Forms to Be Completed with The

FORMS PACKET

FOR THE

SELF-STUDY REPORT

FOR

EDUCATION PROGRAMS FOR THE PREPARATION OF

PHYSICAL THERAPIST ASSISTANTS

March 2013

Recent changes are highlighted

Commission on Accreditation in Physical Therapy Education

American Physical Therapy Association

1111 North Fairfax Street

Alexandria, Virginia22314

(703) 706-3245

DIRECTIONS: Portal Submission

These forms have been developed by the Commission on Accreditation in Physical Therapy Education (CAPTE) to ensure that information is provided in a consistent format across programs. Please do not hesitate to contact staff members in the Department of Accreditation for assistance if needed.

The following forms are included in this document:

* Also available on the Portal, click Access to Additional Needed Materials above the Self-study Report grid, then click Items Provided On Site found under the On-site Visit Materials section. .

** Downloaded forms from Portal (once all data is entered) will provide data in a different format than used to collect data. If providing a paper version of the self study on site for the team, place the forms downloaded from CAPTE Portal Preview/Print page as an Appendix of the Self-study Report.

GENERAL INSTRUCTIONS: Once data has been entered for a particular ‘form’, click the Validation button on the bottom of the page or under the Self-study Report grid to check for related validation errors. Use the preview/print function, to download the ‘forms only’ document to check data for accuracy.

INSTRUCTIONS FOR INDIVIDUAL FORMS:

1.The General Information Form

For Portal report, this form is created from data entered.

For Hard Copy of Self-study Report:

• place after the Table of Contents

This is one of 3 forms provided to the team at start of visit in BOTH hard copy and as a file on disk. This is required even if there are no changes to the form.

Definitions to be used to determine the type of academic calendar:

Semesters =calendar system with 2 semesters during academic year with about 16 weeks for each semester of instruction; may have additional summer term.

Quarters = calendar system with 3 sessions called quarters of about 12 weeks each. May range from 10-15 weeks; may be additional summer quarter.

Trimesters =calendar system with 3 terms of about 15 weeks each.

The Introduction section of the Evaluative Criteria includes definitions related to faculty; these are to be used in determining faculty classifications regardless of how the individual is classified at your institution. CAPTE is aware that many institutions offer other programs in which the faculty may have responsibilities; please try to allocate the correct full-time equivalency (FTE) to each faculty member as it relates to the professional (entry-level) program. Add additional lines to the table as needed for listing additional faculty.

Calculation of FTE Allocations: For consistency, and because typical academic appointments in PTA programs are 9-9.5 months, we are asking that all programs base calculations on 9 months = 1.0 FTE. The following chart provides examples of how to calculate FTEs as requested.

2.*** Persons Interviewed Form: This form identifies the names, credentials, and titles (or areas of responsibility) of those individuals whom the team will interview during the site visit. The team will update the form during the visit to reflect those who were actually interviewed, as well as identifying those who attended the Exit Summary.

3. *** Materials Provided On Site: This form identifies the materials available on site for the team to review. The items listed are those items requested in the Evidence of Compliance listings in the Evaluative Criteria and must be available for on-site review unless the item does not exist, in which case, the form should indicate that the item does not exist. The program should add any additional materials being made available for review on-site to the form.

*** These three forms (General Information, Persons Interviewed, and Materials Provided On Site) must be provided to the team at the very beginning of the on-site visit in both hard copy and electronic copy. The electronic copy should have all three forms as one document - you can access these three forms as one document on the Portal. The Team Leader will submit these forms; they become part of the final Visit Report.

4.Income and Expense Statements: This form is divided into Income (Allocation)and Operating Expenses sections. The three columns represent the same information for the:

• previous academic year,
• academic year of the on-site visit; and
• what is budgeted (will be proposed) for next academic year.

Income refers to the amount allocated to the program each year; it does NOT refer to the total income to the institution that is generated by the program. Generally the amount of money allocated to the program covers all program expenses. The amount entered in the income section on the Portal should never total zero ($00.00).

If the income (Allocation)and operating expenses provided are for multiple programs, provide an explanation in the Narrative regarding the resources available for each program. The Commission is aware that institutions have various ways to present budget materials; however, the Commission requests that a uniform format be used so that a better understanding of the resources available for the program will be achieved.

5.Curriculum Vitae (CV): The required CV format is included in this Forms Packet. This format MUST be used by each core faculty. In addition, use this format for each associated faculty member who teaches 50% or more of the contact hours of a course. On the Portal it is uploaded on the Faculty Detail page for each faculty member. If the program is providing the team with a paper version of the Self-study Report on site, the CVs are placed in the Appendices with a separate tab for each faculty member.

A consistent format must be used for all CVs provided. It is acceptable to change the format; however all CVs must follow the same format. For example, providing information from the earliest to the most recent instead of the requested most recent to earliest (i.e., scholarship, employment) is acceptable. The last section must include current teaching responsibilities.

