Re: Student -- CI Ethics Question

[Guest guest]

None. Let it go and quit being concerned about it!

From: PTManager [mailto:PTManager ] On Behalf

Of Alan Petrazzi

Sent: Saturday, March 03, 2012 10:16 AM

To: PTManager ; hpa-list

Subject: Student -- CI Ethics Question

I was posed with an ethical question on a recent Continuing Ed course. It

got me thinking. and I am looking for your feedback.

Scenario: A female PT student and male PT CI are reviewing myofascial

techniques. They were in an open gym area with patients around and both

were clothed. The PT had the student locate an area on his back and

demonstrate some of the techniques.

A) No problem. This is within the acceptable range of a learning

experience. Don't think too much about it. Better to try on each other

than to learn on a patient. Not a problem but this should have occurred in

a private treatment room.C) Not a problem but this type of learning

experience should happen between same sex persons.D) Problem. This learning

experience needs to happen with the CI guiding the approaches while working

on a patient. Misinterpreted intentions are possible if CI and Student

practice on each other.

E) Crosses acceptable boundaries. Needs to cease immediately.

F) Crosses acceptable boundaries. Warrants discipline.

If this is problematic, what is your greatest concern?

Thank you for your feedback.

Alan PetrazziRehab DirectorPittsburgh, PA

[Guest guest]

None. Let it go and quit being concerned about it!

From: PTManager [mailto:PTManager ] On Behalf

Of Alan Petrazzi

Sent: Saturday, March 03, 2012 10:16 AM

To: PTManager ; hpa-list

Subject: Student -- CI Ethics Question

I was posed with an ethical question on a recent Continuing Ed course. It

got me thinking. and I am looking for your feedback.

Scenario: A female PT student and male PT CI are reviewing myofascial

techniques. They were in an open gym area with patients around and both

were clothed. The PT had the student locate an area on his back and

demonstrate some of the techniques.

A) No problem. This is within the acceptable range of a learning

experience. Don't think too much about it. Better to try on each other

than to learn on a patient. Not a problem but this should have occurred in

a private treatment room.C) Not a problem but this type of learning

experience should happen between same sex persons.D) Problem. This learning

experience needs to happen with the CI guiding the approaches while working

on a patient. Misinterpreted intentions are possible if CI and Student

practice on each other.

E) Crosses acceptable boundaries. Needs to cease immediately.

F) Crosses acceptable boundaries. Warrants discipline.

If this is problematic, what is your greatest concern?

Thank you for your feedback.

Alan PetrazziRehab DirectorPittsburgh, PA

[Guest guest]

There is risk with anything we do. I once had a patient offended because I was

singing/ humming along to a song on the radio that she felt was somehow

" blasphemous " (Octopuses' Garden by The Beatles, I think). I was never quite

sure what exactly offended her, but the safe bet is on my horrible singing

voice. The P.S. to that story is that I now only play instrumentals in my

treatment room.

The point is less ethical, and more one of environmental assessment. Always

consider who might be offended or made uncomfortable. Patient? Student? Other

Clinicians? Other onlooking patients? Consider the other hand too ... by

teaching in an open gym, onlookers get exposure to techniques that they may not

know we as PT's do. It's a subtle marketing tool for thrust joint manipulation,

dry needling, etc.). In conclusion, what may be appropriate under one set of

circumstances may not be appropriate in another. The only ETHICAL concern is IF

the CI considered any of this.

M. Ball, PT, DPT, PhD

Northeast Rehabilitation Gateway

Carolinas Rehabilitation

Orthopedic PT Residency Faculty

Charlotte/Concord, NC

> None. Let it go and quit being concerned about it!

>

> From: PTManager [mailto:PTManager ] On Behalf

> Of Alan Petrazzi

> Sent: Saturday, March 03, 2012 10:16 AM

> To: PTManager ; hpa-list

> Subject: Student -- CI Ethics Question

>

> I was posed with an ethical question on a recent Continuing Ed course. It

> got me thinking. and I am looking for your feedback.

