SAN JACINTO COLLEGE SOUTH

PHYSICAL THERAPIST ASSISTANT (PTA) PROGRAM

CLINICAL HANDBOOK

Revised: July 2014

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TABLE OF CONTENTS

1. Purpose of Clinical Handbook 4 2. Introduction 4 3. Faculty/Staff Directory 6 4. Mission Statements 7 5. Vision Statements 7 6. Values 8-9 7. Curriculum Outline 10 8. Clinical Program Goals 11-12 9. Clinical Requirements 13-14 10. Orientation Day 15 11. Student Evaluations 15 12. Clinical Grading 16-20 13. Clinical Education Process 21 14. Affiliation Agreements with Clinical Facilities 22 15. Responsibilities of Academic Coordinator of Clinical Education 23-24 16. Rights, Privileges and Responsibilities of Clinical Instructor 25-26 17. Responsibilities of the Student 27-30 18. Health Insurance and Emergency Care 31 19. Patients with Communicable Diseases/Confidentiality/HIPAA 31 20. Expectations and Objectives for Clinical Rotations 32-34 21. Evaluation of the Clinical Instructor 36 22. Student Liability Insurance 36 23. Complaint Process/Grievance Procedure 36-37 24. Grievance Procedure for Discrimination 37 25. Notification of Unlawful Behavior 37 26. Suspected Substance Abuse 38 27. Clinical Travelling 38 28. Physical and Mental Requirements 39-40 29. PTA Program Policy Statement 41

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Appendix A Minimum Required Skills of PTA Graduates at Entry Level Appendix B Philosophy and General Instructions from PTA MACS Appendix C Progress Report from PTA MACS Appendix D Midterm Site Visit Appendix E Clinical Grading System Appendix F Student Evaluation of Clinical Education Experience Appendix G Syllabus for PTHA 1360 Appendix H Syllabi for PTHA 2460 and PTHA 2461 Appendix I School Contract Appendix J APTA Guide for Clinical Faculty Appendix K Initial Site Visit Appendix L Clinical Site Information form Appendix M Preference Form Appendix N Clinical Information Sheet Appendix O Facility Commitment Form for Clinical Affiliations Appendix P Clinical Instructor Questionnaire Appendix Q Student Data Sheet Appendix R Email Journal Information Appendix S Your Clinical Instructor Appendix T Student Liability Insurance Form Appendix U Health Form Appendix V Clinical Instructor Information Appendix W Weekly Goals Appendix X Clinical Quality Form

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PURPOSE OF CLINICAL HANDBOOK To provide general information and guidelines to the student, the clinical instructor and other staff at the clinical sites in hopes of creating a seamless transition between the college didactic course work and the clinical experience. The PTA program reviews and updates the PTA Student Handbook annually. Throughout the academic year, the faculty and program director keep notes (in the Departmental Meeting Minutes) on policies and procedures that need to be added or changed. Every new policy applied to the Physical Therapist Assistant Program is cross-reference with the institutional policies. Significant additions or changes are presented to the Advisory Board Committee for approval. Changes are then made to the manuals and redistributed at the beginning of the following academic year.

INTRODUCTION San Jacinto Community College District is a public community college in East Harris County, Texas, which serves a district defined by the combined areas of these independent school districts: Channelview, clear Creek, Deer Park, Galena Park, La Porte, Pasadena, and Sheldon, as well as portions of Clear Creek and Humble. The college is accredited by the Commission on Colleges of Southern Association of Colleges and Schools to award the associate degree. San Jacinto College District is committed to equal employment opportunity. As provided by this policy and to the extent provided by applicable law, no person including students, faculty, staff, and temporary workers will be excluded from participation in, denied the benefits of, or be subject to discrimination under any program or activity sponsored or conducted by the San Jacinto College District on the basis of sex, disability, race, religion, color, age, national origin, or veteran status. San Jacinto College District meets the needs of its community through high-quality education. As part of this mission, Quality Enhancement Plan (QEP) encourages students to read their textbook and course material carefully to succeed in their classes and realize their personal and educational goals. The Physical Therapist Assistant Program strives to promote congruent mission, vision and values statements with our college. Professionalism is the cornerstone

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of our program and our vocation. Our philosophy can be reiterated in the American Physical Therapy Associations’ Code of Ethics for the Physical Therapist, Standards of Ethical Conduct for the Physical Therapist Assistant, Guide for Professional Conduct, and Guide for Conduct of the PTA, at www.apta.org. The PTA program complies with the Executive Council of Physical Therapy and Occupational Therapy Examiners. San Jacinto College is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools. The PTA Program at San Jacinto College is accredited by the Commission on Accreditation in Physical Therapy Education (111 North Fairfax St., Alexandria, VA 22314-1488; telephone: (703) 706-3245); email: accreditation@apta.org; website: http://www.capteonline.org. American Physical Therapy Association (APTA) 1111 North Fairfax Street Alexandria, VA 22314-1488 (703) 684-APTA (2782) www.apta.org Executive Council of Physical Therapy and Occupational Therapy Examiners 333 Guadalupe, Suite 2-510 Austin, TX 78701-3942 (512) 305-6900 www.ecptote.state.tx.us/ Commission on Colleges of Southern Association of Colleges and Schools 1886 Southern Lane Decatur, GA 30033-4097 (404) 679-4501 www.sacscoc.org/

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1. FACULTY/STAFF DIRECTORY Core faculty: Patricia Corley, PT, DPT Laura Oppermann, PT, C/NDT, ACCE Program Director Academic Coordinator of Clinical Ed. Phone: 281-929-4697 Phone: 281-484-1900 ext. 3519 Fax: 281-929-4634 Fax: 281-929-4634 Patricia.Corley@sjcd.edu Laura.Oppermann@sjcd.edu Adjunct faculty: Don Gohn, PTA/LMT Holly Beckman, PTA Phone: 281-922-3476 Phone: 281-922-3476 Fax: 281-929-4634 Fax: 281-929-4634 Administrative assistant: Jodi Rodriguez Phone: 281-922-3476 Fax: 281-929-4634 Jodi.Rodriguez@sjcd.edu Program Information San Jacinto College – South Campus Science/Allied Health (Building 1, room S-1251q) 13735 Beamer Road Houston, TX 77089 281-922-3476 www.sanjac.edu/physical-therapy

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MISSION STATEMENTS COLLEGE Our mission is to ensure student success, create seamless transitions, and enrich the quality of life in the communities we serve. PROGRAM The mission of the Physical Therapist Assistant Program is to provide successful and competent para-professionals who possess the knowledge, skills, and attitudes necessary to succeed in the profession in a variety of health care settings under the direction of a Physical Therapist. The graduate will have a commitment to self-directed lifelong learning; and be of service to man, the community and society.

VISION STATEMENTS COLLEGE San Jacinto College will be the leader in educational excellence and in the achievement of equity among diverse populations. We will empower students to achieve their goals, redefine their expectations, and encourage their exploration of new opportunities. Our passions are people, learning, innovation, and continuous improvement. PROGRAM The Physical Therapist Assistant Program will develop educational excellence in physical therapy and bring to the program students from diverse backgrounds, locations and cultures. All students will have the opportunity to explore their unique interests with the support and encouragement of staff and faculty. Our desire is to create an environment to instill critical thinking, ethical behavior, and compassionate treatments in the classroom and on clinical rotations.

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VALUES COLLEGE Integrity: Ethical and Professional: “We act in ways which instill confidence and trust.” Excellence: In Everything We Do: “We achieve quality results in everything we do.” Accountability: It’s Up to Us: “We take responsibility for our commitments and outcomes.” Innovation: Lead the Way: “We apply knowledge, skill, insight, and imagination to recognize opportunities, solve problems, and recommend new solutions.” Sense of Community: Caring for Those We Serve and Ourselves: “We demonstrate genuine concern for the well-being of our students, our community and ourselves.” Student Success: Our Ultimate Measure: “We enable students to achieve their goals.” Diversity: Celebrate the Differences: “We celebrate the diversity of ideas and cultures.” Collaboration: We Work together: “We work together for the benefit of the college.” PROGRAM Integrity: In every class and clinical experience students will demonstrate professional behaviors and ethical conduct. Excellence: We strive to have not only outstanding classes and resources at the college but also at each clinical and healthcare facility. Accountability: We strive to be accountable to our students, the college, our clinical sites and the community. Innovation: Our innovated thinking is expressed in the classroom and clinical program by adapting policy of creative clinical placement and imaginative learning experiences. Sense of Community: Through service learning and the Student Physical Therapist Assistant Society we provide numerous opportunities for the student to develop a sense of community for the betterment of themselves and others.

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Student Success: Our student success is ultimately measured by the passage of the National Exam for the PTA, their accumulated knowledge, enriched lives as well as a lifelong service to themselves and others. Diversity: In all our professional activities we identify, value and act with consideration for all individuals. Collaboration: Our students work as a team member in class, clinical situations and in the community.

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CURRICULUM OUTLINE First Term Credits PTHA 1405 – Basic Patient Care Skills 4 PTHA 1413 – Functional Anatomy 4 ENGL 1301 – Composition I 3 PTHA 1201 – The Profession of Physical

Therapy 2 BIOL 2401 – Human Anatomy & Physiology I 4 Second Term PTHA 2301 – Essentials of Data Collection 3 PTHA 1431 – Physical Agents 4 PTHA 2409 – Therapeutic Exercise 4 BIOL 2402 – Human Anatomy & Physiology II 4 Third Term PTHA 1191 – Special Topics in Physical Therapy 1 PTHA 1360 – Clinical I – PTA 3 PTHA 1321 – Pathophysiology for the PTA 3 MATH 1314 – College Algebra or

MATH 1333 Contemporary Math for Technical Programs 3

Fourth Term PTHA 2531 – Management of Neurological Disorders 5 PTHA 2435 – Rehabilitation Techniques 4 PTHA 2239 – Professional Issues 2 ENGL 1302 – Composition II or ENGL 2311 – Technical Report Writing 3 PHED 1123 – Weight Training 1 Fifth Term PTHA 2460 – Clinical II – PTA 4 PTHA 2461 – Clinical III – PTA 4 *Humanities or Fine Arts 3 PSYC 2301 – General Psychology 3 PHED Activity 1 Courses that meet Humanities requirements: *English 2322, 2323, 2327, 2328, 2332, 2333 Philosophy 1301, 2306 Arts 1301, 1303, 1304 Dance 2303 Drama 1310, 2366 Music 1306, 1307, 1310 The program is a total of 72 credit hours and the student is awarded an A.A.S. degree upon completion of the program.

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CLINICAL PROGRAM GOALS San Jacinto College Physical Therapist Assistant Program is committed to providing an in-depth curriculum of academic and technical physical therapy and non-physical therapy courses. From a strong didactic base, students advance to clinical internships in various settings and locations. Each learner will have unique experiences involving both physical therapists and physical therapist assistants as clinical instructors. Most clinical sites are in the Houston area but can expand to Southeast Texas when necessary. Goals upon completion of the program include: 1. To work under the supervision of a physical therapist as stated by the Texas Board of Physical Therapy Examiners Rules 322.2.

2. View learning and professional development as a lifelong process. 3. Function as educated, contributing members of the community and society. 4. Execute a plan of care developed by the physical therapist. 5. Acquire, exhibit, and maintain high standards of professional ethics. 6. Excel in patient/client relationships being sensitive to diverse health care populations. 7. Exhibit competent data collecting skills and be able to communicate findings to the physical therapist and other staff. 8. Seek out and acquire new knowledge while integrating the information into quality treatments. 9. Participate as a health care team member to provide competent patient treatment based on scientific facts and principles. 10. Teach established skills to other health care providers, patients, and families. 11. Communicate effectively and honestly in writing in all aspects of physical therapy. 12. Demonstrate excellent team skills when participating in discharge planning, team conferences, and project development. 13. Exhibit critical safety skills by demonstrating the following:

a. The student will carry out the plan of care established by the physical therapist with the minimum of risk.

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b. The student will make sure that the treatment is not contraindicated by the patient’s diagnosis or medical status. c. The student will be able to identify physiological measures and to take corrective action by contacting their CI, PT, physician and nurse when the parameters are outside normal lab valves. d. The student will practice universal precautions to stop the spread of infection through hand washing and applying sterile technique when necessary. e. The student will practice safe techniques in bed mobility, transfers, gait training, therapeutic exercises and physical agents, as well as any other skills the student has been checked off by either the school faculty or the clinical instructor. Correct gait pattern, weight bearing status, and appropriate assistive device will be used for each person. f. The student will maintain a safe work environment by keeping the floor cleared of equipment, shoes and anything else which could be a danger. In acute care lines and tubes will be monitored and maintained. Any piece of nonworking equipment will not be use on a patient.

g. The student will abide by the facilities policies and procedures. h. The student will request assistance any time they are not confident in their ability to give optimum treatment or to keep the patient or themselves safe.

If safety is not maintained the clinical instructor will call the ACCE and a decision will be made if the student should remain in the facility or be removed. For a description of the minimum skills for the entry level PTA developed by the Board of Directors of the APTA, see Appendix A.

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CLINICAL REQUIREMENTS 1. Immunizations Students are required to submit to the PTA department their immunizations or titer for Hepatitis B, varicella, measles, mumps, rubella and diphtheria/tetanus. Tuberculosis skin test or chest x-ray will be done annually. This is due before the end of the second semester except for the Hepatitis B third shot which will be completed in the fall of the second year. Some facilities will also require the seasonal flu shot. All immunizations are at the student’s expense. Pregnant students will need written approval from their physician which will include the amount of weight a student can lift before going out on a clinical rotation. 2. Background Check and Drug Screen Students will have a background check and 10 panel drug test upon entering the PTA Program. (See Student Manual). Some facilities may require an additional background check and/or drug test before coming to their facility. Background check and drug screen are at the expense of the student. The student has an obligation to notify the school of any criminal conviction which occurs after their initial background check and before they graduate and within 20 days after the occurrence. Any student that fails a drug test will be excluded from clinical placement at that time. 3. CPR Students will be required to have a current CPR card before going out on any clinical rotations. 4. Curriculum Students must pass with a “C” or better all prerequisite courses before going on each clinical rotation. All three clinical courses (PTHA 1360, PTHA 2460, and PTHA 2461) must be completed with a satisfactory grade prior to graduation. A student may only repeat one clinical course one time. A student must get permission from both the ACCE and Program Director and must be in good standing with the program in order to have the privilege of repeating a clinical course. 5. PTA students are expected to present themselves in a professional manner in the classroom, laboratory, and clinical settings. Personal cleanliness and hygiene are essential for engagement with others in the healthcare setting. Students should follow the guidelines below and the PTA faculty will counsel students in these areas when necessary. Failure of the student to follow these guidelines after counseling may result in dismissal from the PTA program.

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a. Hygiene should include daily bathing and brushing teeth. No fragrances or perfumes are to be worn. Offensive body odors will not be tolerated, including the lingering smell of tobacco on skin, hair, breath or clothing. b. Moustaches/beards must be neatly trimmed. c. Hair must be clean and trimmed. Students with long hair must be able to tie hair back so that it does not fall loosely over shoulders and face. d. Fingernails must be clean and filed smoothly. The fingernails must not extend beyond the fingertips. e. Simple jewelry such as wedding bands/rings, watch, small chain necklace, and small stud earrings are acceptable. Oversized jewelry is not acceptable. Piercings anywhere other than the ear are not acceptable. All records of immunization, background checks, drug screens and CPR are kept in a secured location.

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ORIENTATION DAY Before Clinical I, students will come to the PTA lab for a day of orientation to the clinical process. This will include: professionalism, behaviors, safety, teaching and learning theory plus education on the PTA MACs. See Appendix W. On that day or on previous days the students will check off on basic gait, transfers and physical agents.

STUDENT EVALUATIONS The clinical process is to nurture student learning in the following ways: Students will be evaluated in the following clinical courses:

PTHA 1360 - Clinical I PTHA 2460 - Clinical II PTHA 2461 - Clinical III

Clinical evaluations will consider the student’s ability to apply theory to practice; conduct, appearance, interpersonal relationships and demonstrated competence in clinical performance (refer to PTA MACS). Clinical evaluations will be completed by the clinical instructor using the PTA MACS. Progress reports will be made at the midpoint of the affiliation and at the end of the affiliation. Frequent meetings throughout the internship between the clinical instructor and student can lead to the best understanding for both participants.

Students will be aware of evaluations and be asked to acknowledge the information by their written comments in the Student Evaluation of Clinical Education Experience (SECEE) and signature on the Progress Report form. Final grades for a clinical will be determined by college faculty, usually the ACCE, based on criteria in the syllabus for each course. See Appendix G for syllabi of the above courses.

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CLINICAL GRADING Each student will buy a PTA MAC. These are bought as a group through the Student Physical Therapist Assistant Society. The PTA MAC will be used for all internships and the student’s skills will be checked off at each facility. This ongoing tabulation summary allows the student, CI, and ACCE to see where there are strengths and weaknesses. By 95-100% completion of the book a student should be entry level and ready to take the National Physical Therapist Assistant Examination and practice safely with a variety of patients/clients under the supervision and direction of a physical therapist. The ACCE or faculty instructor from the school will be ultimately in charge of the final letter grade. In Appendix B are the directions for filling out the PTA MACs. A new CI can also request a one-on-one training session with the ACCE to assist in filling out the PTA MAC. In Appendix C is the Progress Report form with the CI’s midterm and final summary of the student’s strengths and weaknesses. In Appendix D is the Midterm Site Visit form the ACCE fills out when going to the clinical site to speak with the CI and student to assess student’s professional and physical therapy skills. In Appendix E is the Clinical Grading System form the ACCE fills out when the student returns to the college after completing the clinical rotation for a debriefing session with the ACCE. At that time a review is done of the total clinical experience as well as a final grade is assigned. In Appendix F is the Student Evaluation of Clinical Education Experience (SECCE) form the student completes at the end of the rotation. The student offers a copy to the CI to facilitate the clinical site’s learning experience. The original is returned to the school for review. In Appendix G are the syllabi for PTHA 1360, PTHA 2460 and PTHA 2461, the 3 clinical rotations with the individual grading criteria. The PTA MACs: The book is divided into four sections: Professional Behaviors, Data Collection, Interventions, and Site Specific Skills. Professional Behaviors Each skill sheet will be filled out at each clinical experience. By the last

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clinical all skills must be checked off. Data Collection In this section there are two skills (14.8 and 14.10) with multiple check-offs. For those sections each must have 8 check offs. Each skill sheet will be completed at each clinical affiliation. If the skill is not appropriate for the clinical site, the clinical instructor will document a N/A for Not Applicable. Interventions In this section the student must meet the minimal number of skills:

Skill number Check offs needed 16 25 17 10

21 13 (with at least 3 from 21.4) After the skill has been checked off at one clinical, it will be up to succeeding clinical instructors to decide if the skill needs to be rechecked. Site Specific Skills are optional but can be used where other intervention skills are lacking secondary to no opportunity at that facility.

GRADE RANGE: 90 – 100 A 80 – 89 B 76– 79 C 60 – 74 D Below 60 F

A grade below “C” is not acceptable. Therefore, grades of “D” and “F” are not passing and failed courses must be repeated prior to progressing in the program (classes or clinical). Faculty will determine and make known to students the grading system at the beginning of each course. Each course must be passed with a minimum of “C” proficiency and written test average must be 75% or higher. Each semester’s courses must be completed with a satisfactory grade before progressing to the next level. If a student fails to achieve a 75% on their written test average, then the student will receive the grade equal to the average test score for written tests.

A FINAL GRADE OF "C" OR BETTER MUST BE MADE IN EACH COURSE IN ORDER TO PASS THE COURSE AND ADVANCE IN THE PROGRAM

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Clinical I PTHA 1360 Completion of required PTA MACS skills will constitute 66% of the grade. All of the following criteria must be met (or have documentation by the clinical instructor that there was no opportunity to perform the skill at that facility) to pass the course and advance in the program:

Any five skills of 1-12 must be assessed as meeting entry level performance as indicated by a “ √ ” or “+” on the master sheet (blue) or skill sheets (white) in The PTA MACS.

Demonstrate at least ten additional skills are at entry level performance on the Master sheet.

Every “NI” given on Final assessment by the clinical instructor will count as a negative 2 points per “NI” taken off the final grade for the clinical.

Every “U” or “Challenge” given on Final assessment by the clinical instructor will count as a negative 10 points per “U” or “challenge” taken off the final grade for the clinical. Additional mediation may be added as needed including dismissal or an additional clinical.

Developing and presenting an in-service for the clinical facility staff and submitting required documentation on time will constitute 12% of the grade.

Student will email a total of 3 reflective journal articles on their clinical Experience according to email journal guidelines which will constitute 12% of the grade. The articles must be on time or points will be taken off the final grade.

