Clinical Exercise Practicum Guide

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Bachelor of Exercise and Sports Science with Clinical Honours in Exercise Physiology

(54C)

Student Practicum Guide

Clinical Exercise Practicum (CXA443, CXA446, CXA447)

For professional experience placement hours working with

clients with chronic disease or injuries

SCHOOL OF HEALTH SCIENCES

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Table of Contents Unit Staff Contacts ..................................................................................................................... 3

1. What is Clinical Exercise Practicum? ................................................................................. 3

2. Safety In Practice - Compliance ............................................................................................ 4

3. 140 Hours Per Unit and ESSA Course Requirements ........................................................... 4

Acceptable Activities for EP Practicum ........................................................................................................ 5 Observation While on Practicum .................................................................................................................. 6 Supervision ................................................................................................................................................... 6

4. PEP Engagement Activities.................................................................................................... 7

5. Interim and Final Competency Assessments ......................................................................... 9

Competency Assessment Submissions ..................................................................................................... 10 Students “at risk” of failing EP Competency Assessment .......................................................................... 10 Exercise Physiology Competency Assessment Rating Explanations ........................................................ 12 Exercise Physiology Learning Outcome Descriptors ................................................................................. 13

6. What to Expect when on Practicum .......................................................................................17

Expectations of Students ............................................................................................................................ 17 7. The roles of the academic unit ..............................................................................................18

Contact Schedule ....................................................................................................................................... 18 Responsibilities of the Exercise Physiology PEP unit staff ........................................................................ 18

8. The Role of a Supervisor ......................................................................................................19

Effective Supervision .................................................................................................................................. 19 9. Support for Students while on PEP .......................................................................................21

10. Dispute resolution and handling grievances ........................................................................21

Student Complaints .................................................................................................................................... 21 11. Student absence from PEP .................................................................................................21

12. Risk Management / Safety in Practice .................................................................................22

13. “Quiet Times” on PEP .........................................................................................................22

14. Student Insurance Details ...................................................................................................23

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Unit Staff Contacts Bachelor of Exercise Physiology Professional Honours Course Coordinator

Dr Greig Watson greig.watson@utas.edu.au

Unit Coordinator CXA443 CXA446 CXA447

Dr Sibella Hardcastle 03 6324 5406 sibella.hardcastle@utas.edu.au Room C108

PEP Coordinator Vacant

PEP Admin - Compliance - Safety In Practice

Ms Natalie Harding

03 6324 4193 N.Harding@utas.edu.au Nursing Building – J101

Fieldwork Coordinators

South: Eliza Thomas (BN) North: Emma Cairns (BN) North West: Grant Todd (AEP)

Eliza.Thomas@utas.edu.au Emma.Cairns@utas.edu.au Grant.Todd@utas.edu.au

1. What is Clinical Exercise Practicum? Clinical Exercise Practicum Units 1, 2 and 3 are completed by all students enrolled in the Bachelor of Exercise and Sports Science (Clinical Honours in Exercise Physiology). The three clinical practicum units are integral parts of the degree providing students with an opportunity for Work Integrated Learning (WIL) and to apply knowledge and skills they have attained throughout their studies and to achieve the graduate attributes (competencies) and minimum required hours to be eligible for Exercise Physiology (EP) accreditation with Exercise & Sports Science Australia (ESSA).

The requirements for each Clinical Exercise Practicum unit are:

1. Full compliance documentation uploaded into InPlace;

2. A PEP Plan that details your agreed learning goals, attendance dates and hours (uploaded to Mylo);

3. Minimum 140 hours of practical workplace experience in line with ESSA’s EP Professional Standards;

4. Weekly Reflection blog and hours entries (completed in Pebble Pad)

5. 2 x Case Entries (detailing case details of 2 different clients, or groups you have worked with over the unit, in Pebble Pad)

6. An ESSA “Record of Engagement” form (one per block)

7. Interim and Final Competency Assessments (one each per block); and

8. One ‘major’ assessment piece:

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8.1 CXA443 – Clinical Reasoning Viva / Practical Exam

8.2 CXA446 – Digital (video) Presentation and discussions on Interprofessional Practice

8.3 CXA447 – an “Exit Exam”, which is a practical “client consultation” and viva defence exam.

See your unit outlines for specific detail on your assessment tasks.

2. Safety In Practice - Compliance You must have completed all the mandatory compliance requirements before you can attend ANY placements (both in the UTAS EP Clinic and external). See the UTAS PEP Website under “Courses” > “Exercise Physiology”.

Regularly check (diarise) your expiry dates for National Police Check, Working with Vulnerable People card and First Aid / CPR in InPlace. It is your responsibility to keep these compliance requirements current and communicate with the PEP admin team as necessary. You will be removed from placement if any of your compliance documents expire and an update is not provided ASAP to the PEP Admin Team.

3. 140 Hours Per Unit and ESSA Course Requirements For ESSA EP accreditation, you are required to accrue:

1. a minimum of 140 hours of “apparently healthy” practicum within the scope of an Exercise Scientist (this is completed during your Exercise Science Practicum Unit);

2. Then as an EP student you must complete 360 hours minimum in clinical exercise service delivery, where:

Minimum 200 hours must be across cardiovascular, musculoskeletal and metabolic clinical categories,

You must be deemed “competent” by internal (UTAS EP Clinic and your Unit Coordinator), plus external practicum supervisors (Via your “Competency Assessments”) across these pathology domains

The hours do not need to be evenly split between domains.

