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Physical Therapist Assistant Program
Clinical Education Handbook
Vice Presidency of Academic Affairs
2017 - 2018
Clinical Education Handbook – PTA Program
II
a
Table of Contents
Table of Contents ........................................................................................................................................... ii
List of Tables ............................................................................................................................................... viii
Table of Figures .......................................................................................................................................... viii
Message from the PTA Program Coordinator ................................................................................................. 1
Introduction ..................................................................................................................................................... 2
PTA Program Organizational Chart ................................................................................................................ 3
Faculty Directory ............................................................................................................................................. 4
Program Coordinator .................................................................................................................................. 4
Academic Coordinator of Clinical Education (ACCE) .............................................................................. 4
Full-time Faculty ........................................................................................................................................ 4
Part-time Faculty ........................................................................................................................................ 4
Policies and Information ................................................................................................................................. 5
Non-Discrimination Policy ......................................................................................................................... 5
ADA Information ....................................................................................................................................... 5
Students with Disabilities Policy ................................................................................................................ 5
Accreditation Status .................................................................................................................................... 5
Abbreviations used throughout this Manual .................................................................................................... 6
Accrediting Commission of Career Schools and Colleges .............................................................................. 6
Atenas College ................................................................................................................................................ 7
Institutional Vision Statement .................................................................................................................... 7
Institutional Mission Statement .................................................................................................................. 7
Vice Presidency of Academic Affairs ........................................................................................................ 7
Vision Statement of the Vice Presidency for Academic Affairs................................................................. 7
Mission Statement of the Vice Presidency for Academic Affairs .............................................................. 7
PTA Program Overview ............................................................................................................................. 8
PTA Program Philosophy ........................................................................................................................... 9
Clinical Education Handbook – PTA Program
III
PTA Program Vision Statement ................................................................................................................. 9
PTA Program Mission Statement ............................................................................................................... 9
Program Values ........................................................................................................................................ 10
Standards of Ethical Conducts....................................................................................................................... 10
Standard 1A .............................................................................................................................................. 11
Standard 2A .............................................................................................................................................. 11
Standard 3C .............................................................................................................................................. 11
Standard 3E .............................................................................................................................................. 11
Standard 4 ................................................................................................................................................. 11
Standard 4C .............................................................................................................................................. 12
Standard 4E .............................................................................................................................................. 12
Standard 5D and 5E .................................................................................................................................. 13
Standard 6A .............................................................................................................................................. 13
Standard 8A .............................................................................................................................................. 14
Program Goals and Outcomes ....................................................................................................................... 15
Goal #1 ..................................................................................................................................................... 15
Goal #2 ..................................................................................................................................................... 15
Goal #3 ..................................................................................................................................................... 15
Student Learning Outcomes – Graduate Profile Competencies .................................................................... 16
Student Learning Outcomes ..................................................................................................................... 16
Curriculum .................................................................................................................................................... 17
Curricular Conceptual Model ................................................................................................................... 17
Curricular Conceptual Model ................................................................................................................... 17
Curricular Plan .......................................................................................................................................... 17
General Education, Science, and Mathematics Courses ........................................................................... 18
Table 1. General Education, Science, and Mathematics Courses ........................................................ 18
Technical Courses .................................................................................................................................... 18
Table 2. Technical Courses .................................................................................................................. 18
Program Breakdown ................................................................................................................................. 18
Clinical Education Handbook – PTA Program
IV
Table 3. Program Breakdown .............................................................................................................. 18
Course Descriptions .................................................................................................................................. 19
Table 4. PTA Program Course Descriptions ........................................................................................ 19
Placement of PTA Program Students in Clinical Education Sites ................................................................. 23
Policy ........................................................................................................................................................ 23
Procedure: ................................................................................................................................................. 23
Clinical Education Requirements .................................................................................................................. 24
Table 5. Basic Requirements for Clinical Education: .......................................................................... 24
Procedure .................................................................................................................................................. 24
Management of Clinical Database ................................................................................................................. 25
Clinical Education .................................................................................................................................... 25
Clinical Education Site Selection Criteria ................................................................................................ 26
PTA Program Preceptor or Clinical Instructor Selection Criteria ................................................................. 27
Policy ........................................................................................................................................................ 27
Clinical Responsibilities ........................................................................................................................... 27
Rule .......................................................................................................................................................... 27
Responsibilities of Clinical Coordinators ................................................................................................. 27
Responsibilities of the Clinical Instructor ................................................................................................ 28
Responsibilities of the Academic Coordinator of Clinical Education (ACCE) ........................................ 28
Responsibilities of the Program ................................................................................................................ 28
Student Responsibilities ........................................................................................................................... 28
Rights of the Clinical Education Faculty ....................................................................................................... 29
Rule .......................................................................................................................................................... 29
Procedure .................................................................................................................................................. 29
Clinical Learning Outcomes / Assessment .................................................................................................... 30
Course Learning Outcomes for Clinical Practice I and II. ........................................................................ 30
PTA 2201 – Clinical Education I. ............................................................................................................. 32
PTA 2202 – Clinical Education II. ........................................................................................................... 32
Critical Safety / Performance Elements. ................................................................................................... 33
Clinical Education Handbook – PTA Program
V
Development of Competencies throughout the Curriculum. .................................................................... 33
Table 6. Development of Competencies throughout the Curriculum .................................................. 33
Summary of courses approved according to the locations of clinical practice. ........................................ 38
Table 7. Summary of courses approved according to the locations of clinical practice ...................... 38
Development of the Clinical Affiliation ........................................................................................................ 39
Procedure .................................................................................................................................................. 39
Student Dress Code and Conduct for Clinical Practice ................................................................................. 40
Rule .......................................................................................................................................................... 40
Professional Behavior in the Clinic ............................................................................................................... 41
Identification............................................................................................................................................. 41
Documentation ......................................................................................................................................... 41
Environmental Adjustment ....................................................................................................................... 42
Legal Issues .............................................................................................................................................. 42
Behavior ................................................................................................................................................... 43
Parking ...................................................................................................................................................... 43
Communication ........................................................................................................................................ 43
Clinical Attendance ....................................................................................................................................... 44
Rule .......................................................................................................................................................... 44
Procedure for Missed Examination/Practical/Presentation. ...................................................................... 44
Procedure for Missed Clinical Attendance. .............................................................................................. 44
Clinical Grading ............................................................................................................................................ 45
Rule .......................................................................................................................................................... 45
Students Experiencing Difficulty in Clinical Rotation ............................................................................. 45
Procedure .................................................................................................................................................. 45
Clinical Program Assessment ........................................................................................................................ 45
Policy ........................................................................................................................................................ 45
Procedure .................................................................................................................................................. 45
Program Evaluation by Clinical Instructors .............................................................................................. 45
Program Evaluation by the ACCE ............................................................................................................ 45
Clinical Education Handbook – PTA Program
VI
Program Evaluation by Students .............................................................................................................. 46
Clinical Safety Guidelines ........................................................................................................................ 46
Infection control ....................................................................................................................................... 46
Clinical education site safety .................................................................................................................... 46
Standard Precautions ................................................................................................................................ 46
CDC standard precautions for infection control. ...................................................................................... 47
Exposure to Blood and Pathogens ................................................................................................................. 49
Protocol .................................................................................................................................................... 49
Purpose ..................................................................................................................................................... 49
Scope ........................................................................................................................................................ 49
Accident or injury while in the clinical setting .............................................................................................. 51
Accidental Sharp Injuries .............................................................................................................................. 51
Procedure .................................................................................................................................................. 51
Emergency Situations during Clinical Experience ................................................................................... 51
Smoking .................................................................................................................................................... 51
Health Insurance ....................................................................................................................................... 51
Policy on Student Claims and Complaints .................................................................................................... 52
Purpose ..................................................................................................................................................... 52
Procedure .................................................................................................................................................. 52
Accrediting Commission of Career School and Colleges ............................................................................. 53
Right to due process for students and faculty ........................................................................................... 53
Patient’s Informed Consent ...................................................................................................................... 53
Procedure .................................................................................................................................................. 54
Clinical Supervision of Student Physical Therapist Assistants ................................................................ 54
Supervision of Student Physical Therapist Assistants [APTA Position] .................................................. 54
Supervision and Direction of the Physical Therapist Assistant ................................................................ 55
Regardless of the setting in which the physical therapy service is provided, the following responsibilities
must be borne solely by the physical therapist: ...................................................................................................... 55
Clinical Education Handbook – PTA Program
VII
In determining the appropriate extent of assistance from the physical therapist assistant (PTA), the
physical therapist considers: ................................................................................................................................... 56
Supervision of the Physical Therapist Assistant ....................................................................................... 56
The American Physical Therapy Association recognizes the following levels of supervision for the
Physical Therapist Assistant (Levels of Supervision HOD P06-00-15-26): ........................................................... 57
Clinical Education Handbook – PTA Program
VIII
List of Tables
Table 1. General Education, Science, and Mathematics Courses ................................................................................ 17
Table 2. Technical Courses.......................................................................................................................................... 17
Table 3. Program Breakdown ...................................................................................................................................... 17
Table 4. PTA Program Course Description ................................................................................................................. 18
Table 5. Basic Requirements for Clinical Education ................................................................................................... 23
Table 6. Development of Competencies throughout the Curriculum .......................................................................... 32
Table 7. Summary of Courses Approved according to the Locations of Clinical Practice .......................................... 37
Table of Figures
Figure 1. PTA Program Organizational Chart ............................................................................................................... 3
Figure 2. PTA Curricular Conceptual Model .............................................................................................................. 16
Clinical Education Handbook – PTA Program
1
Message from the PTA Program Coordinator
Dear Student:
Welcome to the Atenas College Associate Degree Program in Physical Therapist
Assistant (PTA). You have been selected among the best candidates to be part of
the PTA program; you stand now on a privileged place to walk your first steps
towards becoming a PTA.
Atenas College is committed to prepare competent physical therapist assistants to
work under the direction and supervision of a physical therapist in safe, legal-
ethical way. You will have the support of a committed faculty that will accompany
you step-by-step throughout your training as a health professional. We will provide
all the necessary tools for your formation and practical learning, which integrate
Atenas College Simulation and Clinical Learning Center (Simulated Hospital) with
fully equipped laboratories for the development of the competencies established in
the program.
It is important to realize that in the road to success, your commitment, passion, and
dedication are key to reach the best results to perform as a Physical Therapist
Assistant and to triumph in your board exam. I trust that your experience in the
program will very satisfying and enriching.
Once again, welcome!
Naborí Benítez Viera, PTA, MPhEd
PTA Program Coordinator
Clinical Education Handbook – PTA Program
2
Introduction
This handbook aims to provide a guide for students, clinical instructors, and center
coordinators of clinical education, among others, to ensure high quality clinical
experiences directed to promote the student learning process. Clinical experiences
provide students with the opportunity to integrate and apply knowledge, skills, and
professional values and attitudes. The integration of knowledge and skills that
occurs in the clinical setting provides the opportunity for developing competent
Physical Therapist Assistants who are able to perform within their scope of
practice, according to the standards of physical therapy care, including the ability to
interact with patients, families, physical therapists, and other health care
professionals. Good, collaborative relationships between clinical education sites
and the academic program are the key to successful clinical experiences. Atenas
College administration is committed to develop and maintain coordinated, efficient,
and fruitful associations with clinical instructors and clinical site administrators.
Clinical experience goals include:
● Integrating previously learned knowledge and skills into the clinical
scenario.
● Apply the Physical Therapy Assistant standards of conduct, exhibiting
commitment to the physical therapy core values in all interactions
with patients, families, clinical instructors, and others.
● Attain Physical Therapist Assistant entry-level competencies to
perform procedures within the scope of practice.
Clinical Education Handbook – PTA Program
3
PTA Program Organizational Chart
Figure 1. PTA Program Organizational Chart
Governing Board
Dr. María L. Hernández
President
Widalys González Ortiz
VP for Academic Affairs
Dr. Cenia Romano Ramírez
Associate VP for Academic Affairs
Naborí Benítez Viera
PTA Program Coordinator
Program FacultyAcademic
Coordinator of Clinical Education
Clinical Faculty
Consultants
Clinical Education Handbook – PTA Program
4
Faculty Directory
Program Coordinator Naborí Benítez Viera, PTA, MPhEd
Phone: 787-529-3334
Office location: Annex C
Second Floor
Academic Coordinator of
Clinical Education (ACCE) Elda Santiago
Phone: 787-479-0730
Office location: Annex C
Second Floor
Full-time Faculty Yadira Rodríguez
Phone: 787-638-5534
Office location: Annex C
Part-time Faculty Joan Morales
Office Location: Annex C
Noelia Gómez
Office Location: Annex C
Clinical Education Handbook – PTA Program
5
Policies and Information
Non-Discrimination Policy All students admitted to the PTA Program must adhere and comply with the
institutional non-discrimination policy.
Atenas College guarantees equal opportunity in all its educational programs,
services, and benefits. This institution does not discriminate for reasons of race,
color, religion, gender, origin, disability, age, marital status, physical appearance,
political affiliation, or any other classification protected by the provisions of title
IV of the Amendments to Education of 1992, the American with Disabilities Act,
and any other federal or state law or regulation applicable.
ADA Information Atenas College complies with the dispositions of the American with Disabilities
Act of 1990, Section 504 of the Amended Federal Rehabilitation Act of 1973,
Section 508 of the Rehabilitation Act of 20000, and the ADAAA of 2009 to ensure
equal access to education, facilities, services, and activities. Confidentiality is
guaranteed.
Students with Disabilities
Policy In harmony with its mission and vision statements, Atenas College has established
this policy to ensure students with disabilities receive equal services in the
academic and clinical education area.
1. The student shall notify the admission staff of any disability while in the
admission process.
2. At the beginning of each academic session, the student will relate the
information on his/her condition to the professor or an authorized academic
representative.
3. The professor or authorized academic representative will in turn, forward the
information, in writing, to the counselor and program director for the
corresponding action (safeguarding confidentiality of the information).
4. The counselor is responsible of interviewing the student and offering guidance
about his/her rights, and the services available at the institution.
