Another Approach to the Proficiencies "I really enjoy forgetting. When I first come to a place I notice all the little details I notice the way the sky looks The color of white paper The way people walk Doorknobs Everything Then I get used to the place And I don't notice them anymore So only by forgetting Can I see the place again As it really is." -David Byrne, True Stories (The Movie)

What is a Proficiency? Common grouping of the Competencies: –Cognitive –Psychomotor –Affective All Proficiencies have related Competencies Not all Competencies have related Proficiencies

Spread(sheet)ing Yourself Thin While models such as this meet the intent of the model and conform to the JRC-AT standards, they are overly work-intensive.

Alternate Premise Emphasis on the outcomes Finite evaluation performed in laboratories Decision making and application are emphasis during Clinical Education

Evaluating the Proficiencies Classroom Laboratory Clinical Education

Classroom Evaluation What: –Cognitive and affective competencies Methodology: –Written examinations –Case studies Documentation: –Course syllabus –Examinations –Case study reports

Laboratory Evaluation What: –Psychomotor competencies –Developing the proficiencies Methodology: –Practical examinations –Role playing Documentation: –Course syllabus –Psychomotor evaluation tools

Clinical Assignment What: –Clinical application Methodology: –Actual patient care –Scenarios Documentation: –Syllabus –Clinical Evaluation Forms

Sample Application Cryotherapy

Classroom Cognitive #12 “ Describes the physical properties, biophysics, setup, indications, contraindications, and specific physiological effects associated with the application of therapeutic heat and cold. ” Speak specifically about (and evaluate via written examinations): a. cold whirlpoole. ice immersion b. CCTf. ice massage c. ice packg. cryokinetics d. vapo-coolant spray

Laboratory Psychomotor #5 “ Performs the appropriate setup for therapeutic modalities. ” Teaching Objective #2 “ … demonstrate the ability to select the appropriate parameters for, prepare, and apply the following: Specifically practice and evaluate: a. cold whirlpoole. ice immersion b. CCTf. ice massage c. ice packg. cryokinetics d. vapo-coolant spray

Clinical Can the student identify the indications, contraindications to the use of the modality? Can the student integrate the use of cold into the patient ’ s treatment routine? Does the student demonstrate proper application and decision-making skills? Note: Each of the seven cold modalities does NOT have to be evaluated in this setting.

Lest We Forget…. Professional assimilation Teaching pre-professionals how to be professional Practice-oriented education

NON-ATC ACIs: FYI Content experts can evaluate proficiencies and/or psychomotor skills that fall within their realm of expertise. The student ’ s ability to apply or integrate the skill is then evaluated by an ACI. Example: –Blood pressure assessment evaluated in Ex Phys –ACI evaluates the student ’ s ability to integrate

Course Sequencing Curriculum structure must match clinical plan Classroom comes before Clinical Rotations should describe which proficiencies will be evaluated SYLLABUS for clinical courses!

A New View Review If students demonstrate competence on each the the sub-tasks, finite re-evaluation is not needed. Clinical outcomes should focus on the “ big picture. ” Should (could) lighten the load for clinical ACIs.

Common Pitfalls Courses without labs Under-credited courses Lack of adequate teaching faculty Lack of adequate documentation –e.g., Portfolios Athletic Training Education programs being held to Physical Education FTE models (etc)