Amarillo College

PTA Program
Policy & Procedure Manual

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Program Specific Information…………………………………………………………………………………………………………………….p.3

Admission Policies/Procedures………………………………………………………………………………………………………………….p. 5

Academic Policies/Procedures…………………………………………………………………………………………………………………..p. 7

Clinical Policies/Procedures………………………………………………………………………………………………………………………p. 17

Faculty Policies/Procedures ……………………………………………………………………………………………………………………..p. 32

College Policies/Procedures………………………………………………………………………………………………………………………p. 32

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Program Accreditation

The Physical Therapist Assistant Program at Amarillo College is accredited by the Commission on Accreditation in
Physical Therapy Education (CAPTE), 1111 North Fairfax Street, Alexandria, Virginia 22314; telephone: 703-706-
3245; email: [email protected]; website: http://www.capteonline.org

Program Mission

To provide the student with positive learning experiences within an atmosphere of academic excellence and
to assure that the student acquires the knowledge, skills, and other abilities required of the entry-level
physical therapist assistant to enhance the service area.
Program Goals and Objectives

The goals and objectives of the Physical Therapist Assistant program are as follows:

1. Monitor program effectiveness

a. Program will assess graduate satisfaction
b. Program will assess employer satisfaction
c. Program will assess employment rate
d. Program will assess licensure pass rates
e. Program will assess retention rates
2. Produce clinically competent graduates
a. Students will achieve a clinical instructor ranking of “meets” level of performance compared to an
entry-level PTA or higher after completion of final clinical experience on the PTA MACs progress
report.
b. Students will receive clinical instructor approval and/or re-approval of all skills in the Professional
Behaviors, Data Collection, and Interventions sections of the PTA MACs Progress Report by
completion of the final clinical experience
c. Graduates will receive employer survey ratings of 3 or higher on the area of clinical competence for
employer surveys
3. Produce graduates who can exhibit effective critical thinking and problem solving skills
a. Students will receive clinical instructor approval or re-approval on all components of PTA MACs skills
#6 critical thinking and #9 problem solving by the end of the final clinical experience
b. Graduates will receive employer survey ratings of 3 or higher on the areas of critical thinking and
problem solving
4. Produce graduates who can express effective communication skills
a. Students will receive clinical instructor approval or re-approval on all components of PTA MACs skill
#3 Communication Skills: Oral and Written by the end of the final clinical experience
b. Graduates will receive an employer rating of 3 or higher on the area of verbal communication skills
c. Graduates will receive an employer rating of 3 or higher on the area of written communication skills
5. Promote health and wellness within the community
a. Students will participate in at least one health and wellness event within the community annually

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Plan of Study
Term Prefix, # Title Credits Lecture Contact Lab Contact Clinical Hours
Hours Hours
1 PTHA 1301 Profession of 3 48 ___ ___
Physical Therapy
1 PTHA 1405 Basic Patient Care 4 48 64 ___
Skills
1 PTHA 1321 Pathophysiology for 3 48 ___ ___
the PTA
1 BIOL 2401 Human Anatomy 4 48 48 ___
and Physiology I
1 ENGL 1301 Composition I 3 48 ___ ___

2 PTHA 2409 Therapeutic 4 48 48 __

Exercise
2 PTHA 2301 Essentials of Data 3 32 48 __
Collection
2 PTHA 1413 Functional Anatomy 4 48 48 __
2 BIOL 2402 Human Anatomy & 4 48 48 __
Physiology II
3 PTHA 2305 Neurology 3 48 __ __

3 PTHA 1160 Clinical I 1 __ __ 80

3 PSYC 2314 Lifespan Growth 3 48 __ __

and Development
4 PTHA 2431 Management of 4 48 48 __
Neurological
Disorders
4 PTHA 2435 Rehabilitation 4 48 48 __
Techniques
4 PTHA 1431 Physical Agents 4 48 48 __

4 PTHA 1161 Clinical II 1 __ __ 48

4 SPCH Speech 3 48 __ __

5 PTHA 2317 Issues in Health 3 48 __ __

Care
5 PTHA 2567 Practicum I 5 __ __ 560

5 Language, 3 48 __ __
Philosophy, &
Culture/Creative
Arts

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Admissions Policy

Prospective students must apply and be accepted into the college before applying for admission to the PTA
program. After completing the application process in the preceding spring semester, students are admitted to the
Physical Therapist Assistant program in the fall semester. All necessary application forms will be available online or
from the Program Director.

Although there are no prerequisites for entry into the PTA program, applicants must have all
developmental/remedial coursework completed prior to starting the PTA program. Developmental/remedial
coursework includes courses such as Basic, Beginning, or Intermediate Math/Algebra, Reading, and Writing.

Applicants must complete and submit an online application between February 1st and April 1st. The application will
be available at the www.actx.edu/phys_therapist website during the application period.

After receipt of the online application, the Program Director email a forms packet to applicants (see Appendix A).
The forms packet will contain a link to schedule a mandatory application finalization session. At the finalization
session, students must turn in:

a. Documentation of clinical observation hours

b. Essential Functions of the PTA form or a physical examination form completed by the applicant’s
physician
c. Amarillo College "Student Release and Waiver of Liability" form
d. College/university transcripts indicating previous coursework
e. Documentation of immunizations and/or titers for Hepatitis B (3-shot series), MMR (2 separate
immunizations), Tetanus (most recent immunization must have been completed in the last 10 years),
and Varicella (titer rather than immunization if the applicant has had chickenpox)
f. Current TB test (this expires annually)
g. Current healthcare provider CPR certification

Applications will NOT be considered if the applicant fails to bring any of the above documents to the application
finalization meeting with the Program Director.

After Spring semester courses grades are received, the application score will be calculated.

Applicants will be awarded points based on completion of the following general education courses – Anatomy and
Physiology I and II, Composition I, Speech, one Language/Philosophy/Culture/Creative Arts course, and Life-Span
Developmental Psychology. Students will receive 10 points for each "A" in these courses, 7.5 points for each "B", and
5 points for each "C".

Applicants will also receive points for completion of observation hours as follows:

a. 30 points for 30 observation hours in 3 or more different clinical settings

b. 20 points for 30 observation hours in 2 different clinical settings or experience as a PT tech in 2 different
settings
c. 10 points for 15 observation hours and/or observation in only 1 clinical setting or experience as a PT
tech in 1 setting

After calculation of the application scores, up to 20 applicants with the highest scores will be selected for entry into
the PTA program. In the event of a tie, the student who submitted the application first, as evidenced by the
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computer generated timestamp, will be selected to enter the program. Students not selected will be placed on a
waiting list and encouraged to reapply the next year.

Although the PTA program generally accepts 20 students annually, the PTA program reserves the right to decrease
the number of students accepted to the PTA program to prevent over-enrollment.

Additional Admission Criteria

The Joint Commission on Accreditation of Hospital Organizations (JCAHO) requires hospitals to conduct a Criminal
Background Check (CBC) on all employees to retain accreditation. As a direct result of that accreditation
requirement, Amarillo College requires all allied health and nursing majors to have a CBC prior to acceptance into
their respective program of study. All students applying to the Physical Therapist Assistant Program must pass a
criminal background check conducted by PreCheck, Inc. prior to admission to the program.

Certain criminal convictions that have occurred anytime in a student’s past may prevent the student from training in
a JCAHO accredited hospital and, likewise, prevent the student from taking the state licensing examination
necessary to practice after program graduation. Hospitals reserve the right to refuse admittance to an Amarillo
College physical therapist assistant student based on a past criminal record of that student. Likewise, if the student
is convicted of a crime while enrolled in the program, the hospital reserves the right to terminate training privileges
and the student will receive a grade of “F” in the clinical or practicum course at the time of conviction and cannot be
permitted to enroll in any remaining clinical/practicum courses. The student is required to notify the Program
Director immediately if any changes in his/her criminal background occur while enrolled in the PTA program.

Applicants must complete a “student release and waiver of liability” form, a minimum of 15 observation hours or
employment as a Physical Therapy Technician/Aide, and the Essential Functions for the PTA student form. In
addition, the student must provide proof of all required immunizations (tetanus/diptheria, measles, mumps,
hepatitis B, TB test, meningitis, and Varicella) and of CPR certification.

Application Forms Packet

After submission of the online application, students will receive the Application Forms Packet (Appendix A) online.
The Application Forms Packet should be completed and returned at the application finalization session.

Acceptance Forms Packet

After accepting a position in the PTA program, students will receive an acceptance forms packet (Appendix B) and an
electronic link to the PTA Student Handbook (Appendix C). These forms must be printed, signed, and returned to
the program director by the specified date or the student will forfeit his/her position in the PTA program

Transfer Policy

Students wishing to transfer to the Amarillo College Physical Therapist Assistant program must provide written
documentation from the program director of the PTA program they are enrolled in. This documentation should
state that the student is currently enrolled in “good-standing” in the PTA program and eligible to return the next
semester. If a student is unable to provide this documentation, they will not be considered a transfer student and
will need to apply for admission to the Amarillo College PTA program. If selected for admission, they will need to
retake PTHA coursework as determined by the program director. Acceptance of transfer students is dependent on
current enrollment numbers.

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Academic Policies

After acceptance of a position in the PTA program, students will receive an email containing acceptance forms. See
Appendix B for these forms.

PTA Program Attendance Policy

Regular attendance is necessary for satisfactory achievement. Therefore, it is the responsibility of the learner to
attend class. Amarillo College endorses attendance as a key to success. Attendance is required for successful
completion of the Physical Therapist Assistant program.

At the beginning of each lecture and lab, learners will be expected to sign the roster provided by the instructor.
Failure to sign in will result in the learner being marked absent for attendance purposes even if he/she is present in
class and seen by the instructor. Attendance will be taken beginning with the first course class meeting the first day
of the 2015 fall semester and will continue across the didactic courses through the last day of the 2017 spring
semester.

Each learner will be allowed only one absence for lecture or one for lab in any class. After the first absence a penalty
of five (5) points will be deducted from the final course grade for each subsequent absence. For example, a learner
who misses three (3) lectures will have ten (10) points deducted from the final grade for the course.

Full attendance of class time is also expected. A learner will be counted as “absent” if the learner is out of class more
than 20 minutes of a class time. For example, if in a given day a learner arrives 10 minutes late to class, takes an
extra 5 minutes for break and leaves class for 5 minutes for any reason(phone calls, appointments, bathroom
breaks, illness), that is considered an “absence” for the day. This type of absence counts in the total number of
absences resulting in lowering of the final course grade.

Long Term Illness Policy

Any student who is seriously ill, had surgery, been injured, is temporarily disabled, or absent to such an extent as to
be prevented from attendance in the classroom and/or practicum setting for more than two weeks, will be required
to submit a written physician’s documentation of diagnosis, prognosis, and activity limitations to the course
instructor. This physician documentation will be required BEFORE the student is permitted to return to classes
and/or practicum duty. Based on the medical information and the individual situation concerning the student’s
status in the program, the Instructor, in conjunction with the Program Director, will review the situation and reach a
decision as to the student’s continued status in the program.

If the student cannot meet the practical and/or didactic objectives required by the program, the student may be
asked to apply for a “leave of absence,” or, if necessary, for re-admission to the program at a later date. Every effort
will be made to accommodate the student’s needs; however, if the student cannot meet the required
practical/academic objectives for the specific semester within a given time period, credit cannot be given for the
course.

Late Work/ Make-Up Policy

Late work will not be accepted unless prior arrangements have been made with the course instructor. There will be
no makeups given for quizzes; however, the lowest quiz grade in each course will dropped prior to calculation of the
quiz average. Missed tests or practicals may be made up if prior arrangements have been made with the instructor.
Makeup tests will be scheduled at the end of the semester at the mutual convenience of the student and the
instructor. A 5-point penalty will be deducted from the score achieved on the makeup test. No test grade or
practical grade will be dropped. In the event, a student fails to pass a practical, the student will be given the
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opportunity to retake the practical until demonstrating successful mastery of the skill; however, the recorded grade
will be the grade received on the first practical.

Final Grade of Incomplete (I)

Under special circumstances, it may be necessary for a course instructor to issue a final course grade of
“incomplete” to provide additional time for the student to satisfactorily complete the course. Such circumstances
are rare and must be authorized by the instructor and supported by the program director. A final grade of
incomplete is not appropriate to provide a second-chance to finish a course when a grade of “F” seems inevitable.

When a final grade of “incomplete” is appropriate, a written contract to remove the “I” will be prepared by the
course instructor and signed by the instructor, student, and program director. Normally, the grade of “I” must be
converted to a passing grade within 90 days of the conclusion of the course. Under very rare circumstances, a time
extension of an additional 90 days is possible. Each case will be handled on an individual basis and no one case shall
set a precedent for another case. If the “I” is not removed in accordance with the contract, the final course grade
will be recorded as an “F”.

Progression in the PTA Program

Candidates for a degree in any Health Science curriculum must meet the requirements for graduation of the college.
In addition, students enrolled in the PTA program leading to an associate’s degrees must progress in meeting the
requirements of the program according to the following:

1. Students must complete all general education courses with a grade of “C” or better. In a semester when a
student does not earn a grade of “C” or better in a course, a student will be placed on hold within the
program. The student is eligible only in the next cycle of courses to retake courses not successfully
completed. A student who fails to reenter the program at the next offered cycle of courses needed for the
degree who wishes to complete an A.A.S. in PTA at Amarillo College must begin the PTA degree process
again including application.
2. Students must maintain current CPR certification.
3. Students must maintain annual documentation of required immunizations and health testing such as flu and
TB.
4. Students must maintain acceptable health status that allows required performance within the clinical
environment.
5. Students must successfully complete and pass a background check and remain felony free while enrolled in
the program.
6. Any student enrolled in the PTA Program at Amarillo College may be subject to random drug testing. At
several points during their academic career, students will be eligible for random sampling. Refusal to submit
will result in immediate removal from the program with no option to reapply or re-enter.
7. Students must complete all PTHA and general education courses with a grade of “C” or better prior to the
end of the second fall semester in order to PTHA 2567: Practicum I at the start of the final semester of the
PTA program.
8. Students must complete terminal clinical rotations within 18 months of the last day of enrollment in PTA
courses if there should be a lapse between the sophomore fall semester and the sophomore spring
semester.
9. Students are required to attend all scheduled classroom, laboratory and clinical sessions. The student must
fulfill all requirements for each course in the level of study before promoting to the next higher level of
study. The student must successfully complete all coursework including integrated clinicals before
promoting to the terminal clinical rotations. The grade a student earns on any assignment is the grade which
will be recorded.

