Page | 1

SECTION B

STUDENT CLINICAL EXPERIENCE HANDBOOK

LHSC Victoria Hospital; Fowler Kennedy Sports Medicine; SJHC Parkwood Hospital; VHA/Home Care

Disclaimer: The MPT Professional Program Student Handbook contains the MPT policies, regulations and processes for the academic year. If changes are required to these MPT policies, regulations and procedures that take effect during the academic year, students will be notified of these changes.

Page | 2

TABLE OF CONTENTS

1. General Information about Placements1.1 Placement Timelines1.2 Locations of Clinical Education Sites1.3 Definitions of Settings1.4 Attendance During Placement1.5 Exceptional Leave1.6 Travel and Housing Funding

2. Graduation Requirements2.1 MPT Clinical Education Requirements for Graduation2.2 Tracking and Meeting Graduation Requirements

3. Clinical Education and Placement Requirements3.1 Medical and Non-Medical Requirements3.2 Preceptor Education Program for Health Professionals and Students (PEP)3.3 Student Requirements During Placement3.4 Dress Regulations During Clinical Placements

4. Placement Process4.1 Clinical Placement Offers4.2 Placement Matching Process4.3 Policies and Regulations Regarding Placement Assignment in the UWO Catchment Area4.4 Policies and Regulations Regarding Placement Assignment outside the UWO Catchment Area4.5 Policies and Regulations Regarding International Placements4.6 Student Responsibilities in Preparation for International Placements4.7 Progression Through Clinical Placements4.8 Cancellation of a Clinical Placement

5. Student Supervision and Evaluation5.1 Supervision During Placements5.2 Typical Evaluation of Students During Placement5.3 Concerns During Placement5.4 Pass/Fail Decision5.5 Policy and Procedures after a Failed Placement5.6 Remedial Placements5.7 Course Grades

6. Clinical Accommodations6.1 Formal Accommodations through SSD6.2 Formal Accommodations through the MPT Program6.3 Students at Risk without Formal Accommodations

7. Other Workplace Considerations7.1 Privacy of Information7.2 Legal and Ethical Considerations, Including Patient Privacy and Confidentiality7.3 Student Liability and Worker’s Safety and Insurance Board (WSIB) Coverage

Page | 3

1. General Information about Placements 1.1 Placement Timelines Master of Physical Therapy Program (MPT) education consists of two interrelated components: academic and clinical. Over the two years of the program, each student is scheduled for five clinical experience placements: Junior, Junior-Intermediate, Intermediate, Intermediate-Senior, and Senior. These clinical experience placements provide the opportunity for students to apply the knowledge, skills, behaviours and clinical reasoning learned in the academic component of the MPT program in actual clinical facilities under the supervision of registered physical therapists who volunteer as Clinical Instructors (CI’s).

Placement Course # Level of Student Year of Program Time Period Length

(wks) 1 PT 9581 Junior 1 June – mid July 6 2 PT 9582 Junior Intermediate 2 Mid Nov – Dec 6 3 PT9583 Intermediate 2 Mid March – April 6 4 PT 9584 Intermediate Senior 2 Mid April – May 6 5 PT 9585 Senior 2 Mid July - Aug 6

1.2 Locations of Clinical Education Sites 1.2.1 The MPT program has over 125 clinical

facilities in Southwestern Ontario that offer placement experiences to our students. Placements are offered and arranged within the Western catchment area, which is highlighted (in purple) in the map to the right.

1.2.2 Students are required to complete clinical placements, as arranged and assigned by the Academic Coordinator of Clinical Education (ACCE), at any of our affiliated health care facilities within Southwestern Ontario.

1.2.3 MPT students are responsible for all costs incurred related to completion of required clinical experiences/placements.

1.2.4 All MPT students are required to relocate and complete two or more clinical placements outside the City of London but within the Western catchment area. Approximately 30-40% of Western’s MPT clinical placement offers are available within the City of London with the remaining 60-70% available in cities and small towns outside the city of London.

1.3 Definitions of Settings 1.3.1 In the Ambulatory Care Clinic Setting, care is provided to a person living in the community but

attending an outpatient setting for treatment (may be either a privately or publicly funded facility). The person requires the services of a physiotherapist and may receive services in a variety of areas of practice including neurology, musculoskeletal or cardiovascular and respiratory. Service might include a range of patient age groups.

1.3.2 In the Rehabilitation/Long-Term Care Setting (includes Paediatric Rehab), interdisciplinary care is provided for a person requiring an intensive therapy focus to maximize functional independence or maintain or support function. It is provided within a rehabilitation hospital,

Page | 4

acute care hospital rehabilitation unit, long-term care facility, children’s treatment centre, school, or outpatient clinic. The person might receive services in a variety of areas of practice including neurology, musculoskeletal or cardiovascular and respiratory and it might include a range of age groups. Given that Southwestern Ontario has five children’s rehabilitation treatment centres, Paediatric Rehabilitation placements are available, typically within the public school environment. A Rehabilitation Setting clinical placement in Paediatric Rehabilitation is sufficient to meet Rehab Setting requirements for MPT graduation.

1.3.3 In the Acute Care/Hospital Setting, interdisciplinary care is provided for a person during an acute illness, an acute exacerbation of a chronic illness/disability or a surgical intervention that necessitates admission to an acute care hospital. The person typically has a changing health status and the hospital stay is generally of short duration. The person may receive services in a variety of areas of practice including neurology, musculoskeletal or cardiovascular and respiratory and might include a range of age groups.

1.3.4 In the Community Setting, the person receives therapy services in the client’s home or a retirement home. The purpose is to support an individual in the home environment during recovery from an acute illness/surgery or in the ongoing management of a chronic disease or disability. The model of service delivery is frequently consultative in nature with an emphasis on self- management. The person may receive services in a variety of areas of practice including neurology, musculoskeletal or cardiovascular and respiratory and might include a range of age groups.