> Scenario: A female PT student and male PT CI are reviewing myofascial

> techniques. They were in an open gym area with patients around and both

> were clothed. The PT had the student locate an area on his back and

> demonstrate some of the techniques.

> A) No problem. This is within the acceptable range of a learning

> experience. Don't think too much about it. Better to try on each other

> than to learn on a patient. Not a problem but this should have occurred in

> a private treatment room.C) Not a problem but this type of learning

> experience should happen between same sex persons.D) Problem. This learning

> experience needs to happen with the CI guiding the approaches while working

> on a patient. Misinterpreted intentions are possible if CI and Student

> practice on each other.

> E) Crosses acceptable boundaries. Needs to cease immediately.

> F) Crosses acceptable boundaries. Warrants discipline.

> If this is problematic, what is your greatest concern?

>

> Thank you for your feedback.

>

> Alan PetrazziRehab DirectorPittsburgh, PA

>

>

[Guest guest]

There is risk with anything we do. I once had a patient offended because I was

singing/ humming along to a song on the radio that she felt was somehow

" blasphemous " (Octopuses' Garden by The Beatles, I think). I was never quite

sure what exactly offended her, but the safe bet is on my horrible singing

voice. The P.S. to that story is that I now only play instrumentals in my

treatment room.

The point is less ethical, and more one of environmental assessment. Always

consider who might be offended or made uncomfortable. Patient? Student? Other

Clinicians? Other onlooking patients? Consider the other hand too ... by

teaching in an open gym, onlookers get exposure to techniques that they may not

know we as PT's do. It's a subtle marketing tool for thrust joint manipulation,

dry needling, etc.). In conclusion, what may be appropriate under one set of

circumstances may not be appropriate in another. The only ETHICAL concern is IF

the CI considered any of this.

M. Ball, PT, DPT, PhD

Northeast Rehabilitation Gateway

Carolinas Rehabilitation

Orthopedic PT Residency Faculty

Charlotte/Concord, NC

> None. Let it go and quit being concerned about it!

>

> From: PTManager [mailto:PTManager ] On Behalf

> Of Alan Petrazzi

> Sent: Saturday, March 03, 2012 10:16 AM

> To: PTManager ; hpa-list

> Subject: Student -- CI Ethics Question

>

> I was posed with an ethical question on a recent Continuing Ed course. It

> got me thinking. and I am looking for your feedback.

> Scenario: A female PT student and male PT CI are reviewing myofascial

> techniques. They were in an open gym area with patients around and both

> were clothed. The PT had the student locate an area on his back and

> demonstrate some of the techniques.

> A) No problem. This is within the acceptable range of a learning

> experience. Don't think too much about it. Better to try on each other

> than to learn on a patient. Not a problem but this should have occurred in

> a private treatment room.C) Not a problem but this type of learning

> experience should happen between same sex persons.D) Problem. This learning

> experience needs to happen with the CI guiding the approaches while working

> on a patient. Misinterpreted intentions are possible if CI and Student

> practice on each other.

> E) Crosses acceptable boundaries. Needs to cease immediately.

> F) Crosses acceptable boundaries. Warrants discipline.

> If this is problematic, what is your greatest concern?

>

> Thank you for your feedback.

>

> Alan PetrazziRehab DirectorPittsburgh, PA

>

>

[Guest guest]

There is risk with anything we do. I once had a patient offended because I was

singing/ humming along to a song on the radio that she felt was somehow

" blasphemous " (Octopuses' Garden by The Beatles, I think). I was never quite

sure what exactly offended her, but the safe bet is on my horrible singing

voice. The P.S. to that story is that I now only play instrumentals in my

treatment room.

The point is less ethical, and more one of environmental assessment. Always

consider who might be offended or made uncomfortable. Patient? Student? Other

Clinicians? Other onlooking patients? Consider the other hand too ... by

teaching in an open gym, onlookers get exposure to techniques that they may not

know we as PT's do. It's a subtle marketing tool for thrust joint manipulation,

dry needling, etc.). In conclusion, what may be appropriate under one set of

circumstances may not be appropriate in another. The only ETHICAL concern is IF

the CI considered any of this.

