Welcome
Welcome to the Exxat guide to best practices in clinical education for Physical Therapy programs. No two academic programs are alike and no two Directors of Clinical Education (DCEs) manage their clinical education programs in the same way. The intent of this guide is to provide you with information to guide you in making decisions that meet your program’s unique needs.
Training Yourself
Learning what it takes to be successful as a DCE, whether you’re new to the role or just want to keep up with advances in the field, is no small task! Luckily, there are a number of great resources out there to support you throughout your career.
Terminology
The world of clinical education is full of acronyms and specialized terms. The APTE glossary of terminology for physical therapist clinical education clearly defines the terms widely accepted and used by the community of physical therapy clinical educators.
Nationally
The American Physical Therapy Association (APTA) is not just for clinicians! Academicians benefit from membership as well and we strongly suggest that you join the Academy of Physical Therapy Education (APTE) as well as the Clinical Education Special Interest Group (CE-SIG) if you are from a PT program or Physical Therapist Assistant Educators SIG if you are from a PTA program. Membership in this group provides you with access to a host of resources and an extremely broad community of peers with whom you can problem solve, brainstorm and share best practices. If you are an American Council of Academic Physical Therapy (ACAPT) member intuition, be sure to create a pairing between your program and a clinical site/clinician so that you can participate in the National Consortium of Clinical Educators (NCCE).
Each fall, the APTE hosts the Educational Leadership Conference targeting educators of all kinds – both clinical and academic with programming for every stakeholder and support for attendance from clinicians who serve as Site Coordinators of Clinical Education (SCCEs) and Clinical Instructors (CIs). Within the 2 day conference, there is a wealth of information on the topic of clinical education – poster presentations, platforms and educational sessions as well as opportunities for networking, open forums to discuss current issues and an exhibitor hall aimed specifically at educators.
Locally
Many geographical areas have a “Consortium” or group of clinical educators, both academic and clinical, who collaborate and support each other, ensure that area programs are on the same page across the board and may even collaborate on regional polices, procedures and etiquette for clinical education. Just go to the APTA website to find your local consortium!
Exxat Training
If you are an Exxat client, learning to use Exxat STEPS, our Clinical Education module, is an integral step. It may seem like an overwhelming task but rest assured that we have plenty of resources to help you along the way.
We host regular trainings, both in person and virtual. Our annual all user conference, Cohere, brings together hundreds of users from across professional disciplines and across the country for 2 days of best practices, brainstorming and training on new functionalities. Smaller group trainings, known as Cohere X trainings, take place throughout the year and offer discipline specific trainings at host universities across the country to go “beyond onboarding” and provide more in-depth training on the system as a whole.
Visual learners will love Exxat Academy – our YouTube channel with video tutorials and recordings of past webinars. For those who prefer written instructions, the Exxat Help Center is here for you with hundreds of documents detailing workflows and answering commonly asked questions. For more in-depth requests, our support team is here for you 24/7 through the chat icon in the bottom left of your 6 screen or by e-mail at support@exxat.com and during US business hours, you can always reach your Customer Success Representative (CSR) by phone or e-mail.
Training your Students
Students will have a lot of questions and many have preconceived notions about clinical education based on their discussions with peers at other programs.
Clinical Education Handbook and Syllabi
Creating a clear clinical education handbook that outlines policies, procedures and expectations is invaluable for pro-actively addressing concerns. A little transparency goes a long way. We recommend creating a handbook that addresses the following topics:
- Course of Study including expectations and course descriptions for all clinical experiences.
- Site Selection and Assignment delineating how the clinical sites your program affiliates with are recruited as well as how students can express their preference to complete a clinical experience at a particular site.
- Requirements for Participation outlining program expectations for academic progression that must be achieved and documentation that must be provided to be eligible for participation in clinical education.
- Conduct in Clinic describing the behavior expected of students including dress code, professionalism, communication and completion of assignments.
- Roles and Responsibilities listing the expectations of all stakeholders included in clinical education – Student, Clinical Instructor, Site Coordinator of Clinical Education and Director of Clinical Education.
- Evaluation of Clinical Performance explaining how grades for clinical experiences will be awarded and the criteria upon which these grades are based.
