Martinez 1

Kristina Martinez
RWS 1311 M/W
Research Paper

Physical therapists say what?

Introduction:
The discipline I have chosen to complete my research paper on this fall semester in my
Rhetoric and Composition 1311 class is, Physical Therapy School. I went ahead and chose to do
physical therapy school rather than doing it on Kinesiology because, I believe that physical
therapy school is my main focus right now. Physical therapy is going to depend on my future
career and where Im going to stand in life. As of right now Im on the outside looking into the
inside of the discipline, I can only watch the other students that are in the discipline achieve their
goal. Hopefully after this research project I can feel like Im a part of the discipline. Before I can
move my way into the physical therapy program I must receive a bachelors degree that is based
on high levels of science. The students in the physical therapy program have a high level of
education; these students come into the program with a GPA of 3.5 and higher. The physical
therapy program looks for students that have a great amount of high level of sciences courses.
Throughout the project I believed kinesiology would take me into that route, but I believe now
Biology has many sorts of high level of science classes. The Doctor of Physical Therapy School
is in the College of Health Science.
Physical therapy school is where students go and learn about the field of health care, the
individuals differences of wellness and disabilities. The school is there to provide students the
learning ability to become physical therapist and what it means to become a physical therapist.
Also adapt into the health profession, what it means to care for others and their rehabilitation,
and the nature of being a well characterized therapist with respecting patients. Most importantly

Martinez 2

the students of physical therapy learn the human body, its functions, range, and its motion. In
other words if a person is playing a sport and tears a muscle or breaks a bone or has an accident
the primary doctor that performs surgery on that person is referred to a physical therapist, so that
the physical therapist can help the patient gain their strength back in their muscle or help heal the
broken bone. A physical therapist not only deals with people that have gone through surgery, but
also people that are born disabled or babies that are not physically ready.
Each year around 15-25 students graduate from the program, after graduation the students
then take a National Physical Therapy Examination distributed by the Federation of State Boards
of Physical Therapy. If students pass the exam they hold the title of becoming a physical
therapist and will be able to work as one. According to the graduation results on the UTEP
physical therapy page, UTEP has had an average of 98.3% students become physical therapist
after graduation. The physical therapy program labs are located in the College of Health Science
and Nursing building on the main campus, while offices and classes are located off the main
campus at 1101 N. Campbell Street which is called Campbell Building. There are four lecturers,
three assistant professors, one clinical assistant professor, one clinical associates professor, one
associate professor, and one associate professor emerita. I chose this discipline because I felt like
I knew so much after having knee surgery twice and attending physical therapy for almost two
years. Im a veteran that is how my physical therapist, Kevin calls me. The second time around
I grew to love physical therapy, its atmosphere and the wellbeing of others. The relationship
between my inquiry and me is prospective. Being a physical therapist is my future career.
Learning about the whole entire discipline of physical therapy will expand my knowledge
and will be preparing me for what my future holds. If I dont like what the physical therapy
program offers me, I can explore other disciplines that catch my attention. In order to understand

Martinez 3

my discipline and not feel like an outsider, I created questions that would help me understand all
about my discipline. The main question I had was What are the requirements to become a
physical therapist which is my primary question. With my primary question I created secondary
questions, How challenging is it to become a physical therapist? Is kinesiology the right
major to become a physical therapist? Should I volunteer at a clinic before becoming a
physical therapist? and How can I learn more about physical therapy? With these questions
that I stated I believe they can get me closer to the inside of my discipline and have a better
understanding of what my future holds. I chose this inquiry because I fell in love with physical
therapy after my first surgery it felt as if it was meant for me. Im all about being athletic, and
those athletes that get injured can come to me for help, just like my physical therapist healed me
in order to continue to play basketball. Im comfortable with the inquiry, I am determined in
becoming a physical therapist. I feel like the questions I asked were appropriate for my inquiry
because I know a great amount about physical therapy thanks to Kevin and the questions I
created that I had no answer to.

Literature Review/Background
Throughout this project I have been doing research that will allow me to come to a final
conclusion about my inquiry. I have created a primary research question that helped me expand
my mind and ideas for this project. Based off of my primary research question, I created
secondary research questions. My primary research question is, What are the requirement to
becoming a physical therapist? I have succeeded in answering this question; the answer to this
question is simple, getting a science degree which for me will be Biology. The next step is to
enter a physical therapy school of three years with a GPA of 3.5 and above, I will apply at the
Doctoral physical therapy program at the Campbell building. After completing the three years, a

Martinez 4

test must be taken to determine if I am qualified to become a physical therapist. If I achieve that
part then I will need to expand my knowledge and skills before entering the physical therapy
environment. I will continue my education and go into Clinical Residency which is where I will
learn to improve on my working skills in a clinic, the right technique to treat patients , and
making sure I understand what Im about to do for the rest of my life. Last, I need to pick in what
I want to specialize in which is, Sports Physical Therapy.
I went ahead and brainstormed several secondary research questions and eliminated the ones
that seemed to be similar and dull. From eight secondary research questions, I ended up with four
secondary research questions. The questions I ended up with seemed reliable to my discipline.
The first was, Is kinesiology the right major to become a physical therapist? After conducting
my interview I had a change of heart about kinesiology being my major. The physical therapist I
interviewed told me that kinesiology might not be the right major to enter into the program since
they look for hard science course and kinesiology has more baby science classes. Therefore I
decided that, kinesiology is not the right degree to get as a bachelors degree. I would go with the
harder science degrees, like biology or microbiology, for a chance to enter the physical therapy
program. My second was, How challenging is it to become a physical therapist? The results
from my survey and interview I received were two different answers. The students that answered
my survey were asked to rate the challenge of becoming a physical therapist; from one through
ten they rated from eight and above. The therapist I interviewed told me personally that it is
straight forward and easy once entering a physical therapy school. Kevin the physical therapist I
interviewed says that it is most challenging to get into physical therapy school than the courses
taken in therapy school. I will find out once I try to get into the program and as I advance in the
physical therapy courses I will find out which was more challenging for me.