EXAMPLE:

You have completed 50 hours of practicum for cardiovascular pathology, 90 hours of musculoskeletal pathology and 60 hours of metabolic pathology. Assuming you have been declared competent by supervisor(s) in each domain, you meet this requirement.

3. Minimum 100 hours in any of the other AEP pathology domain eg, respiratory/pulmonary, cancer, kidney, neurological, and mental health,

Note: You do not need to obtain hours in all domains.

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EXAMPLE: You have completed 40 hours in mental health, 40 hours in cancer and 20 hours in neurological, hence you have met the minimum requirement.

4. and Max 60 hours in any of the aforementioned pathology areas OR in any other activities relevant to the AEP Professional Standards.

For UTAS requirements you will accrue more than ESSA requires (e.g. 140 hours minimum per Practicum unit; therefore, a minimum of 420 over the three units). Hours are recorded in the Pebble Pad Workbook - logbook page.

In this Clinical Honours degree as a Student Exercise Physiologist, you are encouraged to accrue more than 140 hours in every unit to ensure you have excess hours (in case any are deemed inappropriate for claiming as practicum) and, that you are surpassing the minimum competencies and developing a strong sense of teamwork, leadership, and initiative, rather than clocking in and out or simply ‘ticking off hours’. Your dedication to your practicum site work, and team is vital to your reputation as a practitioner, and in your success in gaining employment after the degree.

Acceptable Activities for EP Practicum Practicum activity is classified by the main purpose of the treatment. Clients will likely present with multiple co-morbidities. As such, practicum hours are classified by the primary pathology that is being addressed by the clients referral. Examples of acceptable activities:

• Exercise assessment for clients with diagnosed condition (allocated according to pathology) • Exercise prescription for clients with diagnosed condition (allocated according to pathology) • Exercise delivery / intervention for clients with a diagnosed condition (allocated according to

pathology) • Diagnostic procedure (e.g. ECG, stress test, clinical investigations) • Reviewing or developing clinical case (SOAP) notes • Client report writing (i.e. drafting with supervisor oversight/sign off) • Case conferences / team meetings • Education delivery for a specific pathology (e.g. cancer education session to clients, or in-

service presentations to staff) • Research with an exercise intervention for a special population (e.g. conducting a weekly type

two diabetes group exercise class) Examples of unacceptable activities:

• Clients being seen for improving health and well-being with no identified pathology (apparently healthy) cannot be logged in the 360 hours of exercise physiology practicum. I.e. you can work

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with them if required by your placement site, but you cannot log the hours. If unsure speak to the Unit Coordinator about allocating clients to ESSA clinical domains.

• Activities outside of the AEP foundational scope of practice and/or Professional Standards.

Observation While on Practicum Time spent in active observation of practice that involves and engages you to provide a meaningful learning activity within the AEP scope of practice, and that directly assists you towards demonstrating competency, can be counted towards practicum hours. However, passive observational hours cannot be logged or counted towards your practicum hours. Observation hours must also be consistent with existing guidelines (such as the DVA requirements of Department of Health where ESSA has advised that “students should not provide services on behalf of an allied health professional, however student observation and ancillary support should be encouraged to maximise the learning outcomes”.). The following are examples of acceptable active observation tasks according to ESSA:

• Reviewing case notes • Developing mock reports • Developing mock treatment plans with clinical justifications • Taking own case notes • Undertaking assessment and treatment tasks outside of third party funded consultations • Case conference between supervisor and student regarding consultation occurring before, during or

after • Simulation activities*

Given these restrictions, you must limit your “Active Observation” hours to ~90 hours in total across the three practicum units (eg. one short placement block with an agency known to be primarily DVA clientele, OR equates to ~30 active observation hours per unit) and you must ensure your observation work complies with ESSA’s guidelines (above). *Simulation Activities Note: According to ESSA’s Practicum Guide, no more than 40 total hours in the 420 hours can be logged in a simulated learning environment (SLE). Simulated learning environments are those such as undertaking practical classes in cardiac, pulmonary, or musculoskeletal exercise assessment and prescription, physical Occupational Rehab tasks. The use of SLEs must be high fidelity (as close as possible to real-life situations), evidence-based and include an ongoing review and evaluation process.

Supervision At least 200 hours of your total practicum hours must be supervised by an AEP. The remaining 160 hours may be supervised by an AEP or a qualified and experienced professional who holds a qualification (recognised or endorsed by a regulating authority such as a national association or AHPRA, eg Physio,

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OT, cardiac nurse etc) for the activity they are supervising, and relevant to the client condition they are servicing, for the remaining hours. Hours that are not supervised by an AEP must have AEP oversight of the activities (to ensure client safety) and assessment of the learning outcomes, and the competency must be co-signed by an AEP. The PEP team will endavour to place you with only ONE physio-supervised practicum over your three units to ensure you are predominantly supervised by an AEP during your placements. The Unit Coordinator will co-sign and confirm competencies on hours completed with a supervisor other than an AEP in your Pebble Pad logbook entries.