- Attestation concluding the handbook with a signature page asking students to attest to the fact that they have read and understood the policies as well as had an opportunity to have their questions answered.
Your clinical education policies may differ from those of the program or university
– for example, the university calendar may state that there are “no classes” on July 4th; however, your clinical education policy may state that the student is required to follow the schedule of the clinical site meaning that if the site is open and it is a typical workday, the student should still participate in clinical education on July 4th. It is important to highlight these differences to ensure understanding.
Once the handbook is written, it’s a great idea to have your institution’s legal department review it to ensure that the language used is appropriate and the policies written are clearly outlined.
The handbook should be widely shared with all students, academic faculty and staff as well as those at the clinical sites. Just like any other course, Clinical Experiences must also have a syllabus that contains all of the required elements outlined by the CAPTE 6G. Sharing your clinical education handbook, course syllabi along and a copy of the full curriculum is a great way to address CAPTE standard 4J requires that you “Describe the mechanisms used to communicate information about clinical education.
Using your Public Website in Exxat STEPS to share information with external stakeholders ↗
Exxat Training for Students
While curricular design may change from program to program, the student interface of Exxat remains largely constant. Students at academic institutions who utilize Exxat STEPS will benefit from the Student Orientation Video Playlist to walk them through the basics of creating their profile, expressing preferences and providing required documentation for clinical experiences.
Organizing your Data
Organization is key to the success of any clinical education program. Setting your process up thoughtfully now will prepare you for success later. There are several “key categories” of data you will collect: Students, Sites, and Clinical Instructors. Here are a few factors to consider when managing and organizing the information you have.
Students
The first decision to make is how you want to group your students. By graduating cohort is one of the most popular answers as it aligns with the way data is requested by the Commission for the Accreditation of Physical Therapy Education (CAPTE) on a yearly basis through your Annual Accreditation Report (AAR) and your Self Study Report (SSR) for formal accreditation visits.
How to create a group of students in Exxat STEPS ↗
Demographic data
Organization is key to the success of any clinical education program. Setting your process up thoughtfully now will prepare you for success later. There are several “key categories” of data you will collect: Students, Sites, and Clinical Instructors. Here are a few factors to consider when managing and organizing the information you have.
| Data | Rationale for Collection |
|---|---|
| School e-mail address | Communication via school provided e-mail address only is a best practice for maintaining FERPA standards. |
| Date of birth | The AAR asks that you report the average age of students enrolled in your program. |
| Gender, Race, Ethnicity | The AAR asks that you report the number of students in each category. |
| Last 4 digits of SSN | Often required by clinical sites for onboarding procedures and to provide access to electronic medical record systems. |
| Areas of clinical interest | Understanding the types of placements that may be popular with a given class will help in recruiting slots. |
| Regions where the student has access to housing | Knowing which students have the ability to complete a clinical experience out of state will be helpful when making placements. |
| Emergency contact information | In the case of an emergency during clinical education, you may be the first point of contact. |
| Health insurance information | As above |
| Learning style and feedback preferences | Helpful to SCCEs when pairing students with their CI and to CIs when providing instruction to students |
| Academic Status (good standing, probation etc. | The AAR asks you to report the number of students who are decelerated or who have left the program. Helpful when making an appropriate match between student and clinical site. |
| Emergency Contact | In the event of an emergency, the school is often the first point of contact for the clinical site. Having this information on file and at your fingertips is invaluable. |
How to select what student information is collected in Exxat STEPS ↗
Clearance documents
In addition to the above, your academic institution may have a number of medical clearance forms that it requires students to have on file. Your clinical education sites may also require these documents in order to accept a student for a clinical placement. Please work directly with your academic institutions’ office of compliance to ensure that you are collecting, handling and sharing records in accordance with your institutions policies.