Martinez 5

Third, Should I volunteer at a clinic of physical therapy? The answers I got back from my
survey and interview state that I should volunteer at a clinic. The answer to this question should
be yes, the students of physical therapy said I can benefit from volunteering and shadowing a
therapist. Kevin, the physical therapist I interviewed told me that I will have to volunteer at a
clinic either way for my internship once I graduate from the program. The last question was,
How can I learn more about physical therapy? YouTube and the internet is where I can learn
more about physical therapy. While I was interviewing Kevin he pulled up a video on YouTube
of a foot that he and the other physical therapist were studying more into depth in their office.
Blogs or looking up body parts, their functions, and names can give me an advantage of
knowledge.

Procedure/Methodology
The data I needed to collect from this whole entire project was the feedback from people that
belonged in my discipline. For my primary and secondary research questions I had to use three
methods. First, Interviews, which helped me engage with the interviewee and explore if my
unanswered secondary research questions that I created will get me the right results to better
understand my inquiry. The interview gave me a prospective from others point of view and also
gave me valuable information by keeping my questions opened ended. I chose to interview a
physical therapist because he went through the process I am going through right now, so I
believe he can give me the right answers to my questions.
Next, I used site observations; I entered into the environment of physical therapy. I had to get
a feel of what kind of atmosphere an everyday physical therapist goes through. I observed what
kind of behavior patients go through while being treated, are they rude, nice, unstable after their

Martinez 6

surgery and having to have the patients when a patient is having a bad day or an attitude in a
physical therapy clinic. I wrote down in the site observation form what was going on around me
as I walked around the clinic and what information was elaborated for my secondary and primary
questions.
Third, I created a survey to collect data for my research project. I carefully designed
questions that were similar to my secondary research questions but that were closed ended. I
made sure that the survey I created was for the students of physical therapy and that the
questions were based for them for their overview and beliefs.
Last, I interpreted a document analysis for an article finding its argument and how I can
relate it to my discipline. You can see appendix C for more information.

Interviews: I interviewed one person, Kevin Mark. He is a licensed physical therapist and
graduated from the physical therapy school at the Health Science and Nursing building
on Campbell Street. I chose him, because he has taught me a great amount of physical
therapy throughout the time I spent in rehab. He gave me hope that I one day could be
like him. He told me the basic information about physical therapy like, how many years it
takes to become a physical therapist, which is three years, what major I should take as an
undergrad student, which I am still debating between kinesiology and biology. He told
me about the atmosphere of a physical therapy clinic. I wanted more from him like why
he wanted to become a physical therapist, the process he went through before coming one
and the challenge it was for him. He also seems confident in his job and the answers he
provided me while I was his patient. By using the interview method I gain a great amount
of information about physical therapy appendix A shows the questions I asked Kevin and
his feedback. The interview took place at 1700 Murchison Ste, D on October 8, 2014.

Martinez 7

The length of the interview Kevin and I had was about 16 minutes. I know it is not much
time, but I felt that I answered my broken down secondary research questions.

Survey: I designed my survey and handed them out on paper. I distributed the survey to
the student of physical therapy at the Campbell building on October 24, 2014. I
distributed 10 hard copies of my survey. That day I only received 5 from a mix of males
and females. On October 27, 2014 I went back and handed out the last 5 receiving data
from 10 different data from the students of physical therapy. The first day I distributed
the surveys, it was a late Friday afternoon and there was a total of 5 students. On the
second day there was a hand full of students. I approached the ones that were closer to the
entrance of the building. Appendix B has my final draft of my survey and the responses I
got back from the students of physical therapy.

Document: Preparing physical therapy students for the role of clinical educator: a case
study report. The purpose of this document was too describe how transforming students
in their second year of physical therapy school into clinical instructors with the help of
the third year students of physical therapy. This document fit perfect with my disciplinary
because it is giving me great advice how it will be transforming into a physical therapist
and the perspective of students of the second year of physical therapy school. Appendix
C shows the journal I used for my document analysis

Site Observation: The clinic is a huge room. Once you enter, there are work out machines
for legs, arms, and abs. There are a total of 12 tables the patients use to lay down, sit
down or do their stationary exercises. To the far back is an open space with a big window
and there are stationary bikes and treadmills looking out the window. The big open space
is also used for patients that are performing lunges, running in place, squatting or lifting

Martinez 8

weights. The length of my site observation was about two pages front and back, maybe it
was a lot because I write big. The time I started observing was from 11:10a.m.
12:00p.m. While I was observing I was moving around the whole clinic, even the patients
interacted with me and ask what I was doing and what it was for. There were a total of 5
patients both mixes of gender. Each patient had something wrong with them. There was a
man sitting at the leg press then he moved on to lunges then squatting. A lady with a knee
problem was using a muscle stimulator to contract her muscle while she did leg raises.
Another lady was already getting her knee iced after performing her exercises for the day.
There was a man that was barley operated from his knee that was doing basic exercises
like leg pulls with a towel, contracting his muscle, side leg raises, and leg stretches. A
man with a shoulder problem was being evaluated by Kevin towards the back of the
room. Kevin made him do a couple of exercises to see he how he has been progressing
through his therapy sessions. Kevin made the man do push-ups, lifting dumbbells above
his head while walking around the clinic; he even made him so circuits. Observing the
man brought back painful memories when I had to do Kevins circuits. The technicians
were walking around the whole clinic assisting the patients needs. Kevin went from his
office doing paper work or looking at patients results or doing research, to engaging with
the patients and their problems. In appendix D I gave more of an explanation of
observation and reflection part and a picture I created of the clinic.

