Sinclair CollegeDivision of Health Sciences

Rehabilitation Services DepartmentPhysical Therapist Assistant Program

Student Handbook

Last revised April 2017; August 2017, Effective August 2017

TABLE OF CONTENTS

ContentAssociated CAPTE

Standard(s) Page

Welcome 4Sinclair Information

Important Sinclair Policies 3D, 5B 5Student Services 5B, 8H 5

Physical Therapist Assistant (PTA) Program InformationContact Information 4A 6Requirements to Start and Remain in Limited Enrollment Classes 7Mission Statement 1A 8Program Goals and Outcomes 1B, 1C 8Curriculum 7A, 7B, 7C 9Course Descriptions 10-11Clinical Education 12-13PTA Program Community 13Authorization for Release of Records 14Essential Functions of a Physical Therapist Assistant 15-21College-wide Background Check Policy 22Grading 5B 23Assessment Tools 2A 23Assessment 2A 24-26

BehaviorExpected Behaviors in Physical Therapy 27Required Behaviors in the PTA Program 27Professional Behaviors and Clinical Education 28

PTA Program Policies and Procedures 2B5, 5DClassroom / Laboratory Rules 29Attendance 30-32Academic Lab Computer Usage 33Lab Attire and Behavior 34Faculty Advising and Meetings 35Problem Resolution /Complaint Process 36Reinstatement 5E 37-39Photography Release and Program Volunteer 40

Safety 5DStudent Assumption of Risk and Release of Liability 41Infection Control 42

Additional InformationPTA Program Curriculum Plan Standard 6 43Assessment, Planning, and Program Improvement 2C, 2D 44

Forms to Be Completed and Returned to the ProgramHonor Code 45Student Acknowledgement of Risks & Obligations Associated with Laboratory and Clinical Education Experience

46-47

2

Student Assumption of Risk and Release of Liability 48Emergency Contacts 49Photography Release 50Authorization to Interview and Participate in Lab Activities 50Acknowledgement 51

Forms for Future UseNon-Attendance Petition Form 53Student Petition for Reinstatement 54PTA Program Reinstatement Rubric 55-56

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Welcome

I would like to welcome you to the Sinclair Community College (SCC) Physical Therapist Assistant (PTA) Program. Use this student handbook as a guide to assist you with your formal educational training. You are required to read this handbook and adhere to all of the policies and procedures of the program and of the college. Upon successful completion of the PTA program, SCC will confer an Associate of Applied Science (AAS) degree.

During instruction of potential graduates of the PTA program, it is the responsibility of the PTA program faculty to meet the requirements of the following organizations: SCC, the Commission on Accreditation in Physical Therapy Education (CAPTE), and the American Physical Therapy Association (APTA). It is also important to take into account the current trends of the health care profession, including evidence-based practice.

You are advised to use all available resources to increase your chances of success. These resources include the PTA program faculty, Academic Advising, Counseling Services, and many other student services at your disposal. While the faculty are here to help provide you with the knowledge and skills to graduate, it is your responsibility to take ownership of your own education and self-assess your abilities, maximizing your strengths while proactively addressing areas needing improvement. This will require respect, open communication, and a willingness and desire to learn about yourself and others. The ultimate goal of the program is to graduate skilled Physical Therapist Assistants who exemplify the professionalism and commitment to learning that is necessary to successfully meet the challenges of the changing profession.

The curriculum, assessment processes, lab and classroom activities, and clinical experiences are designed to prepare students for becoming a member of a healthcare team. With your existing knowledge base and skills as a foundation, the learning materials, textbooks, lecture content, and case studies will expand upon your previous experiences and enhance your achievement within the physical therapy realm. The faculty and clinical instructors are comprised of licensed Physical Therapists (PT) and PTAs and should be looked upon as role models, mentors, and future colleagues. Successful progression through the curriculum and clinical practicums will determine your readiness to graduate and eligibility to sit for the licensing examination. While passing grades are objective measurements of your educational achievements, they are not the sole determinant of your success. Technical skills, professional behavior, and individual responsibility are additional measures of student success.

I wish you luck as you begin this endeavor and look forward to working with you.

Emily Garber, Chairperson, Rehabilitation ServicesPTA Program Director

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Important Sinclair Policies

All Sinclair students are expected to abide by Sinclair policies and procedures.

Student Code of Conduct

Academic Integrity Policy

Standards of Academic Progress: Academic Intervention, Probation, and Dismissal

Student Records Policy and the Federal Education Rights & Privacy Act (FERPA)

Acceptable Use of Information Technology Policy

Plagiarism Explained

Student Honor Code

Health Science Division Policies

Health Insurance Requirement (http://www.sinclair.edu/academics/divisions/hs/health-insurance-requirement/)

Background Check (http://www.sinclair.edu/www/assets/File/Hom-Aca-AcaDiv-HS/BackgroundCheckPolicy.pdf)

Behavioral Standards (http://www.sinclair.edu/www/assets/File/Hom-Aca-AcaDiv-HS/Behavioral%20Expectations%20for%20HS%20Students%202%2029%2016.pdf)

State Authorization (http://www.sinclair.edu/academics/divisions/hs/state-authorization/)

Student Services Academic Advising Career Advising Counseling Services Disability Services

Financial Aid & Scholarships

Library Ombudsman Student and Community Engagement

Testing Center Tutorial Services Writing Center Service Learning

5

Contact Information

Physical Therapist Assistant faculty members hold professional credentials as Physical Therapists (PTs) and Physical Therapist Assistants (PTAs) and maintain licensure though appropriate continuing education as approved by the Ohio Occupational Therapy, Physical Therapy, and Athletic Trainers Board. Faculty include full-time tenured, tenure track, and annually contracted faculty, as well as, part-time adjunct faculty. Clinical instructors (CIs) are licensed PTs and PTAs who interact with faculty to assure a rich learning experience for the student in the clinical setting. They provide a crucial link between the academic faculty and the clinical environment.

Full-Time Faculty (Dayton Campus)

Emily Garber, PTAssociate ProfessorChairperson of Rehabilitation Services / PTA Program DirectorOffice: 14-320ATelephone: 937-512-3460Student Hours: By Appointment

Debra Belcher, PT, DPTProfessor Office: 14-320DTelephone: 937-512-5455Student Hours: By Appointment

Kalette Hittle, PTA, ATCAnnually Contract FacultyOffice: 14-320FTelephone: 937-512-3183Student Hours: By Appointment

Full-Time Faculty (Mason Campus: Courseview Campus Center - CVCC)

Jim Cropper, PT, DPT, MSProfessor / CoordinatorOffice: 108ATelephone: 937-512-5533Student Hours: By Appointment

Heather Stoner, PTA, MPHAssistant Professor / Academic Coordinator of Clinical Education (ACCE)Office: 111ATelephone: 937-512-5534Student Hours: By Appointment

Adjunct Faculty (As of 8/18/17)

David Brush, PTA Steve Eilerman, PT Megan Fredrick, PT Heather Fronk, PTCarol Jahn, PTA Dianne Khebreh, PTA Mike Klapheke, PT Kristi Krupke, PTARegina McCall, PT Jeremy Clay, PTA Becky Parr, DPT Bev Denny, PTAbby Snook, PT Julie Webb, PTA Doug Westerman, PTA Zack Whitehead, PTASara Young, PT Erin Sinkfield, DPT Brad Harmon, PTA Kelly Hasty, PTAJames Scharf, PTA Amy Schlessman, PTA

Staff

Eileen Trentman (Dayton Campus)Administrative Assistant IOffice: 14-313BTelephone: 937-512-5355

Trese Dvorsky (CVCC)Administrative AssistantOffice 108Telephone: 937-512-5522

Health Sciences (HS) Division

Rena Shuchat, RDH, EdDDean, Health Sciences DivisionOffice: 14-310B

Jan Mains, MS, RNAssistant Dean, Health Sciences DivisionOffice: 14-321

Brenda MarcksAdministrative Assistant II to HS DeanOffice: 14-310CTelephone: 937-512-2919

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Requirements to Start and Remain in Limited Enrollment Classes

Requirements Prior to Starting PTA Limited Enrollment Classes

Prior to beginning their Fall coursework students are required to do the following: Attend Student Orientation and Mandatory Meeting (as scheduled by PTA program) Complete all health requirements

o Health professional’s signature verifying student’s ability to perform Essential Functions of a PTAo 2-Step Mantoux (or Quantiferon Gold) or chest x-rayo MMR titer, demonstrating immunity, or appropriate boosterso Up-to-date Td or TDap immunizationo At least the 1st step of the 3-step HepB vaccineo Varicella titer

BCI&I and FBI Background Check with BCI & FBI Fingerprinting Verification Form (See Health Science Division Background Check Policy for more information – HYPERLINK).

Completed Authorization for Release of Records Form.

Students who do not submit these forms by the due date will not be able to start the limited enrollment classes of the PTA Program. Exceptions may be made under extenuating circumstances, subject to review by the PTA program director and the Academic Coordinator of Clinical Education (ACCE). Any request for an exception must be communicated to the ACCE well in advance of the due date.

Requirements to Remain in PTA Limited Enrollment Classes

To remain enrolled in PTA limited enrollment classes students are required to do the following: Complete annual influenza vaccine Complete all health requirements

o Health professional’s signature verifying student’s ability to perform Essential Functions of a PTAo 1-Step Mantoux (or Quantiferon Gold) or chest x-rayo Up-to-date Td or TDap immunizationo All 3 steps of the HepB vaccine

New BCI&I and FBI Background Check Demonstrated proof of personal health insurance

Students who do not submit these forms by the due date will be unable to initiate clinical rotations. There will be no exceptions to this policy.Clinical sites may have other, additional requirements beyond those of the Sinclair PTA Program (e.g. drug tests, nicotine screenings, orientation meetings, etc.). Students are responsible for completing these requirements at their own time and expense.

Requirements for Reinstated Students Students who are reinstated to the PTA Program are required to have up-to-date immunizations and health records completed at the time of reinstatement. Failure to do so will prevent the student from re-entering the PTA Program’s limited enrollment classes.

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PTA Program Mission Statement

The Physical Therapist Assistant program fosters an interprofessional approach to provide high quality, innovative, and evidence-based physical therapy education to individuals seeking the opportunity to practice as a physical therapist assistant and promote the movement system as a means of improving the health and wellness of patients, clients, and the community.