How to select what student documentation is collected in Exxat STEPS ↗
Sites
Your sites are the lifeblood of your clinical education program. As such, you will want to have a good amount of information regarding your sites organized and at your fingertips. Some of this information may also be helpful to students for the purposes of researching sites at which they are interested in completing a clinical experience. Your first priority should be to ensure that you have the appropriate number and variety of clinical sites to meet your program goals and allow students to experience an appropriate variety of practice areas. CAPTE standards 2C and 8F will ask you to address
Primary Points of Contact
You will be working closely with the Site Coordinator of Clinical Education (SCCE) who is your primary contact at any site for all matters related to clinical education. A clinical site may see the role of SCCE as a full-time job in and of itself, provide a set amount of release time from patient care, or expect that SCCEs will juggle the task of coordinating and overseeing the student program with carrying a full patient caseload. The contact information and preferences for SCCEs is the most valuable information to have at your fingertips. Beginning to organize yourself with a simple list of your clinical sites and their associated SCCEs is a great first step!
How to add a Clinical Site in Exxat STEPS ↗
How to add an SCCE to a Clinical Site in Exxat STEPS ↗
Clinical Instructors
Gathering information on the licensed PTs who provide instruction to your students is required for addressing questions on both your AAR and SSR. The data collected should provide a snapshot of the instructor and their qualifications at the time that they provided instruction to your student – for example, if an instructor worked with your student 3 last academic year, you will be asked to report on the qualifications that instructor had last year, not the qualifications they have today. While you may choose to maintain updated records for each instructor, the ability to look back on historical information is important. For full details on what information to collect on the CIs working with your students and tips for how to collect that information, please see the During Clinical Experience section of this document.
Other Points of Contact
There are likely a number of other people at each clinical site to keep track of – the volunteer services coordinator, contract administrator, administrative assistants. Some of these contacts should be shared with students and others kept on file for your use only. When managing your list of contacts, be sure to include their role or designation and their communication preferences.
How to add site staff and clinical personnel in Exxat ↗
Site Settings
When it comes to finding the right placement opportunities for your students, it’s nice to know what type of population a clinical site serves. Clinical sites will agree to accept a student and let you know what setting they can accept that student in based on the list of setting options you provide.
There is no one right way to structure your program’s list of setting options, but a nice place to start is to consider what your program’s requirements are for types of clinical education experiences. If your program bases your requirements on setting within the continuum of care – requiring your students to complete an Outpatient, Post-Acute and Acute clinical experience, you may consider tracking the setting a site offers using these 3 variables. If your requirements are based on lifespan or body system, you How to add site staff and clinical personnel in Exxat 12 may consider using these variables to track your settings. There are two key factors to keep in mind:
- The ability to draw a clear line between a “setting” for which a site offers to accept a student and a program requirement should be your primary concern. This will save you hours of heartache when clearing students for graduation and/or demonstrating to an accrediting body that your students have each gotten the exposure required by the program
- Consistency type of variables will help avoid ambiguity in placement “setting.” For example, if “Orthopedics” “Acute Care” and “Pediatrics” are all options for setting– incorporating a combination of continuum of care, body system and lifespan individually – and a site offers you a slot they describe as “Post-Op Peds Ortho Surgery”, this slot could be categorized as any of the aforementioned 3 settings leaving your reporting inconsistent. By limiting your settings to one factor only, or a consistent combination of factors – always incorporating both lifespan and continuum of care, for example – the assignment of setting will always be clear
Knowing what each site you are affiliated with has to offer gives you a clear picture of where you stand and to identify if additional sites need to be recruited to allow students to meet their requirements
How to analyze site settings in Exxat STEPS ↗
Contracts
In order to send a student to clinic, a current contractual relationship must be in place between your academic institution and the clinical site. Contracts can take all forms. An “evergreen” or “auto renew” contract typically doesn’t expire unless someone requests in writing to terminate it, other contracts may have strict expiration dates or require that a new addendum is added to the contract on a regular basis to keep the relationship current. Contracts may outline a relationship between your individual program, multiple programs at your institution or the institution as a whole with a single clinical site location, a group of sites or an entire health system. Some programs choose to share these documents with their students so they have a clear understanding of the relationship between school and site before they begin their clinical experiences. Knowing whether the contract is current, and to whom the contract applies, is paramount to ensuring that students are legally allowed to participate in clinical education at a specific site. Paramount enough that CAPTE standard 8G will ask you to describe the process that you utilize to “ensure that there are current written agreements between the institution and the clinical education sites.”