M. Ball, PT, DPT, PhD

Northeast Rehabilitation Gateway

Carolinas Rehabilitation

Orthopedic PT Residency Faculty

Charlotte/Concord, NC

> None. Let it go and quit being concerned about it!

>

> From: PTManager [mailto:PTManager ] On Behalf

> Of Alan Petrazzi

> Sent: Saturday, March 03, 2012 10:16 AM

> To: PTManager ; hpa-list

> Subject: Student -- CI Ethics Question

>

> I was posed with an ethical question on a recent Continuing Ed course. It

> got me thinking. and I am looking for your feedback.

> Scenario: A female PT student and male PT CI are reviewing myofascial

> techniques. They were in an open gym area with patients around and both

> were clothed. The PT had the student locate an area on his back and

> demonstrate some of the techniques.

> A) No problem. This is within the acceptable range of a learning

> experience. Don't think too much about it. Better to try on each other

> than to learn on a patient. Not a problem but this should have occurred in

> a private treatment room.C) Not a problem but this type of learning

> experience should happen between same sex persons.D) Problem. This learning

> experience needs to happen with the CI guiding the approaches while working

> on a patient. Misinterpreted intentions are possible if CI and Student

> practice on each other.

> E) Crosses acceptable boundaries. Needs to cease immediately.

> F) Crosses acceptable boundaries. Warrants discipline.

> If this is problematic, what is your greatest concern?

>

> Thank you for your feedback.

>

> Alan PetrazziRehab DirectorPittsburgh, PA

>

>

[Guest guest]

This is and has been the normative model for clinical education in this

country for at least the 21 years that I have been a PT. In PT school we

worked on each other, in continuing ed courses we work on each other. In

both scenarios, hopefully, we provided valuable feedback to the person

practicing on us. In the clinic I demonstrate a technique on a student and

then he or she in turn demonstrates it on me. Often we have the

opportunity to have a second student or another PT join in the education

experience and then the CI can stand back and watch/critique rather than

participate but in the end, knowing how a technique performed by a student

feels to the patient allows for very important feedback to the student

performing the technique. So, in my opinion, yes, this a perfectly

acceptable teaching situation and performing it in the open gym allows your

patients to observe you and the student in a teaching moment which is great

for public perception.

--

Sincerely,

E. s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

[Guest guest]

This is and has been the normative model for clinical education in this

country for at least the 21 years that I have been a PT. In PT school we

worked on each other, in continuing ed courses we work on each other. In

both scenarios, hopefully, we provided valuable feedback to the person

practicing on us. In the clinic I demonstrate a technique on a student and

then he or she in turn demonstrates it on me. Often we have the

opportunity to have a second student or another PT join in the education

experience and then the CI can stand back and watch/critique rather than

participate but in the end, knowing how a technique performed by a student

feels to the patient allows for very important feedback to the student

performing the technique. So, in my opinion, yes, this a perfectly

acceptable teaching situation and performing it in the open gym allows your

patients to observe you and the student in a teaching moment which is great

for public perception.

--

Sincerely,

E. s, PT, DPT

Orthopedic Clinical Specialist

Fellow American Academy of Orthopedic Manual Physical Therapists

www.douglasspt.com

[Guest guest]

Seems innocent and non-problematic to me. I would think it would raise

more eyebrows if they went into a private treatment room as if there were

something to hide. Then would they have to take the CI in with them? We

encourage students to practice on each other and friends all the time with

or without supervision. As a CI or instructor in a PT program, it wouldn't

have even occurred to me to question the practice unless they were being

inappropriate or disturbing the patients.

B. Harbst, PT, PhD

Clinical Associate Professor - University of Wisconsin-La Crosse Physical

Therapy Program

Pediatric Physical Therapist - Gundersen Lutheran; La Crosse, Wisconsin

On Sat, Mar 3, 2012 at 10:16 AM, Alan Petrazzi wrote:

> **

>

>

> I was posed with an ethical question on a recent Continuing Ed course. It

> got me thinking. and I am looking for your feedback.