Completion and submission of the Student Evaluation of Clinical Education Experience at the clinical facility will constitute 5% of the grade. Your CI should have the opportunity to review and copy of this form. This form needs to be turned in signed by the CI on “debriefing” day or points will be taken off.

Submission of time sheet demonstrating required attendance. The time sheet will constitute 5% of the grade. All absences must be reported to the CI and the ACCE in person or by telephone prior to the start of the scheduled workday. Emails and text messages are not acceptable. A student may have no unexcused absences. Any unexcused absences will result in failure of the clinical course. The ACCE will determine if the absence will be excused. If sick, the student will be advised to obtain a physician’s letter of excused absence. Each day of excused absence will result in 5 points removed

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from the student’s final course grade. In order to receive a C or better in the final course grade, all excused absences must be made up at the convenience of the CI.

ALL FINAL GRADES ARE THE RESPONSIBILITY OF THE ACCE FROM SAN JACINTO COLLEGE AND CAN BE MODIFIED AS NEEDED TO REFLECT THE STUDENT’S OVERALL PROFORMANCE ON THIS CLINICAL. ADDITIONAL DEDUCTIONS INCLUDE: -5 CI information reported past 1 week from start of clinical -5 Not notifying ACCE by telephone or in person you are not at your clinical site and the reason -5 Paperwork not complete on debriefing day

-3 Each email journal late past 3rd day (example- 4th week journal late Tuesday of the following week)

Grading for PTHA 2460 and PTHA 2461:

Completion of required PTA MACS skills will constitute 66% of the grade. All of the following criteria must be met (or have documentation by the clinical instructor that there was no opportunity to perform the skill at that facility) to pass the course and advance in the program:

Any nine for PTHA 2460 and eleven for PTHA 2461 skills of 1-12 must be assessed as meeting entry level performance as indicated by a “ √ ” or “+” on the master sheet (blue) or skill sheets (white) in The PTA MACS.

Demonstrate at least ten additional skills are at entry level performance on the master sheet.

Every “NI” given on Final assessment by the clinical instructor will count as a negative 2 points per “NI” taken off the final grade for the clinical.

Every “U” or “Challenge” given on Final assessment by the clinical instructor will count as a negative 10 points per “U” or “challenge” taken off the final grade for the clinical. Additional mediation may be added as needed including dismissal or an additional clinical.

Developing and presenting an in-service for the clinical facility staff and submitting required documentation on time will constitute 12% of the grade.

Student will email a total of 4 reflective journal articles on their clinical experience according to email journal guidelines which will constitute 12% of the grade. The articles must be on time or points will be taken off the final grade.

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Completion and submission of the Student Evaluation of Clinical Education Experience at the clinical facility will constitute 2 % of the grade. Your CI should have the opportunity to review and copy this form. This form needs to be turned in signed by CI on “debriefing” day or points will be taken

Submission of time sheet demonstrating required attendance. The time sheet will constitute 3% of the grade.

A typed case study on one of the patients that the students follow during this affiliation will constitute 12% of the grade.

All absences must be reported to the CI and the ACCE in person or by telephone prior to the start of the scheduled workday. Emails and text messages are not acceptable. A student may have no unexcused absences. Any unexcused absences will result in failure of the clinical course. The ACCE will determine if the absence will be excused. If sick, the student will be advised to obtain a physician’s letter of excused absence. Each day of excused absence will result in 5 points removed from the student’s final course grade. In order to receive a C or better in the final course grade, all excused absences must be made up at the

convenience of the CI.

ALL FINAL GRADES ARE THE RESPONSIBILITY OF THE ACCE FROM SAN JACINTO COLLEGE AND CAN BE MODIFIED AS NEEDED TO REFLECT THE STUDENT’S OVERALL PROFORMANCE ON THIS CLINICAL. ADDITIONAL DEDUCTIONS INCLUDE:

-5 CI information reported past 1 week from start of clinical

-5 Not notifying ACCE by telephone or in person that you are not at your clinical site and the reason prior to the start of the clinical day

-5 Paperwork not complete on debriefing day

-3 Each email journal late past 3rd day (example- 4th week journal late Tuesday of the following week

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CLINICAL EDUCATION PROCESS The Academic Coordinator of Clinical Education will place the student in various clinical settings during the three different rotations. The goal is to place each student in at least one inpatient and one outpatient setting. This will be impacted by what sites are available at that time as well as student’s interest and capabilities. As the student progress in their clinical rotation they are expected to meet progressively more difficult patients and techniques. The clinical education is designed to:

1. Develop communication skills between the student, physical therapists, physical therapist assistants, other staff as well as patients and families.

2. Apply techniques and principles learned in the classroom to actual patients/clients.

3. To assist the faculty in assessing their program.

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AFFILIATION AGREEMENTS WITH CLINICAL FACILITIES The contract process can begin either with the school or the physical therapy facility. The school has a contract (see Appendix H) or the facility can initiate their own which will be reviewed and revised by the college’s attorney then sent back to the facility for their approval or additional changes. After both sides consider the contract acceptable both sides sign and date it as well as the San Jacinto Board’s approval. The length of term of the contract is decided by both parties. Factors considered when initiating a contract are: 1. What type of learning experiences are offered and are there a variety of patients? 2. What needs does the school have for clinical rotation? 3. Strong professional role models. 4. CIs with excellent communication skills. 5. Facilities that want students and are eager to share their knowledge. 6. The facility’s physical plant. 7. Evidence of strong continuing education and learning. Each year, the Academic Coordinator of Clinical Education reviews the Contract Term Log to determine which written agreements will expire that year and begins the process through the administrative support team. The Academic Coordinator of Clinical Education or school’s attorney will review the written agreement. Also, if the contract has been updated or if changes have occurred either within the school or if the facility recommends revisions it can also be reviewed by the Program Director, Associate Dean or Department Chair of Health Sciences, and/or advisory committee as appropriate. Recommended revisions would be forwarded to legal counsel of the college for review. Only those contracts which are current will be utilized for clinical rotations. In addition to this specific update, the Academic Coordinator of Clinical Education will utilize the Contact Term Log and Contracts in Progress Log to periodically determine if a contract requires renewal and address that site's agreement on an ongoing basis.

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RESPONSIBILITES OF THE ACADEMIC COORDINATOR OF CLINICAL EDUCATION Generally the Academic Coordinator of Clinical Education (ACCE) will place the students in their clinical, do the midterm site visit and meet with the student at the completion of the internship for their debriefing. The ACCE works with other instructors at the college plus clinical staff to provide the best educational experience. Responsibilities: 1. Seeks new clinical contracts in the area of acute care hospitals, rehabilitation facilities and outpatient departments using APTA guidelines for clinical facilities (Appendix J). 2. Reviews existing contracts yearly and renews them as needed including ones that are about to expire plus contracts which need updated language. The ACCE will make a visit to all new facilities and fill out the Initial Site Visit Form (Appendix K). 3. Keeps an updated list of contracts and their clinical sites. The list will be revised completely at least once a year in the summer. 4. Coordinates information between the school and clinical facilities. 5. Sends out the APTA Clinical Site Information Form (CSIF) (Appendix L) every two years or as needed. 6. Educates the student and clinical instructors on the PTA MACs. 7. The ACCE visits each student at midterm in the facility in which they are doing their internship except when distance or other circumstances makes that impossible. At that time the ACCE or the school’s representative, meets with the CI and the student and reviews their progress, answers questions regarding the PTA MACS, and assists in developing strategies to increase the student learning experience. The student meets with the ACCE after completing the clinical and has a debriefing time. 8. Debriefing time comes at the end of each clinical. During this meeting between the ACCE and the student the following forms are turned in: Your Clinical Instructor, the green SECEE forms, the pink progress report, in service paperwork, attendance sheet and for clinical II and III a case study. The ACCE

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and student review the rest of the PTA MAC and discuss areas of weakness or incompleteness. At this time a student is assigned a grade for that clinical. 9. Arrange for CI educational opportunities. The Program Director and ACCE will sponsor and support clinical education learning experiences in the community. 10. Reads and respond to student email journals which the student will write every other week when out on clinical. 11. Organizes and places students in physical therapy facilities without regard for race, color, marital status, gender, sexual orientation, religion, national origin, disability, age, or disabled veteran status as provided by law and in accordance with the College’s respect for personal dignity. Students will fill out a Preference Form (Appendix M). With the student’s choices in mind, the student’s strengths and weaknesses, the complexity of the facility, and its location, the ACCE places the student. 12. The goal of clinical placement is to include at least one inpatient and one outpatient of the three clinical rotations. The student will probably be required to travel some distance for at least one of their internships. To see what clinical sites we have contacts with, the student needs to meet with the ACCE as sites frequently change as well as their availability. 13. San Jacinto College provides liability insurance which the student pays for when they enroll in the clinical course. The ACCE will send a copy of the insurance in each student’s packet which will arrive at the facility before the student. 14. A Clinical Information Sheet (Appendix N) will be sent out to facilities with the student packet which can be used by the CI to disseminate information back to the student. 15. Every spring the ACCE will send out the Facility Commitment Form for Clinical Affiliations (Appendix O) so facilities can let the school know what the availability for student placement will be for the next year. 16. The ACCE will communicate with CCCE’s and clinical instructors on changes to the PTA MAC, changes with the PTA program as well as information on CI certification courses, APTA news, Texas Board of PT Examiners which affect them or their students.

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RIGHTS, PRIVILEGES AND RESPONSIBILITIES OF THE CLINICAL INSTRUCTOR At some facilities there will be an assigned person: Center Coordinator for Clinical Education (CCCE); at other facilities the clinical instructor (CI) will be the contact between the school and their department. If the person is the CCCE, they should have multiple years of rehabilitation experience and good communication skills. If they are a clinical instructor, they need 1 year experience regardless if they are a PT or PTA, graduated from an accredited PT or PTA program, and licensed in Texas. Rights and Privileges start with faculty being helpful to clinical instructors including education on PTA MACs and as stated in the above responsibilities of the ACCE #16. For positive feedback we have students write thank you notes supplied by the school and the student’s vote for their favorite CI. The ACCE then delivers a plaque for Best Clinical Instructor. Rights also include job posting by the PTA Program to upcoming graduates and past graduates. Marketing materials are delivered at midterm site visits. CIs are encouraged to let the school know if they would be interested in an adjunct position or to give a guest lecture. These are similar rights and privileges to the Pharmacy Tech. program which we share many commonalities. The Clinical handbook will be available on our website at anytime. Clinical instructors’ responsibilities include but are not limited to: 1. Understand the PTA MACS and be able to fill it out acceptably so that college faculty can assess student performance. The CI should be able to complete the master sheet (blue) including the Clinical Experience Facility Identification Form (blue), skill sheets (white), site specific forms (yellow) and Progress Report (pink). General instructions and educational philosophy are at the beginning of the book (golden). 2. Provide direction, education and supervision to the student. 3. Initiate a team spirit between the PT, PTA and student. 4. Teach problem solving methods especially towards patients/clients issues. 5. Expose students to new ideas and different diagnoses. 6. Supervise PTA student or have another designated PT/PTA supervising.

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7. Initiate educational goals each week so that the student will achieve the most skills and learning experiences during the internship. A Weekly Goals Form is located in Appendix V. 8. Send students basic information about the facility: Address of facility Hours and days they will be working Packing information Dress code Clinical instructor’s name and contact information Types of patient’s they will observe and treat Types of treatments performed First day instructions Any additional information The Clinical Information Sheet is available (Appendix N) to send student their information. 9. The clinical instructor or CCCE can suspend the student’s clinical with the knowledge of the school’s faculty for either hours or days or can terminate the clinical rotation. This may happen because of hurricanes or other disasters. The hospital or clinic can also have other situations which make it unsafe or impractical to continue to educate the student. 10. After the student completes clinical III, the CI from that rotation will fill out a clinical instructor questionnaire (Appendix P) sent by the ACCE in the following summer to see where the school could improve the program using the CI’s evaluation.

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RESPONSIBILITIES OF STUDENTS Students are expected to communicate with their ACCE and CI about any expectations, desires, or problems they have with their clinical. Duties of the student on during clinical include: 1. To be on time and dressed appropriately; arriving with all the materials you may need. Be professional. 2. To act professionally and ethically at all times. This includes your manner and demeanor while on the facility’s property. No smoking, gum chewing, slouching, lying down on mats in the facility. You are a guest at this facility and the CI is giving their experience and time to you for free so always be gracious and helpful. Your attitude is the most important attribute you bring with you. Never say anything negative about the facility or your CI to friends, other students or on Facebook. 3. To not use their mobile phone except during lunch time. 4. To look up any new material presented in the PT facility and understand it by the next day. 5. To know the PTA MACS and be able to use it as an educational tool. This will include checking off your part at the top of each white page, develop a system with your CI so that she/he knows when you feel you are entry level and ready to be checked off, fill out the green sheets at the end of each clinical and show to your CI followed by a CI signature. It is your responsibility to get the skills checked off. You will need to constantly be thinking about the skills you are doing with your patients and remember to checked them off when you feel you are entry level. Many times students do not keep up with these checks and when they come in for debriefing they remember all the other skills they do not get checked. Unfortunately, if you miss checking off at one clinical, you may not have that opportunity again. This may affect your grade or the need to do an extra clinical. 6. To provide input in the selection of their clinical site (Appendix Q). 7. To actively seek out new learning experiences and to acquire new skills. 8. The ACCE visits each student at midterm in the facility in which they are doing their internship except when distance or other circumstances makes that impossible. At that time the ACCE or the school’s representative, meets with the CI and the student and reviews their progress, answers questions regarding the PTA MACS, and assists in developing strategies to increase the student learning

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experience. The student meets with the ACCE after completing the clinical and has a debriefing time. 9. Debriefing time comes at the end of each clinical. During this meeting between the ACCE and the student the following forms are turned in: Your Clinical Instructor, the green SECEE forms, the pink progress form, in service paperwork, attendance sheet and for clinical II and III a case study. The ACCE and student review the rest of the PTA MAC and discuss areas of weakness or incompleteness. At this time a student is assigned a grade for that clinical. 10. To write email journals to the ACCE dealing with professional issues every other week while on clinical (Appendix R). 11. To give an in-service or other project during each clinical. Subject of in-service or project will be determined by the CI and the student. 12. To write a case study in clinical II and III, which the student will turn into the ACCE at debriefing time. 13. To keep a weekly time sheet, signed by the CI weekly and turned in at debriefing with the total number of hours at the bottom. Students are expected to be prepared and attend their clinical rotation each day. If time is missed the student is expected to make up the time when it is convenient to the clinical instructor. Holidays are regulated by the facility and not by the school so expect to work on a holiday. Students are expected to be at their clinical site 35-40 hours per week. 14. If the student has an unexpected absence, a telephone call or email to the CI, CCCE and ACCE must be made as soon as possible explaining the nature of the emergency. Make up time will be discussed and determined with the CI, CCCE and ACCE at the CIs convenience. 15. If the student has a planned absence, approved by the clinical instructor, the time must be made up at the CI’s convenience. 16. Any time the student is not in the facility or with the clinical instructor during time established as clinical hours the ACCE must be notified. 17. Students are not allowed to contact facilities and try to set up their own clinical rotation. The placing of students is complex and student cannot shortcut the process. Once the student has their assignment, they may contact the facility 2-3 weeks ahead of arriving. 18. At times students will find that clinical assignments must be changed and students will need to remain flexible. The ACCE will try to place them in the same

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type of facility if possible but location will probably change. Students may not cancel their clinical rotation. 19. Students do not: Leave any clinical facility without instructor’s permission.

Serve as a witness. Take verbal/telephone orders. Transcribe orders.

Give patient care to patients if they are not “satisfactorily prepared to do so safely.” Instructors are to dismiss students from clinical area and document loss of a clinical day if the student is not prepared to care for a patient.

Accept gratuities. Treat patients without CI present. Treat patients without PT in the facility.

Dress unprofessionally. Instructors are to dismiss the student and document the loss of a clinical day. Attend clinical with an expired CPR card, expired TB test or expired immunizations.

20. Clinical experience is an essential part of the physical therapist assistant student’s education. Students are required to travel to clinical site and to assume any expenses that may be required. The ACCE will make every effort to find a clinical site that is within a reasonable distance from the student’s home. The student must be able to demonstrate the safe, competent practice of physical therapy during each clinical course. A student is required to discuss with his or her faculty and clinical instructor any physical limitations or injuries that may be worsened by performing patient care in that setting so that appropriate safety measures can be taken. This discussion should occur prior to beginning any field experience. If problems of health develop during the rotation the student will let the ACCE, CI and CCCE know immediately. When necessary, the student may be able to modify the clinical, be placed at another clinical site if available or restart the clinical at a later time. 21. Minimum skill performance must be demonstrated in the lab before being assigned to patient care in the clinical setting. At the beginning of each clinical course, the student will receive a copy of the student learning objectives, skill requirements, and competencies required to pass the course. Students may be assigned to clinical experiences during week day or weekend hours and are to follow the working hours of their clinical instructor. During the clinical, students are required to introduce themselves as a Student Physical Therapist Assistant to each patient they work with to ensure the patient is aware that a student is involved in the treatment. In addition, each student is required to wear a nametag each day of the internship which identifies the student as a Student Physical Therapist Assistant. All clinical experiences will be supervised by San Jacinto College faculty.

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22. The student is required to call or email the facility 2-3 weeks before the clinical starts. During this initial contact the student needs to know: Address of facility Hours and days they will be working Packet information sent from the clinical facility Dress code Clinical instructor’s name and contact information Types of patient’s they will observe and treat Types of treatments performed First day instructions Any additional information From the above information the student should look up and study any of the disabilities they are unfamiliar with along with any treatments procedures. By the time the student arrives they should be organized, professional and prepared to glean the most from this clinical experience. 23. The student will fill out a Student Personal Data Sheet (Appendix Q) which will be sent to the facility in the student packet. 24. There may be facilities that require a recent background or drug test before starting the rotation. These tests are at the student’s expense. 25. Students are to wear a name badge during clinic hours. The college furnishes the student with a badge but some hospitals will provide one as well and theirs would be the one worn. 26. Always introduce yourself as a student physical therapist assistant to patients and staff. Remember patients have the right to refuse to participate in clinical education. 27. Besides your attitude, the other aspect to always remember is to keep the patient safe. Never leave a patient in an unsafe situation. One thoughtless action on your part could change your patient’s life forever. Never do harm. If you feel you are not able to handle a patient either physically, cognitively or emotionally tell your CI and do not treat the patient.

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HEALTH INSURANCE AND EMERGENCY CARE Neither the clinical facility nor the school assumes any responsibility for injury occurring during the clinical or any other time while the student attends San Jacinto College or when the student is out on a clinical rotation. The student is strongly encouraged to carry health insurance. Some facilities may not take the student if they do not have health insurance. All emergency care required by the student is at the student’s expense. The CI or student should notify the emergency contact and the ACCE or Program Director immediately if the student is injured during clinical hours.

Patients with Communicable Diseases/Confidentiality/HIPAA

Caring for patients with a communicable disease is an occupational/professional challenge in health care. Students will be instructed in protocols and procedures to reduce their risk for acquiring an infection or communicable disease. However, all areas of health care practice have inherent risks and no area is completely risk free. Students will be trained in Universal Precautions and will be required to sign documentation (Appendix F) that they have received training prior to the start of their clinical course.

All patients have the right to confidentiality of all records and all communications, written or oral, between patients and health care providers. Students will not reveal (to anyone other than their instructors) any confidential information that may come to their knowledge in the course of their work/studies. Students will hold in confidence all personal matters committed to confidentiality and all family affairs coming to their knowledge in the practice of their profession. Students will be dismissed from the program for breach of confidentiality.

Students will be trained in HIPAA policies and will sign documentation (Appendix F) that they have received training prior to the start of their clinical course.

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EXPECTATIONS AND OBJECTIVES FOR CLINICAL ROTATIONS Clinical I: 5 weeks/5 days a week/40 hours /week Expectations: After approximately one year of classroom learning the student will precede to clinical I to initiate PT skills by observation then supervision by a PT or PTA. Objectives: To have initial contact with patients in a physical therapy setting under the close supervision and direction of a PT and possibly a PTA. The student will use the tools and skills learned during the first year of classroom preparation.

STUDENT LEARNING OUTCOMES: Upon completion of the course and when applicable to the student’s individualized clinical setting, students

will be able to:

A. As outlined in the learning plan, apply the theory, concepts, and skills involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the physical therapy business/industry and will demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the physical therapy business/industry.

B. Demonstrate a commitment to learning. C. Demonstrate competent interpersonal skills including professional

demeanor, respect for all persons, confidence, and delegation of tasks to personnel.