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Repeat of courses/Dismissal from the Program/Withdrawal

A grade of C and above is necessary for successful completion of courses required for graduation from the program.
The student may repeat a given PTA course one time and may not fail more than two courses in different semesters
throughout the curriculum. If the student fails more than two courses, they will be dismissed from the program.
When a student repeats a course, they will need to pass a competency test for all previous PTA courses. If they fail
any or all of the other course competency tests, they will be required to repeat these courses as well.

Students must complete the program within two and a half years from their original admission date. To meet this
requirement, students are expected to enroll in a repeat course the first time it is offered. If for some reason a
student needs to drop out of the program for reasons other than academic failure, the student will be required to
pass the same competency tests for previously completed course work and will be required to complete the
program within two and a half years from their original admission date. Re-entry into the program is not automatic
and will be dependent on current class size. Students must contact the program director if they are wishing to re-
enter the program.

Grading Scale

The physical therapist assistant program uses the following elevated grading scale:
A = 100 – 92.5
B = 92.4 – 83.5
C = 83.4 – 72.5
F = 72.4 - 0

Grade Reports

At the midterm of each course, the student shall receive a grade report. If the midterm grade is failing as indicated
by the grade report, the student must contact the course instructor to schedule a planning meeting. At this
meeting, the student will be expected to develop an action plan for successful completion of the course. This action
plan should include a detailed study schedule, should identify any areas of weakness in understanding course
content, and must include methods/strategies that will be used to correct the learning deficit. Failure to meet with
the instructor or to complete the action plan will result in a 10 point deduction from the final course grade. THE
INSTRUCTOR WILL NOT BE RESPONSIBLE FOR REMINDING STUDENTS OF THEIR RESPONSIBILITY TO COMPLETE THE
MIDTERM PROCESS. THE INSTRUCTOR WILL TREAT ALL STUDENTS AS ADULTS AND WILL THEREFORE EXPECT THE
STUDENT TO APPROACH THE INSTRUCTOR TO DISCUSS ANY CLARIFICATION OF THESE GUIDELINES.

In addition to the midterm grade report, students may access grades online through the Blackboard Learning
Management System

Use of Technology for Courses

Beginning in the fall 2015 semester, students will be required to bring a wi-fi compatible laptop for all PTHA
coursework for testing and academic purposes. In addition, computers are available for student usage at the West
Campus in the Building D computer lab.

Malpractice Insurance

Each student must carry malpractice insurance as prescribed by the college for all clinical affiliations. The premium
should be paid at the Business Office along with your tuition. Each student is required to submit proof of insurance
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to the Physical Therapist Assistant program director in the form of a Xerox copy of your paid receipt. No student will
be permitted to attend clinic until proof of insurance is submitted.

On-Campus Educational Experiences

Any necessary safety regulations or procedures relating to a specific course or activity will be discussed prior to
participation in the event. The program is responsible for maintenance of equipment safety and will ensure annual
inspection/calibration of any equipment used for instructional purposes. Students have the responsibility to adhere
to all safety precautions and instructions given during laboratory and classroom interactions. Any actions taken by a
student that do not adhere to the necessary safety precautions will be addressed by the course instructor. (This
includes students in the role of patient-simulator, subject, and clinician.) Students participating in “open lab”
sessions or other activities outside of regularly scheduled class time are required to obtain instructor permission and
must be observed by the instructor before performing any procedure or using laboratory equipment.

Off-Campus Educational Experiences

During off-campus educational experiences, students have the responsibility to familiarize themselves with the
facility’s safety policies including handling body substances and hazardous materials, security and evacuation
procedures, and use of equipment. The program has the responsibility to ensure that all off-campus facilities are
licensed and/or regulated by the appropriate agency.

During all off-campus educational experiences, students must remember that all patients are protected by HIPAA
(Healthcare Information Portability and Accountability Act) which means that all patient information is to remain
confidential. The student may be reported to the appropriate agencies for failure to comply with HIPAA guidelines.

In addition, students must recognize that all patients have the right to refuse treatment by students and must
appropriately identify themselves as students prior to initiation of all treatments.

Dress Code

The program director retains the right to remove a student from a clinical site for a day or a semester if general and
clinical dress code guidelines are not followed. If a student is removed from a clinical setting, a grade of “F” can be
assigned for any course.

Beginning with the Profession of Physical Therapy and Basic Patient Care Skills courses and continuing throughout
the duration of the program, students enrolled in the Physical Therapist Assistant Program will be expected to
participate in “Professional Dress” days. The purpose of these days is to prepare students for future employment as
a PTA and the specific clothes to be worn for these days will be noted in the course syllabus for each class. Students
will receive advance notification prior to scheduling of “Professional Dress” Days. In general, when dressing for the
“Professional Dress” days and for clinical/practicum rotations, only clean, neat shirts, pants, or skirts are acceptable.
Shirts and blouses must cover the chest and midriff completely even while bending. Logos of any type are
unacceptable. Pants are to cover the hips and buttocks completely even while bending. In the event that guidelines
established by the clinical site’s dress code policies are more stringent than the Amarillo College policies, the student
is expected to abide by the more stringent policy. Shoes must be clean, affording good traction, and only closed-toe
shoes will be allowed for clinical/practicum rotations.

Jewelry should be kept to a minimum. Jewelry can be a source of infection and a source of danger particularly when
working with electrical modalities. A watch, wedding ring, and small post earrings are acceptable. Body piercings
are limited to a single set of ear piercings in each ear of female students. All other piercings visible to the public
must be removed to remain in the PTA program and to allow for healing prior to the start of clinical/practicum. This
includes but is not limited to eyebrows, nose, and any chest or abdominal piercing which might be noticed through a
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t-shirt or scrub top. A pierced tongue appliance is not permitted to be worn while on clinical duty to avoid a
potential speech complication that could jeopardize accurate communication with patients and the medical staff.
Tattoos are to be completely covered on all professional dress days and in all clinicals as well as practicums.

Your personal hygiene cannot be compromised. Body odors and/or bad breath are especially obnoxious to someone
who is already ill. Strongly scented creams, lotions, perfumes, hair sprays, after-shave lotions, etc. should not be
used as these can act as an irritant especially to patients with respiratory distress.

Keep fingernails short and clean. The skin of many patients is very fragile and easily susceptible to germs. Long
fingernails are “weapons” to these patients. Do not use brightly colored fingernail polish colors. Joint Commission
has recently restricted the use of artificial nails in health care settings.

“Hair must be neat, clean and appropriate at all times. Extreme hair styles and colors are not permitted” as noted in
the Pennsylvania Hospital administrative Policy Manual captured August 4, 2007 at
http://www.uphs.upenn.edu/pahedu/gme/policies/hr12.pdf . Hair in general should be well kept and not interfere
with the ability to treat a patient in any setting. If it could be scary to children or make a 90 year old man stare, it
needs to be changed. Your first responsibility is to the general public which you will be serving as a health care
provider. You have elected a professional career in the health care setting.

Conduct

A Physical Therapist Assistant student’s conduct should be above question at all times. Without the cooperation of
the area institutions, this program would not be possible. Misconduct by one student reflects on the entire program
and jeopardizes other students’ use of such services. Students are expected to follow the expectations and
guidelines set forth in the Clinical Instructors Manual as well as the policies of the facilities. Students may be subject
to drug testing as a condition for attendance at clinical settings. The clinical instructor or supervisor has the
authority to dismiss a student exhibiting improper or questionable behavior. Once a student has been dismissed
from a clinical, they may not return until the program director has counseled them. While in the clinics, the
students are expected to conduct themselves in a professional manner. Factors included in professional conduct
are:

a. showing respect for the patient’s needs, desires, and person

b. preserving the confidentiality of patient records and information
c. showing respect for clinical supervisors and hospital/facility personnel
d. performing duties described by the clinical instructors
e. arriving for clinicals on time and leaving at the institution’s typical shift change
f. following the facility’s policies and guidelines

Appropriate student conduct is imperative for classroom success as well. Students will be held responsible
for their actions. If at any time a student behaves in manner which is inappropriate, unprofessional, disrespectful,
argumentative, or endangers the health or safety of fellow students, instructors, patients, or the health care team”,
they will be referred to the Office of Enrollment Management and/or Amarillo College Campus Police.

The following examples of unprofessional conduct will result in disciplinary measures and may ultimately result in
removal from clinic sites, probation, or withdrawal from the PTA program.

 Verbal or nonverbal language, actions or voice inflections, or insubordination which compromises a rapport
or working relations with peers, faculty, patients and their family or healthcare team members.
 Any behavior that may compromise contractual agreements and/or working relations with clinical affiliates
or constitute violations of legal or ethical standards.

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  Using or being under the influence of any drug (OTC, prescription, illegal) that may alter judgment and/or
interfere with safe performance.”
 Dishonesty in either the academic or clinical settings

PROFESSIONALISM

At all times, students are obligated to demonstrate the professional demeanor expected of any health care
provider.

While in this educational program, it is very important that students consistently make every effort to be a team
player at all levels. Classroom, laboratory, and clinical experiences will, to some degree, be performed as a class.
What one class member does may reflect on all other members.

Each new class soon establishes its own identity based upon the attitudes and ideals of all its members. As a
member of this class, it is the student’s immediate responsibility to begin working with peers and faculty. A “loner
mentality” is not appropriate. Whenever there is discontentment or disharmony within a class unit, the goals of the
entire group become jeopardized.

To be successful, a student must ask questions, listen, express opinions, quickly correct mistakes, and respect the
opinion of others.

The faculty who teach your on-campus courses and those who will supervise you in the off-campus clinical setting
will be closely observing each student’s hands-on skills and his/her ability to demonstrate professionalism.

If a student compromises professionalism standards while in the clinical setting to an unacceptable level, the
clinical supervisor may choose to discharge him/her from that facility immediately. If that discharge is
permanent, the student will receive an “F” in the course. This same level of professionalism is also expected
while on campus and carries the same dismissal penalty should it be compromised to an unacceptable level as
determined by the program director.

Informed Consent

All students enrolled in the physical therapist assistant program are expected to participate in laboratory and
classroom activities. Students may be asked to simulate patients or therapists during these activities. All students
have the right to be informed of the activities required by a specific course and any limitations that would preclude
them from participation. All students have the responsibility to inform the course instructor of any limitation(s) that
may limit their ability to participate in an event. Students may be videotaped, audio-taped, photographed, or
otherwise recorded or imaged for instructional purposes. Students will be provided an informed consent form upon
acceptance into the PTA program.

In addition, students will be informed of any requirement(s) of clinical facilities which may include, but are
not limited to the following:
 Drug screening
 Immunization records
 Dress codes

Privacy and Confidentiality

All students have the right to expect privacy and confidentiality in regard to the following:
 Counseling and advising sessions

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  Reports regarding academic performance (including all written and oral evaluations by instructors)
 Reports regarding clinical performance (including all written and oral evaluations by clinical instructor,
student, ACCE, and CCCE)
 Academic records – faculty will respect the rights afforded students by The Family Educational Rights and
Privacy Act as outlined in the “Student Rights and Responsibilities” handbook
 Personal medical records kept by the program
o Records to be kept by the program include immunization records, admission forms, acceptance
forms, and clinical records. These records will be stored in locked filing cabinets in the Program
Director’s office and are accessible only to the program director and the ACCE.

In addition, both faculty and students are required to adhere to HIPAA guidelines regarding patient confidentiality
and privacy.

Safety Procedures

In case of an emergency, the student needs to call the Safety and Security department at 9-371-5163 and if
necessary, 9-911 for an ambulance. Students are permitted to use any available phone in the event of an
emergency.

Patients with a Communicable Disease

All physical therapist assistant students will be assigned to observe and/or work in several medical institutions.
When entering the actual medical environment, students will be expected to perform physical therapy procedures
on the based on academic preparation and skill level. Some procedures will involve patients who have
communicable diseases such as hepatitis, tuberculosis, and AIDS.

Within the course content of PTHA 1405: Basic Patient Care Skills, students will learn practices to follow when
working with patients diagnosed with communicable diseases. These practices are to be strictly adhered to. If the
student contracts a communicable disease (other than the “common cold” or influenza), he/she will immediately
report the illness to the college’s Academic Clinical Coordinator of Education (ACCE). The ACCE will require the
student to visit his/her private physician for a recommendation regarding school attendance. The school will abide
by the recommendation of the physician. A written record of the physician’s recommendation must be presented to
the clinical coordinator before returning to classes.

Potential Health Risks

Throughout the PTA program, the student may encounter potential health risks not limited to communicable
disease in both the classroom and lab setting. These may include, but are not limited to, equipment malfunction,
environmental risks, travel risks, as well as risks associated with participation with physical activities/physical
modalities.

Although faculty take all reasonable precautions and will attempt to notify the student of any risks, it is also the
responsibility of the student to minimize risk by accurately communicating pertinent health information to program
faculty in a timely manner, demonstrating safe/responsible use of all equipment, and adhering to program policies
and procedures.

Universal Precautions

Universal precautions regarding blood and body fluids must be closely practiced at all times. The following general
guidelines should be followed in classroom/clinical/and lab settings:

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 1. Gloves are worn when
a. Touching any blood, body fluids, mucous membranes, or non-intact skin.
b. Handling items or surfaces soiled with blood or body fluids.

2. Gowns or aprons should be worn if soiling of one’s clothing is likely. Hands or other skin surfaces must
be washed immediately and thoroughly if contaminated with blood or other body fluids.

3. Try to prevent injuries caused by needles or sharps. To prevent needle stick injuries, needles should not
be recapped, purposely bent or broken by hand. After use, needles, scalpel blades, and other sharp
items must be placed in a puncture-resistant container.

4. Hands must be washed before and after contact with any patient.

5. In the event of a spill of a hazardous substance (i.e. mercury from broken thermometers), the Safety
Department will be contacted regarding appropriate disposal of the hazardous materials. Any
hazardous materials must be stored in the appropriate location and labeled as hazardous.

Accidents

Any accident that may occur during a clinical or practicum rotation resulting in patient or personal injury and/or
damage to the equipment must be reported immediately to the adjunct clinical instructor or physical therapy
department supervisor. The student will be required to follow the proper procedure for documenting the incident
on the proper form at the time the incident occurred. The incident report should be returned to the clinical
supervisor immediately. A copy of this report must be submitted to a faculty member with an explanation when the
student returns to the college campus. In addition, the Amarillo College Safety and Security department will need to
be contacted so that additional paperwork can be completed.

