Governance of Clinical Education
Time Frame for Selection of Practica
Communication & Management of Clinical Education Experiences
Types of Clinical Education Experiences
Clinical Education Policies
Clinical Site Information
The MWU Physical Therapy Program's philosophy of clinical education is to provide stimulating learning experiences within quality physical therapy facilities that utilize contemporary evidence based practice. Since its inception in 1995, the Physical Therapy Program has worked toward the objectives of preparing therapists to work in under-served areas, providing a strong foundation in health promotion and wellness, and addressing the needs of patients across the life span. The Physical Therapy Program works with clinical education sites in the greater Chicago urban area, in rural Illinois communities, and sites outside of Illinois to provide varied adult and early intervention experiences to our students. The MWU Physical Therapy Program has established clinical education relationships with over 250 facilities across the United States.
Midwestern University's clinical education program is an essential part of the preparation of future physical therapists. The content of the clinical education program as well as the guidelines for implementation, evaluation, and documentation are regulated primarily by The Commission on Accreditation in Physical Therapy Education (CAPTE), but are also subjected to the guidelines set forth by the Illinois Physical Therapy Act, the American Physical Therapy Association, and the Midwestern University Physical Therapy Program Objectives. Midwestern University is also accredited by The Higher Learning Commission, a commission of the North Central Association of Colleges and Schools (NCA).
In the spring quarter (March 1st) of each year, all affiliated clinical sites are sent commitment forms for possible student rotations for the upcoming year along with the other academic program members of the Illinois Physical Therapy Association (IPTA) Clinical Education Special Interest Group (CESIG). The Center Coordinators of Clinical Education (CCCE) check with their Clinical Instructors (CI) for the availability of possible student rotations. The completed commitment forms are due back to the Directors of Clinical Education (DCE) by the end of April. During the fall quarter, the DCE mails out verification letters to sites that have previously indicated that they can provide student rotations for the upcoming year. During the winter quarter, students choose from these clinical education offerings for Practicum II, III, and IV via a lottery system. First year students are assigned to PI sites by the DCE. By the end of December, the DCE mails out letters of confirmation to the clinical sites with student names and dates of specific rotations.
The students receive the necessary clinical education paperwork prior to the start of each practicum. In addition, students can access the necessary clinical education paperwork via the MWU Blackboard website at anytime during their practica.
The DCE sends out the full clinical education packets to the CCCEs approximately 2 months prior to each student rotation. All of the following forms needed for the student rotation are included in this packet: student immunization form, HIPAA training, Clinical Education Policies, Practicum course syllabus, Clinical Facility Midterm Feedback to PT Program form, Staff Development Activity Feedback Form, Weekly Planning Sheets, infection control training, a treatment planning worksheet, and Documentation Made Simple. The Documentation Made Simple form describes the specific due dates for the completed paperwork.
In addition, CCCEs and CIs are encouraged to contact the DCE (via email or phone) at any time before, during, or after student rotations for clarification of specific clinical education issues. When necessary, the DCE can make site visits to meet in person with the CCCE, CI, and/or student.
Clinical field experiences provide an opportunity to directly observe professional behavior, health care delivery, and health care team members in a variety of practice settings. Field experiences begin the student's professional socialization in the context of the health care continuum and provide them the opportunity to exhibit professional behaviors in the physical therapy setting. During the summer quarter of the first professional year, students have the opportunity to spend 2-3 afternoons observing physical therapists in a variety of settings: acute care, subacute/skilled care facility/long term care, rehabilitation, outpatient-hospital, outpatient-private, and pediatrics. During these field experiences, students complete projects to learn about clinical practice, health care professional interactions, the variety of patient populations, and the resources available to physical therapists across the health care continuum.
This three week full-time, supervised clinical practicum enables physical therapy students to develop skills in communication, time management, patient evaluation and basic interventions, mobility training and patient education. This rotation takes place at the beginning of the students' second professional year.
