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BSc & MSc (Pre-reg) Physiotherapy 1

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Page 1: University of Birmingham - A leading global university · Web viewComplete comments related to positive learning indicators achieved, and constructive feedback on development needs

BSc & MSc (Pre-reg) PhysiotherapyPractice Placement Assessment Form –

Marking Guide

1

Page 2: University of Birmingham - A leading global university · Web viewComplete comments related to positive learning indicators achieved, and constructive feedback on development needs

Contents

Practice Placement Assessment Form (E-PPAF) Marking Guide – Dimensions

3

Practice Placement Assessment Form (PPAF) Guide 4

2015 BSc & MSc (Pre-reg) Course Delivery 5-6

What to do if you are concerned that your student is displaying unsafe practice

7-8

Placement Administration System 9

Clinical Tutors & Area Allocation 10

Reflection Form 11-12

How to use guide 13-15

Practice Placement Marking & E-PPAF 16-

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Practice Placement Assessment Form (E-PPAF) Marking Guide – Dimensions

3

Marking Dimensions

Communication(Marked)

Personal & People Development

(Marked)

Quality(Marked)

Assessment & Treatment Planning(Marked)

Intervention & Treatments

(Marked)

Team Work (Marked)

Professionalism(Pass/ Needs

attention/Fail)

Equality & Diversity

(Pass/ Needs attention/Fail)

Health , Safety & Security

(Pass/ Needs attention/Fail

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Practice Placement Assessment Form (PPAF) Guide

4

It is the student’s responsibility to submit the completed PDF to Canvas by the specified submission date

Clinical educator emails a copy of completed form along with any other appropriate documentation to student and cc to relevant clinical tutor

Completed form is saved as PDF

Final assessment: student and educator discuss (as normal) and complete PPAF electronically. The hours section should be updated and completed at this point. Electronic signatures added as appropriate OR educator and student type in their

respective names in the appropriate box

The student sends a copy of electronic PPAF from their University email address to the educator at the beginning of placement

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2015 BSc Course Delivery

SEMESTER 1 SEMESTER 2 SUMMER TERM

0 1 2 3 4 5 6 7 8 9 10 11 V V V V 1 2 3 4 5 6 7 8 9 10 11 V V V V 1 2 3 4 5 6 7 8 9 10 11 12 13 Le

vel C

Fres

hers

R

E S H

E R

Professional Practice into the Workplace

Holiday

Professional Practice into the Workplace

Holiday Ass

essm

ent

Practice Placement

1

Managing the patient with cardiorespiratory problems

Foundations of Physiology & Pathology for Practice

Musculoskeletal reasoning and practice Foundations of Physiology & Pathology for

Practice Anatomy & Functional Movement Physical Activity & Exercise Neurological rehabilitation

Therapeutic Practice Psychosocial Basis of Patient Centred Care

0 1 2 3 4 5 6 7 8 9 10 11 V V V V 1 2 3 4 5 6 7 8 9 10 11 V V V V 1 2 3 4 5 6 7 8 9 10 11 12 13

Leve

l I

L

Managing the patient with cardiorespiratory problems

Practice Placement 2 Holiday Practice Placement 3

Widening perspective in practice

Holiday

Widening perspective in practice

study

Practice Placement 4

Sociology in practice

Sociology in practice

Integrated Studies

MSK reasoning and practice

Research

Neurological Rehab

Car

dio

Neu

ro

Int s

tudi

es

0 1 2 3 4 5 6 7 8 9 10 11 V V V V 1 2 3 4 5 6 7 8 9 10 11 V V V V 1 2 3 4 5 6 7 8

Leve

l H

Leve

l L

v e l I Practice Placement 5

Professional and Service Development

Holiday Professional and Service Development

Holiday

Practice Placement 6

Adm

in

Complex Integrated Care Complex Integrated Care

Dissertation Dissertation

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2015 MSc Course Delivery

Key

Res Meths – Research Methods

EBNMSP – Evidence Based Musculoskeletal Practice

EBNP- Evidence Based Neurology Practice

EBCRP – Evidence Based Cardiorespiratory Practice

CE – Clinical Education

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What to do if you are concerned that your student is displaying unsafe practice.