4. PEP Engagement Activities

Your PEP Engagement Activities serve as a record and personal account of the hours, clientele, and learning experiences you have had during placement and allows you to work towards achievement of the unit Intended Learning Outcomes and ESSA Graduate Attributes (Professional Standards) by detailing the FACTS (e.g. your logbook hours and cases, and by describing the LEARNING (e.g. your goals and your reflections – your feelings during the activities/experiences, outcomes, evaluations, and future planning that that shapes your learning).

We don’t learn only by “doing” but also by reflecting on what we do. Self-evaluation is a very important feature in your development of professional competence in a real-world work setting and will be an ongoing process when you are an Accredited Exericse Physiologist due to the continuing professional development requirements of ESSA.

To help keep your logging and reflections orderly, most students do a daily handwritten notebook entry, typed note on smartphone or laptop, or “talk to text” email of their day-to-day hours, activities, and cases, and then use that entry type up their Logbook and Reflection entries on Pebble Pad more neatly at the end of each day or week. You can also choose to write up hours, cases, and reflection notes, and take video blogs directly into the “Pebble Pocket” smartphone/table app that will link to your Pebble Pad account.

Your PEP Engagement tasks are:

1. PEP Plan

You are required to complete and upload a PEP Plan to MyLo for every placement block. The purpose of these plans are to ensure you have firmly agreed to your PEP attendance start and end dates, and have negotiated adequate days and hours per week in order to achieve the minimum unit competencies and hours. You also need to set (minimum) three (3) learning goals to be achieved during the placement block that are related to any skill or behaviour development gaps as identified by self-reflection on competency assessment criteria and supervisor feedback (where relevant), prior to, or during the first few days of the placement. Further information is in the unit outline.

2. Weekly Reflection blog and hours Your reflection blogs will consist of weekly entries every Monday (to cover the previous week) starting with a pre-placement reflection which describes the expectations you have of your first clinical practicum experience. E.g. what you feel your current strengths and areas for improvement are. What are your expectations about starting Clinical Work Integrated Learning. What are your hopes and fears for this practicum experience.

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Then you will submit a weekly reflection blog each Monday that discusses your experiences over the previous week and highlights the main learning points of the week using a structured reflection approach. Your reflection blog submission may be written, brief video, or audio captured using the Pebble Pad smartphone app interface “Pebble Pocket” that describe and/or demonstrate your experiences, or show you undertaking particular tasks or skills (any photographic or video uploads must protect client confidentiality and privacy). Full details of task are on Pebble Pad. You will also enter the total hours worked during the previous week and tag with the appropriate ESSA clinical domains. For ease of tallying hours, round your entries to the nearest 15 minutes and use decimal format, ie. 15 mins = 0.25hrs, 30 mins = 0.5hrs, 45 mins = 0.75 hrs. Your Weekly Reflection Blog and Hours entries will be “signed off” by the Unit Coordinator and checked by PEP admin staff to ensure the quality and accuracy of your activities / hours.

3. Case Study Entries For each practicum unit, you will create a succinct written case entry for 2 (TWO) clients (or groups) from different clinical domains that you worked consistently with over the placement period, including details of their screening/history, primary pathology, goals, assessments, prescriptions, evaluations, and outcomes. In accordance with ESSAs requirements for demonstration of competency in the Cardiovascular, Metabolic, and Musculoskeletal domains, over the course of your three practicum units, you must ensure you have submitted Case Entries for these three domains, then, from three of the remaining pathology domains (respiratory/pulmonary, cancer, kidney, neurological, and mental health) as suits your experiences.

Reflection entries must be tagged with identifiers in Pebble Pad that demonstrate which ESSA Professional Standards and Graduate Attributes the activities relate to.

Case Entries must clearly demonstrate the following: Cases and description of services: De-identified (no names of any client/supervisor) case description should include age, gender (or if a group – include the age range and gender mix), primary purpose or referred reason for seeing the client/s, co-morbidities and goals of the session. You may describe barriers and barrier solving, any lifestyle counselling or education you gave, describe exercise assessments, prescriptions, evaluations, reviews, modifications and outcomes. Each entry must be tagged with the appropriate ESSA Clinical Domains and related Graduate Attributes worked towards during the experiences.

• e.g. “15.5 hours face-to-face exercise delivery, 56 year old female, Main condition type II

diabetes, comorbidities: hypertension, hyperlipidaemia [Tag with Standard 5: Exercise Delivery, and Standard 10: Metabolic Domain in Pebble Pad]. Goal: to control blood sugar levels through regular exercise as per ACSM physical activity guidelines. Exercises included [list]”, regressions used were.. progressions used were..... Client outcomes were…. 6MWT [improve x metres] etc

See the ESSA accreditation guide for more information on activities and hours for practicum.

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4. Final Reflection You will make a post-placement reflection for each unit, which will be a written synopsis of your experiences throughout the entire practicum. You will consider questions such as: How did the reality of the practicum align with my pre-placement thoughts and feelings? What were the experiences that were my major learning moments? What did I learn from these? How was what I learned on placement different to what I learned at University? What would I do differently next time if the same situation arose?