How to track contract expiration status in Exxat STEPS ↗
Liability Insurance
Academic institutions are often required by their contractual relationship with a clinical site to provide a certificate of insurance (COI) as proof of the presence of a liability insurance policy for students during clinical experiences. This policy may be held by your institution, by the individual student or a combination thereof. Individual certificates may be provided for listing each contracted clinical site as “additionally insured” or a single umbrella certificate may be provided which does not name a specific site. Policies are typically offered for single 12-month period and must be renewed annually.
Site Assessments
Once a relationship is established, clinical sites will need to be assessed at regular intervals to ensure that they continue to provide quality learning experiences. Tracking these assessments, along with any issues that have been identified during these assessments and the actions taken to address these issues, is key to maintaining a strong working relationship with your clinical sites and to addressing CAPTE standards 2C and 3F.
How to enter and track site assessments in Exxat STEPS ↗
How to enter and track interventions with a clinical site in Exxat STEPS ↗
Clearance Requirements and Other Documentation
Each clinical site has its own process for onboarding students completing clinical experiences with them. This process includes site-specific forms and additional documentation that must be provided for each student. These items must be provided in a specific way that varies from site to site.
For example, many sites require that a student completes a background check before completing a clinical experience. Sites stipulate that this check is done with a particular lead time (i.e. 7 days before, 30 days before, within 1 year of start date), that the check is done with a specified level of thoroughness (at the city, county, state, and/or national levels) that the documentation is obtained following a prescribed workflow (i.e. the student runs it themselves and provides the results or that the site runs it on behalf of the student) and that the results are shared in a particular way (i.e. kept on file at the school with the school legally attesting to the fact that they have the needed information, shared by the student with the site or shared by the school with the site)
As you can see, not all “Background Check” requirements are created equal – a site requiring a check run by the site within 14 days of the start date is not the same as a check run by the student within a year of start date and kept on file with the school. The first scenario, where the site runs the check, likely requires that the student fill out a form provided by the site and return it to the site to run the check. In the second scenario, the student will work directly with a vendor to obtain the check and provide it to the school and the school will provide a legal attestation to the site stating that they have it on file.
These variations extend beyond background checks to needed training, serological titer values, certifications, drug screening and more. Stay organized by maintaining a list of these items for each clinical site as well as the way these requirements should be shared with the site. Sharing these documents and requirements with students helps keep expectations clear, allows students to take the lead where possible, and goes a long way towards ensuring your students begin their clinical experiences as scheduled.
How to track site requirements and share them with students in Exxat STEPS ↗
How to organize site documents and share them with students in Exxat STEPS ↗
Gathering Availability from Clinical Sites
Clinical availability is an ever-evolving landscape. With large healthcare systems acquiring previously independent hospitals, a larger reliance on per-diem and contract therapists and increasing pressure on therapists for productivity during the workday, securing the needed opportunities for your students remains one of the most challenging things a DCE does. Forming and maintaining a strong working relationship with a well curated group of clinical sites who know you and your program’s curriculum well will ensure that you have quality placements, not just quantity.
How to send and electronic March 1 Mailing in Exxat STEPS ↗
Voluntarily Uniform Mailing Date
Most programs adhere to the APTA’s Voluntary Uniform Mailing Date sending out their requests for clinical practice placements on March 1 for clinical experiences starting in the upcoming calendar year with a requested response 3 months later, by May 30. For example, sending a request on March 1, 2021 to for placements in the 2022 calendar year. This request is sent based on the calendar year, not the academic year, to ease the burden on clinical sites who run on a calendar year. Many, but not all, clinical sites know about this mailing deadline and some may assign student placements at other times of the year.
Though programs have begun transitioning to sending their “March 1 Mailers” (M1M) electronically, the method of response remains varied with some sites preferring to respond electronically while others rely on faxing or mailing a hard copy form, calling to discuss with the program or sending an e-mail. If How to track site requirements and share them with students in Exxat STEPS How to organize site documents and share them with students in Exxat STEPS How to send and electronic March 1 Mailing in Exxat STEPS 16 your program sends your M1M electronically, attaching a PDF or other downloadable version of your request form is an important best practice.
Keeping Your Files Current
Your M1M is also a great time to make sure that you have the correct information on file for all of your sites. Share what you have on file: Documents, clearance requirements, contact information and addresses, and ask that sites either confirm or update this information with you. Doing this ahead of sending your M1M ensures that your mailer reaches the right person.