D. Demonstrate competent non-verbal, verbal, and written communication skills in the physical therapy setting.

E. Effectively use time and resources in the physical therapy setting. F. Seek feedback and, in a positive manner, apply constructive feedback

to the practice of physical therapy. G. Apply problem solving skills to the practice of physical therapy. H. Follow standards of professionalism in physical therapy including

practicing legally, ethically, and within facility guidelines. I. Accept responsibility for the learning experience and recognize the

need to provide and seek assistance when necessary. J. Apply critical thinking skills to the practice of physical therapy.

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K. Apply stress management skills to the practice of physical therapy. L. Apply safety consciousness in the clinical setting including the

recognition and remediation of safety concerns during patient care, use of proper body mechanics and guarding techniques, use of standard precautions, and safe handling of patients and equipment.

M. Provide education to other healthcare providers. N. Demonstrate competency with data collection techniques. O. Implement the plan of care developed by the physical therapist. P. Modify the plan of care accordingly within the plan of care. Q. Instruct patients in techniques, activities, and skills that need to be

taught from the plan of care. R. Participate in discharge planning within the plan of care. S. Determine appropriateness of exercise for a given patient, appropriate

parameters for the exercise, and implement the exercise in a safe and competent manner.

T. Implement functional training skills into physical therapy treatment within the plan of care.

U. Select and apply appropriate therapeutic massage techniques within the plan of care.

V. Select and apply appropriate manual therapy techniques within the plan of care.

W. Select and apply appropriate wound management techniques within the plan of care.

X. Select and appropriately apply physical agents for treatment within the plan of care

GENERAL EDUCATION OUTCOMES A. READING: Reading at the college level means the ability to

analysis and interpret a variety of printed materials; B. WRITING: Competency/outcome in writing is the ability to produce clear, correct, and coherent prose adapted to purpose, occasion, and audience; C. SPEAKING: Competence in speaking is the ability to communicate orally in clear, coherent, and persuasive language appropriate to purpose, occasion, and audience; D. LISTENING: Listening at the college level means the ability to analyze and interpret various forms of spoken communication; E. CRITICAL THINKING: Critical thinking embraces methods for applying both qualitative and quantitative skills analytically and creatively to subject matter in order to evaluate arguments and to construct alternative strategies; and F. COMPUTER LITERACY: Computer literacy at the college level means the ability to use computer-based technology in communicating, solving problems, and acquiring information.

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Clinical II: 7weeks/5 days a week/40 hours /week Expectations: Student will be progressing in their skills learned in the first year of education and clinical I as well as incorporating new material acquired during the fall of their second year. Objectives: To increase confidence in skills learned in the first year and a half, to present them in a professional and ethical manner at all times, and to grow in critical thinking and problem solving. Clinical III: 7 weeks/5 days a week 40 hours/week Expectations: During this final clinical internship the student will integrate all the material from the classroom plus the three clinical rotations to become an entry level physical therapist assistant. Objectives: As the Capstone course, the student will implement all of the knowledge acquired from didactic and clinical courses and to prepare themselves to be a graduate physical therapist assistant and a member of the physical therapy staff. Students should have all of the skills checked off in their PTA MACS except those skills not available to them. It will be at the ACCE’s discretion to determine if the skills are lacking and if the student needs to go to an additional facility to complete their PTA MAC.

STUDENT LEARNING OUTCOMES (for both Clinical II and Clinical III). Upon completion of the course and when applicable to the student’s individualized clinical setting, students will be able to: A. As outlined in the learning plan, apply the theory, concepts, and skills involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the physical therapy business/industry and will demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the

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physical therapy business/industry. B. Demonstrate a commitment to learning. C. Demonstrate competent interpersonal skills including professional demeanor, respect for all persons, confidence, and delegation of tasks to personnel. D. Demonstrate competent non-verbal, verbal, and written communication skills in the physical therapy setting. E. Effectively use time and resources in the physical therapy setting. F. Seek feedback and, in a positive manner, apply constructive feedback to the practice of physical therapy. G. Apply problem solving skills to the practice of physical therapy. H. Follow standards of professionalism in physical therapy including practicing legally, ethically, and within facility guidelines. I. Accept responsibility for the learning experience and recognize the need to provide and seek assistance when necessary. J. Apply critical thinking skills to the practice of physical therapy. K. Apply stress management skills to the practice of physical therapy. L. Apply safety consciousness in the clinical setting including the recognition and remediation of safety concerns during patient care, use of proper body mechanics and guarding techniques, use of standard precautions, and safe handling of patients and equipment. M. Provide education to other healthcare providers. N. Demonstrate competency data collection techniques. O. Implement the plan of care developed by the physical therapist. P. Modify the plan of care accordingly within the plan of care. Q. Instruct patients in techniques, activities, and skills that need to be taught from the plan of care. R. Participate in discharge planning within the plan of care. S. Determine appropriateness of exercise for a given patient, appropriate parameters for the exercise, and implement the exercise in a safe and competent manner. T. Implement functional training skills into physical therapy treatment within the plan of care.

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EVALUATION OF THE CLINICAL INSTRUCTOR Evaluation of each clinical instructor will be done at the end of the clinical. The forms used will be the Student Evaluation of Clinical Education Experiences form (SECEE), the Midterm Clinical Site Visit form and Your Clinical Instructor form (Appendix S). If there appears to be a problem during the rotation the ACCE will speak to the student, speak to the clinical instructor, make a visit at any time, or withdraw the student from the clinical internship. There can be any combination of the above and action will be determined by the ACCE. The clinical instructor will have at least one year of clinical experience before taking a student. If they are unfamiliar with the PTA MACs the ACCE will review the book either in person or be available by phone and email for questions. The college will send out notification when a clinical certification course will be offered in the Houston area to CI’s not certified but interested. That information is gathered during the midterm site visit. The ACCE and Program Director will work as a resource to disseminate information to CIs.

STUDENT LIABILITY INSURANCE Students pay for liability insurance during registration. The limits are $100,000,000 per incident and $3,000,000 annual aggregate by Bill Beatty Insurance Agency. See Appendix T.

Complaint Process/Grievance Procedure All formal complaints regarding the Physical Therapist Assistant Program can be submitted to the department and will be recorded using the “Complaints” form (Appendix U) in the PTA department. The program director will evaluate all complaints and work towards a resolution for all parties involved.

If the program director is unable to make a resolution, he or she will seek advice from the Health Science department chair and the dean of Science and Health Sciences.

Students in the PTA program are to follow the Policy and Grievance Procedures as outlined in the San Jacinto Community College District Student Handbook. Grievances must be filed in writing with the dean of student development on the South campus and must describe the actions, policies, or practices which the student believes to be discriminatory. Grievances should be filed no later than 30 days after the occurrence of the alleged discrimination. A student may be

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asked to meet with those persons who would be involved in correcting the actions, policies, or practice that he or she believes are discriminatory. The dean of student development will notify the student in writing of his or her agreement or disagreement with the grievance and of any corrective actions taken to restore the student’s rights. If the decision of the dean of student development does not satisfactorily resolve the student’s concerns, the student may appeal the grievance to the campus President.

Grievance Procedures for Discrimination It is the policy of San Jacinto College to provide an educational, employment, and business environment free of discrimination based on race, creed, color, national origin, citizenship status, age, disability, pregnancy, religion, gender, sexual orientation, gender expression or identity, genetic information, marital status, or veteran status. Trustees, administrators, faculty, staff, and other agents of the College will not engage in conduct constituting unlawful harassment or discrimination. The College strives to maintain a learning environment free of harassment. The College will promptly investigate all allegations of harassment and take appropriate disciplinary action against individuals who engage in unlawful behavior. Disciplinary action may include dismissal of employees or expulsion of students. As a student at San Jacinto College, you may not be discriminated against on these bases in: Admission to programs of study; Access to enrollment in courses; Career placement services, Counseling and guidance materials, tests, and practices; Technical Education.

Notification of Unlawful Behavior

A. If a student has any encounter with the police or law or is committed of a misdemeanor or any level of crime while in attendance of the PTA program, it is his or her responsibility to notify the program director immediately. The PTA faculty will meet and determine the appropriate actions that will be taken regarding the situation on an individual basis.

B. Failure to notify the program director immediately may result in dismissal from the PTA program.

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Suspected Substance Abuse

If a student is suspected of being under the influence of any substance during any school related activities including but not limited to class, laboratory, field trips, and clinical courses, the Program Director or ACCE shall be notified by the instructor.

The student will meet with the Program Director. If it is determined that the student has participated in school related activities while under the influence of any substance, he or she will be removed from the program. He or she may be asked to complete a drug screen.

Refusal to take a drug screen or a positive drug screen will result in dismissal from the PTA program.

Clinical Travelling Students need to be prepare to travel greater than 15 miles for one or more of their clinical rotations. This is especially true for acute care hospitals or specialty rotations such as pediatrics.

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Physical and Mental Requirements

A. The following skills are required in the Physical Therapist Assistant program. If a student is unable to meet these skills secondary to a disability, the PTA faculty will meet to determine if adaptations can be made to ensure successful completion of the program. A student may need to withdraw from the PTA program if the following physical and mental requirements cannot be met with or without appropriate modifications.

a. Adequate verbal, reading, and writing skills to communicate in English in an effective and prompt manner.

b. Adequate eyesight to be able to: i. Read paper, computer generated materials, and instrument

panels. ii. Monitor patient’s adverse reactions to treatment. iii. Make visual observations regarding patient’s posture,

exercise performance, and functional abilities. iv. Make adjustments to equipment.

c. Adequate hearing to communicate with human beings and to monitor signals and alarms of instruments.

d. Adequate smell to assess status of patient and to maintain a safe practice environment.

e. Adequate fine touch discrimination to palpate anatomical sites and to determine pathological changes in soft tissue.

f. Adequate motor coordination to operate equipment and perform manual treatment and assessment techniques.

g. Maintain and assume a variety of positions including sitting for up to 2 hours continuously, frequent standing, walking, bending, squatting, kneeling, stair climbing, reaching forward, reaching overhead, turning, and movement of the trunk and neck in all directions.

h. Adequate strength to transport, move, or lift, and guard patients requiring all levels of assistance during transfers, gait training (including stair training) and other appropriate activities. Specifically, a student must be able to:

i. Safely lift up to 50 lbs. independently ii. Safely lift up to 200 pounds with assistance iii. Safely push and pull up to 200 lbs. iv. Demonstrate strong bilateral grasp during joint

mobilization/manipulation and manually resisted exercise, bilateral gross and fine motor control and strength to perform therapeutic massage, find motor control to manipulate testing instruments/equipment/writing instruments/computers

v. Manually palpate various structures during data collection and intervention procedures.

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vi. Balance self and provide support and balance to patients on a variety of surfaces including level and uneven ground, ramp, curbs, and stairs.

vii. Have sufficient endurance to continue performing a variety of exertional activities for up to 8-12 hours with occasional rest breaks.

viii. Respond quickly to emergency situations by lifting/pushing/pulling patients, applying force to perform CPR, assist with transporting patients.

i. Adequate intellectual, emotional, and interpersonal skills to ensure patient safety, to exercise appropriate and independent judgment in rendering of patient care, and to interact with peers, patients, families, and health care workers.

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PTA Program Policy Statement

All unusual or unique circumstances not identified in the previous pages, will be addressed by the program director or ACCE. Please refer to the Student Manual or Faculty Manual for additional information.

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MINIMUM REQUIRED SKILLS OF PHYSICAL THERAPIST ASSISTANT GRADUATES AT ENTRY-LEVEL BOD G11-08-09-18 [Guideline]

Background In August 2007, 30 member consultants convened in Alexandria, VA for a consensus conference. The primary purpose of the conference was to achieve agreement on the minimum required skills for every graduate from a physical therapist assistant program to be able to perform on patients/clients that include, but are not limited to, the skill set required by the National Physical Therapy Examination (NPTE) for physical therapist assistants (PTAs).

Assumptions that framed the boundaries for the discussion during this conference included: (1) A minimum set of required skills will be identified that every graduate from a physical

therapist assistant program can competently perform in the clinical environment. (2) Development of the minimum required skills will include, but not be limited to, the

content blueprint for the physical therapist assistant licensure examination; put differently, no skills on the physical therapist assistant licensure blueprint will be excluded from the minimum required skills.

(3) To achieve consensus on the minimum required skills, 90% or more of the member consultants must be in agreement.

(4) The minimum required skill of the physical therapist assistant will not exceed that described for the physical therapist.

(5) Those aspects of patient/client management that are not part of the scope of work of the physical therapist assistant are not addressed in this conference, i.e. examination, evaluation, diagnosis, prognosis, development of plan of care, re-examination, development of discharge plan.

Minimum skills were defined as foundational skills that are indispensable for a new graduate physical therapist assistant to perform on patients/clients in a competent and coordinated manner under the direction and supervision of the physical therapist. Skills considered essential for any physical therapist assistant graduate include those addressing all systems (ie, musculoskeletal, neurological, cardiovascular pulmonary, integumentary) and the continuum of patient/client care throughout the lifespan. Definitions for terms used in this document are based on the Guide to Physical Therapist Practice. An asterisk (*) denotes a skill identified on the Physical Therapist Assistant (NPTE) Test Content Outline.

Given that agreement on this document was achieved by a small group of member consultants, the conference document was then disseminated to a wider audience comprised of stakeholder groups that would be invested in and affected by this document. The consensus-based draft document of Minimum Required Skills of Physical Therapist Assistant Graduates at Entry-Level was placed on APTA’s website and stakeholder groups, including APTA Board of Directors, all physical therapist assistant academic program directors, PTA Academic Coordinators/Directors of Clinical Education, and PTA faculties, physical therapists and PTAs serving on CAPTE panels, component leaders, the PTA Caucus, Advisory Panel of PTAs, and a sampling of clinical educators were invited to vote. A modified Delphi was used on whether or not to include/exclude specific essential skills that every PTA graduate should be competent in performing on patients/clients under the direction and supervision of the physical therapist. A total of 494 responses were received and the results were tabulated and analyzed. Those skills that the 494 respondents voted to include with an aggregate score of 80% or higher were incorporated into the final draft document.

Appendix A

The final “vote” was provided in a report to the APTA Board of Directors in November 2008 for their review, deliberation, and action. The Board of Directors adopted the document Minimum Required Skills of Physical Therapist Assistant Graduates at Entry-Level as a core document to be made available to stakeholders, including PTA academic programs and their faculties, clinical education sites, students, employers and CAPTE. The final document that follows defines Minimum Required Skills of Physical Therapist Assistant Graduates at Entry-Level.

PTA Skill Category

Description of Minimum Skills for PTA

Plan of Care Review Review of physical therapy

documents Review of medical record Identification of pertinent

information Identification of

indications, contraindications, precautions, safety considerations, and expected outcomes

Access to related literature Match patient goals to

selected interventions Identification of role in

patient care Identification of items to

be communicated to the physical therapist

1. Read all physical therapy documentation, including initial examination and plan of care.

A. Note indications, contraindications, precautions and safety considerations for the patient.

B. Note goals and expected outcomes. C. Seek clarification from physical therapist, as needed.

2. Review information in the medical record at each visit,

including: A. Monitor medical record for changes in medical status

and/or medical procedures. B. Collect data on patient’s current condition, compare

results to previously collected data and safety parameters established by the physical therapist, and determine if the safety parameters have been met.

C. Seek clarification from appropriate health professions’ staff for unfamiliar or ambiguous information.

3. Identify when the directed interventions are either beyond the

scope of work or personal scope of work of the PTA. 4. Communicate to the physical therapist when there are

significant changes in the patient’s medical status, physician referral, or when the criticality and complexity of the patient is beyond the knowledge, skills, and abilities of the PTA.

5. Explain the rationale for selected interventions to achieve

patient goals as identified in the plan of care.

Provision of Procedural Interventions • Compliance with policies,

procedures, ethical standards, etc.

• Risk management strategies

• Protection of patient privacy, rights, and dignity

• Competent provision of interventions, including: • Therapeutic exercise • Functional training • Manual therapy

techniques • Application and

1. Provide interventions compliant with federal and state licensing requirements, APTA standards documents (eg, Guide for Conduct for the PTA, Code of Ethics), and facility policies and procedures.

2. Assure safety of patient and self throughout patient care.

A. Identify the need for and take action when safety of patient or self may be at risk or has been compromised.

B. Utilize risk management strategies (eg, universal precautions, body mechanics).

3. Assure patient privacy, rights, and dignity.

A. Follow HIPAA requirements and observe Patient Bill of Rights.

B. Position/drape to protect patient modesty. 4. Provide competent provision of physical therapy interventions,

PTA Skill Category

Description of Minimum Skills for PTA

adjustment of devices and equipment*

• Airway clearance techniques

• Integumentary repair and protection techniques

• Electrotherapeutic modalities*

• Physical agents and mechanical modalities*

• Assessment of patient response

• Clinical problem solving • Ability to modify

techniques

including: Therapeutic exercise

A. Aerobic Capacity/Endurance Conditioning or Reconditioning

1. Increase workload over time 2. Movement efficiency and energy conservation

training 3. Walking/wheelchair propulsion programs

B. Balance, coordination, and agility training 1. Developmental activities training 2. Neuromuscular education or reeducation 3. Postural awareness training 4. Standardized, programmatic, complementary

exercise approaches (protocols) 5. Task-Specific Performance Training (eg, transfer

training, mobility exercises, functional reaching) C. Body mechanics and postural stabilization

1. Body mechanics training 2. Postural stabilization activities 3. Postural awareness training

D. Flexibility exercises 1. Range of motion 2. Stretching (eg, Passive, Active, Mechanical)

E. Gait and locomotion training 1. Developmental activities training 2. Gait training (with and without devices) 3. Standardized, programmatic, complementary

exercise approaches 4. Wheelchair propulsion and safety

F. Neuromotor development training 1. Developmental activities training 2. Movement pattern training 3. Neuromuscular education or reeducation

G. Relaxation 1. Breathing strategies (with respect to delivery of an

intervention) 2. Relaxation techniques (with respect to delivery of

an intervention) H. Strength, power, and endurance training for head, neck,

limb, trunk, and ventilatory muscles 1. Active assistive, active, and resistive exercises,

including concentric, dynamic/isotonic, eccentric, isometric, diaphragmatic breathing, and low-level plyometrics (eg, kicking a ball, throwing a ball)

Functional training in self-care and home management

A. Activities of daily living (ADL) training 1. Bed mobility and transfer training 2. Activity specific performance training

B. Device and equipment use and training 1. Assistive and adaptive device or equipment

training during ADL C. Injury Prevention or reduction

PTA Skill Category

Description of Minimum Skills for PTA

1. Injury prevention education during self-care and home management

2. Injury prevention or reduction with use of devices and equipment

3. Safety awareness training during self-care and home management

Manual therapy techniques

A. Therapeutic Massage B. Soft Tissue mobilization C. Passive range of motion

Application and adjustment of devices and equipment

A. Adaptive devices 1. Hospital Beds 2. Raised Toilet Seats

B. Assistive devices 1. Canes 2. Crutches 3. Long-handled reachers 4. Walkers 5. Wheelchairs

C. Orthotic and prosthetic devices 1. Braces

D. Protective devices 1. Braces

E. Supportive devices, such as: 1. Compression garments 2. Elastic wraps 3. Soft neck collars 4. Slings 5. Supplemental oxygen

Breathing strategies/oxygenation

1. Identify patient in respiratory distress 2. Reposition patient to improve respiratory function 3. Instruct patient in a variety of breathing techniques

(pursed lip breathing, paced breathing, etc.) 4. Administration of prescribed oxygen during

interventions.

Integumentary protection 1. Recognize interruptions in integumentary integrity 2. Repositioning 3. Patient education 4. Edema management

Electrotherapeutic modalities, such as:

1. Electrotherapeutic delivery of medications 2. Electrical muscle stimulation 3. Electrical stimulation for tissue repair 4. Functional electrical stimulation 5. High-voltage pulsed current

PTA Skill Category

Description of Minimum Skills for PTA

6. Neuromuscular electrical stimulation 7. Transcutaneous electrical nerve stimulation

Physical agents

1. Cryotherapy (eg, cold pack, ice massage, vapocoolant spray, hydrotherapy)

2. Ultrasound 3. Thermotherapy (eg, dry heat, hot packs, paraffin

baths, hydrotherapy)

Mechanical modalities 1. Compression therapies 2. Mechanical motion devices 3. Traction devices

5. Determine patient’s response to the intervention:

A. Interview patient and accurately interpret verbal and nonverbal responses

B. Identify secondary effects or complications caused by the intervention

C. Determine outcome of intervention (positive or negative), including data collection and functional measures

6. Use clinical problem solving skills in patient care.

A. Determine if patient is safe and comfortable with the intervention, and, if not, determine appropriate modifications

B. Compare results of intervention to previously collected data and determine if there is progress toward the expectations established by the PT or if the expectations have been met

C. Determine if modifications to the interventions are needed to improve patient response

7. Modify interventions to improve patient response.

A. Determine modifications that can be made to the intervention within the plan of care

B. Communicate with physical therapist when modifications are outside scope of work or personal scope of work of PTA

C. Select and implement modification D. Determine patient outcomes from the modification

Patient Instruction • Application of principles of

learning • Use of variety of teaching

strategies • Methods to enhance

compliance

1. Apply principles of learning using a variety of teaching strategies during patient instruction.

2. Provide clear instructions (eg, verbal, visual). 3. Apply methods to enhance compliance (eg, handouts,

reporting forms).