If your student demonstrates unsafe practice:

1) Prompt feedback in private - As soon as possible after the incident take your student to a private area to discuss matters. Initially you should try to let the student analyse their action in order to work out what the issues are. If you feel that the student does not have a full understanding of the consequences of their actions you should explain to them, as clearly as possible, exactly what they have done wrong and why it was wrong so they are in no doubt as to the focus of the conversation. You may use the reflective practice form (on page 19) to help both you and the student analyse the situation and agree on the necessary course of action and, if appropriate, the time frame this action should take place in. Using this form in a non threatening way will help the student access deeper levels of learning and it may also be used in their portfolio as evidence of the progression of their clinical reasoning.

2) Complete Reflective Practice form – Once you are happy with the analysis of the incident try to let the student come up with a plan of action points. These are the points that they will implement in order to make the necessary changes in their practice and avoid a repeat of the safety incident. Obviously you are free to give guidance where you feel it is needed. By encouraging the student to create their own action plan you will; encourage a deeper level of learning, be able to check the students understanding of what you have discussed and importantly you may be able to end the discussion on a more positive note. A soon as possible after completing the form you will need to arrange a suitable time in the future (for example, the end of that week or at the ½ way mark) to sit down with the student and review the progress of their action plan. Note: if, following the incident you are not happy with the performance of your student you should bring any planned review forwards to address issues as they arise.

3) Contact the Clinical Tutor for your area – Ideally this should be done soon after the completion of the reflective practice form. For minor incidents this would require no more than a brief e-mail outlining the incident and confirming that the form has been completed and an action plan agreed. If you wish to discuss the matter with your tutor personally please indicate this during your e-mail leaving your contact details at the end. The tutor will contact you as soon as possible after viewing the message. Alternatively please feel free to phone directly on the numbers provided below. For major incidents you may wish to contact the Tutor before agreeing an action plan with the student (or perhaps before you sit down to debrief the student). If so, please use the urgent contact details below. Clinical tutors will be in a position to advise on the safety policy within the School of Health and Population Sciences, they will also be more than willing to come to your place of work to offer support and guidance to both you and the student.

4) Review Action Plan in private – This is an opportunity for you and the student to evaluate their progress in terms of safe practice. Hopefully most issues will have been addressed and the rest of the placement will proceed without incident. However if a safety incident then occurs following the review, go back to start again at point 1 of this safety protocol by discussing the incident in private, and drawing up an additional reflective practice agreement and review date as before.

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What to do if your student has not met their goals by the review

First, contact your clinical tutor before the review to discuss the student’s performance. Discussion with the Tutor will centre around the appropriate course of action based upon the performance of the student on the placement up to that point. The Tutor will offer to be present at the review (assuming a suitable meeting time can be agreed with all parties) to offer support to both you and the student.

During the review the student should be clearly informed which areas they have been deficient in and why. The student will have an opportunity to discuss their performance (providing supporting evidence if they wish) A decision will be taken by you as the Educator in conjunction with the Clinical Tutor and conveyed in clear terms to the student. For example this may be a

decision to:o Alter the goals/action plan and set a date for the next review.o Keep the same goals/action plan, giving the student more time to achieve these aims. However the student may be informed that failure to achieve the

agreed goals by the date chosen may lead to failure of the placement on the grounds of safety.

Note: The above are only examples. As each situation will differ, decisions will be considered on a case by case basis.

If by the end of the placement the student displays a:

“Consistent failure to practice safely within scope of practice with limited evidence of the ability of the student to recognize the pertinent issues and bring about the necessary changes in behaviour.”

PPAF Marking Guide (2008)

They should fail the placement on the grounds of safety. In such a case, please complete the PPAF:

o Work out all grades/marks and enter them on the form in the usual way, except for the final mark.o On the back of the form next to ‘Health, Safety & Security’ ensure you circle “FAIL”.o On the front of the form do not enter a final mark in the box provided, instead write - “Safety Fail”o The form is returned to the School of Health & Population Sciences in the usual way.