How to send an Update Site Information request in Exxat STEPS ↗
How to Make the Ask
Your local consortium may have a standard form that all schools in your area use to gather availability from clinical sites. If your local group does not have a common form, the CE SIG has also a common request form template that is used across the country. The most important thing is that you collect availability to accept students (also known as “slots”) in accordance with your program’s list of settings.
Types of Slots
Traditionally, when a site offers a slot, the name and contact information of the CI who will be working with your student is not provided as they will be assigned closer to the start date. The site agrees to hold the slot specifically a student from your university that you, as the DCE, select and assign. Some variations you may encounter include:
First Come, First Served
A clinical site may say, for example, that they can take 2 students in a given month. For any school sending students to clinic at that time, that site will offer 2 “first come, first served” slots. This means How to send an Update Site Information request in Exxat STEPS 17 that the first programs to provide the names of 2 students for those slots will secure them and they will no longer be available for other programs.
How to manage First Come, First Served slot offerings in Exxat STEPS ↗
Interview Only
A clinical site may want to play a role in the selection of the student assigned to the slot they have offered or may have a competitive process that accepts a limited number of students regardless of which program they are from. Sites who offer slots on an interview only basis typically request that the program narrow down to a small number of well qualified candidates and submit additional information – such as an application or a resume – prior to the interview. After the site completes the interview, they will inform the program of their selections.
How to manage Interview Required slot offerings in Exxat STEPS ↗
Location TBA
A clinical site may have multiple locations and handle student placements at a company-wide level – for example, a large conglomerate of clinics with 100s of locations across the country may have only 1 person in charge of student placements. That person may agree to accept a certain number of students and then place each one at the location that best meets that student’s needs. In this instance, the program selects the best candidate and provides either the ZIP code of the student’s home or the student’s top few selections for locations of that clinical site. The often provides a specific location for the student’s placement close to the scheduled start date.
Benefits for Clinical Sites
While some sites have begun charging for accepting physical therapy students for clinical experiences, it remains the relative norm that sites will agree to accept students for the purposes of furthering the future of our profession. While monetary compensation is not often offered by the academic institution, they often provide incentives to the clinical instructors and clinical sites who accept students. Whether offering access to your campus’ library – either virtually or in person, volunteering to provide on-site in-services or, if your institution is an approved provider, offering Continuing Education Unit (CEU) certificates in accordance with state guidelines, let clinical sites know how you plan to say “thank you.”
Logging Responses
As slots begin to roll in over the course of the spring and into the summer, you’ll need to keep careful track of what you have. The vast majority of sites will agree to accept a student without specifically naming the CI who will work with that student. While some may offer a name and e-mail address for the CI, most will pair the student with their instructor closer to the start date to account for the staffing changes, vacation requests and other circumstances which may shift between when the slot is offered and the student’s first day.
Marking that a site responded to say they could not accept any students is just as important as marking any other response. After all, your follow-up will be quite different if a site responded and said “no” vs. if they have not responded at all. If a site is able to accept students, carefully note the number of students that they are able to accept, the dates/clinical experience for which they are accepting the student and the setting in which the student will be placed.
It is always important to ensure that both you and the site keep a record of the slots offered – whether sending a confirmation e-mail or keeping a copy of the form returned. Using a spreadsheet or database to track this information is highly recommended since analyzing and sorting the data will ease the process of ensuring you have the slots you need.
How to enter a slot in Exxat STEPS ↗
Very few (if any!) schools get responses from every clinical site. Responses rates vary from region to region and institution to institution from as low as 30% with others well over 80%. Be sure to discuss with your local consortium and/or your predecessors to find out if the response rate you are seeing is typical.
Analyzing Offered Slots and Following Up
As the deadline for response to your M1M approaches, you may want to send a “friendly” reminder to sites who have not yet responded.
How to send a Slot Request Reminder in Exxat STEPS ↗
It’s also important to analyze the responses you’ve received so you can individually follow up with sites. You may want to start with the following 3 questions to plan for targeted follow-up:
- What sites have I not heard back from?
