Application Resource Manual Examples of Evidence

Transcription

1 Application Resource Manual Examples of Evidence 1.0 Organization 2.0 Resources 3.0 Curriculum 4.0 Ongoing Evaluation

2 INTRODUCTION Thank you for your interest in seeking initial accreditation or reaccreditation of your residency or fellowship program. Congratulations on your commitment to excellence in physical therapy education and practice. The American Physical Therapy Association s (APTA) American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) has compiled this Application Resource Manual to serve as a guide as you prepare your program s application for accreditation or reaccreditation. As a living document, the Application Resource Manual will be updated regularly and additional sections will be added. There are many benefits to having residency and/or fellowship programs including improving patient/client outcomes, promoting evidence based practice in physical therapy, and establishing your clinic s reputation of excellence in patient/client care and physical therapist education. Going through the accreditation process also has many benefits as you take an in-depth look at your program, compare it to the accreditation requirements (evaluative criteria), identify your strengths and weakness, and further develop your program in a systematic way. As an adjunct to the Evaluative Criteria, the Application Resource Manual provides actual examples for the Evidences required as part of the application. These examples were taken from our accredited programs and are not intended to be prescriptive as every program is unique and that individuality should be reflected in the application. To facilitate reviewing this document, bookmarks have been created which will allow the user to navigate to specific Evidence numbers rather than scrolling through the document. Please activate the bookmark tab within Adobe to utilize this feature. APTA Residency/Fellowship staff are available to answer your questions and may be reached at: APTA Residency/Fellowship Accreditation 1111 North Fairfax Street Alexandria, VA / resfel@apta.org Good luck and we look forward to receiving your application!

3 3 1.0 Organization Evidence Provide the statement of mission and goals of the sponsoring organization of the program. If the program has more than one sponsoring organization, provide the statement of mission and goals for all sponsoring organizations. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 The Umbrella organization s mission, vision, and values are below: MISSION: To provide health care and services to those in need To minimize human suffering To assist people to wholeness And to nurture an awareness of their relationship with God VISION: Catholic Health services will strive to improve the health, independence and spiritual life of the elderly, the poor, and the needy in the archdiocese, through innovative and proactive approaches to: Managing care and providing services; Facilitating transitions across levels of care; Community partnerships and collaborations; Advocacy efforts. VALUES: We believe our first responsibility is to our patients, residents, our families and all others who use our services. We will render our services with skill, compassion and respect for human dignity, regardless of race, creed or religious affiliation. We believe Judaic-Christian tradition that God is present in life and that each person is a manifestation of the sacredness of human life. Our second responsibility is to our employees, the men and woman who enable us to care for our patients and clients. We will respect our employees dignity, recognize their merit and value their contributions to Catholic Health Services. We will provide the resources to uphold their dedication to excellence. Our third responsibility is to our community. We understand that our responsibility extends beyond the physical walls of our building and into our communities. We will serve to the best of our financial abilitythose unable to afford. Our final responsibility is to the future. We will be faithful stewards of our resources to preserve our ability to carry out our Mission and serve our communities for generations to come. CORE VALUES: DIGNITY CHS Dignity acknowledges the uniqueness of every person involved in CHS, patients, residents, staff and families. Each person is respected regardless of race, creed or religious affiliation and economic status.

4 4 COMMITMENT CHS is a firm decision to focus energy on the successful completion of goals in the spirit of our mission. EXCELLENCE CHS excellence is a dedication to establishing and meeting high personal, spiritual, professional and organizational goals and standards. STEWARDSHIP CHS stewardships is the good use of organizational resources, human and material. Example 2 - From UPMC Centers for Rehab Services Geriatric Residency, 2014 UPMC Centers for Rehab Services ( CRS ) MISSIONS AND VALUES To provide the communities we serve with premier rehabilitation programs (physical, occupational, speech and recreational therapy) in patient care, clinical research, education, teaching, and community service. These programs will contribute to an individual s well-being and independence, the prevention, diagnosis and treatment of human disease and disability, and the overall well-being of our communities. These values guide UPMC CRS in achieving this mission: We value patient satisfaction among our highest priorities and strive to ensure a compassionate, patient-centered environment. We nurture highly skilled professionals through a commitment to continuing education, advanced specialty training, competency assessment and certification, teaching and student clinical affiliations throughout a continuum care. We encourage multidisciplinary collaborations in patient care programs, education and teaching. We strive to provide an environment that encourages and supports active participants as faculty in teaching students enrolled in health related professional programs. We seek to be responsive to the needs of individuals of all backgrounds and serve as a vital resource to the local community. We believe that each member of our staff is responsible for the continuous improvement of quality in all aspects of the services we provide. We strive to set the standards of excellence in cost-effective, quality rehabilitation health care. We commit to the establishing mutually supportive liaisons with other health care facilities that are members of the UPMC integrated health system, our partner in rehabilitation patient care programs, clinical research, education and teaching.

5 5 Example 3 - From Drexel University Orthopedic Residency, 2014 University Mission Statement Drexel University (DU) fulfills our founder s vision of preparing each new generation of students for productive professional and civic lives while also focusing our collective expertise on solving society s greatest problems. Drexel is an academically comprehensive and globally engaged urban research university, dedicated to advancing knowledge and society and to providing every student with a valuable, rigorous, experimental, technology-infused education, enriched by the nation s premier cooperative education program. University Strategic Initiatives 1. Invest in Academic Excellence 2. Intensify and improve the student experience 3. Continue to grow Drexel s enrollment College Mission Statement Drexel University College of Nursing & Health Professions prepares competent and compassionate health professionals through technology-infused and evidence-based programs. The College is committed to leading the way in improving health and reducing health disparities through innovative education, interdisciplinary research, and community-based practice initiatives. College Goals 1. The College of Nursing and Health Professions will invest its human and fiscal resources in creating a culture of academic excellence through faculty development, innovative educational and continuous improvement processes. 2. The College of Nursing and Health Professions will contribute to Drexel s innovative Nexus for Research, Technology Transfer, and Economic Development in particularly in the Strategic initiative: Health, Health Science, Technologies and Systems. Department Mission Statement Department of Physical Therapy and Rehabilitations Sciences: to prepare competent, compassionate doctors of physical therapy by promoting excellence, evidence-based practice and life-long learning, and to graduate innovative practitioners who exhibit civic and professional responsibilities in diverse healthcare and community environments. Department Goals 1. The Department of Physical Therapy & Rehabilitation Sciences will establish a residency program in Orthopedic Physical Therapy. 2. The Department of Physical Therapy & Rehabilitation Sciences will achieve recognition of all academic programs. 3. The Department of Physical Therapy & Rehabilitation Sciences will develop, grow and sustain programs that support the non-traditional, postprofessional, working adult student. 4. The Department of Physical Therapy & Rehabilitation Sciences will ensure access to high quality learning opportunities for students.

6 6 5. The Department of Physical Therapy & Rehabilitation Sciences will enhance the quality and diversity of clinical (cooperative) education and clinical practice experiences. 6. The Department of Physical Therapy & Rehabilitation Sciences will secure space, technology and equipment to maximize teaching and learning. 7. The Department of Physical Therapy & Rehabilitation Sciences will promote use of technology and innovation in the education of our students and treatment of our patients. 8. The Department of Physical Therapy & Rehabilitation Sciences will promote a culture of assessments of our teaching, courses and curricula. Example 4 - From HonorHealth & Northern Arizona University Neurologic Residency, 2013 The mission and goals of both program sponsoring organizations, Scottsdale HealthCare (SHC) and Northern Arizona University (NAU), are described below: HonorHealth Mission Statement: We are the Valley s leading therapy provider consisting of a collaborative team of clinical experts and dedicated healthcare professionals. Our personalized care is guided by compassion and exceptional customer service. We provide outstanding patient outcomes through innovative, effective and fiscally responsible methods while emphasizing our patients individual needs. We are committed to professional growth, developing clinical specialist, enhancing specialty programs, conducting research and fostering relationships with the community, physicians and leading educational institutions. We exist to improve the quality of life and promote the health and well-being of those we serve in Scottsdale Healthcare community both now and in the future. Vision Statement: Leading personalized healthcare and shaping healthier communities Non-Profit Community-Based Mission Statement: Provide the highest quality and most compassionate care for all individuals Values: Integrity: Caring: Accountability: Respect: Excellence: Unswerving devotion to what is right, honest, and just. Genuine concern for those who place their trust in us. Accepting ultimate responsibility for our actions Recognition of the inherent values and worth of each person by treating them with dignity and courtesy. Unrelenting and vigorous insistence on the highest standards of performance. Purpose: To provide an excellent, personalized healthcare experience delivered by a talented, compassionate staff in an innovative environment.

7 7 Core Strategies: The Best Clinical Outcome and Patient Experience (Personalized Healthcare-Patient and Family Centered Care, Safe, Effective, Timely, Efficient and Equitable) Requires: Mutual Commitment With the Best Physicians The Best Place To Work for Talented Staff Strong Financial Position And creates the platform for: Pre-eminent Position in the NE Valley Excellence Clinical Service Lines Desired Future State: Move from a hospital system to a clinically integrated healthcare delivery system that extends across the continuum of care Northern Arizona University Missions of Northern Arizona University: Provide an outstanding undergraduate residential education strengthened by research, graduate and professional programs, and sophisticated methods of distance delivery. Goals of Northern Arizona University: Strengthen undergraduate educational excellence in a residential learning community Increase and manage enrollment Strengthen graduate education, economic development, and research Build on our national reputation for excellence in professional programs Provide leadership in the development, use, and assessment of technologies in educational programs Foster a culture of diversity Become the nation s leading university serving Native Americans Ensure financial stability and growth Mission of the NAU Physical Therapy Program: To prepare clinically and culturally competent physical therapist with a foundation in a natural, behavioral, applied, and health sciences, coupled to the art and sciences of physical therapy, who can evaluate and manage individuals across the lifespan and who are committed to life-long learning, professional self-development, and clinical inquiry. Goals of the NAU Physical Therapy Program: The program will provide the student with a foundation in the natural, behavioral, applied, and health sciences related to the practice of physical therapy as well as the opportunity to develop the skills and knowledge necessary to provide clinically and culturally competent physical therapy services to individuals across the life span. The program will provide students with the knowledge, skills and opportunity related to the acquisition, interpretation and application of evidence to the practice of physical therapy and to the profession of physical therapy.

8 8 The program will encourage students and faculty to participate in the American Physical Therapy Association, the Arizona Chapter of the American Physical Therapy Association as well as other associations and activities that advance the profession of physical therapy as well as their own professionalism. The program faculty will contribute to the governance of the Program, College and/or University. The physical therapy core faculty will be recognized locally, regionally, nationally, and internationally as leaders in musculoskeletal, neurologic, and cardiopulmonary therapeutics across the life span through scholarship and professional service. The program will encourage faculty and students to be involved in activities that address the health needs of Arizona, the American Southwest or the United States.

9 9 Evidence Describe the sponsoring organization s ongoing methods used to evaluate the effectiveness of the sponsoring organization s performance. Include evidence of any external agency accreditations (eg, JC, CARF, Medicare provider or provider network standards, CAPTE or another educational accreditation organization if applicable). If the program has more than one sponsoring organization, provide this information for all sponsoring organizations. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From HonorHealth & Northern Arizona University Neurologic Residency, 2013 HonorHealth SHC maintains the following accreditations: Arizona Department of Health Services Center for Excellence in Bariatric Surgery (American Society for Metabolic and Bariatric Surgery) Chest Pain Centers (Society for Certified Chest Pain Centers) Level 1 Primary Stroke Center with Disease-specific Certification (DNV) Level 1 Trauma Center, designated by the American College of Surgeons Magnet Recognition (American Nurses Credentialing Center) Medicare Teaching Hospital Accreditation (Council of Teaching Hospital - Association of American Medical Colleges Council of Teaching Hospitals (COTH)) Staff members receive training on HIPAA; corporate compliance; fire safety and emergency preparedness; patient rights; customer service; preventing patient falls; developmentally appropriate care; adverse events; back safety; identifying and assessing victims of domestic abuse; lifting and transferring patient; affirmative action; workplace violence; pain management; reporting allegations of abuse, assault, or neglect; and sexual harassment in the work place. Scottsdale Healthcare s evaluation methods currently support an Orthopaedic Physical Therapy Residency program, Physicians Family Practice Residency Program, and a Pharmacy Residency Program. The organization has further shown its support in Neurologic Physical Therapy by approving its business plan thereby providing financial and administrative assistance. The table following this text summarizes SHC s core strategies, initiatives, measures, benchmark and goals. *table was not copied into this Application Resource Manual Northern Arizona University NAU is accredited by the Higher Learning Commission of the North Central Association of Colleges and Schools. In 2007, NAU underwent a comprehensive review and received reaccreditation through The program in physical therapy at NAU is accredited by the Commission on Accreditation in Physical Therapy Education until There is an ongoing, formal program assessment process that determines the extent to which the program meets its stated mission. The assessment process: (1) uses information from professional standards and guidelines and institutional mission and policies; (2) uses data related to program mission, goals, and expected program outcomes, program policies and procedures, individual core faculty, collective core faculty, clinical education faculty, associated faculty, communication, resources, admission criteria and prerequisites, curriculum plan, clinical education program, and expected student outcomes; (3) identifies

10 10 program strengths and weaknesses; (4) includes considered judgments regarding need for change; and (5) includes steps to achieve the changes, with anticipated dates of completion. The table following this text provides an outline of how each aspect of the program is reviewed, assessed and if necessary, describes the implementation of changes. The table identifies the sources of data used, the timelines, those individuals responsible, and the factors that prompt discussion of potential change. Using input from a wide variety of sources and determining how they all intersect, decisions are made regarding retention or revision of practices, policies and procedures as well as curriculum components. *table was not copied into this Application Resource Manual Example 2 - From MedStar Georgetown University Hospital Women's Health Residency, 2014 MedStar Georgetown University Hospital s methods of evaluating program effectiveness and efficiency of performance include ongoing performance improvement projects and quality assurance projects. Other methods include meeting the accreditation standards of the Joint Commission (conducted every 3 years). Additionally, the facility meets the requirements of Medicare, Medicaid, and the District of Columbia on an annual basis. In addition, MedStar Georgetown University Hospital uses MGUH SPIRIT AWARD forms that patients use to comment on a provider s care giving.

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12 12 Evidence Program and Participant Mission, Goals, and Objectives A. Provide the program s mission statement, goals and objectives. Multi-site programs must include at least one goal and corresponding objectives addressing consistency of program delivery in all settings. (BOTH CANDIDACY AND REACCREDITATION) B. Describe how the program s mission statement, goals, and objectives are consistent with one another. (BOTH CANDIDACY AND REACCREDITATION) C. Describe how the program s mission, goals, and objectives are consistent with the mission of the sponsoring organization(s). (BOTH CANDIDACY AND REACCREDITATION) D. Provide the participant s goals with corresponding objectives. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From Drexel University Orthopedic Residency, A Program s mission statement, goals and objectives The mission of Drexel University Orthopaedic Physical Therapy Residency Program (DUOPTR) is to provide postprofessional didactic and clinical training to physical therapist who seek to develop advanced clinical decision making, manual, and diagnostic skills in orthopaedic physical therapy. Program Goals: The program will: A. Educate highly competent clinicians who are well prepared to achieve specialty certification in orthopaedic physical therapy. Objectives: The program will: 1. Provide training in evidence-based, comprehensive, skilled physical therapy services by engaging students in didactic and clinical learning activities that explore all areas of the orthopaedic DSP and promote critical thinking and problem solving. 2. Foster the ability to critically assess the literature and integrate relevant material into clinical practice. 3. Advocate self-assessment and promote self-improvement measures when indicated. B. Develop advanced trained clinicians and promote who will provide high quality evidence-based clinical services to the community. Objectives: The program will: 1. Provide mentorship to assist in development of advanced clinical decision making skills. 2. Conduct journal club meetings to advance critical reading and interpretation skills. 3. Provide advanced coursework related to the management of orthopaedic disorders in order to improve examination and intervention strategies. C. Produce clinicians, instructors, and consultants who are prepared to assume leadership roles in orthopaedic physical therapy. Objectives: The program will:

13 13 1. Engage residents in discussion and debate of pertinent issues in relation to physical therapy. 2. Assign residents to serve as instructors in the entry-level DPT program providing didactic lectures and laboratory based psychomotor skills experience. 3. Require residents to be active members of the Orthopaedic Section of the APTA. D. Promote engagement in clinical research in order to advance the body of knowledge in orthopaedic physical therapy. Objectives: The program will: 1. Require all residents to comply with DU s CITI training in the first month of their employment so that that they can participate in clinical research. 2. Enlist residents as clinical researchers for all orthopaedic clinical studies open during the residents term of employment. 3. Require the resident to produce one journal quality manuscript, to include but not limited to case reports, literature reviews, co-authorship on a clinical study, or book chapter. 4. Encourage the resident to discuss any research interest with appropriate faculty for possible development into a formal research proposal. E. Foster involvement in physical therapy professional organizations at the local, state, and national levels in order to promote personal professional growth and development. Objectives: The program will: 1. Require all residents to attend 90% of all SED meetings in order to report pertinent issues to the clinical staff and faculty. 2. Require all residents to submit an abstract for a state, regional or national conference B How program mission statement and goals are consistent with each other The DUOPTR program s mission statement, goals and objectives were developed together to assure consistency. The objectives and goals build on the mission to develop the clinical-decision making process, psychomotor skills of advanced clinical techniques, and maturation of clinicians to critically appraise research and to effectively serve as advocates for their patients and the profession as a whole C How program mission/goals are consistent with the mission of the sponsoring organization The DUOPTR program mission statement, goals and objectives were developed in the process to achieve goals/objectives set by the Department of Physical Therapy and Rehabilitation Sciences. The goals set by the department are developed in coordination with the goals of the goals of the College of Nursing and Health Professions, which are in line with the goals of DU s strategic plan D Program participant goals and objectives Resident Goals: The resident will: A. Obtain the knowledge and skills of a board certified specialist. Objectives: The resident will: 1. Pass the ABPTS Orthopaedic Clinical Specialist examination. B. Provide high quality, evidence-based clinical services to the community. Objectives: The resident will: 1. Demonstrate the use of evidence-based clinical services through, but not limited to, in patient care, in leading journal clubs, organizing case study presentations, assisting with clinical trials, and maintaining a connection with DU research upon graduation.

14 14 2. Demonstrate use of patient region specific outcome measures and satisfaction surveys. 3. Critique and discuss the literature he/she reads to answer questions concerning his/her patients. 4. Search out opportunities to pursue clinical research trials. C. Be involved in and all levels of our professional organization to make a difference in physical therapy. Objectives: The resident will: 1. Attend local and regional meetings annually 2. Obtain a committee appointment on a local, regional, or national level. Example 2 - From Louis Stokes Cleveland VA Medical Center Geriatric Residency, A Program s mission statement, goals and objectives Mission Statement: The mission of the LSCVAMC Geriatric Physical Therapy Residency Program is to systematically advance the resident s clinical competence and expertise in the practice of geriatric physical therapy. The experience provided through the enriched environment and structured learning opportunities will prepare the resident for successful completion of the Geriatric Clinical Specialist certification examination. Program Goals and Objectives: 1. Prepare physical therapy residents to become advanced practice practitioners of geriatric physical therapy. Objectives: A. Clinical instruction will be provided in a variety of environments of patient care. B. The unique needs of the veteran population will be emphasized; however the resident s knowledge of geriatric physical therapy practice will be applicable to other (non-veteran) patient populations. C. Opportunities to practice at a high level of autonomy consistent with the expectations of a doctoral therapist scope of practice will be provided to the residents. 2. Prepare physical therapy residents to attain Geriatric Clinical Specialist certification Objectives: A. Provide a structured curriculum consistent with the Geriatric Physical Therapy Description of Specialty Practice (DSP) through the use of topic specific and systembased modules. B. Physical therapist mentors with advanced specialization, physical therapy faculty with content matter expertise, and other non-physical therapy medical professional instructors will be utilized to comprehensively advance knowledge through didactic and clinical experiences. 3. Assist the resident in developing competence in the utilization of research to provide effective care for geriatric patients/clients. Objectives: A. Didactic content in geriatric specialist practice, including up-to-date peer reviewed literature, will be presented to the resident. B. Clinicians will model the application of evidence to patient examination. C. Clinicians will model the application of evidence to patient treatment.

15 15 D. Clinical research opportunities will be provided to the resident (consistent with their interests and based on opportunities at LSCVAMC and Walsh University). 4. Prepare the therapist to effectively communicate with patients/clients, referral sources, payers, clinical faculty, administrations, physician and other members of the health team. Objectives: A. Residency faculty will mentor the development of professional, effective communication with all stakeholders. B. Prepare the resident to be an effective member of an interdisciplinary care team. C. Prepare the resident to maintain professional communication in potentially stressful and emotionally charged situations. 5. Provide opportunities for the resident to teach and mentor others in geriatric physical therapy. Objectives: A. Prepare the resident to become an effective teacher and mentor. B. Faculty will assist resident in developing and implementing an appropriate teaching plan. C. Faculty will assist residents in development of skills to assess the response to education and need for additional education B How program mission statement and goals are consistent with each other The program s mission was written first, aligning the mission of the new program with that of the VA and PM&RS department. The overarching goals of the program were then identified and more specific objectives were written. These goals and objectives provide guidance in the development of the specific modules and learning opportunities established for the residents. For each program goal, there is a corresponding resident goal and they are parallel C How program mission/goals are consistent with the mission of the sponsoring organization The program s mission, goals and objectives align closely with the mission of the Physical Medicine and Rehabilitation Service. The program s mission is focused on preparing residents to become advanced practitioners of geriatric physical therapy, aligning with the service s mission to provide the most current evidence-based rehabilitation treatment. The program prepares the resident to effectively communicate with patients and prepares the resident to be an effective member of an interdisciplinary team, aligning with the department s mission, which the residency program supports by advancing the clinical skills of current staff, residents and mentors through didactic learning, lecturing and mentoring. Ultimately, the end goal of the program is to prepare an advanced geriatric physical therapist who can sit for the ABPTS Clinical Specialist Board Examination, which directly supports the department s mission to provide high quality care based on the most current technology and education D Program participant goals and objectives 1. Become an advanced practitioner of geriatric physical therapy Objectives: A. Resident will demonstrate critical thinking, clinical reasoning and psychomotor skills consistent with advanced geriatric physical therapy practice. B. Resident will be prepared to meet challenges of an evolving health care system by making them a more efficient and effective clinician. C. Participate in reflective self-assessment to identify strengths and weaknesses to continually improve and enhance his/her development.

16 16 2. Meet qualifications/eligibility and be prepared to sit for ABPTS Clinical Specialist board certification. Objectives: A. Successfully complete all required components of each topic specific and system based module. B. Perform self-assessment, reflect on strengths and weaknesses as pertaining to components of the DSP, to develop a study plan to successfully prepare for the ABPTS geriatric specialist examination. 3. Critically appraise current literature in order to integrate into practice to improve patient outcomes. Objectives: A. Select appropriate outcomes measures based on relevant research. B. Utilize evidence to develop intervention strategies. 3. Contribute to the body of knowledge in geriatric physical therapy by participating in clinical research. Objectives: A. Assist in research project(s) relevant to geriatric physical therapist practice under the direction of a mentor. B. Develop an understanding of clinical research process. 4. Resident will effectively communicate with a variety of audiences, in various settings and with varying end goals. Objectives: A. Demonstrate awareness of self and audience to interact professionally and effectively with audiences using appropriate verbal and non-verbal techniques. B. Effectively deliver formal and informal presentation of material to staff physical therapist, students, and others in topics on geriatric physical therapist practice. i. Identify learning needs of audience. ii. Developing and implementing an appropriate teaching plan. iii. Assessing the response to education and need for additional education C. Become consultants to the public and medical community for the profession of physical therapy Example 3 - From MedStar Georgetown University Hospital Women's Health Residency, A Program s mission statement, goals and objectives Mission Statement: The primary purpose of the MedStar Georgetown University Hospital Women s Health Physical Therapy Residency program is to prepare physical therapist with advanced knowledge in women s health physical therapy integrated with foundation in basic and applied sciences and scientific inquiry. The program will also prepare residents for independent advanced practice in the area of women s health physical therapy and prepare them for their role as a clinical specialist. Graduates will demonstrate their education through excellence in evidence based practice, the pursuit of clinical research and leadership in women s health physical therapy. They will make a strong contribution to their profession and to their community. The program will graduate physical therapists that support and uphold the mission, vision and values held by MedStar Georgetown University Hospital.

17 17 Program Goals: The goals of the residency program are to educate physical therapist to: 1. Support the mission, vision and values of MedStar Georgetown University Hospital by meeting the needs of our patients, physicians and co-workers through provisions of women s health physical therapy services. 2. Contribute to the profession of physical therapy through promoting, writing, teaching, leadership and consultative activities in the area of women s health throughout the residency program. 3. Be critical consumers of scientific literature and be proficient in incorporating new techniques and knowledge into clinical practice 4. Exhibit highest standards of professionalism. 5. Provide necessary curricular content and clinical experience to prepare resident for successful completion of the ABPTS WCS examination. Program Objectives: The residency program will: 1. Provide residents with an advanced level of clinical training and education in the area of women s health physical therapy as outlined in the Description of Specialty Practice (DSP). a. The curriculum will address all areas of the women s health DSP through clinical didactic education. b. The curriculum will promote demonstration of advanced skill in the area of women s health evaluation, diagnosis, prognosis and treatment consistent with DSP. c. The curriculum will promote knowledge of payer rules and regulations pertaining to practice in the area of women s health physical therapy including, but not limited to, prospective payer systems, Medicare and other payers. d. The curriculum will support development of a written project by the resident that reflect knowledge of administrative and clinical concerns related to women s health physical therapy. 2. Promote skills to have the resident critically evaluate scientific literature relevant to the practice of women s health physical therapy. a. Promote the ability of the resident to use search services to obtain relevant literature. b. Promote the ability of the resident to discuss and incorporate scientific literature into current practice. c. Promote the ability of the resident to discuss relevant literature in the context of the current body of evidence available. 3. Prepare the resident for participation in clinical research/case study suitable for submission to a peer reviewed journal or presentation at a national, state or local conference. 4. Engage the residents in appropriate education in the area of women s health physical therapy. a. Identify information the resident must master to successfully practice as an advanced clinician above and beyond entry-level position. b. Prepare the resident for successful completion of the ABPTS examination in women s health physical therapy. 5. Promote appropriate communication skills by the resident sufficient enough to successfully communicate information pertinent to patient care to the patient, resident and other members of the healthcare team. 6. Promote appropriate professionalism by the resident to the public, patient and other members of the healthcare team. 7. Update curricular content on a semi-annual basis to ensure content is consistent with current evidence B How program mission statement and goals are consistent with each other

18 18 The program s mission statement, goals and objectives were developed simultaneously as to ensure consistency with each other. The goals and objectives are based upon the mission statement of the program C How program mission/goals are consistent with the mission of the sponsoring organization The Mission of MedStar Georgetown University Hospital is to provide physical and spiritual comfort to our patients and families in the Jesuit tradition of cura personalis, caring for the whole person. The mission goals and objectives of the MedStar Georgetown University Hospital Women s Health Residency Program are a direct reflection of the mission of the MedStar Georgetown University Hospital. Our program promotes an advanced level of patient and family care through superior education, training, leadership and community service D Program participant goals and objectives Goals: The goals of the resident are to: 1. Support the mission, vision and values of MedStar Georgetown University Hospital by meeting the needs of our patients, physicians and co-workers through provision of women s health physical therapy services. 2. Contribute to the profession of physical therapy as a resident through writing, teaching, and leadership in consultative activities in the area of women s health. 3. Be critical consumers of scientific literature as a resident and be proficient in incorporating new techniques and knowledge into clinical practice. 4. Exhibit the highest standards of professionalism as a resident and clinician. 5. Complete necessary curricular content and clinical experience to prepare for successful completion of the ABPTS WCS examination. Objectives: The resident will: 1. Progressively demonstrate an advanced level of clinical training and education in the area of women s health physical therapy as outlined in the DSP. a. Demonstrate proficiency in the curriculum that addresses all areas of women s health DSP through clinical and didactic education. b. Demonstrate advanced skill in the area of women s health evaluation, diagnosis, prognosis and treatment consistent with the DSP. c. Demonstrate application of evidence based practice and research on an outgoing basis. d. Demonstrate knowledge of payer rules and regulations pertaining to practice in the areas of women s health physical therapy including, but not to limit to, prospective payer systems, Medicare, and other payers. e. Develop a written project that reflects knowledge of administrative and clinical concern related to women s health physical therapy. 2. Demonstrate skills to critically evaluate scientific literature relevant to the practice of women s health physical therapy. a. Demonstrate ability to use search services to obtain relevant literature. b. Demonstrate ability to discuss and incorporate scientific literature into current practice. c. Demonstrate ability to discuss relevant literature in the context of the current body of evidence available. 3. Participate in clinical research/case study suitable for submission to a peer reviewed journal or presentation at a national, state or local conference. 4. Engage in appropriate education in the area of women s health physical therapy.

19 19 a. Master identified information to successfully practice as an advanced clinician above and beyond an entry-level position. b. Demonstrate preparation for successful completion and intent to complete and pass the ABPTS examination in women s health physical therapy. 5. Demonstrate appropriate communication skills sufficient enough to successfully communicate information pertinent to patient care to the patient, resident and other members of the healthcare team. 6. Demonstrate appropriate professionalism to the public and other members of the healthcare team. 7. Participate in updating curricular content ensure content is consistent with current evidence. Example 4 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, A Program s mission statement, goals and objectives Program Vision Statement: The vision of the program is to prepare the trainee for independent advanced practice in geriatric physical therapy and as a clinical specialist in an integrated environment of clinical excellence and educational effort by a team of professionals who are committed and knowledgeable in gerontology and geriatric physical therapy and who are role models in the professional biopsychosocial care of elderly patients. Graduates express their education through excellence in evidence based practice therapy by participating in clinical research, and make a lasting contribution to their local and professional community. Program Mission Statement: The mission of the residency program is to educate physical therapist who are able to meet the needs of society by becoming advanced practitioners of geriatric physical therapy (clinically and administratively). Graduates demonstrate mastery as critical consumers of the relevant scientific literature and incorporate appropriate new techniques and knowledge into advance geriatrics physical therapy practice. They contribute to the body of knowledge in geriatric physical therapy by participating in clinical research and are competent instructors of geriatric physical therapy practice. Graduates becomes consultants, advocates and ambassadors to the public and medical communities for the profession of physical therapy and as advocates for health promotion and wellness for the aging adult and always exhibit the highest standards of professionalism. Program Goals: The goals of the residency program are to: 1. Provide academic and clinical training in advanced skills in geriatric physical therapy. 2. Facilitate the resident s ability to integrate science and theory with advanced clinical practice in geriatrics through structured academic and clinical experiences. 3. Provide opportunities to develop advanced skills as a consultant in a variety of geriatric physical therapy settings. 4. Provide opportunities to develop advanced skills as an educator in a variety of geriatric physical therapy settings. 5. Provide opportunities to develop advanced skills as a direct service provider in a variety of geriatric physical therapy settings. 6. Provide opportunities to develop skills in critical thinking and research to enable them to contribute to the geriatric physical therapy professions in the future.