5. If the student accepts the services offered, he/she must complete the
Reasonable Accommodation Request form (see Appendix 1), to initiate the
process. The Counselor is responsible for keeping a file for the proper follow
up. A copy of said file shall be kept in the student’s academic record in the
Office of the Registrar.
Accreditation Status Atenas College PTA Program is approved by the Puerto Rico Council of Education
and the Accrediting Commissions of Schools and Careers (ACCSC). The current
Accreditation Status with the Commission on Accreditation for Physical
Therapy Education (CAPTE) is as follows:
Effective November 11, 2015, Physical Therapist Assistant Program/Atenas
College has been granted Candidate for Accreditation status by the Commission on
Accreditation in Physical Therapy Education (1111 North Fairfax Street,
Alexandria, VA, 22314; phone: 703-706-3245; email: [email protected]).
Candidate for Accreditation is a pre-accreditation status of affiliation with the
Commission on Accreditation in Physical Therapy Education that indicates that the
program is progressing toward accreditation and may matriculate students in
technical courses. Candidate for Accreditation is not an accreditation status nor
does it assure eventual accreditation.
Clinical Education Handbook – PTA Program
6
Abbreviations used throughout this Manual
ACCSC Accrediting Commission of Career Schools and Colleges
AC Atenas College
CAPTE Commission on Accreditation for Physical Therapy Education
ACCE Academic Coordinator for Clinical Education
CCCE Center Coordinator for Clinical Education
CI Clinical Instructor
PT Physical Therapist
PTA Physical Therapist Assistant
APTA American Physical Therapy Association
Clinical Education Handbook – PTA Program
7
Atenas College
Atenas College was founded under the leadership of Dr. María L. Hernández, on
October 7, 1996, in Manatí, Puerto Rico. It is currently accredited by the
Accrediting Commission of Career Schools and Colleges (ACCSC), and offers
technical certificates, associate and bachelor degrees in health-related areas.
Atenas College stands out for integrating clinical simulation laboratories for the
development of clinical competencies.
Institutional Vision
Statement To be a vanguard, pertinent, enterprising, and proactive institution of higher
education, nationally and internationally recognized; establishing collaboration
alliances that will make it socially and fiscally sustainable.
Institutional Mission
Statement We are a higher education institution that offers academic options in various
modalities, that integrates arts, science, information technologies, and
communication. We promote a culture of service focused on the student of the
Puerto Rican and worldwide community, fostering a humanistic and
comprehensive formation that increases the competencies of the individual.
Vice Presidency of
Academic Affairs The Vice Presidency for Academic Affairs as the purpose of promoting,
supervising, and coordinating all academic aspects of the units, upholding the
highest standards of excellence in teaching and service. Responsible for the
planning, development, and assessment of academic programs, this team is
comprised of the Vice President for Academic Affairs, two Associate Vice
Presidents for Academic Affairs, the Associate Vice President for Academic and
Administrative Affairs, the Simulation and Clinical Learning Center Director, the
Registrar, and the Program Directors and Coordinators.
Vision Statement of the Vice
Presidency for Academic
Affairs
In line with Atenas College vision statement, the Vice Presidency for Academic
Affairs, provides academic services and maintains a diverse academic offering that
integrates general, core, and professional competencies. Through the
implementation of our educational model and the development of curricular and
extracurricular activities, we promote a humanistic formation that increases the
competencies of our students.
Mission Statement of the
Vice Presidency for
Academic Affairs
The mission statement of the Vice Presidency for Academic Affairs is to be the
engine that drives the institution to a competitive level, graduating competent
students who are committed to the community to which they serve. To use
technology to provide excellence service and promote agility in academic
processes. To be at the forefront of higher education in Puerto Rico through the
integration of strategies and novel modalities that respond to the needs of the
student of the 21st Century.
Clinical Education Handbook – PTA Program
8
PTA Program Overview The Associate Degree Program in Physical Therapists Assistant is authorized to
operate by the Puerto Rico Council of Education. It has also begun the process to
obtain candidacy status for professional accreditation by the Commission on
Accreditation in Physical Therapy Education (CAPTE).
The PTA Program faculty is committed with the continuous development of
professional and teaching skills aimed to engage students in an active and effective
learning environment.
Furthermore, students will be capable of showing evidence of skills in planning;
instructional delivery including mastery of course content; and student learning
assessment consistent with an enriched and active environment.
The PTA Program is expected to provide integrated, state of the art, high-quality
hands-on training experiences, through simulation laboratories, peer-practice
laboratories, and supervised clinical experiences to promote the achievement of the
graduate profile and program outcomes. The Program has three laboratories with
the equipment and materials needed for skills development, which are part of the
Simulation and Clinical Learning Center.
In compliance with CAPTE rules and standards, the PTA Program exceeds 125%
of clinical education sites evidenced with letters of intent and agreements. These
clinical sites will provide students with the opportunity to demonstrate achievement
of the expected competencies.
The PTA Program Advisory Committee, comprised by Physical Therapists and
Physical Therapist Assistants, provides informed guidance and advisement to the
program. In addition, the program has consultants in clinical and education areas.
The PTA Program is committed to enable our graduates to provide high quality
clinical care as entry-level PTA under the direction and supervision of a Physical
Therapist.
Clinical Education Handbook – PTA Program
9
PTA Program Philosophy The Associate Degree Program in Physical Therapist Assistant, in line with the
philosophy of Atenas College and that of its Degree Division, is committed to
develop Physical Therapist Assistants that have the knowledge, the abilities, the
values, and the competencies expected for this level of training, and know their
capabilities, acknowledge their opportunities for development, assume
responsibility for themselves, and respond within their capabilities, to the social
needs of health and wellbeing.
We believe that internal reflection of the human being is continuous, as part of the
interaction with its context. Variations of this context, as well as its interpretation,
determine thoughts, acts, and the capability for adaptation, which constitute part of
the growing and development processes. The human being is influenced by past
and present experiences, heritage and environment, and through reflective action
and self-criticism is capable of learning and become an educated person. The PTA
Program faculty is committed to establish and maintain an enriched environment,
which promotes active learning of the technical skills necessary to perform as a
Physical Therapist Assistant, through flexibility, openness, respect, appreciation of
differences, and the use of strategies and learning and evaluating contemporary
techniques that promote integration of “knowing”, “valuing”, and “doing”.
We believe in the fundamental value of optimum health. Likewise, we have
adopted the understanding that the human being is capable of such health state
through dynamic and continuous interaction between their health condition,
environmental or context factors, and personal factor. Physical Therapy directly
contributes to achieving an optimum health state, to minimize consequences of
illness, and to improve the quality of life of the patient, providing care centered in
their needs and problems.
We prepare students who are capable of assuming their duty to serve in a
responsible, effective, ethical, safe, and legal way, toward the profession, patients
and their family and significant others, as well as to society; and capable of
exhibiting a conduct based on each of the values expected from Physical Therapist
Assistants, as adopted by the American Physical Therapy Association in January,
2011.
PTA Program Vision
Statement In line with the institutional vision statement, the vision statement of the Associate
Degree Program in Physical Therapist Assistant is to be an educational program
known for its excellence in learning through innovative strategies, among which
simulation stands out. We expect the program to be distinguished for its input to
the educational field, developing competent professionals and establishing
collaboration alliances at a local, national, and international level in addition to
being leaders in Physical Therapist Assistants training.
PTA Program Mission
Statement In line with the institutional mission statement, the mission statement of the
Associate Degree Program in Physical Therapist Assistant is to provide student
training aimed to develop the expected competencies for an entry-level Physical
Therapist Assistant, and to work under the direction and supervision of a Physical
Therapist in a safe, ethical, and legal manner. Furthermore, the program seeks to
develop graduates who can assume responsibility for themselves and to respond,
within their scope of practice, to the needs of health and wellbeing of the
community.
Clinical Education Handbook – PTA Program
10
Program Values
The PTA Program management adopts the core values of the Physical Therapist
Assistant as defined by the American Physical Therapy Association1 and is
committed to base all its actions in such values. Student conduct must show
adherence to these values in all its actions within the program, including visits and
clinical experiences in clinical education sites. The core values of the Physical
Therapist Assistant are:
Altruism – Altruism is the main consideration or devotion for the
patient/client’s interest, assuming the responsibility of placing their needs
before the PTA’s own.
Care and Compassion – Compassion is the desire to identify with or feel
something for the experience of others, a precursor to care. Care is the
preoccupation, empathy, and consideration for the needs and values of others.
Ongoing Competency – Ongoing competency is the permanent process of
maintaining and documenting through continuous self-evaluation, the
development and implementation of a personal learning plan and subsequent
reevaluation.
Duty – Duty is the commitment to meet the proper obligations to provide
efficient physical therapy services to individual patients/clients, to serve the
profession, and to influence society’s health in a positive way.
Integrity – Integrity is the firm adherence to high principles or ethical
standards; truthfulness, impartiality, to do what you say you are going to do,
and to talk “straight” about why you are doing what you are doing.
PT/PTA Collaboration - The PT/PTA team works united within their
respective roles to reach optimum patient/client care and improve the general
rendering of physical therapy services.
Responsibility – Responsibility is the active accepting of roles, obligations,
and actions of the PTA, including conducts that positively influence the
outcomes of the patient/client, the profession, and the health needs of society.
Social Responsibility – Social responsibility is the promotion of mutual trust
between the PTA as a member of the profession, and the public that needs to
respond to the social needs of health and wellbeing.
Standards of Ethical Conducts
The PTA Program management adopts the Standards of Ethical Conduct of the
Physical Therapist Assistant as defined by the American Physical Therapy
Association 2 and is committed to act according to these. The student must exhibit
compliance with theses ethical principles in all their actions within the program,
including the field and clinical experiences. The standards of ethical conduct of the
PTA are:
2 Physical Therapist Assistant Standards of Ethical Conduct. American Physical Therapy Association. Retrieved from:
http://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Ethics/GuideforConductofthePTA.pdf.. April 2015.
Clinical Education Handbook – PTA Program
11
Standard 1A Respect: Physical therapist assistants shall act in a respectful manner toward each
person regardless of age, gender, race, nationality, religion, ethnicity, social or
economic status, sexual orientation, health condition, or disability.
Interpretation: Standard 1A addresses the display of respect toward others.
Unfortunately, there is no universal consensus about what respect looks like in
every situation. For example, direct eye contact is viewed as respectful and
courteous in some cultures and inappropriate in others. It is up to the individual to
assess the appropriateness of behavior in various situations.
Standard 2A Altruism – 2A. Physical therapist assistants shall act in the best interests of
patients/clients over the interests of the physical therapist assistant.
Interpretation: Standard 2A addresses acting in the best interest of patients/clients
over the interests of the physical therapist assistant. Often this is done without
thought, but sometimes, especially at the end of the day when the clinician is
fatigued and ready to go home, it is a conscious decision. For example, the physical
therapist assistant may need to make a decision between leaving on time and
staying at work longer to see a patient who was 15 minutes late for an appointment.
Standard 3C Sound Decisions – 3C. Physical therapist assistants shall make decisions based
upon their level of competence and consistent with patient/client values.
Interpretation: To fulfill 3C, the physical therapist assistant must be
knowledgeable about his or her legal scope of work as well as level of competence.
As a physical therapist assistant gains experience and additional knowledge, there
may be areas of physical therapy interventions in which he or she displays
advanced skills. At the same time, other previously gained knowledge and skill
may be lost due to lack of use. To make sound decisions, the physical therapist
assistant must be able to self-reflect on his or her current level of competence.
Standard 3E Supervision - 3E. Physical therapist assistants shall provide physical therapy
services under the direction and supervision of a physical therapist and shall
communicate with the physical therapist when patient/client status requires
modifications to the established plan of care.
Interpretation: Standard 3E goes beyond simply stating that the physical therapist
assistant operates under the supervision of the physical therapist. Although a
physical therapist retains responsibility for the patient/client throughout the episode
of care, this standard requires the physical therapist assistant to take action by
communicating with the supervising physical therapist when changes in the
patient/client status indicate that modifications to the plan of care may be needed.
Further information on supervision via APTA policies and resources is available on
the APTA Web site.
Standard 4 Integrity in Relationships - 4: Physical therapist assistants shall demonstrate
integrity in their relationships with patients/clients, families, colleagues, students,
other health care providers, employers, payers, and the public.
Interpretation: Standard 4 addresses the need for integrity in relationships. This is
not limited to relationships with patients/clients, but includes everyone physical
therapist assistants come into contact with in the normal provision of physical
therapy services. For example, demonstrating integrity could encompass working
collaboratively with the health care team and taking responsibility for one’s role as
a member of that team.
Clinical Education Handbook – PTA Program
12
Standard 4C Reporting - 4C. Physical therapist assistants shall discourage misconduct by health
care professionals and report illegal or unethical acts to the relevant authority, when
appropriate.
Interpretation: When considering the application of “when appropriate” under
Standard 4C, keep in mind that not all allegedly illegal or unethical acts should be
reported immediately to an agency/authority. The determination of when to do so
depends upon each situation’s unique set of facts, applicable laws, regulations, and
policies.
Depending upon those facts, it might be appropriate to communicate with the
individuals involved. Consider whether the action has been corrected, and in that
case, not reporting may be the most appropriate action. Note, however, that when
an agency/authority does examine a potential ethical issue, fact finding will be its
first step. The determination of ethicality requires an understanding of all of the
relevant facts, but may still be subject to interpretation.
The EJC Opinion titled: Topic: Preserving Confidences, Physical Therapist's
Reporting Obligation With Respect to Unethical, Incompetent, or Illegal Acts
provides further information on the complexities of reporting.
Standard 4E Exploitation - 4E. Physical therapist assistants shall not engage in any sexual
relationship with any of their patients/clients, supervisees, or students.
Interpretation: The statement is fairly clear – sexual relationships with their
patients/clients, supervisees or students are prohibited. This component of Standard
4 is consistent with Standard 4B, which states:
4B. Physical therapist assistants shall not exploit persons over whom they have
supervisory, evaluative or other authority (eg, patients/clients, students,
supervisees, research participants, or employees).
