Transcript CI Expectations

DTCC Clinical Education
Jason A Dougherty PTA, BS
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Thank you for serving as clinical faculty.
Thank you also for providing input with
regard to what we can do to help you develop
as a clinical instructor
This has been compiled in response to
feedback from your Effective CI Self
Assessment form
Some of these suggestions are constructive
with either student experience (students who
perform above vs. below expectations)
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According to Healey, students will enter their
clinical affiliation with these expectations.
 Patient Interaction
▪ Complex and contextual learning focused on patient care
 Supportive Learning Environment
▪ Strong relationship with a clinical instructor who models
appropriate behaviors such as a commitment to the teaching
and advanced communication skills
▪ Environment allows for student self assessment and
constructive feedback during diverse clinical experience
Some students will consistently exhibit the behaviors
listed below, requiring less intervention from their
clinical instructor
 Above Expectations
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 Safe practitioner/maintains confidentiality
▪ minimal cues required
 Strong behaviors/empathy
▪ appropriate communication throughout clinical environment
 More autonomous/takes responsibility
▪ quickly progresses to greater independence with patient treatment
& clinic procedures
 Requires higher level of challenge
▪ Fear student may become bored
Some students may also consistently exhibit the behaviors
listed here, requiring greater intervention from their
clinical instructor
 Below Expectations
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 Patient Safety/Confidentiality
▪ Requires significant cues with little carryover
 Behaviors
▪ Maintains inappropriate relationship and/or inappropriate
communication with staff and patients with minimal response to cues.
Will not take responsibility for change
 Treatment
▪ Unable to apply prior teachings while offering no explanation for
decision making
 Requires a greater amount of input from CI, possibly taking
away from patient care
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These are just some
behaviors that we
would find
inappropriate
 Abrasive (disrespect)
 Inappropriate language
(vulgar/jokes, racially or
sexually inappropriate)
 Over confident (affiliation
is a waste of time)
 Distracted or unmotivated
(requires cues to do
everything, “I don’t know”)
 Argumentative
 Inappropriate dress
 Lateness or unexcused
absence
 Unprofessional (doesn’t
follow plan of care, doesn’t
complete full treatment,
procedural issues)
 Lack of preparation (fails to
complete
assignment/request)
Algorithm for Student Intervention
+ Carryover – no
longer exhibits
*No need for
follow up
Student
exhibits
behavior
Meet with CI for
constructive
input
Continue
behavior
Meet with
CCCE &
document
weekly
progress
Continue
behavior
+ Carryover – no longer
exhibits
*begin daily log
*continue to document
weekly
Meet with ACCE
Develop learning
Contract
Continue
behavior
Affiliation Terminated
+ Carryover – no
longer exhibits
*continue to
document weekly
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Both student
populations (above and
below expectations),
require some form of
additional intervention.
The following slides
contain some
suggestions for
designing the student's
experience in response
to their level of
performance.
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No matter what the
theme of your
discussion, it is vital
to maintain a positive
attitude
(+) “ You have been
doing really well, let’s
try to change your goals
to include….
 (-) “ You have met all of
your goals, I don’t know
what else to do with
you”
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Don’t assume a high
level of performance
in every aspect of
their clinical affiliation
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Example
 Great with patient care
and maintains a strong,
professional relationship
with professional staff for
5 weeks. BUT,
experiences difficulty
with in-service on their
last day because of a poor
research review or
difficulty with public
speaking
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Maintain
Communication
 Hourly, Daily, Weekly,
Midterm and Final
 Even a strong student
will need guidance
 They may confuse the
CI’s confidence in their
skills' as avoidance
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Example
 “My CI was never
available after the first
couple days”
 “My CI was always in
their office”
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Make sure student
participates in goal
setting (self directed
learning). They
should not believe
they are a passive
participant.
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Examples
 They didn’t give me
enough to do
 They didn’t offer me
anything else.
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Utilize your facility to
it’s full potential as an
educational site.
