department of physical therapy · clinical placement requests 14 6. clinical education policies 20...

Department of

Physical Therapy

PHYSIOTHERAPY

CLINICAL

EDUCATION

MANUAL

2011-2012

Revised August 26, 2011

2

Contents Section Title Page

1. Organization of Curriculum 3

2. Clinical Education Course Outlines 5

3. Clinical Education Course Costs 10

4. Official Documents Required Annually 11

5. Clinical Placement Requests 14

6. Clinical Education Policies 20

7. The Clinical Education Team 26

8. SMR Clinical Education Contact Information 30

9. Appendix: 31

a) Physical Therapist Clinical Performance Instrument (CPI)

b) CPI Scoring Guidelines

c) Clinical Learning Contract

d) Clinical Placement Pass/Fail Form

e) Student Feedback Regarding Clinical Placement Form

f) End of Clinical Placement Checklist

g) Out-of-Province Clinical Placement Request Form

h) 2011-2012 Clinical Education Schedule

Section 1

ORGANIZATION OF THE BMR (PT) CURRICULUM

The Bachelor of Medical Rehabilitation in Physical Therapy [or BMR (PT)] curriculum

is comprised of academic and clinical education components. The curriculum is designed

to present a systematic, integrated and progressive study of health and disease as related

to physical therapy. The program is cumulative and students are expected to utilize

and integrate acquired knowledge at all stages of the program.

OUTLINE OF THE BMR (PT) ACADEMIC PROGRAM

Each of the three years of the program has a distinct clinical focus:

Year 1 - Basic Sciences / Cardiorespiratory

Year 2 – Neuromusculoskeletal

Year 3 – Neurosciences / Integrated Tutorials

OUTLINE OF CLINICAL EDUCATION EXPERIENCES

The purpose of the clinical education experience is to provide opportunities for students

to:

1. Integrate the skills and knowledge acquired during the academic year to the

clinical setting.

2. Develop professionally through the supervised clinical practice of

professional skills.

31 weeks of clinical education are integrated throughout the three years of the program.

In all clinical education courses, students are supervised by Clinical Instructors who are

licensed physical therapists.

IMPORTANT INFORMATION REGARDING THE 2011-12 YEAR

The physiotherapy program has received approval to transition to a two

year, entry-to-practice credential, the “Master of Physical Therapy”

(MPT) degree. Please note the following:

2011-12: There will be no intake of students into the physiotherapy

program. As a result, there will be only one class in the

physiotherapy program, the BMR(PT)2 class.

2012-13: There will be the first intake into the new MPT program.

As a result, there will be a BMR(PT)3 class and an MPT1 class.

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BMR (PT) PROGRAM STRUCTURE

ACADEMIC CLINICAL

Year 1

Basic Sciences/Cardiorespiratory September – March

Cardiorespiratory Clinical Placements PT 1740

January – March (1 x 5 weeks) Neuromusculoskeletal Anatomy REHB 1520

April – May

Year 2

Neuromusculoskeletal September – March

Neuromusculoskeletal Clinical Placements PT 2780

April – August (2 x 5 weeks)

Year 3

Neurosciences/Directed Studies September – February

Neurosciences Clinical Placements PT 3880

March – June (2 x 4 weeks)

Summer Internship PT 3920

May – August (1 x 8 weeks)

NB. All clinical education courses must be completed prior to graduation. The

complete clinical education experience is required for licensure as a

physiotherapist in all jurisdictions in Canada and other countries.

During the course of the program, students may be required to do at least one

placement in a community or rural setting outside the cities of Winnipeg and

Brandon.

CURRICULUM ADMINISTRATION

Year Coordinators oversee the timetable for the year and coordinate units within the year.

Curriculum Chairperson: Jenneth Swinamer

BMR(PT)2 Coordinator: Mike McMurray

Academic Coordinator of Clinical Education: Liz Harvey

Graduate Program Chair: Dr. Brian MacNeil

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Section 2

CLINICAL EDUCATION COURSE OUTLINES

YEAR I

*************** (NB: THERE IS NO PT1 CLASS IN 2011-2012) ***************

COURSE PT 1740 CARDIORESPIRATORY CLINICAL EDUCATION

Credit hours: 8

Course Content: The course is divided into two units: Unit i) Introduction to Clinical

Education, and Unit ii) Cardiorespiratory Clinical Placement. Each unit is evaluated

separately. Each student must pass Unit i) before proceeding to Unit ii). Each student

must successfully complete both Unit i) and Unit ii) in order to pass the course overall.

Unit i) Introduction to Clinical Education

This unit involves:

1. Preparatory sessions to prepare students for the clinical education component of the

physical therapy program by providing basic knowledge, skills, attitudes and

behaviours generic to participation in client-care.

2. Site visits to five community and clinical locations to expose students to the broad

range of environments and resources associated with the practice of physical therapy.

The visits are appropriately sequenced with the other academic courses, enabling

students to consolidate and integrate their developing foundational knowledge and

skills, professional attitudes and behaviors through guided observation, questioning

and general participation in professional settings. As the visits are distributed across

term 1 and into term 2 of the first year of the program, the tasks assigned to students

progress from simple to more complex, reflecting their increasing understanding of the

practice of physical therapy as they advance through the year.

3. Reflection activities involving written and group discussion exercises. These activities

are designed to develop students’ ability for self-reflection, a skill considered essential

in their evolution as effective practitioners during the program and in subsequent

professional life. Each student’s set of written reflection exercises will become

foundational items in his/her own portfolio.

Unit i) Objectives

Upon successful completion of this unit, students will be able to:

1. Describe the organization and evaluation of clinical education throughout the program,

including the sequencing of clinical visits and placements.

2. Access information regarding the required immunizations and the option of obtaining

and managing these through the Bannatyne Immune Status Program.