PTA Skill Category

Description of Minimum Skills for PTA

• Clarity in instructions • Assessment of patient

response

4. Determine patient response/understanding of instruction.

Patient Progression • Competent patient

progression • Communication of

pertinent information • Relationship of

psychosocial factors to progress

• Clinical problem solving

1. Implement competent patient progression. A. Identify the need to progress via data collection. B. Determine what progression can be made within the

plan of care. C. Identify possible progressions that will continue to

advance patient response. D. Select and implement the progression of the

intervention. E. Determine outcomes of the intervention.

2. Communicate pertinent information.

A. Identify changes in patient response due to intervention. B. Describe adjustments to intervention within plan of care. C. Describe response to change in intervention.

3. Recognize when other variables (psychological, social,

cultural, etc.) appear to be affecting the patient’s progression with the intervention.

4. Determine if patient is progressing toward goals in plan of

care. If no, determine if modifications made to the intervention are required to improve patient response.

Data Collection • Competent data collection • Interview skills • Accurate and timely • Clinical problem solving • Ability to modify

techniques • Documentation and

communication

1. Provide accurate, reproducible, safe, valid, and timely collection and documentation of data to measure the patient’s medical status and/or progress within the intervention as indicated in the following categories:

Anthropometric characteristics

1. Measure body dimensions (eg, height, weight, girth, limb length).

Arousal, attention, and cognition

1. Determine level of orientation to situation, time, place, and person.

2. Determine patient’s ability to process commands. 3. Determine level of arousal (lethargic, alert,

agitated). 4. Test patient’s recall ability (eg, short term and long

term memory).

Assistive and adaptive devices 1. Measure for assistive or adaptive devices and

equipment. 2. Determine components, alignments and fit of

device and equipment. 3. Determine patient’s safety while using the device. 4. Monitor patient’s response to the use of the

PTA Skill Category

Description of Minimum Skills for PTA

device. 5. Check patient or caregiver’s ability to care for

device and equipment (maintenance, adjustment, cleaning).

Body mechanics

1. Determine patient’s ability to use proper body mechanics during functional activity.

Environmental barriers, self-care, and home management

1. Identify potential safety barriers. 2. Identify potential environmental barriers. 3. Identify potential physical barriers. 4. Determine ability to perform bed mobility and

transfers safely in the context of self-care home management.

Gait, locomotion, and balance

1. Determine patient’s safety while engaged in gait, locomotion, balance, and mobility.

2. Measure patient’s progress with gait, locomotion, balance, and mobility, including use of standard tests.

3. Describes gait deviations and their effect on gait and locomotion.

Integumentary integrity 1. Identify activities, positioning, and postures that

may produce or relieve trauma to the skin. 2. Identify devices and equipment that may produce

or relieve trauma to the skin. 3. Observe and describe skin characteristics (eg,

blistering, continuity of skin color, dermatitis, hair growth, mobility, nail growth, sensation, temperature, texture, and turgor).

4. Observe and describe changes in skin integrity, such as presence of wound, blister, incision, hematoma, etc.

5. Test for skin sensation and describe absent or altered sensation.

Muscle function

1. Perform manual muscle testing. 2. Observe the presence or absence of muscle

mass. 3. Describe changes in muscle tone.

Neuromotor function

1. Identify the presence or absence of developmental reflexes, associated reactions, or abnormal tone.

2. Identify performance of gross and fine motor skills.

PTA Skill Category

Description of Minimum Skills for PTA

Orthotic and prosthetic devices and equipment

1. Check components, ensure alignment and fit of orthotic devices, braces, and/or splints.

2. Determine effectiveness of components (Is it working or not?), alignment, and fit of orthotic devices, braces, and splints during functional activities.

3. Determine patient/caregiver’s ability to don/doff orthotic, device, brace, and/or splint.

4. Determine patient/caregiver’s ability to care for orthotic device, brace, or splint (eg, maintenance, adjustments, and cleaning).

Pain

1. Define location and intensity of pain.

Posture 1. Determine postural alignment and position (static

and dynamic, symmetry, deviation from midline).

Range of motion 1. Perform tests of joint active and passive

movement, muscle length, soft tissue extensibility, tone and flexibility (goniometry, tape measure).

2. Describe functional range of motion.

Sensory response

1. Perform tests of superficial sensation (coarse touch, light touch, cold, heat, pain, pressure, and/or vibration).

2. Check peripheral nerve integrity (sensation, strength).

Vital Signs

1. Monitor and determine cardiovascular function. (eg, peripheral pulses, blood pressure, heart rate)

2. Monitor and determine physiological responses to position change (eg, orthostatic hypotension, skin color, blood pressure, and heart rate).

3. Monitor and determine respiratory status (eg, pulse oximetry, rate, and rhythm, pattern).

2. Provide timely communication to the physical therapist

regarding findings of data collection techniques. 3. Recognize when intervention should not be provided or should

be modified due to change in patient status.

Documentation • Select relevant information

1. Document in writing/electronically patient care using language that is accurate, complete, legible, timely, and consistent with

PTA Skill Category

Description of Minimum Skills for PTA

• Accuracy • Ability to adapt

institutional, legal, and billing requirements. 2. Use appropriate grammar, syntax, and punctuation in

communication. 3. Use appropriate terminology and institutionally approved

abbreviations.

4. Use an organized and logical framework to document care. 5. Identify and communicate with the physical therapist when

further documentation is required.

Safety, CPR, and Emergency Procedures • Safety • Initiate emergency

response system • CPR

1. Ensure safety of self and others in the provision of care in all situations.

2. Initiate and/or participate in emergency life support procedures

(simulated or actual). 3. Initiate and/or participate in emergency response system

(simulated or actual). 4. Maintain competency in CPR. 5. Prepare and maintain a safe working environment for

performing interventions (e.g. clear walkways, equipment checks, etc.).

Healthcare Literature

1. Reads and understands the healthcare literature.

PTA Skill Category

Description of Minimum Skills for PTA

Education a. Colleagues b. Aides, volunteers, peers,

coworkers c. Students d. Community

1. Instruct other members of the health care team, using established techniques, programs, and instructional materials, commensurate with the learning characteristics of the audience.

2. Educate colleagues and other health care professionals about

the role, responsibilities, and academic preparation and scope of work of the PTA.

Resource Management • Human • Fiscal • Systems

1. Follow legal and ethical requirements for direction and supervision of other support personnel.

2. Select appropriate non-patient care activities to be directed to

support personnel. 3. Identify and eliminate obstacles to completing patient related

duties. 4. Demonstrate efficient time management. 5. Provide accurate and timely information for billing and

reimbursement purposes. 6. Adhere to legal/ethical requirements, including billing. 7. Maintain and use physical therapy equipment effectively.

Behavioral Expectations: a. Accountability b. Altruism c. Compassion and Caring d. Cultural Competence e. Duty f. Integrity g. Social Responsibility

Accountability 1. Adhere to federal and state legal practice standards and

institutional regulations related to patient care and fiscal management.

2. Act in a manner consistent with the Standards of Ethical

Conduct for the Physical Therapist Assistant and Guide for Conduct of the Physical Therapist Assistant.

3. Change behavior in response to understanding the

consequences (positive and negative) of the physical therapist assistant’s actions.

Altruism 1. Place the patient’s/client’s needs above the physical therapist

assistant’s self-interests.

Compassion and caring 1. Exhibit compassion, caring, and empathy in providing services

to patients; promote active involvement of the patient in his or her care.

Cultural competence 1. Identify, respect, and act with consideration for the patient’s

PTA Skill Category

Description of Minimum Skills for PTA

differences, values, preferences, and expressed needs in all physical therapy activities.

Duty 1. Describe and respect the physical therapists’ and other team

members’ expertise, background, knowledge, and values. 2. Demonstrate reliability in meeting normal job responsibilities

(eg, attendance, punctuality, following direction). 3. Preserve the safety, security, privacy, and confidentiality of

individuals. 4. Recognize and report when signs of abuse/neglect are present. 5. Actively promote physical therapy.

Integrity 1. Demonstrate integrity in all interactions. 2. Maintain professional relationships with all persons.

Social Responsibility

1. Analyze work performance and behaviors and seek assistance for improvement as needed.

Communication Interpersonal Communication 1. Develop rapport with patients/clients and others to promote

confidence. 2. Actively listen and display sensitivity to the needs of others. 3. Ask questions in a manner that elicits needed responses. 4. Modify communication to meet the needs of the audience,

demonstrating respect for the knowledge and experience of others.

5. Demonstrate congruence between verbal and non-verbal

messages. 6. Recognize when communication with the physical therapist is

indicated. 7. Initiate and complete verbal and written communication with the

physical therapist in a timely manner. 8. Ensure ongoing communication with the physical therapist for

optimal patient care. 9. Recognize role and participate appropriately in communicating

patient status and progress within the health care team. Conflict Management/Negotiation

PTA Skill Category

Description of Minimum Skills for PTA

1. Recognize potential for conflict. 2. Implement strategies to prevent and/or resolve conflict. 3. Seek resources to resolve conflict when necessary.

Promotion of Health, Wellness, and Prevention

1. Demonstrate health promoting behaviors. 2. Recognize opportunities to educate the public or patients

about issues of health, wellness, and prevention (eg, benefits of exercise, prevention of falls, etc.) and communicate opportunity to the physical therapist.

3. Educate the public or patients about issues of health,

wellness, and prevention (eg, benefits of exercise, prevention of falls, etc.).

4. Recognize patient indicators of willingness to change health

behaviors and communicate to the physical therapist.

Career Development

1. Engage in self-assessment.

2. Identify individual learning needs to enhance role in the profession.

3. Identify and obtain resources to increase knowledge and skill. 4. Engage in learning activities (eg, clinical experience, mentoring,

skill development). 5. Incorporate new knowledge and skill into clinical performance.

Relationship to Vision 2020: (Academic/Clinical Education Affairs Department, ext 3203 [Document updated: 12/14/2009] Explanation of Reference Numbers: BOD P00-00-00-00 stands for Board of Directors/month/year/page/vote in the Board of Directors Minutes; the "P" indicates that it is a position (see below). For example, BOD P11-97-06-18 means that this position can be found in the November 1997 Board of Directors minutes on Page 6 and that it was Vote 18. P: Position | S: Standard | G: Guideline | Y: Policy | R: Procedure

Appendix B

Appendix C

Mid-term site visit Name Date

1. Overall student progress

2. How many patient’s treating/seeing per day?

3. What skills working towards check off?

4. What areas for improvement? Barrier to learning?

5. What are strengths?

6. How does the student best learn?

7. Quality of documentation – any areas that need improvement?

Other comments:

Appendix D

Student

1. What types of diagnosis are you treating?

2. How many patient’s per day?

3. Documentation – how many notes per day? Any areas for

improvement?

4. Other learning opportunities at this facility? (Ex: Sx, team conferences, discharge planning, interdiscliplinary, etc? )

5. What skills are you working towards on PTA MACS?

6. Are you having any barriers to learning?

7. How and when is your CI providing feedback? How would you describe

your CI ‘s feedback – intimidating, critical, fair, honest, positive, helpful?

8. Inservice topic?

Appendix E

Appendix F

Professor: Office Number: Email: Work Phone: Conference Hours:

Only the area above this statement may be altered by the course instructor. If a course instructor has any concern with the terms of the syllabus (including the grading formula and required text books, he or she may complete the Request for Change in PTA Syllabus form (found in the PTA Faculty Handbook) and give it to the program director for review. If the program director approves the changes, he or she will make the appropriate changes to the master syllabus and distribute it to the course instructor.

SAN JACINTO COLLEGE DEPARTMENT OF

PHYSICAL THERAPIST ASSISTANT Syllabus for PTHA 1360

I. COURSE RUBRIC & NUMBER: PTHA 1360

II. COURSE TITLE: Clinical I –PTA

III. COURSE DESCRIPTION: A health-related work-based learning experience that enables thestudent to apply specialized occupational theory, skills, and concepts. Direct supervision isprovided by the clinical professional.

IV. PREREQUISITES: PTHA 1321; PTHA 1191CO-REQUISITES: None

V. (STUDENT CREDIT HOUR:LECTURE CONTACT HOURS—LAB CONTACT HOURS):CREDIT HOURS = 3 (Contact Hours = 192/semester)

VI. STUDENT LEARNING OUTCOMES: Upon completion of the course and when applicable to thestudent’s individualized clinical setting, students will be able to:

A. As outlined in the learning plan, apply the theory, concepts, and skills involving specializedmaterials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the physical therapy business/industry and will demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the physical therapy business/industry. WECM*

B. Demonstrate a commitment to learning. (PTA MACS p. 3) C. Demonstrate competent interpersonal skills including professional demeanor, respect for all

persons, confidence, and delegation of tasks to personnel. (PTA MACS p.5) D. Demonstrate competent non-verbal, verbal, and written communication skills in the

physical therapy setting. (PTA MACS p. 7) E. Effectively use time and resources in the physical therapy setting. (PTA MACS p.9)

Appendix G

F. Seek feedback and, in a positive manner, apply constructive feedback to the practice of physical therapy. (PTA MACS p. 11)

G. Apply problem solving skills to the practice of physical therapy. (PTA MACS p. 13) H. Follow standards of professionalism in physical therapy including practicing legally, ethically,

and within facility guidelines. (PTA MACS p. 15) I. Accept responsibility for the learning experience and recognize the need to provide and

seek assistance when necessary. (PTA MACS p. 17) J. Apply critical thinking skills to the practice of physical therapy. (PTA MACS p. 19) K. Apply stress management skills to the practice of physical therapy. (PTA MACS p. 21) L. Apply safety consciousness in the clinical setting including the recognition and remediation

of safety concerns during patient care, use of proper body mechanics and guarding techniques, use of standard precautions, and safe handling of patients and equipment. (PTA MACS p. 23)

M. Provide education to other healthcare providers. (PTA MACS p. 25) N. Demonstrate competency with data collection techniques. (PTA MACS pp. 29-55) O. Implement the plan of care developed by the physical therapist. (PTA MACS p. 59) P. Monitor patients’ response to interventions and modify the treatment according to the plan

of care. (PTA MACS p. 61) Q. Instruct patients in techniques, activities, and skills that need to be taught from the plan of

care. (PTA MACS p. 63) R. Participate in discharge planning within the plan of care. (PTA MACS p. 65) S. Determine appropriateness of exercise for a given patient, appropriate parameters for the

exercise, and implement the exercise in a safe and competent manner. (PTA MACS pp. 67-74)

T. Implement functional training skills into physical therapy treatment within the plan of care. (PTA MACS pp. 75-80)

U. Select and apply appropriate therapeutic massage techniques within the plan of care. (PTA MACS p. 81)

V. Select and apply appropriate manual therapy techniques within the plan of care. (PTA MACS p. 83)

W. Select and apply appropriate wound management techniques within the plan of care. (PTA MACS p. 85)

X. Select and appropriately apply physical agents for treatment within the plan of care. (PTA MACS pp. 87-91)

WECM*: These SLOs are from the Texas Workforce Education Course Manual. San Jacinto College commits to putting all WECM SLOs on all course syllabi. The PTA program recognizes that the WECM SLOs are not consistently measurable or written in behavior terms. Therefore, additional SLOs have been developed by the program which better reflect the assessment of students’ progression through the PTA curriculum. These SLOs are listed after the WECM SLOs on each syllabus.

VII. GENERAL EDUCATION OUTCOMES

A. READING: Reading at the college level means the ability to analyze and interpret a variety of printed materials;

B. WRITING: Competency/outcome in writing is the ability to produce clear, correct, and coherent prose adapted to purpose, occasion, and audience;

C. SPEAKING: Competence in speaking is the ability to communicate orally in clear, coherent, and persuasive language appropriate to purpose, occasion, and audience;

D. LISTENING: Listening at the college level means the ability to analyze and interpret various forms of spoken communication;

E. CRITICAL THINKING: Critical thinking embraces methods for applying both qualitative and quantitative skills analytically and creatively to subject matter in order to evaluate arguments and to construct alternative strategies; and

F. COMPUTER LITERACY: Computer literacy at the college level means the ability to use computer-based technology in communicating, solving problems, and acquiring information.

VIII. GRADE RANGE: 90 – 100 A

80 – 89 B 75– 79 C 60 – 74 D Below 60 F

A grade below “C” is not acceptable in the PTA program. Therefore, grades of “D” and “F” are not passing and are not acceptable. Faculty will determine the details of the grading system for the specific course at the beginning of each course. This information will be located on the syllabus of each course under Grading Formula. Each PTHA course must be passed with a minimum of “C” based on the instructor’s Grading Formula. Additionally, the average of the written exams and lab exams in each class must be a 75% or higher. That is, if a student’s exam average (the average of all written and lab exams for that class) is less than a 75%, but non-exam grades are strong enough to bring his total class average above a 75%, the student will not receive a “C”. If a student fails to achieve a 75% on their written and lab exam average, then the student will receive the grade equal to the average score for written and lab exams. Each semester’s courses must be completed with a satisfactory grade of a “C” or better before progressing to the next level.

IX. GRADING FORMULA: The final letter grade for this course will be based on the following:

A. Completion of required PTA MACS skills will constitute 66% of the grade. All of the following criteria must be met (or have documentation by the clinical instructor that there was no opportunity to perform the skill at that facility) to pass the course and advance in the program:

1. Any five skills of 1-12 must be assessed as meeting entry level performance as

indicated by a “ √ ” or “+” on the master sheet (blue) or skill sheets (white) in The PTA MACS.

2. The safety skill, number 11, must be checked off as a check or a plus at each clinical rotation. If the student does not achieve entry level on safety skill, the ACCE or Program Director will meet with the student to develop an action plan which will include input from the clinical instructor, the student and the school faculty. The student will write an essay reflecting on the clinical experience giving insight into the problem. The written action plan will provide the process the student must complete before completing another clinical rotation of the same type. If the student cannot be checked off on this second rotation, he/she will be dismissed from the program.

3. Demonstrate at least ten additional skills are at entry level performance on the master sheet.

4. Every “NI” given on Final assessment by the clinical instructor will count as a negative 2 points per “NI” taken off the final grade for the clinical.

5. Every “U” or “Challenge” given on Final assessment by the clinical instructor will count as a negative 10 points per “U” or “challenge” taken off the final grade for the clinical. Additional mediation may be added as needed including dismissal or an additional clinical.

B. Developing and presenting an in-service for the clinical facility staff and submitting required documentation on time will constitute 12% of the grade.

C. Student will email 3 reflective journal articles on their clinical experience according to email journal guidelines which will constitute 12% of the grade. The articles must be on time or points will be taken off the final grade.

D. Completion and submission of the Student Evaluation of Clinical Education

Experience at the clinical facility will constitute 5% of the grade. Your CI should have the opportunity to review and copy this form. This form needs to be turned in signed by CI on “debriefing” day or points will be taken off.

E. Submission of time sheet demonstrating required attendance. Submission of the

time sheet will constitute 5% of the grade.

All absences must be reported to the CI and the ACCE in person or by telephone prior to the start of the scheduled workday. Emails and text messages are not acceptable. A student may have no unexcused absences. Any unexcused absences will result in failure of the clinical course. The ACCE will determine if the absence will be excused. If sick, the student will be advised to obtain a physician’s letter of excused absence. Each day of excused absence will result in 5 points removed from the student’s final course grade. In order to receive a C or better in the final course grade, all excused absences must be made up at the convenience of the CI.

ALL FINAL GRADES ARE THE RESPONSIBILITY OF THE ACCE FROM SAN JACINTO COLLEGE AND CAN BE MODIFIED AS NEEDED TO REFLECT THE STUDENT’S OVERALL PROFORMANCE ON THIS CLINICAL. ADDITIONAL DEDUCTIONS INCLUDE:

-5 CI information reported past 1 week from start of clinical -5 Not notifying ACCE by telephone or in person you are not at your clinical site and the reason -5 Paperwork not complete on debriefing day -3 Each email journal late past 3rd day (example- 4th week journal late Tuesday of the following week)

A FINAL GRADE OF "C" MUST BE MADE IN THIS COURSE IN ORDER TO PASS THE COURSE AND ADVANCE IN THE PROGRAM.