Next, consider this excerpt from the EJC Opinion titled Topic: Sexual
Relationships With Patients/Former Patients (modified for physical therapist
assistants):
A physical therapist [assistant] stands in a relationship of trust to each patient and
has an ethical obligation to act in the patient's best interest and to avoid any
exploitation or abuse of the patient. Thus, if a physical therapist [assistant] has
natural feelings of attraction toward a patient, he/she must sublimate those feelings
in order to avoid sexual exploitation of the patient.
One’s ethical decision making process should focus on whether the patient/client,
supervisee or student is being exploited. In this context, questions have been asked
about whether one can have a sexual relationship once the patient/client
relationship ends. To this question, the EJC has opined as follows:
The Committee does not believe it feasible to establish any bright-line rule for
when, if ever, initiation of a romantic/sexual relationship with a former patient
would be ethically permissible.
The Committee imagines that in some cases a romantic/sexual relationship would
not offend ... if initiated with a former patient soon after the termination of
treatment, while in others such a relationship might never be appropriate.
Clinical Education Handbook – PTA Program
13
Standard 5D and 5E Colleague Impairment - 5D. Physical therapist assistants shall encourage
colleagues with physical, psychological, or substance-related impairments that may
adversely impact their professional responsibilities to seek assistance or counsel.
5E. Physical therapist assistants who have knowledge that a colleague is unable to
perform their professional responsibilities with reasonable skill and safety shall
report this information to the appropriate authority.
Interpretation: The central tenet of Standard 5D and 5E is that inaction is not an
option for a physical therapist assistant when faced with the circumstances
described. Standard 5D states that a physical therapist assistant shall encourage
colleagues to seek assistance or counsel while Standard 5E addresses reporting
information to the appropriate authority.
5D and 5E both require a factual determination on the physical therapist assistant’s
part. This may be challenging in the sense that you might not know or it might be
difficult for you to determine whether someone in fact has a physical,
psychological, or substance-related impairment. In addition, it might be difficult to
determine whether such impairment may be adversely affecting someone’s work
responsibilities.
Moreover, once you do make these determinations, the obligation under 5D centers
not on reporting, but on encouraging the colleague to seek assistance. However, the
obligation under 5E does focus on reporting. But note that 5E discusses reporting
when a colleague is unable to perform, whereas 5D discusses encouraging
colleagues to seek assistance when the impairment may adversely affect his or her
professional responsibilities. So, 5D discusses something that may be affecting
performance, whereas 5E addresses a situation in which someone is clearly unable
to perform. The 2 situations are distinct. In addition, it is important to note that 5E
does not mandate to whom you report; it gives you discretion to determine the
appropriate authority.
The EJC Opinion titled Topic: Preserving Confidences, Physical Therapist's
Reporting Obligation With Respect to Unethical, Incompetent, or Illegal Acts
provides further information on the complexities of reporting.
Standard 6A Clinical Competence - 6A. Physical therapist assistants shall achieve and maintain
clinical competence.
Interpretation: 6A should cause physical therapist assistants to reflect on their
current level of clinical competence, to identify and address gaps in clinical
competence, and to commit to the maintenance of clinical competence throughout
their career. The supervising physical therapist can be a valuable partner in
identifying areas of knowledge and skill that the physical therapist assistant needs
for clinical competence and to meet the needs of the individual physical therapist,
which may vary according to areas of interest and expertise. Further, the physical
therapist assistant may request that the physical therapist serve as a mentor to assist
him or her in acquiring the needed.
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Standard 8A Support - Health Needs - 8A. Physical therapist assistants shall support
organizations that meet the health needs of people who are economically
disadvantaged, uninsured, and underinsured.
Interpretation: 8A addresses the issue of support for those least likely to be able to
afford physical therapy services. The Standard does not specify the type of support
that is required. Physical therapist assistants may express support through
volunteerism, financial contributions, advocacy, education, or simply promoting
their work in conversations with colleagues. When providing such services,
including pro bono services, physical therapist assistants must comply with
applicable laws, and as such work under the direction and supervision of a physical
therapist. Additional resources on pro bono physical therapy services are available
on the APTA Web site.
Issued by the Ethics and Judicial Committee
American Physical Therapy Association
October 1981
Last Amended November 2010
Last Updated: 9/4/13
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Program Goals and Outcomes
The program goals and outcomes provide guidance and direct the faculty towards
what we want to develop, create, or maintain for the correct operation of the
program. The following are the program goals and their respective outcomes. It is
important for the student to become familiar with these goals and outcomes to
ensure an active role in the process of compliance.
Goal #1 The PTA Program faculty will demonstrate ongoing development of professional
and teaching skills aimed to engage students in an active and effective learning
environment.
Outcomes
Upon the annual review, the faculty will evidence the following:
Planning skills; instructional delivery, including mastering of course content;
student learning assessment consistent with an enriched and active
environment.
Upon the annual review, the clinical faculty will evidence the following:
Clinical instruction delivery according to the program goals and expectations.
Goal #2 The PTA Program will provide integrated, up-to-date, high-quality training
experiences through simulation laboratories, peer-practice laboratories, and
supervised clinical experiences to promote achievement of the graduate profile and
program outcomes.
Outcomes
Outcome #1 – To ensure that ninety percent (90%) of program graduates are
satisfied at the end of their academic training.
Outcome #2 – To achieve retention of sixty-five percent (65%) of the student
cohort.
Outcome #3 – To achieve that eighty-five percent (85%) of program graduates
approve the board exam.
Outcome #4 – To achieve ninety percent (90%) employability of program
graduates within one year.
Goal #3 After successfully completing the program, the student will be able to provide high-
quality clinical care as an entry-level PTA, under the direction and supervision of a
PT.
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Student Learning Outcomes – Graduate Profile
Competencies Program Graduates will be able to:
Competencies Student Learning Outcomes
Professional Standards
Patient-centered care
Quality and Safety
Behave in a safe, ethical and legal manner adherent to the standards, regulations,
and values of the physical therapist assistant, to provide patient-centered care, and
meet the expectations of the patient/client, family, the physical therapy profession,
and other health care professionals, acknowledging the individual and cultural
differences. Communication
Patient education
Acquisition of information
Communicate effectively with the patient/client, family, and other members of the
health care team, in a verbal, non-verbal and written manner, for the collection,
documentation, and reporting of data regarding patient status and performance
according to the plan of care. Decision Making
Evidence Based practice Incorporate evidence-based practice to support appropriate clinical decision-
making towards patient/client progression within the plan of care established by the
physical therapist, with knowledge, clinical judgment, critical thinking, responding
to the intervention with consistency, competency, and quality. Use of technology Use technology systems to carry out their function in the rendering of physical
therapy services and obtain information, record data about patient intervention,
billing, and payments, aimed at achieving organizational planning. Collaboration and
Teamwork Collaborate with the interdisciplinary team in the implementation of appropriate
management practices within the physical therapy service. Patient education
Collaboration and
Teamwork
Competently demonstrate abilities for the implementation of instruction and
education programs aimed at achieving goals set by the physical therapist for
patients/clients, family members, caregivers, health providers, and community,
safely, effectively, and efficiently. Plan of Care Demonstrate competent behaviors in their commitment to their roles and
responsibilities as physical therapist assistants, to administer physical therapy
established in the plan of care, under the direction and supervision of a physical
therapist. Professional development Participate in community and professional organization activities that promote
professional development and lifelong learning.
Clinical Education Handbook – PTA Program
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Curriculum Curricular Conceptual
Model The PTA Program developed a Curricular Conceptual Model to ensure interrelation
between all its components. In its center, as focus for the other elements, is the
entry-level PTA. The main objective is to develop a competent entry-level PTA.
The graduate profile is necessary for the development of the expected
competencies. The program maintains a special relation with its philosophy,
mission, vision, and goals and expected outcomes. Its curricular plan was designed
taking into consideration all necessary elements to obtain the expected
competencies, values, and standards for the Graduate Profile. An Assessment Plan
will be applied to ensure all components reach their expectations. This is a
continuous and systematic model.
Students will be able to demonstrate their skills, knowledge, attitudes, values, and
standards, inside and outside the program. These components aim mostly to the
exterior aspect of the program, since graduates must maintain their commitment
with ongoing and permanent learning.
Curricular Conceptual
Model
Curricular Plan The institution’s educational approach is founded on the four pillars of education:
learning to know, learning to do, learning to be, and learning to live together. The
PTA Program is designed to provide competencies-based education, which is based
on the active role of the students as primary responsible for their learning. Courses
focus in competencies for the graduate profile, course objectives, and learning
outcomes, where students can demonstrate their knowledge after an academic
activity and at the end of the course. In order to achieve this, we use a reverse
curriculum design. The principles of this model propose to establish objective and
learning outcomes prior to selecting instructional methods and ways of assessment.
The three stages of the reverse curriculum are to identify the expected outcomes, to
determine the acceptable levels of evidence that support achievement of the
expected outcomes, and to design activities to reach the expected outcomes.
Clinical Education Handbook – PTA Program
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General Education, Science, and Mathematics Courses
Table 1. General Education, Science, and Mathematics Courses
Coding Course Title Hours Credits
BIO1101 Human Anatomy and Physiology I 75 4
BIO1102 Human Anatomy and Physiology II 75 4
COM1100 Introduction to Informatics 45 2
ING1101 English, I 45 3
ING1102 English II 45 3
ESP1101 Spanish I 45 3
ESP1102 Spanish II 45 3
MAT1200 General Mathematics 45 3
PRE1100 Preparation for Student Life 15 1
PSI1100 General Psychology 45 3
TER1200 Medical Terminology 30 2
Technical Courses
Table 2. Technical Courses
Coding Course Title Hours Credits
PTA1000 Introduction to Physical Therapy and Legal-Ethical
Aspects
30 2
PTA1100 Clinical Kinesiology 60 3
PTA1200 Pathological Conditions in Physical Therapy 30 2
PTA1300 Principles and Technics in Patient Care in Physical
Therapy
90 3
PTA1400 Therapeutic Massage 75 3
PTA1500 Therapeutic Modalities in Rehabilitation 105 4
PTA2000 Therapeutic Exercise Techniques 60 2
PTA2100 Physical Therapy applied to Pediatric Patients 90 3
PTA2201 Clinical Practice I 255 5
PTA2300 Neurological Rehabilitation 60 3
PTA2400 Orthopedic Rehabilitation 60 3
PTA2202 Clinical Practice II 375 7
Program Breakdown
Table 3. Program Breakdown
Length
24 months
General Courses,
Science, and
Mathematics
Technical Course Total
Credits 31 40 71
Hours 510 1,290 1,800
Credential Associate Degree in Physical Therapist Assistant
Total Credits Total Clock-Hours
71 credits 1,800 hours
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Course Descriptions
Table 4. PTA Program Course Descriptions
BIO1101 Human Anatomy and Physiology I 4 credits
This course addresses the human anatomical structure and its relationship with the functions of the body. It
discusses the main body systems emphasizing in its structure and functions. It relates students to the functioning
of cells, tissues, and the integumentary, skeletal, muscular, nervous, and endocrine systems. This course meets
three (3) hours for theory and two (2) hours for supervised laboratory per week, for an academic term.
BIO1102 Human Anatomy and Physiology II
Pre-requisite: BIO1101
4 credits
This course is a continuation of BIO1101. Students will learn definition of terms and their relationship with the
characteristics and functions of the various parts of the human body. It also discusses the characteristics of the
human structures organized by system, and the physiological processes that take place in the organism. Systems
discussed include lymphatic, cardiovascular, respiratory, digestive, urinary, and reproductive. This course meets
three (3) hours for theory, and two (2) hours for supervised laboratory per week, for an academic term.
COM1100 Introduction to Informatics 2 credits
This course serves as an introduction to the world of computers, familiarizing the student with the hardware and its
operational parts. It emphasizes in office programs used in health care scenarios and writing of general documents.
After completing the course, students will have the necessary skills to use a computer, write basic commercial
documents, and develop forms to collect patient clinical information. This course meets one (1) hour for theory
and two (2) hours for laboratory per week, for an academic term.
ING1101 English I 3 credits
This course provides students with the opportunity to use grammatical structures in an accurate, meaningful, and
appropriate manner. Students will be able to integrate the four arts of language: reading, writing, speaking, and
listening. Students will acquire aptitude at the sentence level and will learn to communicate appropriately in
different levels. This course also helps improve language development and oral communication. This course meets
three (3) hours for theory per week, for an academic term.
ING1102 English II
Pre-requisite: ING1101
3 credits
This course provides students with the opportunity to use grammatical structures in an accurate, meaningful, and
appropriate manner. Students will be capable of integrating the four arts of language: reading, writing, speaking,
and listening. This course requires the student to progress from the sentence level to the speech and composition
level, and to develop their capability for effective communication. This course meets three (3) hours for theory per
week, for an academic term.
ESP1101 Spanish I 3 credits
This course was designed to study the Spanish language, considering the linguistic background and general
characteristics of the Spanish language in Puerto Rico. It also explores the fundamental rules of oral
communication, grammatical structures, and spelling rules. This course meets three (3) hours for theory per week,
for an academic term.
ESP1102 Spanish II
Pre-requisite: ESP1101
3 credits
This course was designed for students to acquire the necessary skills for the writing process. These include selection
of topic, techniques for generating ideas, and activities to achieve the competencies needed for the writing and
communication process. This course meets three (3) hours of theory per week, for an academic term.
MAT1200 General Mathematics 3 credits
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Comprehensive mathematics for college level students. Elements of theory and logic, numeric systems, exponents
and radicals, polynomials, and rational expressions, basic functions and their graphs. Also, equations and
inequalities, linear equations, quadratic equations, elements of Euclidean geometry, area and volume measures,
elements of probability and statistics, normal distribution, and basic calculus elements. This course emphasizes in
the understanding of mathematical methods and philosophy. It also includes interpolation and extensive tables.
This course meets three (3) hours for theory per week, for an academic term.
PRE1101 Preparation for Student Life 1 credit
This course provides help and guidance for students to better adapt to college life. Emphasis is given to problem
solving and decision making to achieve professional and academic success. It also provides study techniques and
necessary skills for developing critical thinking, and analytic skills to help them meet their academic goals, and
progress in their personal life. This course meets one (1) hours per week, for an academic term.