3. Meet the minimum immunization requirements of the clinical sites involved in the

provision of clinical visits and placements to the program.

4. Discuss the role of the College of Physiotherapists of Manitoba and the responsibilities

associated with inclusion on the Student Register.

5. State their responsibilities under the PHIA legislation.

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6. Perform routine practices effectively and explain basic concepts in controlling

transmission of infection.

7. Navigate a medical chart by being familiar with its organization and content.

8. Visit community and clinical settings (outside the university) and meet practicing

professionals and their clients with increased confidence.

9. Gather and present information regarding local health care related services and

resources.

10. Describe observed clients’ problem lists in terms of the “ICF” categories of

impairment, activity limitation, participation restriction and environmental factors.

11. Discuss the level of “Client Centered Practice” they observed at a variety of health

care settings.

12. Complete the first three steps of the “Clinical Decision Making Process” on an actual

client in a health care setting.

13. Carry out self-reflection regarding their learning and experiences, and share these

perceptions both in writing and with others in a group setting.

14. Build the clinical education portion of their portfolio.

Unit ii) Cardiorespiratory Clinical Placement, consisting of 1 X 5 week clinical

placement during one of the following time slots:

Rotation 1: N/A

Rotation 2: N/A

Unit ii) Overview

This unit consists of a five week clinical placement in a patient-care setting which will

provide students with the opportunity of managing clients utilizing a variety of

cardiorespiratory competencies learned during the academic portion of the year. Students

will be under the supervision of clinical instructors who are licensed physical therapists.

Sites include a variety of facilities / agencies and community settings.

Unit ii) Objectives

During this unit, students will have the opportunity to:

1. Integrate the skills and knowledge acquired during the academic block, to the clinical

setting.

2. Gain experience in the team concept of health care.

3. Develop professionally through the supervised clinical practice of professional skills.

4. Develop an awareness of the environmental factors influencing patient care.

5. Develop an ability to assess patients, plan and implement treatment programs.

6. Develop powers of reasoning and judgment in relation to clinical decision making

7. Develop a sense of professionalism by adherence to the Physiotherapy Code of Ethics.

8. Develop self-evaluation techniques.

9. Be exposed to, and if possible, participate in research programs.

10. Develop knowledge and ability in communication methods.

11. Understand the various aspects of physiotherapy practice (e.g. acute care, long term

care, community care).

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Learning Contracts

Students are to develop a learning contract in conjunction with their Clinical Instructor in

the initial stage of their placement to identify their goals for that placement. The

clinical/practical experience will vary from setting to setting in accordance with the needs

of the patient/client population.

Evaluation

Student will be evaluated using the CPI provided by the Department of Physical Therapy,

School of Medical Rehabilitation. The course is graded on a pass/fail basis. The Clinical

Instructor has the ultimate responsibility for assigning the course score.

YEAR 2

COURSE PT 2780 MUSCULOSKELETAL CLINICAL EDUCATION

Credit Hours: 10

Course Content: 2 x 5 week clinical placements in two of the following time slots:

Rotation 1: April 2-May 4, 2012

Rotation 2: May 7-June 8, 2012

Rotation 3: June 11-July 13, 2012

Rotation 4: July 16 – August 17, 2012

Rotation 5: (Football only): July 23-September 21, 2012

Objectives

During this placement, students will be able to:

1. Assess and treat clients whose primary diagnosis is related to musculoskeletal

disorders.

2. Integrate the skills and knowledge acquired during the neuromusculoskeletal

academic block within the clinical setting.

3. Develop the ability to safely, effectively and efficiently assess, plan and implement

treatment programs for clients with a variety of neuromusculoskeletal pathologies.

4. Develop powers of reasoning and judgment in relation to clinical decision making.

5. Develop professionally through supervised clinical practice and adherence to the

Physiotherapy Code of Ethics.

6. Develop proficiency in effective verbal, nonverbal and written communication with

clients and other professionals.

7. Develop an awareness of the role of interprofessional approaches to health care,

where possible.



10. Be exposed to, and if possible, participate in research programs.

11. Develop an appreciation of the wide range of physiotherapy practice settings (e.g.

acute, long term, ambulatory and community care, and private practice).

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Learning Contracts


the initial stage of their placement to identify their goals for that placement. The

clinical/practical experience will vary from setting to setting in accordance with the needs


Evaluation




YEAR 3

*************** (NB: THERE IS NO PT3 CLASS IN 2011-2012) ***************

COURSE PT 3880 NEUROSCIENCES CLINICAL EDUCATION

Credit Hours: 8

Course Content: 2 x 4 week clinical placements in two of the following time slots:

Rotation 1: N/A

Rotation 2: N/A

Rotation 3: N/A

Rotation 4: N/A

Objectives

During this placement, students will be able to:

1. Assess and treat clients whose primary diagnosis relates to either neurological

conditions/disorders, or gerontology.

2. Integrate the skills and knowledge acquired during the academic year, to the

clinical setting.

3. Gain experience in the team concept of health care.


5. Develop an ability to assess patients, plan and implement treatment programs.

6. Develop clinical reasoning and judgment in relation to clinical decision making.

7. Adhere to the Physiotherapy Code of Ethics.


9. Gain experience in communication methods appropriate to the clinical setting

(verbal, written and presentation styles, etc.).

10. To understand the various aspects of physiotherapy practice (e.g. acute care, long

term care, community care).

11. Participate in presentations or projects as assigned by the Clinical Instructor.

Learning Contracts


the initial stage of their placement to identify goals their goals for that placement. The

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clinical/practical experience will vary from setting to setting in conjunction with the needs


Evaluation




COURSE PT 3920 INTERNSHIP

Credit Hours: 8

Course Content: 1 X 8 week clinical placement in one of the following time slots:

Rotation 1: N/A

Rotation 2: N/A

Rotation 3: N/A

Objectives

During the internship, students will be able to:

1. Consolidate and expand upon knowledge, skills and attitudes acquired over the

entire physiotherapy program.

