HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hayes, K. W Articles by Sanders, B. Search for Related Content PubMed Articles by Hayes, K. W Articles by Sanders, B.

Author Response:

	Introduction

 
We thank Dr Mostrom for her thoughtful comments about our article. She has eloquently expressed many of the ideas we discussed during our work on this project. We especially agree with Dr Mostrom that academic faculty and clinical instructors (CIs) have a dual responsibility to provide feedback to students as soon as unacceptable cognitive or noncognitive behaviors are noted. Inadequate knowledge or psychomotor skills appear to be easy to document and attempt to correct, but noncognitive behaviors may also lead to ineffective care and should be addressed. The recently published Guide to Physical Therapist Practice,¹ A Normative Model of Physical Therapist Professional Education,² and Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists³ are available to help define a standard of safe and effective performance. Fear and discomfort should not prevent faculty and CIs from sharing and documenting their honest opinions about behaviors of concern. In the interest of students' future patients or clients, faculty and CIs should strive to identify those students who lack the appropriate knowledge, skills, and attitudes to render safe and effective care. Generic abilities assessment,⁴ committees that examine student progress, and many other methods are available to identify and discuss behaviors of concern. Regardless of the method used to determine unacceptable behaviors, as soon as they are recognized, faculty and CIs should discuss with the students the unacceptability of those behaviors and the need to change them for successful academic and clinical performance. Incorporating student self-evaluation is an important component of this discussion. Students can be expected to assume the responsibility to acknowledge their behavior, identify strategies to change it, and undertake activities to do so.

Clinical instructors, center coordinators of clinical education (CCCEs), and academic programs can work together in this task. Clinical instructors and CCCEs should not hesitate to contact academic coordinators of clinical education (ACCEs) for advice or even to request that a student be removed from the clinic if the situation has become untenable. In addition, many academic programs offer professional development in clinical education for CIs. Workshops have been offered to assist CIs in evaluating marginal students,⁵ and the American Physical Therapy Association offers a training course for CI credentialing. The CI credentialing program addresses strategies for dealing with noncognitive behaviors.

We also agree with Dr Mostrom's ideas about the directions for future research regarding student performance. As she suggested, our data could be influenced by incomplete recall. Studies gathering more recent critical incidents would yield much richer descriptions of both the behaviors and the nature of the interventions offered. Dr Mostrom suggested studies of the nature of CI interventions, and we agree. Investigating the nature of the interventions was not the original intent of our study, so our information included little detail of the type of intervention offered by the CIs for different types of problems. It would be interesting to identify types of feedback and interventions that are effective or ineffective in producing behavior change. Our study raised the question of potential gender bias in clinical education or performance problems differentially related to gender, but we could not offer explanations. This area also merits further investigation.

We again thank Dr Mostrom for her articulate remarks, and we hope that raising questions and stimulating thought about effective professional education is just a beginning. We join Dr Mostrom in encouraging more research on the nature of clinical competence in physical therapy.

	References

Top Introduction References

 

1. Guide to Physical Therapist Practice. Phys Ther.1997; 77:1163–1650.
2. A Normative Model of Physical Therapist Professional Education: Version '97. Alexandria, Va: Education Division, American Physical Therapy Association,1997 .
3. Commission on Accreditation in Physical Therapy Education. Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists. Alexandria, Va: American Physical Therapy Association,1996 .
4. May WW, Morgan BJ, Lemke JC, et al. Model for ability-based assessment in physical therapy education. Journal of Physical Therapy Education.1995; 9(1):3–6.
5. Verma S, Paterson M. Evaluating the marginal student: a workshop for clinical faculty. J Allied Health.1998; 27:162–166.[Medline]

This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hayes, K. W Articles by Sanders, B. Search for Related Content PubMed Articles by Hayes, K. W Articles by Sanders, B.