This document outlines academic and

management aspects orientating how the

practice cycle is developed (this version
was updated in September 2017).
Israel Cruz Velandia - Physiotherapy
Programme Director
Margin Martínez Matheus - Clinical
Education Coordinator

Clinical Education Guidelines

Physiotherapy Programme

0
TABLE OF CONTENTS
1 Regulatory context for developing training practice ......................................................................................2
2 Physiotherapy-related practice training...........................................................................................................5
2.1 Concerning the concept of practice and practice cycle curricular management ..............................5
2.2 Pedagogical practice model .....................................................................................................................6
2.3 Practice teachers .......................................................................................................................................7
2.4 Subjects involved in the practice cycle..................................................................................................8
3 Practice development stages .........................................................................................................................11
3.1 Contextualisation stage ..........................................................................................................................11
3.2 Development or execution stage ...........................................................................................................11
3.3 Finalisation stage .....................................................................................................................................11
4 Selecting physiotherapy practice-scenarios .................................................................................................12
4.1 Initial contact between both institutions................................................................................................12
4.2 Prior assessment of quality conditions .................................................................................................13
4.3 Legalising the relationship ......................................................................................................................14
4.4 Preparing the conditions for beginning practice ..................................................................................14
5 The method for allocating students to compulsory AFP practice-scenarios ..........................................15
6 The method for allocating elective AFP practice-scenarios .......................................................................16
7 Practice application, approval and follow-up mechanisms for incoming or outgoing national or
international students ...............................................................................................................................................16
8 Mechanisms for disabled students’ entry to and transition in the training practice cycle ......................17
9 Mechanisms for guaranteeing students’ safety and welfare ......................................................................18
10 Procedures regarding communication between the Physiotherapy Programme, practice-scenarios
and instructors ...........................................................................................................................................................20
11 Practice follow-up mechanisms .................................................................................................................20
12 Mechanisms for evaluating practice students’ learning .........................................................................21

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 Practice Training Guidelines

These guidelines provide orientation concerning the Physiotherapy Programme’s

defined procedures, rules and policies for developing the training practice cycle. The
document is aimed at teachers, students and representatives of the institutions
where practice will take place. The proposed elements should enable a reader to
understand the Universidad del Rosario’s (UR) School of Medicine and Health
Sciences’ (SMHS)1 2Physiotherapy Programme’s training practice cycle’s current
structure and facilitate decision-making.

1 REGULATORY CONTEXT FOR DEVELOPING TRAINING PRACTICE

Colombia has a general regulatory framework regulating higher education training

practice and a specific framework regulating training human talent regarding
healthcare. Article 5 Law 115/19943 sates that education will be developed through,
“… training regarding work-related practice, through technical knowledge and skills,
as well evaluating it as the foundation of individual and social development.” The
(Colombian) Ministry of National Education (MNE)4 has specified that practice as a
required activity for completing studies or obtaining a degree must be defined as
such in a study plan and that theoretical subjects incorporating practice components,
academic monitoring, involving students in research seed programmes or as
research assistants in research projects are excluded from this type of activity.

Decree 933/2003 5 defined a learning contract as a special form of

involvment/connection within Colombian labour law which can promote the
professional training required by an occupation and support different types of
students (including university students) thereby guaranteeing their learning through
such modality. It also stipulated that learning contracts’ non-constitutive educational
practice consists of, “ …. university students’ prescribed activities involving
agreements with higher education institutions as internships which are a
prerequisite for obtaining the corresponding degree.”

Legal provisions regulate practice within the framework of training healthcare-

related human talent; Law 1164/20076 determined that an MNE concept is required
prior to evaluating minimum training practice quality conditions for healthcare-
related academic programmes’ approval, assuming that practice must guarantee
the acquisition of the knowledge, skills and abilities, attitudes and aptitudes required

1
Names of entities/programmes and officials and their acronyms in the original document in Spanish are given in
footnotes to facilitate comparison
2
Universidad del Rosario (UR), Escuela de Medicina y Ciencias de la Salud (EMCS)
3
Congress of the Republic of Colombia, Law 115, February 8th 1994 - General Education Law
4
Ministry of National Education. Prácticas: Pasantías y contratos de aprendizaje (practice: internships and
apprenticeship contracts) [Internet]. 2015 [cited July 7 th 2017]. Available from:
http://www.mineducacion.gov.co/1759/w3-article-354776.html
5
Republic of Colombia, Decree 933/2003, regulating the learning contract and dictating other dispositions
6
Republic of Colombia, Law 1164/2007, dictating matters concerning human talent in healthcare-related fields

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by students in each discipline. The Law also stipulated that training institutions must
have an enabled practice network having the required levels of complexity, practice-
scenarios being considered, “the different institutional and community spaces
intervening in the population’s integral healthcare and other non-healthcare sector
entities justified by the profession or occupation as training practice”. Furthermore,
it specified requirements for the recognition of teaching hospitals and those defined
as a healthcare service-providing institution (HSPI) committed to a university’s
essential functions recognised as a supervised teaching and practice hospital
offering training and attention at each level of complexity.

Decree 2376/2010,7 currently compiled in Decree 780/20168, regulated healthcare

programmes’ teaching-service relationship and defined it as the, “….. functional link
established between educational institutions and other organisations for training
healthcare-related human talent or amongst educational institutions when at least
one of them has healthcare-related practice-scenarios. Such link is based on long-
term academic, administrative and research planning agreed between the parties.”
It defined healthcare-related training practice as, “planned and organised
pedagogical strategies seeking to integrate academic training with healthcare
service provision for strengthening and fostering healthcare training programmes’
students and teachers’ skills, abilities and new knowledge within a framework
promoting healthcare quality and the profession’s autonomous, responsible and
ethical practice.”

A technical appendix was incorporated into 2376/2010 for registering the training
plan agreed upon between institutions involved in any teaching-service relationship;
it was aimed at ensuring suitable quality conditions for training healthcare-related
human resources in a practice setting. It stipulated the conditions and strategies
ruling how practice should be carried out, resulting from joint academic reflection
between healthcare-providing institutions (HSPI) and higher education institutions
(HEI).