20 20 7. Provide opportunities to observe and model behaviors reflecting the highest standards of professionalism as a geriatric physical therapist. 8. Prepare residents academically and clinically to successfully complete the geriatric clinical specialist certification examination by the ABPTS. Program Objectives: The objectives for the academic and clinical faculty of the residency program are to: 1. Develop a curriculum that address all areas of the current Geriatric Description of Specialty Practice (DSP). 2. Model professional behaviors, roles and core values identified in the current Geriatric DSP. 3. Provide experience with a variety of medical conditions identified in the current Geriatric DSP through direct patient care or through specialty observation. 4. Provide opportunities for the residents to observe and implement the patient/client management model, including: examination, evaluation, diagnosis, prognosis, intervention, and outcome assessment. 5. Provide on-site supervision of the resident. 6. Provide a minimum of 150 hours of 1:1 patient interaction time with residency mentors with emphasis on guiding the resident s clinical decision-making, including: hypothesis generation, data collection, synthesis of data, and treatment selection (utilizing evidence-based practice). 7. Provide opportunities for the resident to observe and/or participate in a community-based screening program. 8. Provide didactic course work and educational theory. 9. Provide educational opportunities to observe and participate in: a. Patient/caregiver education b. Peer education including in-service c. Community education programs d. Teaching students enrolled in a doctoral level physical therapy program 10. Provide instructions in critical inquiry and research methodology to develop skills necessary to complete the following: a. Critically review scientific literature (rigor, methodology, results, limitations) b. Develop clinically relevant questions c. Search the literature to find evidence to answer a clinical question d. Complete a case report and/or participate in an ongoing study B How program mission statement and goals are consistent with each other The goals were developed using the vision and mission statement as a guide. The goals are significantly different from each other and do not conflict. Goals and objectives combine to reflect how the vision and mission of the program will be accomplished C How program mission/goals are consistent with the mission of the sponsoring organization The program s vision and mission are consistent with the umbrella organization s by providing healthcare to those in need (elderly populations are at risk socioeconomically); minimizing human suffering (clinical excellence implies good physical/functional outcomes); and through involvement in patient education, wellness, health promotion and empowerment, we foster a component of wholeness/spirituality. The goals are consistent with the organization s mission and vision statement: to provide innovative and proactive approaches to managing and providing services, facilitating transitions across levels of care, community collaborations, and advocacy efforts.

21 D Program participant goals and objectives The resident will: 1. Practice advanced geriatric physical therapy (clinical and administrative skills). a. Demonstrate advanced skill in the practice dimensions described in the current ABPTS description of specialty practice in geriatric physical therapy. b. Demonstrate knowledge in all knowledge areas described in the current ABPTS description of specialty practice in geriatric physical therapy. c. Demonstrate the ability to perform patient examinations, evaluation, diagnosis, prognosis and intervention consistent with the description of specialty practice in geriatric physical therapy. d. Demonstrate the application of the principles of evidence based practice in patient care on an on-going basis. e. Demonstrate knowledge of payer rules and regulations pertinent to the practices of geriatric physical therapy, including, but limited to, prospective payment systems, healthcare delivery sites and Medicare. f. Develop a written project that reflects knowledge of administrative concerns and issues relative to geriatric physical therapy. 2. Demonstrate mastery as a critical consumer of the relevant scientific literature who, by virtue of critically assessing the literature incorporates appropriate new techniques and knowledge into advanced geriatric physical therapy practice. a. Demonstrate the ability to proficiently utilize available search services to obtain relevant evidence. b. Discuss the applicability of current literature to current geriatric physical therapy practice and judiciously incorporate new knowledge and skills into advanced clinical practice. c. Critically appraise and discuss relative merits of research studies in terms of rationale, design, methods, instrumentation, statistical analysis and conclusions. d. Discuss, and present to peers, research articles within the context of the current body of knowledge in geriatric physical therapy. 3. Participate in clinical research. a. Prepare a case report or similar written product suitable for publication in peer review journal or presentation at a state or national professional conference. 4. Engage in the process of education to become competent instructors of geriatric physical therapy practice. a. Identify the critical information an intern must master to successfully practice at entry-level. b. Demonstrate the ability to clearly explain and preform aspects of geriatric patient management to interns and peers through a variety of learning formats (journal clubs, grand rounds, in-services, etc.). c. Successfully complete the APTA clinical instructor (Basic) certification course. 5. Become consultants, advocates, and ambassadors to the public and medical communities for the profession of physical therapy and as advocates for health promotion and wellness for the aging adult. a. Demonstrate the oral and written skills required to successfully communicate information pertinent to patient management to other members of the healthcare team involved in patient care. b. Demonstrate the ability to successfully communicate information regarding the profession of physical therapy, specifically geriatric physical therapy, to members of the other healthcare professions, patients, legislators, and the public at large.

22 22 c. Advocate for aging adults with respect to health promotion and wellness and issues related to public health and disease/injury prevention. 6. Exhibit the highest standards of professionalism. a. Demonstrate post-entry level professional behaviors in all categories on the Professional Behaviors Assessment. * (*Developed by Warren May, Laurie Kontney and Annette Iglarsh (2010) as an updated to the Generic Abilities) Example 5 - From Washington University School of Medicine in St. Louis Movement Science Fellowship, A Program s mission statement, goals and objectives Mission Statement: The Washington University School of Medicine in St. Louis Movement Science Fellowship aims to promote graduates ability to 1) critically and systematically establish diagnosis for movement impairment syndromes, 2) use those diagnosis to direct selection of intervention, and 3) practice in a manner that facilitates patient s achievement of optimal functional status. Program Goals: The goals, and specific objectives, of the fellowship program are to: 1. Prepare graduates who will serve as primary health care providers by using a diagnosis-based examination and treatment system by instructing and training fellows in use of: a. A standard and systematic movement of examination to determine a movement system diagnosis for patients with musculoskeletal pain problems; b. Movement system diagnoses designated for each body region, along with the key tests and associated findings for each diagnosis; c. Appropriate treatment strategies that are directed toward each specific movement diagnosis 2. Prepare graduates who will contribute to the profession and to health care through writing/research, teaching, leadership and consultative activities by providing fellows with: a. A clinically applicable methodology to review and apply literature to current practices as it relates to the movement impaired system; b. The resources needed to participate in professional writing, clinical research, teaching, leadership or consultative activities during and after completion of the fellowship as indicated. 3. Provide consistent delivery of mentoring to fellows in all regional sites by: a. Providing initial training on excellent mentoring to all new regional mentors prior to being assigned to a fellow; b. Providing reinforcement of mentor training to ensure currency about the Movement System Impairment curriculum; c. Consulting with both fellows and their respective mentors on at least a monthly basis to ensure that that fellow s mentoring goals and expectations (eg, minimum number 1:1 mentoring hours at each site) are being met; d. Using a standardized performance evaluation across all regional sites to assess each fellow s progress B How program mission statement and goals are consistent with each other

23 23 The fellowship goals were developed using the mission statement as a guide. Each goal is unique and directed towards achieving the mission and designing specific objectives that drive each learning experience C How program mission/goals are consistent with the mission of the sponsoring organization The mission, goals and delivery of the fellowship program mirror the values and aspirations of the program in physical therapy and its parent organization. Outcomes of the fellowship are reported annually to the institution to demonstrate its integral importance to our commitment to advancing human health. The fellowship serves as an extension of faculty efforts to promote an advanced level of patient care through outstanding training in the ability to diagnose and treat movement related musculoskeletal problems D Program participant goals and objectives The goals and specific objectives of the fellow-in-training are to: 1. Develop expertise in systematic examination and evaluation enabling diagnosis and management of movement impairment syndromes that lead to selection of interventions with high expectations of favorable outcomes by demonstrating: a. Knowledge of the movement system impairment diagnosis associated with each body region and differentiation among diagnosis; b. Skill in performance of the standard movement system exam; c. Sound clinical reasoning skills in determining the appropriate movement system diagnosis for a patient and ability to develop a specific treatment plan related to the diagnosis 2. Employ a clinically applicable methodology to review and apply literature to current practice as it relates to the movement impairment system by using: a. Structured review of the literature related to a patient case for presentation to faulty and mentors; b. Current literature to support and justify clinical decisions. 3. Develop skills for communication and dissemination of movement system impairment concepts by demonstrating skill in: a. Oral presentation of concepts related to the movement impairment system; b. Clinical teaching of the movement system impairment examination to students or other clinicians learning the exam.

24 24 Evidence A Provide the program s policies and procedures for all items listed in the ABPTRFE Evaluative Criteria for Accreditation of Residency or Fellowship Programs for Physical Therapists that includes at a minimum, an annual review and assessment of the program s policies and procedures. Please do not include the organization s entire policy and procedures manual. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 SUBJECT: Making, Changing, and Disseminating Policy/Procedure FORMULATION DATE: 06/01/02 REVISION DATE: 5/21/06 APPROVED BY: Greg Hartley, PT, DPT, GCS A designated advisory committee consisting of both academic and clinical faculty will meet at least annually to review, revise, and/or develop policies. This committee will assure all policies and procedures are based on appropriate criteria and conform to legal guidelines. The Program Coordinator will arrange and attend the meeting and record the minutes. The Program Director will set policy as needed during the interim periods. All residency program policies and procedures affecting faculty, staff, and residents are provided in writing prior to implementation, and are applied equitably to all participating faculty, staff, and residents. Example 2 - From Creighton University-Hillcrest Geriatric Residency, 2014 The following policies & procedures are evaluated annually by the program director and updated as appropriate.

25 25 1) Patient/Client Care Issues: a) A policy on confidentiality safeguards for records and personal information Example 1 - From Creighton University-Hillcrest Geriatric Residency, 2014 Neither University nor Residents shall disclose to any third party, except where permitted or required by law or where such disclosure is expressly approved by Facility in writing, any patient or medical record information regarding Facility patients, University and Residents shall comply with all federal and state laws and regulations, and all by laws, rules, regulations, and policies of Facility and its medical staff, regarding the confidentiality of such information, including, without limitation, all applicable provisions and regulations of the Health Insurance Portability and Accountability Act of 1996 ( HIPAA ). The parties agree that Residents are members of Facility s workforce as defined under HIPPA. This subsection applies solely to HIPAA privacy and security regulations applicable to Facility and does not establish an employment relationship between Facility and Residents for any other purpose. Example 2 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Personal Rights and Confidentiality of Records: All records and personal information pertinent to residents are kept strictly confidential and are accessible only to resident and faculty/staff. Records are kept for a period of at least three years. These records are stored in locked storage maintained by the Program Coordinator at St. Catherine s/ Villa Maria. When deemed appropriate, records are destroyed by shredding. In addition, residents must follow all St. Catherine s/villa Maria policies and procedures related to nondisclosure of confidential information, including employee personal records, patient records, release information from Medical Records, consent for the release of confidential information, confidentiality of information transmitted via facsimile (fax Machine), and third party concurrent medical record review. The residency program and its faculty, staff, and residents must comply with HIPAA regulation. Example 3 - From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency Confidentiality standards for safeguard of records and personal information: The residents must abide by MedStar Policies, including the Code of Conduct and HIPAA Privacy Rule in order to maintain confidentiality standards. Included as evidence at the end of this section is the MedStar HIPAA general policy and the MedStar Code of Conduct.

26 26 b) A policy and procedure on the protection of human subjects, consistent with the type of research being conducted by the resident or fellow-in-training Example 1 - From Creighton University-Hillcrest Geriatric Residency, 2014 All human research authorized and conducted under the University s jurisdiction is subject to review for human risk, benefit, and informed consent without regard to the source of financial, physical, (e.g., space, equipment), or logistical support. Many granting agencies require evidence of favorable review before submission of a proposal. In all cases, this review must occur before a funded project can be started. Creighton University adheres to the Statement of Principles governing human research known as the Declaration of Helsinki, and has established an Institutional Review Board. Creighton University is also guided by federal regulations and other ethical principles intended to ensure the welfare of human subjects in research. All research endeavors at Creighton University and Creighton University of Medical Center involving the physical, behavioral, or social welfare of human volunteers must be reviewed by the Creighton University Institutional Review Board. This panel of University experts and citizens determines whether human subjects have volunteered for a research endeavor with informed consent as defined by the committee procedures and policies, and whether risks to the subject or research are outweighed by the potential benefits to be gained from the research endeavor. Evaluation of risk involves weighing the potential for injury to the subjects by reason of direct application of an experimental procedure or circumstance, or by reason of the subject s exclusion from ordinary standards of practice and welfare. The rights of the subjects regarding confidentiality and access to professional care and counsel are included in deliberations, so that human dignity, rights, and physical, behavioral, and social welfare are protected. All residents are expected to complete CITI training through Creighton University to be able to participate in new or ongoing research by Creighton faculty. This training is online and should be completed by September 1 st. Example 2 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Catholic Health Services of Florida has its own Federal Wide Assurance (FWA) which designates the University of Miami to serve as its Institutional Review Board (IRB) of record. Residents participating in studies involving human subjects must comply with the affiliated University s Institutional Review Board (IRB). Residents will obtain written informed consent of persons involved in demonstration studies, case studies, clinical trials, and/or depiction in audiovisual materials. All other applicable federal, state, local, or corporate rules, regulations and policies, or procedures must also be followed. Consent Forms must receive IRB approval. All Forms and procedures must comply with HIPAA regulation. Example 3 - From AllStar Therapy Geriatric Residency Program, 2010 During each residency program, each resident must adhere to appropriate policies for the protection of human research. Such required information on gathering and tracking of information must be approved by the director of Residency in collaboration with the Administrator of the clinical site where information is being obtained. Informed consent will be obtained from all individuals or family members as necessary that are enrolled as research subjects. No investigator or staff person may enroll a human subject into a research protocol without having obtained the informed consent from the person subject or his/her legally authorized representative.

27 27 Minimizing the risks of non-compliance with protection of human rights: Provide proper education to each prospective participant in a research trial for the collection and use of clinical samples. Each resident will be responsible to give those patients/clients who may be participant in such a research program the Patient/Client Care Research Disclosure Form Employee training by company as well as contracted clients Provide proper education to each prospective participant in a research trial for the collection and use of clinical samples Personal or clinical information on subjects used for research purposes will be eliminated or be linked through separate identifiers if needed in preparation for analysis Records will be kept in a locked drawer Termination of resident contract may result from non-compliance of corporate policies on the protection of human rights

28 28 c) A policy on safety regulations, and evidence of its annual review Example 1 - From Creighton University-Hillcrest Geriatric Residency, 2014 It is the policy of Creighton University to provide a safe and healthy environment for all faculty, employees, students, and visitors to campus. The safety and health of our community is imperative in light of our desire for the highest possible quality of life on campus. Under no circumstances will campus safety be ignored or diminished in importance in favor of other financial or cultural priorities. Safety and health issues on campus, and in every facility, will receive a high priority and all safety and health hazards that are discovered will be addressed and corrected without delay. It shall be the responsibility of the Provost, Vice Provosts, Deans, Department Chairs, Directors, and Supervisors to insure that their respective areas are safe and that their employees are properly trained and briefed on the hazards of the workplace. It is the responsibility of all employees to follow safe work practices within their respective work areas. The Creighton Department of Environmental Health and Safety shall determine applicable regulations, develop policies and procedures, and coordinate inspections and compliance with health and safety regulations of all local, State, and Federal regulatory and accrediting agencies, such as the Omaha Fire Department; the Nebraska State Departments of Health, Labor, and Environmental Quality; and the Federal Occupational Safety and Health Administration (OSHA), Environment Protection Agency (EPA), Centers of Disease Control Prevention (CDC); the Joint Commission of Accreditation of Healthcare Organizations (JACHO). A Campus Safety Committee has oversight responsibility for safety on campus. All academic and vice presidential areas are represented, and the members are appointed by the President. The committee shall meet at least quarterly. Hillcrest Onboarding: Hillcrest has an annual safety checklist that is completed at orientation (Onboarding). In addition Hillcrest has a Safety Committee which regularly monitors the safety for the Hillcrest System including safety policies and procedures for the facility. Example 2 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Appropriate safety regulations are posted and reviewed in accordance with St. Catherine s/ Villa Maria policy and procedure including regulations outlining universal Precautions, use of equipment and storage and use of any hazardous materials. Specifically, information on the following subjects is found within the facilities: Workplace Safety Universal Precautions Bloodborne Pathogens Material Safety Data Sheets Use, Storage, and Cleaning of Durable Medical Equipment Residents will be oriented as to their location by the Program Coordinator or designee no later than three days after arrival. Administration for St. Catherine s & Villa Maria review policies and procedures

29 29 annually, and when necessary, residency staff will provide input. All employees (including residents) receive a general orientation upon hire, and annually thereafter, which includes all of these topics. Example 3 - From Centers for Rehab Services Women s Rehab Physical Therapy Residency Program, 2010 Patient and Staff Safety A. All situations which compromise or potentially compromise the safety of patients, visitors, others, or involve complaints regarding patient care must be reported online through UPMC Riskmaster. The online Initial Incident Event Reporting Form must be completed within 24 hours of occurrence. B. All situations which compromise the safety of employees must be reported on the Employee Incident Report Form. The Employee Incident Report Form must be completed within 24 hours of occurrence. The completed Incident Report Form is to be sent as an attachment to HR. HR will reply to the and provide an internal tracking number for recording on the hard copy. Original signed hardcopies are to be mailed to the HR at the CRS Corporate Office. C. Incidents will be individually reviewed on a monthly basis by the Safety Committee. The number of incidents, noted trends, and corrective action plans will be summarized quarterly on the facility QI reports. D. Departmental safety inspections must be performed on a quarterly basis. The inspection will assess the condition of the physical plant; availability of universal precaution materials; correct storage and labeling of hazardous materials; maintenance of equipment; posting of emergency procedures, exit plan, and professional licenses; availability of occupancy permit, fire inspection, and pest control report; resumes for professional staff; policy and procedures manual; and annual disaster inservice report. Corrective action to satisfy any deficiencies should be implemented by the Facility Director. The Quarterly Physical Environment Checklist will be submitted to the Safety Committee for review. E. Annual preventative maintenance, calibration and testing of clinical equipment will be performed through a contractual arrangement with an outside vendor. Records of the annual maintenance inspection will be maintained in each facility and a copy will be forwarded to the Safety Committee for review. F. Since routine cultures of hydrotherapy equipment have not proven to be effective or necessary, laboratory cultures will only be performed in cases of suspected cross contamination. Suspected cases of cross contamination should be reported online through UPMC Riskmaster for review and action as necessary. A summary of suspected cases of cross contamination will be reviewed quarterly by the Safety Committee.

30 30 2) Administrative and Human Resource Issues: a) The policies and procedures related to admission to the residency/fellowship program including the use of transfer credits Example 1 - From Brooks Rehabilitation Neurologic Residency, 2014 Residency Requirements: The following items are perquisites for an individual to meet in order for them to enter the Brooks/UNF Residency Program: 1. Graduate of a CAPTE accredited physical therapy program and/or a graduate degree from a US based Regionally Accredited program. 2. Proof of licensure to practice physical therapy within their current practice setting. 3. Meet all eligibility requirements to be employed as a practicing physical therapist within Brooks Rehabilitation. 4. Applicants are required to submit a personal letter for admission (autobiographical statement) 5. Applicants are required to submit a list of physical therapy continuing education courses that they have attended over the last five years. 6. Submit a current resume or CV. 7. Demonstrate interest in further professional development as documented in the Personal Letter for Admission and the list of continuing education courses submitted within the Residency Application. 8. Demonstrate that they are eligible for membership within APTA 9. Applicants must provide all history of professional physical therapy training as well as any post professional education (formal and/or informal). 10. Applicants are required to provide references from three physical therapists with one being from a PT academician who was one of the applicant s instructors. Admissions Process: The admissions process is standardized for all Brooks Institute of Higher Learning residencies and fellowships. The RF-PTCAS portal is currently utilized for all applicants to submit their application for one of the Brooks IHL residency or fellowship programs. There is a specific section of the Brooks IHL website describing the admissions process which lists the application deadlines for each program as well as provides the link to the RF-PTCAS portal. The admissions process will be carried out as follows: 1. Applicants will submit the applications via the RF-PTCAS portal on or before the stated deadline. 2. Applications submitted after the deadline will be rejected unless extenuating circumstances can be described the determination to review late applications will be made by the Residency Program Director (PD). 3. Applicants will be reviewed for completeness by the Residency Program Education Coordinator (EC). The EC will confirm receipt of the application as well as whether the application was accepted as completed. 4. Applicants who are missing components of their application will be notified by the EC and will be given a deadline for submission of any missing components that is decided by the PM. 5. The EC will create an electronic file for each applicant that will eventually become that individual s permanent folder. 6. The PD will review all of the applications to insure that each individual meets all of the eligibility requirements. The PM may delegate this responsibility (in whole or part) to other members of the Admissions Committee as deemed necessary/appropriate.

31 31 7. Members of the Admissions committee will be given access to the electronic folders to review prior to them meeting as a group. Admission Committee members will be expected to treat these files with the strictest confidence. 8. The Admissions Committee will meet to discuss the applicants. If the committee decides it is necessary they will schedule interviews for applicants to assist with the decision to accept or reject. Some applicants may be accepted without an interview and some applicants may be rejected without an interview. 9. Each applicant will be informed of their status throughout the process, particularly as decisions are made in regards to their status. 10. If interviews are performed, each applicant to be interviewed will be notified via and/or in writing a minimum of two weeks prior to the interview. Once the interview schedule is confirmed each applicant will be informed of the specific time, date, and place for their interview. 11. Once the interviews are conducted the Admissions Committee will meet one last time to make final decisions regarding outright acceptance, conditional acceptance, or rejection. 12. All applicants will be notified of their final status a minimum of 6 weeks prior to the start of the program for which they have applied. Example 2 - From Creighton University-Hillcrest Geriatric Residency, 2014 Resident Qualification: Residents providing Services under this Agreement shall: (i) have a Doctor of Physical Therapy degree awarded from an accredited Department of Physical Therapy and be duly qualified and eligible for licensure as a physical therapist in the state of Nebraska ( State ); (ii) be eligible to participate in federal health care programs, including Medicare and Medicaid; (iii) have passed a criminal background check (if applicable Facility shall notify University of any particular requirements for such a background check); and (iv) provide proof of current tuberculosis test, current immunizations in MMR, DPT, annual influenza, and documentation of either Hepatitis B vaccination or declination of such vaccination. Applicable Standards: University agrees that all Services provided pursuant to this agreement shall be performed in compliance with all applicable standards set forth by law or ordinance or established by the rules and regulations of any federal, state, or local agency, department, commission, association or other pertinent governing, accrediting, or advisory body having authority to set standards applicable to facility. Resident Qualifications: Residents must meet the following qualifications: 1. Graduated from a CAPTE accredited physical therapy program. 2. Licensed or eligible for licensure in the state of Nebraska and the ability to be licensed by residency program start date. 3. Passed a criminal background check and screening requirements criteria established by Creighton University Human Resources for employees of Creighton. 4. Eligible to participate in federal health care programs, including Medicare and Medicaid. Application Requirements: Applicants must meet all requirements as outlined in the Resident Qualification section to apply for a residency program. Application Process: Applications must be completed as directed by the RF-PTCAS centralized application system. Applications are due March 1 st of each year. This application deadline may be extended at the discretion

32 32 of the program faculty. Applications are reviewed by the appropriate Program Director by two weeks post deadline date and with consultation of the overall Residency Program Director and other Resident Program Directors invite appropriate potential candidates for an in person or over-the-phone interview, dependent on availability and convenience. These interviews will occur during March and April. The Academic and Clinical Residency Directors, in addition to available mentors and program faculty, meet with the candidate and score them based on standard interview criteria. Applicants are selected based on qualifications, overall scores and comments on the interview score sheets and consensus by the interview team. Example 3 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Residency Admission Requirements: Enrollment: Selected residents must meet admission criteria set forth by the advisory committee. This includes (but may not be limited to): 1. Graduation from a CAPTE (Commission for Accreditation in Physical Therapy Education) accredited physical therapy program. 2. Hold (in good standing) a current license to practice physical therapy in the state of Florida (temporary licensure is acceptable; however residents must disclose their examination date with the program director at the time of admission). 3. A completed application received by published deadline. 4. An interview (for superior candidates). Acceptance is based on interest, ability, and aptitude for a career as a geriatric physical therapist. Applications are evaluated based on: 1. Academic Education and background 2. Clinical education, internship and mentoring experiences 3. Clinical experience in geriatric physical therapy 4. Research experience and interest Minimum eligibility requirements for acceptance into the program include: 1. Hold a valid Florida Physical Therapy License (temporary licensure is acceptable; however, residents must disclose their examination date with the program director at the time of admission) 2. Comply with all St. Catherine s / Villa Maria employment requirements Desirable applicants include those who: 1. Completed an extended internship or externship under the direct supervision of a Clinical Specialist in Geriatric Physical Therapy 2. Possess superior verbal and written communication skills 3. Have experience in data collection, analysis, and publication 4. Possess strong fundamentals in the principles of clinical reasoning and the application of examination and treatment procedures related to the practice of geriatric physical therapy. Residents are selected by the Admissions Committee and their decision is final. Decisions are based on a candidate s desire to advance their skills in geriatric physical therapy. This is evidenced by review of the essays (in application), resume, letters of recommendation, interests, and genuine desire to advance skills in geriatric clinical research, administration in geriatric facilities, and/or clinical teaching. Superior

33 33 candidates will be given an interview, which is conducted by at least two members of the admissions committee. Candidates are assessed in the areas of commitment, knowledge of the purpose of the program, interests (as outlined above). And personality. Good candidates will possess qualities of flexibility, team building, leadership, and a desire to learn. Applications are accepted year round and are evaluated at three specific time points each year (eg, 12/31, 4/30, 8/31). Applicants requesting disability accommodations must do so by filing a request (detailing necessary accommodations) in writing with the program office. Eligible applicants will be notified within 2 weeks of their eligibility and interviews will be arranged. Final notification of applicants who are accepted to the program will be made within 60 days of the published deadlines for the desired trimester.

34 34 b) The policies and procedures related to academic retention within the residency/fellowship program including the requirements (eg, passing criteria on examinations, timelines, etc.) for the program participant to maintain active status within the program through graduation. Example 1 - From Brooks Rehabilitation Neurologic Residency, 2014 Brooks Rehabilitation Policies: Individuals are required to follow all Brooks Rehabilitation policies and procedures at all times. Failure to do so will lead to dismissal from the residency or fellowship program. Professionalism and Practice Standards: Individuals are required to follow the APTA Core Values of Professionalism, the APTA Code of Ethics, APTA Guide for Professional Conduct, and APTA Standards of Practice for Physical Therapists at all times. Failure to do so will lead to dismissal from the residency or fellowship program. Attendance: General: Residents are required to attend all components of the training program for which they are enrolled. Individuals should notify the Residency Program Manger immediately when the individual s attendance for an activity will be interrupted. Lecture/Lab: Residents are expected to attend all classes. An individual can miss up to three classes with an excused absence. Individuals are required and responsible to make-up any missed work. If an individual misses more than three classes or has one unexcused absence they will be required to perform additional independent study work to demonstrate competency within the area that was missed. If an individual misses more than five classes, they will be placed on an academic probation with a remediation program developed. If an individual misses six more classes they may be dismissed from the residency or fellowship program. Excused absence is defined as one that is related to illness, death, birth, accidents, and extraordinary circumstances. An unexcused absence is defined as anything other than an excused absence. Exams: Individuals are required to attend all scheduled exams. Failure to do so will result in a grade of zero for that specific exam. Individuals may be able to demonstrate an extenuating circumstance, in which case, they will be offered an opportunity to sit for a retake exam. The exam may be the same as the exam taken by the other residents/fellows or it may follow a different format. That decision will be made by the Residency Program Manager and provided to the individual a minimum of three days prior to the date of scheduled retake. Other Activities: Individuals are expected to attend all scheduled activities including, but not limited to, clinical experiences, teaching, teaching and research experiences, case study and journal club presentations, special clinical experiences, etc. Failure to attend these learning experiences may result in dismissal from the residency or fellowship program. Makeup Work:

35 35 Work missed due to any type of absence will be the responsibility of the resident to complete and must be completed within 14 days of the absence unless other arrangements are made with Residency Program Manager. Leave of Absence: An individual may request a leave of absence from the program by submitting a written request to the Residency Program Manager. If they are in good standing they will automatically be able to re-enter the next available same program. If the leave time is six months or less than they will not be required to retake the portions of the course they already participated in. If the leave time is greater than six months they will be required start the entire program from the beginning. Once a resident is on an official leave of absence, they will have up to two years of eligibility to re-enter the program automatically (i.e. without having to reapply). After two years they will have to re-apply and admission will be up to the Admissions Committee. If an individual takes a leave of absence while they are on academic probation, they will be required to re-apply to achieve entry into the program. Lateness: Individuals are expected to be on time for all activities related to the training program. Lateness on three occasions, in the absence of an acceptable reason, will be treated in the same manner as unexcused absence. Examinations: Written and practical exams will be an integral component of the training for residents to demonstrate accountability for the requirements of the program. Therefore, there will be continuous assessment of the resident s/fellow s abilities throughout the course of the 1 year training. The grading of the program will be composed of the following elements: Monthly Written Exams: Ten written exams regarding specific content within the curriculum will be performed approximately every month. The average grade for the quizzes combined will be worth 15% of the individual s final grade. The average grade for the quizzes must be greater than 70%. Individuals who make less than 70% on any monthly written exam may be required to perform independent study activities to demonstrate competency within that area. This will be formulated by the Residency Program Manager. If the individual s average for the written exams falls below 70% for 2 consecutive months they will be placed on academic probation and a formal remediation plan will be established. Final Comprehensive Written Exam: One comprehensive written exam will be administered at the end of the program (weighting for this relative to the final grade may vary per program). Individuals must achieve a grade of 80% or higher on this exam in order to complete the program. If a grade of less than 80% is achieved then the individual will be offered an opportunity to sit for a second exam. If the grade achieved on the second exam is less than 80% they will be placed on probation and a formal remediation plan will be established. Individuals will not be eligible to complete the program with a score of less than 80% on this exam. Individuals will be offered a maximum of three opportunities to pass the final written exam. If it is not passed by the third time the individual will be dismissed from the program. Patient Practical Exams: Each resident will perform at least two practical exams involving patients, rather than models (weighting for this relative to the final grade may vary per program). Individuals must achieve 80% or higher for each practical exam in order to complete the program. If a grade of less than 80% is achieved then the individual will be offered an opportunity to sit for a second exam. If the grade achieved on the second exam is less than 80% they will be placed on probation and a formal remediation plan will be established.