This ten week full-time, supervised clinical practicum enables physical therapy students to further develop their patient care, evaluation, and intervention skills. Practicum II includes completion of a project focusing on serving underserved populations and/or cultural competence in health care. During this practicum, students gather patient information for a formal case study report that will be presented to University faculty and students at the end of their third professional year. IRB approval from MWU and the site are obtained prior to the practicum. This rotation takes place during the spring quarter of the students' second professional year.
This ten week full-time, supervised clinical practicum enables physical therapy students to apply the process of clinical problem solving in evaluation and treatment of clients at a variety of points along the health care continuum, display appropriate professional attitudes and behaviors, and effectively integrate current research into the clinical decision making process. The course includes an independent study component that utilizes evidence based practice to answer a clinical question. For either Practicum III or Practicum IV, students will submit one article review to the American Physical Therapy Association (APTA) "Hooked on Evidence" database. Practicum III takes place in the winter quarter of the students' third and final professional year.
This ten week full-time, supervised clinical practicum enables physical therapy students to apply the process of clinical problem solving in evaluation and treatment of clients at a variety of points along the health care continuum, display appropriate professional attitudes and behaviors, effectively integrate current research into the clinical decision making process, and effectively plan, implement, and evaluate educational programs/interventions. The course includes an independent study component that utilizes evidence based practice to answer a clinical question. For either Practicum III or Practicum IV, students will submit one article review to the American Physical Therapy Association (APTA) "Hooked on Evidence" database. Practicum IV directly follows Practicum III in the spring quarter of the students' third and final professional year.
Throughout the three years of academic preparation, students will have multiple opportunities to visit various clinical sites for short ½ day field trips to enhance the classroom coursework.
The following section describes the policies related to clinical education.
MWU Physical Therapy clinical education experiences encompass management of patients/clients representative of those commonly seen in practice across the lifespan and the continuum of care. Physical therapy students must satisfactorily complete the Health Professionalism I Field Experiences and 33 weeks of full time supervised clinical practice prior to graduation. During Practica I-IV, students will be required to complete 1) a minimum of 3 weeks full time clinical practice working with adults in an inpatient setting whose medical conditions may change quickly (i.e., acute, subacute, and skilled nursing settings) and 2) a minimum of 5 weeks full time clinical practice working with adult orthopedic outpatients. In addition, students are required to engage the management of patients/clients from the following age groups: 0-12 years, 13-21 years, 22-65 years, and over 65 years and the following practice patterns: musculoskeletal, neuromuscular, integumentary, and cardiopulmonary. During Practica I-IV, students will not be allowed to complete more than 18 weeks of full time clinical practice managing patients of similar ages, problems and levels of complexity. Final selections are at the discretion of the Director of Clinical Education (DCE).
Students must provide the academic program proof of current First Aid and American Heart Association CPR certifications prior to beginning each clinical experience. Certification must be valid for the entire length of each clinical experience. Students must submit to a criminal history background check through the University prior to matriculation into the P.T. program. In order to participate in Practicum I, II, III, or IV, students must satisfactorily complete or remediate all academic courses prerequisite to and including those stated in the practica syllabi. Additionally, in order to participate in Practicum III, students must have provided their faculty advisor a complete draft of the case report or systematic review by the end of week 9 of the 3rd Fall Quarter. Students must also have a cumulative GPA of >2.75. Students must meet individual facility requirements in order to participate at that facility. Individual facility requirements may include but are not limited to: additional background check, fingerprinting, respiratory fit testing, drug screen, physical, and interview. The cost for these requirements is the responsibility of the student.
In order to achieve the objectives for the Health Professionalism I Field Experiences and all Practica, legal clinical affiliation agreements have been executed with a wide variety of facilities which meet the clinical site selection criteria of the Physical Therapy Program. Sites may self-identify or be identified by the DCE, faculty, or students. The DCE is responsible for evaluating the ability of sites to meet the clinical education needs of the program. The DCE also has responsibility for establishing legal clinical affiliation agreements with sites. The Physical Therapy Program will continue to develop regional and national clinical education opportunities.