For details on grading processes, students should refer to the policy on Grading in the PTA Student Handbook which can be found at www.sanjac.edu/PTA

X. HOMEWORK/TEST MAKE-UP POLICY: It is the student’s responsibility to make up the missed class work. Make up work must be turned in as soon as the student returns to class. 10% per day will be deducted for late work.

Make-Up Exams: Must be taken within one week of the day of the missed scheduled exam and must be taken at the college’s testing center. Failure to follow the guideline will result in a grade of zero, which will be calculated into the average grade for that unit of study. Make-up exams to be taken are the responsibility of the instructor and student. The instructor must make the test available at the testing center .The student must come prepared with pen and picture identification to take the make-up exam in the testing center.

XI. ATTENDANCE POLICY:

Students are required to attend all lecture and laboratory periods. An accurate record of each student’s attendance is kept by each instructor. An instructor has full authority to drop a student for excessive absences. Three late arrivals equal one absence. A student may be asked to drop the course upon the accumulation of 10% absences of the total number of course hours. When a student is 10 or more minutes late for a scheduled class, it is considered a late arrival (where 3 late arrivals are equal to one full absence of that class). Ten minutes following the beginning of class, the instructor may close the door and not allow further entrance until break time.

XII. CLASS PARTICIPATION POLICY: Students are expected to take an active role in the class.

XIII. CLASSROOM ETIQUETTE: Students enrolled in this course must abide by all policies and procedures as outlined in the Physical Therapist Assistant Program Student Handbook which can be found on the program’s website at www.sanjac.edu/PTA. For clinical courses in the PTA program, students must also abide by all policies and procedures as outlined in the PTA Clinical Handbook which can be found on the program’s website at www.sanjac.edu/PTA.

XIV. WITHDRAWAL POLICY: Students wishing to drop courses must drop themselves over the web. Faculty will not drop students. Students should consult with a Counselor/Advisor before dropping courses. Students starting college for the first time in fall 2007 or after may only receive six grades of W ( grade received from a course dropped after the census date) from all Texas public colleges and universities attended. Grades of W in developmental courses or courses taken while in high school will not count in the six grades of W. After six grades of W are received, students must receive grades of A, B, C, D, or F in all courses. There are other exemptions from the six-drop limit and students should consult with a Counselor/Advisor before they drop courses to determine these exemptions. Please refer to Policy VII (Withdrawal Policy) in the Physical Therapist Assistant Student Handbook which can be found at www.sanjac.edu/PTA.

XV. REPEAT RULE: If a course is subject to the repeat rule, a student may take the course two times and pay the regular tuition. The third time, the student will be charged an additional $50.00 of tuition per credit hour for the third or subsequent time taken.

XVI. HONESTY CODE: As a student at San Jacinto College, you are expected to exhibit honesty, integrity and high standards in your academic work. Members of the college community benefit from an open, honest educational environment. We are all responsible to encourage and promote academic integrity, a code of moral and artistic honesty. Students should refer to the Student Handbook for policies and procedures on Cheating and Plagiarism. Please refer to Policy XII (Academic Dishonesty) in the Physical Therapist Assistant Student Handbook which can be found at www.sanjac.edu/PTA.

XVII. EMERGENCY CLOSURE: In the event the College needs to be closed for any situation, such as inclement weather, students and employees should check the College website at www.sanjac.edu or call (866) 504-5853 for the most immediate and current information. The College will also engage the emergency notification plan which sends a voicemail, text message, and/or email to each student/employee who opts in. The College will also contact local media but the most reliable, accurate and current information will also be found on the College website or at the toll-free number listed above. Official communications with students is through their SJC email account.

XVIII. DISABLITY STATEMENT: If you have a disability that may affect your ability to learn the material in this course, please contact the Disabilities Services Director through the counseling office. Disability Services: If a student has obtained a letter of approval for accommodations for a disability, he or she must give a copy of the letter to the course instructor for each course (even if the student has previously been taught by the instructor). If a student is approved to have increased time to take a written test, the student is to report to the testing center for the test. It is the responsibility of the course instructor to make the test available at the testing center. Students should report to the testing center prepared with pen, necessary paper, and student identification. Please refer to Policy XX (Disability Assistance) in the Physical Therapist Assistant Student Handbook which can be found at www.sanjac.edu/PTA.

XIX. TEXTBOOKS/MATERIALS: Texas Alliance of PTA Educators: The PTA MACs , 6th edition, Texas Physical Therapy Association, Austin, TX, 2009. Please refer to the PTA Clinical Handbook for details of the policies and procedures for clinical courses. This is found on the website at www.sanjac.edu/PTA.

Appendix H

STUDENT AFFILIATION AGREEMENT BETWEEN

__________________ AND SAN JACINTO COMMUNITY COLLEGE DISTRICT

This Agreement is executed on the ______ day of __________, 2009, between SAN JACINTO COMMUNITY COLLEGE DISTRICT, for and on behalf of its _____ Campus (SJCD) Department of _________, hereinafter referred to as “College” in this Agreement, and _________________, hereinafter referred to as “Facility” in this Agreement,

WITNESSETH:

WHEREAS, College offers to enrolled students a degree program in the field of _______________; and

WHEREAS, the proper training of such professionals requires exposure to practical clinical problems, which is primarily attainable through the application of knowledge and skills in actual patient-centered situations in a health care facility; and

WHEREAS, Facility has the environment and facilities within and through which the students of College can acquire such practical, clinical experience; and

WHEREAS, it is agreed by the parties to be of mutual interest and advantage that the students and faculty of the College be given the opportunity to utilize the facilities of the Facilty as a practice laboratory and for educational purposes:

NOW, THEREFORE, in consideration of the foregoing and of the mutual covenant and premises hereinafter contained, the parties agree as follows:

1. RESPONSIBILITIES OF COLLEGE:

a. Clinical Program. College shall be responsible for the implementation and operation ofthe clinical component of its programs at Facility, which programs shall be approved inadvance by Facility. This Agreement shall cover the following clinical program(s) atFacility: ________ (“Program”). Such responsibilities shall include, but not be limited to,the following:

(i) Provision of classroom theory and practical instruction to students prior to theirclinical assignments at Facility;

(ii) Preparation of student/patient assignments and rotation plans for each student and coordination of same with Facility;

(iii) Continuing oral and written communication with Facility regarding student performance and evaluation, absences and assignments of students, and other pertinent information;

(iv) Supervision of students and their performance at FACILITY;

(v) Performance of such other duties as may from time to time be agreed to between College and Facility;

(vi) Provide adequate documentation attesting to competency of each instructor.

Appendix I

All students, faculty, employees, agents and representatives of School participating in the Program at Facility (the "Program Participants") shall be accountable to the Facility’s Administrator.

b. Insurance. College will procure and maintain throughout the term of this Agreement

professional liability insurance in minimum amounts of One Million Dollars ($1,000,000.00) per occurrence and Three Million Dollars ($3,000,000.00) in the aggregate for its faculty members and students assigned to the Facility which shall cover all their activities at Facility. College shall provide Facility with Certificates of Insurance evidencing said coverage and any renewals thereof at the commencement, and upon the renewal, of this Agreement. College shall notify Facility at least thirty (30) days in advance of any proposed cancellation or change in said coverage. By entering into this Agreement, and complying with the terms and requirements hereof, it is recognized that College is not waiving the governmental immunity that College, its agents or employees have under law or any other rights, privileges and immunities belonging to or ascertainable by College under either state or federal law.

c. Health of Program Participants. College shall inform all Program Participants of the

necessity to maintain documentation of their health records, including updated immunization records which may include the following:

(i) Tuberculin skin test within the past 12 months or documentation as a previous

positive reactor or a chest x-ray taken within the past 12 months; and (ii) Proof of Rubella and Rubeola immunity by positive antibody titers or 2 doses of

MMR; and (iii) Varicella immunity, by positive history of chickenpox or proof of Varicella

immunization; and (iv) Proof of Hepatitis B immunization or completion of a certification of declination of

vaccine, if patient contact is anticipated. d. Background Checks. College shall, in a timely manner at the Program Participant’s

expense, conduct (or have conducted) a background check on each and every student assigned to the Program and every member of the staff/faculty responsible for supervision and/or instruction. If College has students or staff/faculty on-site at Facility prior to the execution of this Agreement, then College shall immediately require a retrospective background check on such persons. The background check shall include, at a minimum, the following:

(i) Social Security number verification; (ii) Criminal Search (7-years or up to 5 criminal searches); (iii) Employment Verification to include reason for separation and eligibility for re-

employment for each employer for 7 years; (iv) HHS/OIG List of Excluded Individuals/Entities; (v) GSA List of Parties Excluded from Federal Programs; (vi) Texas HHS List of Excluded Individuals/Entities; (vii) Violent sexual offender and predator registry search; and

(viii) U.S. Treasury, Office of Foreign Assets Control (OFAC), List of of Specially Designation Nationals (DSN) search.

The background check for staff/faculty, if licensed or certified caregivers, shall include all of the above and in addition, shall include the following:

(i) Education verification (highest degree); (ii) Professional License Verification; (iii) Certifications and Designation Checks; (iv) Professional Disciplinary Action Search; (v) Department of Motor Vehicle Driving History, as applicable based on responsibilities:

and (vi) Consumer Credit Report, as applicable based on responsibilities.

Written results of these criminal background checks may be provided to Facility upon receipt of a written consent and release to disclosure executed by the Program Participant. Should the background check disclose adverse information as to any student and/or member of the staff/faculty, College shall immediately remove said student and/or member of the staff/faculty from participation in the Program at Facility.

e. Performance. All faculty provided by College shall be duly licensed, certified or

otherwise qualified to participate in the Program at Facility. College shall have a specially designated staff for the performance of the services specified herein. College and all Program Participants shall perform its and their duties and services hereunder in accordance with all relevant local, state, and federal laws and shall comply with the standards and guidelines of all applicable accrediting bodies and the bylaws, rules and regulations of Facility and any rules and regulations of College as may be in effect from time to time. Neither College nor any Program Participant shall interfere with or adversely affect the operation of Facility or the performance of services therein.

f. College Status. College represents and warrants to Facility that College and its

Program Participants participating hereunder: (i) are not currently excluded, debarred, or otherwise ineligible to participate in the Federal health care programs as defined in 42 U.S.C. Section 1320a-7b(f) (the “Federal health care programs”); (ii) are not convicted of a criminal offense related to the provision of health care items or services but has not yet been excluded, debarred or otherwise declared ineligible to participate in the Federal health care programs, and (iii) are not under investigation or otherwise aware of any circumstances which may result in College or a Program Participant being excluded from participation in the Federal health care programs. This shall be an ongoing representation and warranty during the term of this Agreement and College shall immediately notify Facility of any change in status of the representation and warranty set forth in this section. Any breach of this Paragraph 1(h) shall give Facility the right to immediately terminate this Agreement for cause.

g. Bloodborne Pathogens. College will ensure that all Program Participants who may be

at risk for occupational exposure to blood or other potentially infectious materials will be: (i) Trained in accordance with the Occupational Safety and Health Administration’s

(OSHA) Occupational Exposure to Bloodborne Pathogens (as published in Friday,

December 6, 1991 Federal Register) and any amendments thereto; (ii) Trained in the modes of transmission, epidemiology and symptoms of Hepatitis B

virus (HBV) and Human Immunodeficiency Virus (HIV) and other bloodborne pathogens;

(iii) Trained in the methods of control that prevent or reduce exposure including universal

precautions, appropriate engineering controls, work practices and personal protective equipment;

(iv) Provided information on the Hepatitis B vaccine, its efficacy, safety, method of

administration and benefits of being vaccinated; and (v) Provided proper follow-up evaluation following any exposure incident. h. College Liaison. College shall designate an individual to serve as liaison with the

Facility as it relates to the Program. The College liaison will cooperate with and facilitate communication between the Facility and College. The College liaison will meet with the Facility liaison and other representatives as may be needed to support the Program at the Facility.

2. RESPONSIBILITIES OF FACILITY. a. Facility shall accept the Program Participants assigned to the Program by College and

reasonably cooperate in the orientation of all Program Participants to Facility. Facility shall provide reasonable opportunities for such Program Participants, who shall be supervised by College and Facility, to observe and assist in various aspects of patient care to the extent permitted by applicable law and without disruption of patient care or Facility operations. Facility shall coordinate College's rotation and assignment schedule with its own schedule and those of other educational institutions. Facility shall at all times retain ultimate control of the Facility and responsibility for patient care.

b. Upon the request of College, Facility shall assist College in the evaluation of each

Program Participant's performance in the Program. However, College shall at all times remain solely responsible for the evaluation and grading of Program Participants.

c. Facility shall cooperate with College's faculty members in the coordination of Program

Participants' assignment to clinical areas in the Facility. d. Facility shall cooperate with College in the scheduling and in the participation of

conferences and meetings with College representatives as it relates to the Program. e. Facility shall designate an individual to serve as liaison with the College as it relates to

the Program. The Facility liaison will cooperate with and facilitate communication between the Facility and College. The Facility liaison will meet with the College liaison and other representatives as may be needed to support the Program at the Facility.

f. Facility shall provide basic medical care and treatment to Program Participants and/or

College faculty members in the event of injury or illness while at the Facility until other arrangements, as may be appropriate, for such person's medical care can be made. Any Facility or medical expenses incurred for the provision of medical services shall be the responsibility of the injured or ill Program Participant or College faculty member.

3. MUTUAL RESPONSIBILITIES. The parties shall cooperate to fulfill the following mutual responsibilities:

a. Program Participants shall be treated as trainees who have no expectation of receiving

compensation or future employment from the Facility or the College. b. Any courtesy appointments to faculty or staff by either the College or Facility shall be

without entitlement of the individual to compensation or benefits for the appointed party. 4. WITHDRAWAL OF PROGRAM PARTICIPANTS.

Facility may request College to withdraw or dismiss a student or other Program Participant from the Program at Facility when his or her clinical performance is unsatisfactory to Facility or his or her behavior, in Facility's discretion, is disruptive or detrimental to Facility and/or its patients. In such event, said Program Participant's participation in the Program at Facility shall immediately cease. It is understood that only College can dismiss the Program Participant from the Program.

5. INDEPENDENT CONTRACTOR; NO OTHER BENEFICIARIES.

The parties hereby acknowledge that they are independent contractors, and neither the College nor any of its agents, representatives, Program Participants, or employees shall be considered agents, representatives, or employees of Facility. In no event shall this Agreement be construed as establishing a partnership or joint venture or similar relationship between the parties hereto. College shall be liable for its own debts, obligations, acts and omissions, including the payment of all required withholding, social security and other taxes or benefits. No Program Participant shall look to Facility for any salaries, insurance or other benefits. No Program Participant or other third person is entitle to, and shall not, receive any rights under this Agreement.

6. NON-DISCRIMINATION.

There shall be no discrimination on the basis of race, national origin, religion, creed, sex, age, veteran status, or handicap in either the selection of students for participation in the Program, or as to any aspect of the clinical training; provided, however, that with respect to handicap, the handicap must not be such as would, even with reasonable accommodation, in and of itself preclude the Program Participant's effective participation in the Program.

7. INDEMNIFICATION.

To the extent authorized under the constitution and laws of the State of Texas, College shall hold Facility harmless from liability resulting from College’s acts or omissions within the terms of this Agreement provided, however, College shall not hold Facility harmless from any claims, demands or causes of action arising in favor of any person or entity resulting directly or indirectly from negligence (whether sole, joint, concurring or otherwise) of Facility, its officers, agents, representatives or employees, or any person not subject to College’s supervision or control. Facility shall indemnify College against liabilities, claims, damages and expenses, including reasonable attorneys’ fees, incurred by College in defending or compromising actions brought against College arising out of or related to the Facility’s performance of duties hereunder.

8. CONFIDENTIALITY.

College and its agents, Program Participants, faculty, representatives and employees agree to keep strictly confidential and hold in trust all confidential information of Facility and/or its patients and not disclose or reveal any confidential information to any third party without the express prior written consent of Facility. College shall not disclose the terms of this Agreement to any person who is not a party to this Agreement, except as required by law or

as authorized by Facility. Unauthorized disclosure of confidential information or of the terms of this Agreement shall be a material breach of this Agreement and shall provide Facility with the option of pursuing remedies for breach, or, notwithstanding any other provision of this Agreement, immediately terminating this Agreement upon written notice to College.

9. TERM; TERMINATION. (a) The initial term of this Agreement shall be ______ years, commencing on ______, and

ending on ______,, and may be extended upon mutual consent of both parties hereto evidenced in writing for additional one-year terms, unless sooner terminated in accordance with applicable provisions of this Agreement.

(b) Except as otherwise provided herein, either party may terminate this Agreement at any

time without cause upon at least thirty (30) days prior written notice. Upon termination of this Agreement, as provided herein, neither party shall have any further obligation hereunder except for (i) obligations accruing prior to the date of termination and (ii) obligations, promises, or covenants contained herein which are expressly made to extend beyond the Term of this Agreement, including, without limitation, confidentiality of information, indemnities, and offers to employees. No termination as provided herein, however, shall be effective with regard to Program Participants currently enrolled in the Program at Facility at the time of notice of termination, who shall be given the opportunity to complete their clinical Program at Facility.

10. ENTIRE AGREEMENT.

This Agreement and its accompanying Exhibits set forth the entire Agreement with respect to the subject matter hereof and supersedes all prior agreements, oral or written, and all other communications between the parties relating to such subject matter. This Agreement may not be amended or modified except by mutual written agreement. All continuing covenants, duties and obligations herein shall survive the expiration or earlier termination of this Agreement.

11. SEVERABILITY.

If any provision of this Agreement is held to be invalid or unenforceable for any reason, this Agreement shall remain in full force and effect in accordance with its terms disregarding such unenforceable or invalid provision.

12. CAPTIONS.

The captions contained herein are used solely for convenience and shall not be deemed to define or limit the provisions of this Agreement.

13. NO WAIVER.

Any failure of a party to enforce that party's right under any provision of this Agreement shall not be construed or act as a waiver of said party's subsequent right to enforce any of the provisions contained herein.

14. GOVERNING LAW.

This Agreement shall be governed and construed in accordance with the laws of the State of Texas.

15. ASSIGNMENT; BINDING EFFECT.

College may not assign or transfer any of its rights, duties or obligations under this Agreement, in whole or in part, without the prior written consent of Facility. This Agreement shall inure to the benefit of, and be binding upon, the parties hereto and their respective successors and permitted assigns.

16. NOTICES.

All notices hereunder by either party to the other shall be in writing, delivered personally, by certified or registered mail, return receipt requested, or by overnight courier, and shall be deemed to have been duly given when delivered personally or when deposited in the United States mail, postage prepaid, addressed as follows:

COLLEGE: FACILITY:

San Jacinto College District Facility Chancellor Address 4624 Fairmont Parkway, Suite 200 Address Pasadena, Texas 77504

COPY TO:

San Jacinto Community College _____ Campus President Address Address

or to such other persons or places as either party may from time to time designate by written notice to the other. 17. EXECUTION OF AGREEMENT.

This Agreement shall not become effective or in force until all of the below named parties have fully executed this Agreement.

18. HIPAA REQUIREMENTS.

To the extent applicable to this Agreement, the parties agree to comply with the Health Insurance Portability and Accountability Act of 1996, as codified at 42 U.S.C. Section 1320d (“HIPAA”) and any current and future regulations promulgated thereunder, including, without limitation, the federal privacy regulations contained in 45 C.F.R. Parts 160 and 164 (“Federal Privacy Regulations”), the federal security standards contained in 45 C.F.R. Parts 160, 162 and 164 (“Federal Security Regulations”), and the federal standards for electronic transactions contained in 45 C.F.R. Parts 160 and 162 (“Federal Electronic Transaction Regulations”), all as may be amended from time to time, and all collectively referred to herein as “HIPAA Requirements”. The parties agree not to use or further disclose any Protected Health Information (as defined in the Federal Privacy Regulations) or EPHI (as defined in the Federal Security Regulations), other than as permitted by the HIPAA Requirements and the terms of this Agreement. The parties agree to make their internal practices, books and records relating to the use and disclosure of Protected Health Information available to the Secretary of Health and Human Services to the extent required for determining compliance with the HIPAA Requirements. In addition, the parties agree to comply with any state laws and regulations that govern or pertain to the confidentiality, privacy, security of, and electronic and transaction code sets pertaining to, information related to patients.

The College shall direct its Program Participants to comply with the policies and procedures of Facility, including those governing the use and disclosure of individually identifiable health information under federal law, specifically 45 CFR parts 160 and 164. Solely for the purpose of defining the Program Participants' role in relation to the use and disclosure of Facility's protected health information, the Program Participants are defined as members of the Facility's workforce, as that term is defined by 45 CFR Section 160.103, when engaged in activities pursuant to this Agreement. However, the Program Participants are not and shall not be considered to be employees of Facility.

