Information for Clinical Educators and Students
The following documents are in PDF format and require Adobe Reader, which is a free download.
- Clinical Internship I Syllabus
- Clinical Internship II Syllabus
- Clinical Internship III Syllabus
- Clinical Internship IV Syllabus
- Clinical Internship V Syllabus
- Student Evaluation of Clinical Experience
- Tests and Measures for Clinical Internship I
- Tests and Measures for Clinical Internship II
- Tests and Measures for Clinical Internship III, IV, and V
Midterm Progress Report (used for Clinical Internships I and II only)
All clinical sites are encouraged to update the Clinical Site Information Form (CSIF) annually. Students and faculty use your completed CSIF to learn more about your facility and clinical education program.
Student Information Form. Clinical Sites with assigned students will receive a Student Information Form (SIF) from the University approximately 8 weeks prior to the student's arrival. This form will contain demographic information about the student as well as the student's goals and objectives for the internship.
Midterm Progress Report. For clinical internships I and II, all clinical instructors and students are asked to complete this 2 page form and submit it to the DCE. This form allows the clinical instructor to evaluate the student at the halfway point during the internship. This form also provides the student with the opportunity to self-assess his or her strengths and weaknesses and to communicate these to the clinical instructor and DCE. Students are also asked to let the DCE know if the clinical instructor would like a phone call or site visit to discuss the student's performance.
Clinical Performance Instrument. UTHSC uses the web version of the APTA Clinical Performance Instrument (CPI) for the evaluation of student performance (https://cpi2.amsapps.com). Clinical instructors are asked to complete this online form at midterm for internships III, IV and V, and at the conclusion of all internships. Use of the CPI as a self-assessment tool for the student is also required by the University. Clinical instructors and students should discuss the CPI evaluations.
Documentation of Contact Hours. The Department of Physical Therapy will provide documentation of clinical instructor contact hours following the completion of internships. Certificates with documentation of contact hours will be mailed out within a few months following the completion of the internship.
Carol Counts Likens, PT, PhD
Chairman and Associate Professor
Department of Physical Therapy
The University of Tennessee
Health Science Center
930 Madison – Suite 647
Memphis, TN 38163