Agreement 003/2009 defined criteria for evaluating and verifying practice-scenarios

in Colombia and a “Model for evaluating training practice regarding practice-
scenarios”10 which also outlined special conditions for evaluating reaching hospitals
in compliance with the changes required in Decree 780/2016.

7
Republic of Colombia, Decree 2376/2010, regulating the teaching-service relationship for healthcare-related human
talent training programmes
8
Republic of Colombia, Decree 780/2016, codifying matters concerning concerning the health and social protection
sector
9
Republic of Colombia, Decree 003/2003, for adopting evaluation and verification criteria for teaching-assistant
agreements necessary for developing undergraduate or postgraduate programmes in the healthcare area.
10
Republic of Colombia, Ministry of Social Protection, Human Resources Analysis and Policy Directorate.
Approaches to the teaching-service relationship model. Training practice evaluation model [Internet] [cited 2017
August 8th]. Available from:
file:///D:/Downloads/programa_relacion_docencia_servicio_modelo_de_evaluacion%20(2).pdf

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 Decree 055/201511 established the normative framework for student affiliation and
payment of contributions to the General Work-related Risk System (GWRS) when
their activities meant a source of income for the institution where they carried out
their practice or involved them in an occupational risk. Such provision required an
educational institution, companies or the public or private institutions providing the
scenario for a student’s practice to assume affiliation and contribution payment;
affiliation to the Work-related Risks Administrator (WRA) with which the entity or
institution affiliated its workers had to be made prior to the start of practice (this
decree was modified by Decree 2376/2010, article 15).

The UR’s Physiotherapy Programme also follows the World Confederation for
Physical Therapy’s (WCPT) international guidelines for physiotherapists’ training
practice and legal provisions regulating the exercise of physiotherapy in Colombia.
The WCPT states that physiotherapy programmes must integrate theory, evidence
and practice along a learning continuum and that practice should provide students
with an opportunity for providing care to users having a variety of health conditions
throughout life and along the healthcare continuum. It also states that practice
should take place in multiple contexts and should provide opportunities for
participation in interdisciplinary learning activities. The WCPT recognises that
training practice is an essential element in any professional physiotherapy education
programme which should enable students to:
 Integrate knowledge, skills and professional behaviour and apply them in a clinical
setting;
 Enhance their clinical skills regarding assessment/examination/evaluation,
diagnosis, planning, treatment/intervention and re-evaluation;
 Understand and integrate the bio-psychosocial and contextual bases of practice;
 Enhance their communication skills at all levels;
 Experience professional and inter-professional practice-related norms, values,
behaviour, and social skills;
 Develop behaviour and interpersonal skills which are requisites of the profession;
and
 Become a competent and autonomous practitioner, having a sense of responsibility
for lifelong learning.12
The WCPT considers that practice teaching centres can be institutional, industrial,
occupational, primary healthcare and/or community settings, on condition that they
provide the necessary aspects for planning and implementing physiotherapy
intervention plans, including healthcare, education, prevention and promotion and
development of wellness programmes.

Regarding guidelines for training physiotherapists and exercising the profession in

Colombia, the UR’s Physiotherapy Programme adopts the dispositions laid down by

11
Republic of Colombia. Decree 055/2015, regulating students’ affiliation to the General System of Labour Risks
(and other making other dispositions).
12
World Confederation for Physical Therapy (WCPT). Guideline for physical therapist professional entry-level
education. [Internet]. 2013 [cited 2017 July 7 th]. Available from:
http://www.wcpt.org/sites/wcpt.org/files/files/Guideline_PTEducation_complete.pdf

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 Law 528/199913, the physiotherapist’s professional profile and competences/skills
defined by the Colombian Association of Physiotherapy, the Colombian Association
of Physiotherapy Faculties, the Colombian College of Physiotherapists and the
Colombian Association of Physiotherapy Students14. Based on this, it incorporates
a training practice cycle within a study plan related to the exercise of the profession
as defined by law and the transversal and specific competences approved by the
(Colombian) Ministry of Health and Social Protection (MHSP)15.

2 PHYSIOTHERAPY-RELATED PRACTICE TRAINING

2.1 CONCERNING THE CONCEPT OF PRACTICE AND PRACTICE CYCLE CURRICULAR

MANAGEMENT

The UR’s Physiotherapy Programme study plan includes student training practice
regarding subjects called Academic Fieldwork Programmes (AFP) regulated by
Physiotherapy, Phonoaudiology 16 and Occupational Therapy programmes’
undergraduate academic regulations17 and practice regulations issued by SMHS
Academic Council agreement issued in 2015. AFP are defined as practice carried
out inside or outside the UR through teaching-service agreements, inter-institutional
cooperation or specific agreements with other institutions. Their fundamental
purpose is to familiarise students with real scenarios involved in professional
practice and train them in the different areas of the profile defined by the
Physiotherapy Programme’s Educational Project (PEP). They seek to develop
professional skills related to decision-making and integrating conceptual, procedural
and attitudinal skills, based on the UR’s scientific, ethical and humanistic training.
Such practice enables students to coordinate their disciplines’ theoretical bodies of
knowledge with the environment’s real needs, interact with other disciplinary
knowledge, with work experience and recognise their role as actors of change in
society.