5. ESSA Record of Engagement Form These important forms are part of ESSA Requirements of evidence of your Practicum competencies, experiences, and hours. You may adapt your logbook, final reflection and case entries to write your Record of Engagement forms.

One ESSA ”Record of Engagement” (RoE) form needs to be completed for every placement site you are allocated (one form per agency, even if you had multiple supervisors at the site). The primary day-to-day supervisor you mostly worked with should be asked to sign off your completed RoE form. Hours on your RoE form should match your logbook totals for that site.

**You must complete your sections in the Record of Engagement form before giving to your Supervisor to fill their sections**

ESSA requires that every RoE form is “counter signed” by the university (Unit Coordinator) which verifies that the University confirms activities undertaken are in line with AEP Scope of Practice and AEP Professional Standards. Your Record of Engagement Form/s must be submitted to the specific MyLo submission boxes on or before the due date specified in your unit outline. No. coversheet is required for this submission.

5. Interim and Final Competency Assessments There is one Interim and one Final competency assessment undertaken by Supervisors during your practicum time in each practicum block. The Interim Competency Assessment is undertaken at ~40 hours of practicum, and the Final Competency Assessment, is undertaken in the final week of your practicum time and must be submitted by the final hand in due date specified in the unit outline. The Interim and Final Competency Assessments act as indicators of the skills and behaviour expected of you while on PEP. Each form has identical learning outcome criteria, but the second Final assessment also has a global competency rating across the clinical domains you have worked in during the block. If you receive “Working Towards” rating/s on an Interim Assessment. Your site Supervisor and the PEP (or Unit) Coordinator will help you develop improvement strategies. The site supervisor who is mostly responsible for you will complete the assessments relative to the criteria checklist descriptions in the “Competency Criteria Descriptions: Guide B” (see Competency descriptions below, and a downloadable version of the Supervisor “How to Rate” Guidebook can be found on MyLo and on the PEP Website. Supervisors are encouraged to be honest and constructive in their feedback of your skills and behaviour, and base their judgements on the Competency descriptions provided, and on appraisal of client safety and

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comfort while clients are under your care. The site supervisor is asked to complete both interim and final assessments in collaboration with you and discuss how you are rated, and why. *IMPORTANT*: You must achieve a minimum “PASS” rating in all relevant criteria in every Final Competency Assessment for every block to pass each practicum unit. If you receive a single “Working Towards” rating from one or more sites in a Final Competency Assessment, this indicates you are not yet meeting the Graduate Attributes of ESSA and the minimum safe standards required for a Student Exercise Physiologist. To this end - It is your responsibility to work towards achieving minimum “PASS” ratings by the time of the Final Competency Assessment. You will be supported and guided in this by your Practicum Supervisor, Fieldwork Coordinators, and the Unit Coordinator. Use the “Competency Assessment Guide: Competency Criteria Descriptions” (and see below) to guide you on the list of tasks and behaviours you need to work on becoming competent at. There is no requirement to complete all of the listed competencies whilst on a single placement. But exposure to a wide range of tasks will enhance your learning experience. It is expected that you will be graded minimum “competent” at every criterion over the course of the three practicum units.

Competency Assessment Submissions It is your responsibility to know the timing that your competency assessments are due and organise a meeting with your site supervisors to undertake this online assessment. Competency Assessments may only be completed and submitted online using the link emailled to your supervisor by the Unit Coordinator. Please contact the Unit Coordinator if your supervisor does not have this link. NOTE! There are unit grade penalties that apply for late submission of practicum assessments – see your unit outline for details.

Students “at risk” of failing EP Competency Assessment

Interim Assessment: Students will be viewed as 'at risk of failing' where

• They receive five or more “Working Towards” grades against the 20 learning outcomes in the interim assessment; or

• Where breaches of the School of Health Sciences codes of conduct for PEP, or unprofessional behaviour is identified which leads to the disruption of teaching, learning or research activities of other students/ staff, or which interferes with others performing their normal duties; or

• Where a client/patient is placed at unnecessary risk or the student fails to identify that a given situation requires skills and competencies beyond those of the student, and does not request assistance from the supervising staff member

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Final Assessment: Students will be viewed as 'failed’ where

• They receive any single “Working Towards” grade against the 20 learning outcomes in the final assessment; or

• Where unprofessional behaviour has continued after intervention and led to the disruption of teaching, learning or research activities of other students/staff, or which interferes with others performing their normal duties; or

• Where a client/patient is repeatedly placed at unnecessary risk or the student continually fails to identify that a given situation requires skills and competencies beyond those of the student, and does not request assistance from the supervising staff member.