36 36 Individuals will not be eligible to complete the program with a score of less than 80%. Individuals will be offered a maximum of three opportunities to pass each of the patient practical exams. If each of the exams is not passed by the third time the individual will be dismissed from the program. These practicals will consist of demonstration from the resident that they have incorporated the full breadth of the curriculum into their clinical practice. Residents will be assigned a patient within their clinical practice setting that is coordinated with their mentor. The logistics for the practical exam will differ amongst the various residency programs based on the nuances for each specialty setting. The resident will perform five comprehensive traditional practical exams with 5 patients throughout rotations. The resident will develop a case study, including a literature review that will be presented to the examiners. The patient will also be present and available for the resident to perform specific examination and/or intervention techniques as requested by the examiners. The final grade will incorporate the resident s ability to perform a literature review and incorporate the findings into clinical practice; present the case; demonstrate the use of evidence based practice methods as well as clinical reasoning and problem solving skills while performing the examination and developing the plan of care; the ability to effectively and efficiently perform an examination that leads to an appropriate diagnosis, prognosis, plan of care; the ability to develop a rapport with the patient; ability to safely, efficiently, and effectively apply examination and intervention techniques. The presentation will last no longer than 90 minutes. The resident should utilize appropriate audiovisual techniques for the presentation and supply written handouts for the examiners. The written material should be provided to the examiners at least 24 hours in advance of the exam. Non-patient Practical Exams: At the discretion of the Residency Program Coordinator Residents may perform non-patient practical exams. These exams may be performed on patients rather than models (up to the specific program coordinator for each residency). Individuals must achieve a grade of 70% or higher for each practical exam in order to complete the program. If a grade of less than 70% is achieved then the individual will be offered an opportunity to sit for a second exam. If the grade achieved on the second exam is less than 70% they will be placed on probation and a formal remediation plan will be established. Individuals will not be eligible to complete the program with a score of less than 70%. Individuals will be offered to a maximum of three opportunities to pass each of the non-patient practical exams. If each of the exams is not passed by the third time the individual will be dismissed from the program. These practical exams will be one hour in length and will be divided into two components. In the first part the individual will be asked to perform an examination on a model who does not actually have a dysfunction, however, the resident/fellow will be informed that they should perform the examination on the patient with a pretend dysfunction. Once this of the practical is complete the resident/fellow will be given a dysfunction and they will develop and implement a plan of care for that dysfunction, demonstrating the intervention techniques on the model. The interaction will mimic a real patient interaction as much as possible. For some programs these practicals will be performed on patients so the resident/fellow will demonstrate the appropriate examination and intervention strategies that would be appropriate to manage that patient, given the specific condition, impairments, etc. The resident will be graded on their ability to incorporate newly learned knowledge and skills into the examination and intervention performed on the model during the practical exam. Program Completion: The final grade, when all graded components are averaged, must be an 80% or higher to successfully complete the given program. Residents who fail a practical exam secondary to safety issues/concerns must successfully pass a follow up practical or they will not be able to proceed within the program. Failure to successfully pass the second practical may lead to termination from the program.

37 37 Other Graded Activities: Written Case Reports: Case reports will be a graded component within all of the programs, with each report being worth 5% of the total grade. The following activities will be graded on a Pass/Fail basis, but they must be passed to complete the program: Oral Case Report Journal club Research project Education activities Professionalism activities Practice management activities PT Student Mentoring Shadowing Activities Other program specific requirements may apply Example 2 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Residency Matriculation Requirements: Residents must meet the criteria for the completion of the program as defined by the advisory committee and the policies of the program. Matriculation is to be full-time unless approved by the director. Length of the residency is a minimum of 12 months and a maximum of 15 months in the clinical setting. Residents who are admitted with temporary licensure must disclose their NPTE examination date to the Program Director upon admission. If the resident fails the NPTE, the residents will be immediately terminated from the program and from employment with the organization. Time Allowed to Complete Residency: Completion of Projects: Residents must have completed all aspects of the residency to receive a certificate of completion. This includes clinical rotations, exams, projects, and assignments. It is expected that residents will complete all residency related tasks within the 12 month time-frame. In the event a resident has completed all assignments and clinical components of the program successfully, but has not completed the evidencebased project and/or the administrative project by the time the clinical rotation are finished, he/she will be allowed up to (but not exceeding) 3 additional months to complete the projects. Only then will a certificate of completion be awarded. Any additional time a resident takes to complete these projects does not constitute time in the residency and the resident is no longer considered an employee of St. Catherine s/ Villa Maria. The employer/employee relationship ends when the clinical components are completed. Completion of Clinical Competencies: Residents are evaluated three times a year as to their performance in the program. Each assessment period, residents develop an action plan to address any deficits. Residents are expected to correct deficits (with assistance as needed). In the unlikely event a resident progresses as expected until the final rotation,

38 38 at which time deficits are noted that warrant further attention; the resident may be asked to continue in the clinical portion of the program for up to, but not exceeding three months, during which time he/she would be given ample time and mentoring to correct the deficit(s). If the resident is unable to correct the deficit(s) within the allotted time, he/she will not be awarded a certificate of completion. Should the program faculty feel that the resident would be unable to correct these deficits during the three month extension, the resident will not receive a certificate of completion. During this remediation time, the resident would not be paid by St. Catherine s/ Villa Maria. Example 4 - From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency Academic Retention: Residents are continually evaluated throughout the residency year. These evaluations occur in each of the arms of the residency program, including: clinical, teaching didactic and research components. Failure to meet any of these requirements may result in dismissal from the residency program, and termination of employment through MedStar and/or GW. A remediation plan will be put into place if adequate performance is determined in a given area of the program. Please see remediation policy for more details. To successfully complete the residency, residents must participate in the following components of the residency: 1000 hours of non-mentored clinical hours 200 hours of mentored clinical hours At least 100 of teaching in entry-level DPT program At least 140 hours of physician clinic At least 150 hours didactic coursework At least 125 hours of scholarly project preparation/dissemination Residency Components Required Performance Evaluator Time of Evaluation Clinical Successful completion of 90 day introductory (probationary period at MedStar NRN/WHC (Clinical Performance Evaluation) Passing score on each of 3 Live Patient Examinations Demonstration of advancing competence in each of the clinical mentor reviews at each clinical site(baseline to midterm to final) Satisfactory completion of mentor preparation forms Satisfactory completion of Clinical Skills Checklist Demonstrated progress toward Individualized Learning Plan (ILP) Clinical Manager Clinical Mentors & Academic Director Clinical Mentors Clinical Mentors Clinical Mentors Clinical Mentors & Program Director August (30 day) September (60 day) October (90 day) November February July September/November January/March May/July Weekly November February July November February

39 39 Teaching Didactic Research Goals Compliance with policies and procedures of MedStar Code of Conduct Proficient teaching evaluation scores (incorporating student evaluation feedback) Clinical Mentors & Managers Teaching Mentors July On-going Semester I: December Semester II: May Proficient faculty assessment score Teaching Mentors Semester I: Oct/Nov Semester II: Mar/Apr Compliance with policies and procedures of GW University program handbook Program Manager Ongoing Passing score of %70 or greater on the 2 written exams for the Neurologic Consortium Approval of proposed scholarship and completion of quarterly reports with updates regarding deliverables Acceptable scholarly project dissemination at Grand Rounds Documentation Completion of all required logs (patient, mentor, practice pattern) Ongoing completion of feedback forms (mentors and program-level) Program Director Research Mentor Research Mentors & Clinical Mentor Program Director Program Director October January October January April July July November February July November February July

40 40 c) A policy related to academic remediation of the program participant and the criteria for dismissal form the program if remediation efforts are unsuccessful. Example 1 - From Creighton University-Hillcrest Geriatric Residency, 2014 Remediation: The residency program is one year in length. If at any point during the resident year, a resident is deemed by residency faculty to be performing unsatisfactorily the program director and involved residency faculty will decide on an appropriate course of action. Examples of action items might include, but are not limited to, additional mentoring sessions with resident faculty, additional didactic work assigned by resident faculty, additional clinical practice time at the resident s primary facility or another residency clinical site, or specific practice sessions with a residency faculty member organized around a problem area performance. If additional residency time is needed because of deficiencies in competence (unable to satisfactorily meet the requirements for a successful completion of the residency) the resident will have up to 3 additional months to correct the deficiencies. This time will be unpaid. If the resident is unable to correct the deficiencies as determined by the program directors by the end of the three months the resident will not be awarded a certificate of completion. The syllabus for each residency outlines the specific competencies for success. Example 2 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Resident Evaluation and Remediation: Residents complete a Resident Self-Assessment Tool (RSAT) within the first week of the program. This tool is reviewed by program coordinators and appropriate goals are set, if needed. Residents are evaluated using a revised version of the Clinical Skills Performance Evaluation Tool for Geriatrics (APTA Publication Number E-55) called the Resident Clinical Performance Evaluation (RCPE). This is completed three times per year. Residents must receive a satisfactory rating on each of the components of this tool by the completion of the program. At the completion of each rotation, the program mentor(s) complete the RCPE. It is summarized by the mentor(s) and Program Coordinator(s). Residents must then develop a written action plan detailing how each area marked as unsatisfactory will be addressed in the coming rotation. The action plan is to include specific learning objectives which will be reviewed and revised (if needed) by the faculty. Any revisions will be discussed with the resident. Residents are expected to show improvement from rotation to rotation, with a minimum of 2.5 after the first rotation, 3.0 after the second rotation, and 3.5 after the third. Those who do not will be offered educational advisement where a more detailed action plan will be developed (with the Program Director s input), including specific behavioral and learning objectives with time frames for accomplishment. This will be done on a case-by-case basis. Residents who fail to meet expected outcomes (achievement of a on the total score) in the final rotation of the residency will be offered up to three additional months to satisfy the requirement(s) if the majority of faculty agree that the resident has the potential to make the necessary improvements within the time frame. (See P&P for Time Allowed to Complete Residency ). Residents will also complete a Live Patient Examination (LPE) for each setting Skilled Nursing Facility, Rehabilitation Hospital, and Outpatient. Residents will complete the exam at the end of each rotation and must pass each exam ( 2.0) before moving to the next setting. Students who do not pass the exam will be offered up to two extra weeks in that setting with no less than 4 hours of mentoring before retaking the exam. Students who fail the exam a second time will be referred to the Program Director for education advisement. (See P&P for Time Allowed to Complete Residency ).

41 41 All residents will complete a written exam at the end of each rotation based on the didactic content provided up to that point. The exam will be composed of test questions written by the course instructors for each unit and submitted to the program coordinators for final approval and test construction. Residents must answer all questions without the use of additional materials (eg, texts, notes), and will be given up to 90 minutes to complete the examination. Residents must score a grade of 80% or higher to pass. Those who do not attain a passing score will be given remedial education and allowed to retake portions of the exam that they missed one time. IF the resident does not attain 80% or better (recalculated total score) the second time, a detailed remedial plan will be developed by the Program Director which will include additional written examination(s). (See P&P for Time Allowed to Complete Residency ). Residents also receive weekly written feedback related to mentoring sessions. Residents receive informal verbal feedback on an ongoing basis. Residents must prepare a case report or similar written product suitable for publication in a peer reviewed journal or presentation at a state or national professional conference. This project is graded as Pass/Fail by the Program Director. Example 3 - From Brooks Rehabilitation Neurologic Residency, 2014 Academic Probation: Residents who fail to meet minimum criteria for completion of the program will be placed on academic probation. The individual will be placed on the probation once the faculty of the program determine that the individual is not meeting the minimal criteria. The resident will be notified of their change in status in writing immediately upon the decision being made. The resident will be directed to meet with their mentor to develop a remediation plan. The resident will be on academic probation until the terms of the remediation plan have been satisfied. A resident cannot complete the training program while on academic probation. Remediation: Once the resident has been placed on academic probation they will meet with their Program Coordinator within 7 business days of receiving the written notification. Together they will develop a remediation plan that will outline how the resident will demonstrate competencies on past material as well as develop strategies to successfully move forward through future components of the curriculum. The remediation plan will be specific in terms of the focus, requirements, tasks, and timelines. The Program Coordinator may seek information from other faculty within that program in order to assist with the plans development. Once the plan is developed it will be submitted to the Residency Program Manager for their approval. Once all parties agree to the remediation plan it will be signed, dated, and implemented. Academic Misconduct: Academic misconduct (eg, cheating on an examination, plagiarism, etc.) will be cause for immediate dismissal from the residency program. The accusation will be brought forth by a faculty member, proctor, and/or other resident. Once an accusation has been made the Residency Program Manager will schedule a hearing to review the accusation. If there is evidence of unpremeditated academic misconduct then the penalty may range from the resident being placed on academic probation, temporary suspension from the program with resumption in the next class for that program, required additional activities within the training program, to dismissal from the program. If it is determined that the resident performed premeditated academic misconduct then the individual will be dismissed from the program. In addition, their status as a Brooks Rehabilitation professional staff member will be scrutinized, which may lead to a termination of their employment with Brooks Rehabilitation.

42 42 Example 4 - From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency Academic Remediation: A remediation plan will be initiated for a resident who demonstrates poor performance in any of the following areas (but not limited to these areas): Adherence to MedStar NRN and GW policies and Procedures (refer to MedStar NRN Disciplinary Process Policy and the GW PT Program s Associated Faculty Handbook) Patient Safety Professional behavior/communication Time and attendance Clinical performance Completion of above noted program requirements (clinical, teaching. research, didactic, documentation) as listed in Academic Retention. When a deficiency in the resident s performance arises in one of these areas, coaching and counseling will be initiated. Specific discussion and feedback regarding performance will be provided and documented. Additional residency executive committee members (ex: clinical manager/ supervisor, academic faculty) may be involved as necessary. If poor performance issues continue, a formal remediation plan will be drafted. The remediation plan will include: 1) Residents areas of Deficiency; 2) Objective/measurable goals for performance; 3) Specific consequences; and, 4) Timelines in which the deficiency must be remediated. The plan will be reviewed by the residency executive committee along with the resident. The remediation plan will be signed by the Residency Director, Clinical Manager and the resident. If the resident fails to meet the specified criteria of the remediation plan within the designated time frames or demonstrates ongoing performance issues in related program areas, the consequences will be implemented, including possible termination from the residency program. The committee may seek recommendations from other program faculty (mentors) in making the final decision as to whether the resident will remain within the program. If remediation is recommended and approved, the maximum timeframe allowable for remediation to occur may be an additional 3 months from the scheduled end date of the program. The resident is considered on probation at this time, and if he/she does not meet the remediation goals, he/she will be terminated. If remediation is not recommended, termination of employment from MedStar NRN and GW will follow.

43 43 d) A policy and procedure related to the availability of, and accessibility to educational advising and counseling for both didactic and clinical aspects of the program Example 1 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Residents Access to Educational Advisement: Residents have access to educational advertisement primarily through the role of the Resident Advisor, one of the coordinator responsibilities. This includes ensuring that the residents are matriculating in a manner that reflects advanced practice, and at a pace that is acceptable to maintain expectations within the program. Remediation is provided and overseen by faculty advisors as needed. In addition, residents receive educational advisement including information regarding salary, tuition, reimbursement, current enrollment policies, matriculation, withdrawal, and dismissal policies and procedures. This information is shared during orientation and may be obtained through the Program Director or Coordinators at any time. All residency faculty are available for advisement by appointment. Example 2 - From Creighton University-Hillcrest Geriatric Residency, 2014 Individual resident advising and counseling is available on an ongoing basis. Formal orientation is provided for the academic and clinical components during the first 2 weeks of the residency. At that time all contact information for the Program Director, the Director of Clinical Residency Program and other involved faculty is made available to the resident. The Academic Program Director schedules weekly meetings with the resident during which time any issues are addressed. Residents have access to the Program Directors via cell phone and to address any after hour issues. In addition, residents have the opportunity to utilize resources at Creighton University available to all Creighton faculty for the Employee Assistance Program. Example 3 - From Brooks Rehabilitation Neurologic Residency, 2014 Residents are informed that the Residency Director has an open door policy for all residents within the program. The residents also have access to all faculty via and cell phones and we encourage frequent communication. Residents are aware that they can schedule a meeting at any time. These meetings are considered a two way conversation so that information is exchanged in both directions. Items that may be discussed at this time include: Successes and difficulties within the program. Mechanisms for improvement (particularly suggestions on how to be successful). Answering logistical questions/concerns. Discussing professional development both during the program and afterwards. Mechanism for redemption if appropriate Professional issues as they relate to the residents performance and interactions with others. Feedback to resident from faculty and/or other residents.

44 44 e) Nondiscriminatory policies and procedures for the recruitment, admission, retention, and dismissal of program participants Example 1 - From Creighton University-Hillcrest Geriatric Residency, 2014 Equal Employment Opportunity Policy: In accordance with applicable federal laws and regulations, the employment policies and practices of Creighton University are administered without unlawful regard to race, color, religion, national origin, sex, disability, marital status, veteran status, or age. The University will promote equal employment opportunity through a positive and continuing Affirmative Action Program. This Affirmative Action Program will have as its firm objective equal opportunity in recruitment, hiring, rates of pay, promotion, training, termination, benefit plans and all other form of compensation and conditions and privileges of employment for all employees and applicants for employment. The program is designed to provide equal employment opportunity and an atmosphere of nondiscrimination with respect to women, members of the various minority groups, veterans and the disabled. Coordination of the University s civil rights effort is the responsibility of the Associate Vice President for Equity and Inclusion. Staff members are encouraged to direct inquiries or complaints regarding civil rights policy to the University Office of Equity and Inclusion. Example 2 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Resident Non-discrimination: It is the policy of the program to recruit, admit, and retain participants on a non-discriminatory basis. Specifically, the program does not discriminate on the basis of race, creed, color, gender, age, national or ethnic group. Marital status, sexual orientation, disability, or health status. Example 3 - From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency Non-discriminatory policies: According to the MedStar Code of Conduct, MedStar is committed to equal employment opportunity without regard to race, color, religion, national origin, gender, sexual orientation, age, disability, marital status, or veteran status, pertaining to associates, students, volunteers, and business partners. Residents would be considered associates under this policy, as they are hired as part-time employees. For more information, refer to the MedStar Code of Conduct (included as evidence to part 1A of this section). According to GW University policy, the residency program does not unlawfully discriminate against any person on the basis of race, color, religion, sex national origin, age, disability, veteran status, or sexual orientation. This policy is applicable to all of the University programs, including admission to educational programs such as the residency. For more information, refer to:

45 45 f) A grievance policy or mechanism of appeal that ensures due process Example 1 - From Creighton University-Hillcrest Geriatric Residency, 2014 Harassment, Discrimination, and Grievance Policy: In accordance with its history, mission, and credo Creighton University believes that each individual should be treated with respect and dignity. It is obvious that any form of harassment or discrimination is a violation of human dignity, and the University strongly condemns any such harassment and/or discrimination. Harassment or Discrimination: Discriminatory treatment on the basis of race, color, sex, religion, sexual, orientation, national origin, age, handicap, or disability, marital status, citizenship, maternity or lactation status, status as a Vietnam-era, special, disabled, or other veteran who served on active duty during a war, campaign, or exhibition for which a campaign badge has been authorized in accordance with applicable federal law, or protected activity under the anti-discrimination statues or discriminatory treatment as may be described by state statue law, local ordinances or the University s policies. The conduct must be so objectively offensive as to alter the conditions of the victim s employment or educational experience. That is, the harassment must have culminated in a tangible employment or academic action or be sufficiently severe or pervasive to create a hostile work or educational environment. Examples of harassment include, but are not limited to, intimidation and humiliation as expressed by communications, threats, acts of violence, hatred, abuse of authority, or ill-will that assault an individual s self-worth. Harassment of a non-sexual can include slurs, comments, rumors, jokes, innuendoes, cartoons, pranks and other verbal or physical conduct, frequent, derogatory remarks about a person even if the remarks are not sexual in nature and any other conduct or behavior deemed inappropriate in the University Statues or policies if Creighton University. Sexual Harassment: Sexual Harassment can falls into one or both of two categories: Quid pro quo and hostile environment. Quid pro quo sexual harassment occurs when an individual attempts to use his or her position or authority to obtain sexual favors from an employee or student in an expressed or implied exchange for the granting of job or academic benefits or other favorable treatment. Hostile environment sexual harassment occurs when an employee or student is subjected to an intimidating, hostile or offensive sexually-orientated physical, verbal, or other conduct. Such conduct shall be subject to prompt and effective action. Hostile Environment Harassment: Harassment that is sufficiently pervasive as to alter the conditions of employment or the educational environment and create an abuse environment in which to work or study. The person alleging a hostile environment must show a pattern or practice of harassment against him or her; a single incident or isolated incidents generally will not be sufficient. In determining whether a reasonable person in the individual s circumstances would find the work or educational environment to be hostile, the totality of the circumstances must be considered. Individuals who believe themselves to be victims of harassment or discrimination and who desire University assistance may file an informal complaint with the Affirmative Action Direct ( faculty or staff) or with the Vice President for Students Services (students) or they may file a formal complaint with the chair Chairperson of the Harassment and Discrimination Committee. Unresolved informal complaints or formal complaints will be investigated by the Harassment and Discrimination Committee. The Committee will conduct its investigation in a reasonable confidential manner and promptly after receiving the complaint. The Committee will submit its findings and recommendations to the President of the University who will make the final decision as to what action shall be taken. If the complaint is against a

46 46 faculty member and the President determines that the conduct is such as to warrant the suspension or dismissal of the faculty member, the President will initiate the appropriate procedures for Dismissal as set forth in this Handbook. For further information, refer to the Harassment, Discrimination, and Grievance Policy, Policy in the Guide to policies for Creighton University. ABPTRFE s Compliant Process: Any or all residents have the right to file a grievance with the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) if they feel the residency program has not met the expectations outlined in the handbooks/syllabus or other resident materials. Please refer to: for the Grievance Process. Example 2 - From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency Grievance Policy (residency-specific and ABPTRFE): Questions about any component of the residency the resident may have, should first be discussed at the quarterly meetings with the Program Director. If a resident has a grievance or chooses to appeal any aspect of the residency that is required for completion (including, for example, performance review, scholarly project, etc.), he/she must put his appeal in writing. The issue would be first discussed with the resident s direct supervisor in a specific residency area (i.e. an issue with clinical performance would be directed to the primary mentor, an issue with the teaching would be directed to the course director, an issue with the scholarly project would be directed to the research mentor, and so on). If the grievance cannot be resolved at this level, the director of the residency would be consulted to address the issue. If the grievance cannot be resolved at this level, the residency executive committee would be consulted to address the issue. Any grievances must be handled urgently, and therefore meetings with the necessary residency faculty must be made promptly. Residents are also informed that they can file grievances with the APTA if they so choose. Residents are notified of this policy within their residency program hire letter and supporting documents. Refer to the ABPTRFE website for more information regarding filing a complaint.

47 47 g) A probationary period policy, if applicable Example 1 - From Drexel University Orthopedic Residency, 2014 Probation Period Policy: The first (90) days of employment for all professional staff is considered an introductory period. This employment is classified as at will as described in the Human Resources Policy found at: Furthermore, upon completion, dismissal or withdraw from the Orthopaedic Physical Therapy Residency program, a resident s employment will terminate. A specific policy for probationary periods scheduled for poor performance can be found at the following link: Example 2 - From Creighton University-Hillcrest Geriatric Residency, 2014 There is no probationary period associated with this program. Example 3 From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency If a resident is placed on a remediation plan due to poor performance in any of the areas stated in 2C (eg, lack of adherence to MedStar or GW policies, patient safety issues, professional behavior/communication deficits, time/attendance issues, clinical performance below expectations), the resident will be placed on academic probation. The maximum timeframe allowable for remediation to occur is an additional 3 months from the scheduled end date of the program. During this probationary period, if he/she does not meet the goals outlined in the remediation plan, he/she will be terminated. A resident may also be granted a leave of absence, or request withdrawal from the program if unanticipated circumstances outside of the residency program (not related to poor performance) arise. Leave of Absence (maximum 3 months): A resident may voluntarily request a time-limited leave of absence if circumstances arise which prevent completion of residency commitments (as detailed above). The ability to resume the program (reinstatement) will be handled on a case-by-case basis, and may be limited based on the time at which the resident requests leave of absence (eg, before or after final budget decisions for the following year). The resident will request a leave of absence by notifying the Residency Director. The resident may need to re-apply for the residency the following year if there is not budgetary funds available to extend their position. Withdrawal: A resident may voluntarily withdraw from the residency program if circumstances arise which prevent completion of residency commitments (weekly patient care hours and mentoring, weekly academic courses, physician clinics, scholarly project). Such circumstances may include: illness, family illness or death, etc. The resident will request to withdraw by notifying the Residency Director.

48 48 h) A termination policy and procedure that includes termination of the program participant that becomes ineligible to practice (eg, program participant cannot obtain licensure in the state or loses their temporary licensure and becomes ineligible to practice) and includes the employment status of a program participant should termination from the program occur Example 1 - From Brooks Rehabilitation Neurologic Residency, 2014 When a resident has been placed on academic probation with a remediation program in place and the individual continues to fail to meet the minimum criteria for passing, a meeting of the faculty will be called to discuss the resident s continued participation within the training program. The faculty for the specific program will vote to make a recommendation to the Residency Program Manager who will make the final decision as to whether an individual will be able to continue within the program. The Residency Program Manager will perform interviews with the resident and the program faculty to gain insight into the issue. When a resident is dismissed from the residency program this will not have a negative impact in regards to their employment with BHS. The individual will resume their normal duties and responsibilities at the same level of salary and benefits. The exception to this would be if an individual was dismissed secondary for academic misconduct, in which case their employment with Brooks may be terminated. In the case of an individual who came in for the one year of education, they could continue within the employment arrangement for the remainder of the contracted year with no change in salary or benefits, but must vacate the position at the end of the contract. Example 2 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Resident will be dismissed from the program for any of the following: Failure to abide by the Florida Physical Therapy Practice Act. Failure to abide by the American Physical Therapy Association s Code of Ethics/conduct. If admitted under temporary licensure, failure to successfully pass the NPTE within the timeframe specified by Florida law. Failure to abide by the policies of St. Catherine s Rehabilitation Hospital/ Villa Maria Nursing Center or the policies of the Residency Programs. In the event the resident does not meet the employment requirements of the residency, he/she will be dismissed from the residency program. Failure to achieve a score of satisfactory or better in each of the rotations required as a part of the residency program. At the discretion of the Program Director (for reasons not listed above) DUE PROCESS: as employees of St. Catherine s/ Villa Maria, residents are subject to the same policies governing dismissal, termination, and grievance as any employee at St. Catherine s/ Villa Maria.

49 49 Example 3 - From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency A resident will be dismissed from the residency if they demonstrate consistent unsatisfactory performance in their above responsibilities, if there is no change in performance following remediation, or if there are any behaviors consistent with unethical practice or in violation of the DC Physical Therapy Practice Act. If a resident should become ineligible to practice due to inability to obtain licensure or loss of licensure status, the resident will be terminated. If a resident is terminated from the residency program, their employment with both MedStar and GW will also be terminated. A resident is employed through these institutions based on on-going fulfillment of residency program requirements. Refer to: MedStar Disciplinary Process Policy (740.27) GW PT Program Associated Faculty Handbook Example 4 - From Creighton University-Hillcrest Geriatric Residency, 2014 Each of the following may result in termination of the staff physical therapist position and dismissal from the residency position*: Ineligible to Practice physical therapy in the state of Nebraska (e.g. cannot obtain Nebraska Licensure, disciplinary action by the Nebraska Department of Health and Human Services). Found to be incompetent in clinical skills during the probationary period. Does not follow through with a contract/plan for remediation within timeframes or guidelines set. Does not comply with Creighton University or Community partner policy and procedures. Allows or creates an unsafe working environment. Does not receive a grade of pass in academic or clinical requirements necessary to meet residency requirements. Does not receive a grade of pass in academic or clinical requirements necessary to meet residency requirements. *If the resident is dismissed or terminated from the Residency program at the request of the community partner due to performance or behavior issues, Creighton University School of Pharmacy and Health Professions (SPAHP) reserves the right to terminate employment.

50 50 i) A statement regarding how the program participant obtains malpractice and health insurance coverage Example 1 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Residents will receive malpractice coverage provided by the institution (St. Catherine s/ Villa Maria) at no charge. Health, dental, life, and disability insurance are offered at standard employee rates. See employee handbook. Procedure: Malpractice insurance is provided automatically upon hire (and licensure). During employee orientation, residents will be given an opportunity to select the health/dental coverage plan in which they wish to enroll. Residents may elect not t0o participate at that time as well. Example 2 - From Creighton University-Hillcrest Geriatric Residency, 2014 Professional Liability Insurance: The University shall secure and maintain at all times during the Term, at University s sole expense, professional liability insurance covering University, all Residents and all of University s employees, with a carrier licensed to do business in the State and having at least an A BEST rating, at the following limits: $1,000,000 per claim/occurrence and $3,000,000 aggregate Such coverage shall be primary and non-contributory. University shall annually provide Facility a certificate of insurance evidencing coverage and coverage extensions. This coverage shall be either: 1) On occurrence basis or 2) On claims-made basis. If the coverage is a on a claims-made bases, University hereby agrees that prior to the effective date of termination of University s current insurance coverage, University shall purchase, at University s sole expense, either a replacement policy annually thereafter having a retroactive date no later than the Effective Date or unlimited tail coverage in the above stated amounts for all claims arising out of incidents occurring prior to termination of University s current coverage or prior to termination of this Agreement and University shall provide Facility a certificate insurance evidencing such coverage. Health Insurance: The University offers life insurance, long-term disability insurance, medical insurance, dental insurance, cancer insurance and long-term care insurance benefits. For current details see the separately published insurance booklets available from Human Resources. The University also has General Liability Insurance and Educators Professional Liability (Errors and Omissions) Insurance. The General Liability Policy and the Educators Professional Liability Policy are available for inspection in the Office of the University Risk Manager. Specific questions relating to Creighton s insurance coverage for employees can be answered by the Risk Manager. Example 3 - From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency The resident obtains malpractice insurance once employed by MRRN. Malpractice insurance coverage is: Professional liability: $1,000,000 each incident/ $3,000,000 annual aggregate.

