Coordinator Of Clinical Education Research Articles

New England Consortium Focus Groups: Identification of Economic Factors in Clinical Education

BACKGROUND AND PURPOSEAt 2012 American Physical Therapy Association's (APTA) Combined Sections Meeting (CSM), the construct of a process for developing a vision for physical therapist clinical began.1 As a result of this discussion, APTA organized a task force to promote optimal clinical educational experiences (CEEs) for physical therapist (PT) students that would strengthen partnerships between all levels of PT programs and clinical practice. Dunfee2 outlined several challenges to provision of quality CEEs in her guest editorial in Journal of Physical Therapy Education. These challenges included, but were not limited to, productivity demands on clinical facilities and regulatory and reimbursement environment. These factors have an impact on ability of clinical facilities to provide CEEs for students and, as Blau et al3 described in their research, have often had negative influences on clinicians' perceptions of their work environment.The challenges to provision of CEEs are not unique to physical therapy profession or to practice in United States (US). In medicine, Von Below et al4 reported that facilitators who supervised students during CEEs took pleasure in being clinical teachers and felt that these experiences were worthwhile. However, these facilitators also reported that they lacked support from their superiors for their role as clinical teachers and, furthermore, authors noted a tension between productivity demands and contributing to of future professionals. In 2008, Rodger et al5 reported findings from an international, interdisciplinary discussion about key issues related to clinical (CE) and practice placements. In their report they noted that detrimental influences on CEEs have included fiscal constraints, changes in practice models, and reduced staffing.Prior to APTA CSM, New England Consortium of Academic Coordinators of Clinical Education (NEC-ACCE) organized a meeting, in spring of 2011, with PT program directors and directors of clinical (DCEs) of 17 member institutions to discuss contemporary concerns regarding physical therapist education. NEC-ACCE membership includes all DCEs from 17 PT academic programs in a 6-state area, including Maine, New Hampshire, Vermont, Massachusetts, Connecticut, and Rhode Island. The impetus for this meeting was based on NEC-ACCE member experiences that indicated that clinical facilities were having greater difficulty accommodating requests for student CEEs. During all-day workshop, this select group of stakeholders discussed challenges associated with CE from multiple perspectives. At conclusion of this meeting, participants expressed a common concern that CE may not be sustainable in its current form. Similar to premise of a shared vision for PT education that would later be promoted at 2012 APTA CSM, consortium recognized that it did not have enough direct information from wide breadth of clinical personnel who served needs of academic institutions and students. Participants acknowledged that more information was needed from regional clinical educators to make informed decisions about how academic programs and clinical educators could work collaboratively to meet challenges surrounding provision of CE. The NEC-ACCE charged a 6-member task force to gather this information and report back to group. Specifically, task force's objectives were to obtain New England clinicians' feedback on: (1) variables that impact physical therapy practice and CE; (2) how to strengthen partnership between academic programs and clinical facilities; and (3) possible strategies to manage challenges associated with CE.METHODSDesignA series of regionally based focus group discussions were organized to maximize clinician feedback on status and future of physical therapist education. …

Tobacco cessation counseling training in US entry-level physical therapist education curricula: prevalence, content, and associated factors.

The US Public Health Service (USPHS) recommends tobacco cessation counseling (TCC) training for all health care professionals. Within physical therapist practice, smoking can have adverse effects on treatment outcomes in all body systems. In addition, people with physical disabilities have a higher smoking prevalence than the general population, creating a strong need for tobacco cessation among physical therapy clientele. Therefore, TCC training is an important component of entry-level physical therapist education. The aims of this study were: (1) to determine need for TCC training within entry-level physical therapist education and (2) to identify potential barriers to implementation of USPHS guidelines in the academic environment. A descriptive cross-sectional survey was conducted. Directors or academic coordinators of clinical education from entry-level physical therapist programs (N=204) were surveyed using an online instrument designed specifically for this study. Data regarding program and faculty characteristics, tobacco-related training content, and faculty opinions toward TCC in both physical therapist practice and education were analyzed descriptively. The response rate was 71%. A majority (60%) of programs indicated inclusion of tobacco-related training, most commonly 1 to 2 hours in duration, and of these programs, 40% trained students in the implementation of USPHS clinical guidelines for TCC. Data analyses were constrained by limited or missing data in some areas. A single faculty member completed the survey for each program. There is a need for TCC training in entry-level physical therapist education. Inclusion may be facilitated by addressing perceived barriers toward TCC as a component of physical therapist practice and promoting the relevance of TCC as it relates to intended outcomes of physical therapy interventions.