1.4 Attendance During Placement 1.4.1 100% attendance is expected and mandatory for all clinical placements. Absences from

placement might delay graduation. 1.4.2 Students are allowed time off during clinical placements for illness, bereavement, medical

appointments and exceptional leave. These are considered time missed from the clinical placement. Students are expected to schedule appointments, if possible, outside of clinical placement hours.

1.4.3 The student is required to inform the CI as soon as possible of all absences, including those for religious or compassionate reasons or illness.

1.4.4 For unexpected absences more than one day, the student must notify the ACCE by email or phone.

1.4.5 If the student misses three or more days due to illness, the student is required to provide a medical note to the CI indicating that they are well enough to return to placement. Lost time will be made up at the discretion of the CI and CCCE, in consultation with the ACCE.

1.4.6 For all placements, absences of 5 days or longer must be made up. The time might be made up during the clinical placement period, at the discretion of the CI. If this time cannot be made up, then the placement will be considered incomplete and the placement will be scheduled in the next placement block. Please note that facilities might not be able to accommodate students for periods shorter than a full placement.

1.4.7 In the case of significant health issues, if a student is sufficiently ill or injured and requires immediate medical attention, the student is required to obtain medical documentation indicating:

• That the student is unable to meet clinical placement responsibilities and the amount of time off from placement that is required OR

• That the student is sufficiently healthy to return to a health care environment if provided with specified physical modifications (modifications to be included in documentation) OR

• That the student is sufficiently healthy to return to a health care environment without any restrictions or modifications

Page | 5

• This documentation is required prior to the return to placement. 1.5 Exceptional Leave 1.5.1 Under very exceptional circumstances, a leave of absence might be requested for a period not

exceeding two days in total over the course of all five clinical placements. If multiple events are anticipated during the placements, the student must select which events they will attend. Under no circumstances will more than two days be granted to any student.

1.5.2 All exceptional leaves must be arranged first through the ACCE, via submitting an application by the indicated deadline. Failure to do so will result in denial of the requested leave.

1.5.3 The application must meet the criteria listed on the instructions (see Owl site). Failure to meet the criteria will result in the application being denied.

1.5.4 The form must be submitted prior to the start of placement to ensure that the site and CI are notified in a timely manner.

1.5.5 Once the application is approved, the student will consult the CI for approval. The CI reserves the right to deny the exceptional leave if there is a negative impact on patient care or if the student is having difficulty on the placement.

1.5.6 Lost time is not required to be made up and the absences will be recorded on the ACP evaluation.

1.6 Travel and Housing Funding 1.6.1 The student is expected to cover all costs related to all placements. 1.6.2 Limited funding is available to students via MPT Travel and Housing Funding, which is granted by

the Government of Ontario, Ministry of Training, Colleges, and Universities. This funding is available to offset some of the costs associated with placements but is very limited and is subject to change each year. Students must complete the application by the indicated deadline in order to qualify for funding.

1.6.3 A work stipend is not provided to students during placements. 1.6.4 Other funding sources are available through the university and other bursaries. Students are

encouraged to contact the ACCE for more details and check the Owl website.

2. Graduation Requirements 2.1 MPT Clinical Education Requirements for Graduation 2.1.1 Upon graduation, all students are expected to fulfill multiple professional roles and

responsibilities relevant to contemporary PT practice in the complex and dynamic Canadian healthcare environment. As such, all students must meet minimum requirements for PT essential competencies, clinical experience hours, clinical settings, areas of practice and lifespan. The following policies are in accordance with entry-to-practice standards and current PT practice in the Canadian health care environment.

2.1.2 PT Essential Competencies: In order to graduate, each student must obtain entry-level in the PT essential competencies1 listed below by the end of the final placement. This requirement is based on the Essential Competency Profile for Physiotherapists in Canada (2009). Entry-level is determined based on clinical evaluations completed during placement using the Canadian Physical Therapy Assessment of Clinical Performance (ACP). • Expert (assessment, analysis/ diagnosis/prognosis, intervention) • Communicator • Collaborator • Manager • Advocate

1 National Physiotherapy Advisory Group, Essential Competency Profile for Physiotherapists in Canada (October 2009).

Page | 6

• Scholarly Practitioner • Professional

2.1.3 Clinical experience hours: In order to graduate, each student is required to complete a minimum of 1025 clinical hours. Statutory holidays, illness, bereavement, medical appointments, and exceptional leave are all considered missed time from clinical placements. Students are encouraged to make up any missed time if convenient for the CI and clinical site.

2.1.4 Clinical Settings: In order to graduate, each student must obtain sufficient breadth and depth of clinical experience in the most common clinical settings. As such, students must obtain a minimum of 125 hours in each of the following settings: Acute Care/Hospital, Rehabilitation/LTC/Paediatrics, and Ambulatory Care Clinics. Given the number of placements offered in each of the required settings, students are expected to complete one placement in Acute Care, one placement in Rehabilitation/LTC/Paediatrics and two placements in an Ambulatory Care Clinic.

2.1.5 Elective Setting: Given the Clinical Settings requirements (2.1.4), students must complete four of the five placements in specific settings. One placement can be a setting of the student’s choice. Given the limited number of Rehabilitation/LTC/Paediatrics offers, students can only select Acute Care, Community, Emerging Role or Clinics.

2.1.6 Areas of Practice: In order to graduate, each student must obtain a minimum of 100 hours in each of the following areas of practice—musculoskeletal, neurology and cardiovascular and respiratory care.

2.1.7 Lifespan: In order to graduate, each student must obtain sufficient experience treating individuals across the lifespan and obtain a minimum of 225 hours in each of the following two categories--

• Adults (individuals between 18-64 years of age) • Combination of children (0-18 years) and seniors (>65 years of age)

2.1.8 To ensure variety in students’ clinical experiences, students are not permitted to complete two clinical placements that are of the same setting and area of practice at the same health care facility.