Results/Discussion
With all the data I collected the past three months for my research paper, I have come to
conclusion that I want to change my major from kinesiology to biology. Kevin and the students

Martinez 9

of physical therapy have made me realize that kinesiology is not the right major to enter the field
of physical therapy. Thanks to the interview, survey and site observation and all the data I have
collected throughout the fall semester, I know where I stand and it is not in the kinesiology
community it is in the biology community. The interview made me get a true perspective from a
licensed physical therapist, Kevins thoughts about what it is to work as a physical therapist
every day, and the dedication he put into his studies before becoming a physical therapist. The
site observation gave me a feel about what I will be getting into if I get a job as physical
therapist. The different kind of patients and their disabilities, and what really happens in a
physical therapy school. With my survey I also got a perspective of different students in the
physical therapy program. As I looked over the result they all had the same answer. They put
fifty plus hours of studying per week inside and outside of class. They rated the challenge of
becoming a physical therapist as 8 out of 10 and they were all determined to become a physical
therapist after graduation. My secondary questions did relate to my primary questions. I have
answered the requirements of becoming a physical therapist.

Data coding:
Guide for Formulating Effective Interview Questions

This guide was an example I could have used to formulate my research questions but, I
did not use this guide to help me formulate questions for my interview. I wrote my ideas
on a blank document and took my ideas from there. I formulated four research questions

Martinez 10

and for each questioned I created four more that I believed was related to the question.
You can see appendix A for more details on the chart.

Your Name:

Write your direct research question here.

Write your interview questions

below. Then, check the
indirect research question(s)
for which you believe the
interview question will provide
data.

Interview Questions:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Write a
indirect
question here

Write a
indirect
question here

Write a
indirect
question here

Write a
indirect
question here

Martinez 11

For my survey questions I used the survey grid. It gave me an idea of what questions I
need to ask and that would be valuable to me and my secondary research questions. In
appendix B you can see my final survey questions that I created by using this chart
Your

Survey Question Grid

Name: Kristina Martinez
Survey Objectives:

1. Is Kinesiology the right degree to become a physical therapist or does it not

matter what I major in.
2. Can it be beneficial for me to volunteer in a clinic now to gain more experience
before perusing my career in physical therapy.
3. I not sure if I want to peruse my career in physical therapy but I want to know if
the physical therapy career is challenging
4. I was told that physical therapy take a lot of dedication to your studies

(In the right column below, indicate the appropriate objective[s] that each survey
question addresses.)

Survey Question

Objective #(s)

1. What is your major?

2. Is kinesiology the right major to become a physical therapist?

3. Are the courses you take in physical therapy school challenging?

4. On a scale 1 through 10 how challenging is it to become a

physical therapist? 10 being the hardest and 1 being the easiest.

5. Should students wanting to become a physical therapist

volunteer at a physical therapy clinic?

6. Do you believe physical therapy is going to be your future

career?

7. How much time do you put into your studies

8.
9.
10.

Martinez 12

The bar graph below is the results I got back from all ten students from the physical
therapy program. All ten students put the same answers for all questions in appendix B is
the ten results I got back. The first question I didnt know how to put into the bar graph
so, the question I had asked, What is your major and they all put doctoral of physical
therapy. In appendix B it shows the results I go back on my paper survey I created.
12
10
8
Yes

No
4
2
0
Survey
Question2

Survey
Question3

Survey
Question4

Survey
Question5

Survey
Question6

Survey
Question7

Observation Form

During my site observation I used this observation form. It kept me on the right track and
made sure I was writing down the right information. I was very handy while I was
observing because I didnt have to draw it out on paper to keep me unorganized. In
appendix D you can see my final draft.

Site Observation #1
Date:10.08.2014
Time:11:10am-12:00pm

Martinez 13
Place: 1700 Murchison St, D

Observations

Physical therapist greets patients as they

walk into the clinic
There are 5 patients in the clinic
Each patient has some kind of problem
Patients complete different exercises that
suit their problem
The physical therapist is evaluating a man
with a shoulder problem
The physical therapist stretches his are and
ask if he is having any problems
The man does different exercises in front of
the physical therapist like, holding a
dumbbell above his head, push-ups, and situps
The therapist engages with other patients
He ask them all questions like, how do they
feel, if they have any problems, pain, and if
they need anything to ask him
]The technicians help he physical therapist
with the patients
The physical therapist put more weight on
the leg press for the man that head knee
surgery
After an evaluation the physical therapist
takes the file to his office and puts it in his
computer

Reflections
The therapist is being polite
Less people show up in the morning rather
than the afternoon because people get out
of work/school
The patients have different kind of surgery
The physical therapist is checking the
progress of the patient
In order to evaluate the therapist must
check the muscles or the ligaments of the
patient to see if it is healing
The different exercise help the surgery
He shares his attention
He cares for his patients and their concerns
the therapist needs assistance and help in
the clinic
When the physical therapist cant be there
the technicians help out
The therapist check if the patient is
progress
The primary doctor must stay updated in
order for the doctor to clear the patient

The therapist gives the evaluation to the

primary doctor to determine the status of
the patient

Conclusion
I have changed my mind about the discipline. Kinesiology is not the degree that Id like to
peruse as an undergrad student. For that reason I will like to peruse a degree in biology. Since a

Martinez 14

senior in high school I had the idea of getting a bachelors degree in biology. Then I found out
about kinesiology which deals with a great deal of anatomy, but then Kevin told me, that degree
can take me to become a physical education teacher, a coach or a trainer. Once he told me that I
had changed my mind about kinesiology that instant. When I passed out my surveys, the students
of physical therapy had given me a great amount of information about physical therapy school.
Biology was probably the route that I should take as an undergrad student; I should focus on my
GPA, and study hard in my biology classes. If that is their opinion then I must take into account
that they might be right, and I had always wanted to major in biology then why not stick to my
gut. This project has helped me determine my future at UTEP and gave me a great amount of
information like what I need to do before entering the field of physical therapy. I can say now
Im not in the outside of my discipline, Im now on step closer to the goal line. I have learned a
lot and have had confusion about my discipline but over all I have a mindset and a bright future.
I hope that my project can help those that want to enter into the field of physical therapy. I
believe I gathered enough data and relevant information that can help those answer their
questions like mine. I have fully answered my primary research question and secondary
questions.