PTA Program Goals and Outcomes

Program Goal Program Outcome Associated Courses

Collaborative delivery of ethical, legal, and culturally competent health care

1. Participate in the health care environment in an ethical and legal manner that demonstrates an understanding of the values, roles, and responsibilities of a physical therapist assistant in order to deliberatively work in collaboration with patients and members of the health care team with respect for diversity, culture, and the human experience. (Affective)

ALH 1101, PTA 1000, PTA 1100, PTA 1140, PTA 1200, PTA 1215, PTA 1220, PTA 1230, PTA 1235, PTA 1245, PTA 2305, PTA 2315, PTA 2320, PTA 2325, PTA 2330, PTA 2335, PTA 2400, PTA 2405, PTA 2430, PTA 2435, SOC 1100 or SOC 1101 or SOC 1145

Effective communication and interpersonal interaction

2. Demonstrate effective use of oral, written, and nonverbal communication and appropriate use of technology to enable the coordination, provision, and documentation of caring and compassionate services, assist with the education of consumers and other health care professionals, and find a shared language and meaning to manage and resolve conflict with integrity and professionalism. (Cognitive, Affective)

PTA 1000, PTA 1100, PTA 1125, PTA 1135, PTA 1140, PTA 1145, PTA 1200, PTA 1215, PTA 1220, PTA 1230, PTA 1235, PTA 1245, ENG 1101, PTA 2305, PTA 2315, PTA 2320, PTA 2325, PTA 2330, PTA 2335, PTA 2405, PTA 2430, PTA 2435, COM 2206 or COM 2211 or COM 2225

Quality patient care grounded in critical thinking, problem solving, and current evidence

3. Provide quality patient-centered care as outlined in the plan of care developed by the physical therapist and use critical thinking, problem solving, and current evidence to demonstrate competence in administering appropriate tests and measures and selecting safe and effective interventions in order to meet expected outcomes in a fiscally responsible manner. (Psychomotor, Cognitive)

BIO 1141/1147, PHY 1106/1107, PTA 1100, PTA 1120, PTA 1125, PTA 1135, PTA 1140, PTA 1145, ALH 2220, BIO 1242/1248, PTA 1200, PTA 1215, PTA 1220, PTA 1230, PTA 1235, PTA 1245, PTA 2305, PTA 2315, PTA 2320, PTA 2325, PTA 2330, PTA 2335, PTA 2400, PTA 2405, PTA 2430, PTA 2435

Lifelong learning and continuous improvement based on assessment and informatics

4. Utilize informatics in the process of continual assessment to identify appropriate personal growth and professional development activities and lifelong learning opportunities for the purpose of striving for excellence in achieving goals, meeting outcomes, and responding to the evolving nature of education, research, and practice. (Cognitive, Affective)

PTA 1000, PTA 1100, PTA 1145, PTA 1230, PTA 1245, PTA 2320, PTA 2330, PTA 2335, MAT 1470, PTA 2400, PTA 2430, PTA 2435

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Curriculum

The PTA program curriculum is developed with input from faculty, clinicians, graduates, community leaders, a program advisory committee, guidelines from the American Physical Therapy Association (APTA), the Commission on Accreditation in Physical Therapy Education (CAPTE), and the Ohio Board of Regents (OBOR). Students are awarded an Associate in Applied Science degree upon graduation.

Effective Fall 2016Course # Course Title Credits

Prerequisites to Qualify for PTA Limited Enrollment/Restricted Courses

ALH 1101 Introduction to Healthcare Delivery 2BIO 1141 Principles of Anatomy and Physiology I 4PHY 1106/1107 Physics for Technology 3PTA 1000 Introduction to Physical Therapy 2

Total 11

Semester 1 PTA 1100 Professional Issues 1PTA 1120 Functional Anatomy Lecture 1PTA 1125 Functional Anatomy Lab 4PTA 1135 Introduction to Manual Therapy 2PTA 1140 Introduction to Therapeutic Exercise Lecture 1PTA 1145 Introduction to Therapeutic Exercise Lab 2ALH 2220 Pathophysiology 3BIO 1242 Principles of Anatomy and Physiology II 4

Total 18

Semester 2 PTA 1200 Pathology for the Physical Therapist Assistant 3PTA 1215 Functional Mobility 2PTA 1220 Neuropathology 1PTA 1230 Orthopedic Principles and Application Lecture 1PTA 1235 Orthopedic Principles and Application Lab 2PTA 1245 Clinical Assessment for the PTA 2ENG 1101 English Composition 3

Total 14

Semester 3 PTA 2305 Neuromuscular Rehabilitation 2PTA 2315 The Medically Complex Patient 1PTA 2320 Modalities I Lecture 1PTA 2325 Modalities I Lab 1PTA 2330 Seminar for Clinical Practicum I 1PTA 2335 Clinical Practicum I 2MAT 1470 College Algebra 3

Total 11

Semester 4 PTA 2400 Special Topics 1PTA 2405 Modalities II Lab 1PTA 2430 Seminar for Clinical Practicum II 1PTA 2435 Clinical Practicum II 2PSY 1100 orSOC 1101 orSOC 1145

General Psychology orIntroduction to Sociology orIntroduction to Cultural Anthropology

3

COM 2206 orCOM 2211 orCom 2225

Interpersonal CommunicationEffective Public SpeakingSmall Group Communication

3

Total 11

Total PTA Program Credits 65

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Course Descriptions

PTA 1000: Introduction to Physical Therapy - Introduction to Physical Therapy – Purpose, philosophy, history and development of the physical therapy (PT) profession; physical therapist assistant (PTA) duties; PT/PTA relationship; essential functions; legal and ethical responsibilities and professional behaviors; function of regulatory agencies, licensing bodies and professional associations; PTA program expectations; physical therapy practice; communication basics; medical terminology. Two credits: Two classroom hours per week.

FALL (Year 1):

PTA 1100: Professional Issues - Scope and practice of the physical therapist assistant (PTA); role and responsibilities of the PTA in relation to the health care team; values and ethics; communication and introduction to documentation with an emphasis on medical terminology; critical thinking; teamwork and interprofessional collaboration; culture and spirituality in health care; stress management. One credit: One classroom hour per week.

PTA 1120: Functional Anatomy Lecture - Human anatomy and clinical kinesiology with emphasis on integration of neuromusculoskeletal anatomy, physiology, physics principles and biomechanics in relationship to human movement. One credit: One classroom hour per week.

PTA 1125: Functional Anatomy Lab - Application of human anatomy and clinical kinesiology with emphasis on integration of neuromusculoskeletal anatomy, physiology, physics principles and biomechanics in relationship to human movement. Four credits: Eight lab hours per week.

PTA 1135: Introduction to Manual Therapy - Introduction to palpation and therapeutic touch; massage and manual therapy for soft tissue; patient draping; physiological effects, therapeutic applications, contraindications, soft tissue mobilization and myofascial release for the body. Two credits: Four lab hours per week.

PTA 1140: Introduction to Therapeutic Exercise Lecture - Theory of the use of basic therapeutic exercises and functional activities. One credit: One classroom hour per week.

PTA 1145: Introduction to Therapeutic Exercise Lab - Performance of basic treatment, therapeutic exercises, and functional activities. Two credits: Six lab hours.

SPRING (Year 1):

PTA 1200: Pathology for the Physical Therapist Assistant - Recognition of pathology and clinical rationale for the appropriate therapeutic management of physiological responses in body systems associated with commonly treated pathological conditions. Three credits: Three classroom hours per week.

PTA 1215: Functional Mobility - Theory, clinical rationale and application of therapeutic interventions utilized in the practice of physical therapy, with emphasis on demonstration of knowledge, skillful performance and patient education related to functional mobility and gait training. Two credits: Six lab hours per week.

PTA 1220: Neuropathology - Structure and function of the nervous system; recognition of pathology and clinical rationale for the appropriate therapeutic management of commonly treated neurological diseases/conditions. One credit: One classroom hour per week.

PTA 1230: Orthopedic Principles and Application Lecture - Clinical rationale for the use of basic treatment, therapeutic exercises, functional activities, and special tests for common orthopedic and musculoskeletal diagnoses seen in a general population. One credit: One classroom hour per week.

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PTA 1235: Orthopedic Principles and Application Lab - Application and performance of basic treatment, therapeutic exercises, functional activities, and special tests for common orthopedic and musculoskeletal diagnoses seen in a general population. Two credits: Six lab hours per week.

PTA 1245: Clinical Assessment for the Physical Therapist Assistant - Theory, clinical rationale, application and performance of common tests, measures, and data collection procedures utilized in the practice of physical therapy. Two credits: Six lab hours per week.

FALL (Year 2):

PTA 2305: Neuromuscular Rehabilitation - Use of therapeutic interventions for neurological and pediatric pathologies. Two credits: Four lab hours per week.

PTA 2315: The Medically Complex Patient - Theory and application of physical therapy treatment techniques for more complex and specialized diagnoses across the lifespan including, but not limited to, cardiovascular, pulmonary, and multisystem disorders; recognition of psychosocial concerns associated with aging and end-of-life. One credit: Three lab hours per week.

PTA 2320: Modalities I Lecture - Physiology and clinical rationale for use of commonly used passive and mechanical physical agents. One credit: One classroom hour per week.

PTA 2325: Modalities I Lab - Application of commonly used passive and mechanical physical agents, with emphasis on safe application of the treatment intervention. One credit: Three lab hours per week.

PTA 2330: Seminar for Clinical Practicum I - Integration of didactic and clinical skills and their application of principles in the clinical setting including, but not limited to, concepts related to billing, insurance, and quality assurance. One credit: One classroom hour per week.

PTA 2335: Clinical Practicum I - Introductory experience in the clinical setting under the supervision of a clinical instructor who is a physical therapist or physical therapist/physical therapist assistant team. Application of theories and techniques for patient interventions, and interprofessional collaboration. Two credits: Fourteen practicum hours per week.

SPRING (Year 2):

PTA 2400: Advanced Topics - Exploration of specialty and niche areas of physical therapy practice and ethical situations; resume writing; utilization of current evidence to educate others; participation in volunteerism/service learning and professional/community organizations. One credit: One classroom hour per week.

PTA 2405: Modalities II - Physiology and rationale for use and application of biophysical agents including, but not limited to, hydrotherapy, biofeedback, light therapies and taping. One credit: Two lab hours per week.

PTA 2430: Seminar for Clinical Practicum II - Integration of didactic and clinical skills and their application of principles in the clinical setting including, but not limited to, career development and lifelong learning, risk management, and defensible documentation; preparation for national licensure. One credit: One classroom hour per week.

PTA 2435: Clinical Practicum II - Advanced experience in the clinical setting under the supervision of a clinical instructor who is a physical therapist or physical therapist/physical therapist assistant team. Application of theories and techniques for patient interventions, documentation, and interprofessional collaboration. Two credits: Fourteen practicum hours per week.

