Performance Standards

Performance Standards

Essential Functions:
Health Science programs require specific essential mental and physical functions, which must be possessed to be successful students. In general, all health programs require:

Visual acuity corrected to 20/20 and visual field perception to provide a safe environment for patients and coworkers.

Hearing acuity corrected to no greater than a 40 db hearing loss at 1000 and 2000 Hz.

Manual dexterity in fingering and grasping activities and the ability to perform repetitive fine motor actions.

Gross motor ability to reach, stoop, kneel, stand, walk, and sit.

Strength to lift at least 25 lbs. frequently and 50 lbs. occasionally.

Verbal and written communication skills adequate to exchange ideas, detailed information and instructions to others accurately through spoken or written word.
Each health program has requirements specific to success in that program and profession. Some may be more strenuous than the general functions provided here. The following guidelines are recommended as essential functions necessary for entry-level students involved in the field of Physical Therapy as a Physical Therapist Assistant. The approximate frequency of daily occurrence is also indicated.

 • Must be able to lift and/or maneuver a minimum of 50 pounds independently. (frequently) 
 • Must be able to assist in the maneuvering of up to 400 pounds. (occasionally) 
 • Must walk, stand, kneel, stoop, and lift. (consistently) 
 • Must be able to verbally communicate intent and instructions to others. (consistently) 
 • Must be able to communicate and document in written form. (consistently) 
 • Must be physically, mentally, and emotionally capable of controlling emergency situations. (occasionally) 
 • Must possess sufficient fine motor coordination, including grasping and fingering, for small object manipulation. (frequently) 
 • Must have sufficient cardiac, pulmonary, and musculoskeletal endurance. (consistently) 
 • Must perceive the nature of sounds with no less than a 40dB loss at 1,000 HZ and 2,000 HZ with or without correction. Must be able to receive detailed information through oral communication, and to make fine discrimination in sounds, such as auscultation of lung/heart sounds. (consistently) 
 • Must be capable of touching or being touched by another person or object. (consistently) 
 • Must be able to maintain biomechanical integrity among body parts to safely execute a push/pull, lift, transfer or sustain sitting and/or standing posture. (frequently) 
 • Must be able to use righting and equilibrium reactions to maintain balance during functional activities. (consistently) 
 • Must demonstrate topographic orientation. (consistently) 
 • Must demonstrate skill in multiple cognitive tasks including, but not limited to, critical thinking, generalization, attending, problem solving, recognition and sequencing. (consistently) 
 • Must demonstrate an awareness of others through the use of interpersonal skills, both verbally and non-verbally, including the recognition of gestures, facial expressions, voice quality and tone, questioning to clarify impressions and interacting in a manner that conveys respect and builds rapport. (consistently) 
 • Must possess coping skills, including the ability to recognize and manage stress and stress-related factors, accept constructive criticism, talk in front of groups of varying sizes, and use effective time management strategies. (consistently) 
 • Must be able to recognize, accept and follow the Standards of Ethical Conduct of the American Physical Therapy Association. (consistently)
• Must be able to identify and promote a positive self-concept within self and others and be able to identify, maintain and balance societal functions or roles. (consistently) 
 • Must demonstrate self-control through modifying personal behaviors in response to feedback from environmental demands, constraints, personal aspirations, and feedback from others and to exhibit socially appropriate conduct that incorporates manners, personal space, eye contact, gestures, active listening, self-expression and cultural awareness. (consistently)

These Essential Functions are also available in the Director of Special Populations Office (256-352-8052). It is the responsibility of the student to review the standards and, if required, meet with the Director of Special Populations Office to discuss them.

Clinical Requirements:
Immunizations: The administration and faculty of WSCC are committed to the health and welfare of students enrolled in allied health and nursing programs. Therefore, various immunization and medical requirements will be required following admission to the program.

