Comprehensive Training Program for Respiratory Therapy Clinical Faculty

1. Southeast Kentucky Community & Technical College Respiratory Care Program Clinical Faculty Training

2. Welcome • Welcome to the Southeast Kentucky Community and Technical College Respiratory Therapy Orientation Program. • This program was designed to provide you with important information to make your clinical instructor experience easier and to ensure a fair and enjoyable learning environment for you and our students. • This training consists of information about our program, education and evaluation of our students, and contact information .

3. Goals • Describe the integration of the clinical experience into the overall program curriculum • Discuss the use of skill check-off lists • Discuss the use and completion of the clinical evaluation form • Discuss the concept and measurement of professional behavior in clinical teaching

4. Program Curriculum Design • Our curriculum is designed using the advanced-level examination matrix, the goals and standards of the CoARC and the future of the profession • The curriculum is designed to accomplish competency in three (3) learning domains

5. Learning Domains • Cognitive (Thinking) • Psychomotor (Physical skills) • Affective (Value laden)

6. Cognitive (Knowledge) Domain • A student needs to have the ability to comprehend, apply, and evaluate clinical information relevant to their roll as a respiratory therapist

7. Psychomotor • The student needs to be able to demonstrate technical proficiency in all the skills required of a respiratory therapist

8. Affective Domain • The student needs to be able to demonstrate the professional behaviors consistent with employer expectations for a respiratory therapist

9. Role of Clinical Instructor • You are being asked to not only supervise the students’ activities, but participate in evaluating the students in these three areas. • It is also important that you understand you CAN teach them in an ongoing manner within the three domains

10. Integration of Activities • A requirement of the CoARC is that the classroom, the laboratory and clinical training is integrated • That means what is taught in the classroom is demonstrated and practiced in the laboratory and then accomplished in the clinical portion, (YOUR) portion.

11. The Importance of Clinical • This is the final part of the curriculum where the student has to apply the three learning domains in patient care situations • Your role is to insure that the student can demonstrate and practice the skills, apply theory and interact with the patients and staff in a meaningful way.

12. Overall Goal of the Program • The ultimate goal of our Respiratory Care Program is to produce professionally competent, advanced-level practitioners that can perform in a variety of health care settings.

13. Your Role as a Clinical Instructor

14. Your Role Is: • To provide learning opportunities at your facility • Assist in planning the student’s workload • Observe the student’s practice • To facilitate communication between the students and the physicians • Perform skill check-offs • Complete an evaluation of their performance

15. Day to Day Clinical Activities

16. Critical Items • Make sure the student is signed in correctly at the beginning of the day. • Explain the workload for that day and what is expected of the student • Discuss student needs and expectations, i.e. what do they need to do or see.

17. Punctuality and Attendance • Students are expected to be on time and to stay for the entire allotted time • When you sign their timesheet you verify the time they arrived and were ready to start their clinical and the time they left • We want our graduates to understand that being on time and ready to work is an extremely important behavior

18. Absences • A student is required to call the clinical site at least 30 minutes prior to the scheduled start of the day if they are going to be absent. • They have also been instructed to notify the Director of Clinical Education or other faculty and have been provided with their contact information • Absences DO count toward the clinical grade

19. Assigning Workload • Be informed of what skills the student is ready to perform in the clinical setting • Remember that CoARC prohibits students from replacing regular staff members when establishing the departmental staffing plan • Understand that students cannot have the same productivity as a regular staff member

20. Assigning Workload • It is expected that the student will be able to gradually increase their productivity/efficiency towards the end of the program • You will be able to evaluate them in these areas

21. Dress Code • Our dress code as described in the Program Handbook is mandatory for our all students. • If the student does not meet these guidelines they can: • Go home, obtain proper dress code, return to clinical. Time lost must be made up • Go home and be counted absent for that day. Please call us and let us know this occurs.

22. Lunch and Breaks • As students they are not governed by any “wage and hour” law. • They DO NOT get an hour for lunch, or two fifteen minute breaks. • Put them in a lunch/break rotation like the other staff members.