The DCE has administrative responsibility for determining that Health Professionalism I Field Experiences and Practica provide a context for the attainment of educational objectives for students and overall objectives of the Physical Therapy Program. Prior to the clinical experience assignment and selection process, clinical facilities identify their resources and availability to take students. Students will be randomly assigned to Health Professionalism I Field Experiences and Practicum I by the DCE. The DCE, in consultation with the student, will determine placements for Practica II-IV through a lottery process. Students should be prepared to travel to any facility with which the University has a legal clinical affiliation agreement. Clinical facilities have the right to change agreed-upon arrangements for any clinical experience at any time.
In order to provide students with fair and unique learning experiences, students will not be allowed to participate in Practica II, III, and IV at a clinic site in which they have previously been employed within the department of physical therapy, are currently employed, or have already committed to employment as a physical therapist upon graduation. In exceptional circumstances, the student may petition the DCE to participate in a practicum at the site of a previous employer. The DCE will approve or deny this petition.
Students are responsible for all expenses associated with clinical education. Expenses may include, but are not limited to, transportation, meals, housing, professional attire and library fees. Financial aid planning should include an expense budget for clinical education when determining financial need.
Should a clinical facility determine that it will be unable to provide a clinical experience, the DCE, in consultation with the student, will identify an alternative clinical education site. Expenses related to changes in any clinical education or facility arrangement will remain the responsibility of the student.
Students are required to have health insurance as long as they are enrolled in the University. Health requirements of the University and the facilities where students will have clinical experiences must be met prior to their participating in clinical education experiences. The Physical Therapy Program will cooperate with the Office of Student Affairs to verify each P.T. student's compliance with the health requirements of the University and notify clinical facilities via a health requirement verification form that the student has met the health requirements. However, some clinical facilities may require that the University provide copies of the individual student health record.
Students should also be aware that clinical facilities may have additional health requirements for students participating in clinical experiences. It is the student's responsibility to comply with the requirements of each facility. To avoid delays in beginning clinical practica, students should contact the Center Coordinator of Clinical Education at each assigned clinical facility in a timely fashion regarding specific health requirements. Students may not begin Practica experiences until all health requirements have been met.
Students are responsible for the cost of emergency services during clinical education experiences. If students should incur an injury or needle stick, they should follow the needle stick/injury policy in the University Student Handbook. If the clinical site does not provide access to emergency services, the student (or a representative) should call the emergency response system (usually 911).
All clinical faculty, clinical facility employees or representatives, students, academic faculty or University representatives shall protect from unauthorized disclosure all information, records and data pertaining to clinical facility patients, Physical Therapy Students or to the operations, facilities and staff of Midwestern University and the clinical facility. Students must be in compliance with HIPAA regulations.
Students are expected to emulate the legal, moral, and ethical standards expected of professionals in their respective areas and display behavior that is consistent with these qualities. Students must always identify themselves as a student and not misrepresent themselves as a licensed professional. The Code of Responsibilities and Rights of the Students of Midwestern University clearly states the mode of behavior that is expected of students in a number of areas. This code covers on-campus and off-campus activities. Students are expected to read and follow this code. Students also need to be aware that a lack of professionalism may result in disciplinary action, possible failure or expulsion.
It is the policy of MWU to provide an environment that is free from harassment because such conduct seriously undermines the atmosphere of trust and respect that is essential to a healthy work and academic environment. (The complete MWU policy concerning Harassment may be found in the MWU Student Handbook, section H).
Clinical practice in each facility is governed by state law, which varies from state to state. Students must become familiar with the physical therapy practice acts in states in which they will be doing Practica prior to starting the clinical experience. Clinical facility and University educational responsibilities are defined in legal clinical affiliation agreements between the institutions. Students are responsible for following the rules and regulations of the facility during Practica.