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Clinical Education

Clinical education is an integral and necessary component of the Sinclair PTA Program. Prior to participating in clinical experiences in PTA 2335 and PTA 2435, every student will have the opportunity to observe in clinical settings as a portion of various classes within the curriculum. These observations will be part of assignments designed to improve the student’s understanding of activities that occur within the clinical setting and to reinforce skills learned in the classroom.

Each student will be assigned to two 7½ week clinical rotations during the Fall (PTA 2335) and Spring (PTA 2435) of the 2nd year in the program. There is a corresponding seminar class that spans across the time students are on each clinical rotations (Fall – PTA 2330; Spring – PTA 2430). The Academic Coordinator of Clinical Education (ACCE), is responsible for setting up each of these clinical rotations.

Criteria for determining clinical placement for each student include:

- Providing each student with experience in a variety of settings- Generally, students are assigned to 1 inpatient setting (hospital, skilled nursing facility, rehab department, long term acute care center, inpatient pediatric center, transitional care center, home health) and 1 outpatient setting (outpatient orthopedic center, industrial rehab center, sports medicine center, pediatric rehab center, home health).- Students may be required to travel up to 60 miles from the Sinclair campus to which they are assigned or from their residence.

The ACCE is responsible for making clinical assignments. Generally, students may not select where they perform their clinicals. However, a student may request to do a clinical rotation in a location outside of the Cincinnati or Dayton region. Because all clinical sites must have an active affiliation agreement with Sinclair’s PTA Program, such a request must be made as early as possible so that the ACCE has an opportunity to attempt to develop a contractual arrangement with a clinic site in the distant location. Clinical education experiences outside of Ohio must be approved through Sinclair’s State Authorization policy (http://www.sinclair.edu/academics/divisions/hs/state-authorization/).

Students are notified of their clinical placements approximately 4-6 weeks prior to the beginning of their clinical rotation, allowing them time to contact their Clinical Instructor and determine driving and housing arrangements, when necessary.

Students are required to have at least the following, prior to initiating their first clinical rotation:

All health requirements American Heart Association BLS Provider CPR Clinical Performance Instrument Training New BCI&I and FBI Background Check Demonstrated proof of personal health insurance

*Note: The Sinclair PTA Program does not disallow entry into its limited enrollment classes based on prior criminal convictions. However, entrance into the Sinclair PTA Program is not a guarantee that the student will qualify to participate in required clinical experiences or for Ohio licensure. See Health Science Division Background Check Policy (HYPERLINK). Any student who is denied participation in a clinical experience by a facility due to a prior criminal conviction will automatically be disqualified to continue in the Sinclair PTA Program and will be advised to withdraw and seek career guidance via Academic Advising.

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All of these requirements are at the student’s expense. (The cost of the above requirements vary, dependent on health insurance, financial aid, immunization needs, etc.., but may cost upward of $500 in total). There may be other requirements of the individual clinic sites, e.g. drug screen, nicotine screen, internal background check, etc. These requirements may be at the student’s expense if the clinic site does not pay for them.

The ACCE will meet with all students in a timely fashion to assure they have all necessary information to complete these requirements. All other requirements will be explained and initiated after the meeting between students and ACCE. If certain requirements are initiated too early, they may expire prior to the end of clinical affiliations and have to be repeated.

PTA 2335 and PTA 2435 are classes within the PTA Program curriculum. Students have assignments for these classes while on their clinical sites that coincide and relate to the clinical education they are receiving. The student’s Clinical Instructor (CI) assesses the student while on the clinic site and provides input that assists the ACCE in determining the student’s final grade for each clinical rotation.

PTA PROGRAM COMMUNITY (eLEARN)

The PTA Program Community in eLearn is accessible to active PTA students, and is a repository for important information that students may need to access across the curriculum. The Community is also a place where students may be asked to upload required materials and documents.

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Authorization for Release of Records

I understand that, as a student in the Sinclair Community College PTA Program, certain personal information is required by most health care settings as a prerequisite for student observation and clinical affiliation.

I further understand that in order for the Sinclair Community College PTA Program to assure overall health, safety, and readiness to perform in the classroom, as well as in clinical settings, the College must have access to this personal information.

I hereby provide authorization for the faculty and staff of the Sinclair Community College PTA Program to access personal information that has been stored within the Certified Background Checks website and share it with clinical observation and affiliation facilities upon request.

This authorization begins from the date I was notified of my selection to restricted PTA courses, and will terminate upon graduation, dismissal, or failure from the Sinclair Community College PTA Program.Personal information associated with this authorization includes, but is not limited to:

Medical health status and ability to perform the Essential Functions of a PTA Immunization information Authorization and acknowledgement forms provided and required by the Sinclair PTA Program Proof of CPR certification for the Health Care Professional FBI and BCI background checks Proof of health insurance Other tests requested and required by clinical sites in which you observe or perform clinical affiliation (e.g.

drug screening, nicotine screening,…)

___________________________________________________Name (Print)

___________________________________________________Signature

___________________________________________________Date

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Sinclair Community College

Physical Therapist Assistant (PTA) Program

Essential Functions for PTA Students

To assure safe and successful advancement through the PTA program, the physical, sensory, communication, cognitive/behavioral and social/behavioral functions listed below are the minimum requirements for all students and graduates. The Essential Functions are listed with a projected frequency that a graduate of the PTA program would expect to encounter while practicing as a PTA. However, the frequency may vary depending on the work setting.

Each PTA student is assessed throughout the curriculum to determine his/her ability to effectively and safely perform these functions in both the educational and clinical settings. Each PTA student must demonstrate competency in all of the Essential Functions to complete the PTA Program. Performance expectations are outlined in each required PTA course and must be passed to remain in the program. Terms are 16 weeks in length, and classes involving clinical functions begin the first term in the program.

Each PTA student must demonstrate the ability to complete clinical instruction in a variety of practice settings, to successfully complete the PTA curriculum, including, but not limited to: inpatient rehab, acute care facilities; skilled nursing facilities; adult and pediatric rehab units; outpatient centers for adults and pediatric clients; home health agencies; school-based therapy; hand clinics; and mental health facilities.

If a PTA student (or prospective student) has a disability or physical or mental condition (either temporary or chronic) which may impact his/her ability to perform the Essential Functions, this must be indicated on the Student Health Certificate filled out by the student’s health care provider. The student must register with Sinclair’s Disability Services Office as soon as possible and provide all required documentation and information as directed. An employee in Disability Services will contact the PTA Program Director or Academic Fieldwork Coordinator to make a preliminary determination of whether the PTA student is able to perform the essential functions and requirements of the PTA program, including specifically the listed Essential Functions, with or without reasonable accommodations, or whether any reasonable modifications may be made to the essential functions and requirements. These matters will be discussed with and input sought from the student before any final decision is made. The final decision of whether any accommodation or modification can be implemented resides with Sinclair Community College.

Student: Physician must complete and sign the Student Health Certificate after reviewing the PTA Program Essential Functions.

Refer to the Office of Disability Services for further information and clarification (room 10-421).

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Performance Frequency: O = occasionally 50-74%; F = frequently 75-89%; C = constantly 90-100%Physical Skill Context in which Physical Skill is Used Performance

Frequency:LIFTING: Partially bear weight of people weighing up to 300# safely

during transfers from a variety of surfaces Positioning of people weighing up to 300# Assisting with functional mobility with a person up to 300#

F

LIFTING: Independently & safely demonstrate the strength to carry/maneuver heavy equipment weighing up to 50#

F

BENDING/STOOPING:

Adjust body parts, clothing and/or equipment F

KNEELING: Assist people who may trip, fall, faint Perform CPR Work with people on the floor/mat Developmental activities ADLs/IADLS/work/Play/Leisure/Social Participation activities

F

CROUCHING: Manage wheelchair and other equipment Place/store equipment & materials Assist with lower body ADLs Assist person with seated activities

F

CRAWLING: Work with children on developmental activities Engage in activities on floor

O

REACHING: Retrieve items from multiple locations Adjust equipment Guard people

F

HANDLING: Sustain grasp Manipulate body parts, tools, equipment

C

DEXTERITY: Fine motor functions to perform standardized assessments Fine motor functions to construct, maintain and/or repair

orthotic devices/splints & adaptive equipment Fine motor functions to document

C

STANDING: Stand for extended periods of time up to 6-8 hours/day CWALKING: Safely & timely walk within facility for up to 6-8 hours/day

Safely & timely walk over various surfaces (even, uneven, variety of terrains) inside/outside

C

PUSHING/PULLING

Wheelchairs with people up to 300# without assistance Scooters Hoyer lifts with people up to 300# with or without assistance Other equipment (i.e. IV poles, O2 tanks)

F

BALANCING: Assist people with functional activities sustaining Good balance (w/o losing balance) on even & uneven surfaces

Ascend/descend 1 flight of stairs

C

ENDURANCE Tolerate full-time work (32-40 hours/week) CBODY MECHANICS:

Utilize proper body mechanics performing all physical functions

Ability to perform complex motor functions necessary to provide therapeutic intervention (exercise, functional mobility, transfers, ADLs/IADLs and emergency treatment to patients).

C

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Sensory Functions

Context in Which Sensory Function is Used Performance Frequency:

TACTILE: Feel to palpate contractions Feel to palpate pulses Feel bony landmarks Feel to identify joints Exert adequate pressure Feel varying skin textures Differentiate between hot/cold Differentiate between sharp/dull

C

AUDITORY: Hear verbal instructions Hear distress sounds & calls for assistance up to 10 feet away Hear environment safety alarms Hear for communication from other team members

C

VISUAL: See in detail client’s movements, facial expressions and performance

See and attend to behaviors & needs of up to 5 individuals in a group setting

See in detail to detect changes in skin integrity, sweating, skin color, swelling, muscle atrophy

See to detect non-verbal communication See to detect environmental hazards Read documents Read equipment dials Read manuals/forms Read research material

C

Communication Functions

Context in Which Communication Function is Used Performance Frequency

SPEAKING: Speak clearly & concisely using proper English in person & via telephone with other team members

Establish rapport with other team members Motivate and engage others in treatment

C

RESPONDING: Respond to & communicate with others with communication disorders (i.e. aphasia, hearing loss)

Respond to & communicate with others from a different background/culture

Accurately report findings/results/plans to other team members 1:1 and in team meetings using proper English

F

COMPREHENDING: English oral language English written language

C

WRITING: Clear, legible handwriting Computerized documentation Write in proper English

C

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Cognitive/Behavioral and Social/Behavioral Functions Performance Frequency

Use critical thinking, problem-solving, and sound clinical reasoning in the delivery of physical therapy services including, but not limited to the following:

o Planning and implementing appropriate client-centered interventions.o Making appropriate modifications to therapeutic interventions based on

the client’s physiological and psychological responses.o Identifying the need for consultation and determining the appropriate

resource (i.e. physical therapist or other health care providers/team members).