The Physiotherapy Programme’s self-directed teams (integrating core academic

faculty and clinical education site instructors), together with the Programme Director
and Clinical Education Coordinator, ensure/advocate integral training practice cycle
management. Such teaching staff know/are aware of the PEP, the Colombian

13
Republic of Colombia, Law 528/2009, regulating the exercise of the physiotherapy profession; norms are also
dictated regarding matters of ethics and other dispositions.
14
Colombian Association of Physiotherapy (Asociación Colombiana de Fisioterapia), Colombian Association of
Physiotherapy Faculties (Asociación Colombiana de Facultades de Fisioterapia), the Colombian College of
Physiotherapists (Colegio Colombiano de Fisioterapeutas) and the Colombian Association of Physiotherapy Students
(Asociación Colombiana de Estudiantes de Fisioterapia). Colombian physiotherapists’ professional profile and
skills/competence [Internet]. 2015 [cited 2017 August 8 th]. Available from:
https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/TH/Perfil-profesional-competencias-
Fisioterapeuta-Colombia.pdf
15
Ministerio de Salud y Protección Social (MSPS)
16
i.e. Speech, Language and Hearing Pathology
17
Universidad del Rosario, Decree 1287/2013 by which UR undergraduate academic regulations are adopted

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 population’s healthcare needs, training practice policies and procedures defined in
Colombia regarding healthcare-related human resources, the professional profile
and competencies/skills (transversal and specific) approved by the (Colombian)
Ministry of Health and Social Protection for physiotherapy practice, the WCPT
guideline for physical therapist professional entry level education and UR policies
and regulations defining curriculum management. Based on the forgoing, these
teams are responsible for determining pedagogical and didactic strategies, content,
scenarios and ways of evaluating the training practice cycle, according to the
generic learning results (GLR) and expected learning results (ELR) defined in the
programme.

2.2 PEDAGOGICAL PRACTICE MODEL

In line with the PEP, the pedagogical practice model integrates multiple strategies
enabling the ELR defined in each practice to be achieved through participatory and
student-centred methodologies fasciltating context analysis, acquiring knowledge
and its application to real situations regarding professional exercise. The following
pedagogical strategies are used for theoretical-practice integration, problem
resolution, decision-making and acquiring the necessary physiotherapeutic
interaction skills:

 Guided observation, enabling a student to observe how a teacher develops different

intervention strategies, aligns their tasks with the model to be followed and
recognises how to act in a given situation;
 Supervised intervention or guided practice by experts who could be teachers hired
by the UR or professionals working in institutions. Such strategy enables
physiotherapeutic interaction between a student and the population benefitting from
practice-related programmes or plans. It promotes the development of professional
decision-making critera, the ability to relate to the actors involved in providing
services, acquiring physiotherapy-related planning, execution and follow-up skills;
 Working in pairs, as small groups per area in the same practice promotes students’
collaborative learning;
 Practice-related academic and interdisciplinary activities, such as participating in
practice seminars, scientific committees, clinical review cases and other institutional
or extramural spaces or activities. These enable students to become involved with
professionals from the same discipline (or others), promoting physiotherapeutic
reasoning, communicative abilities, interprofessional work and knowledge of current
issues related to the exercise of the profession, training and healthcare-related
human talent performance;
 Study guidelines, stimulating students’ autonomous work and preparing them for the
best use of academic discussion regarding practice. This is accompanied by
independent reading leading to discussion involving observation, criticism and
interrogation regarding proposed topics;
 Case studies, facilitating the integration of concepts for resolving people’s problems,
considering their sociocultural and health-related conditions. The purpose is to

6
 determine interaction strategies, taking the profession’s ethical considerations into
account and proposing interprofessional work action;
 The critical reading of scientific evidence as a formative research strategy
encouraging students to analyse the validity of the literature consulted, identify the
degree of available evidence and its contribution to physiotherapeutic decision-
making; and
 Using metagraphs. This is a graphical resource representing the relationship of
users’ different elements, clinical findings or needs identified in relation to
intervention resources’ movement and range which could contribute to resolving
clinical or users’ physiotherapy-related problems. Case or context analysis, together
with using a metagraph, could enable students to categorically, hierarchically and
comprehensively graph users’ kinetic processes and physiotherapy-related
decision-making regarding a specific situation18.
The practical experience offered by the Physiotherapy Programme from the sixth to
tenth semester thus provides students with opportunities for
 Integrating theoretical and practice-based concepts, progressively incorporating
contact with a variety of users having different diagnoses and at different stages in
life;
 Performing professional functions under a suitable level of supervision guaranteed
by UR-contracted teachers and professionals working in practice-scenarios;
 Becoming familiar with different models of physiotherapy-related profesional
apporach encouraging reflection on professional practice; and
 Receiving timely and formative feedback regarding profesional skills and clinical
reasoning enabling students to progressively develop clinical and professional
experience.

2.3 PRACTICE TEACHERS

Student training involves them being supervised by physiotherapists having

professional experience and training in the practice area. Such professors receive
ongoing assessment by the UR’s core academic faculty and pedagogical orientation
defined by the Physiotherapy Programme. It is often planned that clinical education
site instructors will be responsible for teaching the whole of a theoretical subject or
some physiotherapeutic intervention courses’ modules to coordinate practice
problems with analysis of theoretical subjects; practice-linked experts are also
invited to some seminars. These two modalities provide students with integrated
practical learning experience promoting ELR achievement. The different types of
teacher linked to practice development are defined in the UR’s university professor
statutes, their responsibilities being defined in the Practice Instructor’s Manual.
Taking into account different practices’ interprofessional work, the agreements also
involve teachers having undergraduate training in other areas of knowledge than

18
Forero S, Luz D. El ‘metagrafo’ entre los mentefactos y los mapas mentales: una estrategia para el aprendizaje de
la toma de decisiones profesionales en fisioterapia (metagraph - a strategy for learning physiotherapy-related decision-
making). Bogotá, Editorial Universidad del Rosario, 2010

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 physiotherapy participating in teaching and student accompaniment (i.e. medicine,
nursing, engineering, social work, psychology, occupational therapy,
phonoaudiology, law, nutrition and sports training).