Appendices

(Appendix A) Interview:
1. How challenging is it to become a physical therapist? Kevin stated that trying to enter
into the physical therapy program is challenging but once youre in it is straight forward
and a great amount of work. The work was not so challenging.

Martinez 15

How did you become interested in physical therapy? He states that I first started
as Pre-Med. In college I played Rugby and hurt my shoulder. I had asked the
physical therapist that was working for the team to check out my arm, but he
never gave me a straight answer. Then I thought there has to be more to it. The
counselors had told me that I should go into Pre-Med because, in the early 90s
there werent any PT programs. Once I graduated I went ahead and went the PT
route. There are only 20 students that graduate and I stuck to it however many
times I had to try. I had asked him if the course were hands on and he told me,
It is not hands on, it is a lot of classroom work. When youre in PT school youre
in class 40 hours a week. Youre in class from 8am-12pm and youre in lab all
afternoon.

What made you choose physical therapy over other health professions? Kevin
stated, I like sports a lot and medicine and I thought I would go this route. First I
wanted to go into professional sports but then I dont want to work 72+ hours a
week, so I went ahead and went with a clinic which Im happy with. I interned
with the Texas Rangers and saw how hard those PT had to work. So I went with
sports medicine because it would give me a secure job. I majored in microbiology
but that did not equal a job so I needed a degree that would equal a job.

Are you happy in this profession? Why? Kevin stated, Yes, because it is like a
hobby I really like the current trend. It evolves now compared what we did a
couple of years ago.

2. Is kinesiology the right major to become a physical therapy? Kevin stated, It is probably
the most applicable with what you learn but maybe not the best degree to get you into the

Martinez 16

program. The program like the harder science degrees, having microbiology helped me
get in. There are many other students applying with Kinesiology degrees. It is not that
they dont get in. The program also likes to see other people from other universities. The
problem with Kinesiology is that is that they should be more complex and there are a lot
of people in that degree that are going to be coaches or P.E teachers or some are pre
physical therapy or be strength and conditioning coaches. If they had a pre physical
therapy degree that would be awesome.

What major did get your bachelors degree in? Kevin said Microbiology and
minor in Chemistry.

Why did you choose the major you chose? Because I was Pre-Med

Is advanced education required to maintain employment or to advance in this

profession? Not to advance but to maintain our licensed we need to do 30 hours
every two years of courses it is a way to keep learning. These courses are most
like classroom typesetting, presentations and there is mini breakout sessions that
is hands on and they demonstrate in small groups.

Does it matter what degree you get in order to become a physical therapist? Why?
Not really you just need to take the pre requisites it is like 90 hours, you have to
have classes that are in your major that are required for physical therapy school.

3. Should I volunteer at a local clinic to gain experience? You have to volunteer just to
apply, so yes. They make you 50+ depending on the school you go too.

Did you volunteer at a clinic before becoming a physical therapist, if yes, how
was your experience? I did and it was bad. I just stood in a corner for 200 hours,
back then it was 150 hours. Nobody talked to me. It was awful. I hated it. We are

Martinez 17

really nice to our volunteers, they wonder around and engage. The experience I
had was pretty poor.

What information can I gain if I volunteer? An idea of what happens in the

clinic.

How much prior experience is needed? none

Would you consider recommending students to volunteer at your clinic? Why?

We do because a lot of our employees here started off as volunteers. Two of our
three techs were volunteers. It benefits our clinic and constantly meet new people
or potential go to physical therapy school and hire them as a PT or work in our
clinic as a tech.

4. How can I learn more about physical therapy? Blogs. When I went to PT school for my
first my first couple years as a physical therapist there wasnt YouTube, I didnt even
have a computer in my office. I talked to a recorder for my notes. So I didnt type I sat at
my desk and talk to my recorder. Now I can read blogs online or stories and endless
learning online. We just watched a YouTube video on the foot. Learn the basics first,
learning anatomy is a good one. If you dont know anatomy you cant read any other
stuff. Basic Bio-Mechanics, joint movement and the basic things. When you come across
a word you can just Google it.

What is physical therapy? Range, motions, and strength.

What kind of activities/duties is involved in this profession? Patient care is your

duty. Psychiatry, psycho social issues, different personalities, having patients for
different personalities. In physical therapy 2+2 almost never equals 4 because it is
like you think the person should be getting better and sometimes they are not and

Martinez 18

why is that? But I really like physical therapy it is pretty much problem solving.
We get to figure things out and a lot of times the doctors write us an order that
says evaluate and treat, which means it is kind of up to us what we want to do
with the person sometimes they give us a specific protocol they kind of want us to
use, but most of our scripts say evaluate an treat. I dont know if PT school tells
you that to figure what to do with a person here in this setting.

What qualities or characteristics do you think make a good physical therapist?

Believing in you. Having good appreciation like what works, what doesnt and
trying not to waste peoples time. People that come to our clinic I want them to
get a huge intervention and get a lot out of there sessions. We just want you to get
the best treatment possible. We are not worried about bottom line we provide to
give service and for people to get better.

(Appendix B) Survey:
The results I got back from my ten surveys were all the same. The mix of females and
males picked the same answers for all 6 questions. I kind of got confused with the first question
because while they were filling out the survey, one of the girls had told me that maybe I should
major in Biology. Instead of majoring in Kinesiology, I will be majoring in Biology.

Martinez 19

Physical Therapy Survey

By: Kristina Martinez
The purpose for this survey is collect data for a research paper Im currently
writing in my Rhetoric and Composition 1311 class this fall semester at UTEP. I
will appreciate if you may help me gather results for my secondary questions by
answering the following questions on the next page.
1. What Is Your Major? Doctoral Physical Therapy
2. Is Kinesiology the right major to become a physical therapist? Circle the choice of your
answer.

Yes

No

3. Are the courses you take in physical therapy school challenging? Circle the choice of your
answer.

Yes

No

4. How much time do you put into your studies per week? Circle the choice of your answer.

Martinez 20

Less than 15 hours

20 hours

30 hours

40 hours

50 hours

More than 50 hours

5. On a scale 1 through 10, how challenging is it to become a physical therapist? (10 being the
hardest and 1 being the easiest.) Circle the choice of your answer.
1

10

6. Should students wanting to become a physical therapist volunteer at a physical therapy

clinic? Circle the choice of your answer.