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Example
 Surgical Observation
 Observation of other
disciplines (OT, Speech)
 Care Conferences
 Community Programs
 Research Opportunities
▪ Libraries
 Shadow Physicians
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Research topics of
interest
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Examples
 Use this time to…
▪ Look up articles about a
previous question
▪ Research topics for inservice
▪ Develop a case study
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Do not shelter
student from difficult
patient interactions.
These interactions
will contribute to your
student’s growth
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Examples
 Combative patient
 Non communicating
patient
 Patient with challenging
pathology
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The remaining slides offer suggestions for
coping with students whose performance
may be below your expectations as a clinical
instructor. Please remember that you can
always contact me should you have any
concerns re: student issues.
Jason Dougherty
 302-657-5131 office / 302-884-9431 pager
 [email protected] /
[email protected]
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Remind student that
their learning should
be self directed
 Discuss goals together
▪ Are student and CI goals
similar (expectations)?
 Clinical setting has
shifted from learner
based to knowledge
based
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Example/Suggestion
 Avoid hearing, “you didn’t
show me…”. Instead ask
the student, “what do
you expect” or “what
would you like to
accomplish”
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Don’t hesitate to
provide constructive
input
 Don’t forget the
positive/affirming
 The sooner the better
 Discuss with student
when they prefer to
discuss performance –
greater self directed
learning
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Example/Suggestion
 Provide input re:
behaviors at the end of
the day allows student to
improve tomorrow
vs.
 Wait until Friday, don’t
expect change until next
week
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Maintain positive
approach during
constructive input
 Focus on behaviors not
personal judgment
 Use cool off period if
necessary
▪ Take time to collect
thoughts and compile
succinct input to provide
to student
▪ If not succinct, impact of
input can be lost
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Example/Suggestion
 “Here is what you did
wrong…”
vs.
 “Here are some areas
that could be improved…”
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Use Diagnostic
Education
 Discuss thought process
to figure out where
“wrong turn” occurred
 Cover all domains of
learning. Explain, exhibit
& discuss, then ask
student to repeat
 Discuss patient prior to
treatment time and
suggest scenarios as well
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Example/Suggestion
 Patient scenario
▪ What are symptoms?
▪ What is causing symptoms?
▪ What can be done to quiet
symptoms?
▪ What can be dome to
alleviate future issues?
▪ Ask student to perform
intervention on CI/staff
▪ Ask student to do necessary
research prior to treatment
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Use Diagnostic
Education (cont)
 Clarifies early
misconceptions
 Ask for student input
(self directed)
▪ Ask student to use a daily
reflective journal –
another opportunity to
understand their
perspective and though
process
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Example/Suggestion
 Avoid hearing, “I thought
we were supposed to…”
or “ This wasn’t what I
wanted to do…”
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Document,
document, document
 Every time you
document constructive
input is another
opportunity for the
student to improve
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Example/Suggestion
 Weekly log
 Midterm and Final
Student Performance
Evaluation
 Learning Contract
 Meeting Minutes (with
student)
 Ask student to compile:
▪ Journal
▪ Proficiency Checklist
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Consider Environment
 Student may hesitate to
communicate in front of
others
 Student may not be
comfortable directing
input directly to CI
▪ Provide every opportunity
for them to talk
 Student may need space
for paperwork
▪ Easily distracted
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Example/Suggestion
 Change environment for
meeting
▪ Cafeteria, coffee shop,
outside
 Use third party for
communication if needed
▪ Student may fear lower grade
if they give CI constructive
input
 Provide desk, locker, shared
office
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Consider CI is always
the model for ideal
practitioner
 “Do as I say, not as I
do…”?
 Maintain continuity if
more than one CI
 Don’t take for granted
the “small stuff” – give
student every
opportunity to be
comfortable in your clinic
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Example/Suggestion
 CI must exhibit positive
attitude about PT &
teaching
▪ A 2nd CI may not display same
attitude toward PT and
teaching
▪ CI must be a willing CI, not
forced to take a student
 “Small stuff”
▪ Orient student to clinic,
equipment, paperwork and
introduce to staff
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Remind student that
we must follow legal
and ethical codes
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Example/Suggestion
 APTA
 Delaware State
 Pennsylvania State
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