2.4 SUBJECTS INVOLVED IN THE PRACTICE CYCLE

The Physiotherapy Programme’s training practice cycle involves five practices

(conceived as compulsory subjects) forming part of the professional disciplinary
curricular nucleus ensuring achievement of learning results defined by the
programme. Students can take one in-depth elective practice within the common
nucleus, selected by students according to their training interets and the area
covered by their undergraduate theses. These subjects include theoretical and
learning practice elements ensuring suitable training in the different settings for
profesional practice recognised worldwide and accepted in Colombia.
Training practice cycle subjects account for 33 credits; they are an integral part of
the study plan and are taken sequentially from the sixth to the tenth semester. These
subjects include learning experience ensuring suitable training in all professional
practice settings recognised worldwide and accepted for physiotherapists’ training
involving contact with users during different life-cycle stages and a broad range of
health conditions.

The Physiotherapy Programme guarantees that students have theoretical training

and bases regarding the professional ethics required for experiencing practice at
the level in which they are enrolled. The practice cycle is structured so that students
have completed the physiotherapist performance-related theoretical and theoretical-
practice subjects prior to the beginning of each one (i.e. professional practice-
related concepts regarding professional reasoning, planning, implementation and
evaluation are developed prior to practice). Many prerequisite subjects incorporate
pedagogical strategies supported by problem-based learning or case analysis to
facilitate students’ early approach to the realities of the population which will be
addressed during the training practice cycle. The programme’s philosophy is that
such learning experience promote resolving problems addressed in the curriculum
from different perspectives, since they integrate classroom learning with practical
skills in real scenarios regarding the exercise of the profession and
physiotherapeutic reasoning.

The practice cycle is structured so that it enables the required training for
guaranteeing the PEP’s occupational profile and developing physiotherapists’
competence as defined in Colombia. The cycle begins in the sixth semester with
promotion and prevention practice, assuming that contact with users must be
progressive, beginning with healthy or at-risk groups. Public health is conceived as
a transversal competence which must be worked on throughout the practice cycle
as it gives meaning and relevance to a physiotherapist’s social objective. It seeks to
develop cognitive and procedural skills preparing students for facing later clinical
situations. Physical and sports-related activity practice is carried out during the

8
seventh semester; it involves healthcare/healthy lifestyle promotion and disease
prevention strategies along with the prevention of injury during sports’ practice, both
being intimately related to studying physiotherapy and enabling graduates to
perform suitably in this area of the occupational profile.

Integral adult and pediatric clinical practices are carried out during the eighth and
ninth semesters. Promotion and prevention in healthy or at-risk populations is
changed for focusing on prevention and functional rehabilitation as fundamental
axes of a physiotherapeutic approach in the population having some type of
deficiency and/or limitation regarding activity. Health and work practice in the tenth
semester faciliates locating work-related problems affecting the population’s health.
This promotes the development of physiotherapy-related action aimed at promoting
health and preventing workplace-related disease.

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 Table 1. Training practice cycle structure
TRAINING INTENSITY
ACADEMIC INTENSITY
AMOUNT CYCLE OF
TRAINING FIELDWORK OF
SEMESTER OF DURATION HOURS OVERALL DESCRIPTION
NUCLEUS PROGRAMMES HOURS
CREDITS (IN PER
(AFP) PER WEEK
WEEKS) SEMESTER
Student training regarding planning, implementing or
evaluating individual and collective healthcare promotion and
Promotion and disease prevention programmes aimed at differing
VI 5 15 18 252
prevention (P&P) vulnerable populations at different stages of life. It is carried
out in public and private sector community or institutional
scenarios.
It promotes student training regarding the design and
implementation of sports training or physical
Physical and
fitness/conditioning programmes in which exercise is
VII sports-related 4 10 18 180
prescribed and actions are carried out for preventing injuries
activity
in different population groups. It takes place in sports centres
or gyms in the public and private sectors.
PROFESSIONAL It enables students’ training in the physiotherapeutic care of
DISCIPLINARY adult acute or ambulatory state patients having injuries to
NUCLEUS Integral adult- their musculoskeletal, neuromuscular, cardiovascular /
VIII 8 20 18 360
(OBLIGATORY related pulmonary and/or integumentary systems. It is carried out in
PRACTICE)) public and private sector medium and high complexity
Healthcare Service-providing Institutions (HSPI).
It enables students’ training in the physiotherapeutic care of
acute or ambulatory state paediatric patients having injuries
Integral paediatric- to their musculoskeletal, neuromuscular, cardiovascular /
IX 8 20 18 360
related pulmonary and integumentary systems. It is carried out in
public and private sector medium and high complexity
Healthcare Service-providing Institutions (HSPI).
It promotes students’ training regarding the evaluation,
planning and implementation of programmes for the
Health and work-
X 4 20 9 180 prevention of risks arising from the physical burden involved
related
in human body movement in public and private sector work-
related contexts.
It encourages students’ research capabilities regarding
COMMON different areas for deepening 704).their experience by
In-
NUCLEUS involving them in research projects or in practice-scenarios
X depth/consolidation 4 20 9 180
(ELECTIVE strategically defined by self-directed teams. It seeks the
course
PRACTICE) integration of knowledge, skills and abilities acquired during
training and encourages postgraduate training in the area.
From the total direct teaching hours of the physiotherapy
TOTAL 33 - - 1512 curriculum (3.704), the practices (1.512) correspond to
40.8% of that time.

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 3 PRACTICE DEVELOPMENT STAGES

3.1 CONTEXTUALISATION STAGE

The contextualisation stage is when a student is located in the context where

practice will be carried out, involving two parts. The first (on the university campus)
is where students become acquainted with practice teachers and the subject
guidelines, the practice plan’s technical appendix, the learning evaluation
mechanisms and UR, the practice regulations and Colombian practice regulations.
It also involves students becoming affiliated to the GWRS, compliance with
vaccination requirements and healthcare-promoting entity (HPE) affiliation being
verified and students being given the names of their practice-scenario institutions
and their characteristics, along with the process for student presentation and registry
there.

The second takes place in the practice-scenario so that the entity can present its
strategic platform, technical-scientific rules, institutional patient safety programme
management guidelines, academic processes, practice rules and administrative
procedures for executing the programme. Students recognise the infrastructure
available in the practice senario and an institution’s staff who will support teaching.

