course. Failure of a Clinical Education course will result in program dismissal. If the Clinical Education course has more than one affiliation (rotation), the failure of one clinical affiliation and an unsuccessful remedial clinical affiliation will be reviewed by the Program Director and can result in program dismissal. Criteria for remediation or failure:

Failure to comply with safe standards of practice as it effects patient care, other healthcare providers, and/or self.

Non-compliance with institutional, program, or facility policies.

The inability to apply theory, knowledge, and procedures previously learned in the academic setting in the clinical setting based upon the specified objectives of the Clinical Education course.

Excessive absenteeism.

Remedial Rotation Procedure: A Student Success Plan will be created and will be signed if deemed appropriate for the remedial rotation.

The student will be mandated to attend remediation with PTA faculty. The program’s ACCE and Program Director will determine the requirements for remediation (SEE APPENDIX F).

The facility assigned for the remedial rotation will be made by the ACCE. The facility’s CCCE will be informed of the situation and specific learning objectives will be outline with the CCCE and the student.

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Student performance in the re-scheduled Clinical Education course must be graded at a designated score level on the CPI by midterm evaluation. If this threshold is not met, the student will be removed from the rotation and fail the course.

All course work/assignments must be completed in a timely manner for course completion.

The clinical rotation may be extended to allow time to demonstrate improvement in performance if the clinical site is agreeable and the CI and ACCE determine that the student’s deficiencies are not significant. However, the need to extend a clinical more than one week may require assignment of a failing grade. If a student fails a Clinical Education course they may be unable to continue with the program. The student will be informed of the re-enrollment policy for potential return to the program in the following cohort. (Refer to Re-entry process in the Carrington College Academic Catalog for specific details.) CRITERIA FOR A GRADE OF INCOMPLETE IN A CLINICAL ROTATION If time is missed during the clinical affiliation which inhibits the student/learner’s ability to successfully complete the objectives for that Clinical Education course due to medical reasons or personal emergencies, then the student/learner will receive a grade of “Incomplete” for the course and may be able to complete the course during the next semester depending on the availability and cooperation of clinical sites. This will delay the graduation date by one semester or more depending upon the individual circumstances of the student. If students are having difficulty with the clinical education requirements, the students will be advised to discuss this with their CI and ACCE at Carrington College as soon as possible. Appropriate steps including tutoring and guidance may be considered.

CLINICAL SITE SUGGESTIONS & COMPLAINTS CIs or representatives of the clinical facility are encouraged to offer suggestions for ways to improve the quality of education offered at the Carrington College PTA program. Suggestions can be made via telephone, email, fax, mail, or in person to the ACCE or Program Director. CIs, representatives of the clinical facility, and patients of the clinical facility have the right to submit a complaint against Carrington College, the PTA program, its employees, and/or its students. If an issue arises, CIs or CCCEs are encouraged to follow the appropriate chain of command. The chain of communication and command should be as follows:

ACCE

Program Director

Dean of Academic Affairs

Campus Executive Director

Verbal communication is initially desired, but complaints may be submitted in writing if warranted. Patients should initially submit complaints with the CI or the clinical facility. If the need arises, the facility may direct the patient to contact the ACCE or PTA Program Director. It is the responsibility of the CI to make patients aware of their rights when being treated by a student of the Carrington College PTA program. The PTA Program Director will maintain records and outcomes of all complaints against the PTA program.

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 22

APPENDICES APPENDIX A: PHYSICAL EXAM FORM

PTA Program Physical Examination Form

This section must be completed and signed by your health care practitioner (MD, DO, NP, PA) Name Date DOB: Gender: M F Height Weight BP / Pulse Check the following if normal. If abnormal, please comment: Skin