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In order to access information about students coming to you on placement and other information held

about your placement area we encourage you to use our clinical placements database. Please visit:

http://mymds.bham.ac.uk/Portal/Clinical/FacilitatorsAccessArea/login.asp?URL=/Portal/Clinical/FacilitatorsAccessArea/index.asp

On entering your password you will be able to view:

Offers you have made for forthcoming placements. Names of students coming to you on placement in the next six weeks.

Student placement evaluations. Placement information held by the university and provided to students.

Change your password and contact details.

If you do not have a password, please contact:

Norma Jones

Telephone +44 (0)121 414 3508

Email [email protected]

If you require any changes to be made to your placement information please speak to Norma Jones, or contact the Clinical Tutor for your area.

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Miss Christina AndersonLead Clinical Tutor in PhysiotherapySchool of Sport, Exercise and Rehabilitation SciencesTelephone +44 (0) 121 415 8613Email [email protected]

Clinical Tutor Area - Central and SandwellSWBH BCH Sandwell MSK Acorns (Selly Oak +/- Walsall) Black Country Partnership Sandwell Community Birmingham Community PaediatricsSandwell Respiratory Care Team Sandwell Paediatrics

Mrs Nicola MiddlebrookClinical Tutor in PhysiotherapySchool of Sport, Exercise and Rehabilitation SciencesTel: +44 (0)121 414 3089Email: [email protected]

Clinical Tutor Area - CentralHeartlands Solihull Royal Star and Garter (Solihull)Good Hope Hospital Balsall Common and associated clinicsWalsall Community Queens Hospital, Burton Northampton – St Andrews West Park Wolverhampton PaediatricsBCHC Trust: MSK (various across the city); West Mids Rehab Centre; Moseley Hall Hospital; West Heath Hospital; Jaffray Centre; Intermediate Care (Norman Power, Perry Trees, Anne Marie Howes etc)

Miss Lizzie GibbensClinical Tutor in PhysiotherapySchool of Sport, Exercise and Rehabilitation SciencesTelephone +44 (0)121 414 2873Email [email protected]

Clinical Tutor Area - North and EastQE BSMHTROH Priory Hospital

Mr Paul JepsonClinical Tutor in PhysiotherapySchool of Sport, Exercise and Rehabilitation SciencesTelephone +44 (0)121 414 7583Email [email protected]

Clinical Tutor Area - West and SouthDGH – RHH, Corbett Brierley Hill Stourbridge Private Practice Droitwich Sunflower Centre Alexander Hospital, Redditch Worcester Royal KidderminsterEvesham Hospital Princess of Wales Hosp,Bromsgrove

Norma JonesPhysiotherapy Placements AdministratorTelephone +44 (0)121 414 3508 Email [email protected]

Physiotherapy – Clinical TeamSchool of Sport, Exercise and Rehabilitation SciencesThe University of BirminghamEdgbastonBirminghamB15 2TTTel: +44 (0)121 414 4115Fax: +44 (0)121 414 4121Our building is is Map reference Y14 on the Edgbaston campus map - Yellow Zone

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REFLECTIVE PRACTICE FORM

Event Summary

What was done well? What could have been done better?

What were the potential consequences of your actions?

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REFLECTIVE PRACTICE FORM

Action Plan – What would you do differently in the future? Support needed

To be reviewed:……………………………………………

Student - Signature ………………………………. Date …………. Educator - Signature ……………………………... Date…………..

Review of Action Plan (Summary)

Student - Signature ………………………………. Date …………… Educator - Signature…………………………….. Date…………..

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How to use this guide

1. A scale of 1-5 with descriptors can be located in the table below. The MSc course delivery figure will assist you understand the appropriate student standard from teaching modules delivered, alongside discussions with the student regarding their current placement experience.