3.2 DEVELOPMENT OR EXECUTION STAGE

All assistance-related or service-providing activities for each practice are carried out
during this stage in accordance with that defined in the technical appendix or
practice plan. Such activities are programmed according to the progressive
delegation of functions and responsibilities defined for students. Such delegation
takes into account the type of activity which a student must perform and the degree
of supervision required; this involves determining whether a student observes or
accompanies a clinical education site instructors’s activities, if an instructor guides
action or if a student acts alone but is observed by an instructor.

Other activities in this stage involve developing skills for recording data in users’
clinical information systems, preparing reports/logs from statistical data regarding
different activities involved in practice and their own or interdisciplinary academic
activities carried out daily with the teachers. Student evaluation at this stage is
ongoing and follows the Physiotherapy Programme’s provisions and instruments
defined for such purpose.

3.3 FINALISATION STAGE

Practice is closed in this stage, culminating in student evaluation and preparing the
practice reports enabling the later monitoring of activities developed during the
academic period.

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4 SELECTING PHYSIOTHERAPY PRACTICE-SCENARIOS

Responding to new practice-scenarios’ demands, the Physiotherapy Programme

takes the teaching-service relationship model as reference, along with the criteria
defined by the Ministries of National Education and Health and Social Protection for
evaluating quality conditions regarding healthcare-related human talent training
practice. New practice-scenarios are selected by the Programme Director and
Clinical Education Coordinator, supported by the SMHS Practice Centre
Coordination office, for advancing procedures with the UR’s Legal Affairs staff and
that of any institution where AFP will take place. Opening or selecting new practice-
scenarios involves different phases (Figure 1).

Figure 1. Phases for setting up practice-scenarios

1. Initial contact between both institutions

2. Prior evaluation of quality conditions

Phases

3. Legalising the relationship

4. Preparing the conditions for beginning practice

4.1 INITIAL CONTACT BETWEEN BOTH INSTITUTIONS

The necessity for setting up a new practice-scenario may arise from training needs
regarding students who have the Physiotherapy Programme within the framework
of their PEP or in response to the interests of a group or institution in developing
partnership/alliance projects with the UR. Initial contact can be made by
computer, e-mail and/or Internet or by printed request addressed to the Programme
Director or Clinical Education Coordinator. It should be born in mind that the
programme is responsible for offering sufficient and suitable practice sites in
accordance with periodically updated academic offer according to the amount of
students who must take advantage of them.

The programme and institutions make known their structure, purposes and the
needs motivating the establishment of such type of alliance during initial contact.
They define the scope of the relationship in terms of undergraduate or postgraduate
teaching activities, coordinated with providing services, interest in developing action

12
 13

in formal or formative research or related to the university’s further education

function.

4.2 PRIOR ASSESSMENT OF QUALITY CONDITIONS

A practice-scenario’s basic suitability for participating in the relationship is identified

during this stage through the Clinical Education Coordinator’s technical visit and by
a teacher team related to this activity in the UR. The institution confirms compliance
with the quality conditions determined by the MHSP within the framework of this visit,
in accordance with the nature of the entity. Such quality conditions involve:
 Evaluating services or programme’s installed capacity concerning physiotherapeutic
practice to be carried out in an institution. Installed capacity is related to existing
conditions for providing a service; for example, clinical practice’s installed capacity
refers to the amount of beds, consulting rooms, rehabilitation or physiotherapy
service and existing promotion and prevention programmes with which practice can
be coordinated;
 Identifying a scenario’s potential user population and verifying informative statistics
related to the demand for providing services or programmes related to its in-house
practice;
 Ascertaining that health service-providing institutions (HSPI) must be enabled and
have proof of a Special Health Services Providers’ Registry habilitation certificate
issued by the territorial health secretariat including all services involving the offer of
practice-scenarios;
 Ascertaining the existence of an agreement signed between the UR and the
practice-scenario (if no such agreement exists, both parties must agree to subscribe
to one);
 Ascertaining the teaching vocation manifest by an entity in its objectives or strategic
platform;
 Ascertaining guarantees regarding students’ safety, protection and welfare (one of
the entities may be responsible for these or they may be shared by both parties);
 Ensuring that teachers have planned how practice will be orientated;
 Ascertaining academic-administrative aspects arranged for coordinating the
teaching-service relationship and any financial matters related to maintaining and
strengthening the teaching-service relationship; and
 Ascertaining the teaching-service relationship’s physical infrastructure concerning
scenario- and welfare-related areas, that involving academic activities and practice-
scenario’s educational resources for academic activities.
After such visit, the teacher team will provide the Physiotherapy Programme
Director’s Office with a prior concept determining whether the scenario has the
quality conditions required for practice and specify the type and characteristics of
such practice. The institution offering the practice-scenario must express the will to
be recognised as such by the Healthcare-related Human Resources Training Inter-
sector Commission (HHRTIC), an essential prerequisite for renewal and updating
the programme’s qualified registry.

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 14

4.3 LEGALISING THE RELATIONSHIP

HSPI-related teaching-service training practice agreements are understood as an

agreement between the UR and an HSPI expressing responsibilities and common
student training objectives. Training practice-related inter-institutional cooperation
agreements or practice and internship agreements for sectors other than health are
the basis for academic, scientific, technical or research cooperation enabling
students to participate in an entity through procedures and activities according to
their knowledge, competence and professional skills; such relationship is based on
a shared concept of responsibilities and training and service provision purposes.
A participating institution’s joint commitment to practice-related programmes must
be made explicit and the scope of such relationship defined. Criteria will then be
determined regarding practice organisation and management over a certain length
of time, the amount of students to be admitted to a particular practice (according an
institution’s installed capacity, quantity, variety and the complexity of services
provided), their teaching responsibilities and the mechanisms for formalising such
agreement.