It is the student’s responsibility to seek medical advice and/or treatment from their private physician or Concentra, a
local business that handles on-the-job injuries. If payment is required “up front”, the student will have to make the
payment and be reimbursed. Thereafter, the student may file a claim through the Amarillo College business office
to be reimbursed in accordance with the limitations of the accidental injury policy that is purchased at the time of
each practicum/clinical course registration. This medical insurance coverage does not apply to an injury that occurs
on-campus.

Equipment

PTA program faculty assume responsibility for monitoring usage of all PTA lab equipment as well as for periodic
inspections. An annual safety check/calibration is performed on all electrical equipment by an independent agent.

Students are not to use PTA lab equipment without PTA faculty present.

Class Cancellations

If Amarillo College is closed due to inclement weather, an official announcement will be made through local radio
and television stations by 6:30 AM.

Student Services

The Amarillo College Student Services tab on the actx.edu website contains links pertaining to academic, counseling,
health, disability and financial aid services.

14
Although the Advising department offers advising services to all students, once admitted to the PTA program,
students are expected to seek assistance from their department advisor – Kelly Jones advises students with last
names starting A-M, Jennifer Hilbert advises students with last names starting N-Z.

The Social Services department assists students with shelter/affordable housing, utilities, transportation, food,
clothing, childcare, substance abuse, counseling, and legal referrals.

The Disability Services department assists students with any disability-related needs.

The Financial Aid department assists students with scholarship/tuition information.

The Student Services tutoring link refers students to sources available for tutoring.

Student Competence

Prior to clinical assignments, the program will provide time for demonstration of clinical skills. Students will be
allowed to practice the skills in lab and “open lab” sessions under the supervision of the course instructor. Students
will then be expected to demonstrate a representative sampling of clinical skills in “skills check-off” sessions and in
practical examinations. If a student fails to demonstrate mastery of the skill in either the “skills check-off” or on the
practical examination, the student will be required to repeat the skill until successful mastery is demonstrated
(However, the first grade will be the recorded grade).

To further assure student competence prior to clinical assignment, students who fail a course and wish to be re-
admitted to the program will be required to demonstrate continued proficiency in all previously approved skills.

Likewise, students are required to inform all patients of their status as a student prior to intervention. Clinical
instructors are informed of this requirement and are expected to ensure that students represent themselves as
students.

Clinical Guidelines

The purpose of the clinical experiences, both part and full-time, is to expose the student to patient care in a real-life
situation. The clinicals are used for observation and application of actual treatment techniques studied in the
classroom and lab. There are three full-time clinical rotations. Students should expect to complete a minimum of
one out-of-town clinical rotation which may cause the student additional expense for room and board for the
duration of the rotation.

A very important question to consider is this: What characteristics about you as an individual may give poor
impressions to others? You cannot begin to realize, at this very early point in your new career, just how closely you
will be observed; how important it is to create a favorable impression with your patients and professional
colleagues.

An unfavorable impression can be very damaging to your long-term career.

The saying “first impressions are lasting impressions” is one that is absolutely true! Your personal appearance must
never be in question when working in close proximity with your patients, the public, and your fellow health team
members.

15
 Clinical Contracts

Clinical contracts are an established agreement between Amarillo College and the participating facility(ies). Copies
of all signed clinical contracts are maintained in the Allied Health Division Office. Both the Program Director and the
ACCE are responsible for reviewing clinical contracts each year at the beginning of the Fall semester to ensure that
all clinical contracts are current and unexpired.

Due Process

A student who has a grievance concerning an academic course in which he or she is enrolled should make an appeal
in the following order:

1. Instructor

2. Department Chair/Program Director

3. Dean

4. Vice President of Academic Affairs

5. College President

The person receiving the complaint will be responsible for conducting a thorough investigation of the complaint
and evaluation of the problem as it has been described. Any personnel on campus will be involved in this process
to the extent that their input would aid in the resolution of the concern. The complaining party will be kept
apprised of the process as it evolves and will be notified of the ultimate resolution of the concern in a timely
fashion. A record of the complaint, the ensuing evaluation and investigation process and the ultimate resolution
of the complaint will be retained in the Program Director’s files with a copy send to the Health Science Dean.
Retaliation for complaints is expressly prohibited.

Complaints Not Addressed by Due Process

This may include, but is not limited to, complaints by clinical education sites, employers of graduates, general public,
and unsuccessful program applicants. Formal complaints will be recorded on the “PTA Grievance Form” available
online. Complaints about the PTA Program should first be addressed to the PTA Program Director. Should the
complaints include the behavior or performance of this individual, the complaints should be addressed to the Health
Science Dean or alternatively, the Vice President of Academic Affairs. Complaints may also be reported online on
the PTA program webpage at www.actx.edu/phys_therapist.

The person receiving the complaint will be responsible for conducting a thorough investigation of the complaint and
evaluation of the problem as it has been described. Any personnel on campus will be involved in this process to the
extent that their input would aid in the resolution of the concern. The complaining party will be kept apprised of the
process as it evolves and will be notified of the ultimate resolution of the concern in a timely fashion. A record of the
complaint, the ensuing evaluation and investigation process and the ultimate resolution of the complaint will be
retained in the Program Director’s files with a copy send to the Health Science Dean. Retaliation for complaints is
expressly prohibited.

Filing Complaints with CAPTE

The Commission on Accreditation in Physical Therapy Education has established a formal mechanism for
consideration of complaints about programs that are accredited, are seeking accreditation, or about CAPTE itself.

16
This policy as well as the link for requesting materials to file a complaint can be found
at.http://www.capteonline.org/Complaints/

Clinical Policies/Procedures

Family Educational Rights and Privacy Act (FERPA)

The Family Educational Rights and Privacy Act (FERPA) afford eligible students certain rights with respect to their
education records. (An “eligible student” under FERPA is a student who is 18 years of age or older or who attends a
postsecondary institution.) These rights can be found at: http://familypolicy.ed.gov/content/model-
notificationrights-under-ferpa-elementary-and-secondary-schools

Criteria for Selecting Clinical Facilities

When a clinical facility is surveyed by the ACCE to join the Amarillo College PTA program, they must meet or exceed
the following criteria:

1. The clinical education site’s philosophy for patient care and clinical education is compatible with those of
the Amarillo College PTA program.
2. The clinical education program provided by the individual clinical facility is planned to meet the objectives
of the Amarillo College PTA program, its individual students, and the physical therapy service.
3. The physical therapy staff practices ethically and legally as outlined by: a. state standards of practice b.
clinical center policy c. the APTA Code of Ethics, Standards of Ethical Conduct for the Physical Therapist
Assistant, Guide to PT Practice and the policy and positions of the APTA.
4. The clinical education site is committed to the principle of equal opportunity and affirmative action as
required by federal legislation.
5. The clinical education site demonstrates administrative support of physical therapy education. a. Each site
agrees to sign and renew as needed a written agreement in a format acceptable to both parties. A
corporate clinical education agreement with an academic program may exist to cover multiple clinical
education sites. b. Each site promotes participation of its staff as a CCCE and as clinical instructors.
6. Each clinical education site has a variety of learning experiences appropriate to the setting available to
students. These learning experience are varied and include education, administration, and social
responsibility and advocacy.
7. The clinical education site provides an active, stimulating environment appropriate for the learning needs of
students. a. Each site agrees to review the Amarillo College PTA program curriculum plan, objectives, and
clinical education policies and procedures. b. Each site agrees to complete and review at midterm and final
appropriate written evaluation forms with its students. c. Each site agrees to review each Amarillo College
student’s Weekly Assessment Forms. d. Each site agrees to complete and forward all clinical education
forms, evaluations on a timely basis.
8. Selected support services are available to students. a. Each center agrees to provide current clinic site
information to the ACCE as a source of these services. b. Support services may include, but are not limited
to: emergency medical care, library facilities, email, internet, educational media and equipment, duplicating
services, and parking. c. Support services will be provided for special learning needs of students with
reasonable accommodation and in accordance with ADA guidelines.
9. The roles of physical therapy personnel are clearly defined and distinguished from one another. a. Current
job descriptions exist and are available for all levels of physical therapy personnel which are consistent with

17
 the respective state practice act and rules and regulations. b. Each site has available a physical therapy
organizational chart and policies and procedures manual.
10. The physical therapy staff is adequate in number to provide an educational program for students. a.
Adequate staff exists to provide supervision for each Amarillo College PTA student in the ratio of one
student to one supervisor unless previously discussed with the ACCE. b. Each center designates individuals
as Clinical Instructors (CIs); each CI must be a licensed PT or PTA possessing a minimum of one year of
continuous clinical experience interested in and willing to work with student.
11. Each clinical facility agrees to designate a Center Coordinator of Clinical Education (CCCE) who is responsible
for coordinating the assignments and activities of students at the clinical center.
12. If available, special expertise of clinical center staff is made available to students.
13. The clinical education site encourages clinical educator (CI and CCCE) training and development including
the completion of the APTA CI Education and Credentialing Program.
14. The clinical education site actively facilitates staff development through on-the-job training, in-service
education, continuing education, and post-professional study.
15. The physical therapy staff is active in professional activities including, but not limited to:
a. self-improvement activities b. professional enhancement activities c. membership in professional
associations d. professional activities relating to offices or committees e. papers, verbal presentations
16. Each clinical education site in its offering of physical therapy service has an active and viable process of
internal evaluation of its own affairs and is receptive to the procedures of review and audit approved by
appropriate external agencies and consumers.

Academic Coordinator of Clinical Education (ACCE)

Roles and Responsibilities

The ACCE is the faculty member at the college who is responsible for supervising clinical rotations. Different faculty
members may be assigned depending upon the clinical. Final authority and responsibility remains with the program
chair.

The responsibilities of the ACCE include, but are not limited to the following:

1. Assigning eligible students to clinical rotation and confirming the assignment in writing to each CCCE.

2. Assuring that all written contracts or letters of agreement between the college and the facilities are signed and
periodically reviewed.

3. Making regular and periodic contacts with each facility where students are placed either by phone or personal
visit.

4. Maintaining a current information file on each facility where students are placed.

5. Maintaining a clinical education notebook with updated information concerning each active clinical facility.

6. Identifying new sites for clinical rotations.

7. Developing and implementing a policy for the withdrawal of students from a facility.
18
8. Orienting students to the general purposes of clinical experiences and providing them with necessary forms.

9. Reassigning students who do not complete original assignments in accordance with the PTA Program’s policy.

10. Developing clinical programs that provide the best opportunity for the implementation of theoretical concepts
offered as part of the didactic curriculum.

11. Maintaining a collaborative relationship with all facilities.

12. Sending necessary correspondence information for each student to the CI unless responsibility is assigned to the
student.

Center Coordinator of Clinical Education (CCCE)

Roles and Responsibilities

The CCCE may be a SLP, OT, PT, or PTA at the selected clinical facility. This person coordinates placements of the
student with the ACCE and CI.

The CCCE also has is responsible for administrative functions and day-to-day supervision of the student. This person,
who may also be the CI, may delegate the day-to-day supervision of the students to one or more staff members.

The administrative responsibilities of the CCCE include, but are not limited to the following:

1. Collaborating with the ACCE in the development of a program that provides the best opportunity for the
implementation of theoretical concepts offered as part of the academic educational program.

2. Completing an updated Clinical Site Information Form (CSIF) and returning it to the ACCE as well as current
information about the facility usage of the conceptual models from which evaluation is derived, and upon which
treatment is based.

3. Collaborative effort with the ACCE in scheduling of students in order to ensure student success in the facility.

4. Familiarizing self with the policy regarding the “withdrawal of student from clinical”.

5. Notifying the ACCE of any student for whom the facility is requesting withdrawal.

6. Reviewing periodically the contractual agreement between the facility and the college and ensuring that these
agreements are signed.

7. Providing regular and periodic supervision of students.

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CLINICAL INSTRUCTOR
Roles and responsibilities of the CI

The clinical instructor must be a qualified physical therapist or a physical therapist assistant. The clinical instructor
must have a minimum of one year of clinical practice post-graduation from PT or PTA school. Clinical instructors are
expected to receive a rating of 3 or higher on the clinical instructor portion of the Student Evaluation of Clinical
Education Experiences which rates clinical instructors on creating an open, supportive learning environment, clearly
communicating weaknesses, providing constructive feedback in an appropriate and timely manner, allowing an
appropriate amount of time for discussions of patients, plans, and interventions, providing a positive role model,
and overall effectiveness as a clinical teacher. The direct day-to-day supervisory responsibilities of the CI include,
but are not limited to the following:

1. Providing an adequate orientation to the facility and to specific departmental policies and procedures.

2. Assigning patients and/or clients to the student.

3. Supervising the provisions of physical therapy services, documentation, and oral reporting of the student.

4. Assessing skill and knowledge level of the student.

5. Meeting with the student on a regular basis to establish skills to be addressed, review performance and to
provide guidance/feedback.

6. Evaluation of the student at the mid-term as well as at completion of the clinical using the performance
evaluation instruments provided by the college and the PTA MAC’S.

7. Notifying the CCCE of any problems a student may be experiencing.

8. Providing documented instances of unsatisfactory performance by a student.

STUDENT
Student Responsibilities

Take responsibility by arriving on time, and dressing according to facility recommendations.

o Show motivation and interest in clinical education.

o Take initiative without being asked.
o Perform at the appropriate level for educational background.
o Ask for assistance when indicated
o Complete an evaluation on the clinical experience in a timely manner
o Demonstrate the ability to accept constructive feedback and act on it to improve performance.
o Constructive use of all clinic time including any time not involving direct patient care.

20
o Communicates with Academic Coordinator of Clinical Education through individual interviews, written
requests, and/or telephone, as appropriate. The student is expected to actively and cooperatively assist the
ACCE in determining his/her specific clinical education objectives.
o Review provided Clinical Site Information on a particular clinical facility once placement has been assigned.
Information to be reviewed includes the dress code, hours of operation, and any requirements unique to that
facility.
o Complies with the requirements of the clinical facility to which they have been assigned which includes dress
code, hours of operation, confidentiality, etc.
o Notifies both their clinical instructor and ACCE AS SOON AS FEASIBLY POSSIBLE if they will be absent or tardy.
All absences and hours missed must be made up prior to the completion of a clinical practicum at the
convenience of the clinical facility.
o Provides transportation to and from their clinical facility.
o Incurs all expenses associated with clinical education (in addition to tuition) including, but not limited to:
transportation, meals, liability insurance, clothing/uniform, name tag, and CPR certification.
o Meets all requirements to participate in clinicals
o Adheres to the Standards of Ethical Conduct for the Physical Therapist Assistant maintained by the American
Physical Therapy Association.
o Adheres to the Drug and Alcohol Policies applicable to Amarillo College. In the event that it is suspected that a
PTA student is under the influence of drugs and/or alcohol on a clinical or PTA sponsored event, they will not
be permitted to participate in that experience. The PTA Program Director and ACCE will be notified by the
involved clinical or academic faculty. Safe transportation from the event and to the student’s place of residence
is the responsibility of the student to include any costs associated with said transportation. In addition, the
involved clinical or academic faculty has full discretion regarding the safety and adequacy of said transportation
arrangements.