A student who would be considered excellent to very good student will demonstrate the following qualities: Proactive behaviour Fluency Accuracy Timely delivery Consistency Autonomy with recognition of scope of student level practice Seek appropriate support if outside acceptable scope of practice Demonstrates positive active behaviour changes to feedback Progressive development of skills allowing increasing complexity of workload

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Highly Commended Commended Competent Below Requirement Fail5 4 3 2 1

Demonstrates and/or shows development of most learning indicators to a very good to excellent student appropriate standard.

Demonstrates and/or shows development of most learning indicators to a good student appropriate standard.

Demonstrates and/or shows development of most learning indicators to an adequate student appropriate standard.

Demonstrates and/or shows development of few learning indicators to an adequate or poor student appropriate standard.

Demonstrates and/or shows limited development of all learning indicators to an adequate or poor student appropriate standard.

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2. At half way and final assessment review each learning indicator with the marking grid to gain an overall view of student learning in the learning dimension. Complete comments related to positive learning indicators achieved, and constructive feedback on development needs of relevant learning indicators. The student should attend half way and final assessment with a completed form and their portfolio to facilitate discussion of self-reflection of learning progress and current scope of practice.

3. Following discussion of the learning dimension circle one mark for the learning dimension. At this point it is also useful to review the learning contract to facilitate an action plan for constructive feedback points.

NB. Within the learning dimensions some learning indicators may not be relevant to your speciality therefore indicate this next to the specific learning indicator with N/A.

All marking dimensions should receive a mark therefore if you are unable to mark a particular marking dimension

contact your Clinical Tutor to discuss this as soon as possible.

1. COMMUNICATIONi) Verbal and Non-verbal Communication Learning indicators:

Demonstrates a range of communication skills, e.g. verbal, non-verbal skills, interpreter, appropriate and adaptable to optimise effective instruction, advice, information and professional opinion to a diverse range of people e.g. service users, colleagues & others, age, culture, capacity, belief, gender, ethnicity, socio-economic

Demonstrates recognition and understanding of service user barriers to communication e.g. cognitive impairment, language, hearing impairment, age,

Demonstrates active listening skills with a range of people e.g. patients, relatives, MDT, to understand needs.

Half-way Assessment: Type comments here

Mark

Final Assessment: Type Comments here

Mark

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4. On the final E-PPAF fill in each circled mark from the learning dimensions in the dimensions table.5. An automatic calculation of the learning dimensions mark will be seen in the Final Mark box.

6. In the marks and % table identify the corresponding percentage range. The percentage range allows clinical educators

to evaluate and reflect in the percentage mark a student who has been close to receiving a higher/lower mark in

several learning dimensions.

7. The percentage mark is then recorded in the Final Percentage box.

8. Clinical educators then complete focused feedback points on the E-PPAF. However greater detail maybe provided in the format of the educators choice to the student.

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Practice Placement Marking

The first three are sections are pass / needs attention /fail. At any point if you are consider any situation may be needs for attention or fail contact the clinical tutor team immediately to discuss this. Once an improvement notice has been issued for a placement it can not be removed. A ‘needs attention’ needs to be reported to the clinical team immediately as aspects of professionalism will need to be addressed prior to future practice placements. The student will meet with their clinical visitor at the University to formulate an improvement plan and will be followed up to ensure the adjustments have been made. If you have any questions regarding the process please contact the clinical visitor for your area.

Failure of any of the three sections would occur if the student CONSISTENTLY displays poor levels of performance in one or more of the areas listed, despite being given the opportunity to make improvements. A student failing the Professionalism or Health, Safety & Security or Equality & Diversity section fails the placement as a whole. If you identify poor levels of Professionalism, Health, Safety & Security or Equality & Diversity in your student please contact your clinical visitor at the earliest opportunity who will arrange a visit to offer support. In the event of a failure in any of these sections then continue to fill in all other marks in the usual way.

Professionalismb) Displays enthusiasm & willingness to learn

c) Has an appropriate attitude to work

d) Has an appropriate manner with patients

e) Has an appropriate manner with staff

f) Ability to deal with constructive criticism

g) Suitable attendance and timekeeping#

h) Maintains patient confidentiality at all times

i) Maintains a professional appearance

j) Recognises professional boundaries

k) Respects patient privacy at all times

l) Understands the importance of maintaining their own health

Half-way Assessment Outcome: Professionalism Assessment – Choose option here

Half-way Professionalism Assessment Needs attention comments. Please state the relevant letter/s the needs attention has been issued for and provide comments.