Lymph Nodes

ENT

Vision

Neck

Lungs

Heart

Abdomen

Orthopedic

Neurologic

Hearing at 20 feet

Extremities

Range of motion Normal: Abnormal; Limitations

Yes No Is the student able to work with and around people? Are there any significant emotional problems? Does student have normal manual dexterity? Would you consider this person employable in the health care profession? Is student capable of lifting loads normally required of a PTA? (Up to 50#) I have examined the student and find no indications of any apparent condition(s) which might represent a possible hazard to the health of this student, fellow employees, patients, or others that would be in contact with this student. I have examined the student and find that he/she is free of the noted communicable diseases, but needs to Be seen by a physician to continue in this program. See comments below: Comments: Date: Examiner’s Signature: Address: Phone #: Fax #:

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 23

APPENDIX B: HEPATITIS B DECLINATION FORM

Student Hepatitis B Information/Declination Form

RISKS

Individuals who work in health care settings are at risk for contracting blood borne diseases. The Occupational

Safety and Health Administration (OSHA) issued a set of regulations designed to protect both patients and

health care workers. Specific training will be provided to students as soon as they begin the program in order to

minimize the risk.

HEPATITIS B

Hepatitis B is a blood borne viral infection. Most people with Hepatitis B recover completely, but the infection

can be fatal and approximately 5-10% of those infected can become chronic carriers of the virus. Most chronic

carriers have no symptoms but can continue to transmit the disease to others. Chronic carriers may develop

chronic active Hepatitis, cirrhosis and possible liver cancer.

VACCINATION

A vaccine for Hepatitis B has been developed, tested extensively and found to be effective in producing an

antibody, and thus protection against Hepatitis B, in 95-96% of health persons. Some persons who have

received the vaccine have complained of redness and soreness at the injection site. Other reported side effects

have been low grade fever, rash, nausea, joint pain and mild fatigue. Long-term side effects are unknown.

The vaccine is administered in three doses with one month between dose one and two, and six months between

dose one and three. The series must be completed in order to be effective.

OSHA strongly encourages students to be vaccinated: “Risks among health care professionals vary during the

training and working career of each individual but are often highest during the professional training period. For

this reason, when possible, vaccination should be completed during training in school of medicine, dentistry,

nursing, laboratory technology, and other allied health professions before workers have the first contact with

blood.” (OSHA: “Final Rule” Fed Reg. Pp 64089).

*************************************************************************************

DECLINATION

I have read the above statements about Hepatitis B and the Hepatitis B vaccine.

I have decided NOT to accept the Hepatitis B vaccine OR I have not completed the series.

Name: ____________________________________________ ___________________

Please Print Student ID#

Signed: ____________________________________________ ___________________

Student Signature Date

Signed: ____________________________________________ ___________________

ACCE Signature Date

Lack of compliance may impact program completion.

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 24

APPENDIX C: CRITERIA FOR SELECTION OF CLINICAL INSTRUCTORS

CRITERIA FOR SELECTION OF CLINICAL INSTRUCTORS**

For the Physical Therapist Assistant Program The Clinical Instructor (CI) shall:

1. Hold current Physical Therapist license or Physical Therapist Assistant licensure/certification in the

state he/she is practicing Physical Therapy services without reservation from the Nevada Board of

Physical Therapy.

2. Physical Therapist Assistants as clinical instructors will require supervision from a Physical Therapist

and work collaboratively with the Physical Therapist

3. Have at least one year’s post-licensure experience prior to assuming the role of the CI.

4. Use and abide by the APTA document, “Guidelines and Self-Assessments for Clinical Education.”

5. Have a regular patient load sufficient to provide the student(s) with an opportunity to apply knowledge

and increase skill in patient treatment.

6. Be committed to high quality Physical Therapist Assistant student education and support the Carrington

College- Las Vegas Campus Physical Therapist Assistant Program.

7. Express positive attitudes and willingness to work with the student(s) and faculty of Carrington

College- Las Vegas Campus.

8. Provide adequate supervision of patient interaction, treatment, and record keeping procedures

performed by the student(s).

9. Follow facilities system for maintaining records of patient evaluation, treatment, and progression.

10. Express willingness to follow written agreement between the clinical facility and Carrington College-

Las Vegas Campus.