Development of Regional Core Networks for the Administration of Physical Therapist Clinical Education

Background and Purpose. Steady growth for physical therapists (PTs) is predicted over the next decade. In turn, enrollment in PT education programs continues to grow, which results in additional clinical education resource needs. The current model to administer clinical education may be unsustainable considering reimbursement rates, productivity demands, staffing, and organizational changes due to health care regulation. Position and Rationale. Compelling evidence supports the context that clinical education is best delivered at a regional level. The collaboration of PT education programs and clinical practice facilities through a regional core network (RCN) should increase efficiency, improve collaboration, and reduce competition amongst stakeholders. The purpose of this paper is to describe the elements and structure of an RCN model for clinical education, and introduce the roles and responsibilities of its stakeholders. Discussion and Conclusion. The development of an RCN would be driven by both efficiency and quality enhancement through the collaboration of 3 associated parties: PT education programs, clinical education sites, and a regional office. The goals for an RCN include streamlining the clinical placement process; building clinical capacity; improving communications; standardizing policies and procedures; advancing use of technology; research development; and improving overall quality of clinical education. Directors of clinical education (DCE) and center coordinators of clinical education (CCCE) are the bridge agents in the development of this new administrative clinical education model. Challenges include funding sources and relinquishing selected elements of individual and institutional autonomy. The RCN model is intended to allow compromise, with the exact design of each network decided by the stakeholders for a shared approach to the delivery of clinical education within a region.

Feedback in Clinical Education, Part II: Approved Clinical Instructor and Student Perceptions of and Influences on Feedback

Approved Clinical Instructors (ACIs; now known as preceptors) are expected to provide feedback to athletic training students (ATSs) during clinical education experiences. Researchers in other fields have found that clinical instructors and students often have different perceptions of actual and ideal feedback and that several factors may influence the feedback exchanges between instructors and students. However, understanding of these issues in athletic training education is minimal. To investigate the current characteristics and perceptions of and the influences on feedback exchanges between ATSs and ACIs. Qualitative study. One entry-level master's degree program accredited by the Commission on Accreditation of Athletic Training Education. Four ACIs and 4 second-year ATSs. Individual, semistructured interviews were conducted with participants and integrated with field notes and observations for analysis. We used the constant comparative approach to inductively analyze data and develop codes and categories. Member checking, triangulation, and peer debriefing were used to promote trustworthiness of the study. Participants described that feedback plays an important role in clinical education and has several purposes related to improving performance. The ACIs and ATSs also discussed several preferred characteristics of feedback. Participants identified 4 main influences on their feedback exchanges, including the ACI, the ATS, personalities, and the learning environment. The ACIs and ATSs had similar perceptions of ideal feedback in addition to the actual feedback that was provided during their clinical education experiences. Most of the preferences for feedback were aligned with recommendations in the literature, suggesting that existing research findings are applicable to athletic training clinical education. Several factors influenced the feedback exchanges between ACIs and ATSs, which clinical education coordinators should consider when selecting clinical sites and training ACIs.

Whatʼs All the “Hype” About Skype? The Effectiveness of Video Calling in Clinical Education

Background and Purpose. The purpose of this case study is to determine if video calling is an effective method of conducting distance site visits with students based on student preference, time, and cost-effectiveness. Participants. Thirty-two Doctor of Physical Therapy (DPT) degree students in their third year of study were asked to participate in this pilot study survey. Twentyseven (92.6%) students participated in the survey. Case Description. Students were required to participate in video calls with the academic coordinator of clinical education (ACCE) during their final clinical education experience. These calls were conducted during the midterm week of the affiliation. Upon completion of the clinical affiliation, students were asked to complete a survey designed to evaluate the benefits, limitations, communication preferences, and feasibility of use of video calling as a method of communicating with students about their overall clinical experience. Descriptive data based on student feedback, and comparative analysis of cost and time efficiency were analyzed. Outcomes. When students were asked to describe their initial feelings about using the video call format (prior to the video call), 72.3% of total responses were positive. After the video call, 91.1% of student responses were positive. Of the student responses, 100% indicated that they were “neutral to very satisfied” with the video call experience, and 66.7% preferred video calling versus an onsite visit (16.7%) or telephone contact (16.7%). With regard to time-effectiveness, the average video call was 25 minutes per student. Therefore, meetings with 16 students took a total time of approximately 8 hours. Additionally, there were no set-up costs for using Skype® or FaceTime,® as both pieces of software used for the purpose of this study were available free of charge, resulting in this method of communication being cost-effective as compared to onsite visits. Conclusions. This pilot project provides preliminary data that video calling meets the demands of providing a cost- and time-effective means of communication with students during clinical education experiences. Furthermore, students are receptive to its use and feel that is beneficial in maintaining the student-ACCE relationship during clinical affiliations. The use of video calling can provide exceptional opportunities for ACCEs to develop clinical partnerships beyond local or busy metropolitan area clinics and into rural areas and communities of the medically underserved.

Physiotherapists and Physiotherapy Student Placements across Regions in Ontario: A Descriptive Comparison

To describe the distribution and type of physiotherapy student placements in one year relative to the number of practising physiotherapists of Ontario. Site information about physiotherapy students' clinical placements in Ontario in 2010 was obtained from Academic Coordinators of Clinical Education. Worksite information about physiotherapists who reported providing direct patient care at a primary employment site in Ontario and at least 600 practice hours in their annual renewal was obtained from the College of Physiotherapists of Ontario. Each placement and each physiotherapist was attributed to one of Ontario's 14 local health integration networks (LHINs). For each LHIN, a ratio of student placements to practising physiotherapists was calculated, using summed counts. Counts of placement types by setting, patient mix, and practice area were also calculated for each LHIN. The 5 LHINs in which the university programmes are located had high placement:physiotherapist ratios, from 0.92 to 0.38. The other 9 LHINs had lower ratios, the 3 lowest at approximately 0.15. There was a wide mix of clinical placement types across LHINs. Physiotherapists' participation in physiotherapy students' clinical education varied widely among Ontario regions. Future research could explore whether regional differences are persistent, why they occur, and whether they should be reduced.