Insurance: All PTA Program courses require students to carry accident and malpractice insurance, which is available through the College. Even though health insurance is not required by the PTA program, it can be required by the clinical agency. If a student does not have valid proof of health insurance, his/ her clinical placement may be limited.
Background Checks: Clinical background checks are required for all students enrolled in the PTA Program.  The cost of these checks is the responsibility of the student. Refusal of a background check or failure to successfully complete the background check will result in program dismissal.  Full guidelines on the Background Check process are available from the College's website.

Travel: Students are required to travel to clinical sites, which may entail two (2) hours or more of driving. Housing, travel, parking, and meal expenses while at clinicals are the responsibility of the student.

Reporting of Infectious Disease: The Alabama Infected Health Care Worker Management Act (Public Law 201-141) mandates that any health care worker who performs invasive procedures and who is infected with human immunodeficiency virus (HIV) or Hepatitis B (HBV) virus shall notify the State Health Officer, or his designee, of the infection. All Health Science Division students are required to follow this policy.

Policy on Drug and Alcohol Testing of Students Enrolled in Health Professional Programs: Wallace State Community College supports the concept of a Drug Free Workplace (as defined by Public Law 100-690) and prohibits the unlawful manufacture, distribution, possession or use of a controlled substance on any property owned, leased or controlled by the college or during any activity conducted, sponsored, authorized by or on behalf of Wallace State Community College. The college prohibits any form of on-campus (or campus affiliated) use and/or possession of illegal drugs, drug paraphernalia, or alcoholic beverage, which is in direct violation of local, state and federal law by students. Students found to be involved in any of these activities are subject to disciplinary action. Education of Health Profession Students at Wallace State Community College requires collaboration between the College and clinical agencies. Education of these students cannot be complete without a quality clinical education component.

The College shares an obligation with the clinical agency to protect the agency’s patients to the extent reasonably possible from harm due to students who are under the influence of illegal drugs or alcohol while in the clinical agency. The College wishes to ensure that the health and safety of students and patients are not compromised and that clinical affiliation agreements exist to provide students with quality clinical education experiences. Therefore, it is the policy of Wallace State Community College-Hanceville that students enrolling in health profession programs submit to drug testing. This testing can be announced or unannounced and will occur upon admission, for cause, or at random intervals. This policy only authorizes drug testing of students who voluntarily choose to enroll in health professional programs at the college. Any student enrolling in a health professional program will be required to submit to such testing. Educational programs and/or information will be provided to students enrolled in health professional programs to prevent drug abuse and to promote the personal well-being of the student. Full guidelines on the drug testing procedure are available from the College’s web site.

Ethical Standards:

The PTA Program also adheres to the American Physical Therapy Association’s Standards for Ethical Conduct for the Physical Therapist Assistant as the expected minimal behaviors necessary for a Student Physical Therapist Assistant. Those standards are as follows:

Guide for Conduct of the Physical Therapist Assistant

This Guide for Conduct of the Physical Therapist Assistant (Guide) is intended to serve physical therapist assistants in interpreting the Standards of Ethical Conduct for the Physical Therapist Assistant (Standards) of the American Physical Therapy Association (APTA). The Guide provides guidelines by which physical therapist assistants may determine the propriety of their conduct. It is also intended to guide the development of physical therapist assistant students. The Standards and Guide apply to all physical therapist assistants. These guidelines are subject to change as the dynamics of the profession change and as new patterns of health care delivery are developed and accepted by the professional community and the public. This Guide is subject to monitoring and timely revision by the Ethics and Judicial Committee of the Association.

APTA Guide for Conduct of the Physical Therapist Assistant

Purpose

This Guide for Conduct of the Physical Therapist Assistant (Guide) is intended to serve physical therapist assistants in interpreting the Standards of Ethical Conduct for the Physical Therapist Assistant (Standards) of the American Physical Therapy Association (APTA). The APTA House of Delegates in June of 2009 adopted the revised Standards, which became effective on July 1, 2010.

The Guide provides a framework by which physical therapist assistants may determine the propriety of their conduct. It is also intended to guide the development of physical therapist assistant students. The Standards and the Guide apply to all physical therapist assistants. These guidelines are subject to change as the dynamics of the profession change and as new patterns of health care delivery are developed and accepted by the professional community and the public.

