Background and Purpose. The assessment of physical therapist student competence in the clinical learning environment is valuable and necessary. However, educators and clinicians are becoming increasingly disenchanted with their chosen assessment tools and delivery platforms. The profession recently called for a pursuit of excellence that includes an analysis of performance evaluation practices and consideration of assessment tools. In line with this call, the purpose of this report was to disseminate one academic institution's exploration, implementation, and early outcomes of the transition from the Clinical Performance Instrument (CPI) to the Clinical Internship Evaluation Tool (CIET) for full-time student clinical performance assessment. Case Description. After identification of key stakeholders, the authors completed an initial exploration and comparison of CPI versus CIET, executed a pilot trial of CIET use, and implemented a transition from CPI to CIET for all full-time clinical experiences. Outcomes. This report presents the outcomes of the initial exploration and comparison of assessment tools, the CIET pilot, the academic processes in transitioning to the CIET, and the post-implementation evaluation results, each with consideration of unique stakeholder perspectives. Discussion and Conclusion. The transition from CPI to CIET for full-time student clinical performance assessment was successful in meeting the needs of key stakeholders. This report presents the first known addition to the literature regarding CIET implementation since the original institution's publications. Ongoing use and evaluation of the CIET and other alternative tools for student performance assessment, both within and across institutions, is necessary to address the profession's pursuit of excellence and to better meet the demand for contemporary educational practices in the clinical learning environment.
Purpose: The coronavirus disease-2019 (COVID-19) pandemic has resulted in an influx of critically ill patients requiring mechanical ventilation, some receiving venovenous (VV) extracorporeal membrane oxygenation (ECMO). The benefits of early mobility while undergoing ECMO have been previously documented. However, the COVID-19 pandemic has presented physical therapists with novel challenges, balancing the risk of a widespread shortage of personal protective equipment (PPE) with the benefits of early mobility for patients on ECMO. The purpose of this case study is to report the successful rehabilitation of a critically ill patient with COVID-19 undergoing VV ECMO. Methods: This is a case description of a 38-year-old man who presented to the hospital with COVID-19 and subsequent intubation and cannulation for VV ECMO. Physical therapy was initiated while the patient remained critically ill on VV ECMO. Focused coordination and education were employed to limit PPE usage by limiting the number of essential staff/therapists that entered the room as well as changing the frequency of therapy sessions dependent on how the patient was progressing functionally. Results: On VV ECMO day 11, he was able to sit up and perform a sit-to-stand. ECMO decannulation occurred on hospital day 14 with extubation on hospital day 18. The patient progressed functionally while quarantined in the room until he was discharged home with supplemental oxygen after spending 29 days in the hospital. Conclusion: This case study demonstrates the clinical decision-making used to provide physical therapy services for a critically ill patient with COVID-19. High-level team coordination resulted in limiting the use of PPE as well as reducing staff exposure frequency during rehabilitation. Despite his severe critical illness, the patient was successfully discharged home within 30 days.
Current issue: Clinical instructors (CIs) are instrumental in the development of competent, entry-level physical therapist graduates. Despite this key role, CIs are often deficient in formal knowledge of the learning sciences that influence quality of clinical education experiences. Clinical education stakeholders also lack a standardized and consistent approach to defining and assessing clinical teaching skills, resulting in an inability to provide adequate feedback and growth opportunities for CIs. Perspective: A gap exists between qualitative descriptions of clinical teaching behaviors and the ability to objectively assess those behaviors in CIs. Grounded in the Model of Excellence in Physical Therapist Education, this perspective calls attention to and proposes steps toward excellence in clinical education. Defining essential competencies of clinical teaching in the physical therapy profession requires a systematic approach. The competencies established through this approach then become the foundation for creating a meaningful assessment tool of CI performance. Implications for clinical education: Developing educator competencies and a related assessment tool for CIs allows for the provision of meaningful feedback, the creation of targeted professional development programs, and opportunities for recognition of clinical teaching excellence. Without effective CIs, new graduates may be inadequately equipped to contribute to the profession’s vision of educational excellence.
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