Review UTAS Policies Relevant to PEP Students are expected to uphold University policies and procedures on professional behaviour. “Not having read” the policies and guidelines are not an excuse if found in breach of policies and guidelines. PEP Code of Professional and Ethical Conduct University Behaviour Policy

Safe to Practice Policy

Work Integrated Learning Policy

University Social Media Guidelines

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Exercise Physiology Competency Assessment Rating Explanations

Working Towards (Not yet

competent)

Pass (Competent)

Highly Competent

(HC)

Outstanding (O)

Not Applicable

(N/A)

Grade Equivalent (fail)

Grade Equivalent (pass)

Grade Equivalent (credit/distinction)

Grade Equivalent (High Distinction) Ungraded

Student does not yet meet minimum standards safe for criterion. (Not yet competent) Knowledge and skills are at an early stage. Does not synthesise information regarding requirements. Frequently fails to comply with criterion. Requires high level of support, and rarely demonstrates independence. Demonstrates limited understanding of requirements. Put client at increased risk or did not take client safety and comfort into account. Contributes little regarding criterion.

Student is at the minimum safe standard for criterion. (Competent) Basic competency and minimum safe standard are evident. Synthesises information within known context but requires some assistance with unknown context and/or external parties. Consistently complies with criterion. Requires some support but is independent in familiar/ appropriate contexts. Demonstrates good level understanding of requirements. Safe clinical reasoning. Considers client safety and comfort. Actively contributes to criterion.

Student exceeds the minimum safe standard for criterion. Good repertoire of competencies. Synthesises information and applies critically within context at entry-level standard. Level of independence is high, but appropriate. Enthusiastic and proactive. Good understanding of requirements. Good clinical reasoning for treatment decisions. Actively and consistently considers client safety and comfort. Consistent contribution regarding criterion.

Student well exceeds the minimum safe standard for criterion. Equal to a Novice (entry level) Exercise Physiologist Extensive repertoire of competencies across diverse client range. Synthesises information and applies critically within context beyond entry-level standard. Level of independence is high, but appropriate. Consistently enthusiastic and proactive. In-depth understanding of requirements. Excellent clinical reasoning for treatment decisions. Client safety is paramount consideration. Consistent contribution and leadership regarding criterion

(A) Criterion not applicable within the context of the facility. OR (B) Insufficient observation of the student at the time to make assessment regarding the given criterion

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Exercise Physiology Learning Outcome Descriptors

Supervisors will use these descriptors as a guide to skills and behaviours expected of Student Exercise Physiologists. If a student ticks off most, or all descriptors, they might be considered in the “Highly Competent [HC]” or “Outstanding [O]” rating range.

Practicum Learning Outcomes:

1. Professionalism, ethical behaviour, teamwork, and attitude The student is appropriate as to agreed expectations of dress, grooming, attitude, and behaviour

Punctual for agreed shifts and in contact in a timely manner where unforeseen circumstances (e.g. ill health or emergency) prevent them from attending placement

Takes ownership of Student Exercise Physiologist clinical role and workplace duties (i.e. acts as a new staff member).

Compliant with workplace administration requirements, WHS policies, AEP Professional Standards, the AEP Scope of Practice, the ESSA Code of Professional Conduct and Ethical Practice

Respects the privacy, confidentiality and rights of others in the workplace

Gains, records informed consent according to workplace protocol

Maintains appropriate professional boundaries with client and staff interaction

2. Communication (Client) The student displays a flexible communication approach. (i.e. Adapts voice features - volume, tone, pitch, uses active

listening skills, uses a range of communication strategies to optimise client rapport and understanding, uses a language register that matches the health literacy of the client.)

Displays appropriate self-confidence and has good interpersonal skills

Has influence, and a sense of authority in their role in one-on-one and group situations

Appropriate non-verbal communication (i.e. facial expressions, postures, and energy levels during client work).

Is empathetic (where appropriate) and creates positive, safe interactions with clients

3. Communication (Team) The student engages actively and respectfully with all team members and contributes to discussions or outcomes

where appropriate

Adapts non-verbal and verbal communication to the workplace setting

Can resolve conflicts with little support

4. Critical thinking, problem solving, and clinical reasoning The student can critically analyse situations and demonstrates sound clinical reasoning in decision making

Can accurately interpret and prioritise a referral

Demonstrates independent thought and action, predicts problems, and fills gaps

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Knows when and how to refer for alternative/additional services appropriately (knows and abides by AEP scope of practice)

Offers solutions promptly and can follow-through on decisions

Willing to take responsibility for clinical reasoning when challenged

5. Ongoing learning and self-improvement

The student recognises own professional limitations and actively engages in self-directed learning

Self-evaluates own performance

Seeks timely feedback and improvement strategies

Responds in a positive manner and acts on feedback/ improvement strategies to improve performance

Demonstrates professional self-care (eg. seeks opportunity to debrief at the end of the day, or following stressful situations)

6. Screening (client interview) The student structures a systematic, purposeful interview seeking qualitative and quantitative details

Sensitively controls the interview timing in a client-centred manner

Notices and responds to important client cues (verbal and non-verbal) during interview

7. Exercise assessment The student chooses tests that are based on evidence-based practice, client safety, abilities, goals, and limitations

Can clearly explain assessment procedures, using correct and clear demonstrations where necessary

Has clear understanding of contraindications for assessment procedures across broad range of clinical conditions

Delivers assessments safely, effectively, with validity (eg. with test-retest reliability), and with client safety and comfort in mind

Chooses, explains and uses appropriate monitoring tools, eg: RPE, dyspnoea, angina charts, pulse oximetry, visual appearance / non-verbal signals, “talk tests”, verbal feedback

Actively identifies, seeks and responds to client feedback (verbal and non-verbal) and can safely modify or terminate assessments in accordance with client condition, medications, changing risk-factors, feedback, or findings throughout testing.