Occasionally a facility will cancel an affiliation prior to its start because of unforeseen circumstances. In the event of
a last minute cancellation, every effort will be made to secure a comparable clinical replacement, depending on the
availability of existing clinical sites.

The physical therapist assistant student is representing not only the profession of physical therapy but also the
college. There are additional expectations each student is to observe during each clinical assignment. These
expectations are as follows concerning appropriate dress and hygiene.

1. Good hygiene is imperative. Any personal hygiene habits that are offensive to patients, patients’ family, as well
as staff members, such as breath and body odors, must be controlled while in the clinical areas.

2. No jeans will be worn, unless the facility expresses permission to do so.

3. Clothes should be clean and neat.

4. Clothes should not be tight fitting or revealing. Clothing should be functional for the clinic setting.

5. Appropriate foundation garments must be worn.

6. No sandals or high heeled shoes may be worn.

21
7. Hair must be clean and tied back if long.

8. Males must be clean shaven except if beard or mustache is worn; these need to be well groomed.

9. Do not wear strong perfumes or colognes.

10. Nails should be short and well groomed. Nail polish color is to be conservative. Artificial nails are not to be worn.

11. Do not wear dangling or excessive amounts of jewelry.

12. No gum chewing, smoking, or chewing tobacco is permitted when working with patients.

13. Lab coats or smocks are to be worn, unless facility specifies otherwise.

14. Name tags are to be worn at all times at the clinical facility with name tag facing forward.

Student Requirements for Participation in Clinicals

1. Grade Point Average
The student must have earned a grade of “C” or higher in all Physical Therapist Assistant courses in order to
participate in PTHA 1160: Clinical I, PTHA 1161: Clinical II, and PTHA 2567: Practicum I.

2. Health Requirements
Students are required to complete the Essential Expectations for the PTA Students after acceptance into the
Physical Therapist Assistant Program and to notify the program director and ACCE if they have any changes in
their ability to complete the essential expectations. After a change in status, they are required to get clearance
from their physician prior to clinical assignments. Health requirements, such as tuberculosis screening and
immunizations must be current, must be maintained by the student and the ACCE, and must be available for all
clinical assignments. In addition, clinic rotations may have additional testing requirements such as drug or lab
testing.

3. Liability Insurance
Each student is required to carry a $1,000,000 liability insurance policy at the cost of

$12.00 per clinical course for PTHA 1160: Clinical I, PTHA 1161: Clinical II, and PTHA 2567: Practicum I. This fee
must be paid prior to the student's participation in the clinical courses. Students who fail to meet this
requirement will not be allowed to intern in Physical Therapy departments until premiums are paid. Absence
because of non-payment of an insurance premium is considered an unauthorized absence, and the student may
be dropped from the course.

4. Current healthcare provider CPR certification.

5. Name tag
Each student must purchase an Amarillo College student PTA name tag through the West Campus Student
Assistance Center. The ACCE will notify students when they may purchase name tags.

22
6. PreCheck Background Check
Students are required to successfully complete a background check through PreCheck prior to acceptance into
the PTA program.

Unacceptable Student Conduct During Clinical Experience

Assignment of students to clinical facilities is dependent on the willingness of the facility to accept a student at a
specified time. Clinical assignment is not guaranteed with enrollment. A student is a guest in the facility to which
he/she has been assigned; consequently, if the student’s behavior or performance in any way disrupts patient
services in the facility, the preceptor or faculty may immediately terminate the student’s assignment. The standard
agreement between the college and the clinical facility states:

While the agency has the right to require the college to withdraw any student whose work, conduct, demeanor, or
willingness to cooperate with co-workers or to serve patients/clients or the public is unsatisfactory to the agency,
the agreement also grants and recognizes the right of an agency department head, in an emergency as interpreted
by that department head, in his or her discretion, to summarily relieve that student from a specific assignment or to
summarily request a student to leave the department pending final determination of the student’s future
assignment by the agency and college.

One or more of the following actions (or like actions) by a student may be grounds for immediate termination by the
college of the clinical assignment or termination from the program.

o Behavior that creates a threat to the welfare of the patient/client.

o Behavior that creates a threat to the facility to which the student is assigned.
o Behavior that threatens the continued relationship between the college and the facility.
o Violation of patient confidentiality o Failure to adhere to facility policy and/or procedures. o Repeated failure to
follow instructions. o Arguing with the supervisor. o Use of profane, abusive, or vulgar language.
o Refusal to carry out assigned duties. o Failure to follow attendance procedures. o Misrepresentation of personal
competency level.

Failure to alter behavior after constructive feedback from supervisor, may lead to the following.

If a CCCE or CI preceptor requests the withdrawal from clinic of a student, the following actions may occur.
Depending on the situation, the sequence of these actions may vary.

1. The CCCE or CI will notify the ACCE of the problems in student performance and indicate at what date
he/she wishes the student’s assignment to be terminated.

2. As soon as possible, the ACCE, CCCE, CI and the student will meet to attempt to resolve the problem(s) in
question. At this point, a plan of action will be developed to improve the identified deficit(s). Compliance with this
plan of action will affect the final decision on continuation or discontinuation of that assignment. This decision will
be determined by the AACE and the director of the PTA Program. If a facility requests the withdrawal of a student

23
from a clinical assignment, the student cannot return to that facility for any future clinical assignments nor shall the
student in any way harass employees of that facility.

3. If, in the judgment of the ACCE or program director, the student should continue in the clinical, but be
placed in another facility, attempts will be made by the ACCE to secure another site following the normal
procedures for site assignment.
4. If the student’s behavior indicates additional learning experiences will be necessary to facilitate a successful
placement, the student will be prescribed additional learning activities by the ACCE, and will be eligible for re-
enrollment. No more than one reenrollment in a clinical assignment will be allowed whether the student is
terminated for behavior problems or academic difficulty.

5. If the student indicates by his/her behavior unwillingness or inability to perform successfully in the clinical,
the student will be withdrawn from the clinical. Ability to reenroll will be based upon the appeal process outcome.

6. Any documented evidence of unprofessional/unethical behavior by the student during the clinical will result
in a written and verbal probationary reprimand (and possible dismissal) by the director of the PTA Program and will
become part of the student’s records.

Student Clinical Resolution Statement

If at any time, problems arise with the student in the clinic, the academic coordinator of clinical education or in his
absence, the program director must be notified and if appropriate, a time will be scheduled for the ACCE to meet
with the student and the clinical coordinator of clinical education to resolve the problem.

24
 Amarillo College PTA Curriculum Plan

Term Prefix, # Title Credits Lecture Lab Contact Clinical

Contact Hours Hours
Hours
1 PTHA 1301 Profession of 3 48 ___ ___
Physical Therapy
1 PTHA 1405 Basic Patient Care 4 48 64 ___
Skills
1 PTHA 1321 Pathophysiology 3 48 ___ ___
for the PTA
1 BIOL 2401 Human Anatomy 4 48 48 ___
and Physiology I
1 ENGL 1301 Composition I 3 48 ___ ___

2 PTHA 2409 Therapeutic 4 48 48 __

Exercise
2 PTHA 2301 Essentials of Data 3 32 48 __
Collection
2 PTHA 1413 Functional 4 48 48 __
Anatomy
2 BIOL 2402 Human Anatomy 4 48 48 __
& Physiology II
3 PTHA 2305 Neurology 3 48 __ __

3 PTHA 1160 Clinical I 1 __ __ 80

3 PSYC 2314 Lifespan Growth 3 48 __ __

and Development
4 PTHA 2431 Management of 4 48 48 __
Neurological
Disorders
4 PTHA 2435 Rehabilitation 4 48 48 __
Techniques
4 PTHA 1431 Physical Agents 4 48 48 __

4 PTHA 1161 Clinical II 1 __ __ 48

4 SPCH Speech 3 48 __ __

5 PTHA 2317 Issues in Health 3 48 __ __

Care
5 PTHA 2567 Practicum I 5 __ __ 560

5 Language, 3 48 __ __
Philosophy, &
Culture/Creative
Arts

25
 Course Descriptions
Term Prefix, # Title Course Description
1 PTHA 1301 Profession of Introduction to the profession of physical therapy and the role of the physical
Physical Therapy therapist assistant.
1 PTHA 1405 Basic Patient Care The application of basic patient handling, functional skills, communication, and
Skills selected data collection techniques.
1 PTHA 1321 Pathophysiology for Study of the pathophysiology of diseases/conditions encountered in physical
the PTA therapy.
1 BIOL 2401 Human Anatomy
and Physiology I
1 ENGL 1301 Composition I

2 PTHA 2409 Therapeutic Concepts, principles, and application of techniques related to therapeutic
Exercise exercise and functional training.
2 PTHA 2301 Essentials of Data Data collection techniques used to assist in patient/client management
Collection
2 PTHA 1413 Functional Anatomy The relationship of the musculoskeletal and neuromuscular systems to normal
and abnormal movement.
2 BIOL 2402 Human Anatomy &
Physiology II
3 PTHA 2305 Neurology Study of neuroanatomy and neurophysiology as it relates to neurological
conditions
3 PTHA 1160 Clinical I A health-related work-based learning experience that enables the student to
apply specialized occupational theory, skills, and concepts. Direct supervision is
provided by the clinical professional.
3 PSYC 2314 Lifespan Growth
and Development
4 PTHA 2431 Management of Comprehensive rehabilitation techniques of selected neurological disorders
Neurological
Disorders
4 PTHA 2435 Rehabilitation Comprehensive rehabilitation of selected diseases and disorders.
Techniques
4 PTHA 1431 Physical Agents Biophysical principles, physiological effects, efficacy, and application of
physical agents
4 PTHA 1161 Clinical II A health-related work-based learning experience that enables the student to
apply specialized occupational theory, skills, and concepts. Direct supervision is
provided by the clinical professional.
4 SPCH Speech

5 PTHA 2317 Issues in Health Organizational patterns, administrative principles, legal and ethical issues in
Care physical therapy, and preparation for licensure and employment
5 PTHA 2567 Practicum I Practical, general workplace training supported by an individualized learning
plan developed by the employer, college, and student.
5 Language,
Philosophy, &
Culture/Creative
Arts

26
Clinical Rotations

PTHA1160 Clinical I:

Clinical I is the first of three clinical experiences in a Physical Therapy setting. The purpose of this initial full-time,
integrated two-week clinical experience is to apply, integrate, and perform learned clinical skills on patients under
the direct supervision of a licensed Physical Therapist and/or licensed Physical Therapist Assistant. Basic patient care
skills, anatomy/biomechanics, therapeutic exercise, selected assessment techniques, and human disease and
pathology will be emphasized. Typical practice settings may include acute care hospitals, private practice, skilled
nursing centers, outpatient rehabilitation centers and home health agencies.

PTHA1161 Clinical II:

Clinical II is the second of three comprehensive clinical experiences in a physical therapy setting. The purpose of this
integrated part-time clinical experience is to apply, integrate, and perform learned clinical skills on patients under
the direct supervision of a licensed Physical Therapist and/or licensed Physical Therapist Assistant. The emphasis of
this experience is to integrate previously learned and practiced PTA skills, therapeutic modalities, advanced
therapeutic techniques, and neurophysiological techniques into an established physical therapy program. Typical
practice settings may include acute care hospitals, private practice, sports, developmental centers, skilled nursing
centers, geriatrics, pediatrics, in-patient and out-patient rehabilitation centers, and V.A. hospitals.

PTHA 2567 Practicum I:

Practicum I is the third of three comprehensive clinical experiences in a physical therapy setting. The purpose of this
final full-time clinical experience is to apply, integrate, and perform learned clinical skills on patients under the
supervision of a licensed Physical Therapist and/or licensed Physical Therapist Assistant. This experience consists of
two seven rotations in two different settings. The emphasis of this experience is to integrate previously learned and
practiced PTA skills, special topics in PT, and clinical management and health care issues into the delivery of a
comprehensive physical therapy treatment program. Typical practice settings may include acute care hospitals,
private practice, sports, developmental centers, skilled nursing centers, geriatrics, pediatrics, VNA, in-patient and
out-patient rehabilitation centers.

Information Sent to Clinical Facility Prior to Arrival of Student

The following information is sent to each CCCE to be forwarded to the CI prior to the clinical rotation. Upon
completion of the clinical, all forms are to be forwarded immediately to the ACCE so that grading can be done on a
timely basis:

a. Student Contact Information

b. Requests for accommodations for clinical education
c. Pertinent Information, when applicable, about previous clinical performance

Attendance

PTA1160 Clinical I:
Students are expected to attend daily, during the clinical settings regular hours, for two consecutive weeks, totaling 80
hours. Missed days for illness/personal reasons must be made up.

27
PTA1161 Clinical II: Students are expected to attend daily, during the clinical settings’ regular hours, for 4 hours for
12 weeks, totaling 48 hours. Missed days for illness and/or personal reasons must be made up.

PTHA 2567: Practicum I: Students are expected to attend two different rotations daily, during the clinical settings’
regular hours, for 4 consecutive weeks totaling 560 hours. Missed days for illness and/or personal reasons must be
made up.

Failure/Termination
If a student fails or is terminated for any reason (academic, health, or other) in either
PTHA1160, PTHA1161, or PTHA 2567, there is NO automatic guarantee that he/she will be allowed to repeat the
clinical. In order to repeat the clinical, the student must make a request in writing within 10 days to the Program
Director and ACCE. If the decision is made to allow the student to be reassigned to a clinic, the placement will
depend on several prerequisites:
• Availability of a clinic in the local area.
• The student's signing a Release of Information form allowing Amarillo College to share relevant information
with the clinic to which the student is reassigned. Upon review of that information, the clinic will have the
option to accept or reject that student.
• When Amarillo College feels it is necessary, the student must seek and receive medical clearance and/or
psychological counseling, during and/or prior to the student's assignment to the clinic.
• Upon failure/termination of PTHA 1160, PTHA1161 or PTHA 2567, a student (with approval as discussed
above) will be allowed to repeat a total of one failed clinical. If the student fails to pass at this point, they will
be automatically dismissed from the program. Housing and transportation are the responsibility of the
student. PTHA 1160, PTHA 1161, and PTHA 2567 must be taken in sequence.