19. FERPA.

For purposes of this Agreement, pursuant to the Family Educational Rights and Privacy Act of 1974 (FERPA) (20 U.S.C §1232g; 34 CFR Part 99), the College hereby designates the Facility as a school official with a legitimate educational interest in the educational records of the Students who participate in the Program to the extent that access to the records are required by the Facility to carry out the Program. Facility agrees to maintain the confidentiality of the educational records in accordance with the provisions of FERPA.

20. NO REQUIREMENT TO REFER.

Nothing in this Agreement requires or obligates College to admit or cause the admittance of a patient to Facility or to use Facility’s services. None of the benefits granted pursuant to this Agreement is conditioned on any requirement or expectation that the parties make referrals to, be in a position to make or influence referrals to, or otherwise generate business for the other party. Neither party is restricted from referring any services to, or otherwise generating any business for, any other entity of their choosing.

THE PARTIES HERETO have executed this Agreement as of the day and year first above written. COLLEGE FACILITY SAN JACINTO COLLEGE DISTRICT FACILITY 8060 Spencer Highway Address P. O. Box 2007 Pasadena, Texas 77501-2007 ________________________________ ___________________________________ Dr. William H. Lindemann, Jr. Name Chancellor Title ________________________________ ___, President San Jacinto College _______

Last Updated: 08/01/12 Contact: nationalgovernance@apta.org

GUIDELINES: CLINICAL EDUCATION SITES BOD G03-06-21-55 [Amended BOD G03-04-22-55; BOD 02-02-25-40; BOD 11-01-05-07; BOD 03-99-23-75; Initial BOD 11-92-43-201] [Guideline]

Preamble

Clinical education represents a significant component of physical therapy curricula that has been continuously examined and discussed since APTA’s publications of Moore and Perry (1976) entitled Clinical Education in Physical Therapy: Present Status/Future Needs and Barr and Gwyer (1981) entitled Standards for Clinical Education in Physical Therapy: A Manual for Evaluation and Selection of Clinical Education Centers. As a result, the Association and the Education Section have launched a number of initiatives to explore and enhance clinical education and to clarify and revise the roles and expectations for individuals responsible for providing student clinical learning experiences. Some of these notable undertakings included conferences held in Kansas City, Missouri (1983), Rock Eagle, Georgia (1985), and Split Rock, Pennsylvania (1987). All of these efforts spurred the growth and development of clinical education research, student evaluation and outcome performance assessment, training and development programs for clinical educators, regional consortia, several National Task Forces on Clinical Education, and universal guidelines for clinical education.

Between 1989 and 1994, two Task Forces on Clinical Education (1989–1991 and 1992–1994), in concert with clinical educators throughout the nation, dedicated their energies towards the development and refinement of voluntary guidelines for clinical education. Approximately 2,500 clinical educators provided substantial feedback on these documents through consortia, academic programs, or individual responses directly to the Task Force on Clinical Education, or through testimony given at a total of five hearings held in San Francisco, Denver, and Virginia in 1992. The culmination of these efforts was the development of three documents: Guidelines for Clinical Education Sites, Guidelines for Clinical Instructors (CIs), and Guidelines for Center Coordinators of Clinical Education (CCCEs). These guidelines were first adopted by APTA’s Board of Directors in November 1992 and endorsed by APTA’s House of Delegates on June 13, 1993. Revisions to these Clinical Education Guidelines have been subsequently approved by APTA’s Board of Directors in 1999 and 2004.

In October 1998, the Guidelines and Self-Assessment for Clinical Education were reviewed and revised by an Ad Hoc Documentation Review Group to ensure that these documents reflected contemporary and forward-looking clinical education, practice, and care delivery. As part of the review process, current APTA documents were used to assist in editing the Guidelines and Self-Assessments for Clinical Education to ensure congruence in language, education and clinical education expectations, and practice philosophy and framework. Documents used to carry out this process included the Guide to Physical Therapist Practice and in particular the patient management model, A Normative Model of Physical Therapist Professional Education: Version 1997, A Normative Model of Physical Therapist Assistant Education: First Revision (January 1998), Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists, and Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapist Assistants. The revised Guidelines for Clinical Education were approved by APTA’s Board of Directors in March 1999.

In March 2004, these Guidelines for Clinical Education were revised and approved by the Board of Directors. Revisions were made to reflect the most contemporary versions of the Guide to Physical Therapist Practice (2003), A Normative Model of Physical Therapist Professional Education: Version 2004, Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists, and Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapist Assistants, and APTA positions, standards, guidelines, policies, and procedures.

The intent of these guidelines is to provide academic and clinical educators with direction and guidance in the development and enhancement of clinical education sites and physical therapist and physical therapist assistant CIs and CCCEs. These documents reflect the nature of current practice and also represent the future ideals of physical therapy clinical education. The guidelines were designed to encourage and direct clinical education in diverse settings ranging from single or multiple clinicians, public or private clinical education sites, and clinical education sites housed within a building or a patient’s home.

These guidelines are most effective when used collectively; however, they have been written in a format that allows them to be used separately. Each guideline is accompanied by measurement statements to help the clinical education site, CIs, and CCCEs understand how to demonstrate the attainment of the specific guidelines and to delineate areas for further growth. In addition, each document provides minimal guidelines essential for quality clinical education as well as ideal

Appendix J

guidelines to foster growth in the clinical education site, CI, and CCCE. Minimal guidelines are expressed through the active voice while ideals are designated by the use of “should” and “may.”

We are indebted to all of the clinical educators and educators who since 1993 have provided feedback and comments on these documents during their initial development through the process of widespread consensus building. Likewise, the contributions of Barr, Gwyer, and Talmor’s Standards for Clinical Education in Physical Therapy (1981) and the Northern California Clinical Education Consortium’s Self-Assessment of a Physical Therapy Clinical Education Site were instrumental to the initial development of the guidelines and self-assessment tools. We are also grateful to the Ad Hoc Documentation Review Group that participated in the process of revising the Guidelines and Self-Assessments for Clinical Education in 1999. APTA is committed to ensuring that these guidelines and self-assessment tools continue to reflect contemporary and forward-looking standards for clinical education that are congruent with expectations for physical therapy education and practice. 1.0 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.

1.1 The philosophies of the clinical education site and the academic program must be compatible, but not

necessarily identical or in complete accord. 1.2 The clinical education site and the provider of physical therapy should have a written statement of

philosophy. 1.2.1 The statement of philosophy may include comments concerning responsibilities for patient/client

care, community service and resources, and educational and scholarly activities.

2.0 CLINICAL EDUCATION EXPERIENCES FOR STUDENTS ARE PLANNED TO MEET SPECIFIC OBJECTIVES OF THE ACADEMIC PROGRAM, THE PROVIDER OF PHYSICAL THERAPY, AND THE INDIVIDUAL STUDENT.

2.1 Planning for students should take place through communication* among the Center Coordinator of Clinical

Education (CCCE), the Clinical Instructors (CIs), and the Academic Coordinator/Director of Clinical Education (ACCE/DCE). 2.1.1 The provider of physical therapy has clearly stated, written objectives for its clinical education

programs consistent with the philosophy and requirements of each academic program. 2.1.2 Clinical education objectives should be written specifically for the provider of physical therapy by

physical therapy personnel. 2.1.3 Students should participate in planning their learning experiences according to mutually agreed-on

objectives. 2.1.4 CIs should be prepared to modify learning experiences to meet individual student needs,

objectives, and interests. 2.2 A thorough orientation to the clinical education program and the personnel of the clinical education site

should be planned for students. 2.2.1 Organized procedures for the orientation of students exist. These procedures may include

providing an orientation manual, a facility tour, and information related to housing, transportation, parking, dress code, documentation, scheduling procedures, and other important subjects.

2.3 Evaluation of student performance is an integral part of the learning plan to ensure that objectives are met. 2.3.1 Opportunities for discussion of strengths and weaknesses should be scheduled on a continual

basis. 2.3.2 The provider of physical therapy gives both constructive and cumulative evaluations of students.

These will be provided in both written and verbal forms, and the evaluation frequency will be scheduled as mutually agreed on by the academic program and the provider of physical therapy.

3.0 PHYSICAL THERAPY PERSONNEL PROVIDE SERVICES IN AN ETHICAL AND LEGAL MANNER.

3.1 All physical therapists and physical therapist assistants provide services in an ethical and legal manner as

outlined by the standards of practice, the state/jurisdictional practice act, clinical education site policy, and APTA positions, policies, standards, codes, and guidelines. 3.1.1 The clinical education site has evidence of valid licensure, registration, or certification for all

physical therapists and physical therapist assistants, where appropriate. 3.1.2 The provider of physical therapy has a current policy and procedure manual, which includes a copy

of the state/jurisdictional practice act and interpretive rules and regulations, APTA’s Code of Ethics, Standards of Ethical Conduct for the Physical Therapist Assistant, Guide for Professional Conduct,

Guide for Conduct of the Physical Therapist Assistant, Guide to Physical Therapist Practice, and a clinical education site code of ethics, if available.

3.2 The clinical education site policies are available to the personnel and students. 3.2.1 Written policies should include, but not be limited to, statements on patients/clients' rights, release

of confidential information (eg, HIPAA), photographic permission, clinical research, and safety and infection control.

3.2.2 The clinical education site has a mechanism for reporting unethical, illegal, unprofessional, or incompetent* practice.

4.0 THE CLINICAL EDUCATION SITE IS COMMITTED TO THE PRINCIPLE OF EQUAL OPPORTUNITY AND

AFFIRMATIVE ACTION AS REQUIRED BY FEDERAL LEGISLATION.

4.1 The clinical education site adheres to affirmative action policies and does not discriminate on the basis of race, creed, color, gender, age, national or ethnic origin, sexual orientation, or disability or health status. These policies apply to recruiting, hiring, promoting, retaining, training, or recommending benefits for all personnel. 4.1.1 The clinical education site has written statements regarding nondiscrimination in its hiring,

promotion, and retention practices. 4.2 The clinical education site does not discriminate against students and ensures that each student is provided

equal opportunities, learning experiences, and benefits. 4.2.1 The clinical education site does not discriminate in the selection or assignment of students or their

learning experiences. Evidence of this nondiscrimination may be demonstrated through the clinical education agreement.*

4.2.2 The clinical education site is sensitive to issues of individual and cultural diversity in clinical education.

4.2.3 The clinical education site makes reasonable accommodations for personnel and students according to ADA* guidelines.

5.0 THE CLINICAL EDUCATION SITE DEMONSTRATES ADMINISTRATIVE SUPPORT OF PHYSICAL THERAPY

CLINICAL EDUCATION.

5.1 A written clinical education agreement, in a format acceptable to both parties, exists between each academic program and each clinical education site. 5.1.1 A corporate clinical education agreement with an academic program may exist to cover multiple

clinical education sites. 5.2 The clinical education site demonstrates support of the participation of its personnel in clinical education

activities. 5.2.1 The clinical education site promotes participation of personnel as CIs and CCCEs. 5.2.2 The clinical education site facilitates growth of clinical educators by providing educational

opportunities related to clinical education such as in-service presentations, CI training and credentialing programs, and attendance at clinical education conferences.

5.2.3 The clinical education site demonstrates commitment to clinical education by reasonable allocation of resources.

5.3 Administrative support should be demonstrated by the inclusion of a statement of educational commitment within the clinical education site's philosophy statement.

5.4 A clinical education program manual exists, which might include, but should not be limited to, structure of the program, roles and responsibilities of personnel, quality improvement mechanism, policies and procedures, sample forms, and a listing of current academic program relationships.

6.0 THE CLINICAL EDUCATION SITE HAS A VARIETY* OF LEARNING EXPERIENCES AVAILABLE TO

STUDENTS.

6.1 Students in clinical education are primarily concerned with delivery of services to patients/clients; therefore, the provider of physical therapy must have an adequate number and variety of patients/clients. 6.1.1 The primary commitment of students is to patient/client care, including when appropriate,

screening, examination, evaluation, diagnosis,* prognosis,* intervention, outcomes, and re-examination (see Guide to Physical Therapist Practice).

6.1.2 Provision of a "variety of learning experiences" may include, but should not be limited to, patient/client acuity, continuum of care, presence of a PT working with a PTA, complexity of patient/client diagnoses and environment, health care systems, and health promotion.

6.1.3 The clinical education site provides a clinical experience appropriate to the students' level of education and prior experiences.

6.1.4 The clinical education site will provide, if available and appropriate, opportunities for students to participate in other patient/client-related experiences, including, but not limited to, attendance on rounds, planning conferences, observation of other health professionals and medical procedures, and health promotion, prevention, and wellness programs.

6.1.5 The provider of physical therapy has adequate equipment to provide contemporary services to conduct screenings, perform examinations, and provide interventions.

6.1.6 The provider of physical therapy indicates the types of clinical learning experiences that are offered (e.g., observational, part-time, full-time).

6.2 Other learning experiences should include opportunities in practice management (e.g., indirect patient/client care). For physical therapist students, these opportunities may include consultation, education, critical inquiry, administration,* resource (financial and human) management, public relations and marketing, and social responsibility and advocacy. For physical therapist assistant students, these opportunities may include education, administration, and social responsibility and advocacy. 6.2.1 The clinical education site will expose students to various practice management opportunities, if

available and appropriate, such as resource utilization, quality improvement, reimbursement, cost containment, scheduling, and productivity.

6.2.2 The clinical education site will expose students to various direction and supervision experiences, if available and appropriate, such as appropriate utilization of support personnel.

6.2.3 The clinical education site will expose students to teaching experiences, if available and appropriate, such as in-service programs and patient/client, family, caregiver, and consumer education.

6.2.4 The clinical education site will expose students to various scholarly activities, if available and appropriate, such as journal clubs, continuing education/in-services, literature review, case studies, and clinical research.

7.0 THE CLINICAL EDUCATION SITE PROVIDES AN ACTIVE, STIMULATING ENVIRONMENT APPROPRIATE

TO THE LEARNING NEEDS OF STUDENTS.

7.1 The desirable learning environment in the clinical education site demonstrates characteristics of effective management, positive morale, collaborative working relationships, professionalism, and interdisciplinary patient/client management procedures. 7.1.1 Less tangible characteristics of the site's personnel include receptiveness, a variety of expertise,

interest in and use of evidence-based interventions, and involvement with care providers outside of physical therapy.

7.2 There is evidence of continuing and effective communication within the clinical education site. 7.2.1 Possible mechanisms of verbal communication might include personnel meetings, advisory

committee meetings, and interaction with other care providers, referral agencies, and consumers. 7.2.2 Possible written communications available includes regular monthly or yearly reports,

memorandums, and evaluations.* 7.2.3 Possible use of information technology includes e-mail, voice mail, computer documentation,

electronic pagers, literature searches on the Internet, and use of APTA’s Hooked-on-Evidence database and Open Door, and the PT CPI Web.

7.3 The physical environment for clinical education should include adequate space for the student to conduct patient/client interventions and practice management activities. 7.3.1 The physical environment may include some or all of the following physical resources: lockers for

personal belongings, study/charting area, area for private conferences, classroom/conference space, library resources, and access to the Internet.

7.3.2 Patient/client-care areas are of adequate size to accommodate patients/clients, personnel, students, and necessary equipment.

7.4 The learning environment need not be elaborate, but should be organized, dynamic, and challenging.

8.0 SELECTED SUPPORT SERVICES ARE AVAILABLE TO STUDENTS.

8.1 Evidence exists that, prior to arrival, students are advised in writing of the availability of support services within the clinical education site and procedures for access to such services. 8.1.1 Support services may include, but are not limited to: health care, emergency medical care, and

pharmaceutical supplies; library facilities, educational media and equipment, duplicating services, and computer services; support for conducting critical inquiry; and room and board, laundry, parking, special transportation, and recreational facilities.

8.1.2 Support services will be provided for special learning needs of students within reasonable accommodations and in accordance with ADA guidelines.

9.0 ROLES AND RESPONSIBILITIES OF PHYSICAL THERAPY PERSONNEL ARE CLEARLY DEFINED.

9.1 Current job descriptions exist which are consistent with the respective state/jurisdictional practice acts and rules and regulations, and are available for all physical therapy personnel. 9.1.1 Job responsibilities reflecting clinical education activities are clearly defined within the job

descriptions of all physical therapy personnel. 9.2 Students are informed of the roles and responsibilities of all levels of personnel within the clinical education

site and provider of physical therapy and how these responsibilities are distinguished from one another. 9.3 The clinical education site and the provider of physical therapy should have a current policy and procedure

manual that includes a written organizational chart for the provider of physical therapy and for the provider of physical therapy in relation to the clinical education site. 9.3.1 The physical therapy organizational chart clearly identifies the lines of communication to be used by

the student during clinical education experiences.* 9.3.2 Organizational charts should also reflect all personnel relationships, including the person to whom the students are

responsible while at the clinical education site. 10.0 THE PHYSICAL THERAPY PERSONNEL ARE ADEQUATE IN NUMBER TO PROVIDE AN EDUCATIONAL

PROGRAM FOR STUDENTS.

10.1 Comprehensive clinical education can be planned for students in a clinical education site with at least one physical therapist in accordance with APTA positions, policies, standards, codes, and guidelines. 10.1.1 Direct clinical supervision of a physical therapist assistant student is delegated to a physical

therapist or a physical therapist/physical therapist assistant team. 10.2 Student-personnel ratio can vary according to the provision of physical therapy services, the composition

and expertise of the personnel, the educational preparation of students, the type (PT or PTA) of students, the learning needs of students, state/jurisdictional practice act, and the length of the clinical education assignments. 10.2.1 Alternative approaches to student supervision should be considered where feasible. Examples

may include two or more students to one supervisor, and split supervision by two or more CIs or split supervision by rotation.

10.3 Physical therapist responsibilities for patient/client care, teaching, critical inquiry, and community service permit adequate time for supervision of physical therapy students.

11.0 A CENTER COORDINATOR OF CLINICAL EDUCATION IS SELECTED BASED ON SPECIFIC CRITERIA.

11.1 To qualify as a Center Coordinator of Clinical Education (CCCE), the individual should meet the Guidelines: Center Coordinators of Clinical Education. Preferably, a physical therapist and/or a physical therapist assistant are designated as the CCCE. Various alternatives may exist, including, but not limited to, non-physical therapist professionals who possess the skills to organize and maintain an appropriate clinical education program.* 11.1.1 If the CCCE is a physical therapist or physical therapist assistant, the CCCE should be experienced

as a clinician; experienced in clinical education; interested in students; possess good interpersonal communication and organizational skills; be knowledgeable about the clinical education site and its resources, and serve as a consultant in the evaluation process of students.

11.1.2 If the CCCE is not from the physical therapy profession, the CCCE should be experienced in clinical education; interested in students; possess good interpersonal communication and organizational skills; be knowledgeable about the clinical education site and its resources; and serve as a consultant in the evaluation process of students. A physical therapist or physical therapist assistant who is experienced as a clinician must be available for consultation in planning clinical education experiences for students. Direct clinical supervision of physical therapist students is delegated to a physical therapist. Direct clinical supervision of the physical therapist assistant student is delegated to a physical therapist or a physical therapist working with a physical therapist assistant.

11.2 Planning and implementing the clinical education program in the clinical education site should be a joint effort among all physical therapy personnel with the CCCE serving as the key contact person for the clinical education site with academic programs.

12.0 PHYSICAL THERAPY CLINICAL INSTRUCTORS ARE SELECTED BASED ON SPECIFIC CRITERIA.

12.1 To qualify as a Clinical Instructor (CI), individuals should meet the Guidelines for Clinical Instructors. 12.1.1 One year of clinical experience with demonstrated clinical competence is preferred as the minimal

criteria for serving as a CI. Individuals should also be evaluated on their abilities to perform CI responsibilities.

12.1.2 CIs demonstrate a desire to work with students by pursuing learning experiences to develop knowledge and skills in clinical teaching.

12.2.3. CIs should preferably complete a clinical instructor-credentialing program such as APTA’s Clinical Instructor Education and Credentialing Program.

12.2 CIs should be able to plan, conduct, and evaluate a clinical education experience based on sound educational principles. 12.2.1 Necessary educational skills include the ability to develop written objectives for a variety of learning

experiences, organize activities to accomplish these objectives, effectively supervise students to facilitate learning and clinical reasoning, and participate in a multifaceted process for evaluation of the clinical education experience.

12.2.2 The CI is evaluated on the actual application of educational principles. 12.3 The primary CI for physical therapist students must be a physical therapist. 12.4 The PT working with the PTA is the preferred model of clinical instruction for the physical therapist assistant

student to ensure that the student learns the appropriate aspects of the physical therapist assistant role. 12.4.1 Where the physical therapist is the CI, the preferred roles of the physical therapist assistant are to

serve as a role model for the physical therapist assistant student and to maintain an active role in the feedback and evaluation of the physical therapist assistant student.