2. Participate in the practice of physiotherapy in diverse practice areas.

3. Recognize the opportunities available for future employment in physiotherapy.

Learning Contracts


the initial stage of their placement to identify goals to achieve in that particular setting. The

clinical/practical experience will vary from setting to setting in conjunction with the needs


Evaluation




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Section 3

CLINICAL EDUCATION COURSE COSTS

TUITION FEES

Students are assessed tuition fees for the three clinical education courses that they

undertake during the program. The fee payment schedules for these courses are shown

below.

Fall/Winter Session Fee Payment Schedule applies to:

Year 1: PT 1740 - Cardiorespiratory Clinical Education

Year 3: PT 3880 - Clinical Education in Neurological Disorders

The tuition fee for these courses is included in the regular Fall/Winter Session tuition fees

for the program.

Summer Session Fee Payment Schedule applies to:

Year 2: Musculoskeletal Clinical Education

Year 3: PT 3920 - Summer Internship.

The timing of these placements designates them as Summer Session courses. Tuition fees

for these courses are proportional to the credit hours, and are assessed when the student

self-registers for these courses on AURORA. Doris Weigel (SMR support staff) will

advise students by email when they can proceed with self-registration on AURORA for

these courses. As a guide, in 2010 self-registration was available in March, and the

tuition fee for PT 3920 was approximately $800.

NB: Students need to check their U of M email account frequently for information from

Doris Weigel regarding registration dates. Fees are assessed as soon as students register

themselves on Aurora.

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Section 4

OFFICIAL DOCUMENTS REQUIRED ANNUALLY

Criminal Record Check (Fee: $32.00) All students must obtain a new Criminal Record Check for each year they are registered

in the program in order to participate in clinical placements. Since the document is

considered to remain valid for 12 months, it must not have an issue date earlier than

August 17, 2011 in order that all students are covered until the end of the possible

placement period in August, 2012. Students must submit a photocopy of their Criminal

Record Check to Charlene Dyck (Room R139) by October 1, and present the original

document to their Program Advisor at their first Program Advisor Meeting for the year.

The original document will be kept in the student’s Portfolio, and the photocopy will be

kept on file by the ACCE.

Criminal Record Checks may be requested in person from:

Bureau of Police Records, 4th

Floor, Public Health and Safety Building

151 Princess Street, Winnipeg; Ph: (204) 986-6073

Monday – Friday 8:00am to 3:45pm.

(NB: Students must bring two pieces of identification.)

Criminal Record Checks may also be requested by mailing in a downloadable form from

the following website: http://winnipeg.ca/police/BPR/info_request.stm

Child Abuse Registry Check (Fee: $10.00 per year)

All students must obtain a new Child Abuse Registry Check for each year they are

registered in the program in order to participate in clinical placements. Since the

document is considered to remain valid for 12 months, it must not have an issue date

earlier than August 17, 2011 in order that all students are covered until the end of the

possible placement period in August, 2012. Students must submit a photocopy of their

Child Abuse Registry Check to Charlene Dyck (Room R139) by October 1, and present

the original document to their Program Advisor at their first Program Advisor Meeting

for the year. The original document will be kept in the student’s Portfolio, and the

photocopy will be kept on file by the ACCE.

Application forms can be downloaded from the Manitoba Government website at

http://www.gov.mb.ca/fs/childfam/child_abuse_registry_form.html and mailed to the

address shown on the form. Instructions regarding submission of identifying documents

together with the application form must be followed, and payment can be made by credit

card or cheque.

Students can also apply for Child Abuse Registry Check in person at:

Provincial Services

1st Floor 102-114 Garry Street

Winnipeg

Monday – Friday from 8.30am - 4.30pm

http://www.gov.mb.ca/fs/childfam/child_abuse_registry_form.html

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Tel: (204) 945-6964

(NB: Students must bring two pieces of registered identification.)

CPR – “Level C” (or “HCP” (Health Care Professional) or “Basic Rescuer”)

(Cost: varies, depending on provider)

(NB: the certification title may contain any of the terms listed above, but must include

adult, child and infant CPR.)

All students must obtain a new CPR certificate for each year they are registered in the

program in order to participate in clinical placements. Since the document is considered

to remain valid for 12 months, it must not have an issue date earlier than August 17, 2011

in order that all students are covered until the end of the possible placement period in

August, 2012. Students must submit a photocopy of their CPR certificate to Charlene

Dyck (Room R139) by October 1, and present the original document to their Program

Advisor at their first Program Advisor Meeting for the year. The original document will

be kept in the student’s Portfolio, and the photocopy will be kept on file by the ACCE.

College of Physiotherapists of Manitoba Student Registration

All students must apply for inclusion on the Student Register of the College of

Physiotherapists of Manitoba (CPM) prior to commencing clinical placements. Students

who do not register with CPM each year will be unable to participate in clinical visits and

placements. All students must register with CPM by October 1, 2011. Registration forms

will be distributed to student mailboxes on the first day of classes. PT1 students are

required to pay an initial registration fee of $35.00. Continuing students are not required

to pay a fee, however a late payment penalty of $7.00 is applied if they fail to register

by the October 1 deadline.

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Section 5

CLINICAL PLACEMENT REQUESTS

Students can communicate with the ACCE to indicate their preferred time slots and

locations for clinical placements within Winnipeg, Brandon and rural Manitoba. Students

also have the opportunity to request placements at locations throughout Canada and

internationally. The National Association of Clinical Education in Physiotherapy

(NACEP) encourages students to travel outside of the catchment area of their home

university to gain as broad a range of experience as possible in a variety of practice

settings. Facilities used for placements must be accredited and affiliated with other

Academic Physical Therapy Programs.