Clinical Skills (for PTHA 1160 and PTHA 2567 only)

The assessment tool used to show competency for the student is the PTA MAC’s.

During the student’s first full time clinic rotation or PTHA 1160: Clinical I, the following skills are appropriate for
mastery as these pertain to the student’s academic preparation.

Section I. Professional Behaviors

Skill(s) 1-12

Section II. Data Collection

Skill(s) 13, 14.4, 14.5, 14.13

Section III. Intervention

Skill(s)15.1-15.4, 17.1, 17.2, 17.3, 17. 5, 17.15, 18.3, 19, 21.1, 20.2, 20.3, 21

Section IV. Site Specific Skills

Skill(s) 22.2,

28
24 other skills only if the student has received academic/didactic preparation.

During PTHA 2567: Practicum I, all skills may be addressed or re-addressed with emphasis on the following.

Section I. Professional Behaviors

Skill(s) 1-12

Section II. Data Collection

Skill(s) 14.1, 14.2, 14.3, 14.5, 14.7, 14.8, 14.9, 14.10, 14.11, 14.12,

Section III. Intervention

Skill(s) 16.1, 16.2, 16.3, 16.4, 16.5, 16.6, 16.7, 16.8, 16.9, 16.10, 17.4, 17.5, 17.6, 17.7,

17.8, 19.8, 17.10, 17.11, 17.12, 17.13, 17.14, 17.15, 17.16, 18.1, 18.2, 18.4, 22.1, 22.3,

22.4, 22.5, 22.6, 22.7, 2.1, 23.2, 23.3, 23.4, 24

Although a student will be have the opportunity to be exposed to other skills, the academic institution is unable to
report credit until the information has been provided in the class room.

If the CI teaches a student a measurement or treatment procedure that has not been presented and practiced in the
academic setting, the clinical instructor is responsible for determining if the student is safe in applying the
procedure. If the measurement or treatment procedure is a skill in which all students in the program must be
competent, the program remains responsible for assuring the competence for all students.

Therefore, even though we encourage you to expose the students to new skills, we can only report credit for skills in
which prior academic/didactic preparation has been received in the class room.

PTA MAC’s

The PTA MAC’s (Mastery and Assessment of Clinical Skills) was developed in 1982 by ACCE’s from several PTA
programs. The concept to adapt the Blue MAC’s to the physical therapist assistant level was an original goal of the
Texas Consortium for Physical Therapy Clinical Education. There was a committee formed that was comprised of
physical therapists and physical therapist assistants who were directly involved with the supervision of the students
in clinical settings, and faculty/ACCE’s from various PT and PTA programs. The PTA MAC’s will be used for
assessment of students for full-time clinical rotations.

The Mastery and Assessment of Clinical Skills describes the skills a new entry level graduate physical therapist
assistant need in order to practice safe and effective clinical practice

29
1. It outlines for students and their clinical instructors skills that all students are expected to master prior to
graduation.

2. It provides a uniform mechanism for rating students from all schools at all clinical education sites.

3. It allows students to assess their own performance and to compare their self assessments with those of
their clinical instructors.
4. It provides an up-to-date summary of the individual student’s current strengths and areas for improvement,
and therefore helps the students and their instructors plan an appropriate clinical experience.

5. It provides a mechanism to identify strengths and areas for improvement in the academic portion of the
curriculum.

Using the PTA MACs

To show competency by the end of the third full time clinic rotation a student must demonstrate entry-level mastery
of all clinic skills.

The PTA MAC’s is divided into four sections, with each section providing key indicators for the mastering of each
skill.

Section I. Professional Behaviors

Section II. Data Collection

Section III. Intervention

Section IV. Site Specific

Grading for PTHA 1161: CLINICAL II Clinical Practicum Written

Assignments:

Format for Clinical II Written Assignment (PTHA 1161 only): There is a written requirement for PTHA 1161: Clinical II.
This assignment will be in the form of a daily log.

Select a two- or three-ring looseleaf notebook and divide it into four (4) sections; Daily Reflective Journal, Clinical
Instructor Feedback, Other Observations, and Handouts and/or Literature Provided You. Each clinic day, make your
entries in the appropriate section and include the date of entry. At minimum an entry should be made daily in the
“daily reflective journal” section. This entry should reflect the specific learning acquired that day. Please de-identify
any patient information so that it will remain confidential. The clinical instructor will need to complete the feedback
form at the end of each four hour clinic day. Completed notebooks must be submitted to the ACCE within seven
days after the completion of the experience. Failure to complete and return the notebook by the due date will result
in an “I”. You may also be dismissed from the program.

Suggestions for the Clinical Instructor

1. The faculty strongly encourages the student to be exposed to other disciplines, especially rehabilitation and
surgery.

30
2. The faculty suggests that the student not be assigned to a clinical staff with less than 1-year experience,
unless it is an emergency situation.

3. The faculty encourage that the CCCE and appropriate staff attend educational opportunities in order to help
ensure the success of the student.

Complaints Policy
Complaints about the PTA Program regarding the general performance of students or staff or the general quality of
the curriculum and practical preparation of the student participants should first be addressed to the PTA Program
Director. Should the complaints include the behavior or performance of this individual, the complaints should be
addressed to the Health Science Dean or alternately, the Vice President of Academic Affairs. Complaints may also be
reported online on the PTA program webpage at www.actx.edu/phys_therapist.

The person receiving the complaint will be responsible for conducting a thorough investigation of the complaint and
evaluation of the problem as it has been described. Any personnel on campus will be involved in this process to the
extent that their input would aid in the resolution of the concern. The complaining party will be kept apprised of the
process as it evolves and will be notified of the ultimate resolution of the concern in a timely fashion. A record of the
complaint, the ensuing evaluation and investigation process and the ultimate resolution of the complaint will be
retained in the Program Director’s files with a copy send to the Health Science Dean.

Evaluation of each clinical facility, clinical instructor and ACCE

Regular evaluation of each clinical facility is critical to the success of the clinical education program. During each
clinical practicum, affiliating students complete the PTA Student Evaluation: Student Evaluation of Clinical Education
Experiences (SECEE). The SECEE will be forwarded to the ACCE for review upon completion/termination of the
practicum. Each clinical facility will also be evaluated by: The ACCE and PTA faculty will use the results of these
evaluations in planning for future practicums, to provide feedback to individual facilities for future experiences, and
to identify developmental areas in planning for clinical faculty development activities. A clinical facility may request
a copy of the student critique of their facility from the ACCE.

Evaluation of the Clinical Instructor occurs through the Student Evaluation of Clinical Education Experiences. This
survey allows the student to evaluate the clinical faculty on areas such as teamwork, modeling of ethical and legal
practice, understanding of the role of a PTA student, and supervision. In addition, the ACCE provides monitoring of
clinical instruction through weekly communication with students and the midterm and final interviews.

Evaluation of the Amarillo College PTA Program and ACCE Regular evaluation of the

ACCE and the Amarillo College PTA Program is critical to the success of the Physical Therapist Assistant Program.
After each clinical practicum, the CCCE, CI, and/or other clinical faculty complete the Evaluation of the Amarillo
College PTA Program and ACCE Form which will be forwarded to Amarillo College’s ACCE for review by the PTA
faculty. The PTA faculty will use the results of these evaluations to update and improve our existing academic and
clinical education curriculums. The ACCE is also evaluated as students complete the SECEE questions regarding
strengths and weaknesses of the academic program and through course evaluations completed during the clinical
course.

31
Faculty Specific Policies

Maintenance of CAPTE Compliance

The Program Director is responsible for

 Maintenance of accurate information, easily accessible to the public, on the program website regarding
accreditation status (including CAPTE logo and required accreditation statement) and current student
achievement measures
 Timely submission of required fees and documentation, including reports of graduation rates, performance
on state licensing examinations, and employment rates
 Timely notification of expected or unexpected substantive change(s) within the program and of any change
in institutional accreditation status or legal authority to provide post-secondary education

The Program Faculty, Amarillo College administration, and the PTA Advisory Committee are responsible for

 Following policies and procedures of CAPTE as outline in the CAPTE Rules of Practice and Procedure
 Coming into compliance with accreditation criteria within two years of being determined to be out of
compliance

Clinical Education

PTA Program faulty assume responsibility for development and implementation of policies related to clinical
education including

 Expectations for students to demonstrate that they are competent and safe prior to engaging in clinical
education
 Determining which skills students must demonstrate competent and safe performance in prior to engaging
in clinical education

Competency and safety expectations and skill selection are determined through use of key indicators on the PTA
MACs.

College Policies and Procedures

Students With a Disability

Any student who, because of a disabling condition, may require some special arrangements in order to meet course
requirements should contact disAbility Services (Student Service Center Room 119, Phone 371-5436) as soon as
possible.

Student’s Rights and Responsibilities

Students are to read the Amarillo College Student Rights and Responsibilities publication with emphasis on reading
the sections on Academic Information, Equal Opportunity Policy, Student Conduct and Responsibilities, Alcohol and
Drug Abuse Education/Prevention Program, Student Complaints and the Student Grievance procedure.

The following policies specifically apply to the Physical Therapist Assistant Program:

32
 Academic Honesty
Students who demonstrate academic dishonesty as described in the Student Rights and Responsibilities
handout will receive a grade of “F” in the course and will be subject to all policies for course failure. Because
dishonesty is a reliable predictor of unacceptable job performance following graduation, each instructor
takes the position that a dishonest student is probably also unethical in other ways and may pose a threat to
the safety of any patient who comes in contact with the student. In other words, this policy will be strictly
enforced!

 Student Grievance
A student who has a problem with the course or the course instructor should make every attempt to resolve
the problem with the course instructor. If that is not successful, the student may appeal the decision of the
instructor to the program director, chairman of allied health division, the dean of instruction, and the
president – IN THAT ORDER.

 Equal Opportunity
Our admission policy does not discriminate on the basis of race, color, national origin, sex, age, religion, or
disability. This same non-discriminatory philosophy continues for students while they are enrolled at
Amarillo College.

33
Appendix A

Amarillo College

Physical Therapist Assistant

Application
2015

34
Dear Applicant,

Thank you for submitting your online information for the Physical Therapist Assistant (PTA) program
application process at Amarillo College. This email includes the steps, processes and forms needed to move
forward in applying to Amarillo College’s Physical Therapist Assistant program. The forms, plus supporting
documentation you provide as directed, are the items you are to bring with you to an application finalization
session.

If you have not applied to Amarillo College, you must do that now. Go to
www.actx.edu/contact/index.php?module=article&id=31 , click the tab “apply”. You cannot participate in a
finalization session unless you have been accepted to Amarillo College.

If you have attended any other college or university, you must have those schools send official
transcripts to the Amarillo College Registrar, P.O. Box 447, Amarillo Texas. The registrar will determine which
courses transfer. I do not file paperwork for course substitutions until AFTER an applicant has officially been
accepted to the Amarillo College PTA program.

If you have declared any other major besides PTA with AC, change it to PTA now. You can do that at
http://www.actx.edu/registrar and use the left menu bar to access “change of information. This is checked prior
to finalization sessions through degree audit.

After you have applied to the college for admission, requested all school transcripts AND declared PTA as your
major, it is time to start completing the enclosed forms. You are awarded points from some of these forms.
These forms are turned in at a finalization session. These sessions will be held after the end of the spring
semester.

If you change your email address in the next 6 months, you may miss communications. If you change your email
it is your responsibility to notify me in writing (an email).

If you do not attend an application finalization session, your online application will be removed from the applicant
pool. If you do not bring every requested form with supporting documentation to the finalization session, your
online application will be removed from the applicant pool. In either case, you are welcome to reapply next year.
Your application becomes the property of Amarillo College and no part of it will be returned to you. It will be
destroyed to protect your private information. If you choose to reapply, completion of a new application packet
will be required.

If you have any questions about the application packet, process or forms, please email me at [email protected].

Again, congratulations to you on your decision to apply to Amarillo College’s physical therapist assistant
program.

Sincerely,

Kelly Jones
Director Physical Therapist Assistant Program
 AMARILLO COLLEGE
Health Sciences Division
PHYSICAL THERAPIST ASSISTANT
PROGRAM

APPLICATION FINALIZATION SESSION CHECKLIST

The application forms and records you are to bring with you to finalize your application
INCLUDE THE FOLLOWING:

1. Release of liability and waiver signed, dated (Form 1)

2. Immunization verification and copies of official records for all required immunizations (Form 2)
3. Verification of varicella (chicken pox) (copy of official record OR Form 3)
4. Observation record (Form 4)
5. Observation statement of completion (form 5)
6. Course listing (Form 6)
7. Official ORIGINAL, SEALED envelopes containing transcripts for each college attended including Amarillo
College
8. Personal Requirements Statement (Form 7)
9. Copy of criminal background check payment receipt
10. Copy of current negative TB test
11. Copy of current CPR card both sides

Bring every form, transcript, document and copy/copies for items 1-11 from above with you to the application
finalization session. This is the ONLY OPPORTUNITY YOU HAVE TO TURN IN THE REQUIRED ITEMS.
Without the above items, an applicant has not completed the application process. By not providing the items, there is
not sufficient evidence to calculate points. Without points, an applicant cannot be ranked into the applicant pool.

Please understand that if you do not bring every item listed above, you will need to apply again next year to the
program. If you do not bring all the required documents, those you do bring are the property of Amarillo
College and will be retained then destroyed to protect the applicant.