C

Effectively cope with stress in order to function safely and calmly under demanding educational and changing clinical environments.

C

Be aware of surroundings and alert to potential emergencies; respond appropriately to client situations including pain, changes in physical and/or mental status, and risk for falls.

C

Manage time effectively; prioritize multiple tasks; maintain composure in situations that require multitasking.

C

Maintain concentration and focus to attend to demanding and continuous tasks throughout the entire class/lab and/or clinical hours

C

Demonstrate interpersonal functions required to build rapport and effectively interact with clients, families, caregivers, supervisors, coworkers, and members of the community; exhibit cultural awareness and sensitivity to members of the same or different cultures; treat others with respect, compassion, politeness, and discretion; exhibit social functions necessary for effective collaboration and teamwork.

C

Demonstrate attitudes/actions consistent with the core values and ethical standards of the physical therapy profession.

C

Demonstrate accountability, responsibility, and maturity in the classroom and the clinical environment when giving/receiving constructive feedback.

C

Demonstrate accountability, responsibility, and maturity in the classroom and the clinical environment when engaging in conflict management and problem resolution.

C

Abide by established policies and procedures of educational and clinical environments

C

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STUDENT HEALTH CERTIFICATE

Sinclair Community College

Physical Therapist Assistant Program

This certificate must be completed and signed by a licensed health practitioner (MD, DO, NP-C, PA). Once completed, student must submit this form to appropriate dropbox in PTA Program Community

Print Name of Student:____________________________________________________________________Last Name First Name Middle Initial

Health Status Determined After Reviewing Essential Functions: (Must be checked & signed)

Student is free of communicable disease and in good physical and mental health, or

Student has a disability or other physical or mental condition which may interfere with the student’s attendance and progress in the program or ability to work in a variety of settings (see attached list of Essential Functions)

This condition is temporary. DATE OF RELEASE:_____________________________

This condition is permanent.

_______________________________________ ____________________________________Health Care Provider’s Signature Date

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STUDENT HEALTH CERTIFICATE—1st Year StudentSinclair Community College - Physical Therapist Assistant Program

Print Name of Student:____________________________________________________________________Last Name First Name Middle Initial

Immunizations: The following immunizations and tests, as described in the Immunization Guidelines, below, are required in order to begin or remain in the PTA Program.

1. Two-Step Mantoux Test (must be 2-Step within past year -or- chest x-ray within past year)#1: Date Tested:______________ Date Read:______________ *Reaction:_______________ #2: Date Tested:______________ Date Read:______________ *Reaction:_______________ *Positive reaction requires chest x-ray

If positive, chest x-ray Date:________________ Student is communicable non-communicable

2. Rubella (German Measles)(Titer required within past year; 1 booster doses needed if not immune)Titer Date:_________________________ Results: Immune Not ImmuneBooster Dates if not immune:_________________________

3. Rubeola (Measles) (Titer required within past year; 2 booster doses needed if not immune)Titer Date:_________________________ Results: Immune Not ImmuneBooster Dates if not immune:_________________________, _________________________

4. Parotitis (Mumps) (Titer required within past year; 2 booster doses needed if not immune)Titer Date:_________________________ Results: Immune Not ImmuneBooster Dates if not immune:_________________________, _________________________

5. Tetanus, Diptheria (within past 10 years)Date of Last Booster:________________________

6. Hepatitis B Vaccine (Step 1 or positive titer within past year required prior to program admission; all 3 Steps complete by 2nd year)Initial Series Date(s): #1:____________________, #2:____________________, #3:_________________Titer Date:_________________________ Results: Immune Not Immune

7. Varicella Vaccine (Chicken Pox)(Titer required within past year; 2 booster doses needed if not immune)—history of disease or prior vaccines is not acceptable)Titer Date:_________________________ Results: Immune Not ImmuneBooster Dates:_________________________, _________________________

**Note: Annual Influenza vaccine will be required in mid-Fall [date TBD] of both 1st and 2nd years of program

______________________________________________ ____________________________________Health Care Provider’s Signature Date

_____________________________________________________________________________________________________Stamp or Print Health Care Provider’s Name, Address, Phone #

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IMMUNIZATION GUIDELINES

MANTOUX SKIN TEST (PPD) This is a requirement each year a student is in the program. First-year students are required to have had a two-step test within the past year. Second-year students may receive a one-step PPD. Positive PPD reactors should have a baseline chest x-ray and be evaluated if symptoms develop. A TB Blood Test is also acceptable.

MMR VACCINE OR TITER Laboratory confirmation of disease or immunity within past year (i.e. titer) is required. If immunity is not confirmed by titer, student must acquire 2 booster doses for Parotitis or Rubeola

or 1 booster dose for Rubella.**History of disease or prior immunization is NOT reliable**

TETANUS AND DIPHTHERIA ADULT VACCINE (Td) A 1-time dose of Tdap is recommended for those who have never or are unsure if they previously

received this vaccine. After that, a Td booster every 10 years is recommended.

HEPATITIS B VACCINE This is a 3-dose series, given at 0, 1, and 6 month intervals, followed by serological (titer) testing 1-

2 months after dose #3. Dose #1 is due prior to admission to the PTA Program. Doses #2 & #3 are due prior to entry into the clinic in Fall of the 2nd program year. Immunity is determined by:

o Documentation of all 3 injections –or-o Laboratory confirmation of immunity (titer test).

VARICELLA (Chickenpox) Laboratory confirmation of disease or immunity within past year (i.e. titer) is required. If immunity is not confirmed by titer, student must acquire 2 booster doses.

History of disease or prior immunization is not acceptable proof**

INFLUENZA VACCINE –Required at a future date 1 dose will be required annually in the Fall of each year a student is in the program.

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College-Wide Background Check Policy

BCI & FBI Fingerprinting Verification Form

This is to verify that ___________________________ (student’s name) completed BCI &

FBI fingerprinting in preparation for required clinical observations while in

the Sinclair Physical Therapist Assistant Program.

________________________________Signature of Officer / Staff Performing Fingerprints

________________________________Police Department

________________________________Date

**Submit to appropriate dropbox in PTA Program Community

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Grading

The grading scale for PTA courses is as follows:A = 93 – 100 B = 85 – 92 C = 77 – 84 D = 70 – 76 F = <70

The grading scale is used to prepare students for first time passage of the national licensure examination. A grade of “C” must be maintained in all courses to remain in the program. A “D” in any non-PTA course must be retaken.

Failure or withdrawal from the program will require reinstatement to the program. Click here to view the Reinstatement Policy.

Assessment Tools

Cognitive Outcomes are assessed by review of:1. Scorebuilders Comprehensive Examination (Threshold: Cohort averageIndividual student score of

70% based on statistical analysis of all candidates who have taken the Scorebuilders exam)2. CPI Clinical Problem Solving (Threshold: Individual student rating of Entry-Level)3. National Physical Therapy Exam for the Physical Therapist Assistant created by The Federation of

State Boards of Physical Therapy

Psychomotor Outcomes assessed by passage of:1. Skill Competencies2. Comprehensive Competencies3. Lab Practicals4. Completion of Clinical Practicum Clinical Performance Instrument (CPI)

Affective Outcomes are assessed by review of:1. Faculty advising meetings/mentoring from faculty2. Assessment of professional behaviors3. Reflection papers included in the Portfolio Assignment4. ACCE or faculty member clinical site visit

Overall Program Outcomes are assessed by review of:1. Graduate Survey2. Program Advisory committee input3. National licensing examination result for first time takers of examination4. ACCE summary of student clinical experiences5. Employer Survey6. Student course assessments7. Faculty

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Assessment

Ongoing assessment is an integral component of the program for personal, educational, and professional growth. Below are examples of the various ways in which assessment occurs in the PTA program.

1. SELF-ASSESSMENT: a. This occurs in meetings with faculty, advisors, peers and in group situations. b. Self-assessment assists the students’ progress toward entry-level professional behaviors and

skills. c. It is critical for students to understand themselves and any changes they will be making

in order to help others using a therapeutic approach.

2. WRITTEN TESTING: a. May occur online or as a written exam during regular class time.b. Textbooks and notes are allowed when taking the test online.c. Textbooks and notes will not be allowed when written tests are given during regular class time.d. Testing time will be limited to the minutes indicated by the instructor for the test.e. All quizzes and examinations will be taken at the scheduled times. Students will be allowed to

make up examinations only in extenuating circumstances. Any make-up test is the sole responsibility of the student and must be arranged with the instructor.

f. There will be no retakes of scheduled exams. g. The Honor Code and Academic Integrity Policy are used to determine consequences for any

infractions regarding testing.

3. PROFESSIONAL BEHAVIORS: a. Standards have been adopted to move students to a level of personal responsibility that may

not have previously been required in a classroom or workplace environment. b. Each faculty member monitors the behaviors and gives input to the student and faculty advisor if

there is a concern. c. Consistently poor behavior will have a consequence in the grade for the course. d. Formal assessment of the professional behaviors occurs through faculty advising meetings.e. Professional behaviors are linked to the clinical assessment standards as well.

4. SERVICE LEARNING: a. Participation in service learning projects will be required as part of the final student

Portfolio. b. Access to the required forms and information about volunteering are at the Service Learning

website.

5. COMMUNITY SERVICE: a. Participation in community service is required as part of the final student Portfolio.b. This component of the Portfolio emphasizes the Values-Based Behaviors (APTA).

6. ROLE PLAYING: a. Students begin role playing for classmates in the lab practical experience during the first term of

the program. b. Being on both sides of this practice helps to learn by doing and experiencing some of the

emotions and confusion both the clinician and patient might feel in practice.

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7. GROUP PROJECTS: a. PTAs always work as a member of a team. b. Group projects are designed to help develop abilities to work with a wide variety of personalities. c. Time management, communication, stress management, and responsibility are beneficial

behaviors learned from this form of assessment.8. PARTICIPATION IN OPTA/APTA ACTIVITIES:

a. The importance of membership and participation with the American Physical Therapy Association (APTA) begins with attending district meetings.

b. The APTA provides inexpensive membership for the student and access to student health insurance.

9. RESEARCH PAPERS AND PRESENTATIONS: a. Research papers, oral presentations, inservices, and group projects are required throughout the

curriculum as a means to develop an appreciation of knowledge and a commitment to learning. b. During the clinical experience, students are required to research and present an inservice to the

staff of the clinical facility.