The ACCE considers students’ requests when arranging placements. However, there are

instances where students will be required to take assigned placements due to limited

availability or in situations where it is deemed that a broader clinical experience would be

desirable.

Students who request a placement in another province must accept any placement offer

from that province that matches their request details. In the event of extraordinary

circumstances preventing the student from accepting the offer, the student will be placed

within Manitoba and will be subject to availability of placement type and timing.

Placement Requests within Winnipeg and the University of Manitoba Catchment

Area (Manitoba and Kivalliq region of Nunavut) For Winnipeg placements, students will be given a list of available placement dates and

locations. Each student will fill out a Placement Request Form where they can prioritize

their placement choices. Depending upon placement availability, students will usually

receive one of the placements listed among their top six choices.

Under normal circumstances, there will be no reimbursement of student costs incurred

during placements that occur within Winnipeg. However, students who are on a

placement in Winnipeg may be invited to participate in an overnight clinical visit outside

the city limits. When this situation occurs, students may be reimbursed for overnight

accommodation costs. This is outlined in section D under accommodation costs.

Canadian Placement Requests (Out-of-Catchment): $50 - $75 per request Students can request clinical placements in parts of Canada that are outside of the

University of Manitoba catchment area (catchment area includes all of Manitoba and the

Kivalliq region of Nunavut). For many out-of-catchment requests students will be

required to pay a non-refundable request fee. McGill, U of Ottawa, U of Toronto, U of

Saskatchewan, U of Alberta and U of British Columbia require a fee of $50. A $75

request fee is required by U of Montreal, U of Laval, and the QE2 Health Centre in

Halifax. Students should be aware that the School of Medical Rehabilitation will not

reimburse any costs associated with Canadian placements that occur outside of the

University of Manitoba catchment area.

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All placements within Canada are arranged by the ACCEs of the 14 Canadian university

physical therapy programs, under the governance of NACEP. Students who wish to

make out-of catchment requests should familiarize themselves with the following

NACEP policies:

1. Each student is only eligible to receive one placement per year per catchment

area.

2. Students should not contact out of province sites directly to organize their own

placements.

3. Students should take a copies of their immunization records, Criminal Record

Checks and Child Abuse Registry checks to out-of-catchment placements.

4. Students must forward out-of-catchment requests to the ACCE before the

specified deadlines (as show in the table below)

NACEP Deadlines for Out-of-Catchment Requests: 2012

Placement Period

Closing date for

students making

out-of-catchment

requests

Date by which requests

will be confirmed or

denied

January to April, 2012 October 1, 2011 Two months prior to

placement start date. May to August, 2012 February 1, 2012

5. NACEP attempts to set standardized dates for Canadian placements in order

to facilitate movement of students from province to province and to minimize

orientation time, which facilities/agencies must provide for students at the

commencement of their placements. Alterations to these dates can be made by

mutual agreement of the student, Clinical Instructor and Centre Coordinator.

If dates are altered, the Centre Coordinator or the ACCE will notify the

College of Physiotherapists of Manitoba.

Placement at the Karolinska Institute in Stockholm, Sweden A competition is held annually to select a student to complete a placement in Stockholm.

This competition is for 2nd

year students only. The School of Medical Rehabilitation,

Department of Physical Therapy supports a significant portion of the student costs of

transportation and accommodation for this placement. For further information about this

placement, students are advised to contact the ACCE.

Other International Placements

Students may wish to arrange placements in other countries. The School of Medical

Rehabilitation will not reimburse any of the costs associated with student-arranged

international placements. Students are eligible to request international placements for the

second placement of courses PT 2780 and PT 3880, and for PT 3920. Students are

responsible for obtaining the name, telephone number, fax number, and e-mail address of

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the potential host facility. This information should be provided to the ACCE who will

consider the feasibility of the request.

The placement arrangements are subject to:

1. Successful completion of academic examinations.

2. Approval of supervising therapist/facility credentials by the College of

Physiotherapists of Manitoba.

3. Successful completion of a University - Facility Legal Agreement

This process takes many months to complete, so students are encouraged to start the

process very early to allow sufficient time for arrangements to be finalized.

Community and Rural Placements

The Department of Physical Therapy encourages all students to consider clinical

education opportunities in community and rural settings. Students may therefore

be required to participate in at least one placement at a site within Manitoba but

outside the cities of Winnipeg and Brandon. Students can use a Placement Request

Form to indicate their interest in specific locales.

To prevent undue financial hardship to students during community/rural placements, the

University and/or the clinical center/agency will help support some of the costs for these

placements as outlined below:

1) Transportation Costs

The student must pay all transportation costs themselves and then submit receipts for

reimbursement. Original transportation receipts along with a completed travel

reimbursement form must be submitted to the SMR Clinical Education Secretary no later

than 6 weeks after completion of the placement. Travel reimbursement forms without

receipts cannot be processed. Receipts must coincide with the dates of the placement.

Reimbursement is usually processed within 14 working days.

There are several situations where transportation costs may be reimbursed: transportation

to accommodations near a placement site, commuting to and from a placement outside of

city limits, and transportation within a community / rural placement.

Transportation to accommodations near a placement site

Transportation expenses allotted will be to an amount equal to, or less than, the cost of

one round-trip bus fare to and from the placement.

If a student chooses to travel by car and the gas receipts for the trip are less than the cost

of one round-trip bus fare, then the student will be reimbursed only for actual gas costs.

If two or more students travel together by car to and from the placement site, only the

equivalent of one round-trip bus fare will be reimbursed. If the gas receipts for the trip

are less than the cost of one round-trip bus fare, then the students will be reimbursed only

for actual gas costs.

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If a student has a residence in Winnipeg, and return travel from the placement site is not

completed within 6 weeks of completion of the placement, then the student will only be

reimbursed for one-way transportation costs.

