Clinical Education

How many and what kinds of clinical sites are available?

Given some of the changes in the clinical arena over the last 5 years (reimbursement issues and managed care issues), most PT programs have had to add clinical sites in order to ensure adequate clinical placements for their students. The number of sites will depend on the number of students, i.e. the more students, the more clinical sites are needed. Contractual arrangements are increasingly common today, where a certain number of placements are guaranteed. Kinds of sites should include acute care, out-patient and rehabilitation as a minimum. Other sites might include specialty areas of practice (pediatrics, spinal cord injury, skilled nursing facility, burn care, women’s health), etc At the University of Miami, we have over 360 clinical sites, in numerous settings and specialty areas.

For clinical education, what is the clinical instructor to student ratio?

Again, due to the changing climate in clinical education because of managed care, it is becoming more uncommon to have a 1:1 ratio in the clinical setting. Many PT programs are incorporating mixed models of 2:1, 3:1 or more, depending on the setting. Some more innovative programs are using an “Inclusion model” of clinical education, where a larger group of students work together, rotate through different settings and with different clinical instructors, and have a university-funded Director of Clinical Education as the Supervisor.

At the University of Miami, we have two Inclusion Models working, which include 40 students per year. We also utilize a 2:1 model, as well as the traditional 1:1 model. Students in the Pilot Program of the Inclusion Model gave it accolades and felt that they performed at a much higher level much earlier than their peers.

How long is the clinical education portion of the program and what areas of specialization are covered?

The clinical education portion of the curriculum varies among PT programs in terms of length/number of weeks and in terms of types of experiences. Usually, there is an expectation that all students be exposed to acute care, rehabilitation and out-patient clinics. Different schools might have additional expectations depending on the length of clinical education.

At the University of Miami, we have a total of 32 weeks of clinical education, in 4 segments of 8 weeks. The first 8 week internship occurs after the first 4 semesters and is assigned in an outpatient orthopaedic setting.  At the end of all of the classroom experiences, every student is required to complete 24 weeks of internship.  This is divided into 3 rotations with one in the acute care setting and one in the rehabilitation setting.  The remaining 8 week internship may be completed in a variety of specialty practice settings.  In addition, students are given the opportunity to observe clinical practice in a variety of settings during the curriculum.