10.LAB CHECKOFFS: a. A lab check off is an assessment of basic skill in a patient-based activity. Lab check offs are

used to assess general knowledge only.b. Lab check offs are used throughout the semester to provide students with feedback on how they

are doing with performing certain clinical skills. Completion of a check off does not necessarily indicate that a student is proficient or competent with that activity. It simply means a student has demonstrated a basic level of understanding of that skill. Greater practice is necessary in order to apply that skill to specific patient-based scenarios.

c. There are no stipulations on the number of times a student may repeat a lab check off before meeting “general competence”. All lab check offs must be completed prior to completing lab practical(s).

11. LAB COMPETENCIES:a. Lab competencies are utilized for skills that have a definite “correct” application. These skills

must be practiced and perfected, as students will be graded on their ability to perform the skill correctly when requested.

b. Prior to performing each lab competency, students will be required to complete a lab practice form for the competency they wish to perform and submit it to the instructor.

c. Students may utilize multiple attempts to successfully complete each lab competency.

12. LAB PRACTICALS: a. Lab practicals are proctored by faculty using a grading format shared with the student prior to

testing.b. Remediation of any lab practical examination is at the discretion of the instructor and dependent

on evaluation of the original failed examination.c. If it is determined a student is to remediate a lab practical examination, the maximum final score

for the second attempt will be 77%, and the entire examination must be remediated.d. No more than one remediation will be allowed for each course per semester.e. Safety and technical skills are a primary determinant in the final grading. Failure to demonstrate

these skills can result in failure of a lab practical examination if deemed unsatisfactory relative to the clinical portion of the curriculum.

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Retesting of Lab Practicals and Remediation Plans: 1. Retesting of any lab practical examination is at the discretion of the instructor and

dependent on evaluation of the original unsuccessful examination. 2. If it is determined a student may retest a lab practical examination, the entire examination

must be completed.3. No more than one lab practical retest for any course will be allowed. 4. A student who is deemed eligible for retesting and/or remediation will be required to work

with the course instructor to create a documented remediation plan, which may include receiving a grade of “I” and use of an Incomplete Contract. The remediation plan will include:

a. A list of activities designed to assist the student in improving skills in the area(s) of concern.

b. Due dates for completion of all deliverables under the remediation plan. c. A set date for the retest lab practical.

5. If a student receives an “I” and has an Incomplete Contract, a lab practical retest can occur up to 30 days into the following term, but the student may be required to meet an earlier deadline for retesting to avoid potential disruption of subsequent courses and/or inability to continue in the program, as prerequisite courses must be successfully completed with a passing grade before subsequent courses can be taken.

6. The maximum final score for the second (retest) attempt at a lab practical is 77%. The maximum score for not passing a practical on a critical indicator is 76%.

7. If a student received an “I”, has an Incomplete Contract, and is successful on the lab practical retest, then the grade of “I” will be changed to the appropriate grade based on the student’s overall course score. A student who is unsuccessful in a lab practical retest will receive a change in grade from “I” to a non-passing grade (D or F), based on the student’s overall course score.

Additional Assessment Information:1. Each skill checkoff, competency, and lab practical examination (used to determine application of skills)

must be passed on specific criteria developed to assure competency and safety. A lab competency or practical grade below 77% will result in the overall grade for the course being

no higher than a "D". "Critical indicators" related to safety and technical skills must be passed to pass the competency or

lab examination, regardless of overall grade. This procedure ensures a student cannot pass a course without clinical skill competence.

2. If a student must be absent from a scheduled examination, the student is responsible for communicating with the instructor to determine a process for rescheduling. In the case of an emergency, notification to the instructor must occur as soon as possible.

3. Any additional requirements for assistance with testing will require a notification from the Department of Disability Services (Dayton campus: 10-421 or Courseview campus: Front desk). Each instructor must receive this notification to determine what assistance can be given. Additional time is not available with lab competencies, check-offs, or lab practical examinations.

These assessments must meet the requirements of the clinical practice environment.

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Expected Behaviors in Physical Therapy

Professional Behaviors for the 21 st Century (2009-2010), Marquette University

Professionalism in Physical Therapy: Core Values, APTA

Values-Based Behaviors for the Physical Therapist Assistant, APTA

Standards of Ethical Conduct for the Physical Therapist Assistant

Required Behaviors in the PTA Program

Students are required to engage in safe, ethical, and professional behaviors, as required by the college and the profession. A student may be removed from a course, lab, workshop, classroom, observation or clinical experience, and assigned an “F” for the course, for engaging in unsafe or unethical behaviors.

Students in the PTA program are held to behavioral guidelines set forth in this handbook. Behaviors related to attendance, tardiness, dress, demeanor, communication, and interpersonal interaction will be monitored during class, lab, and clinical experiences. The development of a professional PTA begins on the first day of the curriculum and will emphasize the Professional Behaviors and Values-Based Behaviors for the PTA.

Progression through each PTA course will include evaluation of professional behaviors. Students are required to self-assess behavior using a Professional Behavior Packet. Evaluation of professional behaviors is ongoing and will be reflected in grading.

A student will receive verbal or written notice of any behavior that does not meet the standards of the PTA program and will be required to demonstrate immediate improvement, with assistance from the faculty, as a first step toward assuring success in class. Counseling may be required with faculty and Health Science counselors to assess future options and development of an Individual Educational Plan.

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Professional Behaviors and Clinical Education

Professional Behavior CPI Performance CriteriaCommitment to Learning Accountability

Cultural CompetenceSelf-Assessment & Lifelong LearningClinical Problem Solving

Interpersonal Skills Clinical BehaviorsAccountabilityCultural CompetenceCommunication

Communication Skills Clinical BehaviorsCultural CompetenceCommunicationDocumentation

Effective Use of Time and Resources Clinical BehaviorsAccountabilityResource Management

Use of Constructive Feedback SafetyClinical BehaviorsCommunicationSelf-Assessment & Lifelong Learning

Problem Solving SafetySelf-Assessment & Lifelong LearningClinical Problem SolvingInterventionsResource Management

Professionalism Clinical BehaviorsAccountabilityCultural CompetenceCommunication

Responsibility SafetyClinical BehaviorsAccountabilityDocumentationResource Management

Critical Thinking SafetySelf-Assessment & Lifelong LearningClinical Problem SolvingInterventions

Stress Management Clinical BehaviorsSelf-Assessment & Lifelong LearningResource Management

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PTA Program Policies and Procedures

Classroom/Laboratory Rules

1. Each student assumes responsibility at all times for equipment used and safety when in the classroom or laboratory.

2. Any damaged equipment must be reported immediately to a faculty member and the program office.3. Treatment areas must be cleaned and equipment must be put away in the proper place following use.4. No smoking, food, drink, or gum allowed in the classroom or laboratory.5. No unauthorized visitors at any time. Children are not permitted at any time.6. At the end of each lab class, the soiled linen must be put in the designated container. Students must

assist the instructor to wash, dry, fold, and store clean linen.7. Students are not permitted in the laboratory alone. There must be another PTA student or faculty

member present for safety. 8. Modalities and/or equipment are not to be turned on or used without instructor supervision. Passive

modalities are not to be used at therapeutic levels during classroom/lab instruction.9. The fire door exit at the back of the classroom on the Dayton campus remains unlocked and sets off an

alarm when used for emergency exit. Equipment must not block access to the fire door exit.10. Students must sign in and out in the PTA program office when using the laboratory during open lab

times. The key to the classroom is available during regular office hours and must be returned by 4:00 pm. A faculty member must be present on campus if students are in the laboratory.

11. The phone is for emergency use only.12. Lockers are provided for use during class time and should be used to store all backpacks and personal

belongings. This is to ensure safe keeping of valuables and an environment free of clutter and trip hazards. Lockers may need to be shared, so use of a combination lock will require sharing the key or combination with someone in the class.

13. Cell phones are not permitted in the classroom/lab unless prior approval from the instructor is granted for emergency situations.

14. It is not permitted to make photo copies or take pictures of test/exam material.15. Exercise equipment is not to be used for personal use.16. Never stand on furniture or chairs to reach a higher level.17. Computers/laptops/tablets/cell phones/audio recording devices are ONLY PERMITTED to be used at

the discretion of the instructor. There will be times when computers/laptops/tablets/cell phones/audio recording devices are not permitted. Inappropriate use of computers/laptops/tablets/cell phones/audio recording devices may result in confiscation of the device until the end of the class/lab.

a. Examples of inappropriate use include, but are not limited to: social media, email, instant messaging, texting, taking pictures, internet searching of irrelevant or inappropriate subject matter

18. Refer to this PTA Program Student Handbook for policies regarding professional behaviors and academic computer usage. Evaluation of professional behaviors is ongoing and will be reflected in grading.

The above rules are to be strictly adhered to during enrollment in the PTA program. Any abuse of the classroom, laboratory, or equipment will be dealt with as a potential dismissal from the program.

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Attendance Policy for Non-Clinical Physical Therapist Assistant Courses

ATTENDANCE:

Attendance for all lectures, labs, and clinical affiliations is verified to ensure student success. Promptness, attendance, and appropriate lab attire are required behaviors. All students are to adhere to lecture and lab hours unless notified otherwise by the faculty or program director. Absence during the clinical affiliation is addressed in the student clinical handbook.

Definitions:• Present: To be present in and remain in class, to be an active and engaged participant in classroom/lab

activities. • Absence: Failure to attend when expected, state of being away or not present (greater than 50% of the

class time has been missed), inattentiveness, preoccupation. • Tardiness: Late, not on time, arriving more than 5 minutes after the start of class/lab.• Early departure: Leaving class prior to the end of the class/lab session and/or before class has been

officially dismissed by the instructor. Less than 50% of the class time has been missed.• Attendance Petition Process: Process by which a student requests exemption from absences/tardies/early

departures through the provision of appropriate documentation to the PTA faculty for evaluation.• Attendance Petition Form: Form utilized by the student to provide documentation for explanation of

absence/tardiness/early departure.• Appropriate communication: Contact the Dayton PTA Program Office (via phone: 937-512-5355; or email: eileen.trentman@sinclair.edu) to report the absence or tardy the day of the occurrence.