Student diversity and implications for clinical competency development amongst domestic and international speech-language pathology students

International students graduating from speech-language pathology university courses must achieve the same minimum competency standards as domestic students. This study aimed to collect descriptive information about the number, origin, and placement performance of international students as well as perceptions of the performance of international students on placement. University Clinical Education Coordinators (CECs), who manage clinical placements in eight undergraduate and six graduate entry programs across the 10 participating universities in Australia and New Zealand completed a survey about 3455 international and domestic speech-language pathology students. Survey responses were analysed quantitatively and qualitatively with non-parametric statistics and thematic analysis. Results indicated that international students came from a variety of countries, but with a regional focus on the countries of Central and Southern Asia. Although domestic students were noted to experience significantly less placement failure, fewer supplementary placements, and reduced additional placement support than international students, the effect size of these relationships was consistently small and therefore weak. CECs rated international students as more frequently experiencing difficulties with communication competencies on placement. However, CECs qualitative comments revealed that culturally and linguistically diverse (CALD) students may experience more difficulties with speech-language pathology competency development than international students. Students’ CALD status should be included in future investigations of factors influencing speech-language pathology competency development.

Survey of International Clinical Education in Physical Therapist Education

Background and Purpose. International opportunities, including international clinical education (ICE), appear to be increasingly offered in education of physical therapist students. ICE encompasses experiences designed primarily for student learning at a site outside of country where physical therapist program is located. Little research exists regarding use of ICE in physical therapist education. The specific purposes of this study were to (1) explore potential program differences between those with and without ICE; (2) discover current use, locations, and durations of ICE opportunities; (3) gather general information about ICE models, including their development, implementation, and evaluation; and (4) examine faculty perceptions of barriers and benefits regarding ICE. Subjects. The participants were directors of clinical education/academic coordinators of clinical education (DCEs/ACCEs) from US-based physical therapist education programs (n = 110). Methods. Direct mailing and listserv postings were used to recruit participants who then completed an Internet-based survey. Results. Of 110 respondents, 40.9% reported that they offered ICE. Of those programs that did not offer ICE, 18.8% (12 out of 64) planned to develop such opportunities in subsequent 2 years. Most ICE programs were 6 to 8 weeks in length, and were located in high-, upper-, or middle-income countries. The majority of ICE opportunities were in outpatient and hospital settings, and most clinical instructors were non-US citizens whose education was commensurate with US-level training. Commonly perceived barriers to ICE included expense, lack of faculty time and knowledge, and difficulty with site coordination. Perceived benefits were positive impact on cross-cultural competency, student personal development, and global awareness. Discussion and Conclusion. This study was first to explore broad use of ICE in US-based physical therapist education programs. Further research and professional dialogue are warranted to explore its present use and perhaps shape future application of ICE. Key Words: International, Clinical education, Global health. BACKGROUND AND PURPOSE Many factors, including rapidly developing technology and greater ease of travel, have contributed to an increasingly connected world. In this changing environment, impact of internationalization is becoming more evident across higher education.1 Knight2 defines internationalization as the process of integrating an international, intercultural or global dimension into purpose, functions or delivery of post-secondary education.(P2) As a reflection of this integration, international opportunities appear to be more prevalent in curricula of many health care profession programs located inside and outside of United States, including medicine,3-9 nursing,1015 and physical therapist education.16-21 A wide range of models are described in this literature. While overlap occurs among them, they may be grouped into 3 broad categories: community service; (2) service and learning, often termed international service-learning (ISL); and (3) student learning. Various terms are found in literature to describe experiences developed primarily for student learning at international locations: study abroad, global or global health training/education/electives/experiences, and international or international health electives/ clinical placements/ clinical rotations/internships/clinical education.3-11,15,19 Global health education also may refer to coursework that addresses health care systems and/or common health problems in countries outside United States, but may or may not include an international experience for student.3 In discussion that follows, term international clinical education (ICE) will be used to encompass all activities focused on student learning at international sites. …

Director of Clinical Education Performance Assessment Surveys: A 360-Degree Assessment of the Unique Roles and Responsibilities of This Position in Physical Therapy Education