Commuting to and from a placement site outside of city limits

If a student chooses to commute by car to and from placements outside of the city limits

(e.g. Steinbach, Portage La Prairie, Beausejour or Selkirk) rather than stay at

accommodations close to the fieldwork site, the student will be reimbursed for

transportation costs at a rate of up to $12/day for every day of attendance at the

placement. Students are strongly discouraged from commuting to clinical centre / agency

sites that are further than 75 kilometres from their place of lodging.

Original gas receipts must be submitted.

If the gas receipts are less than $12/day, then the student will be reimbursed only for

actual gas costs.

The same policy will apply to students who wish to commute to rural placements from

accommodations that are closer to the placement site then their usual place of residency.

In these situations, the student cannot request reimbursement for both transportation and

accommodation costs (i.e. the student must choose to be reimbursed for either

transportation costs OR accommodation costs). The student should consult with the

ACCE prior to the beginning of the placement to determine if this reimbursement policy

applies to their specific situation.

Transportation within a community / rural placement

If a student is required to use his/her car to participate in certain aspects of a placement

and the centre/agency is unable to provide financial support for funding of transportation,

the student should consult with the ACCE. If the ACCE determines that travel is

essential, the student will be reimbursed on a per kilometer basis. This amount will not

exceed $50.00 per placement. Students are advised to consult with the ACCE prior to the

beginning of the placement to determine if this reimbursement policy applies to their

specific situation.

2) Accommodation Costs

When participating in community/rural placements, students can stay at accommodations

arranged by the University, or they can choose to arrange their own accommodations.

Whenever possible, attempts will be made to have direct billing to the University to avoid

the need for students to be reimbursed. Students are responsible for payment of

refundable damage deposits. Students are also responsible for payment of any damages to

the place of accommodation that occurs during their residence.

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Accommodations arranged by the University

The SMR Clinical Education Secretary will make accommodation arrangements for

students who are placed outside of Winnipeg for clinical placements. If a student is

placed outside of Winnipeg, the SMR Clinical Education Secretary will send the student

a memo asking the student to indicate where s/he requires accommodation arrangements.

Once a student has confirmed that s/he does/doesn’t require accommodation, no changes

will be allowed. Students are strongly encouraged to discuss accommodation

needs/preferences with the SMR Clinical Education Secretary prior to arrangement of

lodging. Student preferences for accommodations will always be considered, but students

should be aware that some placement locations are limited in the types and costs of

accommodations available.

If the University has arranged a place of accommodation and a student decides to move

from the place of accommodation, s/he must inform the ACCE before initiating the

move. The ACCE will determine if the change will be approved and paid for, given the

specific circumstances.

Accommodations arranged by the Student

If a student chooses to arrange his/her own accommodation, s/he must inform the SMR

Clinical Education Secretary as soon as possible. Students must have the cost of

accommodation pre-approved by the ACCE or the SMR Clinical Education Secretary.

Accommodation expenses allotted will be to an amount less than or equal to the cost of

accommodations arranged by the University or by the center / agency.

If the student is staying in a private residence where there is a cost associated with

lodging, the individual providing lodging must submit a written invoice to the University

of Manitoba c/o the SMR Clinical Education Secretary indicating the dates and cost of

accommodation. Invoices should be submitted as soon as possible and no later than 6

weeks after completion of the placement. Invoices received after this date will not be

processed.

Overnight stays during a placement

If a student is invited to travel with his/her Clinical Instructor during the clinical

placement, and the trip will involve an overnight stay(s), the student or Clinical Instructor

should consult with the ACCE to determine whether funding is available to help support

the costs of accommodation. If the Department of Physical Therapy is already paying for

accommodation, then the student cannot be reimbursed for accommodation costs at two

sites. However, if the student is living in Winnipeg and a trip to an out-of-town site is

determined to be beneficial to the learning experience, there may be some reimbursement

for accommodation costs. The ACCE will determine if the accommodation will be paid

for (and the amount), given the specific circumstances.

3) Food Costs

Food costs will not be reimbursed. If the University is paying for accommodations and

the cost of accommodations includes food, the student will be responsible to pay daily

food costs as specified by the place of lodging. If the cost of food is not specified, the

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student will be required to pay $4/day in food costs. Depending on the specific situation

the student may have to pay for food costs in an advance lump sum at the beginning of

the placement / accommodation time period.

NB: The above reimbursement policies apply to community / rural placements

only. Except in special circumstances as determined by the ACCE in discussion

with the Department Head, there will be no reimbursement of any costs related

to placements that occur within Winnipeg city limits or outside of the

University of Manitoba catchment area (Manitoba and the Kivalliq Region of

Nunavut).

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Section 6

CLINICAL EDUCATION POLICIES

The student policies with respect to clinical education are intended to serve as a guide for

supervising therapists and students during the period of their clinical education including

internships and clinical placements. While the school may develop specific policies with

regard to students’ clinical education, it is understood that students must comply with the

prevailing policies and recognised procedures of the particular facility in which they

are completing placements.

CLINICAL INSTRUCTOR (CI)

The student will be supervised and evaluated by a licensed therapist. The appointment of the

instructor is done by the Centre/Agency Co-ordinator. Where the Clinical Instructor(s) is

absent from the centre/agency, the student must be assigned a designated instructor for that

time.

CLINICAL HOURS

Students are to conform to the Clinical Instructors’ scheduled hours of work. This may

involve evening and weekend hours.

If clinical centre/agency personnel are required to take days off without pay during the time

of the clinical placement, the Clinical Instructor or the Centre/Agency Coordinator should

notify the ACCE as soon as possible, and preferably before the student begins the

placement. The ACCE will determine if the student will be required to make up additional

time, taking into consideration the length of the placement, the number of days that the

centre/agency will be closed, and other factors specific to each situation.

