12/15/2016. Renée Van Veld, PT, MS Lori Thorp, PT, MS, MBA Kristin Roth, PT, DPT Stephanie Thorsen, PTA, BS AND AND AND

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1 Renée Van Veld, PT, MS Lori Thorp, PT, MS, MBA Kristin Roth, PT, DPT Stephanie Thorsen, PTA, BS Renée Van Veld, PT, MS DCE, Krannert School of Physical Therapy, University of Indianapolis Lori Thorp, PT, MS, MBA Associate Vice President, Eskenazi Health Kristin Roth, PT, DPT Outpatient Manager, Eskenazi Health Stephanie Thorsen, PTA, BS CCCE for acute care, Eskenazi Health Who we are: A clinical education (CE) team! CCCEs, CIs, Administrators, Academic Educators Eskenazi Health: 300-bed urban safety-net county hospital with 32 PTs/9 PTAs. Level 1 Trauma facility since University of Indianapolis (UIndy): PT program est. as MS level in 1980, DPT in 2002, PTA program since

2 Participants will appreciate the current challenges of clinical education for academic and clinical institutions. Participants will identify components of an effective model of clinical education in the hospital-based setting. Participants will consider the ideal role of the CCCE. Participants will discuss alternative clinical education opportunities for the future that can benefit the student and the clinical organization. CAPTE standards represent the minimum standards for PT education, including clinical education. There is no consensus about what is quality or best practice in clinical education. McCallum et al. 2013; Jette et al National initiatives are working to establish characteristics of excellence/quality/best practice. Clinical Education Summit Physical Therapist Education for the 21 st Century Study (PTE-21) Hack et al., 2016 ACAPT Excellence in PT Education Task Force Various national presentations 2

3 Summit 2014 Harmonization: CE Partnerships Clinical faculty preparation & development CCCEs as Education Leaders Summit 2014 Innovation: Culture of shared responsibility for CE Collaboration through networks PTE-21: Include professional education in the mission of CE sites. All clinicians should recognize the need to contribute to CE Making clinical sites full partners with academic programs, in contrast to the existing hierarchy ( educational programs can t exist in isolation and be excellent ). Broadening the view of the benefits of clinical education to clinical sites. Hack et al., 2016 ACAPT Excellence in PT Ed Task Force Tasked with development of benchmarks of excellence against which programs may assess themselves. Survey of PT education programs (admin, faculty, students) in progress. 6 clusters of questions focused on all aspects of PT education, including CE. 3

4 Culture or Excellence? Must develop a culture of education first. Establishing a positive culture requires modeling desired behavior at all levels of management an effective culture must be aligned with employee values and be consistent with the environment in which the organization operates. Sadri & Lees, 2001 CCCE interested in clinical teaching How can DCEs assist? Limited # of active contracts with academic programs to ensure offered spots were selected = more students around all the time. Collected data on student satisfaction. Applebaum et al Inservices on education topics based on data. Development of a department-specific vision statement which included education. Included education as an integral part of annual evaluations to reflect the vision. Wrote a letter to incoming students in the welcome info packet. Elevated the role of the CCCE. 4

5 Lori Thorp, PT, MS, MBA Associate Vice President, Eskenazi Health The mission of Eskenazi Health is to Advocate, Care, TEACH and Serve. The Department of Rehabilitation embraces this mission as well. Dedicated clinical education coordinators: Physical therapy (2) Occupational therapy (2) Speech therapy (1) 5

6 Clinical ladder: Clinical coordinators are recognized and compensated as leaders. Employees are not promoted into position without a formal interview process. Promotion to a team leader. Salary increase. Reduced productivity. Increased expectations and responsibilities. Job Descriptions Student education is part of every JD Variable degree of participation by each employee. Performance Appraisals Employees are held accountable for clinical education as part of their PA. Turnover for non-students: (2014, 2015) 3% Turnover for students: (2014, 2015) 0% National averages 8%-10% 6

7 Cost of turnover for 1 PT: Est. $27, % of overall operating costs PT in Motion, 2010 Productivity: Students have a neutral impact on productivity. 81.2% without students 80.9% with students Patient Satisfaction Data: Q % Q % Q % Q % ** Benchmark is 83.6% 7

8 Vouchers for continuing education and APTA items (UIndy). Other internal and external continuing education benefits. Research partners. Manager/ student roundtables. Advocacy for advanced programming. Management panels at local universities. Other management experiences during student rotations. Student placement statistics. Student feedback and outcomes. Goals. Updates. 8

9 Kristin Roth, PT, DPT Manager of Outpatient Rehabilitation Services Interviewing candidates with clinical education in mind. CCCE involvement with new employee orientation. Hiring former students: Lower turnover rates. Confidence in hiring a former student. Increased ease in orientation and transition to patient care. 9

10 Space Resources Regulations Dual role of Acute Care CCCE and Outpatient CCCE: Both CCCEs involved in all student, CI, and university communication. Cross coverage ability. Shared workload and collaboration. Both CCCEs guide and support clinical instruction through: New CI mentorship. APTA Certified Clinical Instructors. Standardized weekly student goals. Face-to-face check-ins with both student and CI. 10

