What I Learned as a First-Time Clinical Instructor

By Alex Lin, PT, DPT
Physical Therapist, Texas

Many clinicians can recall a great instructor who built their clinical foundations and elevated their craft and love for their respective fields. Unfortunately, there have also been plenty of subpar experiences that result in students shying away from a specific setting or population. Regardless of a good or bad experience, each clinician eventually considers one question when they begin practicing in the field: Would you want to be a clinical instructor/fieldwork coordinator?

As a recent graduate from PT school, many thoughts and concerns emerged as I contemplated if I would be an adequate instructor, nevertheless a qualified one:

“I’m too young”

“What if I can’t answer their questions?”

“What do I have to offer?”

“What if they see me make a mistake with a patient?”

Although I racked up a few instructional experiences as a sponsor to current colleagues, taking on a clinical instructor role was completely different. I would be responsible for ensuring the competency of each hardworking student as they progress through their schooling.

At the end of the day, I saw this for what it was: an opportunity to build my skills as an educator, leader, and role model, and I spent a three-month rotation as a clinical instructor. This is what I learned.

6 Key Takeaways From My CIinical Instructor Experience

1. Accommodate Different Learning Styles

Just as previous instructors and professors had done for me, I wanted to figure out how to best relay information to ensure learning. There are four commonly known learning styles known as VARK — visual, auditory, reading/writing, and kinesthetic. While learners may have preferences, it’s unlikely a person falls solely into one category. In reality, a mix of these four styles is most common for each learner.

Adapting to my students’ learning style not only helps them understand, but I also benefit from watching and physically doing certain techniques such as functional transfers and manual techniques. My advice: Ask your student what worked for them in their previous experience. If this is their first rotation, ask how they best learned during their graduate program when preparing for lab practicals and exams.

2. Set Appropriate Expectations and Communicate Discrepancies Early

Depending on their graduate program, there may be specific requirements included in their rotation. Some programs may require an in-service, case study, or presentation before completing their clinical rotation. Be sure to know what’s needed!

FOX Rehabilitation provides timelines to guide instructors and students throughout their experience. These suggest the recommended caseload ramp-up week to week to ensure that the student meets the requirements of their respective program. Make sure you spend extra time, in the beginning, to set up good habits early to prevent falling behind and having to backtrack and catch up on basic logistics towards the end of the rotation.

3. Provide Feedback Thoughtfully

During my academic career, I was the person receiving feedback, not the one providing it. I found giving feedback to be one of the hardest parts of my clinical instructor experience and the one I looked forward to the least.

Eventually, I found that learning about the process of clinical decision-making that led to the student choosing a certain action, word, or method was the best way to challenge their ability to treat a patient. Instead of focusing on objective “right or wrong” (other than blatant patient safety), I gave different options, methods, or techniques to achieve a specific outcome intended by the student. Our academic schooling teaches us the tools to effectively treat patients, and my job was to guide them on how to effectively use it and help them expand their toolbox at the same time.

4. Allow *Safe* Mistakes

I am a strong believer in learning from your mistakes. The most memorable and teachable moments I had revolved around me making mistakes. Whether it was how I communicated with a patient to achieve a certain response or a technique that I performed that did not have the intended benefit, I learned a lesson. During my clinical rotation, I was intentionally allowed to make safe mistakes so I could reflect and adjust.

The hardest part for me when allowing mistakes was during our days treating in memory care. One of the most difficult parts of initiating therapy is receiving buy-in from the patient, especially those with various stages of cognitive deficits. Allowing students to fail at obtaining buy-in provides a great teaching opportunity in different strategies of redirection and encouragement to participate in therapy. It comes at a loss of productivity, but the adjustments made in the future are worth it.

There will be instances where you have to intervene as the licensed professional when the patient and or student’s safety is of concern. Act accordingly, and these instances can still provide a valuable teaching moment. For example: during my first rotation, my instructor and I were concerned about the risk of a cerebrovascular accident (CVA) given high blood pressure readings. It was my first time seeing EMS arriving to escort a patient to the emergency room. Even just participating from the sidelines made all my other emergency calls less terrifying as a treating provider.

5. Set Time for Reflection

I found it beneficial to sit down at the end of each week to go over goals that were met this week and goals set for the following week. The students and I collaborated on how to achieve certain goals, whether it was a self-identified goal or a program-mandated goal. Discussing areas of improvement and ending strong with strengths was greatly beneficial for us to continue honing our skills. I also ended each week asking how I could improve as a clinical instructor to better facilitate the student’s learning. It allows the student to take ownership of their learning experience and make the best out of it.

6. Remember: You’re Not Alone!

There are plenty of resources that can guide you through this novel experience. I

reached out to my Regional Director and Regional Quality Assurance Liaison before and during my time as an instructor for tips and tricks for success. There is also the Site Coordinator for Clinical Education (SCCE) that you can reach out to at any point to discuss any barriers or difficulties. I also found that colleagues who have been instructors in the past can all give invaluable recommendations.

Lessons Learned for First-Time Clinical Instructors

I learned a lot from my experience as a clinical instructor — including what I won’t do next time.

Looking back, I was too concerned about how much I knew clinically. It’s okay to say “I don’t know” and challenge each other to look up relevant evidence that pertains to those questions. It’s more than okay to lean on your teammates. I would have reached out to my team more to consult on different topics and teaching methods. If it was reasonable, I would have students shadow other disciplines with a shared caseload more as well as other patients with the same discipline.

Finally, after reflecting on this experience, the main lesson I took away was to enjoy the process and embrace that there will always be something new to learn.