Physical Therapy Evaluation and Feedback: Helpful Hints for Objective Evaluation of Student Performance Harriet Lewis, PT, MS Assistant Clinical Professor

Objectives At the end of this module, the participant will be able to: Discuss principles of objective evaluation. Avoid the pitfalls and common errors of performance evaluation. Write meaningful feedback/comments regarding student performance. Deliver useful verbal feedback. Develop strategies for managing student performance issues. Identify legal issues related to student performance evaluation.

Principles of evaluation A good evaluation is based on: –First-hand observations –Typical and frequent behavior, rather than the exception –Behavior at the time of the evaluation Written and verbal feedback –Should be used to denote change

Principles of evaluation The key to good evaluation is timely communication about: –Goals and objectives of the clinical site and the educational program –Expectations of the Clinical Instructor (CI) –Expectations of the student –Expectations of the academic program –Performance “highlights” and “lowlights”

Principles of evaluation How to avoid pitfalls –Establish well-defined goals for the rotation. –Determine daily and weekly objectives that will assist the student to reach the goals. –Maintain consistent expectations that are shared often with the student. –Observe the student’s performance carefully. –Write down your observations.

Principles of evaluation Common Errors –Halo or reverse halo Grading performance criteria that are in close proximity the same. –Error of central tendency Grading by “staying in the middle” to avoid awarding a high or low score. –Leniency Overlooking or choosing to ignore negative aspects of performance.

Principles of evaluation More common errors –Rater mood or memory Choosing a time to complete the evaluation when your mood and/or your memory is hampered. –Initial impressions Allowing first impressions (positive or negative) to unduly influence your rating. –Similarity of background or issues of diversity Allowing similarities or differences in background to influence your rating.

Principles of Evaluation Avoiding errors –Choose a time when you are fresh and alert. –Use your documentation to assist (weekly planning form, personal notes, student documentation and other paperwork, etc.). –Rate each performance criterion on its own merits. –Use your professional judgment to award a rating that reflects the student’s current performance.

Written feedback (comments) What do these comments tell you, the student and/or the academic program about the student’s performance? –Student doing well for his/her level of education. –Student has shown improvement since last assessment –Student doing fairly well with this aspect of care. –No concerns on this skill. –Same as mid-term assessment.

Written feedback (comments) How to make written feedback useful and meaningful to the student and ACCE/DCE –List specific areas where the student is performing well. –Discuss specific areas where the student has shown improvement. –Explain reasons why you have no concerns. –Identify areas that the student is still working to improve.

Written feedback (comments) Good Examples –Student has shown improvement in documentation skills. All evaluations are submitted in 24 hours (clinic policy). They are complete and legible. The short and long term goals are appropriate and related to the patient’s goals. Student requires reminders 25% of the time to use appropriate language and abbreviations. –The student is a good advocate for the patient. She has facilitated several patient/physician encounters, spoken to several family members regarding patient needs, and requested the intervention of social services for several patients. Student requires assistance 10% of the time to work on follow-up on results of her advocacy.

Verbal feedback Feedback addresses behaviors, not personality issues. Feedback discusses the effect of the behavior Good feedback is: – Specific and direct – addresses performance with respect to expectations. – Balanced – includes positive and negative behaviors. – Immediate – occurs as soon after incident as possible. – Brief – discusses the essential aspects of performance. More words do not necessarily make a bigger impact. – Tactical – offers strategies for improvement. –Collaborative – asks for ways CI can assist student.

Managing performance issues Use tools to determine nature of the problem –Clinical Performance Instrument –Generic Abilities or other professional development assessment (see forms) –Core Values assessment (see forms) –Verbal and/or written questions –Weekly planning form (see forms)

Managing performance issues Devise a strategy for success in consultation with the student. Possible strategies for knowledge deficits –Reading assignments – textbooks, journals, internet resources, etc. –Written homework –Paper cases –Verbal or written questioning –Reflective journal

Managing performance issues Possible strategies for skill deficits View instructional videos Review video of student’s performance Observe CI demonstration Practice with CI and/or tech as the patient Practice with student’s hands over CI’s hands patient and/or the reverse Solicit patient feedback after CI and student perform same procedure

Managing performance deficits Possible strategies for clinical reasoning deficits –Paper cases –Directed questioning –Written or verbal discussion of plan prior to patient encounters –Simpler cases –Task dissection to work on problem areas –Guided problem solving where CI and student “think out loud”

Managing performance deficits Professional behavior deficits –Learning contract –Reflective journal –Written assignments –Core values or Generic Abilities assessment Write out a plan for correction of deficits

Legal Issues Supervision –Obey your state’s practice act (Texas Practice Act Rule 322.3, 322.4) –Comply with CMS (Medicare and Medicaid) regulations –Follow APTA policies & positions Reimbursement –Demonstrate sound billing procedures that conform to federal and state laws. Safety –Display safe actions in all situations Policies of your institution –Inform the student of applicable policies and procedures for your site.

References Physical Therapy Clinical Instructor Educator Credentialing Manual. Alexandria, VA: American Physical Therapy Association; 1997 (rev 2005, 2013). A Normative Model of Physical Therapist Professional Education: Version Alexandria, VA: American Physical Therapy Association; 2000: 43-44, Texas Practice Act. Austin, TX: Texas Board of PT/OT Examiners; 2004: 1-6. Clinical Education Handbook. San Angelo, TX: Angelo State University; 2011: II-3,4.