TRACKING ATTENDANCE: Attendance is monitored at every scheduled class meeting. Attendance is recorded in the Attendance

Register in the learning management system. The PTA Program uses the following method for recording attendance.

o AC = Absent, with appropriate communicationo ANC = Absent, without appropriate communicationo TC = Tardy, with appropriate communicationo TNC = Tardy, without appropriate communicationo ED = Early departure

*No entry will be made in the Attendance Register for students who are “Present”

ABSENCE: There are no excused absences. If a student is going to be absent, the student is required to contact the Dayton PTA Program Office

(via phone: 937-512-5355; or email: eileen.trentman@sinclair.edu) to report the absence the day of the occurrence. This information will be given to the instructor. o Adherence to this requirement will be taken into consideration during the Attendance Petition

Process. Absences beyond the following “allowable amount” will result in the loss of one letter grade. If this

occurs and results in a grade of “D” for the course, it will result in dismissal from the program. o Face-to-face, full-term:

- Meets 3x/week: 3 absences- Meets 2x/week: 2 absences - Meets 1x/week: 1 absence

o Face-to-face, A/B term: - Meets 3x/week: 2 absences- Meets 2x/week: 1 absences - Meets 1x/week: 0 absence

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o Face-to-face, flex term: The number of allowed absences will be dependent on the length of the course and will be detailed in the course syllabus.

o Hybrid (combination of face-to-face and online class meetings): The number of allowed absences will be dependent on the number of face-to-face class meetings and will be detailed in the course syllabus.

Personal illness may require a written statement/excuse from a physician presented to the course instructor at the time the student returns to class if the student is absent more than 2 consecutive class sessions. This documentation may be needed to verify the student’s health and/or ability to participate safely in class/lab. The student must contact the instructor directly prior to returning to class to verify if a physician’s note will be needed. The student must retain a copy of this documentation if they plan to petition the faculty to exempt the absence at the end of the term.

It is the student’s responsibility to acquire material/information missed due to absence and make up any missed assessments (Exams, quizzes, assignments, etc.).

Depending on the nature of the absence, the course coordinator may determine if a point reduction is warranted.

TARDINESS: There are no excused tardies. If a student is going to be tardy, the student is required to contact the Dayton PTA Program Office (via

phone: 937-512-5355; or email: eileen.trentman@sinclair.edu) to report the absence the day of the occurrence. This information will be given to the instructor. o Adherence to this requirement will be taken into consideration during the Attendance Petition

Process. Three incidents of being tardy are considered one absence.

EARLY DEPARTURE: There are no excused early departures. If a student misses greater than 50% of the class, then they will be considered absent. If a student knows they are going to miss greater than 50% of the class, the student is required to notify

the instructor on or before the day of early departure.a. Adherence to this requirement will be taken into consideration during the Attendance Petition

Process. Three incidents of early departure are considered one absence.

A combination of tardies and early departures that total 3 is considered one absence.

Attendance Petition Process: At the end of the term, a student may petition the faculty to exempt and/or change the student’s grade

only if absences/tardies/early departures have resulted in the loss of a letter grade.o The student must fill out an Attendance Petition Form and provide the faculty with appropriate

documentation providing explanation for their absence/tardiness/early departure.o An Attendance Petition Form must be filled out for each instance that the student would like the

faculty to consider.o The faculty will meet as a group to discuss the student’s circumstances. The student may or may

not be asked to meet with the faculty as well to provide further explanation for their absences/tardies/early departures.

o The Attendance Petition Form(s) needs to be turned in to the faculty during the final week of instruction (the week prior to the final evaluation week).

The final determination will be given to the student after the faculty have met to discuss the student and their individual circumstances.

Additional documentation will be required for absences/tardies/early departures that occurred as a result of extenuating circumstances such as:

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o Death or serious illness of immediate family member including grandparents.o Personal illness resulting in absence more than 2 consecutive class sessions.

Any questions or concerns about interpretation or application of this policy should be directed to the program director.

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Academic Lab Computer Usage

1. The academic labs are to be used by PTA Program students only.2. The key to the lab is signed out in the PTA Program office.3. The procedures for using the lab are also applied to the use of the academic computers.4. Current programs on the computers include “Manual Muscle Testing” and “Goniometry”.5. Using the computers to surf the web is prohibited. Due to the nature of the computer lab, this puts each

student on the honor system.6. When finished with the use of the computer, go to the START menu and shut down the computer in the

normal sequence.7. If any problems arise with the computer during the time you are using it, report this to the program

administrative assistant so it can be repaired and not affect the ability of other students to use the system.

8. Do not download any information from the web or open attachments from email on these computers.

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Lab Attire and Behavior

Lab Attire:

1. All students must be dressed for lab in appropriate lab attire prior to the start of class.2. Appropriate lab attire includes:

Shorts of appropriate length to provide adequate coverage of the torso/hips/buttocks, but not obstruct visibility of joints of the lower extremity (shorts must not extend below the knee)

Underwear under the shorts (men and women) Clothing must effectively cover underwear – Underwear must not be visible. Bra which allows observation and palpation of cervical spine, shoulder and scapula Tank top for women over bra covering trunk to waist of shorts Tank top for men covering trunk to waist of shorts Tennis shoes and socks

3. The following are not appropriate lab attire: Sports bra with a racerback Thong or string underwear Open toed or flip flop foot wear

4. When lab does not require removal of clothing for a particular palpation or observation tank tops and shirts are to remain on. Sweat pants/shirts may be worn for warmth.

5. If lab attire is forgotten a gown must be used with appropriate draping techniques to provide coverage.6. The storage areas cannot be used as a dressing room.7. To properly observe/treat certain segments of the body, male students may be required to remove tank

tops. Both male and female students may be required to remove tops or shorts and put on a gown, with appropriate draping.

Lab Behavior:

1. Respect for everyone involved in the class including students and faculty must be practiced at all times.2. Suggestive, vulgar, or harassing language or behavior by anyone in the class is prohibited.3. Inappropriate lab attire may require a student to leave the classroom. The student may return to the lab

only if he or she changes into appropriate lab attire or a gown is used appropriately.4. Any instructor or lab assistant witnessing inappropriate lab attire or lab behavior can and will address

the issue immediately and document the incident for the course file.5. More than one incident of documented inappropriate lab attire or lab behavior will require that the

student meet with the course instructor. If the problem persists, the student will be referred to their faculty advisor and may be subject to dismissal from the program.

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Faculty Advising and Meetings

1. All students are assigned a faculty advisor. Mandatory faculty advising meetings occur throughout the student’s enrollment in the PTA program.

2. Faculty advising meetings are used to discuss a student’s professional development, discuss issues or concerns, and to answer questions related to the PTA program, the physical therapy profession, and/or the college.

3. During the first year of the program a Professional Behaviors packet is utilized to assist in facilitating and focusing conversation during faculty advising meetings related to professional development.

4. All appointments for meetings with full-time faculty are to be made by contacting the program administrative assistant. Part-time faculty are routinely available immediately before or following their class sessions and should be contacted directly regarding a scheduled meeting time.

5. Students are welcome to meet with faculty advisors or instructors more than is required through faculty advising meetings.

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Problem Resolution/Complaint Process

1. Any problems, conflict, or concerns with the curriculum, faculty, or peers need to be addressed through timely communication, preferable within three days of the onset of the problem.

2. Communication must initially occur between the student and the appropriate individual first, i.e. faculty member, peer, clinical instructor.

3. If a faculty member needs to meet with a student, the student will receive a written or verbal request to make an appointment. The student must make him or herself available so that the meeting occurs before the next class meeting with that instructor.

4. If a student needs to meet with a faculty member, the student may arrange to meet with the faculty member before or after class, during the faculty member’s office hours, or schedule an appointment with the faculty member. All appointments for meetings with full-time faculty, including the PTA Program Director, are made by contacting the program administrative assistant. Part-time faculty are routinely available immediately before or following their class sessions and should be contacted directly regarding a scheduled meeting time.

5. If a mutually satisfactory resolution of a conflict or problem cannot be reached between a faculty member and student, the following procedure will be followed:a. If the student’s home campus is:

i. Courseview , the student will arrange to meet with the CVCC Program Coordinator. If a mutually satisfactory resolution of a conflict or problem cannot be reached between the CVCC Program Coordinator and the student, the student will complete the online Academic Complaint Form (http://www.sinclair.edu/services/help/complaint/).

ii. Dayton , the student will complete the online Academic Complaint Form (http://www.sinclair.edu/services/help/complaint/).

b. If an online Academic Complaint Form is submitted, the student will be contacted within 2 business days, and the Program Director/Department Chair will submit a Decision Form: Complaint Faculty/Staff Response documenting the resolution decision communicated to the complainant within two weeks, if contact information is provided. If additional time is needed, the Program Director/Department Chair will contact the student and let them know the case is being worked on, but due to the nature of the complaint, additional time is needed to complete the investigation.

c. A Faculty Academic Reporting Form may be completed by the faculty member/CVCC Program Coordinator/Program Director/Department Chair to document the complaint and the outcome, as needed.

6. If further intervention is required, the student must schedule a meeting with the Office of the Dean of the Health Sciences Division.

7. If further intervention is required, the student must schedule a meeting with the Office of the Associate Provost.

8. A student will be redirected to the appropriate channel of communication if initial attempts to resolve a problem are not solved utilizing this procedure.

9. If a student’s behavior violates Sinclair policy as outlined in the Student Judicial Affairs Code of Conduct Handbook, the student will be referred to Student Services.

10. For additional Sinclair resources related to submitting a complaint, please refer to http://www.sinclair.edu/services/help/complaint/.

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Reinstatement Policies and Procedures

SINCLAIR COMMUNITY COLLEGEPhysical Therapist Assistant (PTA) Program

Continued Enrollment in a Health Sciences Program

To continue to be enrolled in any Health Sciences Program, a student must: Adhere to all applicable college and program policies, including but not necessarily limited to,

academic policies, the Student Code of Conduct, and the program specific Student Handbook. Maintain at least a 2.0 cumulative Grade Point Average (GPA). Attain a minimum grade of "C" in each course required by the CTL curriculum plan (available in the

college catalog). Meet each semester's curriculum requirements, as specified by the curriculum plan, and in the

sequence outlined by the curriculum plan, unless otherwise approved by the program director or department chairperson (General education courses may be taken prior to, or according to, the curriculum plan).

Meet stated clinical objectives for each practicum/clinical course in the program. Maintain health and immunization records as set forth in the program handbook. Complete background checks as required by the program. Maintain current professional CPR certification as required by the program. Adhere to all applicable polices set forth by affiliating agencies.

Students who fail to comply with the above requirements will be dismissed from the program, and will be notified of the dismissal in writing.

Opportunities to be reinstated to the program may be available as determined by each department. Any reinstatement will be on a space-available basis.