Background and Purpose. Academic coordinators/directors of clinical education (DCEs) serve unique roles in physical therapist education programs with responsibilities that extend beyond those of teaching, service, and scholarship. Traditional faculty evaluation tools frequently fail to capture the diverse leadership, administrative, managerial, and experiential teaching responsibilities of these faculty members. The purpose of this project was to develop a set of assessment surveys for the DCE to use to solicit comprehensive performance feedback. Method/Model Description and Evaluation. A comprehensive literature review, analysis of professional documents and existing institutional tools, and feedback solicited from evaluator groups informed the development of the DCE Performance Assessment Surveys (Surveys). Fifty-six accredited physical therapist (PT) and physical therapist assistant (PTA) programs self-identified as the sample of convenience to pilot test the Surveys. Outcomes. The majority of program directors (88%) indicated they would consider using the Surveys. Clinical education faculty (88.6%) and academic faculty (84%) respondents stated they would be willing to complete a Survey for the evaluation of a DCE. A range of 85.0%-93.3% of respondents stated they could adequately evaluate the DCE using the Survey unique to their rater group and reported a range of 13.0-15.9 minutes to complete the Survey. Discussion and Conclusion. This project used a systematic process to develop a comprehensive set of Surveys for use in physical therapy academic programs. The Surveys solicit 360-degree performance feedback on the role of the DCE from the program director, DCE, clinical education faculty (clinical instructors, center coordinators of clinical education), academic faculty, and students. Data obtained may be useful to DCEs in professional and program development, workload allocation, promotion and tenure applications, and accreditation reports.

A Tribute to Pauline (Polly) Cerasoli: 1939-2011

Presented at the 14th Annual Pauline Cerasoli Lecture at the American Physical Therapy Association's Combined Sections Meeting in February 2011 At the 14th Annual Pauline Cerasoli lecture this past February, I was given the honor to say a few words about my friend and colleague Polly Cerasoli. I think most of you know that this annual event was initiated in 1997 as a tribute to Polly, whose life was interrupted and tragically cut short by an act of violence over 15 years ago. Polly finally succumbed to her injuries this past fall and now is finally at peace. Many of you never knew Polly personally, although you have read about her professional legacy in the publicity surrounding this annual lecture. In this tribute, I am going to share the more humanistic attributes of Polly and share some highlights of Pollys professional career that are a part of her legacy to her beloved profession. (Just for the record, Polly is also remembered as being the loving "Auntie Mame" to her nieces and nephews and a loving family member.) I sincerely believe that Polly would also like to be remembered as a dedicated professional who made major contributions to the profession of physical therapy. Polly was passionate about advancing the profession of physical therapy and was a risk taker. Polly believed in teamwork, interdisciplinary education, and the development of leadership skills in health professionals. She was never afraid to move forward as an individual or as an advocate for the profession. Although change used to make her nervous and somewhat uncomfortable, Polly would overcome her discomfort if she believed in a new idea. She often did this with a glass of wine with her close friends and lots of chatting (and yes, venting). Polly just loved to laugh! What Was Her Career Path? Polly began her academic career at Northeastern University. During her long tenure from 1967-1981, she served in a variety of roles including therapeutic exercise expert (she just loved PNF!), academic coordinator of clinical education, and acting chair of the Department of Physical Therapy. In 1981, she was recruited to Massachusetts General Hospital (MGH) where she served as the director of rehabilitation services and physical therapy. I really got to know Polly at MGH, especially as we planned the graduate program in physical therapy at the MGH Institute of Health Professions where she was an associate professor. Then, in 1988, the Vermonter headed west to become assistant dean of Allied Health and the director of the Physical Therapy Program at the University of Colorado. Polly brought her New England sensibilities and energy to Denver where she found a new home and loved leading the department. She was in that position when she was injured. So that sums up where she worked, and now I will share some of her spectacular accomplishments. There are so many stories that I could tell you about Polly, but since this is a professional tribute, I decided to focus on her leadership legacy. My friend and colleague, Colleen Kigin, was the second Cerasoli lecturer and she, too, was a good friend of Pollys. Colleens talk focused on leadership, and she talked about the five "Cs: Commitment, Caring/Mentoring, Collaboration, Comfort with change, and Comfort with self.1 With Colleens permission, I have cited examples of Polly s leadership in each of these categories. These are just a snapshot of her numerous professional accomplishments. Commitment In 1987, Polly received her doctorate in education degree from Northeastern University. Her dissertation was titled "The Relationship of Leadership Style and Job Satisfaction in Physical Therapy Clinicians." Her commitment to excellence and professionalism was clear as she completed her education while working fulltime and serving on many APTA leadership committees. Pollys doctorate in education program was interdisciplinary, and her fellow classmates included health professionals in occupational therapy, nursing, dietetics, and social work. …

Examining International Clinical Internships for Canadian Physical Therapy Students from 1997 to 2007

To describe international clinical internships (ICIs) for Canadian physical therapy (PT) students, explore the experiences of individuals involved in ICIs, and develop recommendations for future ICIs based on these findings. This study employed a mixed-methods approach. An online questionnaire surveyed academic coordinators of clinical education (ACCEs, n=14) on the availability, destinations, and number of ICIs from 1997 to 2007. Semi-structured telephone interviews were then conducted with eight PT students, seven ACCEs, and three supervising clinicians to investigate their ICI experiences. Interview transcripts were coded descriptively and thematically using NVivo. ICIs are currently available at 12 of 14 Canadian PT schools. A total of 313 students participated in ICIs in 51 different destination countries from 1997 to 2007. Over this period, increasing numbers of students participated in ICIs and developing countries represented an increasing proportion of ICI destinations. Key themes identified in the interviews were opportunities, challenges, and facilitating factors. ICIs present unique opportunities for Canadian PT students. Recommendations to enhance the quality of future ICIs are (1) clearly defined objectives for ICIs, (2) additional follow-up post-ICI, and (3) improved record keeping and sharing of information on ICI destination countries and host sites.