36
 Amarillo College Health Sciences Division
STATE OF TEXAS

RELEASE AND WAIVER OFLIABILITY

PTA Program Form 1 – print & complete

COUNTYOFPOTTER
AGREEMENT OF RELEASE made this day between AMARILLO JUNIOR COLLEGE DISTRICT (“Amarillo College”) and (“Student”).
(print full legal name of applicant)

In consideration of Student being permitted to enroll at Amarillo College in the Physical Therapist Assistant program and the
acknowledgment of Student of the following facts:
1. That student will be required, as part of the normal educational process towards Student’s degree or certificate to be placed in
a teaching environment including, but not limited to, local medical facilities, offices of local practitioners, ambulances,
medical laboratories, and other medical environments (hereinafter called “medical affiliates”). Student may be exposed to
conditions which could cause bodily injury and/or death and may be exposed to patients afflicted with terminal or potentially
terminal disease processes which may be of a contagious nature; and,
2. That Student will first be provided, as part of the normal educational process toward Student’s degree or certificate with
detailed information about the nature, risks and preventive measures related to communicable diseases of a terminal or
potentially terminal nature prior to the assignment of Student in an environment where these diseases are known to be
present; and,
3. That Student could be exposed to high-risk toxic substances in the medical affiliates, but will first be provided with
information concerning prevention from becoming ill with same.

Student does hereby:

1. Authorize Amarillo College officials to place Student into the respective medical affiliates as they deem necessary for the
completion of Student’s educational program;
2. Release, waive, and covenant not to sue Amarillo College, its officers, agents, employees, and persons or entities acting
together with Amarillo College in its education programs (hereinafter called “Releasees”) from all liability to Student for any
and all loss or damage, and any claims or demands whatsoever therefore on account of injury to the person or property or
resulting in the death of Student or emanating from exposure to said disease processes and toxic substances, or any of these,
whether caused by the negligence of Releasees or otherwise while the Student is on or within any of the program medical
affiliates;
3. Indemnify and hold harmless Releasees from any loss, liability, damage or cost that Student may incur due to the presence
of Student in or upon any of the medical affiliates or in any way observing for any purpose or participating in the
educational process in said medical affiliates; and,
4. Assume full responsibility for any and all risks due to participation in the normal educational process in the medical affiliates
described above.

37
Student expressly acknowledges and agrees that the activities described above could be dangerous and involve the risk of injury
and/or death and/or contracting terminal or potentially terminal disease processes and exposure to high risk toxic substances.

The UNDERSIGNED expressly agrees that the foregoing Release, Waiver, and Indemnity Agreement is intended to be as broad and
inclusive as is permitted by the Laws of the State of Texas and if any portion thereof is held invalid, it is agreed that the balance shall,
notwithstanding, continue in full legal force and effect.

The UNDERSIGNED is at least eighteen years of age and has read and voluntarily signed the Release and Waiver of Liability and
Indemnity Agreement, and agrees that no oral representations, statements or inducements apart from the foregoing written
Agreement have been made.

I have read this document. I understand it is a release of all claims. I understand I assume all risks inherent in the educational
process and clinical experience conducted in the medical affiliates of Amarillo College as part of my progressing toward a degree
or certificate as set out above. I voluntarily sign my name evidencing my acceptance of the above provisions.

Dated this day of _, 20_

Signed:______________________________________________
(full legal name)

Print name:_____________________________________________________________________
(full legal name)

38
 Physical Therapist Assistant Program
AMARILLO COLLEGE
Health Sciences Division

Texas Immunization Requirements

PTA Program Information about Form 2

The state of Texas requires colleges in Texas who have students enrolled in health career programs to
provide proof of certain immunizations. Students enrolled in programs that involve direct patient contact in
program affiliated medical care facilities must comply with the law. This includes Physical Therapist
Assistant program students.

Students who were born on or after January 1, 1957 must show acceptable evidence of immunizations
prior to first patient contact. The only acceptable documentation is an immunization record from a
clinic, hospital, doctor’s office or school. Doctor’s letters are not accepted. If records cannot be
provided by the student, serologic (blood based lab test) confirmation of immunity is acceptable.
Evidence of immunity must consist of a written laboratory report that indicates either
confirmation of immunity or infection.

Tetanus/Diphtheria – one dose within the past 10 years

Measles - two doses since 12 months of age for those born since January 1, 1957 administered since
January 1, 1968

Rubella/German measles – one dose

Varicella/Chicken Pox – two doses unless the first dose was received prior to 13 years of age. Amarillo
College does not recommend Varicella immunization of any person who has had Chicken Pox due to
potential harm. It is recommended that an applicant pursue serological testing (blood) for this situation.
Also acceptable is a sworn statement complete with notary seal and signature attesting to having had
chicken pox OR having a varicella immunity. (See additional related pages).

Mumps – one dose since 12 months of age for those born since January 1, 1957
r

Hepatitis B –The student will not be allowed to enroll in Clinical courses without completing the full 3
injection series. Failure to complete HEP B by August 1 can result in the student not being able to enroll in
fall PTA courses.

Under the requirements of a law enacted by the Texas State Legislature, students who are under 30
years of age and entering higher education in the spring of 2012 or later must demonstrate proof of
inoculation against bacterial meningitis. This must be renewed every 5 years.

39
 Physical Therapist Assistant Program
Written evidence of influenza(flu) vaccination EVERY YEAR. Applicants must show proof of flu
vaccination within last 12 months from date of finalization session. Flu shot or flu mist records must
have a date between May of last year and May of current year.

The Texas Department of Health, pharmacies at drug stores and grocers offer immunizations. P.R.I.M.E.
is a local business that offers serologic testing for those who have had a prior immunization or illness that
is not documented. Contact them for specific information.

Documentation of these immunizations must be turned in to the program director initially at the
application finalization session. Once accepted, future immunization documentation must be provided to
the program director as immunizations occur during the education process.

40
 Physical Therapist Assistant Program
AMARILLO COLLEGE
Health Sciences Division

Texas Immunization Requirements

PTA Program Form 2 print & complete

Please initial each item attesting to the fact that you have the immunization listed. PLACE
THIS PAGE IN FRONT OF THE COPIES OF YOUR IMMUNIZATION RECORDS. PLEASE NOTE
THAT ORIGINAL IMMUNIZATION DOCUMENTS WILL NOT BE ACCEPTED – THE APPLICANT
MUST PROVIDE COPIES OF THE IMMUNIZATIONS. THE PTA PROGRAM WILL NOT RETURN
COPIES OF IMMUNIZATIONS TO APPLICANTS SO KEEP YOUR ORIGINALS IN A SAFE PLACE.

Measles - Initials
Mumps – Initials
Rubella/German measles – Initials
Varicella/Chicken Pox – Initials
Tetanus/Diphtheria – Initials
Hepatitis B –

First dose Initials

Second dose

Third dose Initials

Bacterial Meningitis - Initials

Influenza vaccination - Initials ___________________ date

41
 Physical Therapist Assistant Program
AMARILLO COLLEGE
Health Sciences Division

Texas Immunization Requirement VARICELLA

PTA Program Information about Form 3

§97.65 of the Texas Administrative Code states, “A written statement from a parent (or legal guardian
or managing conservator), adult-age student, or physician attesting to a student’s positive history of
varicella disease (chickenpox), or of varicella immunity, is acceptable in lieu of a vaccine record for
that disease.” Amarillo College shall accurately record the existence of any statements attesting to
previous varicella illness or the results of any serologic tests supplied as proof of immunity. The original
documents should be returned to the student. If a student is unable to submit such a statement or
serologic evidence, varicella vaccine is required.

Any ONE of three documents noted below is acceptable for verification of varicella, also known as chicken pox.
One of the following 3 items must be submitted to complete the PTA application:
1. A copy of a vaccination record which applicant supplies, OR
2. A copy of results of serological testing indicating immunology which applicant supplies, OR
3. A sworn statement complete with notary seal and signature attesting that the applicant has had
chicken pox (next page) which the applicant prints, has notarized and submits with application.

42
 Physical Therapist Assistant Program
AMARILLO COLLEGE
Health Sciences Division

Texas Immunization Requirements VARICELLA

PTA Program Form 3, Option 3, print & complete

Sworn Statement of a History of Varicella Disease

By my signature on this document, I _, attest

Print full legal name

that I had varicella disease (chickenpox) on or about and do

Approximate Month/Day/Year

not need the varicella vaccine.

Student Signature

(exactly as printed above):

Affix Notary Seal Below

Sworn to before me this day of _,

20

Notary Public Signature:

43
 Physical Therapist Assistant Program
AMARILLO COLLEGE
Health Sciences Division

Clinical Site Observation

PTA Program Information about Form 4

Each applicant seeking admission into the Physical Therapist Assistant program is required to complete
observation of the practice of Physical Therapy. These observations will provide the applicant with the
opportunity to see, first hand, the operation of the department including the job skills required by the
physical therapist assistant.

Any facility that employs a licensed physical therapist or physical therapist assistant is considered a
qualified site. Where the applicant elects to visit is dependent on the applicant’s time frame and interests
as well as clinical sites available. Some facilities will accommodate observations on the weekends but the
applicant must ask.

The observation contact hours log sheet is used to document compliance with this requirement. Take
the form or additional copies of the form with you to each visit.

To make a clinical site visit appointment, the applicant must...

1. Select a clinical site that provides physical therapy services. Any facility that offers physical
therapy and employs licensed PTs and/or PTAs is acceptable. Observation does not have to be
done in Amarillo. If licensed therapists or therapist assistants are employed by a facility, it is
permissible to complete observations at that facility.

2. Contact the facility to schedule an appointment. Make an introduction and explain the reason
for the observation. Appointments will be made at the convenience of the medical facility.
PLEASE HONOR APPOINTMENT DAY AND TIME. IF THE APPOINTMENT MUST BE
CANCELLED, PLEASE CALL THE FACILITY IN ADVANCE AND RESCHEDULE.

3. When on a clinical observation, please dress in a manner appropriate for a professional

environment. Do not wear blue jeans or shorts and do not let tattoos show. Applicants should
not wear heavy makeup or strong perfumes or colognes. Applicants should not chew gum. It is
You should not have an odor of smoke, tobacco product, or alcohol on your body.

4. Take the observation form to the visit. Have a licensed Physical Therapist (PT) or Physical
Therapist Assistant (PTA) sign and date the form in the spaces provided. If you need

44
 Physical Therapist Assistant Program
additional copies of form 4, make them. You may also use the observation log found on the PTA
program website.

5. During the observation, please remain in the area(s) assigned by the staff. If there are
questions, be careful not to ask the question within the hearing of a patient. Instead, wait until
the patient has left the area.

6. Bring all signed observation forms to the application finalization session.

7. Points are calculated for the number of hours an applicant observes. Points are awarded as follows:

a. 10 points = 15-29 hours and/or only 1 setting

b. 20 points = 30 hours in 2 different settings (15 hours per setting)
c. 30 points = 30 hours in 3 different settings (10 hours per setting)

All applicants must have a minimum of 15 observation hours in at least 1 setting to apply for the PTA
program. Applicants may submit a total of 30 observation hours in at least 3 settings (10 hours per
setting) to increase their application score. THE MAXIMUM NUMBER OF POINTS THAT WILL
BE AWARDED FOR OBSERVATION HOURS IS 30.

45
 Physical Therapist Assistant Program
Clinical Site Observation Log
PTA Program Form 4, print & complete-reprint this page
as many times as needed
Date Facility name, Licensed PT personnel signature Clock Time in/ Clock
Location (city, phone # of PT Time out hours
Do not count breaks, meals,
number if not in personnel or time observing another
discipline
Amarillo)

1/20/2014 ABC PT Clinic 101010 9:00 – noon 7

Center City Texas 1:00-5:00

888-1234-123

THIS PAGE Total Hours __________

Applicant Printed Name

Applicant Signature

46
 Physical Therapist Assistant Program
Clinical Site Observation Statement of Completion
PTA Program Form 5, print & complete-reprint this page
as many times as needed to document each clinical observation

Using the form on the previous page, please complete a statement for each observation that you complete.
Fill in the day and location exactly as recorded on the observation log.

I __________________________________________________( print first and last name of applicant )

honestly attest by my signature that the observation hours for ______________ (date)
at ____________________________________ (facility name) were completed as recorded. I further verify
by my initials here ___________ that the observation hours were actual clock hours spent observing. These
hours were not spent as a patient receiving therapy nor were these hours spent as a family member or friend
watching a family member or friend receive therapy.

I __________________________________________________( print first and last name of applicant )

honestly attest by my signature that the observation hours for ______________ (date)
at ____________________________________ (facility name) were completed as recorded. I further verify
by my initials here ___________ that the observation hours were actual clock hours spent observing. These
hours were not spent as a patient receiving therapy nor were these hours spent as a family member or friend
watching a family member or friend receive therapy.

I __________________________________________________( print first and last name of applicant )

honestly attest by my signature that the observation hours for ______________ (date)
at ____________________________________ (facility name) were completed as recorded. I further verify
by my initials here ___________ that the observation hours were actual clock hours spent observing. These
hours were not spent as a patient receiving therapy nor were these hours spent as a family member or friend
watching a family member or friend receive therapy.

I __________________________________________________( print first and last name of applicant )

honestly attest by my signature that the observation hours for ______________ (date)
at ____________________________________ (facility name) were completed as recorded. I further verify
by my initials here ___________ that the observation hours were actual clock hours spent observing. These
hours were not spent as a patient receiving therapy nor were these hours spent as a family member or friend
watching a family member or friend receive therapy.

I __________________________________________________( print first and last name of applicant )

honestly attest by my signature that the observation hours for ______________ (date)
at ____________________________________ (facility name) were completed as recorded. I further verify
by my initials here ___________ that the observation hours were actual clock hours spent observing. These
hours were not spent as a patient receiving therapy nor were these hours spent as a family member or friend
watching a family member or friend receive therapy.

47
 Physical Therapist Assistant Program

General Education A.A.S. Degree Requirements

PTA Program Information about Form 6

Courses listed in the left hand column are the required core and related course requirements for the Amarillo
College Physical Therapist Assistant Associate of Applied Sciences degree.

Please complete the information in each row beside the course to indicate that you have completed this
course requirement, the college where the course was taken, the semester and year that the course was
completed and the final grade of the course. If the course is in progress, fill in all the information possible
and leave the grade blank.

Fill in the name and number of the math and humanities/fine arts courses completed along with the number of
hours, college name, semester and year plus final grades.

Bring to the application finalization session OFFICIAL SEALED TRANSCRIPTS FOR ALL COLLEGES and
UNIVERSITIES LISTED ON THE FORM YOU COMPLETE.

