Clinical Experiences Profile

Skill Acquisition Scale 1: Observation - Completed by CI and observed by student 2: Novice – Completes limited portion of the item; limited decision-making 3: Advanced beginner – Completes portions of item; requires CI input in decision-making 4: Competent – Completes item independently in straight-forward cases; consults with CI for decision-making 5: Proficient – Completes item independently in complex cases; consults CI for decision-making occasionally Clinical Experience Form

Evaluation Notes Observatio Novice Advance Competent Proficient Procedures n d beginner Lower Quarter Scan -- 11/19/2014 ------Lumbar Spine 11/19/2014 ------SI Joint 11/19/2014 6/24/2015 ------Knee -- 12/4/2014 ------Foot & Ankle 10/29/2014 ------Pediatric - Descriptive Assessment 5/27/2014 ------Pediatric - Developmental Assessment Tools -- 1/29/2015 ------Adult - Stroke 2/6/2015 5/28/2015 6/24/2015 -- --

Adult - Spinal Cord 5/15/2015 ------Adult - Vestibular 3/27/2015 ------Adult - Balance -- 6/17/2015 6/24/2015 -- -- General Deconditioning 5/15/2015 6/11/2015 ------Fall Risk 3/27/2015 5/14/2015 ------Prosthetic Evaluation 6/16/2015 ------Orthotic Evaluation 6/28/2015 ------Integumentary 6/16/2015 6/24/2015 6/29/2015 -- -- Aerobic Capacity / Endurance 6/4/2014 5/14/2015 7/2/2015 -- -- Range of Motion -- 6/6/2014 ------Strengthening Exercise -- 6/5/2014 5/24/2015 7/1/2015 -- Aerobic Capacity / Endurance Conditioning -- 5/13/2015 ------Clinical Experiences Profile

Balance and Coordination -- 6/6/2014 5/18/2015 7/1/2015 -- Postural Stabilization -- 10/29/2014 5/15/2015 -- -- Neuro-muscular Re-education -- 6/6/2014 5/22/2015 -- -- Home Exercise Programs -- -- 9/24/2014 -- -- Bed Mobility -- -- 6/3/2014 -- -- Transfers -- -- 6/3/2014 -- -- Wheelchair Mobility -- -- 6/3/2014 -- -- Gait Training -- 6/6/2014 5/15/2015 -- -- Prosthetic Training -- 6/24/2015 ------Vestibular Rehab 3/27/2015 ------Superficial Heat/Cold Modalities -- -- 11/19/2014 -- -- Ultrasound -- 10/29/2014 ------Electrotherapeuti c Modalities -- -- 11/19/2014 -- --

Spine Mobilization -- 7/1/2015 ------Soft Tissue Mobilization -- 12/4/2015 ------Pulsed Lavage 4/3/2015 ------Debridement 4/3/2015 ------Dressing 4/3/2015 ------Participation- based Interventions 3/26/2015 ------Safety Procedures -- 7/2/2015 ------Wheelchair Prescription -- 6/3/2014 ------Assistive Device Prescription -- 6/5/2014 ------Orthotic Prescription -- 6/29/2015 ------Family Education 6/4/2014 7/2/2015 ------Activities Specific Balance Confidence (ABC) -- 6/3/2015 -- 6/24/2015 -- Dynamic Gait Index (DGI) -- 5/14/2015 7/1/2015 -- -- Timed Up and (TUG) -- -- 5/18/2015 -- -- Clinical Experiences Profile

Berg Balance Scale -- -- 5/14/2015 7/1/2015 --

Single Limb Stance -- 6/6/2014 6/30/2015 -- -- Functional Independence Measure (FIM) -- -- 5/15/2015 7/2/2015 -- Gait Speed -- -- 5/15/2015 7/1/2015 -- Functional Gait Other: 1 Assessment -- 3/27/2015 ------6 Minute Walk Test -- 6/4/2014 5/18/2015 7/2/2015 -- Scheduling patients -- 7/1/2015 ------Gathering information from chart -- -- 6/6/2014 5/24/2015 -- Writing initial evaluations -- 6/6/2014 5/21/2015 -- -- Writing progress notes -- 6/6/2014 -- 5/22/2015 -- Writing home instructions -- -- 12/4/2014 -- -- Writing discharge summaries -- 5/31/2014 5/22/2015 7/2/2015 -- team communication -- -- 6/30/2015 -- -- interdisciplinary coordination of patient care -- -- 6/29/2015 -- -- understanding roles and responsibilities of team members -- -- 6/28/2015 -- --