- Are there any sites that I haven’t heard back from typically responded previous years?
- For my class graduating this year, how many of them still need to complete each requirement? Do I have enough slots to allow them all to fulfill those requirements?
If you are in need of 12 acute care slots to ensure your graduating class fulfills their program requirements, it makes sense to prioritize reaching out to hospitals. Then consider your historical relationship with a site. If a hospital has offered to accept a student in acute care every year for the past 5 years but hasn’t gotten back to you yet this year, they’re a perfect candidate for a phone call whereas reaching out to a hospital who has not responded to your slot request since 2003 may not be the best use of your time.
How to analyze your historical slot-offers relationship with a site in Exxat STEPS ↗
Placing Students
The first step in the placement process, which often begins more than 6 months prior to the start of any clinical experience, is compiling a list of the slots offered for that particular experience. At this point, some programs choose to confirm with clinical sites that the slots offered are still viable options before sharing the list with students. Because clinical sites offer slots in March of the preceding year, up to 18 months may have passed and things may have changed.
Collecting Student Preferences
How much input you allow students to have in the process of assigning them to the available slots on the list varies widely from program to program. Some programs put the onus on the student alone asking them to select a number “out of a hat” and then choose a site working through the class in numerical order – this is referred to as the “lottery approach.” Others do not request input from the students at all, placing each student based on their knowledge of the students’ strengths and sites’ teaching styles alone.
Most programs allow the students to input on their preferences through a rank-ordered list, or “wish list,” of the slots in which they are interested.
How students create a Wish List in Exxat STEPS ↗
Making the Match Between Student and Site
Using this wish list, programs may place the students by hand considering their preferences and any additional information provided or they may choose to utilize a computer algorithm to make matches based on specific criteria.
Autoplacement Algorithm for Student Matching in Exxat STEPS ↗
How to assign a student to a slot in Exxat STEPS ↗
Notifying the Clinical Site of Assigned Student
After preliminary matches have been made between student and site, it is best practice to notify the site before informing the students. Again, because clinical sites offer slots in March of the preceding year, up to 18 months may have passed and things may have changed. Getting final confirmation from the clinical sites first gives you time to make any needed changes while students are none the wiser. We recommend getting written confirmation from all clinical sites that they are able to accept the assigned student before informing students of their placements.
How to send Placement Notifications to clinical sites in Exxat STEPS ↗
Notifying Students of Assigned Clinical Site
Once confirmation from clinical sites has been gathered, whether before releasing the list of options to students or after making preliminary matches, students should be notified of their placements.
When notifying students, the contact information for clinical site SCCE and CI (if provided by the site), any documents the site has provided and the list of items students are required to provide to the site for clearance purposes should be shared. We recommend notifying students a minimum of 3 months ahead of time to allow for the opportunity to complete any site-specific documentation and requirements and make living and travel arrangements as needed.
How to send Placement Notifications to students in Exxat STEPS ↗
Student view of information on assigned clinical site in Exxat STEPS ↗
Once students are made aware of their placements, they should be expressly informed of their responsibilities in obtaining clearance to begin their clinical experience. As discussed in the section on Clearance Requirements and Other Documentation, each clinical site will have their own required documentation, preferences for how that documentation is provided and the timelines by when students should complete the clearance process.
Notifying Unused Clinical Sites
Once all students have been placed and confirmed at clinical sites, the remaining sites that offered slots which will go unused should be notified. This professional courtesy allows the sites to not only be aware that they will not be hosting a student from your institution but allows them to extend the slot they had reserved for you to another program if they so choose.
Preparing Students for Day 1 in Clinic
Once students are made aware of their assignments for clinical experience, the process of obtaining clearance for participation begins. Expectations for your student participation in this process may range from requiring students to take full responsibility to you as the DCE accepting full responsibility for monitoring the clearance process – regardless of what choice you make, these expectations should be clearly outlined in your clinical education handbook.
In addition to any participation in the provision of clearance documents, the DCE is responsible for ensuring that contracts between the school and clinical site are up to date and accompanied by a current COI.