Interpreting Ethical Standards

The interpretations expressed in this Guide reflect the opinions, decisions, and advice of the Ethics and Judicial Committee (EJC). The interpretations are set forth according to topic. These interpretations are intended to assist a physical therapist assistant in applying general ethical standards to specific situations. They address some but not all topics addressed in the Standards and should not be considered inclusive of all situations that could evolve.

This Guide is subject to change, and the Ethics and Judicial Committee will monitor and timely revise the Guide to address additional topics and Standards when necessary and as needed.

Preamble to the Standards

The Preamble states as follows:

The Standards of Ethical Conduct for the Physical Therapist Assistant (Standards of Ethical Conduct) delineate the ethical obligations of all physical therapist assistants as determined by the House of Delegates of the American Physical Therapy Association (APTA). The Standards of Ethical Conduct provide a foundation for conduct to which all physical therapist assistants shall adhere. Fundamental to the Standards of Ethical Conduct is the special obligation of physical therapist assistants to enable patients/clients to achieve greater independence, health and wellness, and enhanced quality of life.

No document that delineates ethical standards can address every situation. Physical therapist assistants are encouraged to seek additional advice or consultation in instances where the guidance of the Standards of Ethical Conduct may not be definitive.

Interpretation: Upon the Standards of Ethical Conduct for the Physical Therapist Assistant being amended effective July 1, 2010, all the lettered standards contain the word “shall” and are mandatory ethical obligations. The language contained in the Standards is intended to better explain and further clarify existing ethical obligations. These ethical obligations predate the revised Standards. Although various words have changed, many of the obligations are the same. Consequently, the addition of the word “shall” serves to reinforce and clarify existing ethical obligations. A significant reason that the Standards were revised was to provide physical therapist assistants with a document that was clear enough such that they can read it standing alone without the need to seek extensive additional interpretation.

The Preamble states that “no document that delineates ethical standards can address every situation.” The Preamble also states that physical therapist assistants “are encouraged to seek additional advice or consultation in instances where the guidance of the Standards of Ethical Conduct may not be definitive.” Potential sources for advice or counsel include third parties and the myriad resources available on the APTA Web site. Inherent in a physical therapist assistant’s ethical decision-making process is the examination of his or her unique set of facts relative to the Standards.

Standards

Respect

Standard 1A states as follows:

1A. Physical therapist assistants shall act in a respectful manner toward each person regardless of age, gender, race, nationality, religion, ethnicity, social or economic status, sexual orientation, health condition, or disability.

Interpretation: Standard 1A addresses the display of respect toward others. Unfortunately, there is no universal consensus about what respect looks like in every situation. For example, direct eye contact is viewed as respectful and courteous in some cultures and inappropriate in others. It is up to the individual to assess the appropriateness of behavior in various situations.

Altruism

Standard 2A states as follows:

2A. Physical therapist assistants shall act in the best interests of patients/clients over the interests of the physical therapist assistant.

Interpretation: Standard 2A addresses acting in the best interest of patients/clients over the interests of the physical therapist assistant. Often this is done without thought, but sometimes, especially at the end of the day when the clinician is fatigued and ready to go home, it is a conscious decision. For example, the physical therapist assistant may need to make a decision between leaving on time and staying at work longer to see a patient who was 15 minutes late for an appointment.

Sound Decisions

Standard 3C states as follows:

3C. Physical therapist assistants shall make decisions based upon their level of competence and consistent with patient/client values.

Interpretation: To fulfill 3C, the physical therapist assistant must be knowledgeable about his or her legal scope of work as well as level of competence. As a physical therapist assistant gains experience and additional knowledge, there may be areas of physical therapy interventions in which he or she displays advanced skills. At the same time, other previously gained knowledge and skill may be lost due to lack of use. To make sound decisions, the physical therapist assistant must be able to self-reflect on his or her current level of competence.