11. Abide by all applicable state and federal laws and appropriate professional codes of ethics.

12. Follow Policies and Procedures of the Physical Therapist Assistant Program at Carrington College-Las

Vegas campus, the policies and procedures of the clinical site and the APTA Standards for Ethical

Conduct for Physical Therapist Assistant and Code of Ethics.

13. Agree to use the APTA document the Clinical Performance Instrument (CPI) as a student evaluation tool. (Training will be provided to the CI if he/she is unfamiliar or inexperienced with using the CPI.)

______________________________________________________________________ Academic Coordinator of Clinical Education/Date (Name/Signature) _______________________________________________________________________ Center Coordinator of Clinical Education of Clinical Site/Date (Name/Signature) ________________________________________________________________________ Clinical Instructor/Date (Name/Signature) ** When completed, please fax this form along with the CI resume to: ACCE PTA Program 702-688-4142

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 25

APPENDIX D: CONFIDENTIALITY STATEMENT

CARRINGTON COLLEGE

Confidentiality Statement

Throughout the Physical Therapist Assistant Program at Carrington College, I will have access to patient information. I (Name) _______________________________________ realize that this information is private and should be kept confidential. I realize that any unauthorized release of information is punishable by fine and/or imprisonment. (HIPAA) Throughout my education in the Physical Therapist Assistant Program at Carrington College I will at no time inappropriately release confidential information and I will adhere to the Code of Ethics of the American Physical Therapy Association. I understand that release of unauthorized patient information will result in immediate dismissal from the Carrington College Physical Therapist Assistant Program. Student Signature _______________________________________ Date _________________________________________________

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 26

APPENDIX E: STUDENT EVALUATION OF CI & SITE

5740 S. Eastern Avenue, Las Vegas, NV 89119 702-688-4142

CARRINGTON COLLEGE PHYSICAL THERAPIST ASSISTANT PROGRAM

STUDENT EVALUATION OF CLINICAL INSTRUCTOR and CLINICAL SITE

Student Name: _________________________Course: __________________________________________

Clinical Site:___________________________ Clinical Instructor:_______________________________ _

Please evaluate your clinical instructor using the following scale: 5 = completely agree 4 = strongly agree 3 = agree most of the time 2 = disagree 1 = strongly disagree

CRITERIA 5 4 3 2 1

COMMENTS

(CONTINUE ON NEXT PAGE OR

BACK IF NECESSARY)

Problem Solving/Critical Thinking

Encourages critical thinking 5 4 3 2 1

Encourages initiative 5 4 3 2 1

Provides assistance when needed 5 4 3 2 1

Clinical Performance/Competency

Knowledgeable in PT interventions 5 4 3 2 1

Is prepared and organized in clinic 5 4 3 2 1

Communication

Provides a non-threatening learning environment 5 4 3 2 1

Communicates expectations 5 4 3 2 1

Identifies strengths and weaknesses of students 5 4 3 2 1

Documents areas for student improvement 5 4 3 2 1

Professional Conduct

Expects professional accountability 5 4 3 2 1

Acts as a liaison between clinical site, Carrington

College and students 5 4 3 2 1

Adheres to the APTA Code of Ethics 5 4 3 2 1

Models professional behavior with patients 5 4 3 2 1

Models professional behavior with clinical staff/

healthcare providers 5 4 3 2 1

CLINICAL SITE

I felt I treated a diverse patient/client population 5 4 3 2 1

The equipment at the facility was current and in good

working condition 5 4 3 2 1

I utilized and was able to practice Physical Therapy

interventions under the guidance of the supervising

Physical Therapist

5 4 3 2 1

Personal safety precautions were emphasized as well

as during patient interventions 5 4 3 2 1

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 27

APPENDIX F: CLINICAL EDUCATION DISCLOSURE FORM Clinical Education Disclosure Form

One of the tasks of the clinical education component of the Physical Therapist Assistant (PTA) curriculum is to provide student/learners with the opportunity to work in a clinical setting with a diagnosed patient population. Through contractual arrangement, facilities have agreed to allow Carrington College PTA student/learners to work directly with their patients under the supervision of a clinical instructor who is employed by the clinical facility. This type of agreement relies heavily on the trust between the clinical facility and the PTA program’s academic preparation of the student/learner to be able to successfully integrate him or herself into the clinical environment. Faculty and Clinical Instructors (CI) are committed to student/learners’ successful completion of the clinical education component of the curriculum. In the event that a student/learner must re-take a Clinical Education course some decisions need to be made.