Withdrawal from a Health Sciences Program

A student may elect to voluntarily withdraw from a course required for a program. However, enrollment in the course is considered to be an “attempt” of the course. An “attempt” of a course may be a factor in a subsequent decision to dismiss a student from the program. For this reason, all students are strongly encouraged to meet with a department faculty member or an academic advisor prior to withdrawing from any course required for a program.

Students may withdraw from a program for: Academic reasons Non-academic reasons, such as

o Medicalo Personal

Reinstatement Policy

Reinstatement to PTA Program

A student who has failed, withdrawn, or been dismissed from the PTA Program may petition for reinstatement, subject to the conditions which follow.

A student who has been dismissed for academic failure or who has withdrawn from the PTA Program will be notified of his or her status in writing, and be provided with the Student Petition for Reinstatement form, Reinstatement Policies and Procedures, and the Reinstatement Rubric.

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A student who has been dismissed from the PTA program due to violation of college and/or program policies, is not eligible for reinstatement.

A student may only be reinstated once. Additional petitions may be considered based on extenuating circumstances, and are only allowed with approval from the Program Reinstatement Committee (PRC).

If a student has not been enrolled in the PTA program for more than two consecutive semesters (excluding summer semester), reinstatement is no longer an option and the student must utilize the competitive selection process to determine ability to enroll.

Timing of Reinstatement to PTA Program

1. A student granted reinstatement into the PTA program will be required to re-enroll into the first term of the program. This is to ensure the student demonstrates competence in all clinical skills learned in the first term of the program.

2. If a student is initially denied reinstatement, and is eligible to petition for reinstatement again (based on the allowable time frame), the student must submit a new petition for reinstatement and write a new narrative that details the additional changes that have been implemented since the first petition submission.

Reinstatement Procedure

1. A student who seeks reinstatement must have a 2.0 cumulative GPA at the time the petition for reinstatement is submitted.

2. Prior to submitting a petition for reinstatement a student must meet with a counselor in Counseling Services to identify strategies for success if reinstated to the PTA Program, and may meet with the PTA program director.

3. Prior to submitting a petition for reinstatement, a student may choose to meet with the PTA program director to discuss the reinstatement process.

4. A student seeking reinstatement must submit a Petition for Reinstatement to the PTA Program office by the deadline indicated.

a. For Fall dismissals/withdrawals:i. To reinstate to the Fall term, the deadline is the first day of B term of the previous

Spring term.b. For Spring dismissals/withdrawals:

i. To reinstate to the Fall term, the deadline is the first day of B term of the previous Summer.

5. The Petition for Reinstatement must include a narrative that addresses the following:a. Claimed cause(s) of the dismissal/failure or withdrawal from the PTA program.b. Identification of the steps already taken to correct or address the claimed cause(s) of the

dismissal/failure or withdrawal.c. Summary of the success strategies identified during the meeting with the counselor from

Counseling Services.d. Any additional information the student wishes the PRC to consider

6. The Program Reinstatement Committee (PRC) will act on all requests properly submitted in writing. Members include the PTA program director, the academic coordinator of clinical education, and faculty who have had the student in class.

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7. The PRC uses the Reinstatement Rubric to determine reinstatement eligibility and includes, but is not limited to:

a. Merit of the narrative which reflects an honest and accurate assessment of behaviors and circumstances leading to failure or withdrawal.

b. Completion and confirmation of meeting with counselor from Counseling Servicesc. Review of all documentation of student behaviors, counseling, and advising while in the PTA

programd. PRC interview, if conducted.

8. A personal interview with the PRC may be required by the committee or requested by the student.

9. The student will be notified in writing of the PRC decision.

10. A student who is reinstated will be required to take coursework under the curriculum and to comply with all policies and procedures in effect at the time of reinstatement.

11. A student who is reinstated will be required to have completed documentation of all necessary immunizations and/or health records on file with the PTA program at the time of reinstatement to the program.

12. Reinstatement is on a space-available basis. For reinstatement to Fall term, there are up to two available spots on each campus for students who may be reinstated. If space permits, a student who is granted reinstatement may be allowed to switch campuses; however, students granted reinstatement wishing to attend their original campus are given preference.

13. A student whose petition for reinstatement is granted must have a 2.0 cumulative GPA at the time of re-entry into the PTA program.

14. A student may appeal the decision of the PRC to the Health Sciences Division Reinstatement Committee by sending a written notice of appeal to the program director. The written notice must be received within thirty (30) days of the issuance of the decision of the Department Reinstatement Committee.

15. All records related to the reinstatement process will be maintained in the student’s academic file in the PTA department.

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Photography Release and Program Volunteer Policy

There will be opportunities for learning in a variety of environments and situations throughout the curriculum. A student must complete the Photography Release Form found in the Appendix of this handbook to give permission for photographs, videotaping, and professional film and recordings to be used to promote the program and profession.

The student may decline any specific photo or video from being used by submitting that request in writing to the program director.

During the course of the curriculum a student or instructor may use the services of a volunteer to enhance teaching and presentation. If photographs, video, or other recordings of the non-program volunteer are used, the non-program volunteer must also sign the Photography Release form in order to give permission for use of the material by the program.

All signed consent forms will be maintained in the student’s academic file, or in the program course file, if acquired by the instructor.

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Student Assumption of Risk and Release of Liability

If there is a temporary condition requiring reasonable accommodation, the student must bring it to the attention of their faculty and/or faculty advisor at the earliest possible recognition of the condition. To the extent possible, the student will be assisted with temporary accommodations, depending on the particular coursework for that term.

A student identifying a need for reasonable accommodation based on a long standing physical or emotional condition, will be required to meet with the Student Support Services counselors to determine the accommodation to be considered. At that time, the student’s request received through Student Support Services will be evaluated by the faculty for implementation, to the extent feasible and possible, to assure achievement of entry-level skills.

When students are required to attend an off campus seminar they will be responsible to conduct themselves in accordance with the Student Judicial Affairs Code of Conduct Handbook. The instructor will provide directions regarding safety considerations at each off campus site. An emergency contact list for students will be maintained in the program office.

The student’s signature is required on the Student Assumption of Risk and Waiver of Liability form (located in the Appendix) provided to assure they accept and understand this information.

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Infection Control

1. Food are drink are only allowed in designated areas of the PTA program’s dedicated classroom and laboratory space.

2. Anyone with a known infectious condition such as flu, common cold, pink eye, or Methicillin-resistant Staphylococcus aureus (MRSA) will be required to discuss participation in class or lab with the instructor.

a. A student may be required to:i. Leave class until no longer contagious. The program attendance policy will apply to any

absence.ii. Use a face mask (provided by the program)iii. Don protective gloves (provided by the program)

3. All students and instructors will practice hand washing prior techniques prior to and following lab activities.

4. At the end of each lab class, students will be required to:a. Change all linen on the treatment tables and pillows and dispose of soiled linen to be washed by

students/faculty/staff.b. Wipe down equipment and treatment tables used during each lab class with a soap and water

solution or other cleanser (provided by the program).c. Return all equipment and unused supplies to storage.

The Dayton & Montgomery County Public Health website provides further information pertaining to health and infection control.

Centers for Disease Control and Prevention: Hand Hygiene in Healthcare Settings

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PTA Program Curriculum PlanI. Curriculum Design Elements

a. Ohio Department of Education specifications for AAS degreeb. Contemporary practice of physical therapyc. Commission on Accreditation in Physical Therapy Education (CAPTE)

i. PTA Standards with Evidenced. Current literature, documents, publications, and other resources

i. American Physical Therapy Association (APTA)1. Clinical Education Resources2. Guide to Physical Therapist Practice (Guide 3.0)3. Normative Model of Physical Therapist Assistant Education: Version 20074. Minimum Required Skills of Physical Therapist Assistant Graduates at Entry-

Level5. Outcomes Assessment in Physical Therapy Education

ii. Delivery of health care servicesiii. Physical therapy education and educational theory

1. Core Competencies for Interprofessional Collaborative PracticeII. Program Outcomes

a. CAPTE Standards and required student achievement measuresi. Graduation ratesii. Licensure pass ratesiii. Employment ratesiv. Entry-level clinical performance

b. Sinclair missionIII. General Education and Basic SciencesIV. Curriculum Model and Educational Principles

a. Model: 0.5 + 2 academic yearsb. Educational principles

i. Qualityii. Collaborationiii. Innovationiv. Consumer-centricity

V. Organized, Sequential and Integrated CoursesVI. Comprehensive Course SyllabiVII. Learning ObjectivesVIII. Effective Instructional MethodsIX. Effective Tests, Measures, and Evaluation Processes

a. Ongoing formative and summative assessment and evaluationX. Clinical Education

a. Patient/client managementb. Range of practice settings (Inpatient and Outpatient clinicals)c. Involvement in interprofessional practiced. Participation as a member of the PT and PTA Teame. Other experiences

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Assessment, Planning, and Program Improvement

I. On-going, Formal, and Comprehensive Assessment Processesa. Admissions process and criteriab. Program enrollmentc. Faculty and clinical instructorsd. Program resourcese. Program policies and procedures

II. Curriculum Assessment Plana. Analysis of course content to meet CAPTE standards b. Analysis of changing roles and responsibilities of PTAsc. Analysis of tests, measures, assessment, and evaluation processesd. Involvement of stakeholders

i. Faculty ii. Studentsiii. Graduatesiv. Employersv. Sinclairvi. Clinical education

III. Short and Long Term Program Planninga. Analysis of higher education, the health care environment, and contemporary PT practiceb. Involvement of stakeholders

i. Facultyii. Studentsiii. Graduatesiv. Advisory Committeev. Sinclair

IV. Program Outcomes Linked to Curriculum Assessmenta. Analysis of CAPTE standards and required student achievement measuresb. Analysis of current curriculum and practice environmentc. Analysis of clinical educationd. Analysis of program policies and procedurese. Review and revision of curriculum, clinical education, policies and procedures, as needed

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Forms to Be Completed and Returned to the ProgramHonor Code

The college has adopted the following Honor Code to help students, faculty and staff aspire to high standards.

"As a member of the Sinclair College community of students, faculty, and staff, I will uphold the values of citizenship, social responsibility, and personal accountability. I will maintain the highest standards of professional and academic ethics. I will uphold my personal integrity, dignity, and self-respect by being fair and honest at all times and by treating all individuals with respect. By honoring these ideals, I will be building a better future for myself, my college, and my local, regional, and global communities."

Signed: ________________________________________________

Date: __________________________________________________

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Forms to Be Completed and Returned to the Program

Sinclair Community CollegeDivision of Health Sciences

STUDENT ACKNOWLEDGEMENT OF RISKS AND OBLIGATIONS ASSOCIATED WITH

LABORATORY AND CLINICAL EDUCATION EXPERIENCE

In connection with my participation in a laboratory or clinical education experience at Sinclair Community College, I acknowledge that I have read and understand the following statements and agree to abide by and be bound by them.