For TBD faculty: If you had to create a dummy faculty member (TBD Core or TBD Associated) in order to identify a primary faculty member in the Course Details page for a course in which the faculty are to be determined, attach a blank document named: Do Not Bother To Open.pdf.

6.Course List/Course Details: see instructions below. Additionally, the Course Outcomes and Objectives Form (COOF)previously required with the submission of a Self study Report has been eliminated. Use the Curriculum Summary Form to document the data for entry into the fields of the Self study report on the portal. See page 22 of this packet for the requested and preferred documentation of course content and related objectives.

7.Table of Contents is ONLY required IF you are providing a hard copy of the Self-study Report on site for the team. Insert the page number corresponding to the item being addressed; this includes the page number for each appendix listed! Place this form at the beginning of each notebook.

Required materials (Exhibits or Appendices) are already listed. Additional items included in the Appendices must be added to the Table of Contents, identifying the page or appendix where each item can be located. Whenever multiple documents are provided within one Appendix, each document must be listed with the corresponding page where it can be found.

Note: For a paper version of the Self-study Report, tabs are required for each heading listed in the Table of Contents, as well as each CV and each course (for syllabi and exams).

8.Graduation Rate Table: Three years of data must be provided; the Portal will identify the graduation cohorts that are requested for the Portal fields based on the years that all programs can complete given the definition for graduation rate. Data for more current graduating cohorts should be provided in the Narrative response to 2.1.A Graduation Rate Table is provided for the collection of data. The formula within this table must be used to determine the graduation rate; this formula is based on the government’s IPED definition of graduation rate. This rate is always determined based on the number of students who originally matriculated in the first course of the program (2+2 programs) or the technical phase program (1+1 programs).

The Portal now requires data to be provided for each cohort separately. CAPTE defines a cohort of students as a group of students who matriculate into the professional/technical courses at the same time with the expectation that they will also complete the program at the same time.

If there are no graduates for a year requested in the Portal, the response to Portal question #1.1 should be set to ‘No’.

9.Assessment Documentation Grid: The grid is still a required appendix to accompany and support the program response for criteria 4.1.1 through 4.1.12. and must be uploaded and attached in the portal. The Grid is not a stand- alone document as the narrative requires explanations about identified measures and rationales for the thresholds established for measuring programmatic effectiveness.

10.Core and Associated Faculty Information Sheet:The majority of this data will pre-populate from the AAR. Revise data as needed to reflect changes since the submission of the last AAR.

Additional notes regarding faculty information:

If faculty for a course is unknown: You will need to create a dummy/to be determined faculty member named: TBD Core or TBD Associated. You will be required to provide all the data; therefore, enter zero (0) or the most appropriate response. This is necessary because all courses must have at least one primary faculty assigned to it.

11. Workload Distribution Form: It is imperative that there be consistency in calculations across all core faculty workloads when determine % of workload. CAPTE does not have a formula for calculations, but expects programs to use a consistent format. Percentages should be provided based on workload at your institution. If not part of workload, do not include. For example, if a core faculty member has time allotted for clinical practice, then include. But if the institution does not consider this activity as part of the individual’s workload, do not include. The total time will auto calculate on the Portal and must equal100% or a validation error will show on the Validation Page.

*The forms included in this packet should be used only to gather the requisite information for entry on the CAPTE Accreditation Portal. The only form (in addition to any other documentation required in the evidence lists) that will be uploaded to the CAPTE Accreditation Portal is the Assessment Process Documentation Grid. The Faculty Workload Distribution, Curriculum Summary, and Program Expenses and Income formsare now each part of the first section of the self-study report and are not appended as supporting documentation that was previously required in hard copy submissions.

GENERAL INFORMATION FORM

(2 pages)

PERSONS INTERVIEWED FORM

The program is to list the names and titles, or areas of responsibility, of those individuals with whom the team meets during the on-site visit. Please PLACE AN ASTERISK (*) beside the name of each person who attends the Exit Summary on the last day of the on-site visit.

Name of Institution:

Administrative Officers:

Program Administrator (Director, Chair etc.):

Core Faculty:

Adjunct Faculty:

General Education/Supportive Faculty:

Clinical Education Faculty (CCCEs and CIs):

Students enrolled in an early phase of the program (e.g., 1st year in program):

Students enrolled in a late phase of the program (e.g., last year in program):

Recent graduates of the program:

Employers of graduates of the program:

MATERIALS PROVIDED ON SITE FORM

This form should be used to document the materials that substantiate compliance with the Evaluative Criteria that were not included in the Self-study Report. Additional rows may be added to the form if the program includes materials not on this form.

The Materials Provided On Site Form should be provided in both hard copy and on disk to the Team Leader at the beginning of the on-site visit.

PROGRAM INCOME AND EXPENSES FORM