Yes

No

7. Do you believe physical therapy is going to be your future career? Circle the choice of your
answer.

Yes

No

Thank you for taking your time to complete my survey. Your answers will help me determine
data and results for my research paper.

(Appendix C) Document:
Mary Dockter, Joellen Roller and Jody Eckert
Program in Physical Therapy, University of Mary, Bismarck, ND, USA
Received 6 January 2011
Accepted 11 June 2011
Abstract.

Martinez 21

OBJECTIVE: The purpose of this case report was to describe an innovative model for
transforming physical therapist students into clinical instructors with the use of a pro bono clinic.
This model may assist other academic programs in creating effective approaches to transition
entry-level students into future quality clinical instructors.
PARTICIPANTS: Third year physical therapist students served as clinical instructors for
second year students.
METHODS: Peer and self assessments were collected to assess intended objectives.
RESULTS: Second year students were made more aware of the role of the clinical instructor
and were able to evaluate the effectiveness of clinical teaching and third year students
appreciated the impact of clinical teaching and increased their desire to become clinical
instructors in the future.
CONCLUSIONS: Student self and peer assessments reveal that this experiential model is an
effective way of transitioning entry-level physical therapist students into the role of clinical
instructor.
Keywords: Pro bono clinic, clinical instructor, experiential learning
Clinical education is a vital component of physical therapist (PT) education programs and it is
well established that quality clinical instruction is key to student learning. Program directors and
clinical instructors (CIs) agree that quality teaching and evaluation skills, as well as interpersonal
and professional skills such as maintaining an open and collegial environment and making time
for the student are important in professional education [10,12]. Clinical instruction has a
powerful effect on student learning and can shape students future attitudes toward work and
future clinical practice [17]. The American Physical Therapy Association (APTA) created a
voluntary credentialing program for CIs in 1996 [1]. The program consists of 15 contact hours

Martinez 22

and entails didactic training followed by formal assessment. Candidates who successfully
complete the programs assessment centers are awarded
APTAs CI credential. While the Commission on Accreditation of Physical Therapy Education
(CAPTE) requires academic programs to annually report the number of APTA-credentialed CIs
who have worked with students in their program, students do not perceive credentialed CIs to
demonstrate more effective teaching behaviors than non-credentialed CIs [16]. The APTAs
Guidelines and Self-Assessments for
Clinical Education recommends one year of clinical experience as the preferred minimum
criteria for clinical instructors [2]. Recent statistics reveal that the majority of CIs have less than
9 years of experience in that role [5, 8,16].While the optimum number of years of experience is
not known, research has shown that years of experience are positively correlated to effective
teaching behaviors [5,16]. Since students do not regard credentialed CIs as more effective
teachers than non-credentialed and because effective clinical teaching probably comes years after
students graduate from their professional programs, it remains unclear how academic programs
can effectively support and develop clinical faculty in their role as CIs. CAPTE criterion CC
5.15 [6] requires programs to prepare students to participate in the clinical education of students.
While PT programs often contain coursework that prepares students to educate clients and
families, it is not known how programs arent cooperating CI training into their curriculum. It is
known, however, that the use of peer coaching with experienced and novice students are
effective in enhancing the clinical performance and reasoning in PT students [11]. A majority of
PT programs have developed some aspect of pro bono learning activities [15] into their programs
as pro bono clinical experiences have been shown to enhance student readiness to enter full-time
clinical internships [9]. In addition to providing a valuable service to the community, on-site

Martinez 23

clinics also benefit faculty as they are able to maintain some clinical practice hours, reinforce
classroom concepts, and provide an accessible patient population for potential research projects
[13]. This case study describes the development of a unique educational model that integrates
clinical teaching development and peer coaching in an entry-level DPT program within a parttime pro bono clinical experience. Evaluation of outcomes was completed using student self
assessment, peer assessment, course evaluations, and student reflections. Our objective is to
provide a model on which other academic programs could create effective approaches in order to
transition entry level students into quality clinical instructors for the future.
2. History and description
The mission of the University of Mary is to serve the religious, academic, and cultural needs of
the region and beyond, and it has a strong emphasis on servant leadership. All students
participate in experiences that allow competence mastery in the profession, decision making
skills based on the Benedictine Values, and service to others [14]. The PT education program,
with an annual enrollment of 36 students per class, was developed in 1995. With 32 weeks of
full-time clinical internship, the PT program was on the lower end of the range for clinical
experience hours [7]. The on-site pro bono clinic was initially developed in 2000 as a method of
incorporating additional time into the existing curriculum. In 2008, the Director of Clinical
Education (DCE) proposed additional learning activities and assessments that would enhance the
third year students development as clinical instructors as well as the second year students
ability to perform peer review and provide constructive feedback. At the beginning of each
semester, selected students visit area PT facilities to reinforce the mission, deliver marketing
materials, and answer questions. PTs are encouraged to refer patients without insurance, or
patients whose insurance has run out, to the clinic. In addition to referrals from therapists,

Martinez 24

students, faculty, and staff from the University are encouraged to come to the clinic. Initially,
faculty planned to add the clinic without tying it to a course; however, in order for students and
faculty to be covered by liability insurance, the clinic needed to be included in a specific course.
Fortunately, there was availability in the curriculum to add one credit to the spring semester of
Year One and one credit to both the fall and spring semesters of Year Two. Clinic
responsibilities and clinical teaching were included in the Leadership Administration
Management Professionalism (LAMP) III class for third year students. The program director
created a formula that accounted for increased faculty workload for the DCE and supervising
faculty.
3. Curriculum description
The PT curriculum is a 3+3 model; students need a minimum of 92 undergraduate credits and a
minor if they do not have a baccalaureate degree prior to admission. The curriculum is designed
as a hybrid model that encompasses a systems approach to PT practice and has professional
skills and behaviors woven throughout the three years. Core courses are organized into four
major content categories: Foundational Sciences; Clinical Sciences; LAMP; and Clinical
Education and are arranged either vertically or horizontally, depending on how to best facilitate
student learning The full-time clinical education portion of the curriculum allows students to
apply knowledge and skills during four full-time 8-week internships. The first internship occurs
in July-August of the first year; MayJune of the second year; and the entire spring semester of the third year. Students participate in
the integrated clinical education portion of the curriculum during 4 of the didactic semesters. The
specific placement of these clinical experiences is demonstrated in Table 1. During the spring
semester, first year students are paired with second year students for 2-week rotations (Integrated