2.1.9 To ensure variety in students’ clinical experiences, students are not permitted to complete more than three clinical placements at a given facility, even though the setting and area of practice might be different.

2.1.10 Students must meet all graduation requirements by August 31 in their final year in order to be eligible to convocate in the following fall convocation. This deadline is set by the School of Graduate and Postdoctoral Studies.

2.2 Tracking and Meeting Graduation Requirements 2.2.1 Individual student clinical competencies, clinical experience hours, settings, areas of practice

and lifespan hours must be monitored over the course of the five clinical placements. These requirements are monitored and recorded using the Assessment of Clinical Performance (ACP).

2.2.2 Competencies are monitored at both the midterm and final evaluation. 2.2.3 Clinical hours are documented only at the final evaluation. 2.2.4 Students are responsible for ensuring the accuracy of their hours as documented at the final

evaluation for each placement.

Page | 7

2.2.5 Students are responsible for tracking their graduation requirements (clinical hours) over the course of the five placements. Students are able to access their ACP documents via HSPnet. Students can use the checklists provided on Owl to help maximize exposure to CR experiences and are advised to keep a list of neurological conditions that they have assessed and treated. These documents might be needed to substantiate graduation requirements. This information should also be used to optimize the selection process for upcoming placements. Students are strongly encouraged to complete all requirements in their first four placements to ensure that they meet graduation requirements.

2.2.6 The ACCE also monitors and tracks graduation requirements over the course of the five placements. The ACCE will make recommendations as needed to ensure that students will obtain all requirements at the completion of all five placements.

2.2.7 Where deficits are noted in clinical hours as students are making selections for senior placements, the ACCE will meet with students to discuss options for upcoming placement selections to obtain the necessary requirements for graduation. The ACCE might pull a student from the standard matching process for 9585 in order to assign them to a particular placement to meet graduation requirements.

2.2.8 In special circumstances (as determined by ACCE), a Clinical Exposure Partial Placement might be arranged during 9585 in order to obtain the necessary graduation requirements for setting, area of practice or lifespan. This option depends on placement availability, student clinical skills and previous student placement selection.

2.2.9 If the student demonstrates deficiencies in clinical hours by the end of the 9585 placement, the student’s clinical placement might be extended up to a maximum of 6 weeks in order to obtain the necessary requirements for graduation. This option depends on the student’s performance on the ACP (clinical competencies), CI availability, and placement availability. Given the implications of extending the final placement past August 31, this option will be reviewed with the student with final approval from the MPT chair.

2.2.10 Where deficits are noted in competencies, the ACCE will meet with students to discuss strategies to improve clinical performance.

2.2.11 The ACCE confirms that each student has met all graduation requirements by Aug 31st of the second year. This decision is based on data collected via the ACP, communication with the student if necessary (and supported by student documentation of requirements) and the ACCE’s clinical judgement.

3. Clinical Education and Placement Requirements 3.1 Medical and Non-Medical Placement Requirements 3.1.1 Students must complete all medical and non-medical requirements by the deadlines indicated

(on the Owl site) in order to be eligible to complete their clinical placements. This includes requirements of the MPT program and requirements of the clinical facility (if applicable). Failure to submit the required documentation by the deadlines might result in the delay or cancellation of placements.

3.1.2 The student is responsible for all costs related to all medical and non-medical requirements. 3.1.3 Students must keep all original (or copies) of documents over the entirety of the two-year

program.

Page | 8

3.1.4 Students must ensure that all medical and non-medical requirements are up-to-date at all times during the two-year program. Failure to do so will result in the cancellation of clinical placements. Clinical sites can deny a student access to a facility if all documentation is not completed and current.

3.1.5 Students must refer to the Owl site for the most up-to-date list of medical and non-medical requirements. These lists are updated each year prior to September.

3.1.6 It is the student’s responsibility to comply with the UWO policy on AIDS regarding Health Science Faculties (AIDS Policy, Owl site).

3.2 Preceptor Education Program for Health Professionals and Students (PEP) 3.2.1 Students are responsible for completing all PEP modules for clinical experience courses by the

deadlines indicated (in course outline). Failure to do so will result in the delay or cancellation of clinical placements.

3.3 Student Requirements During Placement 3.3.1 Each student is required to complete the placement requirements by the appropriate deadline.

Failure to do so might result in delay, cancellation or failure to successfully complete a placement.

3.3.2 Students must contact the site once the matching process is complete and the placement is confirmed. Students are required to contact their CI and CCCE via email (or contact indicated to student). Students are expected to send a Letter of Introduction and an updated Student Placement Profile (SPP). Students are expected to include areas of strength and weakness in their SPP, based on their previous scores on the ACP.

3.3.3 Students are expected to complete their self-evaluation of performance using the ACP. It is expected that students will include written comments in addition to scoring themselves along the continuum. This is completed during the third and sixth week prior to meeting with their CI(s). Failure to complete the self-evaluation might delay the evaluation process and the successful completion of the placement.

3.3.4 Students are expected to complete the CI and Site Survey (currently completed on EmPower) at the midterm and final evaluation.

3.3.5 Students are expected to ensure the accuracy of their documented clinical hours at the end of placement. This is typically a discussion during the final evaluation and is documented on the final demographics page of the ACP.

3.3.6 Students are expected to complete one presentation/project during each clinical placement. The topic of the presentation/project should be discussed at the start of placement and be relevant to the setting and area of practice of the current placement.

3.3.7 Students are expected to complete and submit a reflection for 9581 and 9582 on a learning incident that occurred during the placement.

3.4 Dress Regulations During Clinical Placements 3.4.1 Students should abide by the dress code of the facility. This information should be requested in

the initial contact email to the CI. In the absence of a formal dress code in the facility, students should adhere to the following guidelines that require a neat and professional appearance at all times.