PSI1100 General Psychology 3 credits
This course provides students with a general overview on the psychology field, relating scientific conduct to health.
It covers from the psychological backgrounds that founded the bases for this discipline, to contemporary events,
equally related to the history of modern psychology. It discusses the main schools of psychological, its theories,
and their main exponents. It explains the various scientific research methods used within the psychology field.
This course meets three (3) hours for theory per week, for an academic term.
TER1200 Medical Terminology
Pre-requisites: BIO1101, BIO1102
2 credits
This component is designed for students to identify the basic concepts related to medical terms. Students will
analyze the origin, prefix, suffix, and abbreviations for each medical term. They will learn to use the most common
terms in English and Spanish, for each of the systems of the human body. This course meets one (1) hour per week,
for an academic term.
PTA1000 Introduction to Physical Therapy and Legal-Ethical Aspects
Pre-requisites: None
2 credits
This course presents the fundamental concepts of physical therapy, its history, and the role of the Physical Therapist
Assistant. Also, the legal-ethical aspects of the practice, laws and regulations that govern the profession, teamwork
and communication, among others. This course meets two (2) hours for theory per week, for an academic term.
PTA1100
Clinical Kinesiology
Pre-requisite: BIO1101
3 credits
This course is designed to prepare students to work simultaneously with different anatomical regions of the human
body, applying kinesiology principles and techniques. Study of the extremities, trunk, neck, posture, and gait will
be the main objective of this course. Concepts on anatomy, neuroscience, biomechanics, physics, kinetics,
cinematics, will be presented to obtain the necessary competencies. The laboratory experience will correlate with
theory to ensure emphasis in the functional application for therapeutic interventions. This course meets two (2)
hours for theory, and two (2) hours for laboratory activities per week, for an academic term.
PTA1200 Pathological Conditions in Physical Therapy
Pre-requisites: BIO1101 Co-requisite: BIO1102
2 credits
This course presents students the common conditions that affect the various systems of the human body. It presents
a general overview on etiology, clinical manifestations, treatment, diagnosis, prevention, and special implications
for the Physical Therapist Assistant. Some of these pathologies will be explored further along the curriculum. This
course meets two (2) hours for theory per week, for an academic term.
PTA1300 Principles and Techniques in Patient Care in Physical Therapy
Pre-requisites: None
3 credits
This course presents students with a selection of principles and techniques for patient care, to provide physical
therapy services. It will also integrate the role of the Physical Therapist Assistant in therapeutic interventions,
behaviors, attitudes, values, cultural diversity, and communication skills expected for patient management.
Discussion of the following topics: body mechanics, positioning techniques, functional transfer, wheelchair
management, infections control, asepsis techniques, isolation procedure, vital signs, gait training with assisted
Clinical Education Handbook – PTA Program
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devices, posture evaluation, application of basic therapeutic exercises, documentation techniques, and
implementation of the plan of care, among others. Simulated clinical practice and laboratories will be used to
improve the knowledge and skills expected for the course. This course meets one (1) hour for theory, three (3)
hours for simulated practice, and two (2) hours for laboratory per week, per academic term.
PTA1400 Therapeutic Massage
Pre-requisites: BIO1102
3 credits
This course presents students with the knowledge, skills, and attitudes needed to provide a therapeutic massage
intervention in the scope of the physical therapy profession. It includes the PTA role at providing therapeutic
massage considering the plan of care, the established clinical environment, body mechanics, informed consent,
positioning of patient, draping, skin evaluation, pain evaluation, communication skills, standards and values, among
others. Discussion of the sequence of therapeutic massage according to the area of treatment and the needs of the
patient, considering the indications and contraindications. In order to improve the learning experience, students
will work in pairs to practice selected massaging techniques in laboratory activities. This course meets one (1) hour
for theory, and four (4) hours for laboratory per week, for an academic term.
PTA1500 Therapeutic Modalities in Rehabilitation
Pre-requisites: PTA1100
4 credits
This course is an introduction to the physical and mechanical agents used in the practice of physical therapy. It
includes physiological principles, clinical applications, indications and contraindications, and precautions, as well
as problem solving skills. Therapeutic modalities included are electrotherapy, ultrasound, thermotherapy,
cryotherapy, laser, and traction, among others. Students will continue developing skills on universal precautions,
patient management and monitoring, and documentation. This course meets two (2) hours for theory, two (2) hours
for laboratory, and three (3) hours for simulated practice per week, for an academic term.
PTA2000 Therapeutic Exercise Techniques
Pre-requisites: PTA1100
2 credits
This course presents the concepts, principles, and application of techniques related to therapeutic exercise and
functional training. Students will learn how to select and design, along with the physical therapist, a safe therapeutic
exercise intervention. Students will also apply various interventions in a safe manner, and will learn how to progress
according to the patient’s condition. Besides concepts on exercises, various post-surgery conditions will be studied,
emphasizing specific-diagnose precautions and treatment guidelines. An introduction to other specialized
interventions will be provided, such as cardiac rehabilitation and aquatic therapy. The simulated laboratory
experience correlates to theory to ensure emphasis in functional application for therapeutic exercise interventions.
This course meets one (1) hour for theory, and three (3) hours for simulated laboratory activities per week, for an
academic term.
PTA2100 Physical Therapy applied to Pediatric Patients
Pre-requisites: PTA 1100
3 credits
This course prepares student in selected therapeutic interventions for pediatric conditions. Theories and principles
on child development and the implications of decision making regarding typical and atypical development. The
role of the Physical Therapist Assistant in the selected plan of treatment include development activities, gait and
locomotion, fine and gross motor training, and balance correction and reaction, among others. Neurological
rehabilitation, sport injuries, congenital disorders, and atypical conditions related to pediatric patients are also
included. This course meets one (1) hour for theory, two (2) hours for laboratory, and three (3) hours for simulated
practice per week, for an academic term.
PTA2201
Clinical Practice I
Pre-requisites: PTA1000, PTA1100, PTA1200, PTA1300, PTA1400,
PTA1500, TER1200
5 credits
The purpose of this clinical education experience is to provide students with the opportunity to practice learned
theories on patients/clients, under the supervision of a licensed Physical Therapist and/or a licensed Physical
Therapist Assistant. Students are expected be able to demonstrate knowledge and skills in the provision of physical
therapy related to legal-ethical aspects, clinical kinesiology, principles and techniques in patient care, therapeutic
modalities, therapeutic massage, among others. Students participate of a one (1) hour seminar per week for follow-
Clinical Education Handbook – PTA Program
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up and compliance with their first clinical experience. Students must meet the standards and expected values of
the Physical Therapist Assistant.
PTA2300 Neurological Rehabilitation
Pre-requisites: PTA1100, PTA1300
3 credits
This course provides students with the opportunity to acquire knowledge and skills regarding management of
patients with neurological diagnosis. Students will demonstrate and apply a selection of interventions for
neurological rehabilitation. Discussion of the role of the Physical Therapist Assistant when using methods of
evaluation with neurological patients and specific interventions according to the injuries or conditions that affect
the nervous system, among others. This course includes an interactive laboratory learning experience. This course
meets two (2) hours for theory and two (2) hours for laboratory per week, for an academic term.
PTA2400 Orthopedic Rehabilitation
Pre-requisites: PTA1100, PTA1300
3 credits
This course describes the role of the Physical Therapist Assistant when managing orthopedic conditions, including
prevention and rehabilitation principles, application of data collection, and therapeutic exercise techniques.
Additional topics include normal and abnormal joint movement, measurement of functional range of movement,
anthropometric measurement, gait and locomotion training, prosthetics and orthopedic management, among others.
Laboratory experience integrates previously learned skills with orthopedic rehabilitation techniques. This course
meets two (2) hours for theory and two (2) hours for laboratory per week, for an academic term.
PTA2202 Clinical Practice II
Pre-requisites: PTA1200, PTA2100, PTA2201, PTA2300, PTA2400
7 credits
This full-time clinical experience prepares students in real work field with an average of forty hours (40) per week.
It provides students with the opportunity to demonstrate achievement of the competencies of a Physical Therapist
Assistant, mainly to work under the direction and supervision of a Physical Therapist Assistant. The full-time
experience is accompanied of a seminar where students are provided with the preparation and requirements to
obtain their Puerto Rico or national Physical Therapist Assistant license. In addition, this seminar prepares students
for the final clinical experience and for working life. Students must complete three hundred sixty (360) hours of
clinical education in a full-time experience, and fifteen (15) hours of seminar, for an academic term.
Clinical Education Handbook – PTA Program
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Placement of PTA Program Students in Clinical
Education Sites Policy
It is Atenas College’s policy to ensure the placement of students from the Associate
Degree in Physical Therapist Assistant Program in Clinical Education Sites is an
organized process, which guarantees a safe and quality clinical experience.
Before placing a student in a clinical education site, the student shall participate of
an academic advisory session with a faculty member where compliance of pre-
requisites to begin the clinical experience is evaluated. All courses must be
approved with a minimum of 70%. Laboratory and simulated practice exams must
be approved with 85% or more, guaranteeing student’s compliance with the
knowledge and skills required for the clinical education experience. The following
procedure was established for these purposes.
Procedure:
1. The Academic Coordinator of Clinical Education (ACCE) or a
faculty member appointed by the Program Coordinator is responsible
for the placement of students in clinical education sites, in
communication and agreement with the ACCE.
2. The first approach to consider a physical therapy center as a clinical
education site is made by means of letter of intent from the physical
therapy center.
3. A site visit shall be coordinated with the ACCE or its representative
for proper evaluation, using the above-mentioned criteria and the
American Physical Therapy Association (APTA) Guidelines and Self-
Assessment for Clinical Education Sites.
4. The ACCE will evaluate the physical therapy center using the clinical
education site requirements established by the Program and will make
a report for the faculty to determine compliance.
5. If the clinical education site meets the requirements established by the
Program, an agreement between the parties must be signed. The
recommended term of agreement is five (5) years.
6. It is necessary to provide the clinical education site’s name and
mailing address to complete the information requested for the
professional liability insurance.
7. The ACCE may place students in clinical education sites as long as
there is a valid agreement between the site and Atenas College, and a
valid professional liability insurance is issued to cover the students’
clinical experience.
8. If there is an agreement in place (from previous years), it is the
ACCE’s responsibility to ensure the agreement and the malpractice
insurance are valid before assigning students to the clinical education
site.
9. Placing a student in a clinical education sit will also depend on the
opportunities available to achieve the executory expectations for an
entry-level student.
10. The ACCE shall ensure diversity of scenarios and clinical education
experiences. For this purpose, the ACCE will keep a Students
Clinical Experience Record and a profile to describe the experiences
provided.
Clinical Education Handbook – PTA Program
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Clinical Education Requirements Atenas College has developed this policy to establish the minimum requirements to
participate in clinical education experiences and the procedure to ensure
compliance. This policy also helps ensure the well-being and health of students and
patients/clients. All students must comply with the requirements established by this
policy to participate in the clinical education experience. The requirements and the
procedure to be followed are:
Table 5. Basic Requirements for Clinical Education:
1. Certificate of immunization: Original and copy
● 3 doses of Hepatitis B vaccine
● 2 doses of chickenpox vaccine or serological test
1. Influenza vaccine
2. Current CPR Certification (cardiopulmonary resuscitation)
Original and certification copy
3. Health certificate: Original and copy
4. Certificate of negative criminal record: Original and copy
5. Copy of Atenas College student identification card
6. Certification of medical insurance coverage
7. 3 2 x 2 photos
8. Additional requirements may be requested by the clinical
education/practice site; these requirements may include a drug test. The
process will take place in accordance with the clinical education/practice
site.
Procedure 1. The coordinator or faculty member in charge of clinical experience or
Academic Coordinator of Clinical Education (ACCE) is responsible to notify
students and provide the document that specifies the basic requirements for
participation of clinical education experience. It is also responsible of
receiving and storing student documents.
2. Students must sign the Certification of Compliance with Basic Requirements
for Participation in the Clinical Education Experience.
3. Students must submit the required documents to coordinator or faculty
member in charge of clinical experience or ACCE on the date established.
4. Students that do not meet the requirements may not participate in the clinical
education.
5. All clinical education-related documents will be filed in the student academic
record and guarded under lock.
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Management of Clinical Database Students are required to maintain their personal information up-to-date in the PTA
Program Clinical Database. This information is required by both Atenas College
and clinical education sites. It is the student responsibility to maintain current
documents. Failure to have the required current information on file will result in
student inability to complete clinical rotation.
Clinical Education
At the clinical education stage of the curriculum, Atenas College Physical
Therapist Assistant program students will perform in a real physical therapy
practice environment, where they will apply the competencies acquired on the first
stage of their plan of study.
For the development of competent professionals, it is of utmost importance to
integrate the student into clinical experiences with real cases that provide the
opportunity to demonstrate acquired competencies and continue broadening their
skills and abilities that are of utmost importance in the working environment.
The existing relation between the clinical education site and the academic program
will be key to the success of these clinical experiences where the student can
demonstrate their professional and personal development aimed to become a
competent Physical Therapist Assistant. PTA Program students and the Clinical
Instructors will have the opportunity to share clinical experiences, knowledge,
skills, and the abilities that are necessary in the development for the Physical
Therapist Assistant profession. Clinical experience will be evaluated utilizing
assessment instruments that enable identifying areas of strength and areas to
improve in the learning-teaching process through clinical instruction. The final
goal of clinical education is to measure knowledge, abilities, and skills, which will
sustain the graduate’s competencies profile and enable the development of a
Physical Therapist Assistant, which complies with the standards of their profession.
In order to begin their clinical education, students must demonstrate mastery of
these competencies by undergoing an Evaluation of Competencies carried out by
the Academic Coordinator of Clinical Education or a core faculty member.
Approval of this evaluation will ensure proper management of the practical aspects
necessary to assist in the physical therapy service to patients, and all the patient
care-related facets of the practice.
A student who does not approve the Evaluation of Competencies, will be given the
opportunity to reinforce his/her knowledge by means of tutoring and a plan of
improvement individually designed for this purpose. Once the plan of
improvement is completed and the professor is satisfied with the student’s
performance, the student will be re-evaluated.
