Transcript Two-week Clinical Experience (January 7 – 18, 2007)

Two-week Clinical Experience
The Collaborative Model
Purpose of PTS 651:
Provide practice time for basic skill
acquisition in a collaborative setting
Collaborative Learning Principles:
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Principles of collaborative learning
(Johnson & Johnson, 1991)
◦ Students actively seek out knowledge, guided
by the Clinical Instructor
◦ Takes place within a cooperative context - no
competition among students!
◦ Students take responsibility for their own and
each other’s learning
Evidence:
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Research on collaborative learning indicates
that students: (Baldry, 2003; Johnson, Johnson & Smith,1998; Johnson &
Johnson, 1990)
◦ achieve at a higher level
◦ apply reasoning strategies more frequently
◦ are more motivated
◦ exhibit more confidence
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Successful in medical, nursing, and
occupational therapy, as well as physical
therapy education
Team Building Behaviors:
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Collaborative learning requires that students:
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work in teams
communicate with each other effectively
become adept at giving feedback
become adept at receiving feedback
(Cohn et. al, 2001)
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Team Building Behavior
 Students are expected to provide each other with
feedback regarding effective teamwork behaviors
◦ self assessment form
◦ peer assessment form
Early Clinical Learning Assumptions:
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Practice needs to occur with real patients,
but not in “real time”, because students
need to “process” what they are learning.
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Learning requires observation and
feedback. Students can learn from
observing and providing feedback to each
other with guidance from the Clinical
Instructor.
And…
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Not all learning needs to be supervised.
Some learning units may be completed
during non-patient care time. However, all
practice sessions involving patients are to
be supervised by a PT.
Structure:
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Only students in good academic standing
are eligible to enroll in clinical education
experiences
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Groups of 2-4 students per Clinical
Instructor
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Practice skills previously acquired in the
classroom
Student Responsibilities:
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Maintain confidentiality and adhere to facility’s
policies & procedures
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Complete 10 learning units (see syllabus)
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Practice self/peer assessment (see
assessment tool) and seek feedback from
CI
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Demonstrate beginning level of clinical
professional behaviors and work on
developing level skills
And…
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Interact effectively with peers, CI and coworkers to maximize learning (see team
building behaviors)
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Acknowledge that CI is primary care
provider who delegates to the student
Structure time and demonstrate initiative
in independent learning with peer(s)
 Identify & access resources needed for
learning units
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Clinical Instructor Responsibilities:
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Serve as a resource for students
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Assume responsibility for patient/client care
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Identify appropriate clients suitable for
students’ skill practice
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Be familiar with the learning units
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Provide clear and concise feedback
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Contact UW-La Crosse faculty immediately
should issues arise
UW-L Faculty Responsibilities:
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Ensure student competency prior to clinical
placement
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Serve as a liaison between clinical facility,
student and university
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Be available for questions or guidance
Learning Units:
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Each student must complete 10 out of 15
learning units:
◦ Units 1-4 are required
◦ Units 5-15: any 6 units are to be selected by
the CI
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Assessment forms are completed by
student and peer
◦ CI only “signs off” that skills were completed
Unit 1: Medical Chart Review
Required unit
 CI may create a collaborative activity
 Example of skill practice:
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◦ Each student reviews the same chart, making note of
what they think is important information. Both
students discuss their findings and “fill in” each other’s
“gaps.” Together, both students present their
combined findings to the CI, who provides feedback
or encourages further exploration with guiding
questions.
Unit 2: Medical History
Required unit
 CI may create a collaborative activity
 Example of skill practice:
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◦ Students collaborate to develop a list of
questions for collecting a subjective history
from a patient. Then one student interviews
the patient, while the other student considers
peer’s effectiveness, SPT & patient non-verbal
messages, or additional questions that would
have been helpful. Together, both students
discuss and seek feedback from CI.