ABSENCE DURING PLACEMENT

Attendance by students during placements is mandatory. Students must notify the

center/agency as early as possible in the event of absence.

Acceptable Reasons for Absence

Examples of approved reasons for absence include:

1. Student illness (medical certificate may be required)

2. Illness / death of a close family member

3. Religious holidays (as listed in the U of M Calendar).

Students who miss more than two days per placement may be required to make up missed

time. The Clinical Instructor, Centre / Agency Clinical Coordinator and ACCE will make

this decision. Lengthy absences would require discussion with the Department Head.

The decision is based on the Clinical Instructor’s ability to adequately evaluate the

student.

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Formula for Time to be Made Up

The following is a suggested formula to calculate the amount of time that should be made

up for clinical placement absences:

Days Missed

within a Placement

Days to be

Made Up

Up to 2 days 0-2 days

3-4 days 1 week

5-6 days 2 weeks

7-8 days 3 weeks

Participation in National and International Events

When a student who is involved in sports, arts, or creative endeavors is required to

participate in a national or international level event during his/her clinical placement, the

student should inform the ACCE as soon as possible about the dates of the

activity/competition. Participation in national or international events does not

automatically qualify as an acceptable reason for absence from clinical placements.

Thus, the ACCE and the Clinical Instructor will jointly decide whether or not the student

will be allowed to miss placement days for the event. The student may be required to

make up the time, or complete the placement at a time that does not interfere with any

scheduled activities/competitions (subject to placement availability).

Conferences, Workshops, and Other Educational Activities

Requests for time away from the clinical facility to attend conferences, workshops, or

other educational activities may be considered. The ACCE will consider requests and

make recommendations regarding their suitability. The final decision regarding student

attendance will require discussion between the ACCE and the Clinical Instructor. If a

student decides to attend an approved course on a weekend, the clinical facility/agency’s

policies regarding time off for continuing education will apply.

SMR Committee Meetings

Students who are involved in committees at the SMR or the University are required to notify

their Clinical Instructor and the Centre/agency Clinical Co-ordinator of their need to be

away from the centre/agency to attend meetings of such committees. Students should re-

arrange their patient schedules to minimize interruption to patient care.

CHARTING

Initially students should prepare their chart notes in draft form. Once the Clinical Instructor

is satisfied that the student has organised the information adequately, the student may be

instructed to enter the information directly in the patient’s medical record. It is important

that each note be accompanied by the student’s signature and identification (“Student

Physiotherapist”). It must then be co-signed by the Clinical Instructor.

CONFIDENTIALITY

Students are bound by the PHIA legislation. Each student is responsible for maintaining

confidentiality in all matters relating to their assigned patients and facility business.

21

Students placed in WRHA facilities should carry their PHIA cards at all times during

clinical placements.

CLINICAL PLACEMENT ASSIGNMENTS Students may be asked to do written and/or oral assignments during their clinical placements

and internships. This is in accordance with the recognition that clinical placements are

courses which have attached expectations such as assignments.

The following guidelines are recommended:

1. Assignments should be relevant to the particular clinical placement.

2. Students may be expected to prepare assignments outside of placement hours.

3. Guidelines for presentation and content of the assignment should be defined by the

clinical facility and made available to the student at the commencement of the

placement.

ACCEPTANCE OF GIFTS FROM PATIENTS A patient may wish to express their appreciation to the student/therapist with a gift. Gifts

that are costly or otherwise inappropriate may not be accepted. The student should seek the

guidance of the Clinical Instructor in dealing with this issue.

EVALUATIONS/CLINICAL REPORTS

Evaluations serve to determine areas of strength in a student’s performance and those

needing improvement. Students should be evaluated on a formal and informal basis.

Informal evaluation involves making a judgment about the quality of the student’s

performance every time it is observed followed by immediate feedback.

Formal Evaluation

The Clinical Instructor is expected to complete the Physical Therapist Clinical

Performance Instrument (CPI) at mid-term and again at the completion of the clinical

placement. This evaluation form is designed to objectively assess the student’s abilities

and skills in 24 different areas of clinical practice. The student may evaluate his/her own

performance on a separate copy of this form. In addition, the student is also expected to

evaluate the Clinical Instructor and the facility / agency using the Student Clinical

Placement Feedback Form.

At mid-term and at the completion of the clinical placement, the student and Clinical

Instructor should have scheduled meetings to discuss the content of the evaluation forms.

These meetings are an opportunity for both the student and the Clinical Instructor to

provide each other with constructive feedback and express any concerns. If the Clinical

Instructor has any serious concerns about student performance, the clinical liaison and the

ACCE should be informed by midterm at the latest.

The Clinical Instructor and the student must sign both the CPI and the Student Clinical

Placement Feedback Form at midterm and at completion of the clinical placement. The

student’s signature on the CPI indicates that he/she has read the report. If a student does

not agree with the evaluation, he/she should refer to the Academic Progression Document

22

in the Student Handbook for specific details about the appeal process. If the student

wishes to have a copy of their CPI, they should contact the ACCE.

LINES OF COMMUNICATION BETWEEN STUDENT AND CLINICAL

INSTRUCTOR

Occasionally, a student and/or a Clinical Instructor may be dissatisfied with the student-

instructor relationship. For example, the student and Clinical Instructor may be having

communication difficulties, or the student may be dissatisfied with the Clinical

Instructor’s style of supervision and feedback.

Students who find themselves in this situation should refer to the following plan of

action:

1. The student and the Clinical Instructor should attempt to resolve all difficulties

between themselves whenever it is appropriate to do so

2. After the first incidence of a problem, both the student and the Clinical Instructor

should feel free to discuss any issues with the clinical liaison

3. Once a problem has occurred repeatedly, both the student and the Clinical

Instructor should feel free to discuss any issues with the ACCE

4. If the student feels uncomfortable discussing issues with the Clinical Instructor or

the clinical liaison for any reason, the student should feel free to express concern

directly to the ACCE at any time.