Final Assessment Outcome: Professionalism Assessment – Choose option

Final Professionalism Assessment Needs attention comments. Please state the relevant relevant letter/s the needs attention has been issued for and provide comments.

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# As agreed with educator at the start of the placement

Health, Safety & Securitya) Works within scope of practice

b) Works to minimise risks to health, safety and security of patients

c) Works to minimise risks to health, safety and security of staff/self

d) Reports Health & Safety issues where appropriate

Half-way Assessment Outcome: Health, Safety & Security Assessment – Choose option

Half-way Health, Safety & Security Assessment Needs attention comments. Please state the relevant relevant letter/s the needs attention has been issued for and provide

comments.

Final Assessment Outcome: Health, Safety & Security Assessment – Choose option

Final Health, Safety & Security Assessment Needs attention comments. Please state the relevant relevant letter/s the needs attention has been issued for and provide

comments.

Equality & Diversitya) Recognises the importance of people’s rights

b) Acts in ways that acknowledge an individual’s beliefs

c) Acts in ways to respect personal preferences

d) Acts in ways to respect diversity

Half-way Assessment Outcome: Equality and Diversity Assessment – Choose option

Half-way Equality and Diversity Assessment Needs attention comments. Please state the relevant relevant letter/s the needs attention has been issued for and provide

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comments.

Final Assessment Outcome: Equality and Diversity Assessment – Choose option

Final Equality and Diversity Assessment Needs attention comments. Please state the relevant relevant letter/s the needs attention has been issued for and provide

comments.

1. COMMUNICATIONii) Verbal and Non-verbal Communication Learning indicators:

Demonstrates a range of communication skills, e.g. verbal, non-verbal skills, interpreter, appropriate and adaptable to optimise effective instruction, advice, information and professional opinion to a diverse range of people e.g. service users, colleagues & others, age, culture, capacity, belief, gender, ethnicity, socio-economic

Demonstrates recognition and understanding of service user barriers to communication e.g. cognitive impairment, language, hearing impairment, age,

Demonstrates active listening skills with a range of people e.g. patients, relatives, MDT, to understand needs.

Half-way Assessment: Type comments here

MARK

Final Assessment Type comments here

MARK

iii) Documentation Communication Learning indicators:

Produces legible, accurate, comprehensive, comprehensible and complete records to professional standards and Trust legislation, policies and procedures.

Utilises range of appropriate documentation e.g. Discharge letters, medical notes, referral forms

Demonstrates maintenance of confidentiality information and disseminates information correctly in accordance with professional standards, safeguarding and information governance legislation, policies and procedures.

Half-way Assessment: Type comments here

MARK

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Final Assessment Type comments here

MARK

2. PROFESSIONAL & PEOPLE DEVELOPMENT

Demonstrates active initiation and negotiation of SMARRT learning objectives with clear strategies and suggested evidence for Learning Contract.

Prepares appropriate material before and during placement to facilitate own learning in speciality area.

Demonstrates responsibility for own personal development taking an active part in organising learning opportunities and utilising any clinical CPD time responsibly and effectively.

Demonstrates understanding and completion of a range reflective practice e.g. CPD log, Gibbs cycle, Pebblepad forms, case studies, with evidence of implementation of a change in their practice.

Demonstrates an active role and shows initiative in preparing and engaging with marking and feedback processes including presenting verbal and written portfolio evidence.

Half-way Assessment: Type comments here

MARK

Final Assessment Type comments here

MARK

3. QUALITY

Demonstrates identification and maintenance of specialty specific Trust, professional policies, and procedures.

Demonstrates awareness of audit and review of quality management within specialty area, and appropriately engages in any quality assurance processes e.g. outcome measures, notes audit

Demonstrates understanding of appropriate student level scope of practice and seeks support if outside acceptable scope of practice for student level.