All patients have the right to refuse care provided by a P.T. student. Any refusal or declination must be honored by the clinical instructor (CI) and student.
Students' interactions with patients, their peers and others must be guided by the fact that they are not licensed physical therapists. P.T. students are not to render patient care and/or service except as such are identified for educational value and such activities are conducted within the context, guidelines, and regulations of academic coursework or clinical practica when the student is supervised by a licensed physical therapist. Students performing physical therapy evaluation or treatment outside of these guidelines may be subject to legal action for practicing physical therapy without a license.
Students are expected to consider the impact of their behavior on the safety of others at all times. The clinical facility may dismiss a physical therapy student, where, in the opinion of the clinical facility, the physical therapy student's behavior is an immediate threat to the health and well-being of the clinical facility or its patients. The clinical facility is encouraged to provide the University 24 hours notice prior to dismissal of a physical therapy student.
Students are not allowed to negotiate for, nor accept, payment for patient services provided during Clinical Practica. Some facilities, however, may choose to provide the student with a small stipend to help defray tuition and housing costs. The DCE must be notified of any stipend arrangements prior to a Practicum. Additionally, the student is responsible for notifying the financial aid administrator that a stipend is received. It is a federal requirement that the student disclose all sources of aid that are utilized to assist with the costs of attending school, including living expenses. This stipend will be listed as a part of the total financial resources available for paying for the education.
Students earn a grade of "Pass (P)" or "Failure (F)" for Practica I-IV. Clinical faculty document student performance; the University determines the student's grade. To earn a grade of "Pass," the student must satisfactorily demonstrate safe, ethical, legal, and effective clinical performance (given academic preparation); complete all assigned projects; and submit all required documentation. Required documentation includes the APTA Student Evaluation of Clinical Experience, Physical Therapist Clinical Performance Instrument (CPI) completed by student and clinical instructor, Weekly Planning Summaries, Staff Development Project Feedback Form, and any other assigned materials.
In the event the student receives a grade of "Failure (F)" or "Incomplete (I)" for Practicum I, II, III, or IV, the student will be required to meet the course objectives by completing a remedial program/course of study/clinical experience designed and documented by the DCE. The Student Academic Review Committee of the Physical Therapy Program shall review the academic progress of the student in accordance with the regulations described in the Midwestern University Student Handbook. Not more than one opportunity to complete a remedial program/course of study/clinical experience will be permitted per practicum. Scheduling of a remedial clinical experience is subject to availability.
Remediation must be satisfactorily completed before the student can participate in the subsequent Practicum. Failure to satisfactorily complete the prescribed remedial program/course of study/clinical experience within the specified time frame will result in a grade of "F."
The Doctor of Physical Therapy Program is a continuous full-time program, extending 34 months from matriculation to graduation. The maximum allotted time for completion of the Doctor of Physical Therapy program is 51 months. Students must satisfactorily complete all Practica requirements within this time period.
During each Practicum (I, II, II, and IV), students will be required to prepare and present a mutually agreeable staff development activity related to the clinical practice of the facility. During Practicum I, the staff development activity should take the form of a review and analysis of an article in a peer-reviewed professional journal. Options during Practicum II may include review and analysis of articles in peer-reviewed professional journals, review and analysis of a patient education program, case studies, literature reviews, and specific topic presentations. Clinical instructors and/or center coordinators of clinical education will provide the student with feedback including organization of the activity, delivery of the activity and the ability of the student to field questions related to the activity. During Practicum II, students will also be required to complete a project on underserved populations or cultural issues related to the population served by the clinical facility. For Practica III & IV, the activity will be in the form of an evidence-based presentation to address a question posed by the student and staff at the facility. See the specific project description for details.