Whenever the clinical liaison or ACCE is called upon to mediate disputes, it is the policy

of the School of Medical Rehabilitation that all issues will be dealt with in a fair and

timely manner and without negative reflection on the professional reputation of either the

Clinical Instructor or the student.

WITHDRAWAL FROM CLINICAL EDUCATION COURSES

The following information is copied from the “Academic Progression of Students in the

BMR (PT) Program” section of the Department of Physical Therapy Student Handbook

2007-2008.

5.2 Clinical Education Courses

5.2.1 A student who is intending to withdraw from a clinical placement without

academic penalty must submit a formal request to the ACCE as soon as

possible. Initial discussion with the ACCE may be verbal, but must be

followed up immediately with a written request. The following reasons

will be considered for withdrawal without academic penalty:

5.2.1.1 Medical reasons: The student must present a physician’s note to

the ACCE, both at the time of withdrawal and prior to resumption

of the placement.

5.2.1.2 Compassionate reasons (e.g. loss of a close family member; major

life crisis).

5.2.1.3 Exceptional circumstances: The student must consult with the

ACCE prior to withdrawing from the placement. The ACCE will

consult with the Department Head, in order to determine whether

23

the student should consider proceeding with the withdrawal

process.

5.2.2 A student is permitted only one voluntary withdrawal from a clinical

placement per course.

5.2.2.1 Students may withdraw from clinical education courses, without

academic penalty until and including the mid-term of the

placement, after discussion of the mid-term evaluation with the

clinical instructor and ACCE. A student who withdraws from the

clinical education placement after the midpoint of the placement

will be considered to have failed the placement.

5.2.3 A student is permitted a maximum of two voluntary withdrawals from

clinical placements over the length of the program.

STUDENT DRESS CODE FOR CLINICAL PLACEMENTS

This dress code is not required for classroom activity unless there are scheduled clinical

visits or scheduled interactions with patients or standardized patients.

Purpose

To provide guidelines for proper attire while placing responsibility on the student to

maintain professionalism at all times. In addition to choosing attire that is professional in

appearance, students should also choose functional clothing that is appropriate for:

1. Patient handling - i.e. avoid restrictive or excessively baggy clothing

2. Quick responses to emergency - i.e. wear secure, comfortable shoes

3. Personal safety - i.e. minimize exposed skin and wear closed-toed shoes.

GENERAL APPEARANCE

Clothing

1. Dress should be professional, neat, clean, practical, safe, avoiding extremes of

fashion and appropriate to staff duties and work area.

2. Shirts should have appropriate necklines (i.e. not too low). Shirts should also be

in conservative colors and be plain or simple in design (e.g. no large or

inappropriate logos).

3. Pants should be ankle length and made of appropriate fabric (i.e. no sweat pants,

leather pants or jeans).

4. Shorts should be no shorter than 4 inches above the knee.

5. Students should wear clothing that allows them to bend and move freely without

exposing their abdominal skin.

Footwear

1. Socks or pantyhose must be worn with shoes

2. Shoes should be well-maintained and presentable with closed toes and closed

heels (i.e. no sandals or clogs)

3. Casual shoes and runners may be worn if they are clean, in good condition and

approved by supervisor.

24

Accessories

1. Jewelry should be minimal: watches, smooth-surfaced rings, and small earrings

are acceptable

2. Conservative make-up is permitted.

Miscellaneous

1. Hair – clean; long hair should be tied back

2. Nails – clean and short; brightly colored nail polish is not recommended

3. Hygiene – all students should be clean and have no discernable body odor; the use

of fragrances and colognes is prohibited.

NAME TAGS MUST BE WORN AT ALL TIMES

1. All students are provided with a University of Manitoba Student Physiotherapist

nametag

2. Lost nametags should be reported to the SMR Clinical Education Secretary, and a

$10 fee will be charged for a replacement.

NB. Students will be expected to adhere to the dress code policy of the

facility/agency to which they are assigned for placement if it is different than the

SMR Student Dress Code.

Students will be required to adhere to the dress code for all clinical situations

including encounters with standardized patients.

(Revised by the Clinical Education Committee, Department of Physical Therapy, June

2003.)

25

Section 7

THE CLINICAL EDUCATION TEAM - ROLES AND RESPONSIBILITIES

CENTRE COORDINATOR OF CLINICAL EDUCATION

At each clinical site there is an individual who is responsible for coordinating the clinical

activities at that site including clinical visits and clinical placements. This individual:

1. Serves as the liaison between the clinical facility and the ACCE.

2. Provides the ACCE with a determination of the numbers and types of clinical

placements that can be allocated to the physiotherapy students from the University

of Manitoba in a given year.

3. Ensures orientation of physiotherapy students to the facility including the policies

and procedures specific to the given facility

4. Acts as a resource to students.

5. Ensures orientation of department staff with respect to all aspects of the clinical

education program

6. Provides feedback through the Post-Clinical Placement component of the fall

Clinical

7. Education Committee meeting on the interface of the academic and clinical

curriculum from their facility's perspective.

8. Ensures the completion and return of all clinical evaluation forms to the ACCE.

9. Ensures an invoice / statement of account is sent to the Department of Physical

Therapy for reimbursement of funds for clinical liaison activities.

CLINICAL LIAISON

A clinical liaison is appointed for each clinical centre/agency which accepts students for

placements. The clinical liaison is a physiotherapist who facilitates communication and

establishes mutual understanding between the University of Manitoba, Department of

Physical Therapy and the clinical centre/agency. The clinical liaison is appointed by the

facility department director/physiotherapy profession leader. Each clinical liaison is

supported by the ACCE in order to fully understand the policies, curriculum, and clinical

education goals of the School of Medical Rehabilitation.