Signing agreements begins with an evaluation of the agreement model which one
of the parties presents to the respective legal office. Any adjustments considered
relevant by the UR and the practice-scenario entity are then made and legal
representatives sign the agreement; this is overseen by the SMHS Practice Centre
Coordination office.

Decree 780/2016 stated that parties must sign a technical appendix forming an
integral part of any such agreement; in it both parties define the competences
students are expected to achieve, the activities forming part of the practice, rotation
areas, the amount of students and teachers per programme, the plan for the
progressive delegation of responsibilities, schedules, shifts and rotations. Both
agreements and technical appendices are fundamental elements of the quality
conditions defined in the qualified registry 19 regulated by Decree 1295/2010 20 ,
currently compiled in Decree 1075/2015.21

4.4 PREPARING THE CONDITIONS FOR BEGINNING PRACTICE

19
Qualified registry (national authority recognition and legal approval of the Rosario University’s Physiotherapy
Academic Programme) is part of the programmes and institutions’ quality evaluation system, a constituent element of
the educational quality assurance system; mandatory compliance requirements for offering and developing a higher
education academic programme in a higher education institution.
20
Republic of Colombia, Ministry of National Education, Decree 1295/2010, regulating what is dealt with by the
qualified registry (national authority recognition and legal approval of the Rosario University’s Physiotherapy
Academic Programme) (Law 1188/2008) and the offer and development of a higher education academic programme
21
Republic of Colombia, Decree 1075/2015, concerning the issue of an education sector regulatory decree

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As stipulated in the teaching agreement, when the UR is responsible for hiring

teachers, the Physiotherapy Programme puts them in contact with practice-scenario
institutions so they become acquainted (before the start of an academic period) with
a given semester’s activities, academic calendar and basic aspects concerning the
entity’s operation. A teacher will base such approach on the guidelines issued by
the respective self-directed team and the Clinical Education Coordinator.

When a teaching agreement specifically states that an institution’s officials will do

the pertinent teaching, then the UR’s Physiotherapy programme will induct them, so
that they become familiarised with technical appendix contents related to general
aspects regarding the UR, the programme and practice, practice purpose, content,
the type of activities, the forms of evaluation, the SMHS and Physiotherapy
Programme officials in charge of practice-related academic processes. Such
accompaniment is maintained during practice.

5 THE METHOD FOR ALLOCATING STUDENTS TO COMPULSORY AFP PRACTICE-SCENARIOS

Students are assigned to obligatory AFP practice-scenarios according to the amount

of places approved by each entity and the amount of students enrolled per practice.
This is planned annually within the framework of the programme’s budgetary
planning, defining the amount of practice-scenarios required for a year’s two
academic periods and the amount of teachers to be hired according to that
established in each agreement.

The Clinical Education Coordinator presents an entity’s practice offer to the SMHS
Academic Secretary each semester, determining the amount of groups and quotas
for each subject. The pattern of the previous semester’s inscriptions is taken as
reference, along with each practice’s academic dropout rate.
Students select their mandatory practice-scenario via the UR’s online subject
registration. The Clinical Education Coordinator then uses the Academic Secretary’s
lists of students enrolled in each practice to assign them to each practice-scenario,
taking the amount of approved places22 and the practice group in which a student
has enrolled into account. The Clinical Education Coordinator orientates students
regarding fulfilling prerequisites and conditions for entering practice (when so
required).

The Clinical Education Coordinator officially lists students assigned to each practice-
scenario (by computer, e-mail and/or Internet or by printed means) and publishes
the academic calendar regarding the practice schedule.

22
Decree 780/2016 defined practice-scenario quotas as the amount of students who can develop their training practice
simultaneously within a practice setting, ensuring quality regarding student training and scenario service provision.
The quota for clinical practice-scenarios is approved through an agreement issued by the Healthcare-related
Human Resources Training Inter-institutional Commission (HHRTIC) issuing a favourable concept regarding a
healthcare programme’s practice-scenario as a prerequisite for being granted qualified registry.

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6 THE METHOD FOR ALLOCATING ELECTIVE AFP PRACTICE-SCENARIOS

Students are assigned to elective AFP in-depth/consolidation practice-scenarios

according to projects regarding degree options or those being carried out in practice-
scenarios. The Physiotherapy programme’s self-directed teams will define the
practice-scenario for each student enrolled in the in-depth cycle in each of the six
consolidation areas defined in the study plan.

The offer of learning contracts regulated in Colombia through Decree 933/2003 is

another way of assigning students. Such learning contracts are regularly offered by
private companies for physiotherapy practice within the Occupational Health and
Safety Management System. 23 Companies request the programme for a certain
amount of practitioners who are then selected by companies’ human talent areas.
Such students’ profile reflects them having chosen an internship24 and consolidation
degree option in the health and work-related area. Such learning contract’s duration
is determined by the UR for a period lasting no longer than six months.

7 PRACTICE APPLICATION, APPROVAL AND FOLLOW-UP MECHANISMS FOR INCOMING OR

OUTGOING NATIONAL OR INTERNATIONAL STUDENTS

The Physiotherapy Programme addresses Colombian and foreign students’

interests to promote academic mobility through the student exchange programme
and in-depth practice or internships in Colombia or abroad. Foreign and national
students’ practice is jointly planned and monitored within the physiotherapy
programme by the person in charge of International Affairs and the programme’s
Clinical Education Coordinator.

The UR’s Office of International Affairs supervises incoming mobility; the

programme offers academic spaces and organises them according to practice quota
availability and students’ interests. The programme’s set of academic credits is
adjusted re timing and intensity, according to entering students’ needs.
The UR’s Office of International Affairs handles applications from students
interested in coming to the UR, within established times, complying with the set
process and presenting requested documents: certificate of grades, letters of
presentation, Spanish language proficiency certificate (if not the mother tongue or

23
Sistema de Gestión en Seguridad y Salud en el Trabajo (SGSST)
24
According to the UR’s SMHS’s Physiotherapy, Phonoaudiology and Occupational Therapy programmes’ degree
test agreement, issued in April 2012, internships are conceived as a means by which a student meets degree
requirement. This means that an undergraduate student must be actively involved in the design or execution of
development programmes or projects addressing specific problems regarding the specific setting in national or
international institutions or communities. Such internship mode is recognised when a student is linked to a project or
institutional programme, having had prior authorisation from the Programme Director or research group director who
is in on-going communication with SMHS’ Extension Coordination Office.
.

