Developing the PT/PTA Relationship in the Academic Setting: A Collaborative Cross-Cohort Assignment
Purpose: The purpose of this assignment is to practice PT/PTA collaboration for patients with neurologic conditions with emphasis on timely, thorough, and accurate two-way communication between PT and PTA. A secondary purpose involves further development of treatment planning and documentation skills for patients with neurologic conditions. Assignment objectives: 1. Students will apply the scope of practice principles for PT/PTA collaboration and delegation of patients with neurologic conditions. 2. Students will collaborate for treatment planning, progression and modification to the plan of care. 3. Students will apply the APTA guidelines for defensible documentation through review and appraisal of examination and intervention notes.Methods and/or Description of Project: Students are required to view a narrated PowerPoint (i.e., VoiceThread) that: 1. Discusses the considerations a PT must take when directing interventions to a PTA, 2. Reviews JCAHO National Patient Safety Goals and guidelines for “hand-off” communication, and 3. Reviews APTA Code of Ethics and other applicable principles and concepts, including defensible documentation. Groups of 2-4 PT students are assigned a patient scenario with one of the following diagnoses (CVA, TBI, Parkinson disease, or cerebral palsy) and are required to view a video (which is about five minutes) of the patient with that diagnosis performing a mobility task. PT students must then write an examination SOAP note. They must “fill in the gaps” for information not included in the video that would be appropriate given what they have viewed. The PT students must then complete “hand-off” communication per guidelines with the assigned PTA students. This meeting could be in person or through video conference. This meeting allows the PTA students to ask questions to the PT group to help guide the treatment plan as indicated. PTA students then develop two treatment sessions and write two separate SOAP notes for the patient based on the plan of care and patient goals. The PTA students then share their two notes with the PT students for co-signature, feedback, and guidance. Then, PTA students are required to document a third treatment session based on a patient status change that is provided by the PTA course instructor. PTA students then document how the change in status was addressed. The note from this third session is used to communicate with the PT student in person during a delegation hand-off practical experience. This delegation hand-off practical is completed with a 1 PT to 1 PTA student ratio and a faculty member observing the communication. Following the practical, all students write a reflection about this experience. Student learning is measured by grading rubrics. The PT rubrics include: Part 1: PT Examination SOAP note, hand-off meeting and PT feedback to PTAs on treatment notes Part 2: Delegation Hand-off Practical Part 3: Reflection The PTA rubrics include: Part 1: PTA SOAP notes 1 & 2 Part 2: Delegation Hand-off Practical Part 3: ReflectionResults/Outcomes: Post-assignment reflections indicate both PT and PTA students experienced increased comfort and understanding of the importance of working as part of a PT/PTA team in order to maximize patient outcomes. Post-assignment reflections of PT students indicated a greater appreciation for the importance of developing a relationship with the PTA’s they will work with in the future in order to open up communication and better understand each others personal style, strengths, and limitations of clinical skills. Post-assignment reflections of PTA students describe having a better understanding of both PT and PTA scope of practice as well as the importance of assessing and reporting new symptoms.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: Both PT and PTA students reported increased comfort with working as a PT/PTA team after the delegation practical where communication was the focus. Exposing both the professional and paraprofessional cohorts to simulated delegation and supervisory experiences prepares both the PT and the PTA for future clinic work as a team. Improved understanding of the each others professional scope of practice achieved with this activity prepares the PT to delegate more appropriately while empowering the PTA to utilize assessment skills to communicate progress and concerns more effectively. This activity could also be utilized with other healthcare professions that utilize professional and paraprofessional assistants.References: 1. Hawthorn K, Cohoon C, Chambers E. Fostering PT PTA relationships: pilot study. IJAHSP. December 2017;16(1):Article 4. 2. Borghese M, Larocque N, Jelley W. Perceptions on the essential competencies for intraprofessional practice. Physiotherapy canada. 2013;65(2):148-151. doi:10.3138/ptc.2012-02. 3. The Joint Commision Website: Facts about the National Patient Safety Goals. Published Dec 28th, 2017. https://www.jointcommission.org/facts_about_the_national_patient_safety_goals/ Accessed March 20, 2018. 4. Foronda C, MacWilliams B, McArthur E. Interprofessional communication in healthcare: An integrative review. Nurse Ed Practice. 2016;19: 36-40. 5. CAPTE Accreditation Handbook. http://www.capteonline.org/AccreditationHandbook/ Accessed March 20, 2018.Course Objectives: 1. The learner should be able to summarize current literature on learning teamwork, communication, supervision, and delegation in intraprofessional PT/PTA teams. 2. The learner should be able to implement an experience for their PT or PTA program that involves PT/PTA teamwork, communication, supervision, and delegation. 3. The learner should understand what CAPTE standards and elements for PT and PTA academic curricula are met by this assignment. 4. The learner should understand how this assignment assists with development of teamwork and communication skills necessary for clinical practice of physical therapy involving PT/PTA teams.Instructional Methods: Lecture, videos, discussion, Q&ATentative Outline/Schedule: Introduction/background (5 minutes) Introduction of speakers Impetus for development of the project Literature review and terminology (15 minutes) Supervision/delegation Teamwork/collaboration Communication Translation to clinic practice Fit with CAPTE standards/elements Description and Walk-through of Assignment (35 minutes) Description of the assignment, including rubrics Show video used to introduce the assignment Show example video of a patient scenario Show example video snippets of the student experience Past to Present and Looking to the Future (15 minutes) What changed/improvement process each year Student commentary Planned future changes Audience Participation (20 minutes) Brainstorming discussion to help audience apply this to their programs Question & answer session