The clinical liaison may be expected to:

1. Interpret SMR policies, curriculum, or goals for Clinical Instructors

2. Mediate disputes between student and Clinical Instructor

3. Observe a student while he/she participates in activities within the facility/agency

for the purpose of later mediating any disputes about a student’s performance

evaluation.

The clinical liaison is not expected to be involved in the clinical evaluation process at

any stage.

CLINICAL INSTRUCTOR

The Clinical Instructor will, prior to the commencement of the clinical placement,

familiarize himself/ herself with the following:

2. The academic curriculum relevant to the particular clinical placement

26

3. The evaluation process for the clinical education course

4. The Department of Physical Therapy Policies and Procedures governing clinical

education.

The Clinical Instructor will guide and assist the student in a manner that promotes the

student's achievement of his/ her own objectives for that clinical placement. The Clinical

Instructor should demonstrate effective:

1. Communication skills to express himself/herself to students, define expectations and

provide feedback which may at times be difficult or confrontational, and in turn be

open to feedback from students on the issues of concern..

2. Interpersonal skills to initially understand the student as an individual, and assist in

the development of a professional peer relationship through role modeling of

professional behaviors.

3. Professional skills through adherence to ethical behavior, a systematic approach to

patient care, the ability to provide a rationale for evaluation and treatment

approaches, and ability to work with others.

4. Instructional skills including an understanding of the student's current level of

performance, the goals of the clinical education experience, and various factors such

as learning style and environment that have an impact on the learning experience.

5. Supervisory skills including clarity of performance expectations, provision of

frequent and timely feedback, collection of information through direct observation,

review of documentation and adjustment of the learning experience.

6. Performance evaluation skills including articulation of performance expectations,

and planning of effective remedial strategies to address deficits in student

performance. The Clinical Instructor should approach evaluation in a constructive,

educational and objective manner, including encouragement of self-assessment by

students of their performance.

STUDENT PHYSIOTHERAPISTS

The student is expected to be familiar with the:

1. General goals and objectives of clinical education

2. Department of Physical Therapy Policies and Procedures governing clinical

education

3. Policies and Procedures of the clinical facilities to which they are assigned

4. Evaluation procedures for clinical education courses

5. Academic Progression Document as it pertains to clinical education courses.

27

Student Responsibilities

The student is expected to:

1. Obtain relevant information regarding the clinical placement from the Facility

Profile Document. Should further clarification be required, the student may contact

the Centre/agency Clinical Coordinator.

2. Wear appropriate professional attire as outlined in the Department of Physical

Therapy Student Dress Code. The name tag must be worn at all times during the

clinical placement to allow identification.

3. Identify areas of insufficient practice or exposure and relay this information to the

Clinical Instructor.

4. Develop objectives for the particular clinical placement in collaboration with the

Clinical Instructor.

5. Collaborate with the Clinical Instructor to determine the type of supervision he/she

would prefer during the placement.

6. Apply classroom knowledge and skills to the clinical environment with the guidance

and assistance of the Clinical Instructor.

7. Prepare and review material on his/her own time. The student should ask appropriate

questions to clarify points of uncertainty. He/she should not be expected to perform

treatment with which he/she is not familiar.

8. Read the patient’s chart before approaching the patient, and be aware of the

professional responsibility of not performing treatment before feeling secure

regarding the patient's medical history and diagnosis. All material reviewed in charts

must remain confidential.

9. Chart all interventions and any changes in the patient's status during treatment. Each

note should be signed by the student and have the label Student Physical Therapist

attached. Charting frequency may vary between facilities/agencies.

10. Meet all general objectives (as outlined in the clinical performance evaluation forms)

and those specific objectives agreed to with their Clinical Instructor.

11. Assess his/her own strengths and weaknesses.

12. Contact the clinical liaison person with questions or concerns about their placement.

The student should make every attempt to solve problems directly with his/her

supervisor before considering taking the matter further.

13. Contact the ACCE to assist in resolving ongoing conflict between the Clinical

Instructor and the student.

14. Adhere to the CPA Code of Ethics.

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CLINICAL PRACTICE INSTRUCTION GUIDELINES

(What the student can expect from the Clinical Instructor)

The purpose of clinical instruction is to ensure:

1. Safe and effective assessment and treatment of patients.

2. Provision of a directed learning environment.

Instruction consists of observation of the student's performance, evaluation of the

performance, feedback to the student regarding that performance, constructive criticism and

suggestions for improvement. Students must also develop self evaluation skills in relation to

their patient assessment and treatment abilities.

Students will proceed through the stages from "dependent novice" to "entry-level"

practitioner. The Clinical Instructor acts as a facilitator in this process while assuring the

student has the opportunity to develop their own individual approach to patient assessment

and treatment.

As students become more mature through clinical exposure, their ability to take greater

responsibility for the planning and implementation of patient treatments should improve and

they should require correspondingly less instruction.

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Section 8

DEPARTMENT OF PHYSICAL THERAPY

CLINICAL EDUCATION CONTACT INFORMATION

Head, Department of Physical Therapy Jenneth Swinamer 977-5636

Academic Coordinator of Clinical Education Liz Harvey 977-5656

(ACCE)

SMR Clinical Education Secretary Charlene Dyck 789-3757

Year 2 Coordinator Mike McMurray 789-3413

30

Section 9

APPENDIX

a) Physical Therapist Clinical Performance Instrument (CPI)

b) CPI Scoring Guidelines

c) Clinical Learning Contract

d) Clinical Placement Pass/Fail Form

e) Student Feedback Regarding Clinical Placement Form

f) End of Clinical Placement Checklist

g) Out-of-Province Clinical Placement Request Form

h) 2011-2012 Clinical Education Schedule