3.4.2 Students should be aware of dress code regulations in relation to infection control regulations specific to their facility.

3.4.3 Students are not permitted to wear jeans. Shorts should be approximately to knee-level. Shirts should be conservative in colour and tucked in.

Page | 9

3.4.4 Students should wear name tags at all times and in full view. Students should also wear facility ID where applicable.

3.4.5 Shoes should be safe, clean, non-slip with a closed-toe and heel. Running shoes should be a solid colour.

3.4.6 Students should wear very limited jewelry (eg. only a wedding band). Watches should not be worn in hospital as per infection control regulations. Earrings should be minimal, such as stud earrings.

3.4.7 Hair should be neat and tidy, with long hair tied back. 3.4.8 Nails should be clipped and clean. Nail polish should not be chipped, as per infection control

regulations. Some facilities do not permit coloured nail polish. 3.4.9 No gum at any time. 3.4.10 No beards or moustache during clinical placements. Facial hair should be kept trimmed and

neat. This is in accordance with infection control guidelines and fit mask guidelines. 3.4.11 Cell phones can only be turned on and used in designated areas within the hospital. Students

are only allowed to access their cell phone during breaks.

4. Placement Process

4.1 Clinical Placement Offers 4.1.1 The MPT program receives clinical placement offers from clinical sites within the Western

catchment area on a voluntary basis. Facilities and CI’s are under no obligation to provide clinical placements to students. The number of these offers varies from placement to placement and year to year. As such, there are no guarantees with the number or types of offers that will be available for a given placement.

4.1.2 Honorarium funding, at a rate of $40/week, is provided to all CI’s supervising a UWO student. This modest token of appreciation is to recognize the significant contribution of CI’s to the training of future Physiotherapists. The university does not provide a salary to any of its CI’s.

4.1.3 Each site makes the final decision whether a clinical placement will be offered at their facility and this offer can be withdrawn at any time, either prior to or during a clinical placement. This decision might be based on, but not limited to, workload issues, changes to CI caseload or employment, facility changes, or changes that might compromise a CI’s ability to supervise and instruct the student adequately and/or safely.

4.2 Placement Matching Process 4.2.1 Based on Human Rights Laws, UWO Policy and MPT Program Clinical Education requirements,

the ACCE is required to accommodate students with medical and athletic considerations as well as formal accommodations. In these circumstances, the ACCE might need to assign these students outside of the random matching process.

4.2.2 Whenever possible, students are assigned placements using a random computer matching system that takes into consideration students’ top10 preferences.

4.2.3 Students submit a top10 preference list online via HSPnet. This list must be submitted by the indicated deadline and according the rules indicated prior to the match. Students must consider whether they are scheduled to be in London or outside of London for a placement prior to making selections.

4.2.4 If any student pressures or coheres another student during the selection process, the student will have their placement cancelled or their assigned placement removed.

4.2.5 A student is able to select placements based on setting, area of practice, site and geographical location. A student is unable to select a placement based on the CI.

4.2.6 There is no guarantee that a student will match with a placement listed on their top10. This depends on the choices of other students and the random match. Students that do not

Page | 10

successfully match with a placement in their top10 are invited to select an option from the Opportunity List (remaining unmatched placements).

4.3 Policies and Regulations Regarding Placement Assignment in the UWO Catchment Area 4.3.1 All placements are arranged by the ACCE for each student. 4.3.2 Students are prohibited from contacting sites to arrange their own placements or inquire about

offers. Doing so could result in the cancellation of a student’s clinical placement. 4.3.3 Each student will submit a top10 list for each placement match. This top10 is submitted via

HSPnet. This list is used in the randomized matching process for each placement. 4.3.4 All students will be required to complete at least two clinical placements outside the city of

London. Given the limited number of placement offers in London, students are permitted to complete more than two placements outside the city of London. In September of the first year, students will submit their preferences for when they would like to complete placements outside the city of London. Students will be randomly selected and assigned according to their preferences. Since approximately 40-60% of the class will be scheduled to be outside of London during a given placement, students might not get their top preferences. Please note that there are no guarantees that a student will be placed in London based on this early assignment. Assignment and matching depends on placement availability that varies each placement and year to year.

4.3.5 Three of the five clinical placements must be completed in the UWO catchment area. This includes 9581 and two others.

4.4 Policies and Regulations Regarding Placement Assignment outside the UWO Catchment Area 4.4.1 Students can apply for placements outside of the UWO catchment area for 9582 – 9585, in other

areas of Ontario and within Canada. These placements are dependent on the availability of clinical placements within these regions and on the needs of the university PT program in the area. Application for a given out-of-catchment (OOC) placement is not a guarantee.

4.4.2 Students must submit their application for their OOC placement by the specified dates (typically six months in advance). Failure to do so will result in your application being denied.

4.4.3 OOC placements are arranged by the ACCE in consultation with ACCE’s from other PT programs across Canada. Students are prohibited from contacting sites to arrange their own clinical placements unless explicitly instructed to do so by the ACCE. Doing so will result in the cancellation of the student’s OOC placement.

4.4.4 Students are only permitted to complete one OOC placement in any one university catchment area.

4.4.5 Administrative Fees: Some universities charge an administrative fee to process placement requests. This fee is required whether the request is filled or not. This fee must be paid by cheque directly to the school. Some OOC facilities might charge a fee to host students on placement. This fee will be paid once the placement has been arranged.

4.4.6 Students completing placements outside of Ontario might be required to register with the provincial regulatory college (British Columbia, Manitoba, Alberta).

4.4.7 University of Toronto accepts a limited number of applications from OOC universities and will only accept 8 requests per class. Students interested in completing a placement in the Toronto catchment area will enter a lottery. These placements are still subject to availability and there are no guarantees.