An in-person checkpoint meeting before your students go to clinic for the first time is a great idea. This gives you the opportunity to
- Review the expectations of all stakeholders as well as policies and procedures
- Ensure understanding of the evaluation tool you plan to use (see section on Objective Assessment of Clinical Performance)
- Address any questions or concerns that the students may have – there will be many
- Provide tips and trick for ensuring they get the most out of their learning experience
- . Role play or brain storm effective management of commonly encountered difficulties in student/CI relationships.
- Remind students that you are there to support them and look forward to hearing from them throughout their experience.
During the Clinical Experience
While students are working directly with their clinical instructors during clinical experiences, it is essential to maintain contact with them throughout. At a minimum, you will want to ensure that each student placed in a full time clinical education experience is working a schedule that qualifies as full time – defined as greater than 35 hours per week by CAPTE. You will also gather information on the student’s assigned CI’s demographics and qualifications, the student’s progress throughout the experience, the CI’s progress throughout the experience and a summary of the type of learning environment provided by the clinical site.
CI Demographics and Qualifications
As mentioned in the Logging Responses section, clinical sites do not typically provide the name and contact information for the assigned CI at the time of offering the slot, instead, preferring to match the 24 student to their instructor closer to the start date. The first few days of clinic are the perfect time to ask students to provide the contact information and qualifications for their assigned clinical instructor.
CAPTE Standard 4O asks for a summary of “the qualifications of the CIs who provided clinical instruction for at least 160 hours to the same student (e.g. years of experience, specialist certification, other characteristics expected by the program).” We suggest collecting the following pieces of information, in addition to any details unique to your program’s expectations, on clinical instructors each time they work with a student from your program:
| Data | Rationale for Collection in Addition to CAPTE Standard 4O (if any) |
|---|---|
| Entry level PT Degree earned | |
| Highest Degree earned | The AAR asks that you report |
| Years of experience as a clinician | The AAR asks that you report if any students had a clinical instructor has had less than one year of clinical experience |
| Years of experience as a CI | A first time CI may need additional support from you as a DCE |
| Advanced certifications or additional credentials | The AAR asks that you report the percent of clinical instructors who worked with your students that held some type of certification of advanced clinical skill |
| Credentialed clinical instructor (APTA or other) | The AAR asks that you report the percent of clinical instructors who worked with your students that were credentialed instructors |
| APTA membership | |
| Membership in other professional organizations |
Programs may use any format they choose to collect this information. The “General Information and Signatures,” also known as the “CI Details” section of the APTA Student Evaluation of Clinical Education and Clinical Instruction (PTSE) for Physical Therapy students and Physical Therapist Assistant students collects the above information in a single, standardized form.
How Students complete CI Details section of the PTSE in Exxat ↗
Student Progress Throughout the Experience
While the student is away from the classroom and working directly with their clinical instructor, it is important that all stakeholders, including the DCE and program faculty, remain apprised of the student’s performance and progress during Clinical Education.
Reports of Progress
CAPTE Standard 5E requires a program to ensure that “students receive regular reports of their clinical performance and progress." As mentioned in the Clinical Education Handbook section, we recommend clearly spelling out these feedback processes and sharing them with all stakeholders. A school may choose any format for this feedback– weekly planning forms, formal meetings, regular check-ins – the essential thing is to ensure that you have them integrated into the experience.
Objective Assessment of Clinical Performance
Just as important as ensuring that students are progressing throughout their planned clinical experiences is to objectively assess the student’s performance. Standard 6J asks programs to “identify instrument(s) used to assess student performance during clinical education experiences.” As well as to “describe how the program ensures that students have achieved the objectives stated for each clinical education experience.”
There are a variety of valid and reliable assessment tools available for both Physical Therapy and Physical Therapist Assistant students. Programs may use any format they choose to collect this How Students complete CI Details section of the PTSE in Exxat 26 information and may also choose the interval at which they evaluate their students – commonly midterm and final.
Three of the most popular forms include the Clinical Performance Instrument (CPI) the Clinical Internship Evaluation Tool (CIET) and the Physical Therapist Manual for the Assessment of Clinical Skills (PT MACS). All three tools provide specific training for students and clinicians alike and are offered in electronic/online platforms.
All students must “demonstrate entry level clinical performance prior to graduation” as mandated by CAPTE standard 1C4. Careful tracking will be required to ensure that all students are trained on the evaluation tool and progress throughout their academic career to meet the “Entry Level” benchmark by graduation regardless of the evaluation tool used.