Demonstrates ability to prioritise and organise one’s own workload and resources including colleagues, to deliver effective service user care provision.

Half-way Assessment: Type comments here

MARK

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Final Assessment Type comments here

MARK

4. ASSESSMENT & TREATMENT PLANNING

i) Subjective Assessment Learning indicators

Demonstrates safe, comfortable and responsive positioning of self and patient for subjective assessment.

Demonstrates involving patients in shared decision making and obtains informed consent for the assessment to be undertaken.

Demonstrates appropriate logical and enquiry based questioning techniques responding to service user cues, and uses a range of resources e.g. patient interview, medical records, consultants letters, X-rays to collate relevant factual and biopsychosocial health impacting information

Demonstrates identification of patient’s goals & expectations for assessment & intervention.

Demonstrates anatomical, physiological and pathophysiological knowledge to underpin the subjective assessment.

Demonstrates clinical reasoning of collated information, clinical signs and symptoms to formulate clinical hypotheses from complete subjective assessment findings.

Demonstrates subjective assessment in a timely manner for complexity of patient.

Formulates and prioritises objective assessment structure from subjective assessment.

Demonstrates appropriate use and interpretation of evidence based subjective outcome measure/s to assist assessment and intervention planning.

Half-way Assessment: Type comments here

MARK

Final Assessment Type comments here

MARK

ii) Objective Assessment Learning indicators

Demonstrates safe and appropriate objective assessment patient comfort & dignity, and manual handling skills.

Demonstrates adaptions to assessment to individual patient presentation and limitations e.g. physical health status, psychosocial, diversity needs

Demonstrates appropriate interpretation of patient cues and objective findings to adapt objective assessment strategy e.g. reacting to non-verbal & verbal feedback

Demonstrates anatomical, physiological and pathophysiological knowledge and understanding of objective assessment.

Identifies elements of normal compared to abnormal presentation from assessment and be aware of the potential interaction between conditions.

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Demonstrates delivery and clinically reasons appropriate tests and measurements for speciality objective assessment.

Demonstrates understanding and implements infection control procedures with objective assessment.

Half-way Assessment: Type comments here

MARK

Final Assessment Type comments here

MARK

iii) Analysis & Planning Learning indicators

Evaluates and clinically reasons the subjective and objective assessment findings to relate physiology, anatomy, pathology to signs and symptoms to formulating clinical hypothesis.

Demonstrates analytical clinical reasoning to formulating problem list, SMARRT goals and treatment intervention options.

Demonstrates ability to prioritise and understand physiotherapy goals within MDT goal setting for service user care.

Demonstrate understanding of contraindications, indications and procedures for intervention to meet goals.

Provides patient advice on options of treatment to incorporate patient choice in treatment delivery to meet goals with explanation of risks, benefits and procedure

Half-way Assessment: Type comments here

MARK

Final Assessment Type comments here

MARK

5. INTERVENTIONS & TREATMENTSi) Intervention Delivery Learning indicators

Evaluates and clinically reasons the intervention choice in relation to physiology, anatomy, pathology to signs and symptoms.

Demonstrates involving patients in shared decision making and obtains informed consent for interventions and treatments to be undertaken.

Demonstrates integration of clinical reasoning, evidence based practice, and patient choice for intervention.

Identifies any specific precautions or contraindications to the proposed interventions/treatments and takes the appropriate action.

Demonstrates safe and appropriate patient comfort & dignity, preparation of treatment environment and manual handling skills during treatment.

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Demonstrates adaptions in intervention delivery during session according to patient cues.

Demonstrates effective intervention prevention and monitoring of adverse effects to patient, colleagues & self.

Demonstrates understanding and implements infection control procedures with intervention.

Completes intervention in a timely manner

Demonstrates identification of differences between individual and group intervention delivery, refers appropriately to groups, and delivers a range of available intervention formats.