Delegation and Empowerment in CAATE Accredited Athletic Training Education Programs

Context: The use of delegation can potentially alleviate some of the stress with administering an athletic training education program (ATEP) and allow program directors (PDs) to focus on other aspects of their academic role. Objectives: To determine the reasons PDs delegate and do not delegate tasks to other faculty of ATEPs accredited by the Commission on Accreditation of Athletic Training Education (CAATE), and to determine if clinical education coordinators (CECs) of accredited ATEPs feel empowered when completing these tasks. Design and Setting: Survey of CECs and PDs of CAATE accredited entry-level ATEPs. Patients or other participants: At the time of this research there were 358 CAATE accredited entry-level ATEPs; 143 of these institutions had both CECs and PDs on staff resulting in 286 possible participants. Data Collection and Analysis: We developed two electronic survey instruments and established the validity and reliability. Descriptive statistics were used to analyze and rank administrative tasks. Results: We ranked five reasons PDs delegate and do not delegate administrative tasks to the other faculty of the ATEP. For over 80% (n=25) of the PDs surveyed, frequency statistics suggested that lack of confidence and lack of trust in others were the number one and number two reasons, respectively, for not delegating tasks to other faculty. Also, PDs ranked improving productivity as their primary reason to delegate tasks to other members of the ATEP. Finally, CECs felt empowered 59% of the time when completing assigned tasks. Conclusions: When used properly, delegation can alleviate some of the job stresses PDs face in accredited entry-level ATEPs. However, in order for delegation to improve the PDs and CECs job satisfaction, the CECs must feel empowered when completing these tasks to the level CAATE requires.

Supporting Student Learning During Physical Therapist Student Internships Using Online Technology

Background and Purpose. All students enrolled in physical therapist (PT) graduate programs are required to complete full-time clinical internships. The internships are synchronized so that all students in a cohort are off campus at the same time and are isolated from sharing learning experiences with their fellow classmates. The purpose of this project was to describe the development implementation and evaluation of a Web-based program that supports student learning and critical-thinking (CT) skills during PT students' clinical internships. Method/Model Description and Evaluation. Eighty-one PT master's degree students across all levels were divided into 2 groups. Thirty-nine students participated in the online program during their internships and 42 students completed their internships without participating in the online program. Participating students enrolled in an online component of their internships using WebCT. The course outline provided 4 areas of participation, including directed threaded discussions, a weekly e-journal, 2 open bulletin boards for questions, and weekly live-chat office hours. Students were required to participate in threaded discussions focusing on subjective assessment, ethical practice, and time management, and were expected to make a PT case presentation to their fellow students online. Assignments were designed to facilitate CT skills. CT skills were measured before and after the internships using the California CT Skills Test (CCTST). A post-internship survey was also administered to both groups to assess communication with classmates during the internships and effectiveness of the online program. Outcomes. Sixty-four percent of students participating in the online support program felt the program was beneficial in that it allowed communication and interaction with classmates across different levels of the program. The free discussion areas for student issues and treatment ideas received the most postings with 70 and 90, respectively. Seventy percent of the students felt the weekly e-journal was a beneficial source of reflection. Eighty-two percent averaged an hour online per week, and 77% found WebCT easy to use. There were no significant differences in CT skills before or after the internships between the online and non-online groups. Participating students recommended dropping required postings in favor of free discussion areas due to the stress and constraints of their internships. The instructor/academic coordinator of clinical education (ACCE) found the e-journals and student discussions aided in an awareness of problems occurring in the clinic facilitating mid-term visits and conflict resolution. Discussion and Conclusion. Students benefited from access to their classmates and professor using online technology during their clinical internship, resulting in a positive learning experience for the students. The online program did not appear to effect students' CT skills. Offering students a virtual environment to communicate questions and concerns with the professor and classmates during their clinical internships may benefit both the students and the professor. Key Words: Online technology, Clinical education, Clinical internships, California CT skills test. BACKGROUND AND PURPOSE Computer-assisted instruction (CAI) is increasingly becoming a method of facilitating learning in physical therapist (PT) education and changing how the academy approaches teaching and learning.1-14 CAI includes software packages that assist in the classroom instruction of foundational knowledge topics such as anatomy, kinesiology, and research, and using Web-based programs such as Blackboard* or WebCT to create a virtual classroom environment.2-14 Online learning strategies using bulletin boards and threaded discussions are intended to replace on-site classroom interaction and discussion.9,10 Distance education or learning is a new aspect of CAI being used in PT education, including using Internet technology to conduct clinical site visits. …

Evaluating the Performance of the Academic Coordinator/Director of Clinical Education in Physical Therapist Education: Developing a Tool to Solicit Input From Center Coordinators of Clinical Education and Clinical Instructors