> Scenario: A female PT student and male PT CI are reviewing myofascial

> techniques. They were in an open gym area with patients around and both

> were clothed. The PT had the student locate an area on his back and

> demonstrate some of the techniques.

> A) No problem. This is within the acceptable range of a learning

> experience. Don't think too much about it. Better to try on each other

> than to learn on a patient. Not a problem but this should have occurred

> in a private treatment room.C) Not a problem but this type of learning

> experience should happen between same sex persons.D) Problem. This

> learning experience needs to happen with the CI guiding the approaches

> while working on a patient. Misinterpreted intentions are possible if CI

> and Student practice on each other.

> E) Crosses acceptable boundaries. Needs to cease immediately.

> F) Crosses acceptable boundaries. Warrants discipline.

> If this is problematic, what is your greatest concern?

>

> Thank you for your feedback.

>

> Alan PetrazziRehab DirectorPittsburgh, PA

>

>

[Guest guest]

Alan,

A good question. A teacher working with a student who is learning hands-on

techniques needs to guide the student. Often this is best done by the student

practicing on the teacher. Unfortunately, it is a teaching situation which could

be misinterpreted as being inappropriate if a third-party unexpectedly came upon

the interaction, such as if it occurred in a private room.

I think the teacher in the case you describe should be commended for making sure

the teaching occurred in an open area that was continuously observable by

everyone so any suspicions of inappropriate behavior would be quickly dispelled.

The other solution is to have an unbiased observer (preferably the same gender

as the student) explicitly present during the hands-on teaching.

Hansen, PT, PhD

Rehabilitation Institute of Kansas City

Kansas City, Missouri

>

> I was posed with an ethical question on a recent Continuing Ed course.  It got

me thinking. and I am looking for your feedback.

> Scenario: A female PT student and male PT CI are reviewing myofascial

techniques.  They were in an open gym area with patients around and both were

clothed.  The PT had the student locate an area on his back and demonstrate some

of the techniques.

> A) No problem.  This is within the acceptable range of a learning experience.

 Don't think too much about it.  Better to try on each other than to learn on a

patient. Not a problem but this should have occurred in a private treatment

room.C) Not a problem but this type of learning experience should happen between

same sex persons.D) Problem.  This learning experience needs to happen with the

CI guiding the approaches while working on a patient.  Misinterpreted intentions

are possible if CI and Student practice on each other.

> E) Crosses acceptable boundaries.  Needs to cease immediately.

> F) Crosses acceptable boundaries.  Warrants discipline.

> If this is problematic, what is your greatest concern?

>

> Thank you for your feedback.

>

> Alan PetrazziRehab DirectorPittsburgh, PA

>

>

[Guest guest]

Alan,

A good question. A teacher working with a student who is learning hands-on

techniques needs to guide the student. Often this is best done by the student

practicing on the teacher. Unfortunately, it is a teaching situation which could

be misinterpreted as being inappropriate if a third-party unexpectedly came upon

the interaction, such as if it occurred in a private room.

I think the teacher in the case you describe should be commended for making sure

the teaching occurred in an open area that was continuously observable by

everyone so any suspicions of inappropriate behavior would be quickly dispelled.

The other solution is to have an unbiased observer (preferably the same gender

as the student) explicitly present during the hands-on teaching.

Hansen, PT, PhD

Rehabilitation Institute of Kansas City

Kansas City, Missouri

>

> I was posed with an ethical question on a recent Continuing Ed course.  It got

me thinking. and I am looking for your feedback.

> Scenario: A female PT student and male PT CI are reviewing myofascial

techniques.  They were in an open gym area with patients around and both were

clothed.  The PT had the student locate an area on his back and demonstrate some

of the techniques.

> A) No problem.  This is within the acceptable range of a learning experience.