12.4.2 Where the physical therapist assistant is the CI working with the PT, the preferred roles of the physical therapist are to observe and consult on an ongoing basis, to model the essentials of the PT/PTA relationship, and to maintain an active role in feedback and evaluation of the physical therapist assistant students.

12.4.3 Regardless of who functions as the CI, a physical therapist will be the patient/client care team leader with ultimate responsibility for the provision of physical therapy services to all patients/clients for whom the physical therapist assistant student provides interventions.

13.0 SPECIAL EXPERTISE OF THE CLINICAL EDUCATION SITE PERSONNEL IS AVAILABLE TO STUDENTS.

13.1 The clinical education site personnel, when appropriate, provide a variety of learning opportunities consistent with their areas of expertise. 13.1.1 Special expertise may be offered by select physical therapy personnel or by other professional

disciplines that can broaden the knowledge and competence of students. 13.1.2 Special knowledge and expertise can be shared with students through in-service education,

demonstrations, lectures, observational experiences, clinical case conferences, meetings, or rotational assignments.

13.1.3 The involvement of the individual student in these experiences is determined by the CI. 14.0 THE CLINICAL EDUCATION SITE ENCOURAGES CLINICAL EDUCATOR (CI and CCCE) TRAINING AND

DEVELOPMENT.

14.1 Clinical education sites foster participation in formal and informal clinical educator training, conducted either internally or externally. 14.1.1 The ACCE and the CCCE may collaborate on arrangements for presenting materials on clinical

teaching to the CIs. 14.1.2 The clinical education site should provide support for attendance at clinical education conferences

and clinical teaching seminars on the consortia, regional, component, and national levels. 14.1.3 APTA’s Clinical Instructor Education and Credentialing Program is recommended for clinical educators. 15.0 THE CLINICAL EDUCATION SITE SUPPORTS ACTIVE CAREER DEVELOPMENT FOR PERSONNEL.

15.1 The clinical education site's policy and procedure manuals outline policies concerning on- the-job training, in-service education, continuing education, and post-professional physical therapist/post-entry level physical therapist assistant study.

15.2 The clinical education site supports personnel participation in various development programs through mechanisms such as release time for in-services, on-site continuing education programs, or financial support and educational time for external seminars and workshops.

15.3 In-service education programs are scheduled on a regular basis and should be planned by personnel of the clinical education site.

15.4 Student participation in career development activities is expected and encouraged. 16.0 PHYSICAL THERAPY PERSONNEL ARE ACTIVE IN PROFESSIONAL ACTIVITIES.

16.1 Activities may include, but are not limited to, self-improvement activities, professional development and career enhancement activities, membership in professional associations including the American Physical Therapy Association activities related to offices or committees, paper or verbal presentations, community and human service organization activities, and other special activities.

16.2 The physical therapy personnel should be encouraged to be active at local, state, component, or national levels.

16.3 The physical therapy personnel should provide students with information about professional activities and encourage their participation.

16.4 The physical therapy personnel should be knowledgeable of professional issues. 16.5 Physical therapy personnel should model APTA’s core values for professionalism.

17.0 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.

17.1 Performance evaluations of physical therapy personnel should be completed at regularly scheduled

intervals and should include appropriate feedback to the individuals evaluated. 17.2 Evaluation of the provider of physical therapy should occur at regularly scheduled intervals.

17.2.1 Evaluation methods may include, but are not limited to, continuous quality improvement, peer review, utilization review, medical audit, program evaluation, and consumer satisfaction monitors.

17.2.2 Evaluations should be continuous and include all aspects of the service, including, but not limited to, consultation, education, critical inquiry, and administration.

17.3 The clinical education site has successfully met the requirements of appropriate external agencies. 17.4 The provider of physical therapy involves students in the review processes as possible. 17.5 The physical therapy clinical education program should be reviewed and revised as changes occur in

objectives, programs, and personnel.

The foundation for this document is:

Barr JS, Gwyer J. Standards for Clinical Education in Physical Therapy: A Manual for Evaluation and Selection of Clinical Education Centers. Alexandria, VA: American Physical Therapy Association; 1981:3-8.

The development of this document was a result of combined efforts of the Task Force on Clinical Education, 1989-1991 and the Task Force on Clinical Education 1992-1994.

Revisions of this document are based on: 1. American Physical Therapy Association. Guide to Physical Therapist Practice. June 2003. Originally

published as Guide to Physical Therapist Practice. 2nd ed. Phys Ther. 2001; 81: 9-744. 2. American Physical Therapy Association. A Normative Model of Physical Therapist Professional Education

Version 2000. Alexandria, Va: American Physical Therapy Association; 2000. 3. American Physical Therapy Association. A Normative Model of Physical Therapist Assistant Education:

Version 99. Alexandria, Va: American Physical Therapy Association; 1999. 4. American Physical Therapy Association. Physical Therapist Clinical Performance Instrument. Physical

Therapy Clinical Performance Instruments. Alexandria, Va: American Physical Therapy Association; 1998. 5. American Physical Therapy Association. Physical Therapist Assistant Clinical Performance Instrument.

Physical Therapy Clinical Performance Instruments. Alexandria, Va: American Physical Therapy Association; 1998.

6. Commission on Accreditation in Physical Therapy Education. Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists. Alexandria, Va: American Physical Therapy Association; 1998.

7. Commission on Accreditation in Physical Therapy Education. Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapist Assistants. Alexandria, Va: American Physical Therapy Association; 2002.

Relationship to Vision 2020: Doctor of Physical Therapy; (Academic/Clinical Education Affairs Department, ext 3203) Explanation of Reference Numbers: BOD P00-00-00-00 stands for Board of Directors/month/year/page/vote in the Board of Directors Minutes; the "P" indicates that it is a position (see below). For example, BOD P11-97-06-18 means that this position can be found in the November 1997 Board of Directors minutes on Page 6 and that it was Vote 18. P: Position | S: Standard | G: Guideline | Y: Policy | R: Procedure

San Jacinto College Physical Therapy Assistant program

Initial Site Visit

Date: _____________

Facility: _______________________Contact name: _________________

Telephone: __________________Email:___________________________ Names of PTs and PTAs plus number of years experience:_____________________________________________________________________________________________________________________________________________________________________________

Type of facility:_______________________________________________________

Type of patients:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Comments from CCCE:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Comments from ACCE/Dir. Of the PTA program:_______________________________________________________________________________________________________________________________________________________________________________

Appendix K

Is equipment checked yearly for safety and effectiveness? ________________________________ Does the student have an adequate work area?________________________ Signature_________________________

CLINICAL SITE INFORMATION FORM (CSIF) developed by

APTA Department of Physical Therapy Education (revised 11-1-99)

Why have a consistent Clinical Site Information Form? The primary purpose of this form is for Physical Therapist (PT) and Physical Therapist Assistant (PTA) academic programs to collect information from clinical education sites. This information will facilitate clinical site selection, student placements, assessment of learning experiences and clinical practice opportunities available to students; and provide assistance with completion of documentation for accreditation in clinical education.

How is the form designed? The form is divided into two sections, Information for Academic Programs - Part I (pages 3-14) and Information for Students - Part II (pages 15-17), to allow ease in retrieval of information for academic programs and for students, especially if the academic program is using a database to manage the information. Duplication of information being requested is kept to a minimum except when separation of Part I and Part II of the form would omit critical information needed by both students and the academic program. The form is also designed using a check-off format wherever possible to reduce the amount of time required for completion. This instrument can be retrieved from APTA's website at www.apta.org. Simply select the link titled “PT Education”, then the link titled “Clinical Education” and choose “Clinical Site Information Form”.

Although using a computer to complete the form is not mandatory, it is highly recommended to facilitate legible updates with minimal time investment from your facility. Additionally, the information provided will be more legible to students, academic programs, and the APTA’s Department of Physical Therapy Education. The form includes several features designed to streamline navigation, including a hyperlinked index on page 18. (Please notes that several of the hyperlinks contained in the document require your computer to have an open internet connection and a web browser).

If you prefer to complete the form manually, you may download the CSIF from APTA's website (see above). If you do not have access to a computer for this purpose, hard copies of the CSIF are available from the APTA Department of Physical Therapy Education, as well as from all PT and PTA academic programs through their Academic Coordinator of Clinical Education (ACCE).

What should I do once the form has been completed? We encourage you to invest the time to complete the form thoroughly and accurately. Once the form has been completed, the clinical education site may e-mail the instrument to each academic program with which it affiliates, minimizing administrative time and associated costs. Please remember to make a copy of this form and retain for your records! To assist in maintaining accurate and relevant information about your physical therapy service for academic programs and students, we encourage you to update this form on an annual basis

In addition, to develop and maintain an accurate and comprehensive national database of clinical education sites, we request that a copy of the completed form be e-mailed to the Department of Physical Therapy Education at csif@apta.org or mail to:

Department of Physical Therapy Education 1111 North Fairfax Street Alexandria, Virginia 22314

Appendix L

DIRECTIONS FOR COMPLETION: If using a computer to complete this form: When completing this form, after opening the original form, and before entering your facility’s information, save the form. The title should be your zip code, your site’s name, and the date (eg, 90210BevHillsRehab10-26-99. Please note that the date must be set apart with dashes; if slashes are used, the computer will unsuccessfully search for a directory and return an error message). Saving the document will preserve the original copy on the disk or hard drive, allowing for you to easily update your information. When completing, use the tab key or arrow keys to move to the desired blank space (the form is comprised of a series of tables to enable use of the tab key for easier data entry). Enter relevant information only in blank spaces as appropriate to your clinical site.

What should I do if my physical therapy service is associated with multiple satellite sites that also provide clinical learning experiences? If your physical therapy service is associated with multiple satellite sites (for example, corporate hospital mergers) that offer clinical learning experiences, such as an acute care hospital that also provides clinical rotations at associated sports medicine and long-term care facilities, you will need to complete pages 3 and 4. On page 3, provide the primary clinical site for the clinical experience. On page 4, indicate other clinical sites or satellites associated with the primary clinical site. Please note that if the individual facility information varies with each satellite site that offers a clinical experience, it will be necessary to duplicate a blank CSIF and complete the form for each satellite site that offers different clinical learning experiences. What should I do if specific items are not applicable to my clinical site or I need to further clarify a response? If specific items on the form do not apply to your clinical education site at the time you are completing the form, please leave the item blank. Opportunities to provide comments have been made available throughout the form.

2

CLINICAL SITE INFORMATION FORM

I. Information About the Clinical Site Date ( / / ) Person Completing Questionnaire

E-mail address of person completing questionnaire

Name of Clinical Center

Street Address

City State Zip

Facility Phone Ext.

PT Department Phone Ext.

PT Department Fax

PT Department E-mail

Web Address

Director of Physical Therapy

Director of Physical Therapy E-mail

Center Coordinator of Clinical Education (CCCE) / Contact Person

CCCE / Contact Person Phone

CCCE / Contact Person E-mail

3

Complete the following table(s) if there are multiple sites that are part of the same health care system or practice. Copy this table before entering information if you need more space. Name of Clinical Site

Street Address

City State Zip

Facility Phone Ext.

PT Department Phone Ext.

Fax Number Facility E-mail

Director of Physical Therapy

E-mail

Center Coordinator of Clinical Education/contact (CCCE)

E-mail

Name of Clinical Site

Street Address

City State Zip

Facility Phone Ext.

PT Department Phone Ext.

Fax Number Facility E-mail

Director of Physical Therapy

E-mail

Center Coordinator of Clinical Education/contact (CCCE)

E-mail

Name of Clinical Site

Street Address

City State Zip

Facility Phone Ext.

PT Department Phone Ext.

Fax Number Facility E-mail

Director of Physical Therapy

E-mail

Center Coordinator of Clinical Education/contact (CCCE)

E-mail

4

Clinical Site Accreditation/Ownership Yes No Date of Last Accreditation/Certification

1. Is your clinical site certified/ accredited? If no, go to #3.

2. If yes, by whom?

JCAHO

CARF

Government Agency (eg, CORF, PTIP, rehab agency, state, etc.)

Other

3. Who or what type of entity owns your clinical site? ____ PT owned ____ Hospital Owned ____ General business / corporation ____ Other (please specify)___________________

4. Place the number 1 next to your clinical site’s primary classification -- noted in bold type. Next, if

appropriate, mark (X) up to four additional bold typed categories that describe other clinical centers associated with your primary classification. Beneath each of the five possible bold typed categories, mark (X) the specific learning experiences/settings that best describe that facility.

Acute Care/Hospital Facility Functional Capacity Exam- FCE spinal cord injury university teaching hospital industrial rehab traumatic brain injury pediatric other (please specify) other cardiopulmonary Federal/State/County Health School/Preschool Program orthopedic Veteran’s Administration school system other pediatric develop. ctr. preschool program Ambulatory Care/Outpatient adult develop. ctr. early intervention geriatric other other hospital satellite Home Health Care Wellness/Prevention Program medicine for the arts agency on-site fitness center orthopedic contract service other pain center hospital based Other pediatric other international clinical site podiatric Rehab/Subacute Rehab administration sports PT inpatient research other outpatient other ECF/Nursing Home/SNF pediatric Ergonomics adult work hardening/conditioning geriatric

4a. Which of these best characterizes your clinic’s location? Indicate with an ‘X’.

rural suburban urban

5

5. If your clinical site provides inpatient care, what are the number of:

Acute beds ECF beds Long term beds Psych beds Rehab beds Step down beds Subacute/transitional care unit Other beds

(please specify): Total Number of Beds

II. Information about the Provider of Physical Therapy Service at the Primary Center

6. PT Service hours

Days of the Week From: (a.m.) To: (p.m.) Comments

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday 7. Describe the staffing pattern for your facility: Standard 8 hour day____ Varied schedules_____

(Enter additional remarks in space below, including description of weekend physical therapy staffing pattern).

8. Indicate the number of full-time and part-time budgeted and filled positions:

Full-time budgeted Part-time budgeted

PTs

PTAs

Aides/Techs

9. Estimate an average number of patients per therapist treated per day by the provider of physical therapy.

INPATIENT OUTPATIENT

Individual PT Individual PT

Individual PTA Individual PTA

Total PT service per day Total PT service per day

6

III. Available Learning Experiences

10. Please mark (X) the diagnosis related learning experiences available at your clinical site: Amputations Critical care/Intensive care Neurologic conditions Arthritis Degenerative diseases Spinal cord injury Athletic injuries General medical conditions Traumatic brain injury Burns General surgery/Organ Transplant Other neurologic conditions Cardiac conditions Hand/Upper extremity Oncologic conditions Cerebral vascular accident Industrial injuries Orthopedic/Musculoskeletal Chronic pain/Pain ICU (Intensive Care Unit) Pulmonary conditions Connective tissue diseases Mental retardation Wound Care Congenital/Developmental Other (specify below)

11. Please mark (X) all special programs/activities/learning opportunities available to students during clinical

experiences, or as part of an independent study. Administration Industrial/Ergonomic PT Prevention/Wellness Aquatic therapy Inservice training/Lectures Pulmonary rehabilitation Back school Neonatal care Quality Assurance/CQI/TQM Biomechanics lab Nursing home/ECF/SNF Radiology Cardiac rehabilitation On the field athletic injury Research experience Community/Re-entry activities Orthotic/Prosthetic fabrication Screening/Prevention Critical care/Intensive care Pain management program Sports physical therapy Departmental administration Pediatric-General (emphasis on): Surgery (observation) Early intervention Classroom consultation Team meetings/Rounds Employee intervention Developmental program Women’s Health/OB-GYN Employee wellness program Mental retardation Work Hardening/Conditioning Group programs/Classes Musculoskeletal Wound care Home health program Neurological Other (specify below)

12. Please mark (X) all Specialty Clinics available as student learning experiences.

Amputee clinic Neurology clinic Screening clinics Arthritis Orthopedic clinic Developmental Feeding clinic Pain clinic Scoliosis Hand clinic Preparticipation in sports Sports medicine clinic Hemophilia Clinic Prosthetic/Orthotic clinic Other (specify below) Industry Seating/Mobility clinic

7

13. Please mark (X) all health professionals at your clinical site with whom students might observe and/or interact. Administrators Health information technologists Psychologists Alternative Therapies Nurses Respiratory therapists Athletic trainers Occupational therapists Therapeutic recreation

therapists Audiologists Physicians (list specialties) Social workers Dietitians Physician assistants Special education teachers Enterostomal Therapist Podiatrists Vocational rehabilitation

counselors Exercise physiologists Prosthetists /Orthotists Others (specify below)

14. List all PT and PTA education programs with which you currently affiliate.

15. What criteria do you use to select clinical instructors? (mark (X) all that apply):

APTA Clinical Instructor Credentialing Demonstrated strength in clinical teaching Career ladder opportunity No criteria Certification/Training course Therapist initiative/volunteer Clinical competence Years of experience Delegated in job description Other (please specify)

16. How are clinical instructors trained? (mark (X) all that apply)

1:1 individual training (CCCE:CI) Continuing education by consortia

Academic for-credit coursework No training

APTA Clinical Instructor Credentialing Professional continuing education (eg, chapter, CEU course)

Clinical center inservices Other (please specify)

Continuing education by academic program

17. On pages 9 and 10 please provide information about individual(s) serving as the CCCE(s), and on pages 11 and 12 please provide information about individual(s) serving as the CI(s) at your clinical site.

8

ABBREVIATED RESUME FOR CENTER COORDINATORS OF CLINICAL

EDUCATION Please update as each new CCCE assumes this position.

NAME: Length of time as the CCCE:

DATE: (mm/dd/yy) Length of time as the CI:

PRESENT POSITION: (Title, Name of Facility)

Mark (X) all that apply: ____PT ____PTA ____Other, specify

Length of time in clinical practice:

LICENSURE: (State/Numbers) Credentialed Clinical Instructor: Yes______ No_______

Eligible for Licensure: Yes____ No____ Certified Clinical Specialist:

Area of Clinical Specialization:

Other credentials:

SUMMARY OF COLLEGE AND UNIVERSITY EDUCATION (start with most current):

INSTITUTION

PERIOD OF STUDY

MAJOR DEGREE

FROM TO

SUMMARY OF PRIMARY EMPLOYMENT (For current and previous four positions since graduation from college; start with most current):

EMPLOYER POSITION PERIOD OF EMPLOYMENT

FROM TO

9

CONTINUING PROFESSIONAL PREPARATION RELATED DIRECTLY TO CLINICAL TEACHING RESPONSIBILITIES (for example, academic for credit courses [dates and titles], continuing education [courses and instructors], research, clinical practice/expertise, etc. in the last five years):

10

CLINICAL INSTRUCTOR INFORMATION Provide the following information on all PTs or PTAs employed at your clinical site who are CIs.

Name

School from

Which CI Graduated

PT/PTA

Year of

Graduation

No. of Years of

Clinical Practice

No. of Years of Clinical Teaching

Credentialed CI Specialist Certification Other

L= Licensed, Number E= Eligible T= Temporary

L/E/T Number

State of Licensure

(Continued on next page)

11

CLINICAL INSTRUCTOR INFORMATION (continued)

Name

School from

Which CI Graduated

PT/PTA

Year of

Graduation

No. of Years of

Clinical Practice

No. of Years of Clinical Teaching

Credentialed CI Specialist Certification Other

L= Licensed, Number E= Eligible T= Temporary

L/E/T Number

State of Licensure

12

18. Indicate professional educational levels at which you accept PT and PTA students for clinical experiences (mark (X) all that apply).

Physical Therapist Physical Therapist Assistant First experience First experience Intermediate experiences Intermediate experiences Final experience Final experience Internship

PT PTA

From To From To 19. Indicate the range of weeks you will accept students for any single full-time (36 hrs/wk) clinical experience.

20. Indicate the range of weeks you will accept students for any one part-time (< 36 hrs/wk) clinical experience.

PT PTA 21. Average number of PT and PTA students affiliating per year.

22. What is the procedure for managing students with exceptional qualities that might affect clinical

performance (eg, outstanding students, students with learning/performance deficits, learning disability, physically challenged, visually impaired)?

23. Answer if the clinical center employs only one PT or PTA. Explain what provisions are made for

students if the clinical instructor is ill or away from the clinical site.

13

Yes No 24. Does your clinical site provide written clinical education objectives to students?

