Policies and Forms
Successful clinical education partnerships between UNC-CH and clinical sites rely on policies and procedures to outline expectations, to plan efficiently, and to protect patients, students, and clinical sites.
- Student Packet
- Health and Immunization Requirements
- Work Schedule and Student Performance Policies
- Insurance policy information
Information Forms for Clinical Education Sites:
- Clinical Instructor Packet
- Clinical Site Information Form
- Mail an electronic version of this form that you have used with other sites
Clinical Education and Site Feedback Forms:
- Clinical instructors will use Web CPI to evaluate student performance during rotations. PT CPI Web was developed by the APTA to provide academic institutions, clinical sites and students an opportunity to assess clinical performance in an efficient and easy to use manner. All students, CIs and CCCEs are required to complete an online learning module which provides instruction on how to assess performance of students using PT CPI Web. Once completed, you will not have to repeat this module for future students or other schools who use PT CPI Web.
Student Evaluation Materials
- Physical Therapy Student Evaluation of Clinical Experience and Instruction
- Student Curriculum Evaluation Form
In the event that you need to work with a student with specific performance concerns, it is our intention to be involved in that process to whatever degree you feel is necessary. We can consult with you by phone, provide guidance and feedback to the student, make site visits to assist in planning for additional work in areas of concern, or whatever else you deem needed.
These forms provide a structure for weekly feedback and planning. They may be useful for students who need additional guidance in planning for their weekly activities, for students who are reticent to provide you with feedback about your clinical instruction, or for environments where sit-down meeting time is difficult to arrange. The student can fill out a form each week to summarize learning experiences and plan for the next step. These forms are appropriate for all levels of students, and are most useful when the instructor and student can review it together for discussion about communication issues and upcoming goals.
This assessment is used at UNC-CH in the clinical education course for all students to reflect on issues related to professional behavior. The 10 generic abilities are qualities that apply to many professional situations and are skills that therapists continue to work toward after they become licensed therapists. The grid lists criteria for each generic ability and can be used as a means for a student to self-assess by highlighting behaviors he or she consistently demonstrates in a few categories or in the entire assessment. The behaviors are divided into beginning level, developing level and entry level representing a continuum of performance. Clinical instructors may also use these behavioral criteria to describe goals for students who are struggling in areas of professional behavior.
This form is used in instances where a record of performance is necessary to formalize feedback with a student. The form is useful as an adjunct to other evaluation tools used for determination of grades as a way to support your observations, in the event that specific instances need to be recalled. The situation is described in the setting and the student action or behavior that was observed is also detailed. The behavior should be described in objective terms without judgmental adjectives. The evaluator interpretation allows the instructor to list possible consequences of the behavior revealing reasons for concern. The student and instructor both sign the form to indicate that this feedback was shared. The student may then make comments if necessary in the final section of the form.
This form may be useful when problematic behaviors in a similar category are observed with a student (i.e. safety issues). This is also useful as an adjunct to the typical evaluation done for the school. It is designed to only include a description of the behaviors without any interpretation on the part of the instructor. Antecedents refer to events or environmental factors that preceded the behavior. Behaviors are described objectively. Consequences include any ramifications for the behavior imposed by the clinical instructor. For instance, if a safety problem has been identified and discussed with the student, the critical incident report form could be used. After the first additional safety issue occurs, the consequence could be a verbal warning and discussion of reasons for concern, but yet another instance of unsafe behavior could result in a call to the director of clinical education or documentation in the written evaluation.
This form provides a structure for development of specific objectives and learning activities for exceptional students. In the event that you need to use this forms, the student can be actively involved in the process of developing objectives and determining appropriate activities to meet those goals.