Unit 3: Documentation
Required unit
 CI may create a collaborative activity
 Example of skill practice:
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◦ Following observation of an intervention by
the CI, both students write their own SOAP
note on loose paper – trying to catch all the
pertinent information. Next, students
collaborate to develop a “better” note. Finally,
CI offers feedback regarding strengths and
areas needing improvement in their SOAP
note. (Need not become part of chart.)
Unit 4: Physiological Status
Required unit
 CI may create a collaborative activity
 Examples of skill practice:
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◦ Students take BP and HR measures of staff in
therapy department.
◦ Students identify medications in patient charts
that indicate or influence BP or HR issues.
◦ While observing interventions by CI, students
make note of the patient’s physiological
responses such as color, perspiration,
respiration, etc.
Unit 5: ROM Measurement
Optional skill per CI choice
 CI may create a collaborative activity
 Example of skill practice:
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◦ Students work together to measure ROM
needed for functional mobility, such as:
climbing stairs, opening doors, getting dishes
out of cupboard, getting out of chairs, getting
into cars, etc.
Unit 6: Strength Measurement
Optional skill per CI choice
 CI may create a collaborative activity
 Example of skill practice:
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◦ Students perform MMT as delegated by CI,
providing each other with feedback regarding
technique and communication.
Unit 7: Posture Assessment
Optional skill per CI choice
 CI may create a collaborative activity
 Examples of skill practice:
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◦ Students observe patients in the waiting
room, making note of postural
problems/concerns.
◦ Students observe neighbors shoveling snow,
making note of postural concerns.
Unit 8: Gait Assessment
Optional skill per CI choice
 CI may create a collaborative activity
 Examples of skill practice:
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◦ Students observe hospital staff in the hallways,
noting gait deviations.
◦ Students observe orthopedic patients
entering the clinic and, without knowing the
involved limbs/joint(s), try to make predictions
regarding impairment(s).
Unit 9: Neuro Examination
Optional skill per CI choice
 CI may create a collaborative activity
 Examples of test & measures:
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Cognition
Coordination
Tone
Cranial Nerves
Balance
Sensation
Proprioception
Unit 10: Heat & Cold
Optional skill per CI choice
 CI may create a collaborative activity
 Examples of skill practice:
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◦ Students administer heat or cold modalities as
delegated by CI, providing feedback for
technique, skin inspection, and patient nonverbal communication.
Unit 11: Electrical Stimulation
Optional skill per CI choice
 CI may create a collaborative activity
 Examples of skill practice:
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◦ Students administer electrical stimulation as
delegated by CI, providing feedback for
technique, skin inspection, and patient nonverbal communication.
Unit 12: Other Providers
Optional skill per CI choice
 CI may create a collaborative activity
 Examples of skill practice:
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◦ Students shadow OT, SLP, Neuro-Psychology,
Respiratory Therapy, etc.
◦ Students select a patient who receives
multiple services, then identify which
impairments/functional limitations each
discipline addresses.
Unit 13: Cost of Care
Optional skill per CI choice
 CI may create a collaborative activity
 Examples of skill practice:
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◦ Students interview social worker regarding
funding sources for care and equipment.
◦ Students interview billing specialist regarding
billing process, reimbursement barriers,
productivity standards, etc.
◦ After observing intervention by CI, students
determine total charges for that visit,
including patient co-pay.
Unit 14: Patient Report
Optional skill per CI choice
 CI may create a collaborative activity
 Examples of skill practice:
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◦ Students develop early clinical decision
making skills by using data from patient
examination to consider possible diagnosis,
prognosis and plan of care.
Unit 15: Optional Unit
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Clinical instructor may develop a
collaborative activity based on:
◦ Learning opportunities unique to this site;
or
◦ Need for an alternative plan due to inclement
weather
Absences:
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Absences are allowed in the following
situations only:
 Inclement weather
 If CI concurs with student that travel would be
dangerous, the CI may create a learning unit for
students to do from home/campus
 Illness
 UW-L faculty must be notified of any absences
We truly appreciate your willingness to
support our students in their early clinical
education.
Please call or email the should any questions
or concerns arise.
Angela Binsfeld
[email protected]
608-785-8472