PTA - Clinical Instructor Assessment - Clin Ed I This survey should be completed by the clinical instructor who directly supervised the student. Question Title * 1. Clinical Instructor Name: Question Title * 2. Name of Clinical Facility: Question Title * 3. Number of years as a CI: Question Title * 4. Number of PT and PTA students supervised within the last 12 months: Question Title * 5. Are you an APTA Credentialed Clinical Instructor? Yes No Question Title * 6. List your main strengths as a CI: Question Title * 7. List your main development needs as a CI: Question Title * 8. Name a least one way New River Community and Technical College PTA program can assist your development as a CI: Next