Correctly interprets assessment findings and implications, and can clearly explain these to clients

8. Exercise prescription The student designs client-centred exercise prescriptions that are safe, effective, innovative, and evidence-based

Exercise prescriptions address client and referrer goals, functional capacity, medical history, clinical status, and any other influencing factors

Can justify exercise choices based on sound clinical reasoning

Demonstrated ability to choose appropriate regressions and progression

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9. Exercise delivery Safe and effective at delivering exercise to an individual (you are confident to briefly leave the student alone and

believe they would do no harm)

Safe and effective at delivering exercise to a group

Actively monitors, recognises, responds and acts on client signs, symptoms or feedback (non-verbal and verbal) during exercise, and can safely, effectively modify (regress / progress) exercises on the spot in response

Offers accurate and appropriate coaching and cueing

10. Treatment evaluation and modification

The student can evaluate the evidence for exercise interventions across the client populations of your worksite

The student understands and can act on contraindications to exercise

Knows when and how to progress or regress treatment plans

Can effectively explain changes in treatment plans to client

11. Knowledge Base The student can apply current anatomical, biomechanical, nutritional and pathophysiological knowledge across the

client populations of your worksite

Able to describe common diagnostic, medical, or surgical interventions as appropriate to the client populations of your worksite

Demonstrated knowledge of commonly prescribed medications and considerations in relation to exercise that are suitable to the client populations of your worksite

Demonstrated understanding of theories and determinants of behaviour change

Accurate and meaningful exercise and lifestyle advice is offered to clients

The student has actively developed further understanding of best practice clinical exercise assessment and delivery (as it relates to your workplace) during the placement

12. Client and workspace risk management

The student correctly considers and stratifies risk for exercise

Demonstrates that client safety is paramount in all interactions

Actively identifies and mitigates workspace hazards and risk for all stakeholders

13. Recording clinical case notes

Written case notes are timely, clear, concise, comprehensive, and in line with workplace standards and medio-legal requirements

14. Applying behaviour change strategies

The student is effective and creative in teaching, coaching and motivating clients to achieve self-management of exercise and lifestyle changes.

Uses evidence-based methods to facilitate client behaviour change which account for client goals, abilities and preferences

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15. Preparedness

The student is well organised

Completes allocated tasks on time

Researches client case prior to service

16. Report drafting

The student drafts accurate and professional letters and reports (eg. Medicare, DVA Workcover, NDIS, or in-house reporting systems) appropriate to an Student EP

17. Active observation

The student engages in purposeful, active observation of expert staff in cases where the activity may be out of Student EP Scope (eg. DVA clients)

Takes own clinical notes

Writes questions and seeks de-briefing session afterwards

Competently assists with tasks where appropriate

18. Development of education to clients or staff

The student develops coherent, accurate and evidence-based education for clients

In-service presentations developed for staff are informative, evidence-based and accurate.

19. Delivery of education to clients or staff

The student delivers medical, exercise, or lifestyle education to clients that is coherent and accurate

In-service presentations to staff are engaging, informative, thought provoking, and accurate.

20. Workplace administration The student is accurate and effective with practice management tasks such as

o data handling / entry, o billing, answering / making telephone calls, o client appointment management, o development and production of workplace resources, o Workplace administration tasks such as copying, faxing, filing o exercise equipment calibration, o cleaning or maintenance.

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6. What to Expect when on Practicum Expectations of Students More detail is provided in the Faculty of Health PEP Code of Conduct, the Safety in Practice Policy and Safety in Practice Agreement. However, the following provides a brief outline of what is expected of UTAS PEP students.

It is expected that students on practicum will: • Work towards becoming competent (attaining “PASS” ratings at a minimum) for all the competencies listed

in the Competency Assessment Supervisor Rating Guide.

• Work towards understanding and achieving the expected Graduate Attributes of ESSAs AEP Professional Standards

• Be punctual, reliable, professional and respectful in communication and behaviour

• Be professionally attired as a Student Exercise Physiologist (a future allied health professional). The image you portray helps to reinforce your credibility as a Student EP. You are required to present to your placements clean and well-groomed, with appropriate hygiene, wearing neat dress appropriate to your workplace (i.e. no board shorts, short running shorts, tights, jeans, thongs, or singlets). Student EPs are directed to wear the black UTas Exercise Physiology (or Exercise Science shirt if not available), and plain black or blue long work pants, cargo pants, or chinos. Black or dark blue knee length walking shorts are acceptable in summer. Your Prac Supervisor is informed that they may direct you in appropriate clothing for their work site and you may be asked to change your clothing if your supervisor finds you are not appropriately dressed for working with clinical clientele.

• You must always wear your UTAS PEP name badge identifying you as a student while on placement. Name badges will not be given until you are confirmed as “compliant” in all Safety in Practice requirements by the PEP Admin Team.

