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