Page | 11

4.4.8 Northern Ontario School of Medicine requires a specific application in addition to the typical OOC request form completed for UWO. This application is available online through their website. NOSM provides some travel funding for students interested in completing placements in the north (subject to availability).

4.4.9 All OOC placements require a completed UWO affiliation agreement between UWO and the OOC site. This is arranged by the ACCE. Failure of a site to sign the affiliation agreement will result in the delay or cancellation of the OOC placement.

4.5 Policies and Regulations Regarding International Placements 4.5.1 In all cases, the MPT program reserves the right to allow a student to complete an international

placement. 4.5.2 Students can complete an international placement during the 9584 or 9585 period. 4.5.3 Students must complete an international placement application by the October 31st deadline.

Failure to do so will result in the withdrawal of the submission. 4.5.4 Students must submit a reference letter from a previous CI that recommends the student as a

suitable candidate for an international placement. 4.5.5 Students can either apply for available international placements or can independently contact

an international health facility and secure a placement offer. 4.5.6 Students securing their own international placement need to submit an offer letter from the

international health facility as soon as possible following the submission of the application. The therapist supervising the student must be a member in good standing of the regional or national professional organization and have at least two years of clinical experience. The therapist must agree to complete the required ACP evaluation.

4.5.7 Students are permitted to participate in only one international placement during the MPT program.

4.5.8 Students interested in completing an international placement must have met (if applying for 9585) or are near meeting (if applying for 9584) all of their graduation requirements for their clinical placements.

4.5.9 A student must maintain an academic average of 75% or greater, without exception, during both the first and second year of the program.

4.5.10 Students must demonstrate strong clinical skills in all preceding placements. Students with borderline performance, significant concerns, or requiring a remedial placement will not be eligible for an international placement.

4.5.11 Students must demonstrate consistent professionalism, strong problem-solving and clinical reasoning abilities in all previous clinical placements to be eligible for an international placement.

4.5.12 Currently, the UWO Senate does not permit UWO students to complete clinical placements in the USA, unless you carry a US passport (citizen or dual citizenship).

4.5.13 If more than one student is interested in a given placement and both students have met all requirements, the successful student will be randomly selected for the placement via a lottery.

4.5.14 All international placements require a completed UWO affiliation agreement between UWO and the international site. This is arranged by the ACCE. Failure of a site to sign the affiliation agreement will result in the delay or cancellation of the placement.

4.6 Student Responsibilities in Preparation for International Placements 4.6.1 The student is responsible for completing the following paperwork, as required by the

international country, once an offer of placement has been received: • Health requirements (ie. Immunizations, etc) • Visa, if required

Page | 12

• Registration with PT professional association, if required• Registration with affiliated university, if required

4.6.2 The student is responsible for completing the following UWO MPT requirements: • UWO International Registration for Safety Abroad• Registration of Canadians Abroad (ROCA) – Foreign Affairs and International Trade

(DGAIT)• Obtain personal health insurance• Sign UWO international placement documents• Researching safety issues related to the host country (personal safety, political

stability) and clinical facility, politics, history and culture of country• Maintain weekly contact with ACCE during clinical placement• Disseminate international experience (can be via presentation, written summary, owl

blog) 4.6.3 The student is responsible for all costs related to the international placement. This might

include, but is not limited to, passport, health requirements, health and travel insurance, visa and work permits, accommodations, travel and correspondence.

4.6.4 Students are encouraged to apply for funding through various sources, including UWO, FHS, SOGS, Leslie Bisbee Bursary, MPT Program and other external sources. MPT Travel and Housing funding is limited and varies year to year depending on multiple factors. Students must submit all applications for funding by the indicated deadline and disclose all funding sources that they have either applied for or received. Failure to disclose this will result in withdrawal of the application.

4.7 Progression Through Clinical Placements 4.7.1 Unless classes are canceled due to a natural disaster or strike action, students must

successfully complete all term courses preceding a placement. Failure to successfully complete the academic term (pass all courses) will result in the delay of the start of a placement.

4.7.2 Students must successfully complete all clinical placements in order. Students will not be able to progress to the next clinical placement unless they have successfully passed all previous clinical placements.

4.8 Cancellation of a Clinical Placement 4.8.1 If a student fails to meet the program requirements (medical and non-medical) by the specified

deadlines, the student risks cancellation of their placement. 4.8.2 If the student fails to complete all necessary paperwork prior to the start of placement by the

deadline set by the facility, the student risks delay or cancellation of their placement. 4.8.3 A clinical site can cancel a placement at any time (either before or during a placement). 4.8.4 At any time during the placement, if the CI deems they are unable to meet their obligations to

either their professional college, health care facility employer and/or patients, while continuing to provide adequate supervision and instruction based on the student’s needs, the placement might be cancelled. In these circumstances, the CI, CCCE and the ACCE will decide whether this should be considered an incomplete placement, failed placement, or determine if the student should/can be relocated.

4.8.5 If a health or infection control issue arises during placement, the decision to continue with the placement is under the guidance of the facility’s Occupational Health and Safety program, UWO policy and other resources appropriate to the situation.

4.8.6 At any time during the placement, if the student demonstrates health, professional and/or clinical performance issues which significantly limit the student’s ability to perform clinical activities in a safe and effective manner, the CI, CCCE and ACCE will decide whether the

Page | 13

placement should be terminated and whether it should be considered an incomplete or failed placement.

4.8.7 If the CI demonstrates unacceptable or inappropriate professional behaviours, the placement will be terminated. Under these circumstances, the placement will be considered incomplete and efforts will be made to arrange alternate placement arrangements.

5. Student Supervision and Evaluation

5.1 Supervision During Placements 5.1.1 A student’s assigned CI or site might change due to unexpected circumstances. These last

minute changes might occur prior to, at the beginning of or during placement. 5.1.2 The CI and student will allocate specific times for discussion of clinical issues, placement

objectives, patient care, and the provision of feedback regarding the student’s clinical performance.