Background and Purpose. The academic coordinators of clinical education/directors of clinical education (referred to in this article as DCEs) in professional (entry-level) physical therapist education programs have unique responsibilities that are not reflected in traditional faculty evaluation tools. In 2006, Buccieri and Brown published relevant criteria and identified clinical educators (CEs), as appropriate reviewers for a multisource assessment of the DCE. Clinical educators are inclusive of both center coordinators of clinical education (CCCEs) and clinical instructors (CIs). The purposes of this project were to develop a model assessment tool for CEs to evaluate DCEs and to examine the tool's content validity. Method/Model Description and Evaluation. A purposive sample of CEs representing diverse practice settings and geographic locations was selected for participation in an electronic survey. Ninetyone CEs completed the survey. More than 60% of the respondents indicated that they could provide moderate to significant information for each criteria in the categories of Administration and Teaching. Forty-five percent or less of the respondents indicated they could provide moderate to significant information regarding the Service category criteria. The second phase of the project tested the tool by sending two versions of the model tool (one including Service criteria, one omitting Service criteria) to CEs supervising students from 3 academic institutions (N = 591). The CEs were asked to complete the tool as an assessment of the DCEs from their respective academic programs and provide feedback to the principal investigator regarding the format and mechanics of using the tool. Outcomes. A model tool to solicit feedback from CEs for the performance evaluation of a DCE was developed based on agreement between CEs and DCEs on identified Administrative and Teaching criteria. Little meaningful information regarding Service performance was obtained from the CEs, suggesting that Service criteria should be omitted when soliciting evaluative input from CEs. Information from the trial use of the tool indicated that valuable Administration and Teaching feedback was received and could be tabulated for inclusion in the DCE faculty evaluation. Discussion and Conclusion. This assessment tool was found to have adequate content validity and can be used to gather CE input regarding the performance evaluation of the DCE. Information obtained may be included in promotion/tenure portfolios and used to guide professional development. Future research should consider establishing validity of criteria for students, program directors, and academic faculty input for a multisource assessment of the DCE.

Clinical Instructorsʼ Self-Perceptions of Competence in Teaching Core Content Areas of Curriculum to DPT Students: Implications for Academic Programs

Background and Purpose. The purpose of this study was to investigate the following questions: 1) What are clinical instructors' (CIs') perceptions of their current and desired levels of competence in knowledge and skills in core areas of the DPT curriculum, and teaching methods and skills when instructing DPT students? And, 2) Are there associations between CIs' perceptions and professional degree status, as well as CI credential status? Subjects. A sample of convenience of clinical affiliation sites from New York and New Jersey (N=480) was compiled from lists of 3 collaborating academic institutions. Center coordinators of clinical education (CCCEs) were sent a letter inviting clinical faculty to participate in this study. Questionnaires were mailed to 828 CIs at 181 clinical sites. Methods. A questionnaire was constructed to collect demographic data, ie, CIs' perceptions of their knowledge and skill in core areas of the DPT curriculum and in teaching methods used to instruct DPT students. Participants were asked to self-assess both their current and desired levels of competence using a 5-point Likert scale. Results. A total of 497 CIs and CCCEs completed surveys for a response rate of 60%, which represented 80% of the clinical sites in the sample. For every item, there was a significant difference between CIs' perceptions of current and desired knowledge and skills, such that the level of knowledge and skills should be higher. Respondents with a DPT were more likely to report current knowledge and skills as “more than adequate” and less likely to report current knowledge and skills as “less than adequate.” Discussion and Conclusion. Clinical faculty desire professional development in core curricula knowledge and teaching skills in order to be clinical instructors in DPT programs. An understanding of their perspectives is essential for academic programs to most effectively meet these needs.

Physical Therapist Education Programsʼ Performance Expectations of Students on Clinical Experiences

Background and Purpose. Physical therapist (PT) education programs often establish rubrics to outline expectations on the Physical Therapist Clinical Performance Instrument (PT CPI). The purposes of this study were to determine if directors of clinical education/academic coordinators of clinical education (DCEs/ACCEs) establish minimum expectations on the PT CPI, if student was expected to increase from the initial to culminating clinical experience (CE), and whether Master of Physical Therapy (MPT) and Doctor of Physical Therapy (DPT) programs expected different levels of student performance. Subjects. Representative DCEs/ACCEs of the nation's PT education programs. Methods. DCEs/ACCEs completed a survey describing how they establish and utilize minimum student expectations using the PT CPI. Descriptive statistics were used to identify frequencies, means, and standard deviations for the data. Multivariate analysis of variance (MANOVA) was used to determine differences in academic programs' expectations from initial to culminating CEs and between MPT and DPT programs. Results. A total of 103 (88.79%) of 116 DCEs/ACCEs reported that they use the PT CPI, and 84 (81.55%) reported that they establish rubrics to define minimum expectations. Range of rubric means for the initial CEs on criteria 1-24 was 41.73 mm-80.94 mm, and 89.42 mm-96.63 mm for the culminating CEs. MANOVA indicated that scores for culminating CEs were significantly greater than those for initial CEs. MANOVA did not indicate any significant differences between MPT and DPT programs' rubric means for criteria 1-24 for initial or culminating CEs. Discussion and Conclusions. The majority of surveyed schools utilized the PT CPI to define acceptable ratings on the PT CPI. PT education programs expect student ratings on the PT CPI to increase from the initial to the culminating CEs; however, the majority of programs do not require students to demonstrate entry-level clinical performance on all criteria. There were no significant differences in the expectations of MPT programs compared to those of DPT programs. Key Words: Clinical Performance Instrument, Entry-level clinical performance, Clinical experience. BACKGROUND AND PURPOSE The American Physical Therapy Association's (APTA's) Vision 2020' statement specifies that, by the year 2020, physical therapy will become a doctoring profession and physical therapists (PTs) will have direct access to patient care. Historically, the profession of physical therapy developed in response to health crises promulgated by wars, epidemics, advancements in medical technology, changes in demographics, and social and political movements. As the demands for physical therapy services expanded, the profession responded by increasing the qualifications and educational standards required to practice physical therapy.2,3 Currently, the Guide to Physical Therapist Practice describes the practice of PTs to include responsibilities beyond traditional services to individuals with impairments, functional limitations, and disabilities. The Guide states that PTs also address patient risk factors and behaviors, provide prevention services, promote health, wellness, and fitness, and act as consultants, educators, and administrators in settings ranging from clinical practice to research and education.4 In response to this change in practice and the development of Vision 2020, the Commission on the Accreditation of Physical Therapy Education (CAPTE) has recognized, in its publication, Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists,5 that PT education programs preparing PT students at the doctorate level have increased didactic content related to diagnostic imaging, differential diagnosis, screening, health promotion and wellness, and management. …