51 51 General Liability: $1,000,000 each incident/ $3,000,000 annual aggregate. The resident has two options when obtaining employment at MRNR: Option 1 includes a full benefits package. A resident who chooses the health insurance coverages has three options: MedStar Select Plan, Care First PPO Plan, and Kaiser Permanent HMO Plan. The resident i8s informed of these options at their MedStar Traditions orientation on their first day of employment. As part-time employees, residents are also eligible for dental coverage, prescription coverages, and vision coverage. Option 2 which waives the health insurance coverage and other benefits for a %15 higher salary. In addition to no health insurance coverage, with option 2 the resident would not accrue personal time off (although they can have personal days and holidays), not eligible for the care bank (donated PTO hours from the other team members), not have access to the voluntary benefits (whole life insurance, critical illness plan, long term care, not have access to the legal plan, not have access to the flexible spending account, and not have access to life insurance/accidental death and dismemberment services. Please refer to the MedStar 2013 Benefits Summary included for more information.

52 52 j) Policies concerning professional, family, and sick leave and the effect such leaves would have on the participant s ability to complete the program Example 1 - From Creighton University-Hillcrest Geriatric Residency, 2014 Creighton recognizes that situations occur where a resident must take an extended leave of absence (greater than 2 weeks) due to personal or family situations. Approval for the leave must be approved by the Specific Residency Program Director and the Director of Clinical Residencies. If approved then the resident will be able to extend their residency program for 3 months beyond the end date to be able to meet the requirements of the residency. This will be considered paid time. Example 2 From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency Leave of Absence (maximum 3 months): A resident may voluntarily request a time-limited leave of absence if circumstances arise which prevent completion of residency commitments (as detailed above). The ability to resume the program (reinstatement) will be handled on a case-by-case basis, and may be limited based on the time at which the resident requests leave of absence (eg, before or after final budget decisions for the following year). The resident will request a leave of absence by notifying the Residency Director. The resident may need to re-apply for the residency the following year if there is not budgetary funds available to extend their position. Withdrawal: A resident may voluntarily withdraw from the residency program if circumstances arise which prevent completion of residency commitments (weekly patient care hours and mentoring, weekly academic courses, physician clinics, scholarly project). Such circumstances may include: illness, family illness or death, etc. The resident will request to withdraw by notifying the Residency Director.

53 53 k) Program specific policies that relate to maintaining program compliance with accreditation criteria Example 1 - From Creighton University-Hillcrest Geriatric Residency, 2014 The Creighton University- Hillcrest Health and Rehabilitation Geriatric Physical Therapy Residency Program provides a post-professional clinical residency experience in the specialty of geriatric physical therapy. The experience includes clinical practice, clinical mentoring, teaching in the area of geriatrics, community service engagements, and opportunities in scholarly productivity. The resident will graduate with advanced clinical practice and teaching skills. The program agrees to meet Evaluation Criteria and maintain compliance with all criteria for accreditation for the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE).

54 54 Evidence B Describe any changes to the program s policies and procedures that were made during the program s recent accreditation period as a result of the review process and the impact of these changes on the program. (FOR REACCREDITATION ONLY) Example 1 - From Hospital for Special Surgery Hand Therapy Fellowship, 2015 One change was made in the program s policies and procedures during the past accreditation period. Beginning April 1, 2014, in accordance with the New York City Sick Time Act and HSS Human Resources Policy and Procedure 2.17, hand therapy fellows, as temporary HSS employees, accrue 1 hour of paid sick time for every 30 hours worked up to a maximum usage of 40 hours of paid sick leave per calendar year. This increases to the maximum of paid sick time from 21 hours to 40 hours. An admission policy has recently been clarified based on ABPTRFE guidelines: a maximum of 10 hours of credit may be given for prior coursework taken at HSS Rehabilitation within the last 2 years from starting the program providing that the coursework exactly matches what is currently being taught in the program; any changes to the course content prevents a resident from receiving past credit (to be determined by program director). Neither the change nor clarification described above had significantly impact on the program. Example 2 - From Baylor Institute for Rehabilitation & Texas Woman's University Women's Health Residency, 2015 The program has undergone a significant amount of changes during its first accreditation period. Specifically to the policy and procedures there have been several: The umbrella organization (and therefore the program) did not start new hires on a temporary license. When there was a change to the testing schedule by the FSBPT, the umbrella organization started to allow new employees to start on a temporary license. With the ABPTRFE policy change to allow residents to do the same, the program also decided to allow residents to start on a temporary license. We instituted an agreement that they must sign understanding that their continuation in the residency is contingent upon their passing of the examination. (see policy located in Appendix A). We developed a document called the Memorandum of Understanding which clarifies the relationship between the expectations for both BIR and TWU. This details what the resident is expected to complete for both BIR and TWU as well as the support they will be given by the mentors. This document came about because of a resident not fulfilling her expectation at TWU and being disenrolled from the university. At that point she was still an employee at BIR, but not a student at TWU and therefore not fulfilling all the requirements of the residency. We addressed this as an individual situation (as we always will if these things happen), and worked with the university for her to take the content as an Independent Study so she could continue the clinic part of the residency and still graduate on time. Depending on the circumstances that led to her not fulfilling the requirements, we could have terminated her position as resident. The document that we drafted provides the resident details on how all entities are inter-related and how the resident must balance all roles in the residency. Example 3 - From Rochester Regional Health System Neurologic Residency, 2015 A new admission and retention policy and procedure was created which included updated information on the application process, as the program began using RF-PTCAS beginning in Also updated in this policy and procedure were the academic criteria for retention in the program.

55 55 Example 4 - From UT Southwestern Medical Center Orthopedic Residency, 2015 During our fifth year of the orthopedic residency we experimented with a staggered start date for our three residents and extended the program from a 12 to a 15-month experience. Our motivation for implementing this as to allow a greater amount of time for payer credentialing and allow a slower introduction to a full load of patient care. In retrospect, we found that the slower build-up to a full patient load and mentoring from the more senior resident did not exceed the loss of camaraderie in each residency class. The residency committee s perception and the input of the residents have resulted in reverting to our original lockstep curriculum with each year s resident class members starting (and finishing) at the same time. We have learned that one of the more valuable elements of the residency experience is the intraresident instruction and this is facilitated by all resident s progressing through the curriculum with the same points of emphasis occurring simultaneously.

56 56 Evidence Provide the program s recruitment materials (not a link to the program s website). (BOTH CANDIDACY AND REACCREDITATION) Example 1 From APTA Residency/Fellowship Staff Items that will sufficiently answer this Evidence: Copies of recruitment/advertising materials o Fliers o Copies of advertisements placed in professional magazines/resources Print off of program s webpage *NOTE: Please include actual copies of recruitment materials or a print off of program s webpage, do not simply direct reviewers to the webpage in your application. Example 2 - From MedStar Georgetown University Hospital Women's Health Residency, 2014

57 57

58 58

59 59 Example 3 - From Louis Stokes Cleveland VA Medical Center Geriatric Residency, 2014

60 60 Evidence Provide a copy of a blank contract, agreement, or letter of appointment between the program and participant. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From MedStar National Rehabilitation Network & The George Washington University Neurologic Residency, 2014 MedStar National Rehabilitation Network & The George Washington University- Neurologic Residency Date: XXXX Congratulations! On behalf of the executive residency committee we are excited to offer you a position in the MedStar National Rehabilitation Network (MNRN) and The George Washington University (GW) Neurologic Physical Therapy Residency Program. Please indicate your willingness to accept this invitation by signing this letter by XXXX and submitting it via to Elizabeth Ruckert (eruckert@gwu.edu). As discussed at the interview, the residency will consist of four main components: 1) Acute Rehab at MedStar National Rehabilitation Hospital, 2) Outpatient at MedStar National Rehabilitation Network at Irving Street, 3) Acute care at MedStar Washington Hospital Center, and 4) Teaching in the George Washington University DPT Program. In addition, you will participate in didactic education through participation in the Neurological Physical Therapy Professional Education Consortium (NPTPEC) and be required to complete a scholarly project. Successful completion of the residency program will require participation in all components of the residency, and are specifically delineated in the Retention/Termination Policies document (see attached). Failure to meet these requirements may result in dismissal from the residency program and termination of employment at MNRN and GW. Your employment at each institution is contingent on your good-standing in the residency program. The residency starts on XXXX and ends on XXXX. Clinical work at MedStar NRN will commence on XXX, and teaching responsibilities at GW will begin the week of XXXX. Please refer to the New Hire Checklist regarding requirements for hiring at MRNR (see attached). Each of these items is required to be completed at least one week prior to Traditions (new employee orientation) date of XXXX. Considering the multi-pronged nature of this residency program, compensation will be provided by both MNRN and GW. As a Part-time benefits-eligible employee at MNRN, you will be compensated with a stipend of $XX/hour (which annualized equals $XX,XXX based on 20 hours of clinical practice per week for the duration of the program). Compensation from GW for work as an adjunct faculty member will be approximately $X,XXX. Tuition for administrative fees related to the program is $X,XXX. No financial aid or stipends are offered through the program, however tuition and airfare for the NPTPEC in Los Angeles will be covered by MNRN. You will be responsible for additional travel expenses associated with attending the modules. Benefits, including health insurance and malpractice insurance, provided by MedStar NRN will begin on the first day of employment. Please see attached benefits information sheet. Time off, including holidays, will be dependent on your clinical site. If you have any additional questions, please do not hesitate to contact me. Specific questions related to MedStar benefits can be directed to Pat Brown, PT, DPT, MS, Director of Physical Therapy and Therapeutic Recreation, at patricia.g.brown@medstar.net or

61 61 Congratulations again. We look forward to working with you in this pilot year of the residency program! Regards, Elizabeth Ruckert, PT, DPT, NCS, GCS Academic Director, MedStar NRN/GW Neurologic Residency Program The George Washington University PT Program rd St NW; Suite 6143 Washington DC I, (print name), accept/decline the resident position in MedStar NRH/GW Neurologic Physical Therapy Residency Program as stated. Signature: Date: Enclosures: 1. MedStar New Hire Requirement Checklist 2. MedStar Benefits Information Sheet 3. MNRN & GW Residency Program Policies & Procedures Example 2 From Virginia Commonwealth University Neurologic Residency, 2014 [DATE] [Name] It is our pleasure to offer you a position in the Virginia Commonwealth Sheltering Arms Neurologic Physical Therapy Residency Program (VCU-SA Residency). This letter outlines details associated with the residency program. After review, please sign the enclosed original to indicate your acceptance of this position. The residency program is 12-months in duration, commencing on May 19, 2014 and concluding on May 15, Residents of the program are employed by Virginia Commonwealth University Medical Center (VCUMC) and Sheltering Arms Hospital (SA) and are affiliate faculty for Virginia Commonwealth University Department of Physical Therapy. Successful completion of the residency requires the following: Completion of all didactic coursework as outline din the attached curriculum Completion of all clinical rotations and experiences as outlined in the attached curriculum Completion of teaching responsibilities as outlined in the attached curriculum Completion of employee requirements and expectations as outlined by VCUMC and SA

62 62 Additional details on graduation, probation, remediation and dismissal from the program, including the appeal process, is outlined in the residency policies and procedures attached. The hours of work during the residency program will be determined by VCUMC and SA but will not exceed [insert number] hours. Additional hours will be required outside of working hours to complete didactic coursework, complete projects and study assignments, and prepare for teaching in the entry-level program. The outline of a typical week is attached. Salary and benefits will be determined by VCUMC and SA and are roughly 70% of a physical therapist base pay for the organization. Fringe benefits, including health and disability insurance, are based on the offers provided to employees of the organization. Please review the attached salary and benefit offer attached to this letter. Costs that may be anticipated by the resident include the cost for the series of didactic courses from the Neuro Consortium (approximately $700). We look forward to working with you over the coming year. Please let us know if you have any questions. Signature VCU-SA Neuro Residency Program Director [Name] Resident

63 63 Evidence Utilize the Form below to provide the name, permanent address, start date, and name of mentor for all currently enrolled program participants. Add additional rows as needed. (FOR REACCREDITATION ONLY) Example PROGRAM PARTICIPANT NAME PERSONAL ADDRESS (eg, yahoo, gmail) START DATE (mm/dd/yy) NAME(S)/CREDENTIALS OF PARTICIPANT S MENTOR(S) Sally Resident sally@ .com 08/01/2014 Mentor Jane, PT, DPT, OCS Good Fellow good@ .com 08/01/2014 Mentor Bob, PT, DPT, OCS, FAAOMPT

64 Resources Evidence A Using the Form below, summarize the number of patients/clients (not number of visits) by diagnostic categories evaluated by all physical therapy staff over the last year. Single-site and multi-facility programs complete 1 comprehensive form. Multisite programs, provide a separate form for each clinic site. Copy this form as needed. Categorize the patient/client population in a manner that clearly captures the intent of the DSP/DASP/DRP/DSSP/analysis of practice upon which the program is based (categorize by diagnosis, impairment, body region, and/or practice location, as needed). For orthopaedic residency, sports residency, and orthopaedic manual physical therapy fellowship programs, please use the Form provided. The patient s primary diagnosis must be counted during the first patient encounter and not during subsequent visits. This chart should also provide a summary of the percentage of the total patient/client population represented in this category. (FOR CANDIDACY ONLY) Evidence A For every program participant graduated within the last 2 years, provide their completed diagnostic category chart using the templates provided below. Please summarize the number of patients/clients (not number of visits) by diagnostic categories evaluated, treated, and/or managed by the residents/fellows during the entire course of the residency or fellowship program (not limited to patients seen during mentoring). Categorize the patient/client population in a manner that clearly captures the intent of the DSP/DASP/DSSP/analysis of practice upon which the program is based (categorize by diagnosis, impairment, body region, and/or practice location, as needed). For orthopaedic residency, sports residency, and orthopaedic manual physical therapy fellowship programs, please use the form provided. This chart should also provide a summary of the percentage of the total patient/client population represented in this category. Do not provide data on patient/clients seen by all staff in the clinic. The patient s primary diagnosis must be counted during the first patient encounter and not during subsequent visits. Please complete one chart for each graduate. Copy this form as needed. (FOR REACCREDITATION ONLY) With input from program directors, ABPTS, APTA Sections/Academies, and the APTA Outcomes Registry, ABPTRFE has created the following form templates for the collection of residency program primary health conditions. The intent of these forms is to begin to streamline and standardize data collection throughout the Association. While the use of these form templates are currently not mandatory, ABPTRFE does encourage their use. For those areas of practice that do not have a form template, please use the generic form located within the accreditation application until ABPTRFE creates the form for that area of practice.

65 65 PRIMARY HEALTH CONDITIONS CARDIOVASCULAR AND PULMONARY Adult respiratory distress syndrome Aneurysms Angina Asthma Atelectasis Bronchiectasis Cardiac dysrhythmias Chronic obstructive pulmonary disease Claudication Coronary arteriosclerosis/coronary artery disease Cystic Fibrosis Emphysema Fibrosis of the lung (eg, pulmonary, interstitial) Heart Failure (acute, chronic, cor pulmonale, left-sided) Heart Transplant Heart valve disorders Hyperlipidemia Hypertension disorder Lung Transplant Malignant tumor of lung Myocardial Infarction Peripheral vascular disease Pleurisy Pneumothorax Pneumonia Pulmonary edema Pleural effusion Pulmonary embolism Pulmonary hypertension Respiratory failure (Reaccreditation) NUMBER OF PATIENTS/CLIENTS TREATED BY THE PROGRAM PARTICIPANT AS PART OF THE PROGRAM -or- (Candidacy) NUMBER OF PATIENTS/CLIENTS AVAILABLE IN THE CLINIC OVER THE LAST YEAR

66 66 PRIMARY HEALTH CONDITIONS CLINICAL ELECTROPHYSIOLOGY Mononeuropathies (atraumatic) of the upper extremity (eg, median, ulnar, radial, axillary, musculocutaneous, suprascapular) Mononeuropathies (atraumatic) of the lower extremity (eg, tibial, fibular, and sural) Mononeuropathies (traumatic) Motor neuron disease Myopathies Nerve plexus disorder (plexopathies) Neuromuscular junction disorders (eg, Myasthenia Gravis & Lambert Eaton Syndrome) Polyneurotherapies Radiculopathies - cervical Radiculopathies - lumbosacral (Reaccreditation) NUMBER OF PATIENTS/CLIENTS TREATED BY THE PROGRAM PARTICIPANT AS PART OF THE PROGRAM -or- (Candidacy) NUMBER OF PATIENTS/CLIENTS AVAILABLE IN THE CLINIC OVER THE LAST YEAR PRIMARY HEALTH CONDITIONS GERIATRICS Acute infectious disease (eg, cellulitis, UTI, C-diff) Acquired brain injury (eg, traumatic brain injury) Anemia Bone density below reference range (eg, osteopenia/osteoporosis) Cerebrovascular accident Chronic obstructive pulmonary disease Congestive heart failure Dehydration Dementia (eg, Alzheimer s and other types) Diabetes (debility from) Diabetic neuropathy (Reaccreditation) NUMBER OF PATIENTS/CLIENTS TREATED BY THE PROGRAM PARTICIPANT AS PART OF THE PROGRAM -or- (Candidacy) NUMBER OF PATIENTS/CLIENTS AVAILABLE IN THE CLINIC OVER THE LAST YEAR

67 67 Electrolyte imbalance Encephalopathy (toxic, metabolic, anoxic) Falls Fractures Frailty/deconditioning/debility Joint Replacement Malignant neoplastic disease (eg, cancer, failure to thrive) Musculoskeletal pain, strain, or sprain Myocardial Infarction (eg, CABG, valve replacement) Myopathies (eg, critical illness myopathy) Neurologic disorders, progressive (eg, ALS, MS, Huntington s disease) Organ transplant (heart, lung, kidney, liver) Osteoarthritis Parkinson s disease Peripheral neuropathy Peripheral vascular disease Pneumonia Renal failure syndrome (acute/chronic) *do not log transplants here Respiratory failure Sepsis Spinal stenosis Vestibular disorders Wound disorder

68 68 PRIMARY HEALTH CONDITIONS NEUROLOGY Acquired brain injury (eg, closed head injury, Brain injury, Traumatic brain injury) Anoxia (eg, near drowning, drug induced) Central nervous system infections (eg, viral infections of the CNS - meningitis, encephalitis) Central nervous system neoplasms (eg, glioma, lymphoma, meningioma, craniopharyngioma, pituitary tumor) Cerebellar disorders (eg, degenerative cerebellar disorder, cerebellar stroke) Cerebral palsy Cerebrovascular accident (eg, hemorrhagic, embolic/thrombotic, anteriorvenous malformation, brainstem stroke, basal ganglia stroke, thalamic stroke) Concussion (post-concussion syndrome) Dementia (eg, vascular, dementia with Lewy Body, mixed, frontotemporal, Huntington disease, Wernicke-Korsakoff Syndrome, Creutzfeldt-Jakob Disease, Alzheimer s disease) Multiple sclerosis Normal pressure hydrocephalus Other neuromuscular disorders (eg, Huntington disease, Myasthenia gravis) Parkinson s disease/parkinsonism syndromes Peripheral neuropathy (metabolic disease/idiopathic) Polyneuropathy (eg, acute inflammatory demyelinating polyneuropathy- Guillain-Barre Syndrome/chronic inflammatory demyelinating polyneuropathy) Spinal cord injury Vestibular disorders (eg, peripheral, central, vestibular pathology associated with disease process, acoustic neuroma) (Reaccreditation) NUMBER OF PATIENTS/CLIENTS TREATED BY THE PROGRAM PARTICIPANT AS PART OF THE PROGRAM -or- (Candidacy) NUMBER OF PATIENTS/CLIENTS AVAILABLE IN THE CLINIC OVER THE LAST YEAR

69 69 PRIMARY HEALTH CONDITIONS ORTHOPAEDICS Chronic Pain Syndromes (eg, fibromyalgia) Ankle / Foot Fracture Ankle / Foot Ligamentous Injuries Ankle / Foot Tendinopathies Hallux Valgus Other Disorders of the Lower Leg, Ankle and Foot Plantar Fasciitis Cubital Tunnel Syndrome Elbow / Forearm Fracture Elbow Instability (eg, subluxation/dislocation, ligamentous) Elbow Tendinopathies Other Disorders of the Elbow and Forearm Carpal Tunnel Syndrome Other Disorders of the Elbow, Wrist and/or Hand Wrist, Hand, Finger Fracture Wrist, Hand, Finger Instability (eg, subluxation/dislocation, ligamentous) Wrist, Hand, Finger Tendinopathies Cervical Disc Pathologies (eg, DDD, protrusion, herniation) Cervical Instability Cervical Radiculopathy Cervical Sprain/Strain Cervicogenic Headache Other Disorders of Cervical Spine Temporomandibular Dysfunction Femoroacetabular Impingement Hip Fracture Hip Osteoarthritis Hip Tendinopathies Other Disorders of the Hip and Thigh (Reaccreditation) NUMBER OF PATIENTS/CLIENTS TREATED BY THE PROGRAM PARTICIPANT AS PART OF THE PROGRAM -or- (Candidacy) NUMBER OF PATIENTS/CLIENTS AVAILABLE IN THE CLINIC OVER THE LAST YEAR

70 70 Trochanteric Bursitis Knee Fracture Knee Ligamentous Injuries Knee Osteoarthritis Knee Tendinopathies Meniscal Pathology Other Disorders of the Knee Patellofemoral Dysfunction Lumbar Disc Pathologies (eg, DDD, protrusion, herniation) Lumbar Instability Lumbar Radiculopathy Lumbar Spondylosis / Spondylolisthesis Lumbar Strain Other Disorders of the Lumbar Spine Other Disorders of the Pelvic Girdle Piriformis Syndrome Sacroiliac Dysfunction Other Disorders of the Shoulder Complex Rotator Cuff Pathology Shoulder Adhesive Capsulitis Shoulder Labral Pathology Shoulder Complex / Arm Fracture Shoulder Instability (eg, subluxation/dislocation, ligamentous) Shoulder Osteoarthritis Other Disorders of the Thoracic Spine Rib Dysfunction Thoracic Outlet Syndrome Thoracic Sprain/Strain

71 71 PRIMARY HEALTH CONDITIONS PEDIATRICS Acquired brain injury (traumatic brain injury including brain tumors) Arthrogryposis Autism spectrum disorders Brachial plexus injury Cerebral palsy (eg, hypotonic, hemiplegic, quadriplegic, tetraplegic, diplegic) Complications of prematurity (eg, osteopenia, RSD, IVH, bronchopulmonary dysplasia, high risk infant) Congenital heart defects (eg, atrial septal defect, tetralogy of fallot, heart transplant) Congenital leg length discrepancy Curvature of the spine (eg, scoliosis, kyphosis, lordosis) Cystic fibrosis Developmental coordination disorders Developmental delay/disabilities Disorders of the foot (eg, in-toeing, club foot, pes planus) Disorders of the ankle (eg, idiopathic toe walking) Complete trisomy 21 syndrome (Down s syndrome) Fractures Genetic syndromes (eg, Pradi Willi, hemophilia) Hypotonia Juvenile idiopathic arthritis Malignant neoplastic disease (cancer) Muscular dystrophy (eg, Duchennes, Becker, SMAs) Musculoskeletal pain (eg, Overuse injuries, joint injuries, growth plate injuries, limb injuries) Myelodysplasia (eg, spina bifida, Arnold-Chiari, hydrocephalus) Obesity Osteogenesis imperfecta Rett s disorder Sensory processing disorders Spinal cord injury (Reaccreditation) NUMBER OF PATIENTS/CLIENTS TREATED BY THE PROGRAM PARTICIPANT AS PART OF THE PROGRAM -or- (Candidacy) NUMBER OF PATIENTS/CLIENTS AVAILABLE IN THE CLINIC OVER THE LAST YEAR

72 72 Musculoskeletal injury due to sports injuries in children (eg, Osgood schlatter, overuse injuries, joint injuries, growth plate injuries, limb injuries) Torticollis/Plagiocephaly Please indicate the percentage of total patients seen that are sports-related injuries: PRIMARY HEALTH CONDITIONS SPORTS Acute/emergency injury Chronic Pain Syndromes (eg, fibromyalgia) Ankle / Foot Fracture Ankle / Foot Ligamentous Injuries Ankle / Foot Tendinopathies Hallux Valgus Other Disorders of the Lower Leg, Ankle and Foot Plantar Fasciitis Elbow / Forearm Fracture Elbow Instability (eg, subluxation/dislocation, ligamentous) Elbow Tendinopathies Other Disorders of the Elbow and Forearm Other Disorders of the Elbow, Wrist and/or Hand Wrist, Hand, Finger Fracture Wrist, Hand, Finger Instability (eg, subluxation/dislocation, ligamentous) Wrist, Hand, Finger Tendinopathies Cervical Disc Pathologies (eg, DDD, protrusion, herniation) Cervical Instability Cervical Radiculopathy Cervical Sprain/Strain Other Disorders of Cervical Spine Concussion Femoroacetabular Impingement (Reaccreditation) NUMBER OF PATIENTS/CLIENTS TREATED BY THE PROGRAM PARTICIPANT AS PART OF THE PROGRAM -or- (Candidacy) NUMBER OF PATIENTS/CLIENTS AVAILABLE IN THE CLINIC OVER THE LAST YEAR

73 73 Hip Fracture Hip Osteoarthritis Hip Tendinopathies Other Disorders of the Hip and Thigh Trochanteric Bursitis Knee Fracture Knee Ligamentous Injuries Knee Osteoarthritis Knee Tendinopathies Meniscal Pathology Other Disorders of the Knee Patellofemoral Dysfunction Lumbar Disc Pathologies (eg, DDD, protrusion, herniation) Lumbar Instability Lumbar Radiculopathy Lumbar Spondylosis / Spondylolisthesis Lumbar Strain Other Disorders of the Lumbar Spine Other Disorders of the Pelvic Girdle Piriformis Syndrome Sacroiliac Dysfunction Other Disorders of the Shoulder Complex Rotator Cuff Pathology Shoulder Labral Pathology Shoulder Complex / Arm Fracture Shoulder Instability (eg, subluxation/dislocation, ligamentous) Shoulder Osteoarthritis Other Disorders of the Thoracic Spine Rib Dysfunction Thoracic Sprain/Strain

74 74 PRIMARY HEALTH CONDITIONS WOMEN S HEALTH Amenorrhea/dysmenorrhea Autoimmune disorders (eg, RA, lupus) Bone density below reference range (eg, osteopenia, osteoporosis) Neoplasm of breast (eg, associated musculoskeletal conditions) Chronic pain syndrome Connective tissue disorder (eg, marfans, Ehler s Danlos) Constipation Diastasis recti Dyspareunia Endometriosis Fecal incontinence Female athlete/female athlete triad Fibromyalgia Gynecologic conditions/surgery High-risk Pregnancy Hysterectomy Interstitial Cystitis Irritable bowel syndrome Lymphedema Menopause Neurogenic bladder Nocturnal enuresis Pain in the coccyx (coccygodynia) Pelvic adhesions Scar tissue (eg, pelvic, abdominal, perineal) Other colorectal disorders Pelvic girdle pain Pelvic organ prolapse Pelvic pain (internal) (Reaccreditation) NUMBER OF PATIENTS/CLIENTS TREATED BY THE PROGRAM PARTICIPANT AS PART OF THE PROGRAM -or- (Candidacy) NUMBER OF PATIENTS/CLIENTS AVAILABLE IN THE CLINIC OVER THE LAST YEAR

75 75 Retention of urine Urinary frequency Urinary incontinence (stress, urge, mixed) Urinary urgency Uterine/Ovarian cancer Vaginismus Vulvar vestibulitis Vulvodynia Please indicate the percentage of total patients seen that are pediatric cases: Please indicate the percentage of total patients seen that are ante/postpartum or pregnancy related cases: Please indicate the percentage of total patients that are males: PRIMARY HEALTH CONDITIONS WOUND CARE MANAGEMENT Abnormality of lymphatic system Abnormality of peripheral nervous system (eg, neuropathic wounds; offloading Charcot fracture) Abnormality of venous system Abnormality of surgical wound Abnormality of traumatic wound Burn Disorder of arterial system Disorders of the skin (eg, fungal rashes, contact dermatitis, moisture associated dermatitis, psoriasis, etc.) Pressure ulcer Wound disorder (eg, inflammatory, malignancy) (Reaccreditation) NUMBER OF PATIENTS/CLIENTS TREATED BY THE PROGRAM PARTICIPANT AS PART OF THE PROGRAM -or- (Candidacy) NUMBER OF PATIENTS/CLIENTS AVAILABLE IN THE CLINIC OVER THE LAST YEAR

76 76 Evidence B Describe the program s plan for providing learning opportunities for all diagnostic category groups/impairments should there be limited patient exposure for any diagnostic category. (FOR CANDIDACY ONLY) Example 1 - From Brooks Rehabilitation Neurologic Residency, 2014 The plan for providing learning opportunities for all diagnostics category groups/impairments should there be limited patient exposure for any diagnostic category is the following: a. Monitor the diagnostic categories of patients the resident is seeing throughout the rotation and the year so that the resident will be scheduled to see these types of patients later in the rotation or year. An example would be if the resident did not have the opportunity to work with a patient with traumatic tetraplegia during their inpatient SCI rotation, this type of patient would be given to the resident later on in the rotation or another rotation (Neurorecovery Center or Outpatient Neuro Rotation). b. Coordinate with clinic managers so that a wide variety of patient types are scheduled with the neurologic residents. c. Provide for shadowing/observations in Brooks specialty clinics or other institutions. An example is that each residents spends 8 hours of direct patient care with a mentor in the Brooks Balance Center to work with vestibular and balance patients since they may have limited exposure to these types of patients within the Brooks IP Rehab Hospital. d. For any diagnostic category that ends up having minimal patient opportunities for our residents we follow the same process as outlined above. In all situations we do our best to supplement the resident s clinical experience for low diagnostic categories. Example 2 - From MedStar Georgetown University Hospital Women's Health Residency, 2014 In the treatment of patients in the area of women s health, it is common for a patient to present with several diagnoses that are addressed during the course of treatment and ultimately influencing the patient s complaints (eg, pelvic pain and urinary frequency; osteoporosis and oncologic issues; urinary and fecal incontinence; sacroiliac dysfunction and pelvic pain). Additionally, dysfunction varies that is related to the stage in life including adolescent, childbearing years, peri-menopausal and post-menopausal periods. Due to these factors, it is possible that a resident may not experience each area as a primary diagnosis alone, but may treat a patient with these issues as a secondary and tertiary issue. Additionally, with each section evaluation with the resident, the Resident Advisor/Program Director will review and evaluate the patient population that the resident had been exposed to in the prior section and make any adjustments possible to increase the exposure of the resident to areas of deficiency. Hands-on clinical exposure will be added as appropriate. Additional lab time, additional didactic coursework and additional evidence based reading will be utilized as appropriate. Example 3 - From UPMC Centers for Rehab Services Geriatric Residency, 2014 The Geriatric Description of Specialty Practice lists a few of the medical conditions commonly seen by geriatric specialist. This program recognized that the listing could be separated essentially by practice pattern (in addition to a few other general categories) and therefore arranged our data collection likewise, there. There however, is not the structure or expectation as there is in other residency programs of receiving exposure to a certain specific number of diagnoses or body regions. The program expects that

77 77 certain diagnoses (such as wounds) will have lower exposure rates and has designed specialty observation experiences to assist with exposure. Specialty observations are also set to include settings in which the resident does not have the opportunity to treat patients (for example, home health and ICU settings). If through tracking of patients the Residency Director notes a lack of exposure to one of the patterns, a corrective plan will be enacted. Some examples of actions that may be taken include: Contacting the Facility Director and site mentor to identify possibilities for increasing exposure to that specific patient population Identification throughout the entire UPMC CRS system or settings that have exposure to the patient population required (with assistance of the UPMC CRS Residency Program Director) Contact of the site with exposure and setting specialty observation experience time to increase resident exposure UPMC CRS is the largest provider of rehabilitative services in Western PA with more than 45 outpatient location, 6 senior living facility locations, and more than 16 hospital locations. Each resident has access to these facilities and resources to meet the needs of his/her training experience.