Supervision

Standard 3E states as follows:

3E. Physical therapist assistants shall provide physical therapy services under the direction and supervision of a physical therapist and shall communicate with the physical therapist when patient/client status requires modifications to the established plan of care.

Interpretation: Standard 3E goes beyond simply stating that the physical therapist assistant operates under the supervision of the physical therapist. Although a physical therapist retains responsibility for the patient/client throughout the episode of care, this standard requires the physical therapist assistant to take action by communicating with the supervising physical therapist when changes in the patient/client status indicate that modifications to the plan of care may be needed. Further information on supervision via APTA policies and resources is available on the APTA Web site.

Integrity in Relationships

Standard 4 states as follows:

4: Physical therapist assistants shall demonstrate integrity in their relationships with patients/clients, families, colleagues, students, other health care providers, employers, payers, and the public.

Interpretation: Standard 4 addresses the need for integrity in relationships. This is not limited to relationships with patients/clients, but includes everyone physical therapist assistants come into contact with in the normal provision of physical therapy services. For example, demonstrating integrity could encompass working collaboratively with the health care team and taking responsibility for one’s role as a member of that team.

Reporting

Standard 4C states as follows:

4C. Physical therapist assistants shall discourage misconduct by health care professionals and report illegal or unethical acts to the relevant authority, when appropriate.

Interpretation: When considering the application of “when appropriate” under Standard 4C, keep in mind that not all allegedly illegal or unethical acts should be reported immediately to an agency/authority. The determination of when to do so depends upon each situation’s unique set of facts, applicable laws, regulations, and policies.

Depending upon those facts, it might be appropriate to communicate with the individuals involved. Consider whether the action has been corrected, and in that case, not reporting may be the most appropriate action. Note, however, that when an agency/authority does examine a potential ethical issue, fact finding will be its first step. The determination of ethicality requires an understanding of all of the relevant facts, but may still be subject to interpretation.

The EJC Opinion titled: Topic: Preserving Confidences; Physical Therapist's Reporting Obligation With Respect to Unethical, Incompetent, or Illegal Acts provides further information on the complexities of reporting.

Exploitation

Standard 4E states as follows:

4E. Physical therapist assistants shall not engage in any sexual relationship with any of their patients/clients, supervisees, or students.

Interpretation: The statement is fairly clear – sexual relationships with their patients/clients, supervisees or students are prohibited. This component of Standard 4 is consistent with Standard 4B, which states:

4B. Physical therapist assistants shall not exploit persons over whom they have supervisory, evaluative or other authority (eg, patients/clients, students, supervisees, research participants, or employees).

Next, consider this excerpt from the EJC Opinion titled Topic: Sexual Relationships With Patients/Former Patients (modified for physical therapist assistants):

A physical therapist [assistant] stands in a relationship of trust to each patient and has an ethical obligation to act in the patient's best interest and to avoid any exploitation or abuse of the patient. Thus, if a physical therapist [assistant] has natural feelings of attraction toward a patient, he/she must sublimate those feelings in order to avoid sexual exploitation of the patient.

One’s ethical decision making process should focus on whether the patient/client, supervisee or student is being exploited. In this context, questions have been asked about whether one can have a sexual relationship once the patient/client relationship ends. To this question, the EJC has opined as follows:

The Committee does not believe it feasible to establish any bright-line rule for when, if ever, initiation of a romantic/sexual relationship with a former patient would be ethically permissible.

…..The Committee imagines that in some cases a romantic/sexual relationship would not offend ... if initiated with a former patient soon after the termination of treatment, while in others such a relationship might never be appropriate.

Colleague Impairment

Standard 5D and 5E state as follows:

5D. Physical therapist assistants shall encourage colleagues with physical, psychological, or substance-related impairments that may adversely impact their professional responsibilities to seek assistance or counsel.

5E. Physical therapist assistants who have knowledge that a colleague is unable to perform their professional responsibilities with reasonable skill and safety shall report this information to the appropriate authority.