"Make-up" experiences will be arranged only under exceptional circumstances. A "make-up" clinical experience is defined as a rescheduled clinical experience due to an excused absence for all or a significant portion of a scheduled Practicum. It is the sole responsibility of the student to inform the DCE in writing when a personal, medical, or other situation exists or is expected to exist which will result in an inability to fully participate in a Practicum during the regularly scheduled time period. Requests for an excused absence and rescheduling of a Practicum must be made in writing to the DCE as soon as possible and must include acceptable and adequate documentation to support the request. The DCE and Program Director shall consider each request on its individual merits, and all decisions for approval or denial shall be final. The scheduling of any make-up clinical experience, if approved and available, shall be the responsibility of the DCE. Any costs, which are a result of the rescheduling of a clinical experience, shall be the sole responsibility of the student.
Each student is required to complete the assigned Health Professionalism I Field Experiences and 40 hours of clinical practice per week during full-time Practica I-IV. Health Professionalism I Field Experience hours will be scheduled by the DCE. Clinical hours during full-time Practica for the student are determined by the clinical facility. Potential hours may include 12 hour work days, evening hours, and weekend hours. Time spent in clinical practice is important to the student's professional development. Missed hours will be indicated on the Practicum evaluation tool. Students and clinical faculty should adhere to the following policy if illness, personal emergency, personal incapacitation, or other exceptional problems of a serious nature causes a student to be absent from required hours of clinical experience.
The student must inform both the Clinical Instructor and the DCE when one or more days of the clinical experience are missed.
When clinical practice time is missed, students are expected to make up the time missed. Options may include extended workdays and/or weekends with adequate supervision within the time period specified for the Practicum unless other arrangements have been confirmed in writing between the clinical facility and the University. Missed time not made up will be indicated on the Practicum evaluation tool. If missed time exceeds that which can be made up at the clinical facility, then refer to the Make Up Policy section.
Any exception to this attendance policy is at the discretion of the DCE.
Any student who becomes ill and is unable to attend any portion of clinical practice must notify his/her Clinical Instructor and the DCE as early as possible on EACH day when he/she is absent. Extended absences beyond 3 days will require verification of illness from a physician and a physician's release to return to the clinical facility. If missed time due to illness exceeds that which can be made up at the clinical facility, then refer to the Make Up Policy section.
The DCE should be notified immediately of any injury incurred by a student during Practicum hours that requires medical care. Emergency medical care will be provided to the student by the facility at the student's expense.
Students will be required to attend Practica on holidays if the clinical facility requires the employees to work on the holiday.
Should the student find it necessary to request time off for exceptional circumstances, he/she is expected to make any such requests as early as possible to the DCE and each individual facility.
The DCE will make a decision to approve or deny this request for time off. It is NOT ADVISABLE for a student to make any plans to take time off prior to receiving approval first from the DCE, and subsequently, from the clinical instructor, and center coordinator of clinical education.
The public and health care providers recognize certain types of apparel as being "professional." The professional attire policy is to remind students that their role in health care is of a professional nature. It will assist students in presenting themselves as professionals in the medical community and as appropriate representatives of Midwestern University. The professional attire policy has been developed in consideration of comfort and ease of care as well as the conveyance of a professional atmosphere. Common sense should rule grooming style and technique. Students are expected to adhere to the professional attire policy during all Field Experiences and Practica. Failure to observe the professional attire policies may result in the student being asked to leave the premises. Habitual violators are subject to review and action by the appropriate college Student Promotions Committee.
Self directed learning is key to building a successful career. Students must take responsibility for attaining and maintaining skills during their clinical experiences and throughout their professional careers. A key component to successful Practica is the willingness to accept the responsibility of directing one's own learning.