78 78 Evidence B Describe how the program tracks and monitors the diagnostic category groups/impairments for each participant to ensure adequate exposure and what learning opportunities have been provided to participants during the recent accreditation period to ensure adequate exposure for all diagnostic category groups/impairments. (FOR REACCREDITATION ONLY) Example 1 - From Harris Health System Orthopedic Residency, 2014 Residents engage in 4 hours of cranial/mandibular lab and lecture with Allison Jeffus PT, DPT, OCS, FAAOMPT & Chris Dewey, PT, DPT, OCS, FAAOMPT. In this lecture/lab recent headache and TMJ articles are covered as well as the current concepts monographs. Several of the clinical staff are utilized for the lab portions when they have TMJ symptoms. Residents also assess TMJ and inquire about headaches in all patients with cervical pain. Thoracic spine/rib diagnosis and treatment is taught as part of the 7 week cervico-thoracic module. Additionally, the thoracic spine is commonly treated in conditions involving upper and lower quarter dysfunctions. The thoracic spine is also implicated in patients with postural dysfunction, regional interdependence, as well as sympathetic chain mechanisms. Residents are taught to consider and assess the thoracic spine in all patients with cervical, upper quarter, or lumbar pain. Thoracic pain is also covered in the primary care module due to it being a common site for referred and non-musculoskeletal spine pain. Evaluation of the pelvic girdle and lumber spine occur concurrently and sufficient experience is gained by the residents in clinic practice, lab, and didactic teaching such that no further experiences are warranted. Lastly, resident s exposure to the elbow, wrist and hand is gained through observation and practice hours with Donna Vicknair, OT, CHT. The residents also gain significant exposure during their time in the orthopedic clinic at LBJ Hospital. The residents alternate 10 week rotations in the orthopedic clinic where they evaluate and screen patients with the surgical residents and faculty 1 day per week. Patients with elbow, wrist and hand can be scheduled on the resident s schedule if they feel like they need more exposure. The content is also covered during the UE module and it is taken from APTA current concepts as well as content from the McGee orthopedic text. Example 2 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 By virtue of having multiple locations that each resident is exposed to, including a wide variety of a patient diagnosis across the continuum of care, there is rarely a problem with this requirement. Residents are exposed to patients in inpatient rehabilitation, and therefore see patients in compliance with the CMS 60% rule (13 major diagnostic categories). While in the sub-acute (SNF) rotation, residents are exposed to a very large diversity of diagnostic conditions (joint replacements, fractures, fall, and infection). While in the outpatient setting, the residents are exposed to community-dwelling outpatients as well as long-term care residents (Part B) which span the gamut of diagnostic categories. Residents are also involved directly in medical outpatient clinics for osteoporosis/fracture prevention, physical medicine/rehabilitation, and Parkinson s disease. On occasion, when low diagnostic categories are noted by the residents or the faculty, faculty have arranged interactions with other practitioners or disciplines as necessary to accommodate the low volume. One example has been with amputees using prosthetics. When this has occurred, faculty have arranged visit with prosthetists (CPO s) both onsite and in their labs offsite. The

79 79 plan to review this includes regular review of the resident s patient tracking log (which is available to all faculty online). Example 3 - From The Ohio State University Sports Medicine Center Orthopedic Residency, 2013 The OSU Sports Medicine Center Orthopaedic Residency Program implements multiple learning experiences to ensure exposure to all the diagnostic categories. The residents assist in orthopaedic lab instruction for The OSU School of Physical Therapy. This experience includes teaching and assisting the students in palpation, joint kinematics, strength testing, and special tests. The residency didactic curriculum is organized to discuss a different body region each month. The curriculum has developed additional opportunities to focus on diagnostic category groups that are less frequently seen in our clinics: o The resident spends 30 hours working in the clinic with an occupational therapist who is a CHT. They are exposed to splinting, post-op and non-op treatment of the wrist and o hand. In addition, the resident shadows the hand surgeons in their clinics. The resident assists in the instruction of TMJ lab and the TMJ lecture for The OSU Physical Therapy School. The resident lists the patients based on their primary diagnosis. Treatment of the patient s impairments typically includes addressing limitations location in regions other than the primary location of pathology. For example, the resident would address limitations of the pelvis in concert with the primary diagnosis of lumbar spine or hip pathology when appropriate.

80 80 Evidence A Provide the program director s job description that includes ensuring the program s compliance with the provisions of the current version of the ABPTRFE Evaluative Criteria and Rules of Practice and Procedure. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From Harris Health System Orthopedic Residency, Develops, disseminates, reviews, and updates policies and procedures for the residency program. This includes, mentors, staff, resident and Residency Program policies and procedures. 2. Ensures that all requirements are met for continued accreditation of the residency Program by the American Physical Therapy Association. 3. Ensures adequate funding for the residency program. 4. Organizes and coordinates all direct didactic, lab, clinical rotations and training experiences. 5. Serves as a mentor to the Harris Health System Physical Therapy Clinical Residency faculty, mentors, staff and residents. 6. Serves as liaison between the Residency Program and affiliated universities clinical rotation facilities, invited and guest lectures. 7. Serves as liaison between the Residency Program and Harris Health System. 8. Conducts faculty, mentors, staff, and resident evaluations. 9. Coordinates the admission and interview process for acceptance of residents into the Residency Program. 10. Ensures outgoing faculty, mentor, staff, and resident development. 11. Maintains record of current and previous residents. 12. Ensures there is adequate support staff and services, space, computers, education books/resources, and equipment. 13. Coordinates curriculum development, to include annual review and update for residency programs. 14. Provides outgoing evaluation of the Residency Program goals and objectives. 15. Assists with marketing of and recruitment for the Residency Program 16. Ensures that all safety regulations and training are implemented.

81 81 Evidence B If there has been a change in the program director, since the program was granted recognition status, complete and attach the Program Director/Program Coordinator Information Form for the program director. (FOR CANDIDACY ONLY) Example (Form can be downloaded on ABPTRFE website at under Application Resources) Program Director/Program Coordinator Information Form Please print all information. Full Name and Credentials: Name of Residency/Fellowship Program: Title: Program Director Phone Number: Program Coordinator Address: Number of hours per week dedicated to the residency/fellowship program: Has there been a change in the program director s job description from what was previously filed? Yes No If yes, please provide the program director s job description that includes ensuring the program s compliance with the provisions of the current version of the ABPTRFE Evaluative Criteria and Rules of Practice and Procedure. For program directors of developing and candidate programs only: Have you taken the Residency/Fellowship 101 Course? Yes No If yes, please attach a copy of the course certificate to this form. If no, have you previously been a program director of an APTA-accredited residency or fellowship program? Yes No If yes, please provide the name of the program and the dates you were program director: Name of Program: Dates: From To For programs enrolled in RF-PTCAS: Please contact Kate Owen, Senior Customer Solutions Manager at kowen@liaison-intl.com to inform her of a change in program director. Submission of Form: A copy of the individual s curriculum vitae MUST be included with this form.

82 82 If submitting this form as part of an accreditation application, please embed the document and CV in the program s application. If submitting this form as part of a substantive change to a program that is currently in candidate status or accredited, please convert a completed substantive change form, this form, and the curriculum vitae to one.pdf file and it to resfel@apta.org.

83 83 Evidence C Provide documentation of the program director taking the Residency/Fellowship 101 course located on the APTA Learning Center. (FOR CANDIDACY ONLY) Example (Respond to questions as located within the Application for Candidacy) Have you taken the Residency/Fellowship 101 Course on the APTA Learning Center (for program directors only)? Yes No If yes, please attach a copy of the course certificate to this form. If no, have you previously been a program director of an APTA-accredited residency or fellowship program? Yes No If yes, please provide the name of the program and the dates you were program director: Name of Program: Dates: From To

84 84 Evidence A Utilize the Form below for each faculty member that meets the description (full-time or part-time) in the ABPTRFE Accreditation Handbook. Provide names, credentials, title, primary place of employment, including the site where the faculty provides instruction/mentoring, areas of responsibility, recent professional development activities and the number of hours per week dedicated to the residency/fellowship program. If single faculty member, briefly describe the program s contingency plan should the faculty member not be able to function in this role. (BOTH CANDIDACY AND REACCREDITATION) Example 1 Copy this Form as needed and complete one Form for all faculty active in the Program. NAME (with credentials) ABPTS CERTIFICATION/RECERTIFICATON (Designate initial year certified/expiration of most recent certification/ recertification) TITLE Cardiopulmonary (Effective Date) (Expiration Date) Clinical Electrophysiology (Effective Date) (Expiration Date) Geriatric (Effective Date) (Expiration Date) Neurologic (Effective Date) (Effective Date) Orthopaedic (Effective Date) (Effective Date) Pediatric (Effective Date) (Effective Date) Sports (Effective Date) (Effective Date) Women s Health (Effective Date) (Effective Date) Number of hours per week dedicated to the residency/ fellowship program: OTHER CERTIFICATIONS/ASSOCIATION STATUS (Designate initial year certified/expiration of most recent certification/ recertification) PLACE OF EMPLOYMENT Certified Hand Therapist (Effective Date) (Expiration Date) SITE WHERE FACULTY PROVIDES INSTRUCTION/MENTORING FAAOMPT or Member of AAOMPT: Yes No Certified Wound Specialist (Effective Date) (Expiration Date) Other: (Name) (Effective Date) (Expiration Date) AREAS OF RESPONSIBILITY IN PROGRAM RECENT PROFESSIONAL DEVELOPMENT ACTIVITIES (eg, continuing education, publications, research, etc.)

85 85 Example 2 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 NAME (with credentials) Greg Hartley, PT, DPT, CEEAA, GCS TITLE Residency Program Director Director of Rehabilitation Assistant Hospital Administrator ABPTS CERTIFICATION/RECERTIFICATON (Designate initial year certified/expiration of most recent certification/ recertification) Cardiopulmonary (Effective Date) (Expiration Date) Clinical Electrophysiology (Effective Date) (Expiration Date) Geriatric 1999 (Effective Date) 2019 (Expiration Date) Neurologic (Effective Date) (Effective Date) Orthopaedic (Effective Date) (Effective Date) Pediatric (Effective Date) (Effective Date) Sports (Effective Date) (Effective Date) Number of hours per week dedicated to the residency/ fellowship program: 5 PLACE OF EMPLOYMENT St. Catherine s Rehabilitation Hospital/Villa Maria Nursing Center SITE WHERE FACULTY PROVIDES INSTRUCTION/MENTORING Women s Health (Effective Date) (Effective Date) OTHER CERTIFICATIONS/ASSOCIATION STATUS (Designate initial year certified/expiration of most recent certification/ recertification) Certified Hand Therapist (Effective Date) (Expiration Date) FAAOMPT or Member of AAOMPT: Yes No Certified Wound Specialist (Effective Date) (Expiration Date) Other: (Name) (Effective Date) (Expiration Date) St. Catherine s Rehabilitation Hospital/Villa Maria Nursing Center St. Catherine s West Rehabilitation Hospital University of Miami, Dept. of Physical Therapy AREAS OF RESPONSIBILITY IN PROGRAM Program Director, Admissions Committee, Advisory Committee, program oversight, program budget, resident matriculation oversight, educational advisement, mentoring, didactic instruction (Healthcare Delivery Sites, OP Billing and Coding, Advocacy/Consultation, Fall/Fracture Prevention), supervision of administrative projects, advisement of resident research projects, faculty development and evaluations, APTA accreditation requirements RECENT PROFESSIONAL DEVELOPMENT ACTIVITIES (i.e., continuing education, publications, research, etc.) See attached CV for details

86 86 Example 3 - From UPMC Centers for Rehab Services Geriatric Residency, 2014 NAME (with credentials) Jennifer McMahon, PT, DPT, GCS TITLE Physical Therapist, Team Leader of Acute Care Services ABPTS CERTIFICATION/RECERTIFICATON (Designate initial year certified/expiration of most recent certification/ recertification) Cardiopulmonary (Effective Date) (Expiration Date) Clinical Electrophysiology (Effective Date) (Expiration Date) Geriatric 2008 (Effective Date) 2018 (Expiration Date) Neurologic (Effective Date) (Effective Date) Orthopaedic (Effective Date) (Effective Date) Pediatric (Effective Date) (Effective Date) Sports (Effective Date) (Effective Date) Number of hours per week dedicated to the residency/ fellowship program: 4 PLACE OF EMPLOYMENT Centers for Rehab Services, UPMC Mercy Hospital 1400 Locust Street Pittsburg, PA Women s Health (Effective Date) (Effective Date) OTHER CERTIFICATIONS/ASSOCIATION STATUS (Designate initial year certified/expiration of most recent certification/ recertification) Certified Hand Therapist (Effective Date) (Expiration Date) FAAOMPT or Member of AAOMPT: Yes No Certified Wound Specialist (Effective Date) (Expiration Date) SITE WHERE FACULTY PROVIDES Other: (Name) (Effective Date) (Expiration Date) INSTRUCTION/MENTORING UPMC Mercy Hospital AREAS OF RESPONSIBILITY IN PROGRAM Interview and Selection Committee; Clinical Mentoring; Curriculum Review; Resident Performance Feedback; Liaison between residency program and specialty observation experience locations RECENT PROFESSIONAL DEVELOPMENT ACTIVITIES (i.e., continuing education, publications, research, etc.) Con-Ed: APTA Advanced CI Course; APTA Combined Sections (San Diego, Chicago) with emphasis on Geriatric; Acute Care and Leadership; Aging the Health Care Challenge; Geriatric Neurology; Acute Care Rehab; Rehab for the Frail Elderly; Creative Rehab and Fitness; Geriatric Therapeutic Exercise; Rehab of the Persons with Common Medical Pathologies Academic/Leadership Experience: Clinical Faculty at University of Pittsburg; Lab Assistant at Chatham University; Clinical Instructor for PT students from various programs across the U.S. ranging from Level 1 to Year-long DPTs; Center Coordinator for Clinical Education at UPMC Mercy Hospital; appointed to APTA Clinical Education Task Force 2013

87 87 Example 4 - From Brooks Rehabilitation Neurologic Residency, 2014 NAME (with credentials) Jacqueline A. Osborne, PT, DPT, GCS, CEEAA TITLE Coordinator of the Brooks Geriatric Residency ABPTS CERTIFICATION/RECERTIFICATON (Designate initial year certified/expiration of most recent certification/ recertification) Cardiopulmonary (Effective Date) (Expiration Date) Clinical Electrophysiology (Effective Date) (Expiration Date) Geriatric 2007 (Effective Date) 2017 (Expiration Date) Neurologic (Effective Date) (Effective Date) Orthopaedic (Effective Date) (Effective Date) Pediatric (Effective Date) (Effective Date) Sports (Effective Date) (Effective Date) Number of hours per week dedicated to the residency/ fellowship program: 5 PLACE OF EMPLOYMENT Brooks Health 3566 University Blvd. South Jacksonville, FL Women s Health (Effective Date) (Effective Date) OTHER CERTIFICATIONS/ASSOCIATION STATUS (Designate initial year certified/expiration of most recent certification/ recertification) Certified Hand Therapist (Effective Date) (Expiration Date) FAAOMPT or Member of AAOMPT: Yes No SITE WHERE FACULTY PROVIDES Certified Wound Specialist (Effective Date) (Expiration Date) INSTRUCTION/MENTORING Brooks Health Other: (Name) (Effective Date) (Expiration Date) AREAS OF RESPONSIBILITY IN PROGRAM Clinical mentoring, teaching a variety of courses in the program, running journal club for the program RECENT PROFESSIONAL DEVELOPMENT ACTIVITIES (i.e., continuing education, publications, research, etc.) Appointed to Florida Injury Prevention Advisory Committee December 2013 Appointed to the ABPTRFE Residency Performance Measurement Work Group February 2014 ABPTRFE Accreditation Services Committee Member/Site Visitor January 2013 to present Speaker at CSM in Las Vegas, NV Neurology Section Balance and Falls SIG Programming 2/5/2014 Guest speaker at the Annual Conference of the Florida Physical Therapy Association 9/8/2013 Completed the American Bone Health Volunteer Training Program 10/7/2013 to 11/10/2013 Co-authored abstracts accepted for posters at CSM Las Vegas, NV 2014 (Please see CV) Publication: Osborne, J. Residency Corner: Brooks Geriatric Residency Program. GeriNotes. 2013;20(1):19. NAME (with credentials) Robert H. Rowe, PT, DMT, MHS, FAAOMPT ABPTS CERTIFICATION/RECERTIFICATON (Designate initial year certified/expiration of most recent certification/ recertification)

88 88 TITLE Residency/Fellowship Program Director Cardiopulmonary (Effective Date) (Expiration Date) Clinical Electrophysiology (Effective Date) (Expiration Date) Geriatric (Effective Date) (Expiration Date) Neurologic (Effective Date) (Effective Date) Orthopaedic (Effective Date) (Effective Date) Pediatric (Effective Date) (Effective Date) Sports (Effective Date) (Effective Date) Number of hours per week dedicated to the residency/ fellowship program: 5 PLACE OF EMPLOYMENT Brooks Health 3566 University Blvd. South Jacksonville, FL Women s Health (Effective Date) (Effective Date) OTHER CERTIFICATIONS/ASSOCIATION STATUS (Designate initial year certified/expiration of most recent certification/ recertification) Certified Hand Therapist (Effective Date) (Expiration Date) FAAOMPT or Member of AAOMPT: Yes No SITE WHERE FACULTY PROVIDES Certified Wound Specialist (Effective Date) (Expiration Date) INSTRUCTION/MENTORING Brooks Health Other: (Name) (Effective Date) (Expiration Date) AREAS OF RESPONSIBILITY IN PROGRAM Academic Coordinator; co-developing, teaching a variety of courses within the program, educational mentoring RECENT PROFESSIONAL DEVELOPMENT ACTIVITIES (i.e., continuing education, publications, research, etc.) Continuing Education: January 20-24, 2013 APTA CSM Meeting (San Diego, CA) March 22-23, 2013 FPTA Annual Conference May 2-4, 2013 Annual Orthopaedic Section Meeting (Orlando, FL) June 26-29, 2013 APTA Annual Conference (Salt Lake City, UT) October 18-20, 2013 APTA CSM Meeting (Las Vegas, NV) Scholarly Presentations: Bertrand B, Rowe RH, Beneciuk JM. Immediate effects of thoracic spine thrust manipulation on shoulder internal rotation range of motion in a patient with suspected adhesive capsulitis. Brooks Research Day, Jacksonville, FL, October Osborne R, Haigst B, Rowe RH, Derienzo V, Beneciuk JM. Brooks advanced specialty training center: new model for excellence in clinical education. Brooks Research Day, Jacksonville, FL, October Beneciuk J, Bialosky J, Lentz T, Zeppieri G, Osborne R, Rowe R, Wu S, George S. Creation of the orthopaedic physical therapy investigative network (OPT-IN) for the optimal screening for prediction of referral and outcome (OSPRO) cohort study. APTA CSM Las Vegas, NV, February Grants: Co-investigator creation of the orthopaedic physical therapy investigative network (OPT-IN) for the optimal screening for prediction of referral and outcome (OSPRO) cohort study, Funding is $300,000 over 3 years. Textbooks: Rowe R. Musculoskeletal physical therapy. In O Sullivan SB, Siegelman RP, eds. National Physical Therapy

89 89 Examination Review and Study Guide. Evanston, IL: International Educational Resources;

90 90 Evidence B Describe the qualifications for appointment to the program s faculty (didactic and clinical). (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From Brooks Rehabilitation Neurologic Residency, 2014 Program Response: There are several criteria that must be demonstrated by an individual in order to be invited to serve as a faculty member within the Brooks PT Neurologic Residency. An individual must have one or more of the following qualifications. Demonstrate that they are NCS through the ABPTS. Completed an ABPTRE accredited Neurologic Residency. Serving as a faculty member of a CAPTE accredited DPT program and teaching the clinical management for neurologic conditions. Having competed a PhD or other advanced academic degree where the area of study was related to clinical neurosciences. An MD who has complete a Neurology, Neurosurgery, or PM&R residency. Demonstration of advanced knowledge and skills via a portfolio review. Example 2 - From Harris Health System Orthopedic Residency, 2014 Faculty: 1. Provide clinical expertise in a particular area through curriculum development, clinical and didactic teaching, and mentorship. 2. Serves as a content expert and serves in an advisory capacity regarding curriculum content and program development to the Residency Manager. 3. Promotion to the Residency Faculty will be approved by the Residency Manager and the Director of Rehabilitation Services once it is established that all of the following criteria have been met: a. Holds a position on staff as a Senior Physical Therapist; b. Holds board certification or has completed fellowship training by APTA; c. Holds prior teaching experience; d. Holds clinical instructor certification; e. Has twenty (20) hours of combined mentorship observation and practice under current faulty member; and f. Is a current adjunct faculty member. 4. Any exceptions to faculty designation must be approved by Program Director. 5. Residency Faculty must abide by all polices/procedures according to the residency faculty job addendum to maintain faculty appointment.

91 91 Designation Definition Members Faculty Develops, coordinates, and/or contributes a significant portion of the core content required in the Description of the Specialty Practice. Provide direct mentorship hours Serves as a content expert and serves in an advisory capacity regarding curriculum content and program development to the Residency Manager and Director Holds specialist certification by APTA in their area of expertise. *Members not meeting the above criteria are reviewed on a case-by-case bases by Program Director. Adjunct Faculty Develops and/or coordinates components of the curriculum as determined by the Residency Manager and Director. If Physical Therapist, may provide direct mentorship hours Guest Lecturer Provides in-services, lectures, labs, etc. as determined by the Residency Manager and Director. Topics provide value-add to the curriculum to meet content required in the Description of Specialty Practice Dana Tew, PT, DPT, OCS, FAAOMPT Wayne Brewer, PT, OCS, CSC, PhD Chris Dewey, PT,DPT, OCS, FAAOMPT Mike DeArman, PT, DPT, FAAOMPT Sarah Ammons, PT,DPT, OCS, FAAOMPT Sara Zehr, PT, DPT, OCS TJ Pelton, PT, MS, OCS, FAAOMPT Jamie Partridge, PT, DPT, OCS Rocio Antone, PT,DPT Cory Perrin, PT, DPT Sarah Lohmann, PT,DPT Peggy Gleeson, PT, PhD Germaine Herman, PT,DPT,OCS Ian Wallace, PT, DPT Abhinit Bhatt, PT, DPT Faculty Expectations PRIOR TO YOUR MODULE 1. Complete the syllabus and pre-module meeting with the program manager 2. Send residents syllabus, grading rubrics, mentorship prep forms, contact information, and orientation requirements for your module 3. Reserve conference rooms and lecture spaces 4. Block schedules as needed 5. Log your time in the Medicare Faculty Log DURING YOUR MODULE 1. Orient the resident to the module, the unit and review expectations at least twice. 2. Allow time for the residents to watch and co-treat with you during the first week if you are mentoring 3. Provide feedback to the residents after EVERY mentorship session no more than 1 day after the session 4. Be present, engaged, and available throughout the module to support the resident. 5. Hold residents accountable to productivity, residency requirements, professionalism standards, verbal and non-verbal communication, team work, preparedness, timeliness, and high quality clinical practice. 6. Grade residents fairly, but provide good feedback. Assignments should be challenging and worthwhile.

92 92 7. Do your best to limit changes to module requirements, lab and lectures times, and scheduling issues (of course, flexibility is expected on their part as well) AFTER YOUR MODULE 1. Log your time in the Medicare Faculty Logs on the R drive 2. Discuss changes for the upcoming year with program manager Example 3 - From St. Catherine s Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency Program, 2013 Clinical Faculty: The requirements for appointment to the clinical faculty include: Board certification in Geriatric PT APTA certification as a Clinical Instructor (Basic required; Advanced preferred) Completion of a Faculty Mentoring Training Course offered by the program or other sources approved by the Program Director Annual mentoring evaluations to be completed by the Program Director Didactic Faculty: The requirements for appointment to the didactic faculty include expertise in the area of content as demonstrated by: Board certification in the applicable specialty area of practice (eg, CCS) Advanced certification(s) in the applicable content area (eg, vestibular, CEEAA) Publication record Academic experience to include knowledge of pedagogy and adult learning

93 93 Evidence Provide a summary of professional development opportunities and resources that allow faculty to maintain and improve their effectiveness as clinicians and educators. (FOR CANDIDACY ONLY) Example 1 - From Brooks Rehabilitation Neurologic Residency, 2014 The faculty will be provided with many opportunities for professional development including the following: Each faculty member will have a formal professional development plan established and reviewed annually. Receive mentoring from the Residency/Fellowship Program Director as needed. Will be permitted to attend up to 32 hours of continuing education offered through Brooks Rehabilitation at no expense to the faculty member. Will attend Journal Clubs and Residency/Fellowship Case Study presentations. Will attend the Annual Faculty Retreat, which will have specific programming designed for faculty development. Faculty are invited to attend courses within the residency curriculum that they are not teaching at no cost to them. Example 2 - From Drexel University Orthopedic Residency, 2014 The faculty of DU is offered a variety of professional development options across the University, the College, and the Department via workshops about learning and teaching methodology for the ever changing needs of incoming students. These workshops often provide new literature on teaching and learning and are a place for dialogue. All DU faculty are required to develop and implement a scholarly agenda, to enhance the opportunities for publishing and research, which will be clinically oriented for all faculty involved in the program. Continuing education monies are also provided to enhance faculty s clinical and teaching skills. All program faculty who are not employed by DU will have several opportunities for professional development. All employers partnered with the program provide continuing education money to their employees for clinical or educator continuing education programs. DU will provide for all program faculty access to the University Library, involvement in monthly journal clubs, and invitations to all special topics seminars or continuing education provided by the Physical Therapy Department at Drexel. Effectiveness of faculty will be evaluated regularly, and, in areas of deficiency, every opportunity for assisting the faculty member will be implemented on a case-by-case basis through resources within the University.

94 94 Evidence Describe the professional development opportunities and resources that were available to faculty over the recent accreditation period to maintain and improve their effectiveness as clinicians and educators. (FOR REACCREDITATION ONLY) Example 1 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Since the initial accreditation, faculty have attained specialty Board Certification, advanced certification in Parkinson s and aquatics, Lee Silverman Voice Techniques (BIG), Certified Exercise Expert for Aging Adults (CEEAA), vestibular rehabilitation, APTA Basic and Advanced CI Certification (sponsored onsite) and have had the opportunity to attend numerous professional conferences and continuing education courses on-site (sponsored) and off-site. Faculty also attend an annual faculty retreat for development of mentoring skills, and additional pedagogical skills. In addition, the following policy is in it: SUBJECT: Faculty Resources FORMULATION DATE: 06/05/02 REVISION DATE: 03/30/07 APPROVED BY: Greg Hartley PT, MSPT,GCS Adequate time and resources are made available to faculty as related to continuing professional development. Examples include: In-services and seminars Continuing education courses Journal Club Clinical rounds Professional association activities (APTA/FPPTA) Procedure: Faculty wishing to participate in on-site educational opportunities need to bring to the attention of their supervisor their desire to attend the educational session so adequate time may be allowed. If a fee is charged or if the session is off-site and will require time away from the clinic, requests must be submitted to the Director of Rehabilitation Services using a Check Request Form and any time off coordinated with their supervisor. Time off for continuing education is approved by the Director of Rehabilitation and does not count as vacation or sick time. Continuing Education courses must support the mission and/or vision of the organization, residency program, and pertain to the clients served. Example 2 - From Louis Stokes Cleveland VA Medical Center Geriatric Residency, 2014 To support the VA mission, enhance clinical care and retain qualified staff, the VA provides financial support for staff to attend clinical education, both locally and distant. PT staff receive up to $1,000 per year in tuition support for relevant education, in addition to all related travel expenses. The VA provides monthly education to physical therapist in a web-based format. VA sponsors paid membership to physicaltherapy.com which provides webinars on topics of interest. LSCVAMC PT Department sponsors on-site continuing education seminars taught by outside experts as well as current staff. Staff is encouraged to become Certified Clinical Instructors. All PT staff involved in the residency as faculty completed VA sponsored Mentor Certification Training. The CCCE for PM&R meets with PT staff before, during, and after each PT/PTA students experience feedback and review feedback given by the student. Staff are able to use feedback to improve their clinical teaching skills.

95 95 VA provides library services on site, many of which are accessible from the PT s desktop computer. VA supplies membership to AccessPhysiotherapy.com which provides access to PT text-books, case studies, test questions, etc. online. VA provides professional and self-development activities through VA Learning University (VALU). The Talent Management System (TMS) provides educational opportunities online at the desktop on both PT clinical topics, general training (ethics, safety, privacy, etc.) and professional/self-development.

