Implementing the “Core Competencies of Entry-Level Practice in Acute Care Physical Therapy” for Excellence in Physical Therapist Clinical Education
Assessment of student performance within the clinical environment is an important aspect of clinical education, but one in which many Clinical Instructors (CIs) feel uncomfortable. When investigating the rationale for clinical instructors taking the Credentialed Clinical Instructor Program one main theme that was observed was the desire to become more effective in assessment of student performance. While utilizing the Clinical Performance Instrument for student assessment, the CI needs to establish entry level standards in order to effectively determine student performance.
In acute care clinical education, a common definition of entry-level expectation can be difficult since no uniform standard for entry level performance expectations existed specific to this setting. This leaves the CIs at each facility to determine an appropriate metric. In December of 2015, The Academy of Acute Care Physical Therapy published a guiding document to assist stakeholders in defining entry-level practice in acute care, The Core Competencies of Entry-Level Practice in Acute Care Physical Therapy (CCELPACPT). This document assists with communication between clinical education sites and academic institutions to ensure entry-level is defined and reached by students in the acute care environment.
This presentation will equip and support CIs, Clinical Coordinators of Clinical Education (CCCE) and Directors of Clinical Education (DCE) in integrating the “Core Competencies of Entry-Level Practice in Acute Care Physical Therapy” into Physical Therapist acute care clinical education. This will enhance communication in acute care clinical partnerships in order to prepare students for entry-level practice in acute care.
Methods and/or Description of Project
The CCELPACPT defines the knowledge, skills, and behaviors specific to acute care that all students should possess upon graduation. Specifically addressed are expected competencies in the domains of clinical decision-making, communication, safety, patient management and discharge planning. The identified entry-level skills defined in this document can be used by CIs, CCCEs, and DCEs to frame entry level expectations for students, more uniformly assess student performance and describe student’s performance in light of entry level practice expectations.
This educational session will include a brief description of the rigorous process that was utilized in development of the CCELPACPT and an overview of the 5 competency domains. Members of the expert panel of educators and clinicians who developed the document will share examples of how the document has been and could be used to promote student assessment in traditional and collaborative clinical education models. Participants will be led through a self-inventory exercise to compare their current clinical curricula and expectations to the competencies defined in the document.
Preliminary use of this document within acute hospital clinical programs as well as one Academic institution will be presented to inform future use for all participants.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
Optimal student assessment can often be limited by varying interpretations of the Clinical Performance Instrument based on variability in clinical settings, experiences and opinions rather than objective, setting specific skills and behaviors. Utilization of the CCELPACPT will help to uniformly define entry- level practice, allowing CIs to better assess student learning. DCEs can use the CCELPACPT to prepare student for clinical expectations, and to help identify areas in need of additional support for students who are having challenges in the clinic. In addition, the document serves to increase effective communication between clinical partners to assist in students achieving the necessary outcomes of entry-level practice in acute acre upon graduation.
American Physical Therapy Association. Minimum required skills of physical therapist graduates at entry-level: BOD G11-05-20-49 [Guideline]. American Physical Therapy Association Web site http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/BOD/Education/MinReqSkillsPTGrad.pdf. Updated October 1, 2013.
Atkinson HL, Nixon-Cave K. A tool for clinical reasoning and reflection using the International Classification of Functioning, Disability, and Health (ICF) framework and patient management model. Phys Ther. 2011; 91: 416-430.
Gorman SL, Wruble Hakim E, Johnson W, et al. Nationwide acute care physical therapist practice analysis identifies knowledge, skills, and behaviors that reflect acute care practice. Phys Ther. 2010;90(10):1453-1467.
Guide to Physical Therapist Practice. Guide 3.0 Alexandria, VA: American Physical Therapy Association; 2014. http://guidetoptpractice.apta.org
Interprofessional Education Collaborative Expert Panel. Core competencies for interprofessional collaborative practice: Report of an expert panel. American Association of Colleges of Nursing Website. http://www.aacn.nche.edu/education-resources/ipecreport.pdf. Published May 2011. Accessed 2014.
