The physical therapist assistant (PTA) is part of physical therapy team who provides physical therapy services under the direction and supervision of a physical therapist. The physical therapist is responsible for the services provided by the PTA when related to patient/client management. Supervision of the PTA varies per state and per setting.
Refer to the APTA document Direction and Supervision of the Physical Therapist Assistant HOD P06-05-18-26 for recommended guidelines for supervision of the PTA.
Refer to the APTA document Procedural Interventions Exclusively Performed by Physical Therapist HOD P06-00-30-36 for APTA position on interventions that a physical therapist is unable to delegate.
Refer to the APTA document Levels of Supervision HOD PO6-00-15-26 for definitions of the levels of supervision.
The Role of Clinical Education
Clinical education provides students with a way to apply their acquired knowledge to real patients in the clinical environment. The students are assigned to clinical instructors to assist in professional development and provide supervision and guidance throughout their clinical experiences. The clinical instructor serves as a role model and mentor in the clinical to assist the student with development of their professional and clinical skills. Students observe the clinical instructors everyday roles and duties to learn what is expected of them as clinicians. After the completion of the PTA program including didactic and the clinical education portion of the curriculum, students are expected to exhibit the minimum required skills of PTA.
Refer to APTA guidelines Minimum Required Skills of Physical Therapist Assistant Graduates at Entry Level BOD G11-08-09-18.
General Clinical Education Guidelines for a Good Learning Experience
- Encourage students to be active learners
- Promote self-discovery and creativity
- Allow students to correct their mistakes
- Encourage self-evaluation
- Make the student feel welcome and accepted
- Encourage openness and self confidence
- Establish a trusting professional relationship
- Coordinate learning experiences that are appropriate for the student’s level
- Set weekly goals with the students
- Increase the complexity of tasks throughout the clinical experience
- Expose the student to a variety of services as able
- Expose the student to a variety of patients and treatment
Refer to APTA document Guidelines: Clinical Education Sites HOD G06-93-27-52 for specific recommended guidelines for clinical education sites.
The Role of the Clinical Instructor (CI)
The Clinical Instructor (CI) can be a licensed physical therapist or physical therapist assistant working under the direction of a physical therapist who has assumed the responsibility of providing on-site instruction, guidance, and supervision of a student physical therapist assistant. CIs need to met standards and criteria set by the CCCE and the ACCE and are willing to provide guidance and supervision to a student. CIs coordinate activities with the CCCE and provide feedback relevant to the student’s progress to the student and ACCE. The CI role includes demonstrating and assisting in patient treatments, providing appropriate supervision for the student, ensuring patient safety, providing frequent feedback to the student, evaluating student’s performance, and discussion of the student evaluation to promote student improvement in their performance. The clinical instructor is responsible for completing the student assessment tool provided by the ACCE.
Refer to the APTA document Guidelines: Clinical Instructors BOD G03-06-21-55 for specific recommended criteria for clinical instructors.
Refer to the article, Clinical Teaching in Physical Therapy: Student and Teacher Perceptions.
Robert W Jarski, Kornelia Kulig, and Ronald E Olson
PHYS THER 1990: 70: 173-175
The Role of Center Coordinator of Clinical Education (CCCE)
The CCCE is an employee of the clinical site whose responsibility is to serve as the liaison between their employer and the University in establishing and maintaining a student clinical program. The CCCE may oversee the scheduling of students in several sites and in the assignment of clinical instructors. Their role is supervisory and administrative and acts as the CI’s first contact in the conduct of a student’s clinical experience. This is an onsite resource to a student if a circumstance arises that the student feels they cannot discuss with their CI; or if a situation has not been satisfactorily addressed by the CI. The CCCE and ACCE work in close cooperation in the delivery of the student program.
Refer to the APTA document Guidelines: Center Coordinators of Clinical Education HOD G06-93-29-52 for specific recommended criteria for CCCE.