Martinez 25

Clinical Experience I and III respectively). During the fall semester, second year students are
paired with third year students. It is during the fall semester that the clinical teaching experience
described in this case study occurs (Integrated Clinical Experience II and IV respectively).
Specifically, third year students are enrolled in LAMP III. As a component of the class, students
prepare for their final two clinical experiences. Additionally, students are taught various teaching
strategies in the clinical setting including the use of paper cases, role playing, and questioning,
appropriate use of feedback and supervision, evaluation principles, and conflict resolution.
Concurrently, second year students are enrolled in Integrated Clinical Experience II.
4. Clinic participants and resources
4.1. Physical therapist student roles and responsibilities
Third year students in LAMP III are required to actively participate in one of six clinic
committees: 1) staffing and scheduling, 2) marketing, 3) quality control, 4) supplies, 5) policies
and procedures, and 6) budgeting and reimbursement. Near the end of the fall semester and prior
to the third year students departure for their final two full-time clinical internships, duties and
responsibilities for each committee are transitioned to the second year students. The second year
students maintain responsibility for clinic management throughout the spring semester as part of
their assignment for Integrated Clinical Experience II. During the fall clinical experience, third
year students supervise and guide the second year students during all patient interactions. If there
is free time available during the clinic, students are expected to role play patient scenarios and
practice learned skills. At the end of a patient session, student pairs discuss patient cases and
assign responsibilities related to documentation with the expectation that third year students will
peer review prior to forwarding the documentation to the supervising faculty member for

Martinez 26

approval and signature. Assignments for the objectives related to clinical education include
completion of a clinical checklist
based on the APTAs Minimum Required Skills of PT Graduates at Entry Level [3]; a summary
of their role on an assigned committee for the clinic; and a self assessment of their skills as a
clinical instructor which was modified and based upon the Guidelines and Self-Assessments for
Clinical Education [2]. The specific objectives and assignments are located in Table 2. In
addition to the completion of a skills checklist and case study, second year students complete a
peer assessment of their assigned third year mentor. The assessment was modified and based
upon the Guidelines and Self-Assessments for Clinical Education [2]. Third year students use this
feedback to complete a self-assessment of their role as clinical instructor. 4.2. Faculty roles
The DCE is responsible for the operation of the clinic and assessment of student learning. In
order to provide continuity to the clinic, the DCE supervises the clinic every session. All core
faculty rotate through the clinic in 2 week increments, thus providing all faculty members the
opportunity to assess and reinforce classroom teaching. The DCE assigns a letter grade to each
student for all integrated clinical education experiences. For the third year students enrolled in
LAMP III, the clinical portion of the grade is determined based upon timeliness of assignments,
appropriate demonstration of professionalism in the clinic, thorough self assessment of their
clinical skills and critical self assessment of their role as clinical educator. Second year students,
in Integrated Clinical Experience II, receive a grade that is based upon timeliness of assignments,
achievement of at least advanced beginner status for clinical skills on an abbreviated version of
the Clinical Performance Instrument [4], and thorough, honest, and constructive feedback for the
assigned third year mentor.
5. Methods used to identify outcomes

Martinez 27

After approval from the University of Marys Institutional Review Committee, data was
collected in the fall of 2010 to determine how third year students (N=34) felt about their role as
clinical educator and how the second year students (N=37) perceived then third year students as
clinical educators. 5.1. Student assessments 5.1.1. Peer assessment following the completion of
the outpatient clinical experience hours, second year students completed the clinical instructor
feedback form (Appendix A) for each third year student who provided > 2 hrs. of direct
supervision and reviewed the feedback with their third year mentor. All second year students
responded positively to the question regarding their student clinical instructors clinical
competence and ethical behavior. In general, students felt that their mentors gave appropriate
rationale for treatment interventions and were able to demonstrate appropriate techniques for
special tests and interventions that they had not yet learned. Clinical demonstrated clinical
reasoning and evidence based practice during patient care management. One student commented,
There were numerous times where she cited clinical prediction rules for various treatments and
I feel I really benefitted from her competence in the evidence. Students related that their
mentors communicated with them before, during, and after a patient encounter as well as listened
to them during their time in the clinic. They felt that the communication, both positive and
constructive, was effective and delivered in a variety of modes (verbal, e-mail, text message).
One student cited this example of feedback he received, CI sent me an email after our first day
together indicating that she thought I knew my stuff but lacked the confidence to use it. I
appreciated her observation and was able to grow from it. All students felt that their third year
student CI was professional with patients, clients, professors, other students and healthcare
professionals in the community. My CI willingly worked with all other students in clinic by
sharing his ideas and listening to everyone elses thoughts. One student commented on the