• Read and abide by your placement site's policies and procedures

• Ensure that all observational work undertaken is “active” rather than “passive” (i.e. you must take SOAP notes, list questions and observations, and then debrief and discuss with your supervisor afterwards)

• Be thoroughly aware of the specific requirements and timing of PEP unit assessments (e.g. the exact competencies expected of you as detailed in the Competency Assessment Guide, and the times you must arrange for these to be completed by the Supervisor and handed back to the Unit Coordinator for grading)

• Prepare in advance for the particular worksite, or client pathology, as necessary

• Respect the skills, knowledge, and experience of your supervisors and other worksite staff

• Be polite, respectful, and receptive to furthering your knowledge and skills (in taking and asking for feedback on your performance)

• In short: treat the placement as if it is your job; your supervisor is your boss, and you LOVE YOUR JOB!

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PEP students are asked to: • If requested, provide Supervisors with details of any work experience or external qualifications you have

that are relevant to the profession (eg. ASCA S&C, sports taping, specialist short courses attended). The Supervisor will be provided with details of the core units of the Bachelor of Exercise Science in the Supervisor Guidelines, but you may need to provide specific information regarding any electives studied, or any other relevant information regarding your current skills or competency attainment.

• ensure that you have been taken through a thorough induction process at your PEP site, including the organisation’s specific Occupational Health and Safety practices, including fire and emergency evacuation plans

• Introduce yourself (e.g. “Hello my name is.... and I am studying ......”) and be respectful to all staff (e.g. clinicians, cleaners, computer technicians, admin staff etc), clients and client family/supports.

• Actively offer to undertake or assist in additional duties where you see an opportunity (“fill gaps”) and in quiet times as appropriate, i.e. demonstrate initiative

• List questions that you would like answered over the course of the placement

• ensure that you discuss with the Supervisor the expectations the Supervisor has of you and list the goals you mutually want to achieve by the end of the placement. Eg. there may be certain competencies you know you need to concentrate on improving at the outset.

7. The roles of the academic unit Contact Schedule

• Prior to a placement, the PEP Coordinator will meet with the student to discuss placement options, preferences and needs, and to determine suitable placement attendance dates.

• Prior to a placement, the PEP Coordinator will contact the Site Supervisor (phone, email or site visit as preferred) to: (a) provide PEP-related documentation, and (b) to ensure that the Supervisor has received details regarding a student’s knowledge, current skill competency, relevant experience and qualifications, and academic commitments.

• During the placement period, Supervisors and students can expect at least one early contact (phone or email as preferred) from the Fieldwork Coordinator per semester and more if required by the student, or agency. The purpose of this is to ensure you and the Supervisors needs are being met while on PEP, and there are no issues that need resolving regarding your placement, or the PEP documentation.

• Supervisors can expect a minimum of one face to face site visit per year from a Fieldwork Coordinator (with a minimum of one site-visit every two years for remote placements) to discuss issues relevant to PEP.

Responsibilities of the Exercise Physiology PEP unit staff • Liaising with PEP sites to secure suitable practicum opportunities and administering placements • Educating students as to their professional role and requirements while on PEP, and their legal obligations

under the UTas and ESSA codes of conduct and behaviour

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• Ensuring that students have completed the University’s pre-placement procedures • Providing PEP sites and Supervisors with the documentation that outlines the expectations for both the

PEP Supervisor and the student, and also the documentation for assessment • Checking the suitability of each student’s placement and the qualifications of the PEP site Supervisors

(documented on paper) • Problem solving PEP situations • Providing quality assurance and grading for student’s hours, activities, logbooks, Record of Engagement

forms, reflections and competency assessments. • Providing the students with information about career pathways and ESSA accreditation procedures

8. The Role of a Supervisor PEP Supervisors play an essential role in your development as a novice Exercise Physiologist, which enhances your clinical and interpersonal effectiveness in a client-focussed environment. Effective supervision aims to build respectful and inclusive clinical environments which involve the student as an equal partner.

Effective Supervision An effective Supervisor typically assists Exercise Physiology students’ progress by:

• making them feel welcome • ensuring students understand what is expected of them • creating time to discuss the student’s expectations, concerns, planning, and progress • respecting that the student brings their own knowledge base, skills and preferred styles • providing ongoing and timely corrective feedback on observed performance which is in line with the

criteria listed on the Competency Assessment evaluation forms • balancing corrective feedback with specifically-directed praise in order to support the student’s confidence

(recognising that students may be balancing a number of responsibilities throughout the PEP) • involving the student as appropriate, in decision making and problem solving activities • assisting the student to monitor their progress towards their expected competencies • encouraging students to be self-reflective, know their limitations, and seek help as needed

Student and Supervisor Fears and Expectations When embarking on a new Supervisor/student relationship both the Supervisors and students typically have fears and expectations. Respect and empathy on both sides are crucial to a productive teaching and learning environment.