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26
Clinical Education Site
Selection Criteria
Atenas College is committed to provide clinical education sites that will enrich the
overall growth of the PTA student. The PTA program will use the APTA
Guidelines and Self-Assessment for Clinical Education, when considering potential
clinical education sites.
APTA Guidelines and Self-Assessment for Clinical Education
The philosophy of the clinical education site and provider of physical
therapy for patient/client care and clinical education is compatible with
that of the academic program.
Clinical education experiences for students are planned to meet specific
objectives of the academic program, the provider of physical therapy, and
the individual student.
Physical therapy personnel provide services in an ethical and legal
manner.
The clinical education site is committed to the principle of equal
opportunity and affirmative action as required by federal legislation.
The clinical education site demonstrates administrative support of
physical therapy clinical education.
The clinical education site has a variety* of learning experiences
available to students.
The clinical education site provides an active, stimulating environment
appropriate to the learning needs of students.
Selected support services are available to students.
Roles and responsibilities of physical therapy personnel are clearly
defined.
The physical therapy personnel are adequate in number to provide an
educational program for students.
A center coordinator of clinical education is selected based on specific
criteria.
Physical therapy clinical instructors are selected based on specific
criteria.
Special expertise of the clinical education site personnel is available to
students.
The clinical education site encourages clinical educator (CI and CCCE)
training and development.
The clinical education site supports active career development for
personnel.
Physical therapy personnel are active in professional activities.
The provider of physical therapy has an active and viable process of
internal evaluation of its affairs and is receptive to procedures of review
and audit approved by appropriate external agencies and consumers.
Source:
https://www.apta.org/Educators/Assessments/ACCE/DCE/GuidelinesandAssessme
ntsforClinEd/
Clinical Education Handbook – PTA Program
27
PTA Program Preceptor or Clinical Instructor
Selection Criteria Policy
It is Atenas College policy to provide students with quality clinical experiences
through clinical instruction that promotes a comfortable and clinical learning
environment. The Preceptor or Clinical Instructor (CI) is the person that provides
instruction and direct supervision to students during their clinical experience in
assigned practice site. To ensure the Preceptor or CI has the necessary expertise to
meet the program expectations; we have established the following procedure and
selection criteria.
1. The Center Coordinator for Clinical Education (CCCE), in response to
the request of the Academic Coordinator of Clinical Education (ACCE),
and following the selection criteria established on this policy, shall notify
the CCCE about the recommended candidates for the Preceptor or CI
position.
2. The CCCE will inform the ACCE about the candidate(s) after evaluating
the selection criteria, on a previously established date.
3. The following criteria should be evaluated by the ACCE for the selection
of Program Preceptor or CI:
a. A Program Preceptor or Clinical Instructor must be a qualified
professional according to their specialty area, as required by the
law that governs each profession.
b. Must have a minimum of two (2) years of clinical experience.
c. Must Foster a legal and ethical practice, following the laws that
regulate their profession in Puerto Rico.
d. Must demonstrate the values and standards of the profession.
e. Must have the desire to serve as clinical educator.
f. Must have the ability to carry out the student performance
evaluation process.
g. Must possess good supervising skills according to the needs of
the students.
h. Must demonstrate good skills for managing conflicts and
stressing situations.
i. Must possess good communication skills with students during
the teaching process.
j. Must demonstrate good interpersonal relations with co-workers.
k. Must acknowledge the value of the professional relationship
between the student and the Preceptor or CI.
l. Must possess skills for effective student supervision and
promote the necessary guidance for clinical development.
Clinical Responsibilities
Rule All members of the clinical team will have clinical responsibilities.
Responsibilities of Clinical
Coordinators
Clinical Education sites may assign either a Center Coordinator for Clinical
Education (CCCE), or a Clinical Instructor (CI) as the coordinator. The assigned
CCCE or CI will act at liaison between Atenas College and their physical therapy
department.
Clinical Education Handbook – PTA Program
28
Responsibilities of the
Clinical Instructor
The clinical instructor (CI) is responsible for:
Providing direct student supervision while in the clinical setting.
Facilitating clinical instruction and supervision for Atenas College PTA
students assigned within that clinical education site.
Acting as a positive role model.
Respecting student confidentiality.
Identifying student and program strengths and weaknesses.
Consulting with the ACCE regarding the student learning needs in a
timely manner.
Progressing students towards meeting objectives.
Providing ongoing written and verbal feedback to the student and the
program.
Seeking assistance/resources to manage clinical education issues as
needed
Responsibilities of the
Academic Coordinator of
Clinical Education (ACCE)
The PTA Program ACCE is responsible for:
Maintaining regular communication between Atenas College and the
clinical education site regarding students, program goals and needs for
accreditation compliance, and developing educational opportunities such
as seminars, on an ongoing basis.
Placing, confirming, and supervising students in clinical education sites.
Facilitating quality-learning experiences for students during their clinical
education.
Evaluating each clinical education site by means of student evaluation
tools, on-site visits, and ongoing communications.
Ensuring new CI receive training on the supervision of a PTA student
before receiving the students.
Assessing and determining student readiness for clinical experience.
Determining student final grades based on the grading criteria as detailed
in the course syllabus.
Maintaining a valid agreement with the clinical education site.
Placing students in clinical experiences.
Maintaining an up-to-date student clinical database. Providing the
necessary clinical education paperwork to CI and students.
Responsibilities of the
Program
The program is responsible for:
Providing liability insurance through student fees.
Protecting student confidentiality.
Maintaining policies to help provide a safe learning environment for
students.
Ensuring quality-learning experiences.
Providing a curriculum that prepares students for success in the clinical
setting.
Student Responsibilities
PTA students are responsible for:
Documenting clinical hours
Completing the requirements of the clinical experience
Demonstrate ethical behavior and professionalism
Abide by clinical site rules
Maintain good frequent communication with the ACCE and CI
Clinical Education Handbook – PTA Program
29
Rights of the Clinical Education Faculty Rule
Rights and privileges of the clinical education faculty are commensurate with those
with similar appointments within the institution. The Academic Coordinator of
Clinical Education (ACCE) communicates these rights and privileges to the clinical
education faculty. Procedure
The Clinical faculty is invited to comment on the program during each supervisory
visit, on surveys sent to clinical instructors, and at any other time. The Clinical
faculty is included on the Program Advisory Committee and will be included in the
program review process.
Clinical Instructors have the right to:
Comment on the program during supervisory visits or on surveys sent to
clinical instructors.
Request removal of students with inappropriate behavior; documentation
of any inappropriate behavior must be submitted immediately to the
ACCE as well as documentation supporting counseling sessions.
Request the involvement of the ACCE during the counseling sessions; request that
the ACCE presence during the student's clinical hours.
Clinical Education Handbook – PTA Program
30
Clinical Learning Outcomes / Assessment Performance in the clinic is assessed by the clinical instructor assigned at the
clinical site. Performance assessment will be conducted by means of APTA’s
Physical Therapist Assistant Clinical Performance Instrument, and other clinical
assessment tools established in the course syllabus.
Course Learning Outcomes
for Clinical Practice I and
II.
Upon completion of the Clinical Education stage of the curriculum, the student will
be able to:
Apply good communication skills, verbal and non-verbal, in an effective
and appropriate manner with patients/family, clinical instructors, and
other members of the clinical education site. (CPI Performance Criteria
#5)
Behave according to the standards of ethical conduct and values expected
form a physical therapist assistant; uphold respect for cultural diversity
and the expectations from a society member during the rendering of
physical therapy services. (CPI Performance Criteria #2, #4)
Provide assistance to the physical therapist on interventions assigned in
the various areas and physical therapy modalities, executing their role
with care and patient-centered service, ensuring safety and quality. (CPI
Performance Criteria #8, #9, #10, #11, #12)
Apply guidelines of ethical and professional conduct as per Law 114, for
the practice of physical therapy in Puerto Rico, and APTA, during the
provision of physical therapy services to patients/clients. (CPI
Performance Criteria #2)
Competently apply the components selected from the plan of treatment
aimed to achieve short-term and long-term goals, as identified in the Plan
of Care (POC) established by the physical therapist. (CPI Performance
Criteria #7, #8, #9, #10, #11, #12)
Demonstrate clinical thinking and judgment during decision-making in
providing physical therapy services. (CPI Performance Criteria #7)
Competently demonstrate data collection skills, essential to carry out the
Plan of Care. (CPI Performance Criteria #7)
Acknowledge when an intervention should not be provided due to
changes in the status of the patient and report to the clinical
instructor/physical therapist in charge of the patient. (CPI Performance
Criteria #7)
Acknowledge when the direction to perform an intervention goes beyond
the appropriate for a physical therapist assistant and initiate clarification
with the physical therapist. (CPI Performance Criteria #7)
Adjust interventions in the Plan of Care established by the physical
therapist in response to the clinical indications of the patient, and report
to the supervising physical therapist. (CPI Performance Criteria #7)
Clinical Education Handbook – PTA Program
31
Provide instructions to patient, family, and caregivers to achieve patient
expected outcomes, based on the Plan of Care established by the physical
therapist. (CPI Performance Criteria #5, #7)
Complete correct, accurate, logic, concise, timely, and legible
documentation that follow guidelines and specific formats required by
state practice laws, clinical education sites, and other regulatory agencies.
(CPI Performance Criteria #13)
Participate in the discharge and follow-up planning as indicated by the
supervising physical therapist. (CPI Performance Criteria #7)
Under the direction and supervision of the physical therapist, instruct
health-care team members using established techniques, programs, and
instructional material, commensurate with the audience learning
characteristics. (CPI Performance Criteria #3, #7, #14)
Interact with other health-care team members in patient-care related and
non-related activities. (CPI Performance Criteria #5)
Provide accurate and timely information for billing and reimbursement
purposes. (CPI Performance Criteria #14)
Describe aspects of organizational and operational planning of physical
therapy service. (CPI Performance Criteria #14)
Demonstrate awareness on social responsibility, citizenship, and
advocacy, including community participation and service and activity
organizations. (CPI Performance Criteria #3)
Identify career development opportunities and lifelong learning. (CPI
Performance Criteria #6)
Take appropriate actions in emergency situations. (CPI Performance
Criteria #1)
Educate others on the role of the physical therapist assistant. (CPI
Performance Criteria #1)
Participate in improvement activities (quality control). (CPI Performance
Criteria #14)
Demonstrate commitment with satisfying the needs of patients and
consumers. (CPI Performance Criteria #4)
Acknowledge possible fraud and abuse regarding the provision and
billing of physical therapy services, so that it can be reported to the
corresponding authorities. (CPI Performance Criteria #2, #14)
Acknowledge the role of the physical therapist in the clinical education of
physical therapist assistant students. (CPI Performance Criteria #1)
Demonstrate behavior based on APTA’s eight values in the provision
patient/client care and as a member of the inter-professional team. (CPI
Performance Criteria #3)
Voluntarily participate in community activities for the development of
empathy with social needs. (CPI Performance Criteria #3)
Demonstrate leadership skills in organizing activities that offer voluntary
services to people in need and communities in general. (CPI Performance
Criteria #3)
Clinical Education Handbook – PTA Program
32
PTA 2201 – Clinical
Education I.
PASS/FAIL for this course will be based on the following criteria. Final grade
consists of 30% from the Seminar component and 70% from the Clinical Education
Experience.
Method for Evaluation of Seminar Weight
SOAP Notes 30%
Reflective Notes 30%
Clinical Case 40%
TOTAL 100%
Method for Evaluation of Clinical Education Weight
Certification of Clinical Education Hours
TOTAL 100%
PTA 2202 – Clinical
Education II.
PASS/FAIL for this course will be based on the following criteria. Final grade
consists of 30% from the Seminar component and 70% from the Clinical Education
Experience.
Method for Evaluation of Seminar Weight
Twenty-five (25) SOAP notes 30%
Nine (9) reflective notes 30%
Participation in seminar activities 40%
TOTAL 100%
Method for Evaluation of Clinical Education Experience Weight
Physical Therapist Assistant Clinical Performance
Instrument (CPI)
(CI Evaluation)
70%
Physical Therapist Assistant Clinical Performance
Instrument (CPI)
(Student Evaluation)
10%
PTA Student Evaluation: Clinical Education Experience and
Clinical Instructor
10%
Clinical Education Participation Report
(Certification of Clinical Education Hours)
5%
Rubric for evaluation of oral presentation at the clinical site 5%
TOTAL 100%
Clinical Education Handbook – PTA Program
33
Critical Safety /
Performance Elements.
Students must approve all Critical Safety Elements (CSE) and Critical Performance
Elements (CPE) identified in APTA’s Physical Therapist Assistant Clinical
Performance Instrument (CPI). Failure to approve all CSE and CPE items will
result in failure of the skilled assessment regardless of points earned. Students will
be allowed one (10) attempt to repeat the skill assessment.
The Clinical Instructor (CI) shall notify the PTA Program Academic Coordinator
of Clinical Education (ACCE) when a student does not meet any CSE or CPE
items. After analysis of the situation, the ACCE shall prepare a Plan of Action to
the CI, to work with student on such items. Once the Plan of Action is completed,
the student will be given the opportunity to repeat the skills assessment. Failure to
approve the skills assessment on the second attempt will result in failure of the
clinical education course.
Development of Competencies throughout the Curriculum.
