FOUNDATIONS OF TEACHING AND LEARNING

Student As Learner and Teacher in Clinical Education

Student as a Learner

How Do You Learn?

How do you learn?

Definition of Learning: the process of gaining information, changing behavior, acquisition of new skills, and affective skils.

Process of Learning Trial & Error Conditioning Imitation: pt. and PT Experimental: theroize Primarily Cognitive (need Affective and

Psychomotor)

How do you learn? Pedagogy vs Androgogy

First time learning Didactic with responsibility on learner Emotional Intelligence

Domains of Learning Cognitive Psychomotor Affective

Learning Styles

Adult Learner –Is this you?

Independent Prefers Participation Seeks Relevance Utilizes Past Experience Problem Oriented Open to Learning (Readiness) Tolerates Ambiguity (More than one

answer)

Objectives of the Module

Review Definitions, Roles, Responsibilities of ADCE, CCCE, CI

CI / Student Relationship Communication Methods Feedback Tools

Factors for Becoming a CI Appreciate the Role of the CI Consider Future Role as a CI

Definitions, Roles, Responsibilities Relevance

You are a current consumer Make the most of your clinical

education experiences Understand how your performance

will be evaluated You are a future provider of clinical

education

Definitions, Roles, Responsibilities “The Stage”

The Environment What is present at the facility Physical setting Personnel (administrative, professional

staff, support staff)

Definitions, Roles, Responsibilities“The Players”

Academic Coordinator of Clinical Education (ACCE)

Associate (Academic) Director for Clinical Education (ADCE)

Center Coordinator of Clinical Education (CCCE)

Clinical Instructor (CI) Student

Definitions, Roles, ResponsibilitiesACCE/ADCE

Definition: Person employed by the university

whose primary concern is relating the students’ clinical education to the curriculum

Roles: Administrator, educator, facilitator,

coordinator, problem solver, decision maker

Definitions, Roles, Responsibilities ACCE/ADCE Responsibilities

Communicates between academic institution and clinical education sites

Clinical education program planning, implementation and assessment

Develops new clinical education sites Provides clinical faculty development Schedules clinical education affiliations Manages student assignments to clinic Monitors student progress

Definitions, Roles, Responsibilities ACCE/ADCE Responsibilities

Assists students and clinical faculty with problems

Individualizes clinical education for students as necessary

Develops remediation plans as necessary

Decides when students have satisfactorily completed clinical education

Definitions, Roles, ResponsibilitiesCCCE

Definition: Person at each clinic site who

coordinates and arranges the clinical education for the students and also the one who communicates with the ADCE and faculty at the school

Role: Administrator, educator, coordinator,

facilitator, problem solver, decision maker

Definitions, Roles, Responsibilities CCCE Responsibilities

Oversee the clinical education program at the facility

Serve as liaison between university and facility

Prepare CI(s) for their role Communicate information to CI(s) Facilitate student /CI communication Assist the CI in problem solving Update the clinical education program

yearly Stay current with developments in clinical

education

Definitions, Roles, ResponsibilitiesCI

Definition: Person who is responsible for the direct

instruction and supervision of the student in the clinical education setting.

Role: Clinical teacher, clinician, facilitator,

coordinator, evaluator Work under their license

Definitions, Roles, ResponsibilitiesCI Responsibilities

Plan meaningful learning experiences to promote student achievement of objectives

Supervise and evaluate the student Be available to meet with the student

for daily discussions Meet with the CCCE primarily during

terminal affiliations

Definitions, Roles, Responsibilities CI

Be vigilant of patient and student safety at all times

Develop a learning contract with the student if applicable

Work with the clinical education team (ADCE, CCCE, and student) if challenges arise

Take full responsibility for all patient care related actions of the student

Definitions, Roles, ResponsibilitiesStudent

Definition: Learner…the person whose behavior is

expected to change

Role: Physical Therapist – Novist Clinician Colleague Teacher Evaluator

Definitions, Roles, ResponsibilitiesStudent Responsibilities

Meet all general, specific, and personal objectives for the clinical experience

Perform all duties expected of a physical therapist with the degree of competence expected for the level of the course

Adhere to all departmental policies and procedures

Evaluate self, experience, CI, facility, and academic preparation

The Clinical Education Sequence

Fall Winter Spr/Summer

Year 1Clin Observation

Intro to Clin Practice

Year 2Clin Ed II

Year 3Clin Ed III Clin Ed IV

Clin Ed VClin Ed VClin Ed VI

Any Questions?