11 Both CCCEs: Seek student feedback. Receive Management / Director Support: Lower productivity standard Quarterly director / CCCE meetings Have autonomy to pursue alternative learning models and program expansion. Stephanie Thorsen, PTA, BS CCCE, Eskenazi Health My Background: PTA since 2010, CI since 2011, CCCE since TA at University of Indianapolis. Eskenazi Background: 2 PT CCCEs; interview process for promotion. One on acute care side (hospital-based therapists). One on outpatient side for outlying clinics. 11

12 In 2016 our student program took on: 21 PT students and 10 PTA students (additional 5 slots offered) for 19 PTs/PTAs. 34 OT students for 13 OTs (including 1-2 week observation students). 7 ST students for 5 SLPs. New staff throughout 2016, projected to take 46 PT/PTA students in No students your first year at Eskenazi. Mentorship from seasoned CI with your first student. UIndy offers CI Credentialing Course (CCIP) partnering with another local university. CI has ongoing dialogue with CCCE with all students. Student surveys on CI specifically and Eskenazi as a whole. Eskenazi is a teaching hospital with a lot to offer! Emergency Department Occupational Health Burn Unit and Wound Care Specialty clinics (Ortho, Amputee, Women s Health) OR observations are standard *NEW* Pedigo clinic to serve homeless population 12

13 We currently have contracts with 6 universities for PT. Trial a one year contract with new universities upon request. Invite DCE here for tour, layout of our student program. /Phone DCE for updates on either end. Quarterly meeting for PT/OT/ST CCCE CI input, questions, concerns Research needs = student project Orientation process same for PT/OT/ST E-learning Weekly goal guidelines Inter-professional powerpoint for coevaluations Maintain a productivity standard that is decreased 5% from other staff. Orientations split between 2 CCCEs for PT to decrease burden. Set aside time to complete electronic communication with schools/ students regularly. 13

14 Twice monthly Over lunch to prevent time away from patient care. Located at hospital or outpatient clinic. Student facilitator Topics chosen by CCCE Determined by student discipline/staff needs. Director-led meetings for interviews/resumes. Needs assessment: Too many requests for undergrad student observations. Stress on staff. Provide structured environment for hands on learning: Real patients, wound care models. PT/OT representation and IP/OP settings. Minimal staffing needs for maximal benefit. Examples: ED, Clinic for Homeless, Burn, Wound Adjust goals for specific settings: Rely on expertise of CI in each area. Work with DCE at student s university. Modify expectations for entry level. 14

15 For CCCEs / Clinical Sites: Start with management share data, encourage a study of productivity/patient satisfaction. Ask for autonomy in decisions for CCCEs. Staff involvement/education in any way, not just managing a full-time rotation. For DCEs / Academic Programs: Seeking partnerships, reaching out to management-level people as well as CCCEs. Sharing specific data about measurable benefits of CE. Education of staff including CCIP, inservices, etc. Include sites in research. What are your ideas for: Initiating or improving a partnership? Creating a culture of education? Developing excellence in clinical education? 15

16 References 1. Allen DG, Bryant PC, Vardaman JM. Retaining talent: replacing misconceptions with evidence-based strategies. Acad Manag Perspect. 2010;24(2): American Council of Academic Physical Therapy. Summit report and recommendations Accessed March 8, Applebaum D, Portnoy L, Kolosky L, et al. Building Physical Therapist Education Networks. J Phys Ther Educ. 2014;28(suppl): Deusinger Ss, Crowner BE, Burlis TL, Stith JS. Meeting contemporary expectations for physical therapists: Imperatives, challenges and proposed solutions for professional education. J Phys Ther Educ. 2014;28(suppl): Hack LM, Nordstrom T, Jensen GM, Gwyer JL. Leadership: the key to excellence in physical therapist education: recommendations from the physical therapy education for the 21st century study. Presented at: APTA Educational Leadership Conference; October 8, 2016; Phoenix, AZ. 6. Jette D, Nelson L, Palaima M, Wetherbee E. How do we improve quality in clinical education? Examination of structures, processes, and outcomes. J Phys Ther Educ. 2014;28(suppl): Jewell DV, Moore JD, Goldstein MS. Delivering the physical therapy value proposition: a call to action. Phys Ther. 2013;93(1): American Physical Therapy Association. Physical Therapy Workforce Data. Accessed December 12, Recker-Hughes C, Wetherbee E, Buccieri KM, Fitzpatrick Timmerberg J, Stol AM. Essential Characteristics of Quality Clinical Education Experiences: Standards to Facilitate Student Learning. J Phys Ther Educ. 2014;28(suppl): Sadri G, Lees B. Developing corporate culture as a competitive advantage. J Manage Dev. 2001;20(10): Sheldon M, Cavaugh J, Croninger W, et al. Preparing rehabilitation healthcare providers in the 21st century: Implementation of interprofessional education through an academicclinical site partnership. IOS Press. 2012;41(3): Vanderhoff, Michelle. How to Keep the Grass Greener on Your Side of the Fence. PT in Motion; 2010 (11). Accessed December 1, Wetherbee E, Peatman N, Kenney D, Cusson M, Applebaum, D. Standards for clinical education: A qualitative study. J Phys Ther Educ. 2010;24(3): Willard G. How to Really Calculate the Cost of Employee Turnover. ERE Media. July 18, Accessed March 8, 2016.