96 96 Evidence A Utilize the Form below to list all facilities (didactic and clinical) utilized for program participant education. (BOTH CANDIDACY AND REACCREDITATION) Example NAME OF FACILITY FACILITY ADDRESS CLINICAL OR DIDACTIC FACILITY Clinical Didactic Clinical Didactic Clinical Didactic Clinical Didactic Clinical Didactic Clinical Didactic Clinical Didactic Clinical Didactic OWNED/OPERATED BY SPONSORING ORGANIZATION (if clinical facility) Yes No Yes Yes Yes Yes Yes Yes Yes No No No No No No No NAME AND CREDENTIALS OF MENTOR(S) AT FACILITY (if clinical facility)

97 97 Evidence B Provide signed letters of agreement for all clinical facilities not owned/operated by the program s sponsoring organization that define clearly the relationship, the governance, and the responsibility that will be borne by the organization and the practice site(s) for all aspects of the program. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - The following is a sample of an Affiliation Agreement, provided by the American Physical Therapy Association, which identifies elements typically found in such a contract. If such a contract is not currently in use, it is recommended that legal counsel be sought in its drafting. AFFILIATION AGREEMENT THIS AFFILIATION AGREEMENT (this Agreement ) is made as of [date] (the Effective Date ) by and between the [insert name of corporation or other entity that owns/operates the clinical residency program] (the Residency ), a [corporation/not-for-profit corporation/partnership] organized under the laws of [insert state of incorporation/organization] having its principle place of business at [insert address], and [insert name of corporation or other entity that owns/operates the clinical facility] (the Center ), a [corporation/not-for-profit corporation/partnership] organized under the laws of [insert state of incorporation/organization] having its principle place of business at [insert address]. WHEREAS, the Residency operates a post-professional clinical residency program in physical therapy (the Program ) for residents who have met the clinical residency application criteria; WHEREAS, the Program involves the residents managing patients under the supervision of physical therapists on the Center s staff; WHEREAS, the Center operates a clinical facility (the Facility ) known as [insert name of facility] and located in [insert city and state] that offers physical therapy services to patients on an in-patient and/or out-patient basis; WHEREAS, the Residency and the Center are interested in entering into an arrangement under which students in the Program would manage patients at the Facility under the supervision of physical therapists on the Center s staff, subject to the terms and conditions set forth in this Agreement; NOW, THEREFORE, in consideration of their respective agreements, the representations and warranties contained herein, and other good and valuable consideration, the parties agree as follows: 1. Joint Responsibilities 1.1 Neither the Residency nor the Center will show any discrimination on the grounds of sex, race, creed, or color in the admission of qualified residents to any affiliated program, nor in the provision of instruction for such residents. 1.2 The number of residents, their program of education with the Center, and the scheduling of their education at the Center will be determined by mutual agreement between the Center and its affiliate(s). 1.3 A copy of the printed rules and regulations, and a calendar for both the Residency and its affiliate(s) activities should be made available to both participants. 1.4 The dismissal of a resident for academic or disciplinary reasons will be the responsibility of the Center, but the affiliate(s) maintain the right to remove a resident from the clinical education portion of the program, if a resident s behavior should violate existing rules and regulations of the affiliate in such matters as procedure, policies, patient contact, and in such other respects that the affiliate may require to prevent interference with its proper operation. Both the clinic and the affiliate should determine joint when and if a student, who has been removed from the clinical phase of the program, should be permitted to return to the clinical phase.

98 98 2. Responsibilities of Residency 2.1 The clinic shall have control over all phases of the administration of the program, curriculum content, evaluation, faculty appointments, admission requirements, promotion, and graduation, and such other matters as are internal to the clinic. The clinic will maintain the necessary records of the residents. 2.2 The philosophy of the program will be determined by the clinic. 2.3 The clinic will assign students to an affiliate for their clinical education in accordance with the clinic s calendar and the agreement reached on the capacity of the affiliate to accommodate residents for the necessary experience. 2.4 Where appropriate, and if required by accreditation or other considerations, clinical personnel will be given clinic appointments. The rights and responsibilities of the appointees will be those that are established by the clinic. 2.5 The clinic will provide a staff/faculty member who will serve as liaison with the clinical instructors. 2.6 The clinic will provide certain benefits and accord privileges to the clinical faculty, appropriate to their role in the Program. Reimbursement of expenses for clinical faculty will be based upon established clinic policies. 2.7 The clinic warrants that it carries professional and general liability insurance, with single limits of at least $1,000,000 per occurrence, to protect itself and its participating residents and faculty members, from the consequences of bodily injury arising out of negligence, malpractice, error, or mistake in the rendering or failure to render of any professional service by said residents or faculty members, with respect to this educational clinical experience program at the affiliate(s). 2.8 The clinic credentials will provide verification of each resident s credentials. 3. Responsibilities of Clinical Center 3.1 The affiliate(s) shall provide emergency health services and routine medical and dental care on a space available basis for the students during assignment. 3.2 The affiliate(s) shall provide clinical instruction and supervision of the residents by qualified personnel, who meet the standards of recognized professionals accrediting agencies or state agencies and the stated objectives of the educational program. 3.3 The affiliate(s) shall provide emergency health services and routine medical and dental care on a space-available basis for residents during assignment. 3.4 The affiliate(s) shall permit residents and faculty to have use of cafeteria and parking facilities, if available, at the same rate of charges as for employees. 3.5 The affiliate(s) will provide time for clinical instructors to attend clinical supervisors meetings and conferences called by the clinic as part of the educational program. 3.6 The affiliate(s) will provide cooperation when asked, in formal evaluation of the resident and will maintain the records and reports required by the clinic for conducting the educational program. 3.7 The affiliate(s) warrant that it/they carry professional and general liability insurance with limits of at least $1,000,000 per occurrence to cover itself and its personnel (including those who may also have clinical appointments at the clinic) from the consequences of negligence, malpractice, error, or mistake in the rendering or failure to render of any professional service, which includes the Program covered by this agreement. Officials signing the agreement for the participating institutions: Director, Clinic Director, Affiliate Date Date

99 99 Example 2 - From Durham Veteran's Administration Medical Center Geriatrics Residency, 2013 Example 3 From Virginia Commonwealth University Neurologic Residency, 2014 VIRGINIA COMMONWEALTH UNVERISTY SHELTERING ARMS NEUROLOGICAL PHYSICAL THERAPY RESIDENCY THIS AGREEMENT (Agreement) is made as of May 1, 2014 (Effective Date) by and between Virginia Commonwealth University (VCU), Virginia Commonwealth Health System (VCUHS), and Sheltering Arms Rehabilitation Hospital (SA) to operate a residency in neurologic physical therapy known as the Virginia Commonwealth Sheltering Arms Neuro Residency (Residency). WHEREAS, VCU operates a postprofessional clinical residency program in physical therapy for residents who have met the clinical residency application criteria;

100 100 WHEREAS, VCUHS and SA operate clinical facilities that offer physical therapy services to patients on an inpatient and/or outpatient basis; WHEREAS, the Residency involves the residents managing patients under the supervision of physical therapists on the VCUHS and SA clinical staff; WHEREAS, VCU, VCUHS, and SA are interested in entering into an arrangement under which students in the Residency would manage patients at VCUHS and SA under the supervision of physical therapists on the facilities staff, subject to the terms and conditions set forth in this Agreement; NOW, THEREFORE, in consideration of their respective agreements, the parties agree as follows: Responsibilities of Virginia Commonwealth University (VCU) 1. Prepare, submit, and coordinate the accreditation application, annual reports, fees, and any other information requested by APTA to achieve and maintain accreditation of the program. 2. Provide teaching and research opportunities to the residents, including active mentorship of such by VCU faculty. Activities may include teaching lab and lecture content to DPT students, providing continuing education (CE) to healthcare professionals, presenting abstracts and research findings. 3. Recruit residents yearly from the pool of VCU DPT graduates and solicit external applicants. Develop, maintain, and update the residency website, whose link is located on the VCU PT Program site. Respond to questions regarding the program and provide promotional material to various conferences and professional venues for recruitment and publicity purposes. 4. Provide a Residency Director, Administrator, and associated staff support to coordinate the residents schedules, supervise the program, and address any remediation plans. 5. Provide the resident with an affiliate faculty appointment that allows access to VCU library, VCU identification card, and other applicable VCU benefits. 6. Provide a Chairperson and additional members as appropriate for the Residency Curriculum and Admissions committees. 7. Process and screen all residency applications based on resident qualifications as outlined in Attachment 1. Communicate with applicants, distribute application information for review by the Residency Admissions Committee, and coordinate interviews with SA and VCUHS staff. 8. Find and schedule, in coordination with SA and VCUHS, learning opportunities for the resident to meet the requirements for didactic programming and to round out the full range of neurologic patient experiences outlined in the ABPTRFE accreditation requirements. 9. Communicate at least monthly with the residents and the SA and VCUHS residency coordinators. 10. Create, update, and distribute a residency handbook that contains policies and procedures of the residency program to be provided and reviewed with residents as part of their VCU-SA residency orientation. Responsibilities of Virginia Commonwealth University Health System (VCUHS)

101 Provide a one-year appointment as a resident to 1 full-time physical therapist to be paid at a salary roughly equivalent to 70% of a full-time physical therapist s starting salary. The anticipated starting date with be the first Monday of August each year. 2. Author a letter of appointment to each resident assigned to in accordance with the responsibilities herein, including the following details: (a) Duties of the resident (b) Duration of the agreement, including grounds for termination (c) Hours of work (d) Fringe benefits (eg, meals, uniforms, vacation policy, sick leave policy, housing provisions, and payment of dues for membership in selected professional organizations) (e) Health, hospital, and disability insurance benefits (f) Professional liability insurance and worker s compensation coverage (g) Mechanism of appeal (h) Information about the compensation package [This item is a requirement for APTA accreditation.] 3. Provide the resident with 30 hours per week of clinical treatment exposure with neurologic disorders including a wide breath of all of the major neurologic diagnoses. If a major set of diagnoses are missing from the resident s caseload, arrangement may need to be made by VCUHS or SA to supplement the resident s clinical experience in key areas. 4. Provide up to 10 hours of additional experience, to include grand rounds, journal clubs, specialty clinics, interdisciplinary team participation, clinical teaching, observational experiences, didactic teaching, and research activities. These hours and experiences may occur at VCUHS, SA, or affiliated locations. 5. Provide employee orientation, OSHA training, HIPAA training, clinic supervision, and other typical employee training. 6. Provide a clinical mentor for the resident for three hours per week of one-on-one mentoring. The mentor must meet the mentor qualifications as outlined in Attachment Provide a report of the residents number of clinical, mentoring, and didactic hours, and the patient diagnoses seen to the VCU Residency Administrator. No protected patient information will be transferred. 8. Provide evaluations of the resident, completed by the resident s mentor(s), at the end of each clinical rotation. The evaluation results shall be shared with the resident in face-to-face meetings. Evaluations will also be shared with the VCU Residency Director. 9. Assign at least one VCUHS NCS-certified physical therapist to be a member of the Residency Admissions Committee who communicates regularly through and meets annually at a minimum. 10. Supply all information for accreditation as requested by the VCU Residency Administrator. Responsibilities of Sheltering Arms (SA)

102 Provide a one-year appointment as a resident to 1 full-time physical therapist to be paid at a salary roughly equivalent to 70% of a full-time physical therapist s starting salary. The anticipated starting date with be the first Monday of August each year. 2. Author a letter of appointment to each resident assigned to in accordance with the responsibilities herein, including the following details: (i) Duties of the resident (j) Duration of the agreement, including grounds for termination (k) Hours of work (l) Fringe benefits (eg, meals, uniforms, vacation policy, sick leave policy, housing provisions, and payment of dues for membership in selected professional organizations) (m) Health, hospital, and disability insurance benefits (n) Professional liability insurance and worker s compensation coverage (o) Mechanism of appeal (p) Information about the compensation package [This item is a requirement for APTA accreditation.] 3. Provide the resident with 30 hours per week of clinical treatment exposure with neurologic disorders including a wide breath of all of the major neurologic diagnoses. If a major set of diagnoses are missing from the resident s caseload, arrangement may need to be made by SA or VCUHS to supplement the resident s clinical experience in key areas. 4. Provide up to 10 hours of additional experience, to include grand rounds, journal clubs, specialty clinics, interdisciplinary team participation, clinical teaching, observational experiences, didactic teaching, and research activities. These hours and experiences may occur at SA, VCU, or affiliated locations. 5. Provide employee orientation, OSHA training, HIPAA training, clinic supervision, and other typical employee training. 6. Provide a clinical mentor for the resident for three hours per week of one-on-one mentoring. The mentor must meet the mentor qualifications as outlined in Attachment Provide a report of the residents number of clinical, mentoring, and didactic hours, and the patient diagnoses seen to the VCU Residency Administrator. No protected patient information will be transferred. 8. Provide evaluations of the resident, completed by the resident s mentor(s), at the end of each clinical rotation. The evaluation results shall be shared with the resident in face-to-face meetings. Evaluations will also be shared with the VCU Residency Director. 9. Assign at least one SA NCS-certified physical therapist to be a member of the Residency Admissions Committee who communicates regularly through and meets annually at a minimum. 10. Supply all information for accreditation as requested by the VCU Residency Administrator. Responsibilities of the Resident

103 Work 40 hours/week for SA or VCUHS, of which 30 hours will be clinical treatment of SA or VCUHS patients with neurologic disorders. The remaining 10 hours of the work week will be used for additional learning experiences including grand rounds, journal clubs, specialty clinics, interdisciplinary team participation, clinical teaching, observational experiences, didactic teaching, and research activities. 2. Complete an additional 10 to 15 hours of unstructured activity per week including didactic coursework, studying, data reduction, preparation for teaching, outside seminars, and other activities. 3. Actively participate in mentorship by master clinicians, NCS certified physical therapists, teachers, and researchers. 4. Supply documentation to the VCU Residency Program Administrator of clinical hours and a breakdown of patient diagnoses treated. 5. Supply documentation of other learning experiences to the VCU Residency Program Administrator. 6. Communicate monthly with the VCU Residency Program Director. 7. Participate in exit interview after residency completion. Term The assignment shall become effective immediately and shall remain in effect for one year unless otherwise sooner terminated as hereinafter provided. At the end of said initial terms, the Agreement shall be automatically renewed for one-year successive terms unless a party provides notice of termination or non-renewal at least sixty (60) days written notice, provided that any resident(s) currently assigned to VCUHS or SA at the time of notice of termination shall be given the opportunity to complete his/her or their residency experience, such completion not to exceed six months. Notice Any written communication or notice pursuant to this Agreement shall be made to the following representatives of the respective parties at the following address: For VCU: Mary Shall Chair, Department of Physical Therapy Virginia Commonwealth University School of Allied Health Professions Department of Physical Therapy 1200 East Broad Street Richmond, VA For VCUHS: John Duval CEO MCV Hospitals, VCUHS VCU Health System 1250 East Marshall Street Richmond, VA For SA: James E. Sok President and Chief Executive Officer

104 104 Sheltering Arms Hospital 8254 Atlee Road Mechanicsville, VA Entire Understanding The agreement contains the entire understanding of the parties as to the matters contained herein, and it shall not be altered, amended or modified except by a writing executed by the duly authorized officials of VCU, VCUHS, and SA. Severability If any provision of the Agreement is held to be invalid or unenforceable for any reason, this Agreement shall remain in full force and effect in accordance with its terms, disregarding such unenforceable or invalid provision. Captions The caption headings contained herein are used solely for convenience and shall not be deemed to limit or define the provisions of this Agreement. No Waiver Any failure of a party to enforce that party s rights under any provision of the Agreement shall not be constructed or act as a waiver of said party s subsequent right to enforce any of the provisions contained herein. Governing Law This Agreement shall be governed and constructed in accordance with the laws of the Commonwealth of Virginia. Binding Effect This Agreement shall insure to the benefit of, and be binding upon, the parties hereto and their respective successors and assigns. Signatures: Virginia Commonwealth University: VCU Medical Center: Sheltering Arms: **For purposes of space, the signature lines as well as Appendices 1 and 2 were not replicated in this Application Resource Manual example.

105 105 Example 4 From TIRR Memorial Hermann Neurologic Residency, 2014 AFFILIATION AGREEMETN IN SUPPORT OF POST-GRADUATE RESIDENCY IN NEUROLOGIC PHYSICAL THERAPY This Affiliation Agreement ( Agreement ) is made by and between TIRR Memorial Hermann ( TIRR ); The University of Texas Medical Branch on behalf of its School of Allied Health Sciences ( UTMB ); and Texas Woman s University on behalf of its School of Physical Therapy ( TWU ) (collectively, Parties ). Having recognized that it is of mutual benefit and in the public good to establish a postgraduate training program ( Residency ) in Neurologic Physical Therapy, the Parties have entered into this Agreement, each pledging to the others that it intends to carry out its responsibilities as herein outlined. I. Responsibilities of UTMB and TWU A. TWU and UTMB each will develop course curriculum pertaining to the didactic portions of the Residency, which will consist of 3.0 credit hours of coursework per semester (summer, fall, spring) in the form of non-degree seeking independent study courses or competency courses, depending on whether the resident chooses to receive university credit or not, respectively. TWU or UTMB faculty will teach the courses when the Resident is enrolled in their respective university from time to time during the Residency. Residency enrollment per semester will depend, in part, on the needs and resources, at that time, of TWU and UTMB. B. TWU and UTMB will cooperate with TIRR in seeking APTA residency accreditation; however, it is not necessary for such accreditation to be in place before the Residency begins and no Party guarantees eventual accreditation, but each will use its best efforts to garner accreditation for the Residency. With respect to the initial APTA accreditation fee, TWU and UTMB will each be responsible for 25% of the fee. C. TWU and UTMB will cooperate with TIRR in seeking any renewal of APTA residency accreditation. With respect to any renewal APTA accreditation fee, TWU and UTMB will each be responsible for 25% of the fee. D. TWU and UTMB will provide faculty mentorship for at least one research project of the Residency which should be jointly agreed upon by the Resident, TIRR, and TWU and/or UTMB. II. III. Responsibilities of TIRR A. TIRR will serve as the clinical sponsor of the Residency and TIRR s facilities and patients will be central to the clinical experience of the Resident enrolled in the Residency. B. TIRR will employ the Resident on a part-time (0.5 FTE) basis throughout the period of the Residency program. Prior to such employment, TIRR will verify the Texas license of the Resident to practice physical therapy. The salary and other terms of employment for the Resident will be established by standard TIRR employee benefits policy and according to TIRR s contract with the Resident (the Contract ). TIRR will have the right to terminate the Resident s employment at any time pursuant to TIRR employment policies and the Contract. C. TIRR will cooperate with TWU and UTMB in seeking the accreditation referred to in Section I (B and C), above. TIRR will pay 50% of the initial accreditation fee and 50% of any renewal fee. TIRR will provide 100% of site visit fees and annual renewal fees. Term

106 106 This Agreement shall have a term of five years beginning June 1, 2014, and may be renewed for successive five year terms upon written agreement of the Parties at least one hundred twenty (120) calendar days prior to the end of the then current term. Such written notice may be given by certified mail or by facsimile. Resident(s) enrolled in the Residency will be allowed to complete the Residency prior to any termination that would cause the Residency to cease to exist. IV. Regulatory Matters and Consents This Agreement is made subject to present and future applicable local, state, and federal laws and to the regulations or orders of any local, state, or federal regulatory authority having jurisdiction over the matters set forth herein. Authorizations, approvals, consents, licenses, notices and filings, if any, that are required to have been obtained or submitted by each part with respect to this Agreement have been obtained or submitted, or if not yet obtained or submitted, each Party shall use due diligence in doing so. V. Media References To The Other Parties With respect to print or electronic advertising or public announcements, each Party will gain the prior approval of the other Parties if the names of the other Parties would be mentioned in such advertising or announcement. VI. No Third Party Beneficiaries This Agreement confers no rights whatsoever upon any person other than the Parties and shall not create, or be interpreted as creating, any standard of care, duty or liability to any person or entity not a Party hereto. VII. Notices Addresses for official notices to and between the Parties are as follows: TIRR: TWU: UTMB: Anna Lisa de Joya, PT, DSc, NCS TIRR Memorial Hermann 1333 Moursund Houston, TX Peggy Gleeson, PT, PhD School of Physical Therapy Texas Woman s University 6700 Fannin Houston, TX Carolyn Utsey, PT, PhD Department of Physical Therapy UTMB School of Allied Health Sciences 301 University Blvd. Galveston, TX VIII. Entire Agreement; Amendment; Counterparts

107 107 This Agreement (including any exhibits and any written supplements hereto) constitutes the entire agreement between the Parties with respect to the matters set forth herein. No amendment or modification to this Agreement shall be enforceable unless reduced to writing and executed by the Parties. This Agreement and any modification hereof may be executed and delivered in counterparts, including by a facsimile transmission thereof, each of which shall be deemed an original, but all of which together shall constitute a single Agreement. The Parties acknowledge that this Agreement represents an expression of only the general responsibilities of the Parties and not that more detailed plans and understandings will be reached by the Parties as they jointly plan and execute the various logistics and components necessary to the Residency made the subject of this Agreement. IX. Authority Each individual signing this Agreement warrants that the party for which he or she is signing has duly authorized such execution and that all necessary corporate action to authorize the execution and performance of this Agreement by each party has been taken. Executed and made effective as of the date first above written. Signatures: TIRR TWU UTMB *For purposes of space, the signature lines were not replicated in this Application Resource Manual example.

108 108 Evidence C Describe how the program will ensure uninterrupted, quality didactic and clinical learning for all program participants should any of the program s resources be suddenly terminated/annulled. (FOR CANDIDACY ONLY) Example 1 - From Kaiser Permanente Neurologic Physical Therapy Residency, 2013 Should any of the program resources be interrupted we have backup plans to ensure continuity of clinical and didactic learning. For example, if the neuro consortium, which provides part of didactic curriculum, were to end suddenly, then the program would resume previous coursework that was developed prior to the consortium. We continue in fact to utilize coursework previously developed. We have built in a certain level of redundancy into the program for that purpose. For the mentors we always have backup in place in case of vacations and unexpected illness. Additionally, the program director fills in as a mentor. We continuously work to offer education and opportunity for learning to staff for professional development so that we can continue to draw from a pool of well qualified clinicians. Example 2 - From The Ohio State University Sports Medicine Orthopaedic Residency Program, 2013 Postprofessional PT program development is one of the five key objectives within the Strategic Development Plan for OSU Sports Medicine. OSU Sports Medicine has 7 facilities with over 65 physical therapists, half of which are board-certified specialists (13 board-certification in Orthopedic Physical Therapy). If specific clinical mentoring and/or didactic components are terminated the program will utilize these clinicians to remedy identified deficits. The Director of Postprofessional PT Programs meets annual with the Director of OSU Sport Medicine and Division of Physical Therapy to review budgetary needs and ensure appropriate financial support for the program. Regular communication between the program, clinic (OSU Sports Medicine), and academic program (OSU Division of Physical Therapy) occur throughout the year and the program director has a dual clinic and academic appointment to aid in communication. Example 3 - From the University of Southern California/Children s Hospital Los Angeles Pediatric Physical Therapy Residency Program, 2013 USC and CHLA have a legal document (MOU) that describes the commitment and expectations of each of the institutions to the pediatric physical therapy residency. Both USC and CHLA are fiscally sound entities, dedicated to providing continuing patient care for the foreseeable future. In addition to providing patient care, both institutions have dedicated themselves, as reflected by their mission statements, to education and research. Thus, it is highly unlikely that the programs resources, physical or otherwise, will be suddenly terminated. Nor is it likely that the program will be terminated due to a change in the philosophy or mission of either USC or CHLA. The CHLA/CA-LEND program is supported through a grant from Health Resources and Service s Administration s (HRSA) Maternal and Child Health Bureau (MCHB). It is a 5-year grant, but the CA-LEND program has had this grant for the past 20 years (see Evidence A). We are currently in the second year of the 5-year cycle. Notification of termination of the support would be given in enough time to allow for planning for future residents; the current resident would still finish his/her CA-LEND training. Should loss of resources occur, however unlikely it may be, every effort will be made to complete the resident s education, as laid out in their contract.

109 109 Evidence C Summarize any changes to affiliations (both clinical and didactic) during the recent accreditation period and the impact they have had on the program. (FOR REACCREDITATION ONLY Example 1 - From Baylor Institute for Rehabilitation & Texas Woman's University Women's Health Residency, 2015 There have been no significant changes to the agreement other than the original agreement was between Baylor Healthcare System and Texas Woman s University. In 2011 when the Joint Venture occurred, a new agreement was made between BIR JV and Texas Woman s University with new names and CEO signatures. Example 2 - From UT Southwestern Medical Center Orthopedic Residency, 2015 With the growth of our department and services we have been able to add 2 satellite clinic locations since our initial accreditation. We started a rotation for each resident to spend a semester working in the physical therapy department of our pain management program. This coverage now equates to approximately 10% of each resident s patient care coverage responsibility. This addition has proven to be an invaluable asset as it has increased our central sensitization, honing their clinical reasoning skills, and developing a keen sense of the benefit to multidisciplinary involvement. Periodic rotation through our sports physical therapy service has also broadened their exposure to younger, more active population and given the residents an opportunity to see more patients post-operatively. Example 3 - From University of Delaware Sports Residency, 2015 Overall our affiliations have not changed significantly. Our residents have always gone out to shadow physicians during office visits and surgeries. The emphasis on this has been slightly decreased over the past 10 years. Residents now shadow on average 8-12 hours per week versus as in years past. This has had no impact on the residency other than they have more time to complete their didactic work which has also grown since The sports resident continue to observe and treat alongside of the athletic training staff 2-3 afternoons during the week and weekends as well as goes offsite to ATI Physical Therapy for mentoring in wrist and hand and aquatics PT. Our didactic section has grown immensely since At that time we had mostly self-study and journal clubs for the residents. At this time each resident has module pieces they ready, study and are tested on while their complete their outside rotations. These things are done in concert with one another so if they are going on an outside experience in the wrist and hand they will finish completing this module prior to or during that experience. We have well over 150 hours of didactic curricula. When the resident begins the residency, they complete module A (self-study, literature review and psychomotor check-offs). Once they get through this module, which should be within the first 4-5 weeks of the orientation period, they move into module B which is the residency curriculum. The other portions of the didactic curriculum are the same: journal clubs, case rounds, DPT rounds, etc. The change to increase our didactic curriculum has helped us to stay on top of the resident in their learning experience to make sure they are up to date on the newest literature for all areas of study. Overall this seems to be providing an avenue for great references for the resident and has helped them oval

110 110 become a stronger clinician with the most up to date evidence based information. This next specialist exam period will be our first data points in determining the impact that the new didactic curriculum has had on our outcomes. Example 4 - From Marquette University & Zablocki VA Medical Center Neurologic Residency, 2015 When we expanded to 2 residents, we also added a second pediatric site (see Form A for clinic name). This pediatric site is an urban early education setting to complement our original suburban private practice clinic. Our primary mentor at this new site has recently changed, and we are pleased to now have a PCS certified mentor at both facilities. All residents who have had this comparative experience have appreciated the opportunities at both settings. A school-based opportunity has been mentioned by past residents, which we are considering as we go up to 3 residents, but historically the logistics for offsite opportunities limits the feasibility of 3 residents being able to rotate through 3 different settings. Instead, our current pediatric sites faculty have included a discussion about school-based (educational) goals to the pediatric module that goes along with this experience.

111 111 Evidence A Describe the program s current sources of funding. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From MedStar Georgetown University Hospital Women's Health Residency, 2014 The program is funded by MedStar Georgetown University Hospital Department of Physical Medicine & Rehabilitation. However, the residency program is a budget neutral item. Eligible residents receive a lower than usual salary that offsets cost associated with administering, marketing and running the program. Example 2 - From Brooks Rehabilitation Neurologic Residency, 2014 Brooks Rehabilitation has made a commitment to support the PT Residency/Fellowship Programs by internally designating investment income sufficient to sustain the Program over the long term. The investment income is derived from our endowment which is earmarked for community benefits activities and internal or external educational initiatives. We do not look forward nor anticipate the Residency/Fellowship Program to have a need to obtain funds from sources outside the health system. Example 3 - From Kaiser Permanente Los Angeles Movement Science Fellowship, 2009 The curriculum development and clinical supervision costs provided by the clinical faculty are funded by the Community Benefits Workforce budget within the Southern California Permanente Medical Group. This has amounted to.72 FTE in The administrative costs associated with fellows, such as the salaries of the fellows, are funded by each of the three facilities that employ the fellows. The registration fees paid by the fellows fund other miscellaneous expenses, such as APTA credentialing annual fees, graduation dinner costs, graduation certificates, and equipment expenses.

112 112 Evidence B Describe the program s plan to assure funding throughout the period of accreditation. (FOR CANDIDACY ONLY) Example 1 - From MedStar Georgetown University Hospital Women's Health Residency, 2014 The program is funded by MedStar Georgetown University Hospital Department of Physical Medicine & Rehabilitation. However, the residency program is a budget neutral item. Eligible residents receive a lower than usual salary that offsets cost associated with administering, marketing and running the program. MedStar is an extremely large non-for-profit organization which is fiscally sound. MedStar s 30,000 associates and 6,000 affiliated physicians support MedStar s patient-first philosophy of care, compassion, clinical excellence, and customer service. We proudly care for more than halfmillion patients each year across Maryland and the Washington, D.C., region in our hospitals, urgent care and ambulatory care facilities, and physician offices. Our extensive network of providers enables us to offer the highest quality, most advanced care close to where our patients live and work. And, because we are committed to our not-for-profit mission, we remain dedicated to reinvest in the health and wellness of all the communities we serve. MedStar Health combines the best aspects of academic medicine, research and innovation with a complete spectrum of clinical services to advance patient care. Our areas of clinical excellence include cardiology and cardiac surgery, orthopaedics, cancer, transplantation, rehabilitation, and emergency and trauma services. As the largest healthcare provider in Maryland and the Washington, D.C., region, MedStar s 10 hospitals, the MedStar Health Research Institute, MedStar Physician Partners, and our other programs and services are recognized regionally and nationally for excellence in medical care. Our associates also provide primary care, urgent care, adult day care, and home health care services in communities and homes across the region. For patients requiring non-acute care, MedStar operates subacute, assisted living and long-term care services. Example 2 - From Brooks Rehabilitation Neurologic Residency, 2014 The residency program is a component of our annual budgeting process and provided sufficient resources for the start-up, participant recruitment and on-going operational needs required to operate the program in 2014 and beyond. The financial condition of the program will be measure against compliance with the annual budget.

113 113 Evidence B Describe any changes to funding during the program s recent accreditation period and its impact on the program. (FOR REACCREDITATION ONLY) Example 1 - From Marquette University & Zablocki VA Medical Center Neurologic Residency, 2015 We had hoped to fund the residency partially through providing local CE courses. However, since the CE market is declining, our program director has covered the costs of the residency program out of other budgets. This situation has not had any noticeable impact on our program. Example 2 - From Baylor Institute for Rehabilitation & Texas Woman's University Women's Health Residency, 2015 There have been no changes to funding since the original accreditation period.