48
 Physical Therapist Assistant Program
General Education A.A.S. Degree Requirements
PTA Program Form 6 print & complete

Course name and Sem College name Semester & Final

number Hrs. Year Grade
BIOL2401 4
Human Anatomy &
Physiology I
BIOL2402 4
Human Anatomy &
Physiology II
ENGL 1301 3
Freshman Composition

PSYC 2301 3
General Psychology

PSYC 2314 3
Lifespan Developmental
Psychology
HITT 1305 3
Medical Terminology I

SPCH 1315 OR 3
SPCH 1318 OR
SPCH 1321(circle one)
Speech

MATH # 3
Name of course
___________________
Credit math

Course Code 3
________________
Name of course
________________
Humanities/fine arts
from list

49
 Physical Therapist Assistant Program
Personal Requirements Statement
PTA Program Form 7 print and complete

There are many important factors to consider when determining your future career. To be successful in the
PTA classroom and employed as an PTA, you should be able to meet all of the following personal requirements:

 Attend class approximately 20-30 hours per week, including lecture, lab, and clinical observation times
 Attend (1) two week full-time and (2) seven week full-time clinical rotations
 Complete all assignments on time
 Participate in classroom discussions.
 Perform or instruct others in the following procedures (as learned in class): transfers, gait training,
physical agents, activities of daily living, therapeutic exercise or activities, and data collection
procedures.
 Use sound judgment and safety precautions.
 Exposure to blood-borne pathogens and/or infectious disease may occur as part of the educational
experience. Students will be trained in safety/infection control and will be expected to follow these
guidelines to avoid contracting or transmitting disease.
 Meet class standards for successful course completion.
 Use critical thinking when making decisions.
 Follow standards in the PTA Student Handbook.
 Address problems or questions to the appropriate person at the appropriate time.
 Maintain classroom work area, equipment, supplies, personal appearance and hygiene conducive to
professional setting as appropriate.
 Behave in a competent, professional manner.
 Physical requirements for the PTA program include the need to occasionally, frequently, or continually
stand 3-7 hours per day with lecture blocks up to 4 hours.
 Stand 1-6 hours with lab time blocks up to 4 hours.
 Travel 1-1 hours to clinic or be willing and/or financially able to relocate for up to 7 weeks.
 Lift up to 60 pounds unassisted.
 Push/pull up to 50 pounds of force exerted at waist level.
 Squat or stoop.
 Use auditory, tactile, and visual senses to assess physiological status of an individual.
 Demonstrate good standing and unsupported sitting balance.
 Demonstrate good finger dexterity.
 Coordinate verbal and manual instructions.
 Communicate effectively with a variety of people through written and verbal methods.
 Use hands repetitively.
 Shift weight in sitting or standing.
 Use a firm grasp.
 Reach above shoulder level.
 Kneel, kneel-stand, and half-kneel.
 Use equipment that emits electrical, ultrasonic, and thermal energy.
 Physically move and transfer patients.

50
By my signature, I indicate that I can, to the best of my knowledge, perform the requirements for the PTA
program. I have been provided a copy of the demands. If my ability to meet the demands change, I will notify the
PTA program director immediately (within 12 hours).

Date

_______________________________________________________________________
___
Signature

Printed Name

Students who have concerns about their ability to perform any of these functions should contact the PTA
Program Director at 354-6043. Individuals with disabilities may request reasonable accommodations or
information by calling disAbility Services at 371-5917.

Amarillo College does not discriminate on the basis of race, color, age, marital status, national origin, religion, sex,
or disability.

ANY APPLICANT/STUDENT WHO IS CURRENTLY BEING, OR HAS BEEN, TREATED BY A

PHYSICIAN DURING THE LAST YEAR FOR ANY CONDITION WHICH MIGHT IMPACT
ABILITY TO PERFORM THE REQUIREMENTS NOTED ABOVE SHOULD DISCLOSE THIS TO
THE PROGRAM DIRECTOR.

THE APPLICANT/STUDENT MAY BE REQUIRED TO OBTAIN A DOCTOR’S RELEASE FROM

THEIR PHYSICIAN PRIOR TO PARTICIPATION IN THE PROGRAM.

A MEDICAL CONDITION CAN NOT BY LAW HAVE ANY IMPACT ON A PERSON’S ABILTY
TO ENTER THE PROGRAM.

A STUDENT WHO DOES NOT DISCLOSE A LIMITATION OR THE FACT THAT THEY ARE
UNDER THE CARE OF A DOCTOR CAN BE IMMEDIATELY DISMISSED FROM THE
51
PROGRAM DUE TO THE POSSIBILITY OF ADDITIONAL INJURY TO SELF AND PLACING
OTHERS IN JEOPARDY OF INJURY.

IN ADDITION, STUDENTS RECEIVING MEDICAL CARE WHILE ENROLLED IN THE PTA

PROGRAM WILL BE REQUIRED TO A OBTAIN DOCTOR’S RELEASE AS APPLICABLE.

52
 Criminal Background Check Requirement
Amarillo College PTA Program Information and instructions

Complete the background check online, print a copy of the receipt and
submit it at the application finalization session

The hospitals affiliated with Amarillo College, to provide clinical education courses, require criminal background
checks on incoming students to insure patient safety. A background check typically takes 3 – 5 normal business days
to complete.

The background checks are conducted by PreCheck, Inc., a firm specializing in background checks for healthcare
workers. Your order must be placed online only through “StudentCheck.”

Go to www.precheck.com and click on the "Students" link. No fingerprinting is required.

Complete all required fields and hit Continue to enter your payment information. The payment can be made
securely online with a credit or debit card. You can also pay by money order, but that will delay processing your
background check until the money order is received by mail at the PreCheck office. You will be provided an order
confirmation number and instructions on how to check the status on the completion of your report by email.

PreCheck will not use your information for any other purposes other than a background check. Your credit will not
be investigated, and your name will not be given out to any businesses.

If you need assistance, please contact PreCheck at [email protected]

FREQUENTLY ASKED QUESTIONS:

Do I get a copy of the report? No. Only the affiliated hospitals and the director of the PTA program have
access to the reports. However, you can order a copy of your report for an additional fee at the time
you place your order.

Does PreCheck need every street address where I have lived over the past 7 years? No, just the city and
state.

I have been advised that I am being denied entry into the program because of information on my report and
that I should contact PreCheck. Where should I call? Call PreCheck’s Adverse Action hotline at 800-203-
1654. Adverse Action is the procedure established by the Fair Credit Reporting Act that allows you to see
the report and to dispute anything reported.

I have a criminal record. What should I do? Disclose the crime on your application.

53
 AMARILLO COLLEGE
Health Sciences Division
PHYSICAL THERAPIST ASSISTANT
PROGRAM

Complete the background check online and print a copy of the

PAYMENT receipt from PRECHECK. Submit the PAYMENT receipt at the
application finalization session

54
 AMARILLO COLLEGE
Health Sciences Division
PHYSICAL THERAPIST ASSISTANT
PROGRAM
TB Requirement

Amarillo College’s Physical Therapist Assistant program requires a current negative TB test report to complete
the application process. In addition the applicant that is accepted agrees to continually have a current negative
TB test report on file with the program in preparation of clinicals and employment in health care facilities.

Documentation of this test must be turned in to the program director initially at the application finalization
session. A copy of the medical record or test result is acceptable documentation.

55
 AMARILLO COLLEGE
Health Sciences Division
PHYSICAL THERAPIST ASSISTANT
PROGRAM
CPR Requirement

Amarillo College’s Physical Therapist Assistant program requires an applicant be currently CPR certified to
complete the application process. In addition the applicant that is accepted agrees to continually have a
current CPR card on file with the program in preparation of clinicals and employment in health care
facilities.

ONLINE CPR IS NOT ACCEPTED BY MANY HOSPITALS!!

The PTA program does not accept online CPR.

American Heart Association Healthcare Provider course

is accepted at most hospitals.

The PTA program accepts AHA Healthcare Provider CPR.

Amarillo College offers American Heart Association Healthcare Provider courses in CPR frequently. Search the
Amarillo College website to find a course that suits your schedule.

Documentation of current CPR certification must be turned in to the program director initially at the
application finalization session. A copy of both sides of the CPR card is acceptable documentation. If the
applicant enters the PTA program, it is the students responsibility to keep current with CPR across the
time of enrollment in PTA courses.

56
 AMARILLO COLLEGE
Health Sciences Division
PHYSICAL THERAPIST ASSISTANT
PROGRAM

Application Finalization
Requirement
Finalization sessions are conducted for applicants in groups. The session is held in the PTA lab,
Health Sciences Building room 165. The sessions typically last approximately 1.5 hours. Space in
each session is limited and spaces are filled on a first come first serve basis.

Please sign up for only ONE session. There are adequate spaces available for all applicants IF each
person signs up for ONLY ONE SESSION. Be considerate of others attempting to schedule and
make only ONE APPOINTMENT PER APPLICANT. If multiple appointments are noted for the
same person, the earliest appointment will be kept in the system and all others will be deleted to
free up space for other applicants. Be sure of the finalization session time you plan to attend
BEFORE you sign up.

You will need to follow this link to schedule your appointment time.

Appointments are currently available for:

May 19th at 9:00 a.m.
May 19th at 2:00 p.m.
May 20th at 9:00 a.m.
May 20th at 2:00 p.m.
May 21st at 9:00 a.m.

Bring your application packet completed forms and supporting documentation to the session
you sign up for. Do not fold your papers. Do not staple any papers. Do not place them in any
type of folder with brads or fasteners. Arrive on time and be prepared to take notes from
the presentation.

57
 Appendix B
Amarillo College
DIVISION OF HEALTH SCIENCES
Physical Therapist Assistant
Program 2015-2017
Instructions: Please PRINT all information requested on the forms. ALL items must be answered
before the form is considered complete. If any are not applicable, mark as N/A. ALL information
submitted on this form must be current and accurate. After the form is submitted, it must be
updated as necessary through a written notification to the Physical Therapist Assistant program
director.

_______________________________________________________________
First name Middle name Last name

Name you wish to be called by:

_______________________________________________

Social Security Number:__________-______-____________

(Clinical sites require a SSN. You will be providing this to sites as needed. If you do not have a
SSN, you may not be able to be placed in clinical rotations, may not be able to progress through
the program and may not be able to obtain a degree as a PTA.)

Driver’s license: State___________Number _____________

(Some clinical sites require a DL. You will be providing this to sites as needed. If you do not have a
DL, you you may not be able to be placed in clinical rotations, may not be able to progress through
the program and may not be able to obtain a degree as a PTA.)

Address:_______________________________________________
_________________________________________________________
City State Zip

Email: _____________________________________________
How often do you check this account? Hourly ___ Daily __ Weekly __

Phone: _______-____________-_____________

Emergency contact: __________________________________________

Name
__________________________________________
Phone

58
 ___________________________________________
Relationship

STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

Are you employed: Yes _____ No____

If yes, where ______________________________________________________
and number of hours worked per week:_________________

Health Insurance:
Student health insurance is the sole responsibility of the student and is
recommended to be carried by all students.
Insurance Company:_____________________________________________
Policy number:___________________________________________________

Prescription & Nonprescription Drugs

This is to inform the Health Science faculty that I am presently taking

the following medications:

Name of medication/OTC drug Reason or diagnosis for taking med

A release statement may be required from your physician stating that the medications
will not interfere with your decision making and/or performance.

It is my responsibility to update this form as any changes arise in my medication

treatment regimen (additions, deletions).

Print name of student: _____________________________________________________

59
Signature of student: _______________________________________________________

Date: ___________________________________
STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

The following information must be reported to the Commission on Accreditation in

Physical Therapy Education, CAPTE. Your cooperation by providing this
information is greatly appreciated!

Sex: Male ________ Female_________

Date of birth INCLUDING YEAR: Month _______ Date ________ Year ______

Age as of August 24th, 2015 __________________ years, _________ months

How did you learn about the profession of Physical Therapy?

___personal experience (someone I know was treated in PT)
___career search/career counseling
___computer search/internet
___media – TV, radio, brochure
___job fair/recruitment event
___Amarillo College event
___Other location _____________________________
____other source: Please name, be specific
_____________________________________

How did you learn about Amarillo College’s PTA program?

___personal experience (someone I know told me about the program)
Who was that person ___________________________________
___career search/career counseling
___computer search/Internet
What did you search for? AC___
PT ___
Other ___ what _______________________
___media – TV, radio, brochure
Please list which source specifically _______________________
___ recruitment event
Amarillo College event

60
 ___Sneak Peek
___high school visitation day
___Other event_____________________________
____other source: Please name, be specific _________________________________

STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

Ethnicity and Race

Are you Hispanic/Latino? (Choose only one)

___No, not Hispanic/Latino
___Yes, Hispanic/Latino (A person of Cuban, Mexican, Puerto Rican, South or Central
American, or other Spanish culture or origin, regardless of race)

The above question is about ethnicity, not race. No matter what you selected above,
please continue to answer the following by marking one or more lines to indicate what
you consider your race to be.
What is your race? (Choose one or more)

___American Indian or Alaska Native. (A person having origins in any of the original
peoples of North and South America, including Central America, and who maintains a
tribal affiliation or community attachment.)
___Asian. (A person having origins in any of the peoples of the Far East, Southeast Asia,
or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan,
Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.)
___Black or African American. (A person having origins in any of the Black racial groups
of Africa.)

___Hispanic/Latino of any race—A person of Cuban, Mexican, Puerto Rican, South or

Central American, or other Spanish culture or origin, regardless of race. The term
“Spanish origin’’ can be used in addition to “Hispanic/Latino or Latino.’’
___Native Hawaiian or Other Pacific Islander. (A person having origins in any of the
original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.)

___White. (A person having origins in any of the original peoples of Europe, the
Middle East, or North Africa.)

61
STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

OFF CAMPUS TRIP RELEASE FORM

The Division of Health Science of Amarillo College endorses a number of off

campus trip experiences for you, the adult students. These trips are planned to
be an educational experience and are sponsored by a number of organizations
related to the PTA curriculum. Any student who participates in a field trip
becomes a representative of Amarillo College. Since your behavior is a reflection
on your curriculum you are expected to conduct yourself in a mature manner
that would favorably reflect your chosen profession.

An Amarillo College PTA student must be ever mindful of HIPAA, the Physical
Therapy Standard of Ethics and professional conduct. If you are to be
respected in your anticipated profession you must be worthy of it.

I, (print name) _____________________________________________________

understand that every effort will be taken to ensure my safety and welfare on
any field trip endorsed by my curriculum. I will not hold any Health Science
Division faculty or Amarillo College employee responsible for any accident or
injury incurred to, from or on any field trip. This includes travel by private
vehicle which I operate as a licensed driver, is driven by a licensed classmate or
by a licensed Amarillo College employee.