 Don't think too much about it.  Better to try on each other than to learn on a

patient. Not a problem but this should have occurred in a private treatment

room.C) Not a problem but this type of learning experience should happen between

same sex persons.D) Problem.  This learning experience needs to happen with the

CI guiding the approaches while working on a patient.  Misinterpreted intentions

are possible if CI and Student practice on each other.

> E) Crosses acceptable boundaries.  Needs to cease immediately.

> F) Crosses acceptable boundaries.  Warrants discipline.

> If this is problematic, what is your greatest concern?

>

> Thank you for your feedback.

>

> Alan PetrazziRehab DirectorPittsburgh, PA

>

>

[Guest guest]

Alan,

A good question. A teacher working with a student who is learning hands-on

techniques needs to guide the student. Often this is best done by the student

practicing on the teacher. Unfortunately, it is a teaching situation which could

be misinterpreted as being inappropriate if a third-party unexpectedly came upon

the interaction, such as if it occurred in a private room.

I think the teacher in the case you describe should be commended for making sure

the teaching occurred in an open area that was continuously observable by

everyone so any suspicions of inappropriate behavior would be quickly dispelled.

The other solution is to have an unbiased observer (preferably the same gender

as the student) explicitly present during the hands-on teaching.

Hansen, PT, PhD

Rehabilitation Institute of Kansas City

Kansas City, Missouri

>

> I was posed with an ethical question on a recent Continuing Ed course.  It got

me thinking. and I am looking for your feedback.

> Scenario: A female PT student and male PT CI are reviewing myofascial

techniques.  They were in an open gym area with patients around and both were

clothed.  The PT had the student locate an area on his back and demonstrate some

of the techniques.

> A) No problem.  This is within the acceptable range of a learning experience.

 Don't think too much about it.  Better to try on each other than to learn on a

patient. Not a problem but this should have occurred in a private treatment

room.C) Not a problem but this type of learning experience should happen between

same sex persons.D) Problem.  This learning experience needs to happen with the

CI guiding the approaches while working on a patient.  Misinterpreted intentions

are possible if CI and Student practice on each other.

> E) Crosses acceptable boundaries.  Needs to cease immediately.

> F) Crosses acceptable boundaries.  Warrants discipline.

> If this is problematic, what is your greatest concern?

>

> Thank you for your feedback.

>

> Alan PetrazziRehab DirectorPittsburgh, PA

>

>

[Guest guest]

I'd say none of the above, but closest to D.

Being a manager and a male, I am aware of concerns that something inappropriate

could appear to be the case if this was done in a private area with no one but

the student and the CI present, even if it was unintentional or misinterpreted.

There is also an element of " know your audience, " as there is always potential

that a guest/customer/patient could find this distasteful or inappropriate.

I think the best way to handle would be out of sight of patients UNLESS it's to

help teach a student in a patient-care experience AND the patient agrees to it

when explained to them. It would be advisable to avoid this 1:1 in a closed

treatment room as there is the potential for misinterpretation given the

CI/student relationship not being equal.

Great topic and I don't think there is one right answer--I've enjoyed reading

others' responses.

>

> I was posed with an ethical question on a recent Continuing Ed course.  It got

me thinking. and I am looking for your feedback.

> Scenario: A female PT student and male PT CI are reviewing myofascial

techniques.  They were in an open gym area with patients around and both were

clothed.  The PT had the student locate an area on his back and demonstrate some

of the techniques.

> A) No problem.  This is within the acceptable range of a learning experience.

 Don't think too much about it.  Better to try on each other than to learn on a

patient. Not a problem but this should have occurred in a private treatment

room.C) Not a problem but this type of learning experience should happen between

same sex persons.D) Problem.  This learning experience needs to happen with the

CI guiding the approaches while working on a patient.  Misinterpreted intentions

are possible if CI and Student practice on each other.

> E) Crosses acceptable boundaries.  Needs to cease immediately.

> F) Crosses acceptable boundaries.  Warrants discipline.

> If this is problematic, what is your greatest concern?

>

> Thank you for your feedback.

>

> Alan PetrazziRehab DirectorPittsburgh, PA

>

>