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Common Student Fears

• They will be asked to do too much

• The Supervisor will expect them to be perfect

• They are expected to recall all of the information which they have learned

• They will be a burden

• They will hurt a client

Common Student Hopes or Expectations

• They will be challenged

• They will be allowed to make mistakes

• They will be treated with respect and acknowledged for their knowledge and experience level

• That the Supervisor can empathise with their nervousness and excitement

• They will have an active role in the clinical setting

Common Supervisor Fears

• That students have all the latest knowledge and the Supervisor themselves are expected to know everything

• They may have forgotten a lot of the information they learned at university

• They must always be available to the students

• The time demands of having a student will be unmanageable

Common Supervisor Hopes or Expectations

• They will be respected for their experience and knowledge

• Students will be enthusiastic

• Students will be honest about their abilities and be able to accept criticism

• Students will implement Supervisor recommendations to improve performance.

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9. Support for Students while on PEP If you find you are struggling in any way, whether for personal, professional, or academic reasons, or you are concerned about achieving the minimum “PASS” ratings from your site Supervisor during your assessments, we encourage you to immediately discuss your concerns with your site Supervisor to develop strategies to help you improve. Please also contact the PEP Coordinator or Unit Coordinator at any time to discuss your concerns. If it is determined (between yourself, the site Supervisor and PEP Unit staff) that you require specific support, a Student Communication and Support Plan may be developed to overcome any potential problems. Such a plan will detail the areas of concern, how the issues will be addressed, and the consequences of not meeting the requirements. UTAS recognises the clear link between your wellbeing and your academic success. To ensure you maintain good mental health throughout your studies, check in with the Student Wellbeing page regularly to ensure you are practicing effective self-care. You may also access University student counsellors for personal or professional counselling services: http://www.utas.edu.au/students/shw/counselling

10. Dispute resolution and handling grievances

Student Complaints According to UTas policies, students may lodge a complaint without fear of disadvantage. While you are encouraged to attempt to resolve complaints informally between your Supervisor and the PEP Unit Supervisor, there are formal procedures at UTas for handling disputes and grievances. In the first instance you are to report the complaint to the Unit Coordinator in writing as soon as possible after the incident and express your wish to have the complaint dealt with formally. If the situation cannot be resolved, an alternate placement may be sourced, where possible. If a formal complaint is lodged by a student, the Unit Coordinator will provide information to the student and Supervisor on the University’s procedures for complaints (Ordinance 8). The following link has information on how to lodge a formal complaint: http://www.utas.edu.au/governance-legal/student-complaints/ordinance,-rules--and--policies

11. Student absence from PEP Any day(s) of absence for compassionate reasons or illness must be notified to the Site Supervisor by phone (or a message left if they cannot be located) at least one day before the day of absence, or before 9:00 am on the day of absence in cases of illness. Unexplained or unsupported non-attendance at PEP is considered a lack of professional behaviour, which may result in failure of the unit, via the Competency Assessment tools. Please ensure you notify your Site Supervisor if you know you will be absent from an agreed practicum session. “Catch up time” for lost PEP hours due to absence may not be possible due to pre-arranged PEP durations as set out in the “Student PEP Plan” at the start of the placement. Discuss the possibility of “catch up time” with the PEP Coordinator.

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12. Risk Management / Safety in Practice You are insured by the university for professional indemnity to undertake PEP (see below), and are thus not covered under any workers compensation schemes of the PEP worksite. If you have an accident or injury whilst on PEP, please notify the PEP Coordinator who will determine whether an injury or near miss report needs to be completed. The University manages risk during PEP through the identification of roles and allocation of responsibilities for PEP Unit staff, students and PEP Supervisors. This includes:

• Provision of the Student Guidelines, Competency Assessment Guidelines & Forms and other PEP documents

• Students completing the mandatory Safety in Practice Requirements prior to attending external PEP • provision of health and safety procedures to students via a “Safety In Practice Policy”

13. “Quiet Times” on PEP If for whatever reason, you are restricted for client-contact opportunities whilst on PEP, then a useful site-based project is recommended to be developed in conjunction with your site Supervisor. In accordance with the ESSA requirements for practicum hours a “quiet time” project is expected to relate to exercise service delivery or clinically-relevant administration tasks, for example:

• research and report on current evidence-based practice into exercise and sports science issues/topics relevant to the work site (~ 800 to 1000 words)

• develop an innovative hypothetical 6-week exercise program specific to a population relevant to the work site

• develop a client handout, flyer or PowerPoint presentation on a topic of relevance and usefulness to the work site.

• analyse data including analysis of assessments before and after exercise interventions • set up referral forms • prepare hypothetical Interim or final consultation reports for a referrer • prepare and participate in case meetings and case conferencing • use client management software (i.e. record keeping and data entry) • billing – learn about Medicare, DVA, WorkCover, and health funds

In addition, during “quiet times” you may also work on your assessment pieces but remember time spent on university assessment tasks cannot be counted towards practicum hours unless the activity also contributes to needs of the placement site. For instance you are developing an in-service presentation to deliver to practicum site staff which may also form part of an assessment piece. Discuss with Unit Coordinator if you are unsure on claiming hours practicum activities.

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14. Student Insurance Details The University of Tasmania’s insurance program provides cover for students whilst undertaking unpaid Work Integrated Learning placements approved by the University. The Work Integrated Learning Insurance letter is updated on the Financial Services Form website annually. Review the WIL Insurance letter here: https://www.utas.edu.au/__data/assets/pdf_file/0007/330487/Work-Integrated-Learning-Insurance-Form-2019-Student.pdf