CI/STUDENT RELATIONSHIP

Observe Assist Team patient care Supervised patient care “Independent” patient care

CI/STUDENTCommunication

Orientation Patient Planning Feedback to students

Immediate – Daily – Weekly Mid placement formative evaluation Final placement summative evaluation

Feedback to CI(s) Informal Formal

CI/STUDENTCommunication

Constructive Criticism Appropriate Non-verbals Setting expectations Admitting weaknesses Self assessment Conflict Resolution Ownership/Solutions Initiation

CI/STUDENTCommunication

KEY TO SUCCESS:

COMMUNICATION!!!!!

Effective Communication

Active listening Clarifying intent of communication and

thus conveying meaning Assertiveness versus aggressiveness

Professional Boundaries (Purtillo)To main communication on a

professional basis

Cliche conversation Very general

Almost nothing personal “TMI”

Personal ideas & judgment May be offensive

Feelings & emotions Professional maintain emotions to the best

of their ability Peak communication

Right place, right time

CI/STUDENTFeedback Tools to Assist

Communication

APTA Code of Conduct Generic Abilities APTA Core Values Clinical Performance Instrument (CPI) –

Entry Level 3. Demonstrated professional behavior during

interactions with others 6. Communicates in ways that are congruent

with situational needs 15. Educates others (pt, family, caregivers,

staff, students, other HCW) using relevant and effective teaching methods

CI/STUDENTFeedback to the UniversityTo Assist Communication

Surveys Exit interviews Site visits Individual student performance evals Community Advisory Committee Informal from colleagues

Interactions with CI/Student

Appropriate professional boundaries See previous slide

Addressing CI, patients, staff Title Formality Roles

Role as Student During Clinical Education Experiences

Clarifying expectations with clinical instructor

Goals and objectives Culture of clinical setting Expectations of clinical instructor Dealing with differences between

student and clinical instructor Feedback

Constructive

What are the characteristics of a good CI?

CI CHARACTERISTICSStudents’ Perspective

Good clinician Collegial Good communicator Informs student of expectations Open to student’s ideas Is organized Gives frequent feedback (both + & -) Good sense of humor Good teacher Lets student “try their wings”

CI CHARACTERISTICSClinicians’ Perspective

Enthusiastic Good sense of humor Challenges in supportive way Gives feedback (both + & -) Excellent clinical skills Takes time with the student Negotiates supervision with student Orients student to facility and community Considers students’ needs and expectations

Appreciate the Role of the CI

Welcomes you into their facility Fear of not giving the student what

they need Fear of conflict Longer hours, more work and NO PAY Fear of the unknown May not live up to students’

expectations

Why would anyone want tobecome a CI?

Appreciate the Role of the CIWhy take a student?

Enhances your learning Gives new perspective on field of PT Sharing information Indirect Physical Therapy Gratification to know you had an

integral part of developing a future physical therapist

Networking

STUDENT AS A CLINICAL TEACHER

How do you know you are ready? Experience Capacity Interest Credibility Availability Ability to assess the performance of others Capable of occasional difficulty

conversations

APTA Website: CI Self Assessment

Case #1

At midterm, student is told they use the cell phone too often, chew gum during patient care, don’t come prepared with homework (look up medical diagnoses of pt case’s for next day)

What T & L principles could have been use to facilitate the learning – and in the long term plan, the outcome?

Case #2 The student has been identified as

not being able to measure ROM of peripheral joints when the patient is in modified positions from standard position, cannot remember MMT positions and resistance, and does not recall special tests for orthopedic pt populations.

What T & L principles could have been use to facilitate the learning – and in the long term plan, the outcome?

Case #3

The CI has reviewed definitions of physical assistance with the student numerous times. The student keeps mixing up the definitions during documentation.

What T & L principles could have been use to facilitate the learning – and in the long term plan, the outcome?

Case #4

The student is in the acute care setting and keeps missing important orders that are precautions or contraindications for the physical therapy examination and/or intervention.

What T & L principles could have been use to facilitate the learning – and in the long term plan, the outcome?