Faculty Bibliography

Background and Purpose. Clinical education experiences (CEEs) provide physical therapist (PT) students with opportunities to be immersed in clinical practice to develop professional skills and behaviors under the supervision of a clinical instructor (CI). Essential characteristics and qualities of CIs and of the clinical practice environments in which CEEs take place that promote student learning are clearly described in the literature and in professional documents. However, there are currently wide variations in the quality of CEEs. Factors that appear to contribute to this variability include the CIs' teaching skills, the culture of the clinical site, and supports extended by physical therapist (PT) education programs. The purpose of this paper is to define the baseline qualifications and essential characteristics of CIs and of practice environments that our profession should consider as standards for clinical education and to make recommendations for changes that are needed to promote consistently high quality CEEs. Position and Rationale. It is our position that all stakeholders in clinical education need to engage in a deliberate effort to ensure that all students have access to quality CEEs that demonstrate agreed upon, evidence-based professional standards. We propose that the development of CIs is analogous to the development of a skilled PT, such that CIs move from being novice to expert clinical teachers. Clinical instructors and clinical education sites should be assessed in a standardized manner and the results shared across PT education programs education programs to cultivate high quality CEEs. Directors of clinical education (DCEs), working together through regional consortium, can meet the identified professional development needs of CIs and of center coordinators of clinical education (CCCEs) in an efficient and timely manner. Furthermore, we recommend that the expert CI be recognized as a clinical education specialist in the same way other specialists are recognized by the American Board of Physical Therapy Specialties (ABPTS). Physical therapist education programs, clinical education sites, and the profession at large must acknowledge the benefits of quality CEEs and assume responsibility to foster the development of expert CIs and of learning environments conducive to student learning. Discussion and Conclusion. Physical therapist education programs and clinical sites need to be held accountable to ensure that evidence-based and agreed upon standards for CEEs are available to all students. This will require negotiation and compromise by administrators at both settings. National-level discussion is required to develop a strategic plan to determine how these recommendations might be implemented so that professional standards for all CEEs are realized.

This case study will describe the journey of a patient admitted to an urban, tertiary medical center for bariatric surgery and the unexpected challenges encountered by the clinical staff in caring for him. Despite having awell-established bariatric surgical program, it took only one patient who deviated from the "norm" to cause thestaff to reexamine the way that bariatric patients are cared for in the facility, particularly with regard to their mobility and safe patient handling needs. The lessons learned from this experience and the patient’s own perspective have enabled a more informed approach to how bariatric patients are cared for throughout the hospital and led to an adjustment of protocols in this area of practice