114 114 Evidence Describe the educational resources, including methods of access, available to faculty and program participants. (FOR CANDIDACY ONLY) Example 1 - From Brooks Rehabilitation Neurologic Residency, 2014 Brooks currently contracts with Ebsco to provide an opportunity for the clinical staff to attain full text articles. Brooks also has created the Scholarly Resource Center (SRC) located on the Brooks intranet which houses items in four categories including 1) full text journal articles; 2) CAT Bank; 3) published Clinical Practice Guidelines; 4) Functional Outcome measurement tools. This is available to all clinical staff within Brooks. The SCR was created as an idea from the Brooks/UNF Orthopaedic Residency and vast majority of the content has been uploaded by past and current residents and fellows (from amongst all of the Brooks residency programs). Brooks Rehabilitation has the required and recommended textbooks located in the Residency/Fellowship space for the participants to check out text books. The residents are expected to be members of the APTA, so they receive PT Journal. Brooks Rehabilitation staff (including faculty and residents/fellows) have access to Memorial Hospital s Medical Library, which includes the ability to request articles through interlibrary loans. Residents are provided with instructions on how to perform computerized literature searches on APTA s Open Door, APTA s Hooked Evidence, Pubmed, PEDro, which are all available to them for use within their clinical practice setting. Each resident is provided the opportunity to utilize their Brooks clinic laptop (with Wi-Fi internet access) for use during the year they are in the program. In addition, they are provided with a secure ID card or VPN access so they can have remote access to all of their documents while off site. The residents are permitted to use the laptops for all activities related to residency both within and outside the clinical and teaching environment. Brooks Rehabilitation offers multiple computer classes throughout the year, so the residents have the opportunity to take classes in Excel, PowerPoint, Microsoft Word, Access, and Internet Explorer. Brooks Rehabilitation also offers multiple continuing education courses throughout the year that the residents are eligible to attend. Residents are involved in a journal club that meets 7-10 times a year. The Neurologic Residents are responsible for pre-readings and activities as assigned. They are prepared to discuss and moderate assigned sections of each article. Residents will receive mentoring to assist them with teaching professional physical therapy students at the UNF and/or USA. Each resident will also complete two written case reports during the course of the year. The resident will orally present four case studies to healthcare professionals invited from the entire Jacksonville area. Each resident will be required to submit at least one of their case studies for presentation at a national professional conference (approved by the Residency Program Coordinator). The following Departments within Brooks Rehabilitation will work closely with the resident providing support and resources: Community Service Public Relations Marketing

115 115 Learning Brooks Center for Rehabilitation Studies Institutional Technology Administration Example 2 - From Drexel University Orthopedic Residency, Educational Resources a. Health Sciences Libraries b. PT Department Library c. Internet access d. Free software (eg, Microsoft Office, Endnote) e. Professional courses and conferences 2. Access to Educational Resources a. Residents have access to the Health Sciences Libraries, with customized services and collections to support the DU College of Medicine, the College of Nursing and Health Professions and the School of Public Health. The Health Sciences Libraries meet the needs of students, faculty, and clinical practitioners. Both the Center City Hahnemann Campus and the Queen Lane Medical Campus Libraries offer 24/7 facilities and expert staff. The library can be accessed at this link: They offer many services to assist with academic research and work. All staff can assist with borrowing materials from interlibrary loan service. They can assist in supporting research through: i. Research Databases - The libraries offer access to an extensive collection of research databases. While some are of general academic interest, many are highly specialized. The database can be viewed alphabetically or by subject area. ii. E-Journals & E-Books - The libraries offer an extensive collection of electronic journals and e-books. All e-journals and e-books are included in the library catalog and e-journals can be divided by title or subject area. iii. Research Guides - Research Guides are a valuable tool complied by Liaison Librarians to identify particularly valuable research resources in specific subject areas. While they are primarily aimed at beginning researchers, they also serve as valuable pointers to unfamiliar resources, particularly in interdisciplinary projects. iv. Citation Searching - Web of Science offers searching by cited-reference, a valuable measure of research-impact for visa and tenure documentation. b. All residents and resident faculty will have a DU password protected account and an ID providing electronic and in-person access to all materials in the on-site libraries and all electronic databases. Remote electronic access to available via EZ Proxy. c. The PT Department Library is located on the Center City Campus within the department s conference room and all text are available for residents to borrow. d. A laptop computer will be provided for all residents with all necessary software. e. The physical Therapy Clinic conducts a monthly Journal Club that will be organized and run by the residents. f. All residents will receive a copy of ISC 21.2 Current Concepts in Orthopaedic Physical Therapy, 3 rd ed as part of their independent learning requirements.

116 116 Example 3 - From Harris Health System Orthopedic Residency, 2014 Educational Resources: APTA Current Concepts 3 rd edition Library Access: Houston Academy of Medicine - Texas Medical Center Library Rehab Department Library: Textbooks, SharePoint, and Educational CDs Internet available on all computers Professional courses and conferences In-house didactic education Resident-guided monthly journal clubs Monthly Grand Rounds Guest Lecture Series and Rounds developed by other specialties Monthly rehabilitation department staff meetings The residency program encourages attendance at professional conference each year. Funding is not guaranteed, but residents/faculty will be able to take hospital business.

117 117 Evidence Describe the resources that have been available to both faculty and program participants over the recent accreditation period and any anticipated changes for the upcoming accreditation period. (FOR REACCREDITATION ONLY) Example 1 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Residents and faculty have online access to the University of Miami, Miller School of Medicine, Calder Library (Health Sciences). Inter-library loans are also available. Residents and faculty alike will find a wealth of peer-reviewed journals on geriatrics. In addition to U of M online resources, residents have access to books and journals belonging to faculty and in an onsite resident library at St. Catherine s/villa Maria. Each resident and faculty member is provided with a personal computer with unlimited internet access available on-site at St. Catherine s/villa Maria. The residency program also asks its residents to provide a list of resources they might find useful as our library continues to grow. Residents are also eligible to attend continuing education courses (paid by St. Catherine s/villa Maria) as deemed appropriate. Residents are also required to be members of APTA and the Academy of Geriatric Physical Therapy and they receive paid dues as an employee, which provides access to PTJ, JGPT, GeriNotes, PTNow, Open Door, Hooked on Evidence, etc. Example 2 - From Hospital for Special Surgery Hand Therapy Fellowship, 2015 The educational resources listed below have been available to the HSS Hand Therapy Fellowship faculty and fellows since the beginning of the program. No changes have been made or are anticipated. Educational Resources 1. HSS Medical Library 2. Weill Cornell Medical College Library 3. Hand Therapy Center Library 4. Live and online library skills classes 5. Internet access 6. Weekly fellowship education series and splint labs 7. Bimonthly inservices in the Hand Therapy Center 8. Monthly educational inservices presented by the Rehabilitation Department on a broad range of topics related to rehabilitation 9. Weekly Hand Conference with the HSS Hand Service 10. Conferences/Grand Rounds 11. Observation

118 Curriculum Evidence Identify the year and version of the DSP/DRP/DASP/DSSP, ABPTRFE approved analysis of practice, or comprehensive needs assessment used to develop the curriculum. (BOTH CANDIDACY AND REACCREDITATION) The American Board of Physical Therapy Specialists (ABPTS) provides Descriptions of Specialty Practice (DSP) in the following areas: Cardiovascular and Pulmonary Clinical Electrophysiology Geriatric Neurologic Orthopaedic Pediatric Sports Women s Health These documents are available by contacting APTA Residency/Fellowship staff at resfel@apta.org. If the most recent version of a DSP was published less than one year before a clinical residency program submits its application, it may develop its curriculum from the prior version. However, in such a case the Council or ABPTRFE may require the program, at or before its site visit, to describe its plan for updating the curriculum. If ABPTRFE accredits such a program, then its first annual report must describe its plan for updating the curriculum. A program that is an orthopedic manual physical therapy fellowship must develop its curriculum from the most recent version of the Description of Advanced Specialist Practice (DASP) issued by the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) which is available for download at their website If a clinical program s focused area of clinical practice is not covered by a DSP or by the DASP, the program may develop its curriculum from an analysis of practice that has been conducted in accordance with accepted sound psychometric standards and that has been approved by ABPTRFE. Before the program establishes its curriculum, it must apply for and obtain ABPTRFE s approval of an analysis of practice that the program has carried out. The application must demonstrate a need for ABPTRFE recognition of the focused area of clinical practice by identifying at least four other existing or planned programs in the focused area of clinical practice, each of which must indicate in writing its interest in obtaining accredited status. Please refer to the ABPTRFE Rules of Practice and Procedures for complete details on petitioning a new area of residency or fellowship training.

119 119 Evidence A Provide the major content areas of the program's curriculum and their relationship to the DSP/DRP/DASP/DSSP/analysis of practice or comprehensive needs assessment using the form template located on the ABPTRFE website under Application Resources. For those programs in areas without a form template, use the generic form. (BOTH CANDIDACY AND REACCREDITATION) Please download the respective form template from the ABPTRFE website. The following examples are excerpts from real program applications and does not include the entire form submitted within the program s application. Example 1 - From Rochester Regional Health System Neurologic Residency, 2015

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123 120 Example 2 - From Baylor Institute for Rehabilitation & Texas Woman's University Women's Health Residency, 2015

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128 121 Evidence B Utilize the Form below to provide an example of a typical weekly schedule for the program participant that at a minimum outlines time for didactic, mentoring, clinic, and other learning opportunities provide by the program. (BOTH CANDIDACY AND REACCREDITATION) Example 1 Form template from ABPTRFE 2015 Evaluative Criteria 7:00 AM 8:00 AM 9:00 AM 10:00 AM 11:00 AM NOON 1:00 PM 2:00 PM 3:00 PM 4:00 PM 5:00 PM 6:00 PM 7:00 PM 8:00 PM 9:00 PM SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

129 122 Example 2 - From Brooks Rehabilitation Neurologic Residency, 2014 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 7:00 AM 8:00 AM Patient Care (begins at 8:00 or 8:30am) Patient Care (begins at 8:00 or 8:30am) Patient Care (begins at 8:00 or 8:30am) Patient Care (begins at 8:00 or 8:30am) 9:00 AM 10:00 AM 11:00 AM NOON Lunch Lunch Lunch Lunch Lunch 1:00 PM 2:00 PM 3:00 PM Mentoring during patient care Patient Care (ends at 4:30 or 5:00pm) 4:00 PM 5:00 PM Didactic/ 6:00 PM 7:00 PM 8:00 PM 9:00 PM Patient Care (ends at 4:30 or 5:00pm) Psychomotor Class (5:30pm to 9:00pm) Patient Care (ends at 4:30 or 5:00pm) Patient Care (begins at 8:00 or 8:30am) Patient Care (ends at 4:30 or 5:00pm) In addition there are the following activities that are not routine (therefore not included on the above weekly schedule), and are included intermittently throughout the course of the year: 7 weekend Foundational Classes held on a Saturday (one is a Saturday-Sunday course) 2 weekend Neuropractice Overview Classes, one is held on a Saturday and a second is a Saturday-Sunday course 4 weekend Neurological Practice Management Classes are held during the program (Saturday- Monday 24 CH) 4 case study presentations (typically 4:00-6:00pm on a night other than the day of class) Research Day is one afternoon in the second quarter (4:00-7:00pm on a night other than the day of class) 2 half day teaching opportunities to the PT students at a local University (typically 1:00-5:00pm) 7 Journal Club Meetings (typically held during a weekly class time from 5:00-7:30pm)

130 123 Example 3 - From Drexel University Orthopedic Residency, 2014 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 7:00 AM Physician Hours Physician 8:00 AM DUPTS 11 th DUPTS DUPTS Rec Hours 9:00 AM 10:00 AM 11:00 AM NOON 1:00 PM Street Family Health Services Travel Rec Center Lunch Lunch Center Lunch Lunch/Travel 2:00 PM Lunch/1:1 Travel Travel Travel DUPTS Rec Mentoring 3:00 PM DUPTS Rec Center 1:1 Mentoring 4:00 PM 5:00 PM 6:00 PM 7:00 PM Bucks PT 1:1 Mentoring DUPTS Rec Center Spine Rehab Lab -TA 8:00 PM Clinical Topics in 9:00 PM Extremity Rehab Center

131 124 Example 4 - From UPMC Centers for Rehab Services Geriatric Residency, 2014 Sample Weekly Schedule- Acute care MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SAT/SUN 7:00 AM Patient Patient Care Patient Care Journal Club Patient 8:00 AM Care Care on 9:00 AM Specialty Experiences Specialty Experiences rotation (ends at 5:30pm) 10:00 AM 11:00 AM NOON 1:00 PM Patient Care with Mentor 2:00 PM Patient Care (ends at 5:30pm) Work on home study CE and modules 3:00 PM 4:00 PM 5:00 PM 6:00 PM 7:00 PM SWD 8:00 PM 9:00 PM meeting (2 nd Tuesdays) Patient Care with Mentor Patient Care (ends at 5:30pm) Patient Care with Mentor Patient Care (ends at 5:30pm) PT Grand Rounds (Sept April) Common residency time (1:30-4:30pm) time used for meetings, projects, didactic education *Clinical Mentoring occurs 3 hours/week during the resident s clinical caseload. The time is coordinated weekly by the mentor assigned to the resident. Times provided are only a sample and are not set times. *Specialty Experiences are scheduled throughout the program with attempts to place these during open times in schedule. When this cannot occur, the schedule is altered.

132 125 Sample Weekly Schedule- Skilled Nursing MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SAT/SUN 7:00 AM Journal Club 8:00 AM Patient Patient Care Patient Care Patient Care Patient 9:00 AM Care with Mentor (ends at Care on 10:00 AM 4:30pm) TA Geriatric rotation 11:00 AM PT Univ Pittsburg Jan-April (ends at 4:30pm) NOON Patient Care PT Grand Rounds (Sept Dec) 1:00 PM Common 2:00 PM 3:00 PM 4:00 PM residency time (time used for meetings, projects, didactic education) 5:00 PM HRS 2307 (Falls & Balance course) ends at 7:30pm Jan-April 6:00 PM 7:00 PM SWD meeting (2 nd Tuesdays) 8:00 PM 9:00 PM *Clinical Mentoring occurs 3-4 hours/week during the resident s clinical caseload. The time is coordinated weekly by the mentor assigned to the resident. Times provided are only a sample and are not set time. *Specialty Experiences are scheduled throughout the program with attempts to place during open times in schedule. When this cannot occur, the schedule is altered.

133 126 Residents Weekly Schedule- Inpatient Rehab MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SAT/SUN 7:00 AM Journal Club 8:00 AM Patient Patient Patient Care Patient Care Patient 9:00 AM Care Care care on 10:00 AM TA Geriatric rotation 11:00 AM PT Univ Pittsburg Jan-April (ends at 4:30pm) NOON PT Grand Rounds (Sept April) 1:00 PM Mentoring Mentoring Mentoring Mentoring Common 2:00 PM Patient Patient Patient Care Patient Care Care (ends Care (ends (ends at (ends at at 4:30pm) at 4:30pm) 2:30pm) 4:30pm) 3:00 PM 4:00 PM 5:00 PM HRS :00 PM 7:00 PM SWD meeting 8:00 PM 9:00 PM (2 nd Tuesdays) (Falls & Balance course) ends at 7:30pm Jan-April residency time (1:30-4:30pm) time used for meetings, projects, didactic education *Clinical Mentoring occurs 3-4 hours/week during the resident s clinical caseload. The time is coordinated weekly by the mentor assigned to the resident. Times provided are only a sample and are not set time. *Specialty Experiences are scheduled throughout the program with attempts to place during open times in schedule. When this cannot occur, the schedule is altered.

134 127 Sample Weekly Schedule- Outpatient MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 7:00 AM Journal Club 8:00 AM Patient Patient 9:00 AM Care Care 10:00 AM 11:00 AM NOON SAT/SUN Patient Care Patient Care Patient care on rotation PT Grand Rounds (Sept April) 1:00 PM Mentoring Mentoring Mentoring Mentoring Common 2:00 PM Patient Patient Specialty Patient Care Care (ends Care (ends Experiences (ends at at 4:30pm) at 4:30pm) 4:30pm) 3:00 PM 4:00 PM 5:00 PM 6:00 PM 7:00 PM SWD 8:00 PM meeting 9:00 PM (2 nd Tuesdays) residency time (1:30-4:30pm) time used for meetings, projects, didactic education (ends at 4:30pm) *Clinical Mentoring occurs 3-4 hours/week during the resident s clinical caseload. The time is coordinated weekly by the mentor assigned to the resident. Times provided are only a sample and are not set time. *Specialty Experiences are scheduled throughout the program with attempts to place during open times in schedule. When this cannot occur, the schedule is altered.

135 128 Example 5 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 7:00 AM 8:00 AM Patient Care Patient Care Mentoring Time Didactic Time Patient Care 9:00 AM Patient Care Patient Care Mentoring Time Didactic Time Patient Care 10:00 AM Patient Care Patient Care Mentoring Time Didactic Time Patient Care 11:00 AM Patient Care Patient Care Mentoring Time Didactic Time Patient Care NOON 1:00 PM Patient Care Patient Care Patient Care Didactic Time Patient Care 2:00 PM Patient Care Patient Care Patient Care Didactic Time Patient Care 3:00 PM Patient Care Patient Care Patient Care Didactic Time Patient Care 4:00 PM Patient Care Patient Care Patient Care Didactic Time Patient Care 5:00 PM 6:00 PM 7:00 PM 8:00 PM 9:00 PM

136 129 Evidence C Provide an outline or flow chart of the overall sequencing of content in the program s curriculum across the entire time period of the residency or fellowship, including both didactic and clinical experiences. Briefly explain the rationale behind the organization and sequencing of the curricular content as well as how the program ensures congruency between the didactic and clinical aspects of the curriculum. Describe how the organization, sequencing, and integration of the courses facilitate participant achievement of the expected outcomes. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From Drexel University Orthopedic Residency, 2014 Didactic portion (110 hours minimally): The DUOPTR is a 13-month program developed to promote postprofessional education towards achievement of the Orthopaedic Clinical Specialist certification and lifelong learning. The length of the program is 13-months to provide overlap with the start of new residents every June to facilitate the transition of patients from seasoned residents. The didactic program is set up so the Advanced Musculoskeletal Anatomy course provides foundational science to enhance residents understanding of anatomical literature as well as reinforce anatomical knowledge through cadaveric dissection as the platform for clinical decision making. Anatomy is the basis for all orthopaedic patient care and allows specialists/residents to critically analyze the published research for quality and diagnostic/intervention decisions. This course will provide a basis of understanding of the evidence for the residents as they are discussed in future courses, monthly journal club, and mentorship sessions. In the fall the residents will focus on their scholarship as part of the Independent Learning described below. In the winter and spring quarters the residents will participate in our postprofessional orthopaedic PT courses. These courses are hybrid on-site/online courses that run in multiple postprofessional physical therapy programs. The residents will interact with other licensed clinicians in these courses, which will enhance discussion of the topics covered. Clinical Portion: 150 hrs. of 1:1 clinical mentoring minimally within DUPTS; up to 165 hrs. with clinical partners hrs. of direct patient care both supervised and unsupervised.

137 130 The residents will spend a minimum of 25 hours working in DUPTS clinics, 20% of which will be in our pro-bono clinic, 11 th Street Family Health Services. Here the residents get the opportunity to work with chronic pain in an interdisciplinary environment, treat various orthopaedic/musculoskeletal disorders, and participate in primary care of the uninsured and low income patient population. The other 80% of their treatment time for DUPTS is in our fee-for-service facilities the DU Recreation Center and Parkway Health & Wellness. These facilities service a general orthopaedic population from the DU community and surrounding Philadelphia area. We are also the primary referral facility for Drexel Varsity Athletes and (working in conjunction with the Athletic Training Department), and DU Workers Compensation. Due to our patients on campus primarily being a young, active and athletic population, we determined a need to partner with other clinics that offer treatment to patients across the spectrum of Orthopaedic PT. DUOPTR has affiliation agreements (see Appendix F) with Bucks Physical Therapy Sports Rehabilitation & Aquatics, Optimum Physical Therapy, and Strive Physical Therapy. All 3 facilities have agreed to provide patient care opportunities for the residents 4-5 hours/week for 11 week periods. Each resident will rotate through all 3 facilities and work with the mentors we have designated. They will assist in treating the patients scheduled during their mentor s treatment time. The mentors will also assist us as they are able in providing the variety of patients required by the DSP. During their orthopaedic PT courses, the residents will also spend time with physicians during office hours and surgery. They will observe the medical clinical decision making process with regard to utilization of physical therapy services, surgery, medication/supplements, and referral to other health care practitioners. The residents will have opportunity during surgical observation to become familiar with techniques and devices/materials typically used in orthopaedic surgery. This experience will enhance their ability to discuss how those procedures affect the rehabilitation process. Throughout the year, the residents will treat any patients presenting to our facilities and our partner clinics. All efforts will be made to schedule patients needed so that both residents achieve the percentage population required under the current DSP. The residents will provide monthly statistics about the patients they are seeking in all clinics to the Director of the Orthopaedic PT Residency. The Director will monitor and make suggestions to scheduling staff and our partners to direct appropriate patients to the resident s schedules. To ensure congruency with didactic courses, patient monitoring will continue throughout the year and all efforts will be made move patients with extremity injuries to the resident s schedule during the winter quarter, and patients with spine injuries during the spring quarter. At the same time, the residents will be scheduled with physicians/surgeons who specialize in the areas the residents are studying in the didactic curriculum. To ensure that the residents receive enough experience in hand therapy, they will be participating in on-site weekends for the hand courses taught in the Hand and Upper Quarter Rehabilitation Certification Program, and spending some time with the CHT who works in the office with Dr. Kimberly Accardi during office hours. To provide exposure to patients with TMD the residents will spend time with a maxillo-facial surgeon. Independent Learning: Each resident will be responsible to complete the Current Concepts of Orthopaedic Physical Therapy, 3 rd ed. Independent Study Course between September and January. This is performed during their administrative time or outside of work as needed to complete all 12 modules prior to taking the exam. At this time, the residents will spend their time preparing and focusing their scholarship project, which may range from a case study to case series to involvement in one of our currently running clinical studies. Residency faculty will work closely with the residents to help make this decision early in the fall to allow them the time to get their project started, develop a plan, and work on it throughout the last 2 quarters. By the end of spring quarter, it is expected that that residents projects will be at a level such that he/she can submit for publication prior to completion of the program.

138 131 Example 2 - From UPMC Centers for Rehab Services Geriatric Residency, 2014 The program is designed to provide clinical experience and mentoring throughout the continuum care: acute hospitalization, inpatient rehabilitation, skilled nursing, and outpatient care. Didactic learning experiences begin by focusing on foundation sciences and Medicare reimbursement structure for each setting of care delivery via continuing education home study courses and reimbursement independent study modules. Courses with foundational knowledge, such as the Section on Geriatrics FOCUS home study series, are placed early in the curriculum to lay the foundational knowledge for treatment of the older client. The resident attends additional continuing education courses at times that are as close to the portion of clinical practice which they most directly apply. Perfect sequencing is not always possible due to scheduling that is beyond the control of this program. The Bone Health Independent Study module is scheduled for when the resident is in the outpatient care rotation. This topic is applicable to all settings, but the assessment and treatment specifics for osteoporotic individuals discussed in the module lends itself most to the outpatient environment when clients are less likely to be in the acute stages of recovery from a fracture. The Ethics module takes place over several months starting in January - the timing allows the resident to be fully integrated into the program and occurs during the SNF and IRF clinical rotations where discharge dilemmas and end of life issues more frequently arise. A Reimbursement Independent Study module is assigned at the beginning of each rotation to discuss different aspects of the Medicare payment system. Didactic learning is supplemented by the clinical decision making portion of the curriculum where residents are required to attend weekly Grand Rounds at the University of Pittsburgh Department of Physical Therapy, meet regularly with geriatric PT research faculty at the University of Pittsburg, and eventually present a clinical case in a grand rounds format. In addition, the resident is expected to develop either that oral presentation or another pertinent geriatric related topic into a written format as either a draft suitable for submission to a scholarly journal, or for a company-wide didactic module, or evidencebased project. For more multidisciplinary clinical decision-making, residents attend the Geriatric Medicine Core Curriculum (didactic and journal club) of the Geriatric Medicine Fellowship Program at UPMC St. Margaret Hospital and the Long Term Care Education Series with pharmacy, geriatricians, physician family practice residents, and physician geriatric fellow colleagues. This occurs throughout the program with varied topics that all pertain to the care of older clients. Specialty practice observations are provided with the goals of increasing knowledge of the interdisciplinary nature of healthcare, providing adequate exposure to enhance appropriate referral of clients, and sharpening communication skills about the benefits of physical therapy with other therapist and other health care disciplines. Preparation for observations include readings and information sheets for each experience that detail the expected outcomes from the experience. Residents are then asked to evaluate the experience and its impact on their evolving specialization. There will be some ability to tailor experiences to the resident s interests and areas assessed to require further learning. In addition, we feel strongly that geriatric specialization and professional conduct involves more than the patient care that occurs in the clinic. Therefore, residents are required to attend local physical therapy association district meetings and learn about volunteerism within out professional organization. To understand the various levels of involvement in our association as well as the advocacy efforts undertaken by physical therapists, residents are also required to attend state and national physical therapy meetings as well as a board meeting of both the Pennsylvania Physical Therapy Association and the APTA Section on Geriatrics. Involvement in current or developing company advocacy efforts or community outreach programs is also expected as opportunities arise. The professionalism and advocacy experience culminates with the resident speaking about physical therapy and/or health related issues to legislators or their staff near the end of the residency program.

139 132 Sequencing of Content: Curriculum Content Acute Care Skilled Nursing Inpatient Rehab Outpatient Rotation 1 (August- October) Rotation 2 (November -February) Rotation 3 (March- June) Rotation 4 (July- October) Clinical Practice CP I CP II CP III CP IV Clinical Mentoring CP I CP II CP III CP IV Clinical-Decision Making CDM I CDM II CDM III CDM IV Teaching Internship Didactic Coursework Specialty Practice Observation Professionalism and Advocacy Inservice presentation; APTA Clinical Instructor Course (time offered may vary) FOCUS Home Study CE course; Ind. Study modules; PPTA conference Inservice presentation; TA spring semester Ind. Study modules; HRS 2307; APTA conference Inservice presentation Ind. Study modules; HRS 2307 Inservice presentation; present to other providers Ind. Study modules; Geriatric Orthopedics CE course (time offered may vary) SPO SPO SPO SPO Required professional meetings; PPTA Annual Conference and board meeting (October) Required professional meetings; CSM and SoG board meeting (February) Required professional meetings; meeting with legislator; involvement in advocacy projects as needed Required professional meetings; meeting with legislator; involvement in advocacy projects as needed

140 133 Example 3 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Unit Topic Faculty Assignment 1 Overview of Aging Self Study Self Study 2 Pharmacology and Lab Values Self Study Self Study 3 Models of Physical Therapy Practice Neva Kirk-Sanchez, PT, PhD Weekly Mentoring Forms 4 Interpreting and Using Research in Kathy Roach, PT, PhD Journal Club Clinical Practice 5 Healthcare Delivery Sites Greg Hartley, PT, DPT, GCS, Journal Club CEEAA Jennifer Cabrera, PT, DPT, GCS 6 Musculoskeletal Considerations and Exercise Prescription Topics and Focus Reading 7 Neurological/Sensory Considerations Jennifer Cabrera, PT, DPT, GCS Topics and Focus Reading 8 Vestibular Rehab Marangela Obispo, PT, MS, GCS Topics Reading and Journal Club 9 Cardiac and Pulmonary Considerations 10 Cognitive/Psychiatric Considerations and Psychosocial and Caregiver Issues Meryl Cohen, PT, DPT, CCS EXAM I and LPE Kathy Roach, PT, PhD Topics and Focus Reading Journal Club 11 Geriatric Gain/Posture Aaron Dougherty, PT, GCS PT Journal on Gait Reading and Journal Club 12 Balance/Fall Risk and Functional Assessments and Exercise Prescription Greg Hartley, PT, DPT, GCS, CEEAA Topics Reading 13 Orthotic Considerations Gemma Longfellow, PT, MS, GCS Journal Club 14 Prosthetic Considerations Gemma Longfellow, PT, MS, GCS Topics Reading 15 Health Promotion, Wellness and Aquatic Therapy Gemma Longfellow, PT, MS, GCS Topics Reading and Community Project EXAM II and LPE 16 Principles of Adult Education Mauro Abreu, PT, DPT GCS Journal Club 17 Ethical Considerations Carol Davis, PT, EdD, MS, FAPTA Topics Reading 18 Frail Elderly and Environmental Karen Lagares, PT, DPT, GCS, Topics Reading Adaptations CEEAA 19 Bariatric Medicine, Breast Cancer Karen Lagares, PT, DPT, GCS, Topics Reading and Lymphedema CEEAA 20 Integumentary and Wound Care Jorge Casauay, PT, CWS, GCS Topics and Focus Reading 21 Sexuality and Aging and Sherrie Hayes, PT, PhD Journal Club Incontinence 22 Medicare Regulation & Administration and Consulting, Case Management, and Advocacy Greg Hartley, PT, DPT, GCS, CEEAA Topics Reading

141 134 EXAM III and LPE Administrative Project and Case Report 23 RAI/MDS Aaron Dougherty, PT, GCS Staff Inservice 24 IRF PAI Susan Rodman, PT, MS, CPC Staff Inservice 25 OP Billing and Medicare Part B Greg Hartley, PT, DPT, GCS, CEEAA Staff Inservice Residents begin with some foundational topics, and content then shifts to specific areas of practice. The residents are in different locations (at all times) and rotate through the 3 primary settings during the year. The content taught didactically is applied to their current setting, regardless of where that is. For example, cardiopulmonary considerations for aging adults is taught, then applied clinically in outpatient, SNF, or rehab hospital settings depending on where the resident is located. Concepts are threaded throughout the program and carry over from setting to setting. The last 3 modules listed above (23, 24, 25) are setting specific and are taught 1:1 when the resident is in each of those settings.

142 135 Evidence D Provide the course syllabi, including course description, educational objectives, requirements for successful completion, and instructional methods. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From Brooks Rehabilitation Neurologic Residency, 2014 BPRN Advanced Neurologic Practice Overview Course Description: This course provides valuable information to the resident regarding the foundational sciences including neuroscience, neuroanatomy, neurophysiology, movement science: the behavioral sciences including neuropsychology; the clinical sciences including motor development, culminating in an integrated framework for decision making in the neurologic physical therapy screening, assessment and evaluation, and differential diagnosis. Foundational concepts and advanced skills relative to differential assessment of the neurologic patient will be the emphasis. Course Faculty: Pamela M. Spigel, PT, MHA, NCS Guest Speakers as assigned Contact Hours: Lecture and lab 14 hours Outline of Content: Required Readings: As assigned (available in electronic file) An Integrated Framework for Decision Making in Neurologic Physical Therapy Practice Schenkman, M et al. PT (2006) 86, Recommended Readings: Neuroanatomy through Clinical Cases; Blumenfeld Motor Control Translating Research into Clinical Practice; Shumway-Cook, et al. Cranial Neuroimaging and Clinical Neuroanatomy; Kretschman, et al. Clinical Neuroanatomy made ridiculously simple; Goldbert S Session One: Patient interview, History taking, System Review Session Two: Cognitive Screens, Musculoskeletal Assessment Session Three: Neurologic Exam, Test and Measures Session Four: Evaluation, Prognosis, Goals, POC 3.5 CH 3.5 CH 3.5 CH 3.5 CH Resident Objectives: At the completion of this course the resident will be able to: 1. Perform an interview and ask questions to determine the best systems review process. 2. List the components of the mental status examination and demonstrate the administering of the MOCA and the mini-mental exam. 3. List the components of the neurologic examination and demonstrate on normal individuals.