Interpretation: The central tenet of Standard 5D and 5E is that inaction is not an option for a physical therapist assistant when faced with the circumstances described. Standard 5D states that a physical therapist assistant shall encourage colleagues to seek assistance or counsel while Standard 5E addresses reporting information to the appropriate authority.

5D and 5E both require a factual determination on the physical therapist assistant’s part. This may be challenging in the sense that you might not know or it might be difficult for you to determine whether someone in fact has a physical, psychological, or substance-related impairment. In addition, it might be difficult to determine whether such impairment may be adversely affecting someone’s work responsibilities.

Moreover, once you do make these determinations, the obligation under 5D centers not on reporting, but on encouraging the colleague to seek assistance. However, the obligation under 5E does focus on reporting. But note that 5E discusses reporting when a colleague is unable to perform, whereas 5D discusses encouraging colleagues to seek assistance when the impairment may adversely affect his or her professional responsibilities. So, 5D discusses something that may be affecting performance, whereas 5E addresses a situation in which someone is clearly unable to perform. The two situations are distinct. In addition, it is important to note that 5E does not mandate to whom you report; it gives you discretion to determine the appropriate authority.

The EJC Opinion titled Topic: Preserving Confidences; Physical Therapist's Reporting Obligation With Respect to Unethical, Incompetent, or Illegal Acts provides further information on the complexities of reporting.

Clinical Competence

Standard 6A states as follows:

6A. Physical therapist assistants shall achieve and maintain clinical competence.

Interpretation: 6A should cause physical therapist assistants to reflect on their current level of clinical competence, to identify and address gaps in clinical competence, and to commit to the maintenance of clinical competence throughout their career. The supervising physical therapist can be a valuable partner in identifying areas of knowledge and skill that the physical therapist assistant needs for clinical competence and to meet the needs of the individual physical therapist, which may vary according to areas of interest and expertise. Further, the physical therapist assistant may request that the physical therapist serve as a mentor to assist him or her in acquiring the needed knowledge and skills. Additional resources on Continuing Competence are available on the APTA Web site.

Lifelong Learning

Standard 6C states as follows:

6C. Physical therapist assistants shall support practice environments that support career development and lifelong learning.

Interpretation: 6C points out the physical therapist assistant’s obligation to support an environment conducive to career development and learning. The essential idea here is that the physical therapist assistant encourage and contribute to the career development and lifelong learning of himself or herself and others, whether or not the employer provides support.

Organizational and Business Practices

Standard 7 states as follows:

7. Physical therapist assistants shall support organizational behaviors and business practices that benefit patients/clients and society.

Interpretation: Standard 7 reflects a shift in the Standards. One criticism of the former version was that it addressed primarily face-to-face clinical practice settings. Accordingly, Standard 7 addresses ethical obligations in organizational and business practices on a patient/client and societal level.

Documenting Interventions

Standard 7D states as follows:

7D. Physical therapist assistants shall ensure that documentation for their interventions accurately reflects the nature and extent of the services provided.

Interpretation: 7D addresses the need for physical therapist assistants to make sure that they thoroughly and accurately document the interventions they provide to patients/clients and document related data collected from the patient/client. The focus of this Standard is on ensuring documentation of the services rendered, including the nature and extent of such services.

Support - Health Needs

Standard 8A states as follows:

8A. Physical therapist assistants shall support organizations that meet the health needs of people who are economically disadvantaged, uninsured, and underinsured.

Interpretation: 8A addresses the issue of support for those least likely to be able to afford physical therapy services. The Standard does not specify the type of support that is required. Physical therapist assistants may express support through volunteerism, financial contributions, advocacy, education, or simply promoting their work in conversations with colleagues. When providing such services, including pro bono services, physical therapist assistants must comply with applicable laws, and as such work under the direction and supervision of a physical therapist. Additional resources on pro bono physical therapy services are available on the APTA web site.

Issued by the Ethics and Judicial Committee

American Physical Therapy Association

October 1981

Last Amended November 2010

Last Updated: 11/30/10

Contact: ejc@apta.org