Table 6. Development of Competencies throughout the Curriculum
Development of Competencies throughout the Curriculum
PTA1000 – Introduction to Physical Therapy
and Legal-ethical Aspects
Competencies developed in this course:
Legal-ethical aspects of the Physical Therapy
Profession
o Values founded on the behavior of the
Physical Therapist Assistant
o Standards of ethical conduct for Physical
Therapist Assistants
Patient/Client and family education
Pain scales
PTA1100 – Clinical Kinesiology Competencies developed in this course:
Values founded on the behavior of the Physical
Therapist Assistant
o Standards of ethical conduct for Physical
Therapist Assistants
Locating of main muscles
Actions of main muscles
Basic kinesiology
Clinical terminology
o Flexion y extension
o Abduction and adduction
o Circumduction
o Internal and external rotation
o Radial and ulnar deviation
o Inversion and eversion
o Anterior and posterior
PTA1200 – Pathological Conditions in Physical
Therapy Verbal and non-verbal communication skills
The most common pathological conditions
regarding Physical Therapy
Clinical Education Handbook – PTA Program
34
Development of Competencies throughout the Curriculum
PTA1300 – Patient Care Principles and
Techniques
Competencies developed in this course:
Legal-ethical aspects of the Physical Therapy
Profession
o Values founded on the behavior of the
Physical Therapist Assistant
o Standards of ethical conduct for Physical
Therapist Assistants
Clinical terminology
o Flexion and extension
o Abduction and adduction
o Circumduction
o Internal and external rotation
o Radial and ulnar deviation
o Inversion and eversion
o Anterior and posterior
Applying of patient care techniques in Physical
Therapy services
o Patient/Client identification
o Review and implementation of the Care
Plan
o Vital signs
Pulse
Blood pressure
Respiration
Oxygen saturation
Temperature
Pain scales
Management of techniques for infection control
o Hand washing with water and soap
o Dry wash
o Use of personal protection equipment.
Placing of gloves, mask and gown.
o Management in isolation areas
Correct positioning of the Patient/Client
o Prone
o Supine
o Sideways
o Seated
Body mechanics
o Patient management
o Object management
Mobility in bed
o From supine to seated
o From seated to supine
o From supine to sideways
Functional transfers
o Sit to stand
o Half Standing Pivot”
o Standing Pivot
o Sliding board
o Lifter
o Sheets
Ambulation with different assisted equipment
Clinical Education Handbook – PTA Program
35
Development of Competencies throughout the Curriculum
o Ambulation patterns
o Location of equipment measure
o Weight status
o Patient custody
Wheelchair management
o On even surfaces
o On uneven surfaces
o Sidewalks management
o Wheelchair fitting
Mobility and ambulation equipment management
o Oxygen tanks
o IV fluids
o Foley
o Gastrostomy (PEG)
Draping techniques
Basic exercises
o PROM
o AAROM
o AROM
o Resistance
Continuous Passive Motion (CPM)
Tilt Table
Standing Frame
SOAP documentation
Patient/Client and family education
PTA1400 – Therapeutic Massage Competencies developed in this course:
Draping techniques
Therapeutic massage techniques for:
o Face
o Neck
o Back
o Upper extremity
o Lower extremity
Lymphedema management
SOAP documentation
PTA1500 – Therapeutic Modalities in
Rehabilitation
Competencies developed in this course:
Applying of therapeutic modalities and physical
agents:
o Electric stimulation
o Ultrasound
o Infrared lamp
o Neuromuscular Electrical Stimulation
(NMS)
o Electrical stimulation of facial points
o TENS
o Functional Electrical Stimulation (FES)
o Hot compresses
o Cold compresses
o Paraffin
o Laser
Clinical Education Handbook – PTA Program
36
Development of Competencies throughout the Curriculum
o Diathermy
o Fluid therapy
o Whirlpool
o Phonophoresis
SOAP documentation
PTA2000 – Therapeutic Exercise Techniques Competencies developed in this course:
1. Therapeutic exercises
o Indications and contraindications
o Balance
o Proprioception
o Stretching exercises
o Strengthening exercises
o Coordination exercises
o Plyometric exercises
Cardiorespiratory exercises, aerobics, endurance, and re-
conditioning
PTA2100 – Physical Therapy applied to
Pediatric Patients
Competencies developed in this course:
Pediatric rehabilitation
o Neurodevelopmental interventions
o NDT Techniques
o Reflex integration
PTA2201 – Clinical Practice I Competencies developed in this course:
During the clinical education experience, the
competences developed in the previous technical courses
are applied according to the plan of study. Students must
work to increase their level of competence in the following
areas:
Ethics, values and responsibilities
Patient / client management
Plan of Care
Intervention
Test and measurements
Participation in the health care environment
Practice management
Clinical Education Handbook – PTA Program
37
Development of Competencies throughout the Curriculum
PTA2300 – Neurological Rehabilitation Competencies developed in this course:
Therapeutic exercises
o Indications and contraindications
o Balance
o Proprioception
o Strengthening exercises
o Coordination exercises
o Pre-ambulatory exercises
1. Neuro-rehabilitation techniques
a. Motor control and Motor Learning
b. PNF techniques
c. Neuromuscular education and reeducation
d. Stroke Rehabilitation
i) Spinal Cord Injury Interventions
ii) Posture Training
iii) Peripheral Nerve Rehabilitation
iv) Traumatic Brain Injury rehabilitation
v) Daily Living Activities (DLA)
Daily living Instrumental Activities (DLIA)
PTA2400 – Orthopedic Rehabilitation Competencies developed in this course:
Therapeutic exercises
o Indications and contraindications
Proprioception
o Strengthening exercises
Pre-ambulatory exercises
Orthopedic rehabilitation techniques
o Basic Goniometry
o Manual Muscle testing
o Amputations and pre-prosthetic and prosthetic
treatment
Assess Range of Motion
PTA2202 – Clinical Practice II Competencies developed in this course:
During the clinical education experience, the
competences developed in the previous technical courses
are applied according to the plan of study. Students must
work to increase their level of competence in the following
areas:
Ethics, values and responsibilities
Patient / client management
Plan of Care
Intervention
Test and measurements
Participation in the health care environment
Practice management
Clinical Education Handbook – PTA Program
38
Summary of courses approved according to the locations of clinical practice.
Table 7. Summary of courses approved according to the locations of clinical practice
Clinical Practice Level Type of Clinical
Experience
Clinical Practice
Clock Hours
Technical Courses Approved
PTA2201
Clinical Practice I
Part-time clinical
practice
*Two full-day
participation in
clinical practice per
week
240 Hours
PTA1000 Introduction to the Physical
Therapy and ethical-legal aspects
PTA1100 Clinical Kinesiology
PTA1200 Pathological Conditions in
Physical Therapy
PTA1300 Principles and techniques in
patient care in Physical Therapy
PTA1400 Therapeutic massage
PTA1500 Therapeutic modalities in
Rehabilitation
PTA2202
Clinical Practice II
Full-time Clinical
Practice
360 Hours PTA2000 Therapeutic Exercises
PTA2100 Physical therapy applied to
pediatric patients
PTA2300 Neurological Rehabilitation
PTA2400 Orthopedic Rehabilitation
All Technical Courses and General
Courses
Total Hours of Clinical Practice 600 Hours
Clinical Education Handbook – PTA Program
39
Development of the Clinical Affiliation Procedure
Quality assessment of the clinical education program is a fundamental process
aimed to provide guidance to the PTA faculty to realize the proper adjustments to
the clinical education program to ensure the program mission and goals are met.
The ACCE analyses the Student Evaluation of the Clinical Experience completed
by the students after each clinical experience. Based on this information and
clinical site visits, the ACCE will provide the necessary training for the clinical
instructors in areas such as supervising, training, performance assessment, and any
weaknesses observed from the annual review.
In addition, APTA offers several resources aimed to improve the quality of clinical
education in a PTA program, such as:
Clinical Education Guidelines and Self-Assessment
Lecture materials and access to texts used on PTA Program
APTA guidelines on topics such as supervision and delegation,
documentation and ethical conduct
APTA Clinical Education and Credentials Program
Clinical Education Handbook – PTA Program
40
Student Dress Code and Conduct for Clinical Practice Rule In order to ensure a quality experience, it is of utmost importance for students to
follow all rules of clinical practice. Students who do not meet the established
requirements will be referred to the Program Coordinator for corresponding
guidance and action. Following are the rules for clinical practice:
Students must wear the uniform established by the institution, which
consists of navy blue scrubs pants and white scrubs shirt with the
program’s logo, and closed black professional shoes (no sneakers). The
uniform must be in optimum conditions.
Make-up must be conservative.
Hair must be clean and pulled up.
Jewelry must be minimum, e.g. one ring, watch with seconds hand, and
small earrings. Men are not allowed to wear earrings.
Nails must be cut to a maximum length of 1/8 (no more than 8 mm long).
The Puerto Rico Department of Health prohibits acrylic nails.
Women who wear skirts must wear pantyhose.
Visible body piercings are prohibited.
Hair color must be conservative, abstaining for extravagant colors.
Visible tattoos must remain covered at all times.
Cellular phones in the practice area are prohibited.
Smoking is prohibited as well as any other act out of the regulations
already established by the institution while at practice or while wearing
the institution assigned uniform.
Family visits during practice hours are prohibited. Emergency phone
calls must be channeled through the Clinical Instructor.
Once the daily tasks are assigned, the student may not abandon the area
without consent of the clinical instructor or supervisor in charge.
Students are authorized to perform only and exclusively the tasks
assigned by the clinical instructor or supervisor.
Student must notify their clinical instructor or supervisor when taking
their food recess.
Entry and exit hours established by the clinical practice must be complied
with, considering a maximum lateness of 8 minutes.
Lunch hour is established by the clinical instructor or supervisor no later
than the 5th hour of practice.
Students are responsible for their transportation, food money, and any
materials needed.
Eating at the practice area without previous authorization of the clinical
instructor is prohibited.
Chewing gum within practice hours is prohibited.
Student must fully comply with HIPAA. It is prohibited to discuss
confidential patient information in hallways, elevators, food lounges, or
any other place.
Meetings or gatherings in the hallways of the clinical practice area are no
allowed. ● Students shall commit to the rules established at the clinical
education/practice site and follow all policies and procedures, as long as
these meet with the legal and ethical principles that govern the Physical
Therapy profession.
● The student and clinical instructor shall maintain communication with the
ACCE in the event of a concern, assessment process, or other.
Clinical Education Handbook – PTA Program
41
Professional Behavior in the Clinic Professional behavior is expected from the student in all their interactions with
faculty, clients, family members, peers, and other professionals in both the campus,
and the clinical education site.
The most important individual in physical therapy is the patient/client. All
patients/clients should be treated with dignity and respect, and inspire their
confidence. Professional conduct reflects the profession of physical therapy and
Atenas College Physical Therapist Assistant Program. At all times, the student
must maintain professional behavior, and respect for the rights of the patient/client
to individualized quality treatment, and for the professional health care team.
The PTA Academic Coordinator of Clinical Education (ACCE) may visit the
student at any time during the clinical education experience. The student should
contact the ACCE as soon as possible if any problem arises. The Atenas College
PTA Program or clinical education site may terminate a student’s clinical education
assignment at any time for unethical or unsafe behaviors, resulting in course
failure, disciplinary action, and/or dismissal from the program. Identification
The Atenas College student identification card must be visible at all
times.
Students should introduce themselves to clients and staff by including
their name, school, and position (PTA student).
Students should identify themselves as Student PTA before having any
direct contact with patients, thereby giving them the opportunity to refuse
treatment by a student. Patients have the right to refuse to participate in
clinical education.
Documentation
All client documentation or communication concerning a client or the
clinical education site must be approved and signed by the supervisor.
All documentation and other paperwork must be completed and turned in
on time.
Documentation must be accurate in content and format, clean, and neat.
Clinical Education Handbook – PTA Program
42
Environmental Adjustment
Always follow the established chain of command in all activities. Clarify
the chain of command during orientation.
Respect diversity of clients, the healthcare team, and the people around,
including peers.
Request guidance when needed. Try to be specific about the information
sought.
Follow standard precautions at all times.
Avoid negative situations and gossip.
Profanity in any form is not acceptable.
Legal Issues
Demonstrate ethical conduct at all times.
Be aware of clients’ rights.
Safeguard confidentiality of client information.
Make sure to never remove (either deliberately or by accident) any forms
or client information from the clinical site. All client records, including
your notes, are the property of the clinical site.
Photographing and video/audio recording at the clinical education site is
not allowed.
Personal vehicles are not permitted to transport clients (even during
personal time).
Do not engage in personal relationships (i.e. dating), do personal
shopping, run errands, accept or make loans of either money or personal
items, or take gifts from clients.
Do not give clients personal identification information, such as phone
number or address. Do not communicate with clients outside the facility.
Leaving the facility during scheduled hours for any reason other than a
specific assignment, is perceived as abandonment and will result in
failure of the clinical education.
Do not return to clinical education sites during non-scheduled times, even
if you personally know the client. Visiting a client that you have a
previous relationship with, in a professional manner, without proper
supervision may raise issues of misrepresentation and possible
malpractice.
Clinical Education Handbook – PTA Program
43
Behavior
Do not socialize with peers while at work.
Keep personal phone calls to emergencies. Cell phones or any other
electronic devices that may disrupt treatment are not permitted during
clinical education hours.
Client information is confidential and not to be discussed in any area in
which confidentiality cannot be ensured (lunch, elevators, lobbies, etc.),
even with fellow students, instructors, or supervisors. Client information
should only be shared on a need-to-know basis as per HIPAA guidelines.
No conversation should take place in the presence of a client unless the
client is part of the conversation. This includes speaking in another
language not spoken or understood by the client.
Verify all information. It is the student’s responsibility to clarify verbal
and written instructions from academic and clinical instructors.
Acknowledge the presence of unfamiliar persons.
Look up the information if there are questions. It is the responsibility of
the PTA to ask only appropriate questions, not information covered in
coursework.
Eating (including chewing gum) is prohibited except in designated areas
at designated times. No smoking or use of tobacco products (including
electronic cigarettes) at clinical sites.
Students must refrain from engaging in physical relationships with CI
and/or facility staff due to possible interference with the clinical
experience.
Students are not to make comments or post information concerning the
clinical site on social networking sites (e.g. Facebook, Twitter, personal
blogs).
All student or client related accidents, injuries, or unusual occurrences
must be reported immediately to the CI and the ACCE. Failure to do so,
not only affects the student’s clinical placement, but may also affect
future license application.
The student is responsible to inform his/her supervisor of their
whereabouts at all times during the workday.
Follow all standards outlined in the APTA Standard of Ethical Conduct
for a PTA.
Parking
Follow clinical education site rules, regulations, and procedures about parking use
or related.
Communication
The primary means of communication with the ACCE during the clinical education
experience are email and phone. In the event of an emergency (absence, injuries,
accident, etc.), the student should contact the ACCE by phone and leave a
voicemail if the ACCE cannot be reached.