Martinez 28

mutual benefits for all students in the program by sharing their patient care experiences in order
to better serve the patients. My mentor had just had a clinical experience in acute care whereas I
had an experience with outpatient and this was helpful because she could help me with areas I
didnt have experience with and I was able to give input in areas that she had not been exposed
to. Ninety percent of the second year students commented that their CI maximized the learning
experience with all patients seen in clinic. Student quotes included:
We would pull the patients folder and discuss starting my clinical competence and working
with a student and patients. Students recognized the difficulty of transitioning from student to
therapist to clinical instructor. One student commented, It is difficult to transition from a student
to a teacher, especially when I am still learning about the field myself. I am still developing the
skills to become a competent physical therapist. Some students (18%) began making future
plans to gain further continuing education as a clinical instructor. Other students (7%)
commented that they planned to gain some experience as a therapist to become more confident in
their own abilities before transitioning to a clinical instructor after graduation. All felt that the
experience they gained as a clinical instructor in the pro bono clinic was a beneficial experience.
All third year students reported that the experience helped them communicate effectively with
their peers. They cited good listening skills, written and verbal
Communication, non verbal cues and building an open, trusting relationship with their peers as
keys to great communication. Some students identified areas of communication that were
difficult. For example, one student wrote, I think before I could be a good professional CI, I
would like to have some experience in conflict resolution, and another said, One area of
communication that I feel I need to develop more as a CI is to hold back and let the student
answer patient questions first before I jump in to answer them. All third year students felt that

Martinez 29

they were capable of acting as role models for the second year students. In retrospect, 3% of
student clinical instructors realized they could have shared with their second year students more
of their perceived strengths and weaknesses. Overall, however, they all believed they acted
professionally in the clinic setting. After completing the clinical teaching assignment, students
recognized that they had a unique situation in mentoring students that were one year behind them
in the PT program. One student commented, I know that I am only a year ahead of the students
that we get to work with, so it was easy for me to relate my weaknesses. I was also able to bring
forth some experience that I gained on my last two clinical to demonstrate my strengths, for
example safe transferring skills for both the PT and the patient. Another student commented,
All questions were answered honestly and included ways that I struggled or dealt with situations
I am still developing my skills regarding becoming an effective educator. Most third year
students (71%) felt that they had enough knowledge of varied learning styles to adapt to the
needs of second year students and an additional 28% felt they were developing that skill. One
student commented, I remember when I was a second year student working with the third years,
and what helped me, was a variety of different learning styles. Some of it included doing
research on my own and reporting my findings, and sometimes simply reviewing a chart
together. I tried to provide these same opportunities to my student, to accommodate her style of
learning. There were third year students who went further than the original assignment and
reported that they assigned learning experiences outside of the clinic and attempted to schedule
patients that would maximize learning for their mentee. Students also saw ways that they could
improve as a CI as evident by the comment, I think to be a good CI in the future, I would need
to have some training in the different learning styles so that I could properly teach a student who
doesnt learn most effectively in a traditional manner.

Martinez 30

Third year students felt prepared to deliver feedback before, during, and after patient sessions,
and on documentation. Past experiences with ineffective feedback from a CI was helpful for
some. One student wrote, I am a big advocate of feedback ever since my most recent clinical.
The vast majority of my previous CIs feedback was negative. My self-esteem suffered. So I
gave the second year student feedback every session, whether verbal or written. However,
students recognized the need for continued competence in this area. A student wrote, I am still
developing these skills and learning the best times to provide feedback and how often I value
feedback on my own performance, and I tried to do the same. In the future, I would probably
have a time set aside each week for
Feedback/questions/what went well and what did not. At the conclusion of LAMP III, which
includes other components in addition to clinical education, students reflected on how the course
impacted their thoughts on leadership? Approximately 1/3 of the students chose to include a
paragraph about how they were impacted by their clinical educator experience. Many related that
the clinical educator experience made them realize how much they liked to teach and mentor
others and that they would definitely like to become a clinical instructor in the future. No
negative feedback was given from the third year perspective. Examples include: After hearing
from leaders in our field and being a clinical instructor briefly in our pro bono clinic I feel that
my motivation to be a clinical instructor has increased. This experience opened my eyes to the
clinical education aspect of being a physical the patient prior to seeing them which provided for a
better clinic learning experience for me. The CI verbally explained and physically
demonstrated tests they were not familiar with while with patients, as well as during one on one
interactions. All students reported the feedback given was frequent, positive, constructive, and
in a timely manner and that the experience was mutually beneficial. They appreciated the time in

Martinez 31

clinic and felt it was a good learning tool. One student wrote that the experience was helpful
and made me excited to come back to clinic the next day. 5.1.2. Third year self-assessment
Following the completion of the outpatient clinical experience hours, third year students
completed a self-assessment of their skills as a clinical instructor (Appendix). The majority of
third year students (89%) reported that they enjoyed the clinical experience and their role as a CI.
A student wrote, I feel that I did well demonstrating my clinical competence and working with
a student and patients. Students recognized the difficulty of transitioning from student to
therapist to clinical instructor. One student commented, It is difficult to transition from a student
to a teacher, especially when I am still learning about the field myself. I am still developing the
skills to become a competent physical therapist. Some students (18%) began making future
plans to gain further continuing education as a clinical instructor. Other students (7%)
commented that they planned to gain some experience as a therapist to become more confident in
their own abilities before transitioning to a clinical instructor after graduation. All felt that the
experience they gained as a clinical instructor in the pro bono clinic was a beneficial experience.
All third year students reported that the experience helped them communicate effectively with
their peers. They cited good listening skills, written and verbal communication, non verbal cues
and building an open, trusting relationship with their peers as keys to great communication.
Some students identified areas of communication that were difficult. For example, one student
wrote, I think before I could be a good professional CI, I would like to have some experience in
conflict resolution, and another said, One area of communication that I feel I need to develop
more as a CI is to hold back and let the student answer patient questions first before I jump in to
answer them. All third year students felt that they were capable of acting as role models for the
second year students. In retrospect, 3% of student clinical instructors realized they could have