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first language) and medical insurance. Once an application has been approved, a
student receives support in locating a place to stay.

Outgoing mobility begins with a student’s expressed interest in practice or internship

abroad during the last year of study. The UR’s Office of International Affairs
oversees such application, taking the Physiotherapy Programme’s approved
homologation plan into account, insisting on a greater than 3.7 weighted average,
no disciplinary sanctions, demonstrated proficiency in the target country’s language
and having medical insurance. Internships or international internships are managed
with the teacher orientating such student’s in-depth area or degree option (which is
why they occur during the last year of studies). A student must also submit the host
institution’s acceptance letter and address the work plan together with the receiving
tutor and the UR tutor. The UR reimburses 80% of the value of internship and
practice credits studied abroad to stimulate and support students such movement.
Another mobility option is offered to Physiotherapy graduates (from the UR or
another university) who want to update their knowledge or have an interest in a
particular study plan area. Any such graduate must request studying the subject as
an attending student. The programme organises the academic offer according to a
request by a student who must pay for any credits to be taken.

8 MECHANISMS FOR DISABLED STUDENTS’ ENTRY TO AND TRANSITION IN THE TRAINING

PRACTICE CYCLE

Handicapped students or those suffering a disease or temporary injury can enter

the training practice cycle, having previously met study plan and academic
regulations’ entry, admission and permanence requirements. Their training practice
cycle transition is thus consistent with adjustments or reasonable accommodations
and needs documented during their previous training and during accompaniment.
The Tutoring Programme’s Coordinator and his/her Clinical Education Site
Instructor meet before the training practice cycle begins to identify any required
adjustments, analysing case characteristics and taking a student’s expectations or
proposals into account, based on their current health situation (making a student
jointly responsible for adjustments planned for practice).

Daily and weekly hourly practice intensity, ELRs, available practice-scenarios,

service provision activities included in each practice and their respective
requirements are taken into account for defining adjustments; any need for
curriculum adjustment is then discussed and identified. Such adjustments’
relevance is analysed jointly with the SMHS’s Academic Secretary in the light of UR
regulations and institutionally-defined academic processes.

Reasonable adjustments could include a change of practice or practice-scenario to

enable a student to achieve the ELR, adjusting the ELR according to a student’s
possibilities and capabilities, consequent adjustment in service provision activities
involved in practice and defining a particular teacher orientation scheme. The

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Programme Director’s office may approve the above, taking into account that such
adjustments should guarantee fulfilling the professional and occupational profile
defined in the PEP, maintaining national and international physiotherapists’ training
standards and enabling a student to advance in the study plan.

Practice-scenarios must be conversant with and accept adjustments requested for

practice admission, permanence and completion. Students are thus presented to an
institution’s education director, or equivalent, special reference being made to their
condition and particular needs so that their personal safety and that of users and/or
the community is ensured at all times.

Disabled students or those suffering a disease or temporary injury are provided

equal opportunities for successfully completing their training practice; however, this
does not guarantee successful results per se. Students must comply with all practice
requirements and meet the training levels proposed in the programme’s study plan
to fulfil graduation requirements.

9 MECHANISMS FOR GUARANTEEING STUDENTS’ SAFETY AND WELFARE

Mechanisms for guaranteeing the safety of Physiotherapy Programmeme practice

students are stipulated in line with current General Healthcare-related Social
Security System (GHSSS) safety and protection regulations and guarantees defined
in decrees 780/2016 and 055/2015 regarding the teaching-service relation ship.
Such guarantees include being familiar and complying with biosafety protocols,
having civil liability policies against third-party claims, General Work-related Risk
System (GWRS) affiliation, verified SGSSS affiliation, a verified vaccination scheme,
designated rest and cafeteria areas and day and night shift training practice
schedules.

The UR and the programme’s Clinical Education Coordinator will do the following to
ensure compliance with the above:

 Periodically agreeing with each practice-scenario on student induction concerning

biosafety, patient safety, waste management, risk prevention and control,
humanising service provision, the strategic platform and the entity’s service offer
regarding prevailing technical-scientific norms. Institutional induction can be in
person at the institution’s facilities or virtually once a semester. The programme has
induction training during the first week of practice in which students are made aware
of regulations regarding the practice cycle, the technical appendix or practice plan
contained in the subject guide, student evaluation mechanisms and how practice
works in each scenario. This induction is supported by Clinical Education Site
Instructors in UR facilities;
 Ensuring compliance with agreements defined with each practice-scenario
regarding the provision of personal protection elements required by students.

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Delivery and administration of such supplies is subject to each practice’s demands