Jette DW, Bertoni A, Coots R, Johnson H, McLaughlin C, Weisbach C. Clinical instructors’ perceptions of behaviors that comprise entry-level clinical performance in physical therapist students: A qualitative study. Phys Ther. 2007;87(7):833-843.
Lekkas P, Larsen T, Kumar S, et al. No model of clinical education for physiotherapy student is superior to another: a systematic review. Aust J Physiother. 2007; 53(1):19–28.
Malone, DJ. The New Demands of Acute Care: Are We Ready? Phys Ther. 2010;90(10): 1370-1372.
Masley, P. M., Havrilko, C.-L., Mahnensmith, M. R., Aubert, M., Jette, D. U., & Coffin-Zadai, C. (2011). Physical therapist practice in the acute care setting: A qualitative study ... including invited commentary with author response. Physical Therapy, 91(6), 906-922.
McCallum CA, Mosher PD, Jacobson PJ, Gallivan SP, Giuffre SM. Quality in physical therapist clinical education: A systematic review. Phys Ther. 2013; 93(10): 1298-1311.
Musolino GM, van Duijn J, Noonan AC, Eargle LK, Gray DL. Reasons Identified for Seeking theAmerican Physical Therapy Association-Credentialed Clinical Instructor Program (CCIP) in Florida. Journal of Allied Health, 2013; 42(3), pp. 51E-60E(10).
Physical therapist clinical performance instrument (PT CPI) . American Physical Therapy Association Web site. Http://www.apta.org/PTCPI/.
Rindflesch AB, Hoversten KM, Patterson BM, Thomas LN, Dunfee HJ. Students’ description of factors contributing to a meaningful clinical experience in entry-level physical therapist professional education. WORK: A Journal of Prevention, Assessment and Rehabilitation. 2013.
Rindflesch AB, Dunfee HJ, Cieslak KR, Eischen SL, Trenary T, Calley DQ, Heinle DK. Collaborative model of clinical education in physical and occupational therapy at the Mayo Clinic. J Allied Health. 2009 Fall; 38(3):132-42
Sass, K, Frank L, Thiele A, Newton AD, Bork B, Hartung S, et al. Physical Therapy Clinical Educators’ Perspectives on Students Achieving Entry-Level Clinical Performance. Journal of Physical Therapy Education, 2011; 25(3), 46-52.
Smith B, Fields C, Fernandez N. Physical therapists make accurate and appropriate discharge recommendations for patients who are acutely ill. Phys Ther. 2010; 90:693-703.
Tsuda H, Low S, Vlad G. A description of comments written by clinical instructors on the Clinical Performance Instrument. Journal of Physical Therapy Education. 2007; 21(1), 56-62.
Wainwright SF, Shepard KF, Harman LB, Stephens J. Novice and experienced physical therapist clinicians: a comparison of how reflection is used to inform the clinical decision-making process. Phys Ther. 2010; 90:75-88.
Wetherbee E, Giles S. Physical therapist education programs' performance expectations of students on clinical experiences. Journal of Physical Therapy Education. 2007; 21(1), 48-55.
Wetherbee E, Peatman N, Kenney D, Cusson M, Applebaum D. Standards for Clinical Education: A Qualitative Study. Journal of Physical Therapy Education. 2010; 24(3), 35-43.
1. Participants will be able to discuss the five domains of competency that define acute care entry-level practice and provide examples of skills, knowledge, and behaviors from each domain.
2. Participants will be able to create physical therapist student clinical education objectives that correspond with identified acute care competencies in the CCELCACPT.
3. Participants will be able to integrate the CCELCACPT with the CPI in their own programs to evaluate and provide feedback on student performance in acute care clinical settings.
Lecture, Panel Discussion, Self-Assessment, Case-based learning, Small/large group discussion
I. Introduction (20 min)
a. Development of document
b. Overview of domains
II. Utilization of the CCELPACPT (50 min)
a. Clinical Facility use
i. Look at current expectations
ii. Using document to ground CPI
b. Academic Clinical Education use
i. Setting student expectations
ii. Use with Challenging students
III. Questions (20 min)