143 Perform a thorough, timely, neurological examination. 5. Determine and utilize the best tests and outcome measures for the patient s case. 6. Determine diagnosis and prognosis, and best practice plan of care in assigned clinical cases. Teaching Methods and Learning Experiences: Through presentation of didactic information along with discussion of actual clinical cases, the resident will hone clinical decision making and psychomotor skills. Residents will use interactive methods, discussion of pre-readings and group problem solving as methods of inquiry. This material will be tested on Quiz #1 and on the final written exam as well as on all of the practical examinations. Example 2 - From Harris Health System Orthopedic Residency, 2014 Foundation Sciences August - November Instructor(s): Course Description: Dana Tew, PT, DPT, OCS, FAAOMPT Winnie Powell, PT, DPT Meredith Franklin, PT, DPT, GCS This 8 week course is designed to prepare residents from all Harris Health System Physical Therapy Residency programs for management of the complex client. Residents will develop skills for collaboration with fellow health care providers, tools to screen for conditions that mimic and/or accompany common neuro-musculoskeletal conditions, and review the basics of management of musculoskeletal and nonmusculoskeletal conditions that present in the clinic. This course will provide the resident structure and organization for managing clients in a holistic, evidence-based, and autonomous manner. Correlation between clinically relevant anatomy and physiology with patient presentation will comprise the bulk of the neuro-specific lectures, while mentorship will be focused on building the resident s examination and clinical problem solving skills. Goal: Objectives: Develop clinical examination and evaluation skills, with emphasis on differential diagnosis and exercise prescription, for effective patient management. Provide the physical therapist with patient-centered framework for management of bio-psycho-social factors and care coordination in the medically complex population. 1. Residents will demonstrate integration of professional communication, interviewing skills, and physical exam skills through written exams, live patient exams, and during patient care. 2. Residents will continue to demonstrate professionalism commensurate of a doctoring profession (APTA Core Values, APTA Guide for Professional Conduct, HCHD Policies and Procedures) which will be demonstrated weekly through proper preparation for mentoring sessions,

144 137 ability to formulate and answer clinical questions, ability to effectively and efficiently coordinate care for clients including management of interdisciplinary and inter-professional relationships. Grading Requirements: Research Proposal: Exams: ASSIGNMENT WEIGHT Research Design Proposal 20% Written Exam 25% Research Article Presentation 12.5% Practical Exam 20% Quizzes 10% Professionalism 12.5% TOTAL: 100% Residents will be required to prepare a 30 minute presentation on a research topic they would like to investigate. They will be asked to propose a research idea that could be done at Harris Health. Be mindful of availability of participants, personal equipment, and time to make the idea feasible. Requirements of the specific proposal, including grading requirements, will be provided in class. At a minimum the proposal should include a statement of your research question, a summary of the problem, relevance to Harris Health System, and a description of your proposed design. The written exam will be mostly open-ended questions regarding all reading, lecture, and lab material presented during this module. The written exam will take hours. The practical exam will focus on examination skills learned throughout the module. The residents will be asked to perform certain skills on a non-resident staff member. The exam will take 30 minutes. Article Presentations: Professionalism: 12.5% of total Foundations graded A. Each class you will be asked to find an article based on the previous week s discussion that contains the statistical test that was previously discussed. B. Articles must be assed to SharePoint (res_pharm_imaging_weekly article database) no later than Friday the week before you will present. C. Present the article using the top of the article review/critique form (SharePoint site).you will be responsible for understanding and using the bottom of the form for discussion purposes. D. You will be given up to 10 minutes to present the article you chose. Professionalism will be graded based on adherence to Harris Health Systems policies and procedures, Residency policies and procedures, as well as APTA s Core Value and Code of Ethics. Professional behaviors include, but are not limited to: timeliness, preparedness, appropriate and consistent communication with faculty, staff and managers, response to and incorporation of feedback, responsibility, responsiveness, and commitment to learning. Residents are required to maintain their own

145 138 schedules to ensure appropriate patient care and productivity standards are met. They must be present, on time, and prepared for all lectures, labs and mentorship sessions. This includes providing mentors with prep forms at least 24 hours prior to the start of any mentorship session. Residents must be prepared for and score an average of 80% on all quizzes, and maintain the minimum job requirements provided in their job addendum. Residents are expected to participate as a member of the Neurological physical therapy team including acceptance of flex assignments, care coordination with other disciplines, and case managements as appropriate. Additional Requirements: Documentation: A minimum of 3 charts will be reviewed and graded. Grades for documentation will be calculated as a combination score of both quality and content. The staff chart audit form and the attached rubric will be used to score each chart. It is essential that residents meet basic staff chart standards while also presenting a concise professional opinion in an organized and timely manner. Labs: Residents will spend time each week in lab. Please bring lab appropriate attire at least every Thursday; it might be wise to keep appropriate lab clothes available during the week in case lab practice time presents itself during the typical work day. Appropriate attire includes loose fitting gym clothes or scrubs. Staff Meetings: Staff meetings are held from 12:30-1:00pm on the first Thursday of each month for all outpatient employees in Rehab Services at Quentin Mease. Residents, as staff members, are required to attend. Meetings are held in the conference room on the 5 th floor. Productivity: Residents, like staff, are required to meet a standard for productivity in patient care. Productivity is measured monthly, based on the RVUs billed by the resident. The standard productivity requirement for a resident is 67.5 RVUs per week. Adjustments will be made for non-productive time spent in scheduled residency related activities (clinic visits, labs, lectures) not accounted for in the 25% deduction already assumed. Required Readings: To be assigned by individual lecturers. Lecture Schedule: Week 1 Orientation Week 2 Orientation, Patient hand-off Mentorship Orientation Research 1 Week 3

146 139 Teaching and Learning 1 Teaching and Learning 2 Foundations 1: Current healthcare environment, inter-professional communication, patient interview Research 2 Week 4 Research 3 Foundations 2: The neurologic evaluation: subjective Week 5 Research 4 Week 6 Research 5 Foundations 4: Concepts of imaging modalities Week 7 Research 6 Foundations 5: Physical exam and differential diagnosis Week 8 Foundations 6: Critical lab values & exercise considerations for aging and chronic disease Research 7 Week 9 Foundations 7: Written exam Research 8 Live Patient Exam Week 10 Foundations 8: Skills integration and practical exams Attendance and Participation: Academic Dishonesty: Attendance is essential to optimizing time spent within each module and achieving an ideal learning environment for resident growth and development. It is expected that each resident attend all scheduled learning experiences, actively participate in collegial discussion and all learning activities. Scheduled absences will be permitted on a case-bycase basis and require the approval of both the instructor and the program manager. The resident is responsible for coordinating and covering his/her responsibilities to minimize disruption of patient care, staffing, and additional burden on the instructors. It is the resident s responsibility to contact the lead instructor in advance should there be a conflict regarding attendance, scheduling, patient care, module related assignments, or to make arrangements to obtain course materials. Cheating, plagiarism, or other kinds of academic dishonesty will not be tolerated and will result in appropriate sanctions, including failure of an assignment, failure of a module, or dismissal from the program.

147 140 Example 3 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 Unit on Resident Assessment Instrument& Minimum Data Set For Extended Care Facilities and Long-Term Care General Description: Faculty: Fundamental concepts of the RAI and MDS. An overview of the history of assessment instrument, and more thorough presentation of its current use in ECF/LTC facilities will be provided. Aaron Dougherty, PT, GCS; Jorge Casauay, PT, GCS, CWS Teaching Methods: Unit Objectives: Course Outline: Recommended Resources (partial list): Lecture, demonstration (computer-based assessments), chart review, selected readings. Four hours of lecture/demonstration. 10 hours of selfstudy/readings/inservice preparation. Upon completion of this session (unit), residents will be able to: 1. Integrate their basic understanding of geriatric patient assessment as it relates to the RAI/MDS. 2. Evaluate implications of RAI/MDS has physical therapy practice patterns. 3. Discuss the quality of care issues that are part of the RAI/MDS. 4. Provide a rationale as to how the RAI/MDS affects the physical therapy plan of care. 5. Integrate the RUGs classification system into their decision making process when developing a physical therapy plan of care. 6. Demonstrate an awareness of the time requirements for completing an MDS, and how this impacts the delivery of rehabilitation services. 7. Interpret the meaning of a rehabilitation team s assessment as they relate to RUGs classification and the prospective payment system (PPS). 1. Self-study, guided research, readings. 2. Lecture: RAI/MDS introduction, history, quality of care issues, plan of care, practice patterns. 3. Self-study, readings. 4. Lecture: RAI/MDS/RUGs classification. PPS, time frames, impact on delivery of rehabilitative services. 5. Self-study, inservice preparation with guidance as needed. 6. Staff educational inservice presentation. Conditions of Participation Manuals, The Federal Register, PT Magazine, PT Bulletin, Section on Geriatrics Newsletter (GeriNotes) Methods of Evaluation: Completion of an inservice provided to rehabilitation services employees on The MDS: Implications for Rehabilitation Professionals Grading Policy: Pass/Fail using Resident Teaching Evaluation Form

148 141 Evidence A Identify the minimum and maximum amount of time (in months) allowed for the participant to complete the program that is inclusive of remediation and leave of absence periods. If the program provides more than one model (eg, part-time and fulltime) provide the length of the program for each model. (BOTH CANDIDACY AND REACCREDITATION) Example 1 - From MedStar Georgetown University Hospital Women's Health Residency, 2014 The minimum tine required to complete the residency program is 12 months. The maximum time allowed to complete the residency is 36 months allowing for time for remediation as appropriate. Procedure: the residency time period will be designated prior to the start of the program and determined on a case-bycase basis. Completion of Projects: Residents must have completed all aspects of the residency to receive a certificate of completion. This includes clinical rotations, exams, projects and assignments. It is expected that residents will complete all residency related tasks within the designated timeframe. In the event a resident has completed all assignments and clinical components of the program successfully, but has not completed the clinical project or administrative project by the time the clinical portion of the residency is completed, the resident will be allowed up to, but not to exceed, 3 additional months to complete the project. Only then will a certificate of completion be awarded to the resident. An additional time a resident takes to complete these projects does not constitute time in the residency and therefore the resident is no longer considered a employee of MGUH and will not be compensated as an employee (unless the resident was an MGUH employee prior to initiating the residency). The employer/employee relationship ends when the clinical components are completed unless the resident was an MGUH employee prior to initializing the residency. Completion of Clinical Competencies: Residents are evaluated at least 3 times per year as to their performance in the program. During each assessment period, residents develop an action plan to address any deficits. Residents must develop a written action plan detailing how each unsatisfactory area will be discussed in the next rotation/section of the residency. The action plan is to include specific learning objectives which will be reviewed and revised as needed with the faculty. Any revisions will be discussed with the resident. Residents are expected to show improvement from rotation/section to rotation/section. Those who do not will be offered educational advisement where a more specific action plan will be developed in conjunction with the Program Director, including specific behavioral and learning objectives and accompanying timeframes. This will be conducted on a case-by-case basis. Residents who fail to meet expected outcomes in the final rotation of the residency will be offered up to 3 months to satisfy the requirements if the majority of the faculty agree that the resident has the potential to make improvements during that timeframe. Should the program faculty feel the resident would be unable to correct these deficits during a 3 month extension; the resident will not receive a certificate of completion. Example 2 - From Drexel University Orthopedic Residency, 2014 All residents begin the program on the first working day of June of each year. The program is 13 months long. Should a resident require additional time due to a remediation plan, a maximum of 3 months can be added for successful completion of the program.

149 142 Example 3 - From Harris Health System Orthopedic Residency, 2014 The residency is intended to be 54 weeks in length and cannot be completed in less than 1 year. There is extra time built into the curriculum if an individual needs remediation or is placed on academic probation. An individual who is placed on academic probation may not complete the program until the remediation is completed.

150 143 Evidence B Provide a summary of the amount of time previous participants took to complete the program. (FOR REACCREDITATION ONLY) Example 1 - From St. Catherine s Rehabilitation Hospital & Villa Maria Nursing Center Post-professional Residency in Geriatric Physical Therapy, 2009 To date, all residents have completed the program within its allotted time of 12 months. (One current resident will require additional time due to personal medical reasons). Example 2 - From Harris Health System Orthopedic Residency, 2014 To date we have had 12 residency graduates of our program who have all finished the program within the allocated time 1 year, without any occurrences of academic probation delaying graduation. Example 3 - From Brooks Rehabilitation Neurologic Residency, 2014 All of our graduates have successfully completed the program within the allotted timeframe.

151 144 Evidence Use the Form below to list the number of hours dedicated to each instructional method used to achieve the performance outcomes. Single-site and multifacility programs, provide one form that is inclusive of the entire program. For multi-site programs, a separate form is required for each program participant. (BOTH CANDIDACY AND REACCREDITATION) Example 1 For Multi-site Program Only: Include Name of Program Participant PROGRAM COMPONENT INSTRUCTIONAL HOURS Classroom Instruction (List all courses) TOTAL HOURS IN PROGRAM Journal Club Research Activities Home or Independent Study Course(s) Grand Rounds Other: (Please list) INSTRUCTIONAL HOURS SUBTOTAL CLINICAL MENTORING (minimum of 150 hours for residency; 100 hours for fellowship; 130 hours for orthopaedic manual physical therapy fellowships). For non-clinical programs, please provide a total of mentoring hours provided to the participant over the course of the program. 1:1 clinical mentoring/instruction from physical therapist clinical faculty while program participant is treating patients (minimum 100 hours for residency; 50 for fellowship; 110 hours for orthopaedic manual physical therapy fellowship) 1:1 patient/client related planning/discussion/review of participant s caseload and/or physical therapist mentor demonstrating treatment techniques on patients MENTORING HOURS SUBTOTAL CLINICAL HOURS Clinical Practice Clinical Observation Mentoring provided by a non-pt mentor Athletic Venue Coverage (sports residency/fellowship programs only) CLINICAL HOURS SUBTOTAL GRAND TOTAL HOURS IN PROGRAM

152 145 Example 2 - From Harris Health System Orthopedic Residency, 2014 PROGRAM COMPONENT TOTAL HOURS IN PROGRAM INSTRUCTIONAL HOURS Classroom Instruction (List all courses) Evidence Based Practice/Research 16 Exercise Science and Prescription 15 Foundational Science/Differential Diagnosis 15 Lumbo-Pelvic Spine 28 Lower Quarter: Hip, knee, ankle 28 Cervical/Thoracic Spine 28 Upper Quarter: Shoulder, Elbow, Wrist 28 Student Mentorship 6 Pain and Culture 20 Orthotics, Prosthetics, Gait Analysis 12 Journal Club 12 Research Activities 3 Capstone Project (including time for formal presentations) Home or Independent Study Course(s) weeks x approximately 8 hours/week Grand Rounds 36 Other: (Please list) INSTRUCTIONAL HOURS SUBTOTAL 647 CLINICAL MENTORING (minimum of 150 hours for residency; 100 hours for fellowship; 130 hours for orthopaedic manual physical therapy fellowships). For non-clinical programs, please provide a total of mentoring hours provided to the participant over the course of the program. 1:1 clinical mentoring/instruction from physical therapist clinical faculty while program participant is treating patients (minimum 100 hours for residency; 50 for fellowship; 110 hours for orthopaedic manual physical therapy fellowship) 1:1 patient/client related planning/discussion/review of participant s caseload and/or physical therapist mentor demonstrating treatment techniques on patients MENTORING HOURS SUBTOTAL 184 CLINICAL HOURS Clinical Practice 1791 Clinical Observation 6 Mentoring provided by a non-pt mentor Athletic Venue Coverage (sports residency/fellowship programs only) CLINICAL HOURS SUBTOTAL 1797 GRAND TOTAL HOURS IN PROGRAM

153 146 Example 3 - From Brooks Rehabilitation Neurologic Residency, 2014 PROGRAM COMPONENT TOTAL HOURS IN PROGRAM INSTRUCTIONAL HOURS Classroom Instruction (List all courses) BCRF 800 Orientation & Introduction to the Residency 12 BPRN 808 Advanced Neurologic Practice Overview 14 BCRF 825 Evidence Based Practice 8 BCRF 830 Clinical Problem Solving 4 BCRF 835 Research Methods 8 BCRF 845 Educational Theory and Practice 4 BCRF 830 Nutrition for the Clinician 4 BCRF 880 Chronic Pain 4 BCRF 895 Motor Control and Learning 8 BPRO 805 Exercising Dosing 16 BCRF 870 Pharmacology 4 BPRN 890 Non-violent Crisis Intervention 6 BGRF 810 Falls Assessment and Screening 3.5 BGRF 810 Functional Outcome Measures 3.5 BPRN 864 Advanced NPT Management of the patient post-cva 34.5 BPRN 866 Advanced NPT Management of the patient post-sci 34.5 BPRN 874 Advanced NPT Management of the patient post-tbi 34.5 BPRN 876 Advanced NPT Management of the Vestibular Patient 31 BPRN 878 Advanced NPT Management of the Movement DO Patient 25.5 BPRN 884 Advanced NPT Management of the Pediatric Patient 20 BCRF 880 Clinical Gait Analysis 8 BPRN 888 Orthopaedic Management of the Neurologic Shoulder 13 Journal Club (BCRF 870) 24.5 Research Activities 118 Collect and analyze patient data and write up 2 case presentations (60 hours) Develop and orally present 4 case studies (48 hours) Develop and present poster for research day (6 hours) Participate in Brooks Research Day (4 hours) Home or Independent Study Course(s) Grand Rounds Other: (Please list) 214 Teaching a neurologic modules (2 classes) at an area University (20 hours) Supervision of a PT student (100 hours) Community service project (30 hours) Critically analyze 10 peer review articles/upload to Brooks Intranet (20 hours) Program rotation preparation and documentation training (44 hours) INSTRUCTIONAL HOURS SUBTOTAL CLINICAL MENTORING (minimum of 150 hours for residency; 100 hours for fellowship; 130 hours for orthopaedic manual physical therapy fellowships). For non-clinical programs, please provide a total of mentoring hours provided to the participant over the course of the program. 1:1 clinical mentoring/instruction from physical therapist clinical faculty while 130

154 147 program participant is treating patients (minimum 100 hours for residency; 50 for fellowship; 110 hours for orthopaedic manual physical therapy fellowship) 1:1 patient/client related planning/discussion/review of participant s caseload 20 and/or physical therapist mentor demonstrating treatment techniques on patients MENTORING HOURS SUBTOTAL 150 CLINICAL HOURS Clinical Practice 850 Clinical Observation 20 Physician Practice and Clinic (4 hours) Peer Residents (4 hours with each rotation) (16 hours) Mentoring provided by a non-pt mentor Athletic Venue Coverage (sports residency/fellowship programs only) CLINICAL HOURS SUBTOTAL 870 GRAND TOTAL HOURS IN PROGRAM Example 4 - From Drexel University Orthopedic Residency, 2014 PROGRAM COMPONENT TOTAL HOURS IN PROGRAM INSTRUCTIONAL HOURS Classroom Instruction (List all courses) PTRS 590 Advanced Anatomy 30 PTRS 766 Clinical Topics in Extremity Rehabilitation 40 PTRS 765 Spine Rehabilitation Journal Club 30 Research Activities 150 Home or Independent Study Course(s) 96 Grand Rounds Other: (Please list) Lab Teaching Assistant N/A 120 INSTRUCTIONAL HOURS SUBTOTAL 534 CLINICAL MENTORING (minimum of 150 hours for residency; 100 hours for fellowship; 130 hours for orthopaedic manual physical therapy fellowships). For non-clinical programs, please provide a total of mentoring hours provided to the participant over the course of the program. 1:1 clinical mentoring/instruction from physical therapist clinical faculty while program participant is treating patients (minimum 100 hours for residency; 50 for fellowship; 110 hours for orthopaedic manual physical therapy fellowship) 1:1 patient/client related planning/discussion/review of participant s caseload and/or physical therapist mentor demonstrating treatment techniques on patients MENTORING HOURS SUBTOTAL 150 CLINICAL HOURS Clinical Practice

155 148 Clinical Observation 92 Mentoring provided by a non-pt mentor 200 Athletic Venue Coverage (sports residency/fellowship programs only) N/A CLINICAL HOURS SUBTOTAL 1392 GRAND TOTAL HOURS IN PROGRAM 2076

156 Ongoing Evaluation Evidence Describe the process for regular and ongoing evaluation of the program s goals as stated in A. Include how often the goals are reviewed, what would trigger a review, who is responsible for the review, etc. (FOR CANDIDACY ONLY) Example 1 - Adapted from Brooks PT Geriatric Residency, 2012 This is a new program so the review process has been formulated, but will be continually assessed to determine its effectiveness. The faculty expects to learn much over the first year (or more) of how this process will be best accomplished. The faculty are responsible for assessment of the goals, but will report their formal and informal discussions to the Brooks Residency/Fellowship Program Director for further action. The programs goals will be assessed in the following ways: Formal review annually as a component of the Annual Faculty Retreat. Formal review in Faculty Meetings (held at least twice per year) based on feedback from residents as well as observations from the faculty. Informal review among the faculty that will occur as a result of spontaneous dialogue. Something that would trigger an unscheduled review of the goals would be: Modification of one of the core documents such as the Case Report Grading Schema. Unexpected outcomes of the residents. Although unlikely, a change in the Brooks Rehabilitation mission would trigger a review of the program s goals to ensure that we were still in sync with our umbrella organization. Example 2 - From Louis Stokes Cleveland VA Medical Center Geriatric Residency, 2014 See policy Physical Therapy Residency Program: Ongoing Program Evaluation below. In summary, the goals and objectives are reviewed at least annually. An additional review would be triggered when: a) Additional goals are identified b) Change in DSP or practice pattern c) A stakeholder identifies a need for review Policy PHYSICAL THERAPY RESIDENCY PROGRAM: ONGOING PROGRAM EVALUATION I. PURPOSE: To establish timelines for ongoing evaluation of the PT Residency Program including the mission/goal/objectives, faculty/mentors, and curriculum within the Physical Medicine and Rehabilitation Service (PM&RS) II. POLICY: The LSC VAMC Physical Therapy Residency Program complies with VHA Handbook Supervision of Associated Health Trainees and current accreditation requirements of the ABPTRFE. The Physical Therapy Residency functions under a model of continuous performance

157 150 improvement. Feedback is elicited both formally and informally from involved stakeholders, including the resident, mentor(s), and faculty. Improvements, additions, and deletions from established curriculum are considered as they are identified by the participants. III. PROCEDURE: a. The residency curriculum committee meets quarterly and on an ad hoc basis to review content and feedback for complete modules. b. An annual review of the Program is completed by the Faculty and other stakeholders to include: i. Programs Mission, Goals, Objectives 1. Mission as related to umbrella organization, program &DSP 2. For attainment of Program Goals and Objectives for prior academic year ii. Resident Goals and Objectives 1. For attainment of Resident Goals & Objectives for cohort of residents iii. Curriculum for each residency c. Ongoing review of the Mentor (s) and Faculty performance is conducted: i. The resident completes a written assessment of each mentoring session and reviews his/her feedback with the mentor. The written assessments are reviewed with the Program Director. ii. Mentors and Faculty are assessed at least annually by the Clinical Specialist and/or Program Manager. iii. A mentoring session observation is conducted by the Clinical Specialist at least annually. Written and verbal feedback is given to the mentor and reviews by the Program Manager. d. Ongoing assessment of the Resident is conducted: i. The mentor completes a written assessment of each mentoring session and reviews their feedback with the resident. The written assessments are reviewed by the Program Manager. ii. Pre-tests and other assessment tools are utilized to determine knowledge gaps and learning needs. iii. Post-tests and other assessment tools are utilized to determine knowledge assimilation. iv. Two live patient evaluations are completed with the resident and clinical specialist. v. A written evaluation is completed at least once during the program. The resident is allowed two attempts to attain a passing score. e. The following would trigger an ad hoc review and potential change to the program and/or resident s goals and objectives and/or curriculum: i. Changes/updates to the Description of Specialty Practice. ii. Updates in current evidence that triggers a change in clinical practice (eg, new clinical practice guidelines, etc.) iii. Concerns about the quality and/or relevance of a specific portion of the curriculum or mentoring (brought forth by any stakeholder) iv. Inability of resident to master the content area of a specific module due to delivery method or other concern. v. Unavailability of a portion of the curriculum f. Proposed changes to the established module must be reviewed and approved by the Clinical Specialist(s), Program Manager and Faculty prior to implementation. This is to ensure that the DSP content areas will continue to be addressed. g. Upon completion of each module, the resident is responsible for completing a written assessment of each module as a whole and each didactic session (classroom instruction,

158 151 grand rounds, clinic observation, etc.). The assessments are discussed with the faculty responsible for the module and/or didactic. Once this is completed the resident reviews the assessment with the PT Residency Program Manager. IV. FOLLOW-UP RESPONSIBILTY: The Rehabilitation Therapies Service Manger is responsible for reviewing and updating this policy. V. RECISSION: None Example 3 - From St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency, 2013 As in Evidence A, the goals of residency program are to: Provide academic and clinical training in advanced skills in geriatric physical therapy. Facilitate the resident s ability to integrate science and theory with advanced and clinical practice in geriatrics through structured academic and clinical experiences Provide opportunities to develop advanced skills as a consultant in a variety of geriatric physical therapy settings. Provide opportunities to develop advanced skilled as an educator in a variety of geriatric physical therapy settings. Provide opportunities to develop advanced skills as a direct service provider in a variety of geriatric physical therapy settings. Provide opportunities to develop skills in critical thinking and research to enable them to contribute to the geriatric physical therapy profession in the future. Provide opportunities to observe and model behaviors reflecting the highest standards of professionalism as a geriatric physical therapist. Prepare residents academically and clinically to successfully complete the geriatric clinical specialist certification examination by the ABPTS. The program evaluates its performance to the program goals on an ongoing basis via regular faculty meetings and advisory committee meetings. The Advisory Committee meets at a minimum of once a year with the explicit purpose of completing this task. More frequent review is completed by the program director, coordinators, and faculty as needed. Graduate outcome data is collected and summarized annually for the advisory committee for review and revision to the program as needed. An unscheduled review of the program would be triggered by knowledge of failure of the GCS exam by a program graduate or by failure of work performance in a subsequent job (discovered via employer surveys) of a program graduate. The P&P for the advisory committee is below: The committee will be comprised of clinical faculty, academic faculty and at least one CHS corporate officer. There will be a minimum of five committee members who should reflect the diversity of the faculty and staff of St. Catherine s/vila Maria and the Residency Program. Members will be invited to the committee by the Program Director. The committee will meet at least annually for planning and development of activities, including revision to the curriculum, based on outcome measures (Graduate Performance Feedback, pass rate on GCS

159 152 exam, graduate achievement of program goals and objectives). The committee will also revise policies and procedures as needed, review goals and objectives, as well as admission and completion criteria. Additional meetings may be held as needed and will be called by the Program Director and arranged by the Program Coordinators.

160 153 Evidence Summarize the program s annual review process of its goals and describe any changes made over the accreditation period as a result. Describe any triggers that resulted in a mid-cycle review of the program goals. Provide minutes from all meetings over the recent accreditation period. (FOR REACCREDITATION ONLY) Example 1 - From Hospital for Special Surgery Hand Therapy Fellowship, 2015 The program director and faculty perform an annual review of program goals at a faculty meeting each summer in the interim between the completion of one program and the start of the next. In addition, the program director has less formal, ongoing discussions with faculty throughout the year. A midcycle review of program goals was prompted in 2010 due to the publication of a new practice analysis of Hand Therapy (Dimick MP, Caro CM, Kasch MC, et al Practice Analysis of Hand Therapy. Journal of Hand Therapy. Oct-Dec 2009;22: ). Based on this analysis of hand therapy practice, the Hand Therapy Certification Commission revised the definition of hand therapy, changing upper quarter to upper limb, based on current practice trends (most hand therapists report screening and referral versus treatment for patients with cervical spine problems). In response, we updated our program goals to reflect a focus on hand and upper extremity rehabilitation versus the previous hand and upper quadrant rehabilitation.

161 154 Example 2 - From Rochester Regional Health System Neurologic Residency, 2015 The program and resident goals and corresponding objectives are reviewed annually by the residency codirectors, physical therapy supervisor, and core faculty at a review meeting to see if they continue to be relevant, reasonable, attainable, and reflect current practice in neurologic physical therapy. Additional reviews may be conducted as needed if concerns regarding program goals are expressed by any of the program s faculty, co-directors, or the resident himself. During 2014, a mid-cycle review of the program goals took place as a result of the loss of Ithaca College as one of the organizations sponsoring our residency program. At this time, the program co-directors and physical therapy supervisor scrutinized the program goals to see if this change required a goal revision. See evidence tab for program meeting minutes over the recent accreditation period. Example 3 - From Baylor Institute for Rehabilitation & Texas Woman's University Women's Health Residency, 2015 The mentors, clinic management, and faculty from Texas Women s University meet multiple times throughout the year to discuss resident performance and logistics of the residency. The main meetings regarding residency goals and evaluations happen in November and March. Besides discussing any issues with the residents and logistics of transitions in November, we discuss the Summer and 2 Fall Courses, changes to be made regarding curriculum for the next year, and any glaring omissions in the resident experience at that time so we have several months to make sure the resident has exposure to all the diagnoses. We assess to see if we are on track to meet our goals and can adjust midyear to make sure the residents see certain types of patients, have exposure to different educational opportunities, and staff is meeting their obligations. In March we begin preparations for the new residents. We re-evaluate oru forms we are using for mentoring and clinical reasoning, we reflect on our own performance, we re-assess our goals and the resident s goals, and adjust the schedule for the upcoming year. There have been no significant changes to the goals of the residency, however how we reach those goals has changed due to our review process. The forms we use for mentoring and how the resident is required to document reflection on practice has changed. We also changed the skills check list and live patient examination in year 3 to more accurately measure progress and improve ease of use. Please see appendix for a sample of meeting minutes demonstrating discussion of residency goals. Binder with minutes for the last 5 years is available for review during the site visit.

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