1. What remediation needs to take place for the student/learner to be more successful in the clinical setting? 2. Whether or not to disclose the reasons that the student/learner was not successful in the first attempt with

the clinical education course. 3. Which clinical sites would provide an opportunity for a student/learner to repeat a clinical education

course?

Every student/learner has the right to privacy with regard to his or her academic and clinical performance. This information is not disclosed to anyone without the expressed consent of the student/learner. When a student/learner needs to re-take a Clinical Education course it is the opinion of the PTA faculty that this information would be very helpful to disclose. Once the information is disclosed to the CI, a remediation plan can be developed by the PTA program faculty and implemented. This plan would be designed to assist the student/learner to become more successful as he or she re-takes the Clinical Education course. Please indicate whether or not you agree to let the PTA program faculty members disclose this information on your behalf and develop a remediation plan for you. Failure to grant this permission will make you ineligible for the development of any remediation when you re-take this clinical education course.

I agree to have the PTA program faculty disclose that I am re-taking this Clinical Education course, and the reasons that I need to re-take this course. I understand that the purpose of this disclosure is to help me be more successful.

I do not want the PTA program faculty to disclose any information about my re-taking this Clinical Education course. I understand that this makes me ineligible for the development of a remediation plan for this course.

Signature: ______________________________________ Date: ________________________

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 28

APPENDIX G: CLINICAL SKILLS SCHEDULE

Physical Therapist Assistant (PTA) PROGRAM CLINICAL SKILLS SCHEDULE

The course of study follows a hierarchical progression from rudimentary to complex academic and clinical experiences with the

primary goal of graduating an entry-level PTA that is well educated, ethical, professional, and compassionate. Skills competencies

checklists and practical examinations are incorporated into the PTA program to ensure that students have achieved entry level skill

and knowledge base for all therapeutic interventions, and that they are consistently practicing all critical safety and communication

elements. A student may only participate in a clinical experience once he/she has achieved a level of skills proficiency commensurate

with the objectives established in the program curriculum.

Semester 3A Semester 3a Semester 3b Semester 3b

PTA112 PTA224 PTA153 PTA177

Reviews plan of care and ensures readiness for treatment

Applies knowledge of contraindications and precautions for treatment

Hand washing: cleanser, soap

Introduction to patient, name and title, and confirming patient’s identity

Explanation of interventions & expectations, confirms comprehension

Obtains consent for treatment

Application of gait belt

Body Mechanics: deep squat, half kneel, golfers, & heavy objects lifts, pushing/pulling

Glove donning/ doffing

Precautions and PPE (droplet, contact, & airborne)

Transfers assisted: stand pivot, squat pivot, sliding board, floor to W/C

Transfers dependent: hoyer lift, 2 person W/C to bed

W/C components and fit

W/C propulsion & safety

Gait: parallel bars, axillary crutches, walker, SPC, quad cane, hemiwalker, lofstrands

Gait types: 2 point, 3 point, 4 point, swing to, swing through

Bed mobility

Prone to supine

Log rolling

Supine to Sit

Positioning in bed: with and without draw sheet

Positioning with support

Vital signs: Heart (Pulse) rate Respiration rate

Blood pressure Oxygen saturation level

Temperature

Anthropometrics (height, weight), BMI

Girth measurements

Sensory assessment: touch awareness, sharp/dull, 2pt discrimination, vibration, temperature

Sensory assessment: proprioception, kinesthesia

Deep tendon reflexes: patellar, Achilles, biceps, or triceps, brachioradialis, hamstrings

Goniometric measurements

Manual muscle testing: against gravity, gravity minimized

Leg length discrepancy

Muscle length testing

Pain: Numerical pain distress scale, visual analogue scale, faces pain rating scale, McGill-Melzack pain questionnaire