23. Smoking • Students are NOT allowed to smoke during clinicals, regardless of the clinical site’s smoking policy. • If a student smells of smoke, you need to inform them that you have noticed this and then decrease the grade in professional appearance

24. Skills Check-Offs

25. Clinical Skills Check-off Instrument

26. Clinical Skills Check-Off Instrument • Each clinical task has an assigned a Clinical Check–Off Sheet • Every clinical skill has a certain number of procedural steps that must be completed • Students have practiced these steps and then undergone peer and assessment by an instructor in the laboratory setting • After the laboratory process has been completed the student is ready to perform skill in clinical setting

27. Clinical Skills Check-Off Instrument • Each step must be completed before clinical instructor indicates on the back of each check off sheet that the was procedure performed unassisted • If student requires assistance it should be so documented on back of check off sheet • Practice of each procedure in the clinical setting is required before students are allowed to perform final clinical check off

28. Clinical Skills Check-Off Instrument • The student should inform you if they are ready to perform their final check-off on a specific clinical skill. • They will provide you with the correct skill check-off instrument

29. Skill Check-Off Outcomes • Dependent upon the student’s performance the following are possible outcomes: • the student completes the skill satisfactorily and the clinical instructor checks and signs the clinical column on the front of the check off sheet • the student incorrectly performs procedure and must practice and repeat attempt at a later date

30. Student Is Unable to Complete the Skill • Return check off to the student and explain mistakes, errors, or deficiencies • PLEASE: Do not feel compelled to sign-off a student if the skill was performed below program standards

31. Faculty Demonstration Skill Check off

32. Evaluation

33. Evaluation • At the END of each clinical assignment the student will give you a blank Clinical Evaluation Instrument for their rotation at your facility. • Complete the rating as soon as possible and return to the program faculty (Margie at the Pineville Campus and Lori at the Whitesburg Campus). Feel free to discuss your rating with the student but do not give the student the rating form

34. Evaluation • Evaluation scores add up to a maximum of 40 points and scores are attached to each point value. • You have a discretionary range of 3 points for each evaluation meaning you may add or subtract 3 points to the final score, however, you should make sure you write an explanation for either. • Most students should know how they did at a clinic site prior to their evaluation. It should not come as a surprise. Discuss issues as they arise and keep documentation to avoid misunderstandings.

35. Evaluation • Technical Performance • 4 Consistently delivers safe, effective, well monitored therapy with attention to detail. • 3 Sometimes neglects details which do not affect patient safety or effectiveness. • 2. Neglects details of assignment. • 1 Unsafe and/or ineffective therapy. • 0 Harmful to patient or others.

36. Evaluation • Problem Solving, Clinical Judgment • 4 Recognizes and solves problems related to suboptimal patient care and/or equipment malfunction • appropriate for level in class. • 3 Recognizes and solves problems related to suboptimal patient care and/or equipment malfunction • in most situations. • 2 Needs help in recognizing and solving problems in most situations. • 1 Cannot recognize or solve problems without significant help from staff/instructor. • 0 Neglects or attempts to solve problem which leads to placing patient in danger

37. Evaluation • Dependability and Reliability • 4 Never absent, always on time. • 3. Tardy two times. • 2 One absence. • 1 More than one absence or tardy more than two times. • 0 Absence from clinical without notice.

38. Evaluation • Time Management • 4 Plans ahead, works efficiently, and manages time wisely. • 3 Completes assigned tasks and seldom needs direction. • 2 Inconsistent in completing tasks and needs help prioritizing workload. • 1 Rarely completes assigned tasks, wastes time. • 0 Cannot complete assigned tasks without constant assistance.

39. Evaluation • Dress Code • 4 Always exceptionally neat and well groomed. • 3 Is usually neat and well groomed, except watch, stethoscope, clinical notebook etc. • 2 Appearance is occasionally appropriate. • 1 Appearance is rarely appropriate. • 0 Does not maintain a professional appearance.

40. Evaluation • Relationship with peers, health care staff • 4 Excellent team worker, effectively consults, integrates, and shares information with team members. • 3 Very good team worker, relates well to team members and usually consults and shares information. • 2 Good team worker, consults and shares information with team members when encouraged. • 1 Poor team worker, rarely consults or shares information with team members. • 0 Not a team player, doesn’t know when to consult or share information with team members.