Half-way Assessment: Type comments here

MARK

Final Assessment Type comments here

MARK

ii) Intervention progression, handover and discharge planning Learning indicators Demonstrates application of Trusts protocols or national guidelines for management delivery including timeframes. Evaluates evidence based outcome measure changes, service user feedback, and goals to clinically reason adaptions in intervention and timeframes. Demonstrates use of information sharing technologies to update service user needs e.g. whiteboard, outpatient booking systems, clinic letters, case conference reports

Demonstrates understanding and utilises patient care pathways and discharge planning pathways e.g. clinics, community, IMC, community classes, care case conferences

Identifies withdrawal or independent management of treatment appropriately.

Half-way Assessment: Type comments here

MARK

Final Assessment Type comments here

MARK

6. TEAM WORK Demonstrates provision of career or MDT education to safely continue patient physiotherapy goals outside physiotherapy intervention sessions.

Demonstrates effective team work and active participation in MDT working e.g. ward rounds, case conferences, joint assessments, MDT referrals, to optimise patient care with patient consent.

Demonstrates effective and appropriate relationships with service users, professional and support staff, and others e.g. relatives.

Demonstrates understanding of a range of appropriate professionals to specialty area and refers appropriately.

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Demonstrates understanding of the need to work as an independent clinician and collaboratively as a team member or lead appropriate for student level.

Half-way Assessment: Type comments here

MARK

Final Assessment Type comments here

MARK

Many thanks for your help and cooperation. Please contact your Clinical Tutor if you require any support during placement.

E-PPAF - Choose an item.

Students & Clinical Educator Instructions - Please refer to the submission flow chart.

Submission - Refer to the relevant canvas submission dates. Any late submission will incur a penalty according to standard physiotherapy assignment submissions.

Student Name:Type comments here Clinical

Educators

Type comments here

Placement Location: Type comments here Type comments here

Speciality: Type comments here Type comments here

Professionalism Choose an item.

PASSHealth, Safety & Security Choose an item.

PASSEquality & Diversity Choose an item.

PASS

Marked Dimensions1. 2. COMMUNICATION

1.i) Verbal and Non-verbal Communication Choose an item.

1.ii) Documentation Communication Choose an item.

3. 4. PROFESSIONAL & PEOPLE DEVELOPMENT Choose an item.

5. 6. QUALITY Choose an item.

7. 8. ASSESSMENT & TREATMENT PLANNING

4.i) Subjective Assessment Choose an item. 1

4.ii) Objective Assessment Choose an item. 1

4.iii) Analysis & Planning Choose an item. 1

9. 10. INTERVENTIONS & TREATMENTS

5.i) Intervention Delivery Choose an item. 1

5.ii) Intervention progression, handover and

discharge planning

Choose an item. 1

11.12. TEAM WORK Choose an item. 1

FINAL MARK Type comments here

Has the student been involved in a recorded incident on placement? Choose an item.

YESIncidient Reference No.: Type comments here

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Practice Placement TimesheetWEEK HOURS

MON TUES WEDS THURS FRI SAT1 Hrs Hrs Hrs Hrs Hrs Hrs2 Hrs Hrs Hrs Hrs Hrs Hrs3 Hrs Hrs Hrs Hrs Hrs Hrs4 Hrs Hrs Hrs Hrs Hrs Hrs5 Hrs Hrs Hrs Hrs Hrs Hrs6 Hrs Hrs Hrs Hrs Hrs Hrs7 Hrs Hrs Hrs Hrs Hrs Hrs8 Hrs Hrs Hrs Hrs Hrs Hrs

TOTAL PLACEMENT HOURS

Marks ≤25 26-30 31-35 36-40 41-45% ≤39% 40-49 50-59 60-69 70-84

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FINAL PERCENTAGE

Type comments

here

Fill in the Marked Dimension options then add up the marks total and complete the final mark box. Review the mark bracket & relevant percentage then complete the final percentage box.

Summary Comments

Please provide 3 clear points of strength in the students performance e.g. professional manner.

Type comments here

Please provide 3 priorities of improvement with a suggested action plan for the student to take forward, e.g. Documentation accuracy within a timely manner; Review the elements of SOAP notes and identify key aspects appropriate for next speciality by creating a crib sheet.

Type comments here

Additional Comments:

Type comments here

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