5.1.3 The CI will provide more instruction and supervision during the first half of placement, decreasing in instruction and supervision during the second half. The amount of supervision depends on the level and ability of the student. As the student works under the license of the CI, the level of supervision required is based on the CI’s professional judgement.

5.1.4 Junior students require the most supervision and Senior students will require the least, with students expected to be performing at entry-level at the completion of their final placement. Please refer to Expectations for Students on Placement_ACP Competencies (on Owl) for supervision guidelines.

5.1.5 Students are expected to evaluate the site and their CI at both midterm and final evaluation. This evaluation is currently completed via EmPower. If at any point a student has concerns with the site or CI, they are encouraged to contact and discuss this with the ACCE. All information will be kept strictly confidential.

5.2 Typical Evaluation of Students During Placement 5.2.1 Student clinical performance is evaluated using the online Assessment of Clinical Performance

on HSPnet. Clinical performance is evaluated by the CI(s) and also by the student (self-evaluation). Incomplete CI or self-evaluations will delay the successful completion of a given placement.

5.2.2 Students will be evaluated during the third week for the midterm evaluation and the sixth week for their final evaluation. Variations in this schedule might occur in cases where a CI is on vacation or to accommodate clinical schedules.

5.2.3 Students are evaluated on the following competencies: • Expert (assessment, analysis/ diagnosis/prognosis, intervention) • Communicator • Collaborator • Manager • Advocate • Scholarly Practitioner • Professional

5.2.4 Students are assigned a credit/pass or no-credit/fail at each evaluation based on the expectations set out in the Expectations of Students on Placement_ACP Scoring Guidelines (on Owl). This determination is based on the CI’s clinical and professional judgement. If required, the CCCE and ACCE might be included in this decision.

5.2.5 The ACCE reviews all ACP evaluations to make the final determination. The ACCE will follow up with inconsistencies or concerns.

Page | 14

5.2.6 The ACCE will set up meetings with students, as necessary, to review areas of weakness or concern.

5.2.7 Students are expected to note areas of improvement and include this information in the Student Placement Profile for the next placement.

5.2.8 A Guide for Students in Professional Program Placements, Clinical, Practica is available to students to better understand how decisions about student performance in clinical experience placements are made to help promote student success (www.uwo.ca/ombuds).

5.3 Concerns During Placement 5.3.1 If at any time during the clinical placement there are concerns with performance on any of the 7

ACP competencies, the student and the CI are expected to contact the ACCE as soon as possible. 5.3.2 If warranted, the ACCE will arrange a meeting with the student and CI to review the student’s

strengths and areas of concern. Strategies will be implemented to maximize the student’s learning and progress over the remainder of the placement. The number and frequency of meetings scheduled will be dependent on the student’s needs.

5.4 Pass/Fail Decision 5.4.1 Students that consistently perform below expectations or demonstrate significant deficits in

professionalism, communication, safety or clinical reasoning might not receive credit for a placement.

5.4.2 The following criteria justifies an unsatisfactory grade and is evaluated in relation to the expectations for a given placement level: • Consistent deficiency demonstrated despite repeated feedback and instructions • Deficiency was observed by two or more therapists in the placement. • Failure to observe safety precautions • Failure to achieve an adequate level of independence • Failure to follow ethical procedures regarding patient confidentiality • Failure to communicate effectively with clients and the health care team • Failure to develop professional standards in promptness, attendance, charting, dress and

behaviours • Failure to perform satisfactory assessments • Failure to perform satisfactory treatments • Failure to provide timely and accurate chart documentation and reports • Failure to complete facility patient statistics related to workload • Failure to set up and modify appropriate goals and programs based on assessment • Failure to meet time management and caseload requirements • Failure to demonstrate adequate clinical reasoning and judgement • Failure to treat complex patient cases appropriately • Failure to meet expectations for other areas of knowledge, skills, behaviours or clinical

judgement 5.4.3 By the end of the placement, should there be any concerns by the CI at the end of the

placement as to whether the student should pass or fail, the CI, ACCE and CCCE, in consultation with the student, will make a collaborative and unanimous decision. The decision will be based on the following criteria: • The student’s clinical performance during the placement • Placement expectations based on the Expectations of Students on Placement guidelines (on

Owl) • Verbal and written comments provided by the student, CI, and when warranted, the CCCE

and ACCE (typically provided during the final evaluation) • Areas of significant concern indicated in the ACP evaluation tool

Page | 15

5.4.4 The student is encouraged to invite a supportive colleague or ombudsperson to attend the final evaluation to act as an observer and provide moral support for the student (the colleague cannot be a parent).

5.4.5 Upon reviewing the final ACP evaluations, if the ACCE determines the CI has evaluated the student incorrectly, the student’s pass/fail mark can be revised if warranted. In order to do so, the student is consulted, after which the ACCE, CCCE and CI will discuss the revision and a collaborative and unanimous decision related to a pass or fail will be made. If a consensus is not achieved, the Student Affairs Chair will be included in the final decision.

5.4.6 Under circumstances when the student may be at risk of failing a second clinical placement, a MPT faculty member might be requested to attend the final evaluation as an unbiased decision-maker, in addition to the student, CI, CCCE and the ACCE.

5.5 Policy and Procedures after a Failed Placement 5.5.1 One unsatisfactory placement will result in an incomplete mark for that clinical course. 5.5.2 When a student fails a clinical placement, the student, ACCE, MPT Chair and Chair of Student

Affairs will discuss whether an assessment through Services for students with Disabilities (SSD) is required to formalize any accommodations.

5.5.3 Students are eligible to appeal the course grade by following the procedures outlined in the academic handbook.

5.5.4 Students are eligible to request a remedial placement following the procedures outlined in the academic handbook. This request requires the permission of the MPT Chair. It is at the discretion of the MPT Chair to grant or deny a remedial placement.