A Description of Comments Written by Clinical Instructors on the Clinical Performance Instrument

Background and Purpose. The Clinical Performance Instrument (CPI), developed by the American Physical Therapy Association (APTA), is used by clinical instructors (CIs) to evaluate physical therapist (PT) student and physical therapist assistant (PTA) student performance. This tool includes quantitative scores using a Visual Analog Scale (VAS) and qualitative comments to support the ratings on the VAS. These narrative comments are also intended to provide students with feedback on their performance. The purpose of this study is to describe and compare the ratings on the VAS with written comments for each criterion, including the performance dimensions (PDs) of quality, supervision, consistency, complexity, and efficiency. Subjects. Twelve educational programs in California participated in this field study which included the 13 corresponding academic coordinators of clinical education (ACCEs) and directors of clinical education (DCEs), 320 PT and 101 PTA students, and their respective CIs. Methods. Data recorded by the 12 programs included VAS scores at mid term and conclusion of student affiliations, written comments, and any checks of the following boxes: “Not Observed” (NO), “Significant Concerns” (SCs), or “With Distinction” (WD). ACCEs and DCEs rated all written comments that were noted for any of the PDs (quality, supervision, consistency, complexity, and efficiency). The ACCEs and DCEs rating evaluated whether the final VAS score for each criterion was considered “passing” by their respective education program. Interrater and intrarater reliability was established using percent agreement prior to rating inclusion of the PDs. Frequency distributions of all variables were calculated. Results. Fifty-four percent of the PT CPIs had at least 1 criterion listed as “NO” at the final evaluation, 40% of all PT CPIs had criterion #17 (consultation) listed as “NO” by the end of the affiliation, and 30% of PTA CPIs had criterion #15 (other services) listed as “NO” by the end of the affiliation. SCs were checked in only 4 of the 320 PT CPIs, although 50% of these had at least 1 criterion that did not meet a program's standard for passing. At least 1 criterion was marked WD in 40% of all CPI's. Ninety percent of all CPI's had at least 1 comment written for each criterion, and 68% of those comments only addressed 1 or no PDs. The frequency with which each performance dimension was addressed was 42% for quality, 10% for supervision, 15% for consistency, 12% for complexity, and 12% for efficiency. Discussion and Conclusion. While many comments are written in the CPIs, most do not provide an adequate description of the student's performance relative to the 5 PDs. CIs may benefit from additional training to make comment writing more relevant and efficient. Future research should further explore the reasons for the prevalence of “NO” marks on criteria considered to be part of professional practice.

Evaluating the Performance of the Academic Coordinator of Clinical Education in Physical Therapist Education: Determining Appropriate Criteria and Assessors