Print name of student: _____________________________________________________

Signature of student: _______________________________________________________

Date: ___________________________________

62
STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

PHYSICAL THERAPIST ASSISTANT PROGRAM

AMARILLO COLLEGE
PHOTOGRAPHIC MODEL/STUDENT CONSENT RELEASE

1. In consideration of the sum of ZERO dollar(s), I am a minor born on

_____________, ______ ______________ (initial).I will not be involved in
photographs while a minor enrolled in Amarillo College’s PTA program.

2. In the consideration of the sum of ZERO dollar(s), I certify I am eighteen

years of age or over ______________ (initial)

And I hereby give Amarillo College, its successors and assigns and those acting
under its permission or upon its authority, the unqualified right and
permission to reproduce, copyright, publish, circulate or otherwise use my
name and/or photographic likeness of me still, single multiple or moving in
which I may be included in whole or in part, or composite.

I waive any right to inspect and approve the finished product or copy that may
be used or the use to which it may be applied. This authorization and release
covers the use of said materials in any published or broadcast form, and any
medium or advertising, publicly or trade in any part of the world for a period of
ten years.

Furthermore, for the consideration above mentioned, I, for myself, my heirs,

executors, administrators, or assigns, transfer to Amarillo College, its
successors and assigns, all my rights, title, and interests in and to all
representatives of the organization. This agreement represents in full all terms
and consideration, and no other inducements, statements, or promises have
been made to me.

Print Name of model/student:

_____________________________________________________

Signature of student/model:
_______________________________________________________

Date: ___________________________________

Signature of Amarillo College’s Representative:

______________________________________________________________________________

63
 Date: _______________________________________
STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

Amarillo College PTA Program Course Repeat Statement

I am aware of the policy related to one repeat of PTA courses. As stated in the
2015 AC Catalogue online at 2015-16 Catalog

“A grade of C or higher is required for satisfactory completion of all PTHA courses and any
prerequisite courses.

To continue in the program, a student may repeat a PTHA course only one time and may repeat
no more than two PTHA courses while enrolled in the program. The term “repeat” shall be
interpreted to mean re-enrollment following withdrawal, drop or unsatisfactory grade.

This includes:

 PTHA 1160 - Clinical I

 PTHA 1161 - Clinical II
 PTHA 1301 - The Profession of Physical Therapy
 PTHA 1321 - Pathophysiology for the PTA
 PTHA 1405 - Basic Patient Care Skills
 PTHA 1413 - Functional Anatomy
 PTHA 1431 - Physical Agents
 PTHA 2301 - Essentials of Data Collection
 PTHA 2305 - Neurology
 PTHA 2317 - Issues in Health Care
 PTHA 2431 - Management of Neurological Disorders
 PTHA 2409 - Therapeutic Exercise
 PTHA 2435 - Rehabilitation Techniques
 PTHA 2567 - Practicum I

I understand that failure to pass any PTA course on the second attempt with a
“C” or better prohibits progression in Health Science programs. In addition, I
am not eligible to re-enter the program or reapply to the program at any time in
the future.

Print name of student: _____________________________________________________

Signature of student: _______________________________________________________

64
 Date: ___________________________________

STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

Amarillo College Services for Students with Disabilities

The disAbility Services Department provides and coordinates services for
Amarillo College students with documented disabilities. The purpose of these
services is to ensure equal access for students to participate in all programs
and activities.
DisAbility Services offers academic support and advising, professional
tutoring, arrangements for placement test and class test administration,
assistance with obtaining recorded books and materials, coordination of (ASL)
interpreters, and other accommodations as required. Amarillo College students
must apply to receive services. Students must provide a copy of documentation
for each disability requiring accommodations. Services provided will be based
on need and appropriateness for each individual. Reasonable accommodations
are provided in a timely manner; however, students should allow some time for
processing and the provision of services. This program does not provide
diagnostic testing or evaluation, personal care attendants, or a specific learning
disability program.

The Office of disAbility Services is located in the Student Service Center,

Room 119. Students may contact the disAbility Services Department at 806
345 5639. More information is available online at www.actx.edu/disability
Faculty in the Health Science Division believes it is important to provide
equal educational opportunities to all students. In order to implement
reasonable accommodations which may be needed, the faculty must be aware
of your special needs. If you need accommodations for any type of disability,
please contact disAbility Services Department at 806 345 5639.

I was made aware that if I need special accommodations, I can request them
and to whom to direct the request.

Print name of student: _____________________________________________________

Signature of student: _______________________________________________________

Date: ___________________________________

65
STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

PTA PROGRAM ATTENDANCE POLICY

Regular attendance is necessary for satisfactory achievement. Therefore, it is

the responsibility of the learner to attend class.

Amarillo College endorses attendance as a key to success. Attendance is

required for successful completion of the Physical Therapist Assistant program.

At the beginning of each lecture and lab, learners will be expected to sign the
roster provided by the instructor. Failure to sign in will result in the learner
being marked absent for attendance purposes even if he/she is present in class
and seen by the instructor. Attendance will be taken beginning with the first
course class meeting the first day of the 2015 fall semester and will continue
across the didactic courses through the last day of the 2017 spring semester.

Each learner will be allowed only one absence for lecture or one for lab in any
class. After the first absence a penalty of five (5) points will be deducted from
the final course grade for each subsequent absence. For example, a learner
who misses three (3) lectures will have ten (10) points deducted from the final
grade for the course.

Full attendance of class time is also expected. A learner will be counted as

“absent” if the learner is out of class more than 20 minutes of a class time. For
example, if in a given day a learner arrives 10 minutes late to class, takes an
extra 5 minutes for break and leaves class for 5 minutes for any reason(phone
calls, appointments, bathroom breaks, illness), that is considered an “absence”
for the day. This type of absence counts in the total number of absences
resulting in lowering of the final course grade.

Print name of student: _____________________________________________________

Signature of student: _______________________________________________________

Date: ___________________________________

66
STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

Progression in the PTA Program

Candidates for a degree in any Health Science curriculum must meet the
requirements for graduation of the college. In addition, students enrolled in the
PTA program leading to an associate’s degrees must progress in meeting the
requirements of the program according to the following:

1. Students must complete all general education courses with a grade of “C”
or better. In a semester when a student does not earn a grade of “C” or
better in a course, a student will be placed on hold within the
program. The student is eligible only in the next cycle of courses to
retake courses not successfully completed. A student who fails to
reenter the program at the next offered cycle of courses needed for the
degree who wishes to complete an A.A.S. in PTA at Amarillo College
must begin the PTA degree process again including application.
2. Students must maintain current CPR certification.
3. Students must maintain annual documentation of required
immunizations and health testing such as flu and TB.
4. Students must maintain acceptable health status that allows required
performance within the clinical environment.
5. Students must successfully complete and pass a background check and
remain felony free while enrolled in the program.
6. Any student enrolled in the PTA Program at Amarillo College may be
subject to random drug testing. At several points during their
academic career, students will be eligible for random sampling. Refusal
to submit will result in immediate removal from the program with no
option to reapply or re-enter.
7. Students must complete all PTHA and general education courses with a
grade of “C” or better prior to the end of the second fall semester in
order to PTHA 2567: Practicum I at the start of the final semester of the
PTA program.
8. Students must complete terminal clinical rotations within 18 months of the
last day of enrollment in PTA courses if there should be a lapse between
the sophomore fall semester and the sophomore spring semester.
9. Students are required to attend all scheduled classroom, laboratory and
clinical sessions. The student must fulfill all requirements for each

67
 course in the level of study before promoting to the next higher level of study.
The student must successfully complete all coursework including integrated

STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

Progression in the PTA Program, continued

clinicals before promoting to the terminal clinical rotations. The grade a student
earns on any assignment is the grade which will be recorded.

Print name of student: _____________________________________________________

Signature of student: _______________________________________________________

Date: ___________________________________

68
 STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

PTA PROGRAM DRUG AND/OR ALCOHOL USE POLICY

The PTA program adheres to the drugs and/or alcohol policy as outlined below.
PTA faculty who suspect drug and/or alcohol abuse are required to take action
as appropriate to patient and student safety. Any one or more of the following
behaviors may constitute evidence that a student is under the influence of
alcohol or drugs.
1. Observable lack of motor coordination without reasonable explanation.
Such behavior must be described objectively by the person making
such observations.
2. Incoherent speech without reasonable explanation.
3. Inappropriate decision-making behavior without reasonable
explanation. This behavior must be described objectively by persons
making such observations. The behavior must clearly be inappropriate
based upon reasonable expectations of other students at the same
academic level.
4. Odor of alcohol detected from a minimum distance of 2 feet.
Any student whose behavior or job performance indicates that they are working
under the influence of drugs or alcohol in the clinical facility or campus
laboratory will be approached by an instructor or clinical facility official. If the
student acknowledges the use of drugs or alcohol, dismissal from the program
will occur.
If a student refuses to acknowledge use of drugs or alcohol, upon being
approached by the instructor, he or she may be asked to submit to a drug or
alcohol test at the student's expense. If the student then chooses to submit,
the fieldwork educator or college personnel will accompany the student to the
emergency department to have the drug or alcohol test done. The student will
be required to sign a release, which would enable Amarillo College to receive
the test result(s).

Refusal to submit to a drug or alcohol test under these conditions will result in
immediate removal from the clinical area or lab setting. Disciplinary action up
to and including dismissal from the program may occur. The student will be
asked to remain in the clinical facility or laboratory until someone can come to
transport the student to his/her home.

A positive drug or alcohol test or an incident of reasonable suspicion will result

in dismissal from the program. The incident will be reported to the Dean of the
Health Science Division and Vice President of Student Affairs. A written report
will be placed in the student's file.

69
 Print name of student: _____________________________________________________
Signature of student: _______________________________________________________
Date: ___________________________________
STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

Amarillo College PTA Program Student Agreement

In consideration for my acceptance to the Physical Therapist Assistant program

in the Health Science Division of Amarillo College, I, the undersigned, agree to
pursue this course of education to the best of my ability.

1. I will take care to maintain a professional attitude in my relationship with

patients, peers, and instructors.
2. I will abide by the Students Rights and Responsibilities governing the
College.
3. I will perform my work, both didactic and clinical, to the best of my ability.
4. I will treat every patient with courtesy and consideration and will regard all
information concerning patients as strictly confidential.
5. I will exercise extreme care to insure that my personal appearance and
hygiene will not be questioned.
6. I will not conceal any health problem that might endanger my patients or
peers.
7. I will do all in my power to live up to and improve the highest traditions of
my chosen profession.

Print name of student: _____________________________________________________

Signature of student: _______________________________________________________

Date: ___________________________________

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STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

STUDENT RESPONSIBILITIES
Informed Consent
Throughout the PTA Program, students are often requested to perform physical
therapy demonstration, interventions and assessments (collectively known as
“activities”) on other students, instructors and /or patients. Each person must
accept the following responsibilities when involved in PTA program activities.

Faculty Responsibilities
Prior to participation as a subject or student practitioner in demonstration or
assessment or, intervention, the faculty will:
1. Explain the purpose, risks and benefits of the activity.
2. Provide the opportunity for questions regarding the activity.
3. Provide an appropriate level of licensed supervision throughout the activity.
4. Respect the student’s and patient’s rights to not participate as a subject
without adverse effect to grades.

Subject Responsibilities
When participating as the subject in a demonstration, assessment or
intervention, the student is responsible to:
1. Inform the faculty of any medical condition or change in medical condition
that would prevent safe participation in the activity.
2. Immediately notify the student practitioner and faculty of any discomfort or
pain caused by the activities.
3. Immediately request that the faculty assist in the application of an activity if
there are any concerns about the skill or procedures used by the student
practitioner.
4. Report any injury to the faculty immediately

Student Practitioner Responsibilities

When performing demonstrations, assessments or interventions on a subject,
the student is responsible to:
1. Obtain verbal consent from the subject.
2. Immediately terminate the activity upon any verbal or physical indication by
the subject.
3. Refrain from performing any activity that the student practitioner is not
adequately prepared to perform safely.

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 4. Request assistance from the faculty when needed.
5. Inform the faculty of any factors that prevent safe performance of an activity.

STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

STUDENT RESPONSIBILITIES, continued

Please be advised that refusing to participate as a student practitioner or

subject will prevent the student from successful completion of the PTA
program.

Print name of student: _____________________________________________________

Signature of student: _______________________________________________________

Date: ___________________________________

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STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

CLINICAL EDUCATION AND THE AMARILLO COLLEGE

PHYSICAL THERAPIST ASSISTANT PROGRAM

Student’s Name: ______________________________________________________

Address: ______________________________________________________________
Phone Number: _______________________________________________________

Beginning in the first semester of the program, students will be involved

in integrated clinical experiences. The Amarillo College Physical
Therapist Assistant Program also requires students to successfully
complete full-time clinical rotations. Full-time rotations consist of a
two-week clinical in the first summer of the program as part of PTHA
1160: Clinical I as well as two seven-week clinicals in the second spring
semester of the program for the course PTHA 2567: Practicum I.

In order to promote student success with clinical experiences and to

insure variety in clinical experiences, the Academic Clinical Coordinator
of Education (ACCE) reserves the right to determine all clinical
placements. Clinical placements are determined based on student
academic needs, not convenience.

The student hereby acknowledges that he/she will be required to

complete at least one out-of-town full-time clinical rotation and may have
to complete up to three out-of-town full-time clinical rotations. The
student acknowledges that he/she will be required to adhere to the work
hours established by the clinical site for each rotation. I

Print name of student: _____________________________________________________

Signature of student: _______________________________________________________

Date: ___________________________________

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STUDENT NAME:_________________________________________________________
Entering program August 2015, graduation 2017

Amarillo College PTA Program Student Agreement

In consideration for my acceptance to the Physical Therapist Assistant program

in the Health Science Division of Amarillo College, I, the undersigned, agree to
pursue this course of education to the best of my ability.

1. I will take care to maintain a professional attitude in my relationship with

patients, peers, and instructors.
2. I will abide by the Students Rights and Responsibilities governing the
College.
3. I will perform my work, both didactic and clinical, to the best of my ability.
4. I will treat every patient with courtesy and consideration and will regard all
information concerning patients as strictly confidential.
5. I will exercise extreme care to insure that my personal appearance and
hygiene will not be questioned.
6. I will not conceal any health problem that might endanger my patients or
peers.
7. I will do all in my power to live up to and improve the highest traditions of
my chosen profession.

Print name of student: _____________________________________________________

Signature of student: _______________________________________________________

Date: ___________________________________

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