CI Progress Throughout the Experience
In addition to the CI’s demographics and qualifications, CAPTE Standard 4O also asks how the “program expectation’s for clinical teaching effectiveness of the CIs” are monitored. As mentioned in the Clinical Education Handbook section, we recommend clearly spelling out these expectations and sharing them with all stakeholders. Metrics on teaching effectiveness are best collected, at a minimum, at midterm and final. This allows for identification of any deficits, the opportunity to provide remediation and documentation of improvement in a CIs effectiveness if needed. Programs may use any format they choose to collect this information. “Section 2” of the APTA Student Evaluation of Clinical Education and Clinical Instruction (PTSE) for Physical Therapy students and Physical Therapist Assistant students collects this information in a single, standardized form at midterm and final.
Summary of Learning Experiences Provided by the Clinical Site
Each clinical site provides students with exposure to a unique mixture diagnoses while treating patients at a particular point the lifespan and the continuum of care. Depending on the individual site, students may also have the opportunity to participate in interprofessional practice. CAPTE standards 6L 1-4 (or 6J 1-4 for PTA programs) requires that you provide evidence that your curriculum plan includes “clinical education experiences for each student that encompass, but are not limited to” treatment of patients across the lifespan, continuum of care, practice settings, and involvement in interprofessional practice.
As discussed in the Site Setting section, a site should be categorized as offering settings which align with your program’s graduation requirements for ease of tracking student requirements; however, it is still essential to track the types of experiences your students have within those settings. Returning to the example of the slot for a student to work in “Post-Op Peds Ortho Surgery,” which you may have categorized as “Orthopedics” based on your program’s requirements for students to complete an “Orthopedics” “Neurological” and “Cardiopulmonary” clinical experience before graduation, standard 6L (or 6J) still requires you to know that the student worked with pediatric patients and in an acute care setting.
Programs may use any format they choose to collect this information. “Section 1” of the APTA Student Evaluation of Clinical Education and Clinical Instruction (PTSE) for Physical Therapy students and Physical Therapist Assistant students collects this information in a single, standardized form through a variety of questions asking students to report on their exposure during clinical education.
After the Clinical Experience is Completed
Saying Thank You to your CIs
Thanking clinical instructors for educating students is an important step. These clinicians volunteer to provide mentorship and guidance to the future of our profession. Showing your academic institution’s appreciation is not only important, but common place. Below are a few, non-monetary, ways that schools say “Thank you!”
CEU Certificates
Many states allow academic institutions to offer Continuing Education Units (CEU) to their clinical instructors. Programs should check with their state’s individual guidelines as well as ensure that they are an approved CEU provider before providing any certificates.
Sending CEU Certificates Exxat STEPS ↗
Academic Library Access
Practicing clinicians often struggle to gain access to the scholarly content required for true evidence-based practice. Providing online access to your institution’s library can be a meaningful addition to a therapist’s toolbox.
In-services
While academic institutions rely on clinicians to provide education to their students, it is also important for those clinicians to receive education as well. The offer to provide an on-site in-service to the staff at a clinical site is often well received. While the topic of serving as an effective clinical educator is a popular one, clinical sites may also enjoy presentations on advancements in clinical care, refreshers on lesser-utilized interventions and modalities or high-level treatment techniques from faculty and staff at your institution who are experts in the area.
Conclusion
The Exxat team hopes that this guide to best practices in clinical education for Physical Therapy programs has provided you with information to guide you in making decisions that meet your program’s unique needs and the ways in which Exxat STEPS can support your workflow throughout the lifecycle of a clinical experience. For more information on Exxat STEPS please go to www.exxat.com or reach out to our team by sending an email to info@exxat.com.
Educating Smarter with Exxat
Exxat is a company focused on giving health sciences students and academicians “exactly what they are looking for” by providing education management solutions. Founded in 2011, Exxat has grown from a stand-alone product built for a single client to an integrated suite of 4 modules supporting a dynamic community of over 1000 health science education programs, including nearly 250 PT and PTA programs, through clinical education placements, accreditation processes, compliance management and more.
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