Students may enter into their Practica believing that they will passively absorb everything that they need to learn through observation and practice. However, it is imperative for students to take a more active role in providing direction for their individual learning experiences. Reading, study, discussion and reflection are indispensable and should be done daily. Frequent experience in evaluation, treatment and follow-up will provide the student with depth of understanding and technical proficiency. Students will need to take responsibility for monitoring the types of learning experiences to which they are being exposed. It is important to achieve a balance between managing the frequently occurring and the less common conditions for which physical therapy services are provided.
Students may also have the opportunity to act as a team with another PT student from this program or another PT program during some or all of their Practica. Students will be expected to participate in and facilitate the learning of their fellow PT students. PT students are strongly encouraged to seek out opportunities to interact with OT, PTA and other health profession students when opportunities arise. Establishing early links with the other health professionals will help to prepare the PT student to refer appropriate clients for their individual services.
Midwestern University Physical Therapy Program will utilize the following criteria when considering potential clinical education sites:
Criteria (based on APTA Guidelines and Self Assessment for Clinical Education)
The DCE(s) are the course coordinators for all Clinical Education Practica and are responsible for all aspects of the courses. The DCE(s) are responsible for recruiting sites, establishing legal clinical affiliation agreements, assigning students to sites, and providing grades based on information from the clinical sites and completion of all coursework. The DCE(s) serve as the liaison between the Midwestern University Department of Physical Therapy and the clinical education sites, and are responsible for the development and implementation of the clinical education program.
The DCE(s) work with the students to provide information, consultation, and facilitation of appropriate clinical site selection. The DCE(s) communicate with the students, CCCE, and CI prior to, and during each clinical education experience to provide support and to foster a positive clinical education learning experience.
The Center Coordinator of Clinical Education (CCCE) is responsible for coordinating assignments and activities of students at a clinical education site. Most often, a physical therapist or physical therapist assistant is designated as the CCCE; however, nonphysical therapy professionals may possess the skills to organize and maintain a clinical education program.
Duties of a CCCE are to:
The Clinical Instructor (CI) is the physical therapist responsible for instruction, supervision, and evaluation of the student at the clinical education site. One year of clinical experience is preferred as minimal criteria for serving as the CI. At some sites, more than one CI may share a student (2:1 model), or one CI may supervise more than one student (1:2 model).
Guidelines for Clinical Instructors (based on the APTA Guidelines and Self-Assessment for Clinical Education - 2004 Revision)
The CI demonstrates:
In appreciation of the time, effort, and support our clinical education sites provide to the physical therapy community of Midwestern University, Midwestern University's Physical Therapy Program is pleased to be able to offer the following benefits to clinical facilities who serve as clinical education sites:
Clinical educators may access the Midwestern University Library website from an offsite location via a special login and password. Please contact the DCEs for more information.
Clinical sites will have the opportunity to send their staff to continuing education courses sponsored by Midwestern University at a reduced tuition fee. Courses are usually offered in the spring and fall of each year.
Midwestern University's Department of Physical Therapy will offer 3 scholarships per year for CCCE or CI attendance at an APTA sponsored Clinical Instructor Training Course. Requests for scholarships will be submitted to the Director(s) of Clinical Education and will be considered in the order that they are received.
American Physical Therapy Association. A Normative Model of Physical Therapist Professional Education: Version 2004. Alexandria, VA. 2004.
American Physical Therapy Association. Guidelines and Self-Assessment for Clinical Education. Alexandria, VA. 2004.
American Physical Therapy Association. Guide to Physical Therapist Practice - Second Edition. (January 2001, Revised 2003).
American Physical Therapy Association. Physical Therapist Clinical Performance Instrument. Alexandria, VA. 1998.
American Physical Therapy Association. Reference Manual for Center Coordinators of Clinical Education. Alexandria, VA. 2004.
Commission on Accreditation in Physical Therapy Education. Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists. (Adopted October 26, 2004 and effective January 1, 2006; Revised 10/05).
Midwestern University Catalog, Downers Grove, IL 2006-2007.
Midwestern University Student Handbook, http://www.midwestern.edu/.