5.6 Remedial Placements 5.6.1 An administrative fee of $250 is required for a remedial placement. 5.6.2 Once a remedial placement has been granted, the student will meet with the ACCE to review

significant concerns related to the failed placement and develop strategies to improve success during the remedial placement.

5.6.3 If there is a need for formal accommodations, the assessment through SSD must be completed with recommendations prior to the student being assigned to the remedial placement. The information specific to the type of accommodations must be shared with the clinical site and CI prior to confirming an offer to ensure the placement is an appropriate fit for the student.

5.6.4 The remedial placement is arranged by the ACCE and will be in the same setting and area of practice as the failed placement.

5.6.5 The ACCE, CI and student will meet prior to or at the beginning of placement to confirm the timeline, requirements, key areas for improvement, strategies to assist the student in maximizing performance and placement expectations.

5.6.6 Remedial placements require three evaluations completed during weeks 2, 4 and 6. The ACCE will attend these evaluations if necessary. If the ACCE is not in attendance, immediate follow up is required by the student and the CI if concerns persist.

5.6.7 Students must successfully complete a remedial placement before progressing to the next clinical placement. Students are eligible to continue progress in the academic term, if approved by the MPT Chair.

5.6.8 Remedial placements are typically completed during the next placement block. In the case of failing the Senior placement (9585), students will be expected to complete the remedial placement in the next fall term, thereby necessitating a delay in their convocation date. The timing of the placement will be dependent on placement availability and suitability for the CI and site, and as such, might vary from the typical placement time period.

5.6.9 The site and CI will be informed that the request is for a remedial placement, as well as information regarding the ACP areas of concern, formal accommodations through SSD (if

Page | 16

required), alternate structure for evaluation and additional time requirements for feedback, evaluation, supervision and instruction.

5.6.10 A second unsatisfactory clinical placement, whether remedial or in a subsequent clinical placement, constitutes a fail in that clinical course. In this case, there is no option for remedial work. Students who fail two clinical placements will be required to withdraw from the MPT program.

5.7 Course Grades 5.7.1 Each student will receive a course grade for each placement at the end of each placement.

Course grades are pass/fail or in some cases, listed as ‘in progress’. Course grades will not be posted prior to the completion of a placement.

5.7.2 Each placement is awarded one full credit on the transcript. 5.7.3 The course grade is based on the student’s performance on the ACP. As such, any incomplete

documents will result in the withholding of a course grade, which might delay the student’s progress to the next term.

5.7.4 Incomplete documents for 9585 might delay the student’s registration with the regulatory college and subsequent ability to work as planned. Course grades must be submitted by the SGPS deadline of August 31 in order to qualify for the fall convocation.

6. Clinical Accommodations

6.1 Formal Accommodations through Services for Students with Disabilities (SSD) 6.1.1 Students who wish to seek out formal accommodations for clinical placements must ensure that

a request for formal accommodations is made in accordance with and within the time limits prescribed under the university’s policy on Academic Accommodations for Students with Disabilities (http://www.westerncalendar.uwo.ca/2010/pg118.html)

6.1.2 All requests for formal accommodations related to clinical placements for an identified physical, learning or medical limitation, which is long-term in nature (> 3 months duration), must be made through SSD.

6.1.3 It is the student’s responsibility to contact SSD for an assessment as soon as possible once admission to the MPT program has been received.

6.1.4 It is the responsibility of the student and SSD to provide an assessment that identifies the student’s areas of need as well as obtain necessary medical information from the student’s doctors as needed.

6.1.5 The SSD accommodations must be shared with the ACCE at least 10 weeks prior to the beginning of clinical placement. If results are received less than 10 weeks prior, the ACCE cannot guarantee that a clinical placement with accommodations will be provided.

6.1.6 Once the assessment has been completed, the ACCE will discuss the results with a representative from SSD to ensure clarity of what is required. The number and frequency of these meetings will depend on the evolving needs of the student.

6.1.7 The ACCE and the student will meet prior to organizing the clinical placement to ensure clarity of what is required and further develop clinical placement recommendations, identify requirements of the placement and the realities of the clinical placement health care environment. These details will be shared with the CI or CCCE at the facility where the student will be completing their placement. These details are shared prior to the facility offering a placement. This is to ensure that the CI and site are able to provide adequate instruction and supervision for the student, while still providing adequate and safe patient care. Failure to share this information with the site will result in cancellation of the clinical placement.

6.1.8 Once a placement is confirmed, the ACCE, CI and student will meet prior to the start of the placement to discuss the recommendations, expectations and develop additional strategies as

Page | 17

necessary. If required, other individuals might attend these meetings as needed (ex. psychologist, representative from SSD). The number and frequency of these meetings will depend on the needs of the student and CI.

6.1.9 In all cases, when formal accommodations are granted, the student must still meet all of the expectations and learning outcomes of the clinical placement as outlined in the Expectations of Students on Placement documents (on Owl). The purpose of the formal accommodations are to assist the student by providing an environment that will maximize learning and performance, but does not change the expectations of the clinical placement. It is the student’s responsibility to meet the expectations of the clinical placement.

6.2 Formal Accommodations through the MPT Program 6.2.1 Health limitations that are short-term in nature (< 3 months duration) and might affect a

student’s clinical performance are dealt with on an individual basis by the MPT program and ACCE.

6.2.2 In some cases, the student’s placement will be cancelled if the student is unable to perform the activities required to meet the expectations and learning outcomes of the placement.