1. I understand that during my laboratory or clinical education experience, I may be required to participate in activities with may present a risk to me and which may cause me to sustain illness or injury. These activities include, but are not limited to, exposure to communicable diseases or infections, blood and body fluids, lifting persons and equipment, and performing and receiving invasive procedures or therapies.

2. I acknowledge that I have been advised to carry my own health care insurance.3. I understand that if medical treatment of an illness or injury connected to my participation in a laboratory

or clinical educational experience is not covered by Sinclair Community College’s liability insurance, that I am solely responsible for the cost of such medical treatment.

4. I will conduct my educational activities only under the supervision of a Sinclair faculty member or qualified preceptor.

5. I will comply with all Sinclair rules and regulations and policies and procedures, as well as those of the clinical site.

6. I understand that Sinclair Community College has the right to remove me from the laboratory or clinical education experience or course at any time and that the clinical facility has the right to remove me from the facility based on my conduct or performance, in accordance with the written agreement between Sinclair and the clinical facility.

7. I acknowledge that I will not be used to meet minimum staffing requirements, or in substitution for essential personnel while in a laboratory or clinical experience.

8. I acknowledge my responsibility to maintain confidentiality of and not disclose confidential information I will have access to, including but not limited to student (patient) health information and medical records.

9. I confirm that I have not been excluded from participating in any federally funded healthcare program, including Medicare and/or Medicaid.

10. I understand that I may be prohibited from participating in the laboratory or clinical education experience until I have received an orientation from Sinclair Community College, signed the required forms, and provided evidence of required immunizations and vaccinations.

11. I will obtain written permission from Sinclair before publishing any material related to my educational experience.

12. I have read and executed this document with full knowledge of its significance, and I understand that I may not participate in any course without this signed document.

[SIGNATURE ON NEXT PAGE]

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Department: _____________________________________________________________________

Student Signature: ________________________________________________________________

Student Printed Name: _____________________________________________________________

Date: ___________________________________

Each student must complete and sign this form and submit it to the PTA program prior to the commencement of the first laboratory class experience.

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Forms to Be Completed and Returned to the Program

Sinclair Community CollegeDivision of Health Sciences

STUDENT ASSUMPTION OF RISK AND RELEASE OF LIABILITY

I understand that there are inherent risks, both known, and unknown, associated with the activities required for my participation in the laboratory courses and clinical education experiences for my program of study (“the activities”).

I confirm that representatives of Sinclair Community College have explained to me the known risks associated with participation in the activities.

I understand that although Sinclair Community College and the facility/facilities at which I undertake my clinical experience will make reasonable efforts to assure my safety, there are unavoidable risks involved in the activities.

I accept full responsibility for my safety and well-being by participating in the activities.

I hereby agree to release and hold harmless Sinclair Community College, its employees, officers, agents, and affiliates and to indemnify any or all of them from any and all liability, loss, damages, costs, or expenses which may be sustained or incurred by me as a result of my participation in the activities.

I understand that I am giving up specific legal rights by signing this document.

I understand that this document will remain in effect unless I deliver a signed written statement to the Chair or Program Director of the program of study in which I am enrolled.

I understand that I may not participate in any limited enrollment courses in my program of study without this signed document.

I have read and executed this document with full knowledge of its significance.

Department: _____________________________________________________________________________

Student Signature: ________________________________________________________________________

Student Printed Name: _____________________________________________________________________

Date: ______________________________________

Each student must complete and sign this form and submit it to the PTA program prior to the commencement of the first clinical education experience.

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Forms to Be Completed and Returned to the Program

Emergency Contacts

Print your name and the contact information in case of an emergency. Each faculty member and the program administrative assistant will have a copy. If any of this information changes, YOU MUST NOTIFY THE OFFICE IMMEDIATELY SO THE INFORMATION CAN REMAIN CURRENT

Student Name____________________________________________________________

Contact Person(s)_________________________________________________________

Relationship to Student_____________________________________________________

Contact Person’s Telephone Number__________________________________________

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Forms to Be Completed and Returned to the Program

PHOTOGRAPHY RELEASE FORMI give my consent to the use of photographs, video tapes, film and recordings of me for advertising, broadcast, or other uses by Sinclair Community College. In giving this consent, I release Sinclair Community College, or its assignees or licensees and its agents, and assignees or licensees from any and all liability for any use or violation of any personal or property rights which I might have in connection with such materials, and waive any right to approve accompanying written or narrative material.

If under 18, a parent or guardian’s signature is also required.

Name (print)______________________________________________________________________________

Date____________________________________________________________________________________

Name (signature)__________________________________________________________________________

Parent/Guardian (signature)_________________________________________________________________

AUTHORIZATION TO INTERVIEW AND PARTICIPATE IN LABORATORY ACTIVITIES

I, ___________________, authorize Sinclair Community College, and/or faculty members of the Physical

Therapist Assistant Program to present my case as a teaching experience in physical therapy courses. I

further agree to participate in teaching demonstrations involving therapeutic intervention. I understand that any

intervention I may receive is educational in nature and not intended as recommendations to be used outside of

the classroom experience.

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Forms to Be Completed and Returned to the Program

ACKNOWLEDGEMENT

I have received and read the Sinclair Community College Physical Therapist Assistant Program Handbook. I

understand it is my responsibility to review and comply with the policies of Sinclair Community College and the

Physical Therapist Assistant Program.

_____________________________________________________PRINT NAME

______________________________________________________SIGNATURE

______________________________________________________DATE

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The forms on the following pages do not need to be completed at this time.

They are for future use, if needed.

NON-ATTENDANCE EXCUSE PETITION

NAME: DATE FORM IS TURNED IN:

COURSE: INSTRUCTOR:

Date of occurrence:

Circle one:

Absent

Tardy

Early departure

Notification to program office on date of occurrence (circle one):

Yes No

Additional documentation provided, if appropriate (circle one):

Yes No

Reason for occurrence:

FOR FACULTY PURPOSES ONLY:

Date of review: Notification of occurrence verified:

Yes No

Occurrence exempt:

Yes No

Explanation of decision:

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Sinclair Community College Petition Received in Dept OfficeSTUDENT PETITION FOR REINSTATEMENT

Student Name:_________________________________Dept:_________Tartan ID#:________________________

Address:__________________________________________________________ Phone:_____________________City:________________________________________________State: ________Zip Code:___________________Term/Yr of Failure/Withdrawal/Dismissal:____________ Term/Yr of Anticipated Reinstatement:_____________

PART I: To be Completed by Student

Word process a detailed response to the following two items and attach to this form.

1. What were the circumstances contributing to your failure/withdraw/dismissal from your program of study?

2. Outline the steps that you will take or have taken to correct the cause of your failure/withdrawal/dismissal?

______________________________________________ __________________________________Signature of Student Date

PART II: To be Completed by the Department ChairpersonDate of Counseling/Advising Appointment:_________________________

Summarize key discussion points from the above meeting:

______________________________________________ __________________________________Signature of Department Chairperson Date

PART III: To be Completed by the Department Reinstatement Committee

Did the student withdraw in good standing? Yes No

Is the student eligible for reinstatement? If no, cite policy statement. Yes No

Is the student’s petition for reinstatement granted? Yes No

If reinstatement request is granted, what courses/actions must be taken by student?

If reinstatement petition is denied, list reasons cited by the committee:

____________________________________________________ __________________________________Signature of Department Reinstatement Committee Chairperson Date

Copy: Department, HS Reinstatement Com., Student

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Letter of notification sent to student: _____________________________ Revised 6/10Date

Rehabilitation ServicesPhysical Therapist Assistant Program

Reinstatement Rubric

Student Name: Tartan ID: Reinstatement requested for (Term/Year):

Eligibility to ReinstateYes

NoWas the student dismissed from the PTA program due to violation of applicable college and program policies, as set forth in the college, including academic policies, the Student

- If student was dismissed from the PTA program due to a violation of college/program policies, then they are not eligible to reinstate.

Meeting with Counseling Services Yes

NoDid the student meet with Counseling Services and was the meeting confirmed by a representative from Counseling Services?

- If student has not met with Counseling Services, the petition for reinstatement is denied.

Withdrawal/Failure Status PointsWithdrew passing all courses for documented non-academic reasons 10Withdrew failing and/or failed 1 PTA program course, but withdrew passing or passed other PTA courses

5

Withdrew failing or failed 2 PTA courses 0

Academic Standing: Cumulative GPA as of the time petition for reinstatement is being reviewed

Points

3.3 or above 102.5 to 3.299 52.0 to 2.499 0

- If student’s GPA is less than 2.0, they are not eligible to reinstate.

Academic Standing: Prerequisite course score total (as calculated by the PTA Competitive Selection Rubric

Prior Counseling/Advising (Documented) PointsNo significant problems or attendance issues 101 advising record for attendance and/or behavioral issues 52 or more advising records for attendance or behavioral issues 0

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Narrative/Outline Rubric

Criteria Poor (0 Points) Good (5 Points) Excellent (10 Points)

Description of the cause(s) of dismissal/failure or withdrawal from the PTA program

A brief description is provided. Minimal details are provided and the cause(s) are unclear or not specified.

An adequate description is provided. Several specific details are provided and the cause(s) is clear.

A thorough description is provided. Many specific details are provided and an in-depth reflection regarding the cause(s) is clear.

Summary of success strategies identified during the meeting with Counseling Services

A brief summary is provided. Minimal details are provided and the success strategies are unclear or not specified.

An adequate summary is provided. Several specific success strategies are provided.

A thorough summary is provided. Many specific success strategies are provided and an in-depth reflection regarding their effectiveness is clear.

Outline or identification of steps already taken to correct or address the cause(s) of the dismissal/failure or withdrawal

A brief outline or identification of steps is provided. Minimal details are provided and/or the steps have not already been implemented.

An adequate outline or identification of steps is provided. Several, but not all, specific steps have already been implemented and their effectiveness is documented.

A thorough outline or identification of steps in provided. All specific steps have already been implemented and their effectiveness is documented. A clear connection to how implemented steps will assist with success in the program is provided.

Spelling, grammar, and punctuation

3 or more errors 1 – 2 errors O errors

Total Narrative/Outline Rubric Points

To be filled out by PTA program only:

Date Reinstatement Material Received: Received by:

Total Reinstatement Rubric Points:

Reinstate student: Semester/Year: Reinstatement denied

Reinstatement Requirements:

PTA Program Director: Date:

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