and each entity’s prevailing standards;
 Verifying students’ GSHSS affiliation. Students must submit current HPE affiliation
certificates to the Academic Secretary and practice teachers at the beginning of their
rotation. Students’ HPE affiliation is their own responsibility or that of their tutor.
Foreign students must have international medical insurance;
 Signing and renewing an annual extracontractual civil liability policy (covering no
less than 250 current monthly minimum legal wages25 = Col pesos 184,429,250 /
£ 46,415 for third-party risks/claims for all students and teachers/instructors),
including legal accompaniment regarding any malpractice claim. The Academic
Secretary then records the list of SMHS students enrolled in practice each semestert
and reports this to the insurer; the policy includes national or international students;
 Ensuring compliance with agreements with each practice-scenario (or addenda to
such agreements) defining which of the two entities is responsible for student
affiliation to the GWRS. The prevailing norm states that students must be affiliated
to the WRA to which the entity’s workers are affiliated before practice begins. The
affiliation period covers the teaching practice and is paid monthly; it is thus
imperative that students maintain their GHSSS HPE affiliation. The UR affiliates all
the programme’s students to the WRA from the first semester onwards, except when
the entity expressly assumes this.
 Verifying the vaccination scheme required by the practice-scenario in line with
MHSP requirements for personnel working in healthcare entities. Students must
present their vaccination cards to the UR and practice-scenarios for verification of
compliance with required schemes;
 Requesting students to always have available and valid HPE and WRA affiliation
certificates and vaccination cards (with complete scheme), magnetically and
physically, re UR and practice-scenario requirements. Law 1581/201226 requires
students to sign an informed consent form agreeing to the management of personal
and sensitive HPE-, WRA- and vaccination-related information because such data
must be sent to practice-scenarios; and
 Defining (along with practice-scenarios) day and night-time shift schedules
according to quality norms and standards regarding providing students with
healthcare and welfare services. This ensures that day and night shifts last a
maximum 12 hours and cannot exceed 66 hours per week. The physical and mental
recovery of students on night shift is guaranteed with pre-turn and post-turn rest
breaks; both parties define the availablity or provision of student rest area, having
appropriate sanitary facilities and feeding facitities for night shift students. The UR
will issue food vouchers if a hospital/practice-scenario does not cover food costs.
The Physiotherapy Clinical Education Coordinator is responsible for applications to
the SMHS Administrative Directorate and delivery to students.

25
Salarios mínimos legales mensuales vigentes (SMLMV), Col pesos 737,717 (£ 185.66) for 2017
26
Republic of Colombia, Law 1581/2012, issuing general provisions for protecting personal data

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All integral adult AFP and integral paediatric AFP-related clinical training activities
performed by undergraduate physiotherapy students which require being noted in
any type of patients’ clinical records must be done so by the member of staff
responsible, backed by their signature, name and professional registration number.
Regarding welfare conditions, the UR and practice-scenarios will agree on how to
provide available spaces for academic activities, services or attending users, access
to and/or use of libraries (if available in a practice-scenario), technological resources
for accessing the entities’ clinical histories or information systems and lockers for
students. In line with HSPI teaching-service agreement provisions, the UR transfers
a percentage of student enrollment fees to the practice-scenario to support welfare
conditions. All the above information is made available during student induction.

10 PROCEDURES REGARDING COMMUNICATION BETWEEN THE PHYSIOTHERAPY PROGRAMME,

PRACTICE-SCENARIOS AND INSTRUCTORS

Formal communication between the Physiotherapy Programme, practice-scenario

and instructors involves using digital-media, e-mail and/or Internet-based, printed or
telephonic means, as do all practice-related monitoring mechanisms. The Clinical
Education Coordinator maintains on-going communication with the institutions,
teachers/instructors and students to guarantee proper practice development and the
timely resolution of difficulties or unforeseen problems. It formalises practice student
lists, the academic calendar, student evaluation formats and receiving or sending
the documentation required by practice-scenario entities to keep their collections of
documents supporting teaching-service updated. This unit channels requests for
and receiving grades/scores from teachers having a work-related link with the UR
or those from practice-scenario education offices.

11 PRACTICE FOLLOW-UP MECHANISMS

The UR’s Physiotherapy Programme has a training practice tracking system

involving the processes and actors described below:

 The Service-Teaching Committee (regulated by Decree 780/2016) coordinates,

follows-up and evaluates practice-scenario teaching-service activities. It involves
the students’ representative, the medical education or agreement coordinator, the
programme’s Clinical Education Coordinator, the SMHS Practice Centre
Coordinator and Clinical Education Site Instructor, meeting every trimester (i.e.
every four months/quarterly);
 Monitors’ meetings follow-up practice based on students’ perception of academic,
administrative, welfare and safety matters, teacher assessment and students’
progressive delegation of responsibilities, according to the Technical Appendix. It
involves the students’ representative (monitor) and Clinical Education Coordinator;
 Practice-scenario follow-up visits in situ regarding practice development for verifying
the progressive delegation of responsibilities and students’ acquisition of

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competence/skills according to the Technical Appendix. They involve the

teacher/leader of the programme’s self-directed team, students and Clinical
Education Coordinators, meeting every semester; and
 Semester-based tutorial follow-up of all practice-scenarios and theoretical subjects
per cohort for identifying strengths, weaknesses and improvement strategies
regarding students’ performance, the settings and learning strategies used. This
activity involves the students’ representative, the clinical education coordinator, the
academic coordinator, the tutorial coordinator, the Accompaniment for All cohort
programme director (PACTO), teachers, tutors and the Programme Director,
meeting once every semester.

The Physiotherapy Programme’s self-directed teams follows-up the practice plan by

analysing teachers’ reports delivered at the close of practice, containing data
obtained from students’ logs.

12 MECHANISMS FOR EVALUATING PRACTICE STUDENTS’ LEARNING

The Physiotherapy Programme has two main dimensions which are evaluated
regarding obligatory practice:

 Physiotherapeutic reasoning related to planning, executing and evaluating the

decision-making required in each practice according to the ELR defined in the
subject guide; and
 Profesionalism, understood as the set of behaviours and attitudes characterising the
actions of a physiotherapist graduating from the UR within the framework of the
guidelines established for the profession.

Every practice outlined in the study plan has evaluation instruments incorporating
the above dimensions applied to the occupational profile area. The self-directed
teams draw up and update such instruments. Each component incorporates
elements contained in transversal and specific professional competencies/skills,
defined by professional and government organisations regulating the professional
exercise of physiotherapists in Colombia.

Regarding AFP in-depth/consolidation elective practice, students are evaluated

according to fulfillment of the work plan. This evaluation can be made jointly between
the entity’s teachers and the UR professor in charge of follow-up and advising
students.

Students’ learning is evaluated according to UR arrangements as defined in the

Academic Regulations, the academic calendar, programme formats and the practice
organisation’s internal characteristics related to the amount of areas or programmes
involving student rotation and rotation duration times.

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