6.2.3 The student is required to provide a doctor’s note indicating the nature of the medical condition, the impact on the student’s clinical placement performance, and the recommended physical modifications or limitations to participating in a clinical placement. These recommendations should also include a timeline. Please note that a diagnosis will not be shared with the MPT program unless the student specifically agrees to share the diagnosis

6.2.4 Formal accommodations will be developed by the ACCE, in consultation with the student. These details must be shared with the clinical site prior to confirming an offer, if the student’s health issues will have an impact on their clinical placement performance. This is to ensure that the site is able to provide adequate supervision and an appropriate environment for the student.

6.2.5 Once an offer is confirmed, the ACCE, CCCE, CI and student will meet prior to the placement to discuss how the implement the accommodations to maximize the student’s clinical placement performance prior to the placement.

6.3 Students at Risk without Formal Accommodations 6.3.1 Students are considered ‘at risk’ if significant deficits are demonstrated in either academic or

clinical performance that could significantly and negatively impact the student’s clinical performance, patient safety, and/or the clinical instructor’s ability to provide adequate care to patients. This might be due to a learning disability, attention deficit, physical or mental health condition or medical condition. Students will be directed to SSD and Student Health Services. If the reason is short-term in nature, the student will be directed to seek formal accommodation through the MPT program.

6.3.2 If formal accommodations are required, the student’s next placement might be delayed to ensure the necessary assessments are completed and accommodations can be granted.

6.3.3 If the student declines a recommended assessment by SSD or fails to follow up with a doctor’s note, the MPT will be unable to implement accommodations for clinical placements.

6.3.4 If the underlying cause is related to poor academic performance, these details will be shared with the CCCE and CI if these limitations will have an impact on the student’s performance on clinical placement.

6.3.5 When no formal accommodations are in place (either short-term or long-term), the student will be assigned a placement based on the standard random computer matching process. In some cases, at the discretion of the ACCE, a placement might be assigned. The student is encouraged to share information related to their academic and clinical performance, learning and physical disabilities or medical conditions via the Student Placement Profile.

Page | 18

6.3.6 If the student refuses to allow the MPT program to share pertinent information related to previous academic issues or clinical performance that will impact a placement, the placement will be cancelled.

7. Other Workplace Considerations

7.1 Privacy of Information 7.1.1 The MPT Program is required to share pertinent student information with the placement facility.

This includes all relevant information such as academic performance, clinical performance, medical issues, learning or physical disabilities, accommodations, or other information which could negatively affect the health and safety of patients, the ability of the facility and/or CI to meet obligations to patients and staff, or the student’s clinical performance.

7.1.2 Prior to a student starting a placement, the ACCE might share information if deemed necessary for the CI and CCCE to make decisions regarding the CI’s ability to offer the student a placement. This information will be used to determine if sufficient resources are available at the facility to maximize the student’s clinical performance and learning during placement and to ensure the student is appropriately assigned to a CI that can adequately support the student.

7.1.3 The MPT program follows the guidance of the UWO Privacy Officer and UWO Legal Services to clarify all legal obligations related to the sharing of student information with sites when warranted. Once confidential information is provided to a site, the CI and CCCE will ensure that this information is only used for the purposes for which it was given to the facility. This information will not be disclosed to any other person without permission of the university.

7.2 Legal and Ethical Considerations, including Patient Privacy and Confidentiality 7.2.1 Students must sign the facility Privacy and Confidentiality form (if applicable) 7.2.2 The student should avoid discussing the patient outside of the clinical area, including areas such

the hallway, elevator, cafeteria, etc. 7.2.3 The student should avoid mentioning the patient’s name when discussing conditions seen in the

clinic. 7.2.4 The student should avoid discussing the patient with other professionals in front of the patient. 7.2.5 The student should ensure that the discussion within the professional area is within hearing

distance of medical personnel only. 7.2.6 The student should explain the treatment procedure and purpose to the patient. Any questions

from the patient relating to his diagnosis or prognosis might be discussed with the patient, provided that the student has first consulted with the supervising therapist.

7.2.7 All communication by the student to members of the medical profession regarding a patient must be made known to the supervising therapist.

7.2.8 The student should make sure other members of the medical team are well identified prior to discussing a patient’s progress with them.

7.2.9 A student should be careful of what is said when talking in front of a patient. The student should be professional in all matters.

7.2.10 A student should not advise WSIB patients the they can resume work without consultation with the supervising therapist and a doctor.

7.2.11 A student should not allow the patient to have access to patient records without the approval of the therapist in charge of that patient.

7.2.12 A student should not show a medical chart or discuss the condition of a patient with volunteer staff.

7.2.13 Nothing should be photocopied from the chart. If a report is needed for its educational value, arrangements can be made to obtain a copy through Medical Records with the patient’s confidential information removed.

Page | 19

7.2.14 The student must avoid personal involvement with patients.

7.3 Student Liability and Worker’s Safety and Insurance Board (WSIB) Coverage 7.3.1 Students are covered by Malpractice Liability Insurance by UWO while on clinical placement,

provided that they are carrying out duties that are part of the clinical experience course. This insurance is extended to students in a clinical affiliation outside the province of Ontario or outside of Canada.

7.3.2 Students are covered for WSIB or ACE-INA Insurance (sites not covered by WSIB) claims by the Government of Ontario, Ministry of Training Colleges and Universities (MTCU) for any injuries which might occur during placements undertaken in the province of Ontario.

7.3.3 Students injured at a WSIB-covered facility will be required to sign the Student Declararation of Understanding Workplace Safety and Insurance Board or Private Insurance Coverage on Students on Program-Related Placements document indicating they are aware of MTCU-WSIB coverage. This signed document will be kept in your MPT file.

7.3.4 Should a student be injured during placement, the ACCE must be notified immediately and the following forms must be completed and sent to the CE Admin:

• Site Accident/Incident form• MTCU – Letter of Authorization to Represent Employer form• MTCU – Postsecondary Student Unpaid Work Placement Workplace Insurance Claim

form or ACE-INA Insurance form7.3.5 Students should carry personal health accident insurance for all placements undertaken outside

Ontario.