Clinical Education Handbook – PTA Program
44
Clinical Attendance Rule
Clinical Education courses require a minimum of 90% attendance. Students are
responsible of meeting the minimum clinical education hours required by the
program. Those who do not meet this requirement will be requested to withdraw
from the course and the program, due to inability to complete all requirements.
At times, clinical education experiences may coincide with a holiday; therefore, the
student is responsible to clarify work hours expected from the clinical site. Any
absence from the facility will count against the minimum time requirements.
Students may be required by the facility to “work” on the holiday, and this request
must be honored. A student may not ask the Clinical Instructor (CI) to rearrange
required workdays, including holidays.
If a student misses a clinical education experience day, the student is responsible to
schedule make up hours for missed time. The student will collaborate with CI to
determine make up time/days, and notify the ACCE of scheduled make up days.
In the event of illness or injury that hinders a student’s ability to perform in the
clinical setting, the faculty reserves the right to require a medical certificate
authorizing the student to continue clinical education at the appropriate level of
competency. All medical restrictions must be evaluated by the faculty and/or
clinical education site.
Procedure for Missed
Examination/Practical/Prese
ntation.
1. Notify absence to course professor before class begins. If the instructor is
not notified prior to beginning of the class, “0” a score will be awarded.
2. The student must make arrangements with the instructor within 24 hours
of the missed exam/practical/presentation, to be able to make up the
missed examination.
3. The student will have 5 school days after the absence to make up the
missed examination/practical/presentation.
Procedure for Missed
Clinical Attendance.
1. The student is responsible of informing the CI and the ACCE if he/she
will be absent or late. Notification should be prior to begin clinical
education experience. It is the student’s responsibility to keep current
phone number of clinical supervisors and college personnel.
2. The student is responsible to schedule make up hours for missed time:
a. The student will collaborate with CI to determine make up
time/days.
b. The student will notify ACCE of scheduled make up days.
Clinical Education Handbook – PTA Program
45
Clinical Grading Rule
Students will satisfy clinical requirements through completion of required
assignments, per clinical experience, as well as completion of the PTA Clinical
Performance Instrument (CPI).
If the student does not complete the required assignments or completion of the CPI,
the student will be dismissed from the clinical education course and will not
continue in the program.
Students Experiencing Difficulty in Clinical Rotation
Procedure
Atenas College PTA Program faculty is committed to provide support to all
students to succeed within the PTA program clinical rotations.
Students experiencing difficulty with clinical rotations are expected to do their best
to work within the guidelines of their Clinical Instructor (CI) and to comply with
all recommendations made. Should a situation arise:
1. The student should contact the ACCE immediately for assistance in
handling the situation, and should take any problems or questions to the
assigned clinical instructor.
2. If the student and the CI are unable to find a resolution within a
reasonable amount of time, an onsite meeting may be arranged between
the student, the CI/CCCE, and the ACCE.
3. The ACCE, CI, and the student will develop a plan of action to be
implemented for the remainder of the clinical experience.
4. If the conflict is not resolved through the above procedures, the ACCE
may:
a. choose to re-assign the student to a different clinical site (pending
availability)
b. the student may be dismissed from that clinical site and course,
causing delay in progression within the program Clinical Program Assessment
Policy
Atenas College PTA program uses various mechanisms to document assessment of
the clinical education experience. These include, but are not limited to, clinical
surveys developed by the institution and completed by the students and clinical
instructors and the assessment carried out at the site visit.
Procedure
Program Evaluation by
Clinical Instructors
Clinical instructors will evaluate the ACCE, the student and the PTA program after
every clinical experience using the following forms, among others:
Clinical Instructor evaluation of clinical education program
Clinical instructor evaluation of the ACCE Program Evaluation by the
ACCE
The ACCE will evaluate the CI and the student after every clinical experience
using the following tools, among others:
Site visits
Student evaluation of the clinical instructor
Student evaluation of clinical experience
Clinical Education Handbook – PTA Program
46
Program Evaluation by
Students
The students will evaluate the CI and the program after every clinical experience
using the following tools, among others:
Student evaluation of the clinical experience
Graduates Survey
Clinical Safety Guidelines
Infection control
The Academic Coordinator for Clinical Education or designee will serve as
Coordinator for Infection Control. The ACCE will be responsible for the
administrative implementation of this policy including care of confidential records
(documentation of the incident and follow-up procedures instituted). Clinical education site safety
Each clinical site will be responsible to provide the appropriate and necessary
equipment needed for a safe practice. If this equipment is not available, the ACCE
is responsible of removing the students from unsafe practice settings. Standard Precautions
Students may be exposed to environmental hazards and infectious diseases while at
the clinical education facilities. Risk of infectious diseases include, but is not
limited to, Tuberculosis, Hepatitis B, and HIV. The student understands and
assumes these risks and agrees to abide by the policies and procedures of the
clinical education site concerning exposure to infectious diseases and infection
control.
Clinical education experiences may include care to individuals who have
transmissible diseases. Students are expected to treat all patients with the same
respect and dignity as per professional standards of care. Student are also required
to follow all guidelines for prevention of blood borne pathogens transmission.
Prior to begin their clinical education, students will be provided with the following:
Current literature on ways of acquiring and transmitting infectious
disease.
Standard precautions to minimize risk of transmission of infectious
disease.
Supervised practice of standard precautions in the lab setting.
Close supervision and monitoring of precautions during clinical
experiences.
Education in isolation techniques related to the prevention of specific
infectious diseases.
Clinical Education Handbook – PTA Program
47
CDC standard precautions
for infection control.
The following standard precautions measures replace the old universal precautions
system in the recently finalized patient isolation guidelines by the Centers for
Disease Control and Prevention. Key tenets of the new standard infection control
precautions are summarized as follows:
Hand washing: Wash hands after touching blood, body fluids,
secretions, excretions, and contaminated items, whether or not gloves are
worn. Wash hands immediately after gloves are removed, between
patient contacts, and when otherwise indicated to avoid transfer of
microorganisms to other patients or environments. It may be necessary to
wash hands between tasks and procedures on the same patient to prevent
cross-contamination of different body sites. Use a plain, non-
antimicrobial soap for routine hand washing. Use an antimicrobial agent
or a waterless antiseptic agent for specific circumstances such as
outbreaks.
Gloves: Wear clean, nonsterile gloves when touching blood, body fluids,
secretions, excretions, and contaminated items. Put on clean gloves just
before touching mucous membranes and non-intact skin. Change gloves
between tasks and procedures on the same patient after contact with
material that may contain a high concentration of microorganisms.
Remove gloves promptly after use, before touching non-contaminated
items and environmental surfaces, and before going to another patient;
wash hands immediately to avoid transfer of microorganisms to other
patients or environments.
Masks, eye protection, and face shields: Wear a mask and eye
protection or a face shield to protect mucous membranes of the eyes,
nose, and mouth during procedures and patient care activities that are
likely to generate splashes or sprays of blood, body fluids, secretions, and
excretions.
Gowns: Wear a clean, nonsterile gown to protect skin and to prevent
soiling of clothing during procedures and patient care activities that are
likely to generate splashes or sprays of blood, body fluids, secretions, or
excretions. Select a gown appropriate for the activity and amount of fluid
likely to be encountered. Remove a soiled gown as promptly as possible
and wash hands to avoid transfer of microorganisms to other patients or
environments.
Patient care equipment: Handle used patient care equipment soiled with
blood, body fluids, secretions, and excretions in a manner that prevents
skin and mucous membrane exposures, contamination of clothing, and
transfer of microorganisms to other patients and environments. Ensure
that reusable equipment is not used for the care of another patient until it
has been cleaned and reprocessed appropriately. Make sure single-use
items are discarded properly.
Environmental controls: Ensure the hospital has adequate procedures
for the routine care, cleaning, and disinfection of environmental surfaces,
beds, bed rails, bedside equipment, and other frequently touched surfaces,
and ensure that these procedures are being followed.
Linen: Handle, transport, and process used linen soiled with blood, body
fluids, secretions, and excretions in a manner that prevents skin and
mucous membrane exposures and contamination of clothing, and that
avoids transfer of microorganisms to other patients and environments.
Occupational health and blood borne pathogens: Take care to prevent
injuries when using needles, scalpels, and other sharp instruments or
devices; when handling sharp instruments after procedures; when
cleaning used instruments; and when disposing of used needles. Never
recap used needles, otherwise manipulate them using both hands, or use
Clinical Education Handbook – PTA Program
48
any other technique that involves directing the point of a needle toward
any part of the body. Instead, use either a one-handed "scoop" technique
or a mechanical device designed for holding the needle sheath. Do not
remove used needles from disposable syringes by hand, and do not bend,
break, or otherwise manipulate used needles by hand. Place used
disposable syringes and needles, scalpel blades, and other sharp items in
appropriate puncture-resistant containers, which are located as close as
practical to the area in which the items were used, and place reusable
syringes and needles in a puncture-resistant container for transport to the
reprocessing area. Use mouthpieces, resuscitation bags, or other
ventilation devices as an alternative to mouth-to-mouth resuscitation
methods in areas where the need for resuscitation is predictable.
Patient placement: Place a patient who contaminates the environment or
who does not (or cannot be expected to) assist in maintaining appropriate
hygiene or environmental control in a private room. If a private room is
unavailable, consult with infection control professionals regarding patient
placement.
Source: 1. Centers for Disease Control and Prevention. Hospital Infection Control
Practices Advisory Committee. Guideline for isolation precautions in hospitals.
Infect Control Hosp Epidemiol 1996; 17:53-80. *
Clinical Education Handbook – PTA Program
49
Exposure to Blood and Pathogens Protocol
Students from all health programs that include laboratory practice and/or clinical
rotations in their curricula must be aware of the risk of exposure to pathogens
contained in blood and other bodily fluids at laboratory and clinical areas. Students
are exposed to blood due to injuries from needle sticks and scratches or other
injuries by sharp instruments, and contact with mucous membranes or broken skin
for a few minutes or more. These types of injuries may cause serious or fatal
infections or pathogen agents contained in blood and other fluids such as Hepatitis
B, Hepatitis C, Human Immunodeficiency Virus, and Tuberculosis, among others.
Our institution, as part of its commitment with student’s health and safety and in
accordance to the requirements of state and federal accrediting agencies, has
established rules and measures for prevention and control. These rules aim to
reduce accident risk due to exposure to bodily fluids, blood or pathogen agents
during their laboratory or clinical practice experience.
Health programs curricula include courses and workshops on safety, universal
precautions and techniques, and safety rules that guide and train student using
audiovisual equipment, personal protection equipment, rules of operation and
conduct for the laboratory and clinical area, which are available in writing and
distributed and explained to students. Nonetheless, considering these and other
prevention and control measures, risk of accidents by exposure is still present.
Purpose
The main purpose of this document is to establish a protocol that serves as a
general guide in case of an accident where there is exposure and to allow us to
properly monitor and respond with effectiveness and promptness.
Scope
This protocol applies to all health programs that require laboratories, clinical
rotations, research, or other activities sponsored by Atenas College, involving risk
of exposure to pathogens, blood, or any other bodily fluid.
Prior to any patient contact, all Atenas College students will be provided with the
following:
Current literature on acquiring and transmitting infectious disease.
Instruction on standard precautions to minimize transmission of
infectious disease.
Education on isolation techniques pertaining to the prevention of specific
infectious diseases.
The following standard precautions are to be followed by all Atenas
College faculty and students:
1. Gloves must be worn at all times when in contact with:
a. Blood and body fluids
b. Mucous membranes
c. Non-intact skin
d. Items or surfaces soiled with blood or body fluids
2. Change gloves and wash hands between patients.
Clinical Education Handbook – PTA Program
50
3. Wear protective eyewear when suctioning or at any time when blood or
other body fluids might contaminate your eyes.
4. Place needles in sharp containers immediately after use.
5. Needles shall not be manipulated by hand; do not bend, break, or remove
from syringes.
6. Disposable syringes and needles, scalpel blades, and other sharp items
shall be disposed of in the sharps container.
7. Reusable needles and syringes, or other sharp items shall be left on the
tray unwashed and wrapped in plastic for transport.
8. Any break in skin integrity of the caregiver shall be covered with
protective covering.
9. Gloves that are punctured or torn while in use must be removed as soon
as possible. Proceed with hand hygiene and wear new gloves to continue
with the task.
10. Laboratory specimens must be handled with gloves and labeled
appropriately.
11. Soiled linens will be put in bags at the bedside and are not to come in
contact with the uniform.
12. Wear gloves at all times when providing patient care and while doing any
procedure where contact with blood, or body fluids may be expected (i.e.
injections).
13. Wear gloves and use paper towels to remove spills. Have housekeeping
clean and disinfect the area.
In case of exposure to a harmful substance, please follow this procedure:
1. The professor/instructor in charge shall ensure the student exposed
follows the facility’s policy for reporting the incident. The Health
Professions Division Occurrence Report must contain the same
information on the incident report.
2. Testing of the source patient shall be done according to agency protocol
and state law. Copies of the source patient’s lab work will be forwarded
to the student’s health care provider. Students who do not have a personal
health care provider will be given a list of facilities that can provide
follow-up testing and counseling.
3. All expenses for any initial and follow-up testing and care of the exposed
student are to be paid by the student.
4. Atenas College nor the facility where the exposure occurred are
responsible for initial and follow-up testing or counseling of the exposed
student.
5. The completed Health Professions Division Occurrence Report must be
forwarded to the Associate Vice President for Academic Affairs who in
turn, shall forward a copy of the Vice President for Student Affairs.
Clinical Education Handbook – PTA Program
51
Accident or injury while in the clinical setting If a student is injured while in the clinical setting, the ACCE must be notified
immediately. The ACCE should be given a copy of the facility’s incident report
and may require that a Health Professions Occurrence Report be completed. The
student is responsible for all medical care expenses. Atenas College and the clinical
education site are not responsible for any claims or expenses that result from an
action of the student or a patient/client in the clinical setting. Students must carry a
personal health insurance policy. Atenas College PTA Program also reserves the
right to require a medical certificate authorizing the student to safely
resume/continue patient/client care at appropriate level of clinical requirements,
after an illness or injury. Each case will be considered on an individual basis.