Martinez 32

shared with their second year students more of their perceived strengths and weaknesses.
Overall, however, they all believed they acted professionally in the clinic setting. After
completing the clinical teaching assignment, students recognized that they had a unique situation
in mentoring students that were one year behind them in the PT program. One student
commented, I know that I am only a year ahead of the students that we get to work with, so it
was easy for me to relate my weaknesses. I was also able to bring forth some experience that I
gained on my last two clinical to demonstrate my strengths, for example safe transferring skills
for both the PT and the patient. Another student commented, All questions were answered
honestly and included ways that I struggled or dealt with situations. I am still developing my
skills regarding becoming an effective educator. Most third year students (71%) felt that they
had enough knowledge of varied learning styles to adapt to the needs of second year students and
an additional 28% felt they were developing that skill. One student commented, I remember
when I was a second year student working with the third years, and what helped me, was a
variety of different learning styles. Some of it included doing research on my own and reporting
my findings, and sometimes simply reviewing a chart together. I tried to provide these same
opportunities to my student, to accommodate her style of learning. There were third year
students who went further than the original assignment and reported that they assigned learning
experiences outside of the clinic and attempted to schedule patients that would maximize
learning for their mentee. Students also saw ways that they could improve as a CI as evident by
the comment, I think to be a good CI in the future, I would need to have some training in the
different learning styles so that I could properly teach a student who doesnt learn most
effectively in a traditional manner. Third year students felt prepared to deliver feedback before,
during, and after patient sessions, and on documentation. Past experiences with ineffective

Martinez 33

feedback from a CI was helpful for some. One student wrote, I am a big advocate of feedback
ever since my most recent clinical. The vast majority of my previous CIs feedback was
negative. My self-esteem suffered. So I gave the second year student feedback every session,
whether verbal or written. However, students recognized the need for continued competence in
this area. A student wrote, I am still developing these skills and learning the best times to
provide feedback and how often I value feedback on my own performance, and I tried to do the
same. In the future, I would probably have a time set aside each week for
feedback/questions/what went well and what did not. At the conclusion of LAMP III, this
includes other components in addition to clinical education, students reflected on how the course
impacted their thoughts on leadership. Approximately 1/3 of the students chose to include a
paragraph about how they were impacted by their clinical educator experience. Many related that
the clinical educator experience made them realize how much they liked to teach and mentor
others and that they would definitely like to become a clinical instructor in the future. No
negative feedback was given from the third year perspective. Examples include: After hearing
from leaders in our field and being a clinical instructor briefly in our pro bono clinic I feel that
my motivation to be a clinical instructor has increased. This experience opened my eyes to the
clinical education aspect of being a physical therapist. I know that I will definitely want to do
this in a year or two. I do love to teach and this will be a great way for me to do this. I LOVED
BEING A CLINICAL INSTRUCTOR this semester. I communicated very effectively and we
collaborated very well. I loved teaching her new skills that she had not yet learned. I used
various teaching strategies. I asked her to review concepts before coming to clinic. I presented
new treatments to her during clinic using both written and verbal examples. I asked her to

Martinez 34

perform many treatment techniques on me in order to hone in on her skills. I really had fun with
this experience.
5. Discussion
An innovative method of experiential learning during the didactic portion of a PT curriculum for
the purpose of developing students into the role of clinical instructors was examined. The model
for this project has been evolving over the past decade into one that is now defined and
accentuated with assignments and responsibilities. The result is that we have second year
students becoming aware of the role of the CI and evaluating the effectiveness of clinical
teaching, something very vital to them as they have 24 weeks of clinical education remaining. In
addition, third year students are becoming more aware that the role of CI could possibly be theirs
someday, and this awareness leads to an appreciation and ultimately a desire to someday become
a CI. 6.1. Challenges A challenge, as iterated by some
third year students regarding lack of readiness to be a clinical instructor when still learning
themselves, can indeed be an issue with this model. It is important that students are cognizant of
the purpose of this model of learning. That is, although students may not be ready to
independently examine, evaluate, and establish a plan of care for complex patients, much less
teach someone else to do so, they can take part in the role of teaching and mentoring someone
who knows even less than they do. 6.2. Future research/assessment to further research this
clinical educator model of experiential learning, it will be important to include questions
regarding the impact this activity had on our alumnis decisions to become clinical instructors,
which can be ascertained through alumni assessments.

Martinez 35

(Appendix D) Site Observation:

Yellow: Patients
Green: Physical Therapist
Blue: Techs

Site Observation # 1

Date

Begin Time

11.08.2014 11:10am

End Time

12:00pm

# People at Site
(demographic info.)

Place

1700 Murchison Ste, D

Closets
Table

O
f
fi
c
e

Table

Table

Table

Exit

Restrooms
Ice Room

Wall
Table

Table

Bike
Table

Table

Bike
Bike

Machine

Bike
Table

Machine
Machine
R
o
o
m
s

Open
space

Mill

Table

Machine

Table

Table

Table

Mill

W
i
n
d
o
w

Table

Door
Mirror

Observations

Physical therapist greets patients as they

walk into the clinic
There are 5 patients in the clinic
Each patient has some kind of problem
Patients complete different exercises that
suit their problem

Reflections

The therapist is being polite

Less people show up in the
morning rather than the
afternoon because people get out
of work/school
The patients have different kind

Martinez 36

The physical therapist is evaluating a man

with a shoulder problem
The physical therapist stretches his are and
ask if he is having any problems
The man does different exercises in front of
the physical therapist like, holding a
dumbbell above his head, push-ups, and situps
The therapist engages with other patients
He ask them all questions like, how do they
feel, if they have any problems, pain, and if
they need anything to ask him
]The technicians help he physical therapist
with the patients
The physical therapist put more weight on
the leg press for the man that head knee
surgery
After an evaluation the physical therapist
takes the file to his office and puts it in his
computer
The therapist gives the evaluation to the
primary doctor to determine the status of
the patient

of surgery
The physical therapist is checking
the progress of the patient
In order to evaluate the therapist
must check the muscles or the
ligaments of the patient to see if
it is healing
The different exercise help the
surgery
He shares his attention
He cares for his patients and their
concerns the therapist needs
assistance and help in the clinic
When the physical therapist cant
be there the technicians help out
The therapist check if the patient
is progress
The primary doctor must stay
updated in order for the doctor to
clear the patient

Document Analysis Citation

Dockter, M., Eckert, J., & Roller, J. (2013). Preparing physical therapy students the role of
clinical educator: A case study report. Work: A Journal of Preventions, Assessment and
Rehabilitation, 44, 255-263. http://iospress.metapress.com/content/2625672513216x35/