The Role of the Academic Coordinator of Clinical Education (ACCE)
The ACCE is an employee of the university whose responsibility is to act as the liaison between University PTA program and the clinical sites. Coordination would occur between the Center Coordinator of Clinical Education (CCCE) and the ACCE in establishing and maintaining a student clinical program at the clinical site. The ACCE is responsible for scheduling students, monitoring their progress, and facilitating clinical faculty in their roles. The CI and/or the CCCE may contact the ACCE if there are any concerns involving the students. The ACCE should be contacted if the student is not progressing in a manner to successfully meet the objectives of the clinical. The ACCE can assist the student and clinical instructors in the development of a remediation plan to address those identified areas of deficiency. The ACCE would facilitate remediation for the student within reasonable limits. The ACCE is responsible for assigning a grade for the clinical experiences.
The Role of the Student
The role/responsibility of the student during their clinical experiences is to observe the physical therapy environment, gain an understanding of the roles and responsibilities of the various professionals involved, and to assist in the treatment of patients. The student will be expected to demonstrate competency and a thorough knowledge of the skills necessary to become a physical therapist assistant. The student is expected to adhere to each clinical site’s departmental policies as provided during their orientation. Appropriate legal and ethical professional behavior is expected of the student at all times. The role of the student includes maintaining professional demeanor at all times, asking appropriate questions, accepting feedback and use of feedback for development, and to set and achieve objectives. Students will be expected to seek learning opportunities, provide patient care as directed by clinical instructors, and complete necessary documentation as directed by clinical instructor.
The clinical instructor is responsible to provide the appropriate level of supervision for students in the clinical environment based upon the student’s education level, complexity of the patient, the clinical setting, state practice act, and reimbursement requirements. The students will have an understanding of the appropriate level of supervision however they will need to know what is expected from them and who will be supervising them. Physical therapist assistant students can be supervised by a licensed physical therapist and/or physical therapist assistant working under the direction and supervision of a licensed physical therapist.
APTA recently amended their position on PTA student supervision. Refer to Supervision of Student Physical Therapist Assistants HOD P06-11-09-17 for details.
APTA has resources concerning student supervision and Medicare located under Payment tab on APTA home page.
Students must not only demonstrate competent patient treatment skills, but also must develop and demonstrate professional behaviors in the clinical setting. The clinical instructors along with the academic faculty are responsible for mentoring professional development in students.
Refer to APTA position Mentoring of Professionalism in Academic and Clinical Education HOD P06-03-29-27.
The Values-Based Behaviors for the Physical Therapist Assistant describes the values that would most significantly influence the PTA when performing patient treatments as part of the physical therapy team. There are eight values-based behaviors that include altruism, caring and compassion, continuing competence, duty, integrity, PT/PTA collaboration, responsibility and social responsibility. Students are instructed on the values-based behaviors and complete the Values-Based Behaviors for the Physical Therapist Assistant Self-Assessment Tool to increase their awareness and to foster development of the behaviors. Academic faculty also completes assessments on the students and discusses the students’ progression in development of these behaviors.
Ethical and Legal Practice
All students are required to comply by all ethical and legal standards for patient/client management. The students receive education on the Standards of Ethical Conduct for the Physical Therapist Assistant which describes ethical obligations as determined by the APTA. Students are also expected to abide by the practice act of the state they are practicing in and the clinical sites policies and procedures. Students are educated on the practice acts of the states that clinical education sites are located in. CIs and CCCEs are expected to promote legal and ethical practice and mentor the students as needed to maintain all ethical and legal standards.
Refer to the APTA Guide for Conduct of the Physical Therapist Assistant that interprets the Standards of Ethical Conduct for the Physical Therapist Assistant.
Refer to the APTA document Ethical and Legal Consideration for Clinical Education HOD P06-01-16-18 for their position.
Refer to Practice Acts by States to find the practice act of the state you are located in.
Being a clinical instructor includes providing frequent feedback to students. When giving feedback it is best to be concise and direct to deliver the correct message. CIs should provide the students with positive feedback along with constructive criticism as needed to promote positive development of patient treatment skills and professional behaviors. When providing feedback, it is important to consider the time and place. Providing feedback in front of the patient is not always appropriate. Thorough out all interactions, it is best to attempt to maintain a positive student-CI relationship.
The Weekly Goal Form is a tool that can be used to establish student’s weekly expectations and to facilitate feedback. This form will promote the development of weekly goals and help to identify the student’s strengths and areas of needed improvement. This form can be found on the Penn State Fayette PTA Program website under Clinical Education Faculty Resources.