If no, go to # 27. 25. Do these objectives accommodate: the student’s objectives? students prepared at different levels within the academic curriculum? academic program's objectives for specific learning experiences? students with disabilities? 26. Are all professional staff members who provide physical therapy services acquainted with the

site's learning objectives? 27. When do the CCCE and/or CI discuss the clinical site's learning objectives with students? (mark (X) all that apply) Beginning of the clinical experience At mid-clinical experience Daily At end of clinical experience Weekly Other

28. How do you provide the student with an evaluation of his/her performance? (mark (X) all that apply) Written and oral mid-evaluation Ongoing feedback throughout the clinical Written and oral summative final evaluation As per student request in addition to formal and

ongoing written & oral feedback Student self-assessment throughout the

clinical

Yes No

29. Do you require a specific student evaluation instrument other than that of the affiliating academic program? If yes, please specify:

OPTIONAL: Please feel free to use the space provided below to share additional information about your clinical site (eg, strengths, special learning opportunities, clinical supervision, organizational structure, clinical philosophies of treatment, pacing expectations of students [early, final]).

Information for Students - Part II

14

I. Information About the Clinical Site

Yes No

1. Do students need to contact the clinical site for specific work hours related to the clinical experience?

2. Do students receive the same official holidays as staff?

3. Does your clinical site require a student interview?

4. Indicate the time the student should report to the clinical site on the first day of the experience:

Medical Information

Yes No Comments

5. Is a Mantoux TB test required? a) one step_________ b) two step_________

5a. If yes, within what time frame?

6. Is a Rubella Titer Test or immunization required? 7. Are any other health tests/immunizations required prior to the

clinical experience?

a) If yes, please specify:

8. How current are student physical exam records required to be?

9. Are any other health tests or immunizations required on-site? a) If yes, please specify:

10. Is the student required to provide proof of OSHA training?

11. Is the student required to attest to an understanding of the benefits and risks of Hepatitis-B immunization?

12. Is the student required to have proof of health insurance?

a) Can proof be on file with the academic program or health center?

13. Is emergency health care available for students?

a) Is the student responsible for emergency health care costs?

14. Is other non-emergency medical care available to students?

15. Is the student required to be CPR certified? (Please note if a specific course is required).

a) Can the student receive CPR certification while on-site?

16. Is the student required to be certified in First Aid?

a) Can the student receive First Aid certification on-site?

Yes No Comments

15

17. Is a criminal background check required (eg, Criminal Offender Record Information)?

a) Is the student responsible for this cost?

18. Is the student required to submit to a drug test?

19. Is medical testing available on-site for students?

Housing

Yes No Comments

20. Is housing provided for male students?

for female students? (If no, go to #26)

$ 21. What is the average cost of housing?

22. If housing is not provided for either gender:

a) Is there a contact person for information on housing in the area of the clinic? (Please list contact person and phone #).

b) Is there a list available concerning housing in the area of the clinic? If yes, please attach to the end of this form.

23. Description of the type of housing provided: 24. How far is the housing from the facility? 25. Person to contact to obtain/confirm housing: Name: Address: City: State: Zip:

Transportation

Yes No

26. Will a student need a car to complete the clinical experience? 27. Is parking available at the clinical center? $ a) What is the cost?

28. Is public transportation available?

29. How close is the nearest bus stop (in miles) to your site? a) train station? b) subway station? 30. Briefly describe the area, population density, and any safety

issues regarding where the clinical center is located.

31. Please enclose printed directions and/or a map to your facility. Travel directions can be obtained from several travel directories on the internet. (eg, Delorme, Microsoft, Yahoo).

16

Meals Yes No Comments

32. Are meals available for students on-site? (If no, go to #33)

Breakfast (if yes, indicate approximate cost) $________

Lunch (if yes, indicate approximate cost) $________

Dinner (if yes, indicate approximate cost) $________

a) Are facilities available for the storage and preparation of food?

Stipend/Scholarship Yes No Comments

33. Is a stipend/salary provided for students? If no, go to #36

$ a) How much is the stipend/salary? ($ / week)

34. Is this stipend/salary in lieu of meals or housing?

35. What is the minimum length of time the student needs to be on the clinical experience to be eligible for a stipend/salary?

Special Information

Yes No Comments 36. Is there a student dress code? If no, go to # 37. a) Specify dress code for men: b) Specify dress code for women: 37. Do you require a case study or inservice from all students? 38. Does your site have a written policy for missed days due to

illness, emergency situations, other?

Other Student Information

Yes No

39. Do you provide the student with an on-site orientation to your clinical site? (mark X) a) What does the orientation include? (mark (X) all that apply)

Documentation/billing Required assignments (eg, case study, diary/log, inservice) Learning style inventory Review of goals/objectives of clinical experience Patient information/assignments Student expectations Policies and procedures Supplemental readings Quality assurance Tour of facility/department Reimbursement issues Other (specify below)

In appreciation... Many thanks for your time and cooperation in completing the CSIF and continuing to serve the physical therapy profession as clinical teachers and role models. Your contributions to students’ professional growth and development ensure that patients today and tomorrow receive high-quality patient care services.

17

Index Saving the Completed Form……………………………………………………………………………………………..Page 2

Affiliated PT and PTA Educational Programs ………………………………………………………………….Page 8 Arranging the Experience ……………………………………………………………………………………Page 15

Required Background……………………………………………………………………………...…...Page 16 Required Medical Tests…………………………………………………………………………………Page 15

Available Learning Experiences……………………………………………………………………..…………….. Diagnosis………………………………………………………………………………………………..Page 7 Health Professionals on Site………………………………………………………………………...…….Page 8 Specialty Clinics………………………………………………………………………………………....Page 7 Special Programs/Activities/Learning Opportunities……………………………………………………….Page 7

Center Coordinators of Clinical Education (CCCEs)……………………………………………………………… Education…………………………………………………………………………………………….….Page 9 Employment Summary……………………………………………………………...…………………....Page 9 Information……………………………………………………………………………………………...Page 9 Teaching Preparation…………………………………………………………………………………...Page 10

Clinical Instructors…………………………………………………………………………………………………. Information…………………………………………………………………………………………Page 11-12 Selection Criteria………………………………………………………………………………………...Page 8 Training…………………………………………………………………………………………………Page 8

Clinical Site Accreditation…………………………………………………………………………………..Page 5 Clinical Site Ownership……………………………………………………………………………………..Page 5 Clinical Site Primary Classification…………………………………………………………………………Page 5 Information about the Clinical Site……………………………………………………………………………..Page 3

Information about Physical Therapy Service at Primary Center……………………………………………………………………………………Page 6

Satellite Site Information…………………………………………………………………………………Page 4 Physical Therapy Service…………………………………………………………………………………………...

Hours……………………………………………………………………………………………………Page 6 Number of Patients………………………………….…………………………………………………... Page 6 Staffing…………………………………………………………………………………………………. Page 6

Student Information………………………………………………………………………………………………... Housing………………………………………………………………………………………………..Page 16 Meals………………………………………………………………………………………………….Page 17 Other…………………………………………………………………………………………………..Page 17 Stipends………………………………………………………………………………………………..Page 17 Transportation…....…………………………………………………………………………………….Page 17

18

PREFERENCE FORM FOR CLINICAL l 2014

Student Name: __________________________________Date:_________ Address: _________________________ City: ____________ Zip: ______ Phone: _______________ Work: ______________ Cell: ______________

List prior Physical Therapy experience (include observation sites and employment.

List any special considerations which may be relevant to the location of your assignment:

List your preferences regarding your assignment: 1. 2. 3.

Comments:_________________________________________________________________________________________________________________

Do not write below this line______________________________________

Comments:______________________________________________________________________________________________________________________________________________________________________________

Appendix M

San Jacinto College

Physical Therapist Assistant Program

CLINICAL INFORMATION SHEET

Name of Facility:_______________________________________________

Location: _____________________________________________________

Phone: ____________

Hours and days the student will be expected to be at the facility: _____________________________________________________________

Parking: (Cost /Where): __________________________________________

Dress code: ____________________________________________________

Clinical Instructors name and contact information: ______________________________________________________________ ______________________________________________________________

Types of disabilities:_____________________________________________

______________________________________________________________

Types of Treatments Performed: ___________________________________

______________________________________________________________

First Day Instructions: ____________________________________________

______________________________________________________________

Any Additional Information: _______________________________________

______________________________________________________________

Appendix N

Physical Therapist Assistant Program San Jacinto College South

13735 Beamer Road Houston, TX 77089

FACILITY COMMITMENT FORM for CLINICAL AFFILIATIONS

2015

Affiliation Dates Number of Students

Clinical II Jan 19 – Mar 6, 2015 ____ (Out pt., Rehab, Acute)

Clinical III Mar 23 - May 8, 2015 ____ (Out pt., Rehab, Acute)

Clinical I July 14 - Aug 12, 2015 ____ (Out pt., Rehab, Acute)

Students will have completed all academic courses prior to Clinical II and III. Clinical I students will have completed Therapeutic Exercise, Pathology and Physical Agents but not The Management of Neurological Disorders or Rehabilitation Techniques.

Please indicate the number of students that your facility may accommodate for each affiliation and return this form to Laura Oppermann. If you have any questions, please call me at 281-484-1900 ext. 3519 or email Laura.Oppermann@sjcd.edu. Forms can be faxed to 281- 929-4634. Thank you for your participation.

Go to our website to see our clinical handbook www.sjcd.edu/PTA

Name of Facility: ______________________________________________________________

Address: _____________________________________________________________________

Type(s) of Setting: _____________________________________________________________

Phone: ________________________________ Date: ______________________________

Email address: ____________________________Fax:_______________________________

Center Coordinator of Clinical Education: ________________________________________ (Signature)

Appendix O

SAN JACINTO COLLEGE SOUTH PHYSICAL THERAPIST ASSISSTANT PROGRAM

CLINICAL INSTRUCTOR QUESTIONNAIRE 2014

Thank you for taking a PTA student for their third clinical rotation. We would appreciate you completing the following questionnaire to help us further improve our program.

Please check the column which best indicates how well the SPTA has been prepared academically and clinically to perform the skills listed at entry level.

4 = strongly prepared 2 = weakly prepared 3 = adequately prepared 1 = no opportunity to observe

1. The San Jacinto College PTA Program prepared the PTA to: 4 3 2 1 Work under the supervision of a physical therapist in a ethical, legal, safe, and effective manner by demonstrating a knowledge of:

a. The rationale and effectiveness of physical therapy treatmentprocedures.

b. The APTA Standards of Practice for Physical Therapy, theStandards of Ethical Conduct for the PTA and the Guide forConduct of the Affiliate Member and other relevant ethicalprinciples.

c. Applicable state and federal laws.d. The scope of the PTA’s abilities in the delivery of care.

Communicate on a timely basis with the supervising physical therapist about the patient’s status so treatment and goals can be appropriately modified. Interact with patients and families in a manner which provides the desired psychological support including the recognition of cultural and socioeconomic differences. Participate in teaching patients, families, and other health care providers. Document relevant aspects of patient treatment. Participate in discharge planning and follow up care. Demonstrate effective written, oral and nonverbal communication with patients and their families, colleagues, other health care providers, and the public. Demonstrate appropriate knowledge of the general physical therapy delivery system including policies and procedures, fiscal considerations, continuous quality improvement, ect. Effectively read and interpret professional literature. Participate in the continued development of knowledge and skills. Use critical thinking and problem solving skills in daily activities.

Appendix P

Please check the column which best indicates how well the SPTA has been prepared academically and clinically to perform the skills listed in an entry level position. 4 = strongly prepared 2 = weakly prepared 3 = adequately prepared 1 = no opportunity to observed

2. The program adequately prepared the PTA to implement a comprehensive treatment plan developed by a PT including the application of the following modalities and treatment techniques:

4 3 2 1

Activities of daily living and functional training

Assistive/adaptive devices

Balance and gait training

Biofeedback

Developmental activities

Electric current

Electromagnetic radiations

External compression

Hydrotherapy

Orthoses and prostheses

Patient/family education

Postural training and body mechanics

Pulmonary hygiene techniques

Therapeutic exercise

Therapeutic massage

Thermal agents

Topical applications (including iontophoresis)

Traction

Ultrasound

Universal precautions/infection control

Wound care

Please check the column which best indicates how well the PTA has been prepared academically and clinically to perform the skills listed in an entry level position. 4 = strongly prepared 2 = weakly prepared 3 = adequately prepared 1 = no opportunity to observed 3. The program adequately prepared the PTA to perform

appropriate assessment and measurement techniques to assist the supervising PT in monitoring and modifying the plan of care within the knowledge and limits of practice to identify the patient’s status with respect to the following:

4 3 2 1

Architectural barriers and environmental modifications Endurance Flexibility/joint range of motion and muscle length Functional activities Gait and balance Pain Posture Righting and equilibrium reactions Segmental length, girth, and volume Skin and sensation Strength Vital signs

4. Based on the performance of other physical therapist assistants with similar experience in your facility, please rate the overall performance of our graduate.

____ Excellent ____ Good ____ Adequate ____ Fair ____ Poor

5. Please add any comments regarding the performance of our graduate which will help us to

evaluate and strengthen our program. Please fax to 281-929-4634-Julianne Blanford PT ACCE SIGNATURE___________________________

Facility: ________________________________________ Clinical Dates from: _______to_______

Student Name: ____________________________________________________ Age: _______

When sending information prior to the clinical, please send to the following:

Address: ________________________________________________________________________________ Street City State Zip

Email Address: _______________________________________________

Phone: _________________________________________________________________________________ Home Work Cell Pager

Previous colleges or universities attended (please include degrees earned):

Clinical experience prior to this rotation (briefly describe volunteer, work, and any other clinical experience):

Special skills and interests (please include interests related to PT, foreign language skills, other interests):

San Jacinto College South PHYSICAL THERAPIST ASSISTANT PROGRAM

Student Personal Data Sheet CLINICAL I July 8-August 6, 2014

In case of an emergency, please notify:

Name: ___________________________________ Relationship: ________________________________

Address: _________________________________ Phone: (Hm) ____________________

_________________________________ (Wk) ____________________

Appendix Q

EMAIL JOURNALS

Email journals will be required for each clinical. Before each assignment, which you will choose from the following list, please write 5-6 lines about: your likes, dislikes or any problems being encountered, your schedule, interesting learning experiences, perception of your CI and the clinical site, or goals set by CI. Send all emails to: Laura.Oppermann@sjcd.edu

ASSIGNMENTS 1. State the topic you have chosen.2. Write ½ page on that topic.3. Send to me.4. I will comment on it and save a copy for your final course grade.5. The first half of the alphabet A-F will write on weeks 1, 3, 5 the

last half of the alphabet will write on weeks 2, 4, 6.6. On week seven all students write a reflection of how this clinical

experience has prepared you to become a competent PTA.7. All communication will be confidential.8. All assignments are to be of your personal experiences.9. If you do not have access to email you can fax it.

TOPICS:

From “Professionalism in Physical Therapy: Core Values”

1. Seeing patients needs placed above the needs of the therapist2. Assuming responsibility for learning and change3. Educating students in a manner that facilitates the pursuit of

learning4. Designing patient interventions that are congruent with patient

needs.5. Embracing the patient’s emotional and psychological aspects of

care6. Conveying intellectual humility in professional and interpersonal

situations7. Sharing one’s knowledge with others8. Knowing one’s limitations and acting accordingly9. Taking pride in one’s profession

Appendix R

10. Promoting community volunteerism From other sources:

1. How was it handled when patients brought up spiritual or religious issues? How do you think it should have been handled?

2. Did you see anyone in “spiritual distress”? How was it handled? How do you think it should have been handled?

3. Explore your feelings of a situation which took place in the clinical setting.

4. Reflect on your clinicals so far and see if the staff and therapists have modeled humanistic behavior. Explain.

5. How are the patient’s emotional feelings being handled in the clinic or hospital?

Your Clinical Instructor

On a scale of 1-10, rate the following: (10 being the best)

1. Clinical instruction: including hands-on teaching and guidance1 2 3 4 5 6 7 8 9 10

2. Professional Behavior1 2 3 4 5 6 7 8 9 10

3. Communication with CI1 2 3 4 5 6 7 8 9 10

4. Mutual respect between you and your CI1 2 3 4 5 6 7 8 9 10

5. CI assists to develop your critical thinking and problem solving skills1 2 3 4 5 6 7 8 9 10

6. Confidentiality with HIPPA at the facility and your CI1 2 3 4 5 6 7 8 9 10

7. Knowledge of PTA MACS by CI1 2 3 4 5 6 7 8 9 10

8. Constructive feedback includes areas you need improvement from CI1 2 3 4 5 6 7 8 9 10

9. Positive feedback from CI1 2 3 4 5 6 7 8 9 10

10. Frequency of feedback: (circle) after pt tx daily at the end of the weekDid your CI assist you to develop professional behaviors in the clinical setting? Whichones?

11. What were your CI’s strengths? Weaknesses?

12. Is there anything else you would like to share about your CI?

Appendix S

MEMORANDUM OF INSURANCE Date Issued: 9/6/2013 Producer:

Bill Beatty Insurance Agency, Inc. 1202 Richardson Dr., Suite 100 Richardson, Texas 75080 (800) 451-8358

This memorandum is issued as a matter of information only and confers no rights upon the holder. This memorandum does not amend, extend or alter the coverages afforded by the Certificate listed below.

Company Affording Coverage Insured:

Students of San Jacinto College District 4624 Fairmont Parkway, Suite 103 Pasadena, Texas 77504

Chicago Insurance Company

Covered Person

This is to certify that the Certificate listed below has been issued to the insured named above for the policy period indicated, notwithstanding any requirement, term or condition of any contract or other document with respect to which this memorandum may be issued or may pertain, the insurance afforded by the Certificate described herein is subject to all terms, exclusions and conditions of such Certificate. The limits shown may have been reduced by paid claims.

Type of Insurance Certificate/Policy

Number Effective Date Expiration Date Limits Professional Liability

Student Blanket Medical Liability

Insurance

AHC 2000917 09/01/2013 09/01/2014 Each incident

Annual aggregate

$ 1,000,000.

$ 3,000,000.

General Liability N/A Per occurrence

Aggregate

$

$

THIS IS AN OCCURRENE POLICY FORM. POLICY INCLUDES COVERAGE FOR THE STUDENTS LISTED ON THE APPLICATION, THE FACULTY & COLLEGE ADDED AS ADDITIONAL INSURED’S.

Memorandum Holder

EVIDENCE OF INSURANCE

Should the above described Certificate be cancelled before the expiration date thereof, the issuing company will endeavor to mail 30 days written notice to the Memorandum Holder named to the left, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives. San Jacinto College District

Department of Safety & Risk Management 4624 Fairmont Parkway, Suite 103 Pasadena, Texas 77504

Authorized Representative:

Appendix T

This form should be filled out by the physician.

Name of Applicant__________________________________________________________________

Last First Middle

Date of Birth___/__/____

Immunizations Date(s)

PPD _________

Hepatitis B #1 _________

Hepatitis B #2 _________

Hepatitis B #3 _________

MMR date or Titer _________

Varicella/ Titer/Hx. _________

Tdap Vaccine _________

Seasonal Flu _________

HEPATITIS B VACCINE WAIVER I understand that due to my Occupational Exposure to blood or other potentially infectious materials that I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine. However, I decline hepatitis B vaccine at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease.

_____________________________

Student signature if Hepatitis B is waived

Flu H1N1 (if applicable) _________

_________________________________________

Medical Personnel Signature Title Date

Physical Therapist Assistant

Health Form

Appendix U

Clinical Instructor’s Information

The student is to fill out this form the first week and return to ACCE by faxing or scan and email.

Fax 281-929-4634

Email Laura.Oppermann@sjcd.edu

Student name ________________________________

Clinical name _________________________________

Where is the PT department (floor/room number)____________________________________

Clinical instructor’s name___________________________

Best phone number to call__________________________

CI’s email address _________________________________

Work hours and days ______________________________

Any days the CI would prefer to have midterm site visit or when not available __________________

Laura M. Oppermann, PT, ACCE

Appendix V

San Jacinto College PTA Program Weekly Goals

Date: _______

Overall Student Summary ________________________________________________________ ____________________________________________________________________________________________________________________________________________________________

Student Strengths _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Student Needs Improvement _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Student Goals (to be completed by the student) __________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Clinical Instructor Goals _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Overall Goals for next week _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

Student Comments __________________________________________________________________________________________________________________________________________________________________________

Clinical Instructor Comments __________________________________________________________________________________________________________________________________________________________________________

Appendix W

Clinical Quality Form Facility: __________________

Date: ____________________

Name of PTs and number of years of experience __________________________________________________________________

Name of PTAs and number of years of experience

CIs for PTAs at facility and their number of years as a CI___________________________________________________________________________________________________________________________________

Diagnosis most commonly treated

General treatments

___________________________________________________________________CCCE and Experience_________________________________

Does the facility send out a student packet?______

Parking information if necessary____________

Do you have an orientation for the students? ________ explain_____________

Other Information_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Appendix X