Background and Purpose. The role of the academic coordinator of clinical education (ACCE)/director of clinical education (DCE) in physical therapist education programs is evolving as physical therapy moves to a doctoring profession. Faculty evaluation of the ACCE on traditional academic criteria does not capture all of the responsibilities of the ACCE. Teaching occurs in individualized instructional sessions, making it difficult to obtain student feedback of teaching performance on course evaluations that assume a more typical classroom format of teaching. Administrative activities are not represented on course evaluation forms. The purpose of this study was to determine relevant criteria and identify appropriate individuals to contribute to the faculty evaluation of the ACCE. Subjects. The ACCEs and DCEs from all accredited physical therapist education programs in the United States were surveyed. Methods. An anonymous questionnaire was developed using institutional promotion criteria, traditional course evaluation forms, and published roles of the ACCE. Content validity was established. The percent responses were rank ordered to determine the importance of items in the categories of administration, teaching, scholarship, and service. Data obtained regarding individuals qualified to contribute input on performance were reported. Results. The response rate was 63%. The items rated the most valuable were in the category of teaching, followed by administration, service, and scholarship. Academic administrators, faculty, center coordinators of clinical education, clinical instructors, and students were identified as qualified to provide input on various items in evaluation of the ACCE. Discussion and Conclusion. Results are valuable in designing a comprehensive faculty evaluation of the ACCE for the purposes of promotion, tenure, and career satisfaction. The information will be useful in designing appropriate evaluation criteria for formative and substantive feedback to ACCEs. Key Words: Faculty evaluation, Academic coordinator of clinical education, Physical therapist education, Promotion and tenure. BACKGROUND AND PURPOSE Accredited professional (entry-level) physical therapist education programs in the United States include both academic and clinical coursework. Clinical education coursework occurs at health care facilities, schools, and wellness programs providing physical therapist (PT) students opportunities to apply learned academic knowledge with the supervision and guidance of a licensed physical therapist. Specific objectives for the experiences are set and collaboratively monitored by the clinical instructors (CIs) and the academic program. These experiences are required by the Commission on Accreditation in Physical Therapy Education (CAPTE)1 and are defined in A Normative Model of Physical Therapist Professional Education: Version 2004(2) as an integral component of the entire curriculum to prepare students to enter the profession of physical therapy. These courses provide students opportunities to apply theory and didactic information learned in the classroom and laboratory to patient care and are facilitated, coordinated, and monitored by the academic coordinator of clinical education (ACCE) or director of clinical education (DCE) employed by the academic program. For simplicity purposes in this paper the term ACCE will be used to be inclusive of the DCE terminology. In its Model Description Position for ACCEs/DCEs, revised in 2002,3 the American Physical Therapy Association (APTA) defines the position as follows: The ACCE/DCE holds a faculty (academic or clinical) appointment and has administrative, academic, service, and scholarship responsibilities consistent with the mission and philosophy of the academic program. This individual demonstrates competence in clinical education, teaching, and curriculum development. In addition, the ACCE's/ DCE's primary responsibilities are to plan, coordinate, facilitate, administer, and monitor activities on behalf of the academic program and in coordination with academic and clinical faculty. …

The Optimal Length of Clinical Internship Experiences for Entry-Level Physical Therapist Students as Perceived by Center Coordinators of Clinical Education: A Pilot Study

Background and Purpose. Clinical education represents a significant segment of the physical therapist education program curriculum and allows students to apply and integrate theory and didactic knowledge to the real world of practice. The purpose of this study was to explore the perceptions of center coordinators of clinical education (CCCEs) with regard to the optimal length of full-time clinical education experience for PT students who have completed their first and final full-time clinical education experiences. Case Description. A pilot study was conducted using an open-format questionnaire. The questionnaire was sent to CCCEs at clinical sites across the United States that currently have agreements with American International College (N = 273). Results. A response rate of 57% was obtained. For students in their first full-time clinical education experience, an average of 7.3 ± 2.26 weeks was suggested, with a range of 3-16 weeks. For a student's final full-time clinical education experience, the average was 9.1 ± 2.09 weeks with a range of 5.5-16 weeks. Discussion. The results of this survey support the current trends for those professional programs that require PT students to complete an 8-week clinical experience as part of their first experience. The results also demonstrated a bimodal split in the distribution between a 5-8-week full-time clinical experience and a 9-12-week clinical experience for a student's final clinical experience as expressed by the CCCEs. This study may assist the director of clinical education (DCE) and/or the academic coordinator of clinical education (ACCE) to develop a consensus on the optimal time for the development of skills in the clinical environment. Key Words: Physical therapy, Clinical internship experience, Clinical education. INTRODUCTION Moving professional (entry-level) physical therapist (PT) students into a clinical education experience is an important aspect of a physical therapist education program curriculum and requires careful and deliberate planning on the part of both the educational institution and the clinician. Clinical placements that consider each student's unique needs are optimal. The physical therapist clinical education experience is a relationship fostered between the academic institution and the clinical facility and should ensure an environment that is engaging and provides a critical learning environment.1 Paschal indicated that clinical education in real practice settings, with real patients and with real physical therapists as clinical teachers.2(p257) Clinical education represents a significant segment of the PT curriculum and allows students to apply and integrate theory and didactic knowledge to the real world of practice while under the supervision of clinical instructors. According to Mostrom and Shepard,' physical therapist professional preparation occurs in 2 environments, the classroom and the clinical setting, each of which contribute to the students' learning experience. Integration of the didactic portion of the PT curriculum occurs through the implementation of carefully thought out clinical experiences providing an opportunity for problem solving which occurs as students participate in clinical settings.3 The Division of Physical Therapy at American International College (AIC) in Springfield, Massachusetts, requires all PT students to successfully complete three 8-week full-time clinical education experiences for a total of 24 weeks in order to fulfill the requirement for a master's degree in physical therapy.4 According to the American Physical Therapy Association 2002 Fact Sheet for Physical Therapist Education Programs,5 the average length for a student's final fulltime clinical education experience is 14.5 weeks at the master's level, with a total length of the full-time clinical education experience averaging 27.9 weeks.5 While visiting clinical sites, conversations with the center coordinators of clinical education (CCCEs) often lead to questions inquiring if AIC PT students could continue beyond the required 8 full-time clinical experience weeks. …

Complementary Therapies in Rehabilitation.

Owner of DeVita/Becker Physical Therapy PC in Staten Island, New York Academic Coordinator of Clinical Education @ the College of Staten Island in New York