41. Evaluation • .Relationship with patients • 4 Always demonstrates respect, sensitivity, and consideration for others, consistently anticipates and • attends to patient’s and family’s needs for comfort and help. • 3 Consistently shows concern and support of others, usually anticipates and attends to patient’s and • family’s needs for comfort and help. • 2 Usually concerned for and supportive of others, reasonably aware of and attentive to patient’s and • family’s needs for comfort and help. • 1 Seldom shows concern or interest in others, inconsistent in attending to patient’s and family’s needs for • comfort and help. • 0 Selfish, sometimes inconsiderate or rude, unaware of patient’s needs or insensitive to patient’s or • family’s feelings.

42. Evaluation • Initiative • 4 Takes EVERY opportunity to improve knowledge and performance, seeks additional workload • 3 Participates willingly in learning activities and seeks additional workload. • 2 Seeks opportunities to learn when prompted, but does not seek additional workload. • 1 Seeks opportunities to improve only with encouragement from instructor. • 0 Does NOT seek opportunities to improve knowledge and performance and avoids work.

43. Evaluation • .Professionalism • 4 Always exhibits concern for the dignity and welfare of the patients and team members, always takes • measures to deal with conflict effectively. • 3 Consistently displays concern for the dignity and welfare of the patients and team member, seeks • assistance when conflict arises. • 2 Generally displays concern for the dignity and welfare of the patients and team members, recognizes • conflicts as they arise. • 1 Sometimes neglectful of patient’s or team member’s dignity or welfare, needs direction in avoiding • conflict. • 0 Is negligent or inconsiderate of patient’s or team member’s dignity or welfare, provokes conflict.  

44. Evaluation • Confidence in Abilities • 4 Self-confident, always seeks assistance when appropriate, respects professional boundaries, and • remains calm is stressful situations • 3 Respects limitations, recognizes professional boundaries, usually seeks assistance when necessary, • usually remains calm in stressful situations. • 2 Recognizes limitations the majority of the time, occasional seeks assistance when necessary, acts • appropriately in stressful situations. • 1 Not always aware of limitations or professional boundaries, occasionally fails to seek assistance which • jeopardizes patient care. • 0 Doesn’t know when to seek assistance, oversteps professional boundaries, and makes inappropriate • decisions that are harmful to patient care.

45. Evaluation • Grading Scale • 35-40 93-100% A • 27-34 84-92% B • 20-26% 75-83% C • 20 points and below will result in a failing grade for that particular clinical rotation and may result in the dismissal of the student from the Respiratory Care Program. • Instructors Comments:

46. Rating Scale • 4 –Consistently Exceeds Expectations • Used for a student who clearly excels in the area being rated. • Recognizes and solves problems related to suboptimal patient care and/or equipment malfunction appropriate for level in class. • Example-A first semester student could set up a cannula with a humidifier and when the pop off sounds recognize there was an obstruction and without any prompting, find it and correct the problem

47. Rating Scale • 3 – Fully Meets Expectations • Used for a student making satisfactory progress • Example-A first semester student could set up a cannula with a humidifier and when the pop off sounded recognize there was a problem and with prompting find the obstruction and correct the problem

48. Rating Scale • 2 – Meets Minimal Expectations • The student has difficulty performing a skill that they have been checked off on; needs extra supervisory time; constantly asking about the how and the why • Example-A first semester student could set up a cannula with a humidifier and when the pop off sounded recognize there was a problem but even with prompting they were not able determine what was causing the problem.

49. Rating Scale • 1 – Need Remediation to Meet Expectations • The student has difficulty performing a skill that they have been checked off on; needs extra supervisory time; constantly asking about the how and the why • Example-A first semester student needed prompts to set up a cannula with a humidifier and when the pop off sounded they failed to recognize the problem without prompting. They needed help troubleshooting to find the obstruction.

50. Rating Scale • 0– Does Not Meet Expectations • A student clearly did not meet the criteria listed on the individual behaviors • Example-A first semester student could not set up a cannula with a humidifier without prompts and when the pop off sounded even with prompts they did not recognize it as a problem and continued with set up. When prompted they were unable to voice the causes of this nor could they troubleshoot to find the problem.