Cryotherapy: cold packs, ice massage, ice bath

Thermal modalities: US, SWD, paraffin, moist hot packs

Electrotherapy: NMES, IFC, TENS, iontophoresis

Hydrotherapy: aquatics, whirlpool

Mechanical Traction: cervical, lumbar

Compression therapy: intermittent, bandaging

Soft Tissue Mobilization

Massage Techniques

Special Tests: KNEE

Special Tests: SHOULDER

Special Tests: HIP

Special Tests: WRIST & HAND

AROM/PROM UE & LE

Stretching UE & LE: manual & self

PNF: hold relax, contract relax, rhythmic stabilization

Strengthening: isometric, concentric, isotonic, isokinetic, eccentric

Therapeutic exercise: OKC, CKC

Aerobic training: maxHR, target HR, BORG

Balance training: functional reaching, Romberg, perturbations

Spinal stabilization

Muscle length tests

Gait training

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 29

Semester 4a Semester 4b

PTA210 PTA

19

9 C

linical Ed

ucatio

n I

PTA223 PTA

25

9 C

linical Ed

ucatio

n III

PTA

28

9 C

linical Ed

ucatio

n III

Developmental sequencing

Observation of pediatric development

Assess arousal

Assess orientation Assess ability to follow commands

Sensory assessment: dermatomes, stereognosis, kinesthesia

Assess tone: synergies

Facilitation: approximation, tapping, vibration, quick stretch, Pressure

Inhibitory: approximation, rhythmic rotation, prolonged stretch, prolonged pressure

Assess righting reactions

Assess equilibrium reactions

Balance assessment & progression: static, dynamic, sitting, standing

Assess primitive reflexes

Supine progression

Prone progression

Assess postural reactions

Orientation to a vertical position with tilt table

SCI Interventions

SCI bed mobility, rolling, transfers

SCI W/C management & mobility

Skin Inspection

Pressure relief

CVA/TBI functional mobility: bed mobility, transfers, gait

NDT techniques

CVA/TBI therapeutic exercises PNF diagonals and techniques

Home/work assessment

Treatment interventions for OA & RA

Prosthetics: Don and doff, gait training, transfer training, skin inspection

Orthotics: Don and doff, gait training, transfer training, skin inspection

Amputations: therapeutic exercise, residual limb wrapping

Cardiac rehabilitation target heart rate, maxHR, RPE, exercise termination guidelines

Vestibular interventions

Wound/burn assessment

Whirlpool

Wound/burn dressing changes

Diaphragmatic breathing

Pursed Lip breathing

Postural drainage

Percussive therapy

Huff cough

Active breathing cycle Chest wall expansion/ excursion

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 30

APPENDIX H: CONSENT FOR RELEASE OF INFORMATION

I (NAME)_____________________________________authorize Carrington College to release the following

to health care facilities for clinical education courses:

attendance record

grade point average

instructor evaluations of skills and abilities

drug and background screens

immunization records

physical examination

photo ID

CPR

Yes No

I consent that Carrington College may release my name, home address, telephone number and e-mail address to

clinical sites.

Yes No

I consent that Carrington College may release performance information in regards to my academic preparation

from clinical affiliation sites.

Yes No

I consent that Carrington College may release performance information in regards to my academic preparation

from clinical affiliation sites, employers and consumers.

Yes No

Student Signature/Date_______________________________________

STUDENT CLINICAL EDUCATION HANDBOOK REV 01/2016 31

APPENDIX I: ACKNOWLEDGEMENT

Carrington College Physical Therapist Assistant Program

I, the undersigned, have received a copy of the Clinical Education Student Handbook. My signature acknowledges that this information has been explained to me and that I have been given the opportunity to ask questions about the content of the handbook. I understand that I will be held accountable for the expectations of students within this handbook as well as all PTA Program and Carrington College policies and procedures. My signature is provided voluntarily. I have retained my copy of the other pages. I will keep this Clinical Education Student Handbook as my guide throughout the PTA Program.

Student Name: __________________________________

Signature: ______________________________________

Date: __________________________________