Accidental Sharp Injuries Procedure
Students must report any incident that can place themselves and the faculty or
clinical personnel at risk. The student should notify the clinical instructor and
program faculty, and complete an incident report. Sharp injuries include, but are
not limited to, needle sticks, punctures or cuts with exposure to a potentially
contaminated source, splash injury to eyes or mucous membranes, secretion contact
with non-intact skin. The student should wash the affected area with soap and water
immediately, and consult their health care provider if testing and treatment
becomes necessary. All expenses incurred from the exposure incident, initial and
follow-up, are the sole responsibility of the student. Emergency Situations
during Clinical Experience
If the student suffers an injury or an emergency arises during the clinical
experience, the clinical education/practice site shall enforce their emergency
protocol or procedure. The student is responsible to cover all medical expenses.
The CI is responsible to inform the ACCE for the corresponding action. Smoking
Smoking (e.g., cigarettes, pipes, cigars, electronic cigarettes, vapor devices) is
strictly prohibited college buildings and on college grounds, including parking
areas and structures, sidewalks, walkways, and college owned buildings, nor during
field trips or clinical training.
Atenas College policy on Drug Use and Abuse is part of the institution’s
commitment to create a healthy environment for all members of our institutional
community. In addition, tobacco users are expected to adhere to the policy and
likewise be respectful to ex-tobacco users and non-tobacco users.
Health Insurance
Faculty and students are required to have health insurance and are responsible for
their own individual or family insurance policies. Students enrolled in the PTA
Program are required to have personal health insurance to begin their clinical
education.
Clinical Education Handbook – PTA Program
52
Policy on Student Claims and Complaints Purpose
It is Atenas College’s policy to provide students with an academic environment,
which fosters integrity, freedom of speech, and attention to the needs of the
students. This is why we offer students the opportunity to file a claim or complaint
when they feel preoccupied or negatively affected by a situation regarding Atenas
College or its allies, such as clinical practice sites. In addition, we are committed
to provide students with the proper mechanisms to resolve or manage their claim or
complaint. The following procedure was developed for these purposes: Procedure
1. Claims or complaints must be reported to the Guidance and Counseling
Center within thirty (30) days after the event or situation has occurred.
The student must complete the Claim or Complaint Notification form,
narrating the facts, and hand it to the academic counselor or social
worker.
2. Anonymous claims or complaints must be place in the box assigned for
these purposes. Said box is located at the Julio E. Hernández building,
first floor, next to the stairs to the second floor. Nevertheless, for
evidence purposes, signing the claim or complaint is recommended.
3. The academic counselor must evaluate the type of complaint in order to
channel the reported information accordingly.
4. The person to whom the complaint is addressed will have five (5)
working days to respond and meet with the complainant to present and
discuss the Action Plan. The handler and the complainant must sign the
Action Plan.
5. If the student believes that his/her claim or complaint has not been
properly handled or is not satisfied with the decision, he/she can visit the
office of the Vice President for Student Affairs to request an appeal. The
student must complete the Request for Appeal form and detail the reason
his/her appeal.
6. The Vice President for Student Affairs shall conduct an investigation
regarding the student’s appeal, within five (5) working days.
7. The Vice President for Student Affairs shall report her decision in the
Response to Appeal form.
8. If necessary, the Vice President for Student Affairs may refer the
complainant to the Evaluating Committee on Claims and Complaints,
which will have five (5) working days to respond. The committee must
complete the Response from the Evaluating Committee on Claims and
Complaints form.
The Evaluating Committee on Claims and Complaints is comprised of at
least three (3) of the following representatives:
Social Worker or Counselor
Associate Vice President for Academic Affairs
Program Director/Coordinator
Faculty member
Vice President for Student Affairs
Clinical Education Handbook – PTA Program
53
9. In the event the student is not satisfied with the response by the
Evaluating Committee on Claims and Complaints, he/she will have the
option to submit a Notification of Complaint submitted to the President of
the Institution. This notification must detail the nature of the
dissatisfaction with the response to their claim or complaint.
10. The Office of the President will have five (5) working days to respond to
the claim or complaint presented by the student by completing the
Response to Notification of Complaint submitted to the President form,
stating the established agreements.
11. In the event the student does not agree with the decision made by the
President, he/she has the right to appeal to the Accrediting Commission
of Career Schools and Colleges, using the ACCSC Complaint Form.
Institutions accredited by this accrediting commission must publish a procedure and operational plan to
handle student complaints. If a student feels that the institution has not handle their preoccupation or complaint, the
student can consider communicating with the accrediting commission. All complaints submitted to the Commission
must be in writing, with the complainant’s authorization for the Commission to copy the institution for its response.
Complainant/s will be informed of the status of their complaint, as well as the institution, for its response. Please
direct your complaints to the following address:
Accrediting Commission of Career School and Colleges 2101 Wilson Boulevard, Suite 302
Arlington, VA 22201
Tel.: (703) 247-4212
www.accsc.org Copy of the ACCSC Complaint Form is available at the Guidance and Counseling
Center or the Vice Presidency of Student Affairs.
Right to due process for
students and faculty
Atenas College Physical Therapist Program will review all complaints concerning
accreditation compliance. The PTA Program ensures program quality and ongoing
improvement, but does not intervene or appeal on behalf of students or faculty
members in matters of admission, appointment, promotion, or dismissal. It is our
belief that ongoing feedback is essential for self-improvement.
Complaints should be filed as soon as possible after the facts. The program will
conduct an investigation within 3 months of the complaint. All complaints must be
signed by the complainant in order for the Program Coordinator to act upon it. The
Program Coordinator will review all signed complaints and report to the Associate
Vice President for Academic Affairs. Complaint records are kept under lock in the
Program Coordinator’s office.
Patient’s Informed Consent
Prior to providing physical therapy treatment, the student must ensure that patients
are informed a student physical therapist assistant will provide their treatment. All
patients must consent to receive treatment by a student PTA. The student and the
clinical instructor are responsible to ensure consent by the patient or its
representative.
Clinical Education Handbook – PTA Program
54
Procedure
1. The clinical instructor and the student are responsible of providing the
patient with the Consent Form to Receive Treatment by a Student
Physical Therapist Assistant.
2. The patient shall read the consent form and determine his/her willingness
to receive physical therapy treatment by a student PTA. If the patient
agrees, he/she or their representative must complete and sign the consent
form.
3. Patient consent shall be guarded by the clinical education/practice site.
The student is not authorized to take the document out of the practice site.
The program does not request return of this document to ensure non-
disclosure of patient protected health information.
4. All student physical therapy assistants must provide treatment under the
direction and supervision of his/her clinical instructor.
5. To ensure the process of consent between the patient and the student was
properly carried out, the Clinical Instructor shall submit the Certification
of Number of Patient Consents for Treatment by a Student Physical
Therapist Assistant form to establish the number of patients managed by
the student during the clinical experience. This document shall not
disclose patient’s name or any information that may identify the patient.
6. If the patient does not consent to receive treatment by a student PTA,
his/her decision must be considered with respect and must not affect the
quality of treatment received.
Clinical Supervision of
Student Physical Therapist
Assistants
The Program requires that clinical education sites adhere to the fundamental
principles of supervision of student physical therapist assistants as established by
the American Physical Therapy Association (HOD P06-11-09-17, Amended HOD
P06-00-19-31; HOD 06-96-20-35; HOD 06-95-20-11).
Supervision of Student Physical Therapist Assistants [APTA Position]
"Student physical therapist assistants, when participating as part of a physical therapist assistant education
curriculum, and when acting in accordance with American Physical Therapy Association policy and applicable state
laws and regulations, are qualified to perform selected physical therapy interventions under the direction and
supervision of either the physical therapist alone or the physical therapist and physical therapist assistant working as
a team. When the student physical therapist assistant is participating in the delivery of physical therapy services while
being supervised by the physical therapist alone or the physical therapist and physical therapist assistant working as a
team, the physical therapist or the physical therapist assistant is physically present and immediately available at all
times.
The physical therapist or the physical therapist assistant will have direct contact with the patient/client during
each visit as visit is defined in the Guide to Physical Therapist Practice. The physical therapist maintains responsibility
for patient/client management at all times, including appropriate utilization of the physical therapist assistant as
described in Direction and Supervision of the Physical Therapist Assistant, and for interventions performed by the
student physical therapist assistant.”
Clinical Education Handbook – PTA Program
55
Supervision and Direction of
the Physical Therapist
Assistant
The program requires the clinical education site to adhere to the policy established
by the American Physical Therapy Association for the supervision and direction of
the physical therapist assistant. APTA Policy HOD P06-05-18-26, Amended HOD
06-00-16-27; HOD 06-99-07-11; HOD 06-96-30-42; HOD 06-95-11-06; HOD 06-
93-08-09; HOD 06-85-20-41; Initial HOD 06-84-16-72/HOD 06-78-22-61/HOD
06-77-19-37) is as follows:
“Physical therapists have a responsibility to deliver services in ways that protect the
public safety and maximize the availability of their services. They do this through
direct delivery of services in conjunction with responsible utilization of physical
therapist assistants who assist with selected components of intervention. The
physical therapist assistant is the only individual permitted to assist a physical
therapist in selected interventions under the direction and supervision of a physical
therapist”.
Direction and supervision are essential in the provision of quality physical therapy
services. The degree of direction and supervision necessary for assuring quality
physical therapy services is dependent upon many factors, including the education,
experiences, and responsibilities of the parties involved, as well as the
organizational structure in which the physical therapy services are provided.
Regardless of the setting in
which the physical therapy
service is provided, the
following responsibilities
must be borne solely by the
physical therapist:
● Interpretation of referrals when available.
● Initial examination, evaluation, diagnosis, and prognosis.
● Development or modification of a plan of care, which is based on the
initial examination or reexamination and which includes the physical
therapy goals and outcomes.
● Determination of when the expertise and decision-making capability of
the physical therapist requires the physical therapist to personally render
physical therapy interventions and when it may be appropriate to utilize
the physical therapist assistant. A physical therapist shall determine the
most appropriate utilization of the physical therapist assistant that
provides for the delivery of service that is safe, effective, and efficient.
● Reexamination of the patient/client considering their goals, and revision
of the plan of care when indicated.
● Establishment of the discharge plan and documentation of discharge
summary/status.
● Oversight of all documentation for services rendered to each
patient/client.
The physical therapist remains responsible for the physical therapy services
provided when the physical therapist’s care plan involves the physical therapist
assistant to assist with selected interventions. Regardless of the setting in which the
service is provided, the determination to utilize physical therapist assistants for
selected interventions requires the education, expertise, and professional judgment
of a physical therapist as described by the Standards of Practice, Guide to
Professional Conduct, and Code of Ethics.
Clinical Education Handbook – PTA Program
56
In determining the
appropriate extent of
assistance from the physical
therapist assistant (PTA),
the physical therapist
considers:
● The PTA’s education, training, experience, and skill level.
● Patient/client criticality, acuity, stability, and complexity.
● Predictability of the consequences.
● The setting in which care is being delivered.
● Federal and state statutes.
● Liability and risk management concerns.
● The mission of physical therapy services for the setting.
● The needed frequency of reexamination.
In addition, when the physical therapist assistant provides services in any off-site
setting, it is required that the supervisory process abides to APTA policy as
follows:’
● “A physical therapist must be accessible by telecommunications to the
physical therapist assistant at all times while the physical therapist
assistant is treating patients/clients.
● Regularly scheduled and documented conferences must be carried out with
the physical therapist assistant regarding patients/clients, which frequency
is to be determined by the needs of the patient/client and the needs of the
physical therapist assistant.
● In those situations, in which a physical therapist assistant is involved in the
care of a patient/client, a supervisory visit by the physical therapist will be
made:
o Upon the physical therapist assistant's request for a
reexamination, when a change in the plan of care is needed,
prior to any planned discharge, and in response to a change in
the patient’s/client’s medical status.
o At least once a month, or at a higher frequency when established
by the physical therapist, in accordance with the needs of the
patient/client.
o A supervisory visit should include:
▪ An on-site reexamination of the patient/client.
▪ On-site review of the plan of care with appropriate
revision or termination.
▪ Evaluation of need and recommendation for utilization
of outside resources."
It is also highly recommended to refer to the PTA Supervision Algorithm from the
American Physical Therapy Association (APTA), to go over the decision process to
follow when supervising a Physical Therapist Assistant.
Supervision of the Physical
Therapist Assistant
The American Physical Therapy Association (APTA) established three (3) levels of
supervision for the Physical Therapist Assistant and defined each one of these. The
program requires clinical education sites to adhere to these fundamental principles
for the supervision of physical therapist assistants and to act in conformity to the
law and regulations applicable to the practice of physical therapy in Puerto Rico.
Clinical Education Handbook – PTA Program
57
The American Physical Therapy Association recognizes the following levels of supervision for the Physical Therapist
Assistant (Levels of Supervision HOD P06-00-15-26):
General Supervision: The physical therapist is not required to be on site for direction and supervision, but must be
available at least by telecommunications.
Direct Supervision: The physical therapist is physically present and immediately available for direction and
supervision. The physical therapist will have direct contact with the patient/client during each visit that is defined in
the Guide to Physical Therapist Practice as all encounters with a patient/client in a 24-hour period.
Telecommunications does not meet the requirement of direct supervision.
Direct Personal Supervision: The physical therapist or, where allowable by law, the physical therapist assistant is
physically present and immediately available to direct and supervise tasks that are related to patient/client
management. The direction and supervision is continuous throughout the time these tasks are performed.
Telecommunications does not meet the requirement of direct personal supervision."
1
Values-Based Behaviors for the Physical Therapist Assistant. American Physical Therapy Association. January 2011. Accessible
at: http://www.apta.org/uploadedFiles/APTAorg/PTAs/Careers/Values/ValuesBasedBehaviorsforPTA.pdf Accessed on December 21, 2014.
1 Physical Therapist Assistant Standards of Ethical Conduct. American Physical Therapy Association. Retrieved from:
http://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Ethics/GuideforConductofthePTA.pdf.. April 2015.