pta 213 pta therapy clinic - mcccbehrensb/documents/pta213handbook2014.pdf · pta 213 pta therapy...

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Mercer County Community College Physical Therapist Assistant Program

Course Handbook (to be used in conjunction with the PTAP Student/Learner Handbook)

PTA 213 PTA Therapy Clinic

Spring 2014

Holly Beinert, PT, MPT [email protected]

Course Instructor MS 157

609-570-3478

Spring 2014 Office Hours Mondays 1:00 to 4:00

Wednesdays 1:00 to 3:00

Success in PTA 213 requires that skills obtained in PTA 210 be current, competent and utilized in laboratory activities, competency tests and practical examinations. With the exception of residual limb wrapping techniques, all other skills practiced in PTA 213 are built upon foundational knowledge and hands-on skills from PTA 210. PTA 213 requires that you utilize these skills in a more complex manner. Your competency tests and practical examinations will require that you can perform vital sign measurements, patient positioning, patient draping, use of proper body mechanics, bed mobility, transfers, wheelchair management and mobility, instruction in therapeutic exercise, choosing an appropriate assistive device and ensuring that it is the correct height, gait training and use of proper guarding techniques.

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Course Syllabus

Course #: PTA 213

Course Title: Therapy Clinic

Credit Hours:(Lecture/Lab) 3/3

Contact Hours: 45/40

Number of weeks: 10

Clinical Contact Hours 0

Number of clinical weeks: 0

Pre-requisite course(s): PTA 210 PTA Techniques PTA 211 Physical Agents

Co-requisite courses: PTA 235 PTA Clinical Ed II

Course Grading

Domain Assessment Timeline Possible

Points

Cognitive Written Exam #1

Week 4 Mon 2/10 – Wed 2/12 (testing center)

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Written Exam #2 Week 7 Mon 3/3 – Wed 3/5 (testing center)

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Quiz (SCI)

Week 8 Mon 3/10 – Tues 3/11 (testing center)

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Written Exam #3 05/13/13 (in class)

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Psychomotor Paper Assignment Due 05/05/13 10

4 SOAP Notes Due 1/30, 2/6, 2/13 & 3/6 10

2 Competency Tests** Weeks 4 & 5 10

1 Practical Examination* Week 9 20

Affective Generic Abilities Assessment Ongoing 20

TOTAL: 100

*In the event that a student/learner is unsuccessful in passing the Practical Examination, the student/learner will

not receive a passing score for the course. Please refer to the “Practical Examinations” section of the PTAP

Student/Learner Handbook

**Please note that competency tests are scheduled outside of regularly scheduled class time

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Operation: SOAP NOTE Documentation is probably one of the most challenging aspects of the clinical environment. To assist learners with gaining experience with documenting, and in particular the use of the SOAP note format for documentation, the PTA program has adopted the following policy for each lab course within the curriculum. This will provide learners with the opportunity to practice their documentation skills prior to each clinical education course of the curriculum and strengthen their skills through the collaboration of their peers. Learners will be required to hand in four (4) SOAP notes during the semester for each lab course. Each SOAP note will come from one of the lab experiences, which has been identified by the Course Instructor in the course syllabus. Each SOAP note must meet the following criteria prior to being submitted for grading:

1. It must be written by the "clinician" who performed an activity during lab. 2. It then must be reviewed by a classmate utilizing the SOAP Note Assessment Forms that are available

in the PTA Lab . (To get the most out of your peer review, have the classmate who was your patient during your lab experience perform the peer assessment.)

3. Submit the completed SOAP Note Assessment Form with your final SOAP note. There should be evidence that you have incorporated some of the feedback from your classmate into your documentation.

4. Please note that SOAP notes will not be accepted after the due dates that have been specified by your Course Instructor. Due dates help prepare student/learners and assure that there is sufficient time to receive feedback prior to subsequent SOAP notes and prior to the next clinical affiliation.

PTA 213 Operation SOAP Note:

Required SOAP note from this lab Due Date

Week 1 (1/23/14): Posture, ADA & Outcome Measurement Tools Lab Thursday, 1/30/14

Week 2 (1/30/14): Arthroscopy Lab Thursday, 2/6/14

Week 3 (2/6/14): Amputation Lab Thursday, 2/13/14

Week 6 (2/27/14): CVA Lab Thursday, 3/6/13

Courses that support Operation: SOAP NOTE PTA 106 Yes

PTA 210 Yes

PTA 211 Yes

PTA 213 Yes

PTA 216 Yes

Written Assignments Grading Criteria for all written assignments will be provided with the assignment. *Please note that a penalty of 5 points per day may be imposed for late submission of assignments.

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Generic Abilities Assessment

Commitment to Learning: 1. Attends class consistently (5 points) (In an effort to prepare for clinical experiences and a career in health care, it is expected that student/learners

will attend all classes. If a student/learner is unable to attend class, professional behavior would include contacting the course instructor via email.)

2. Demonstrates evidence of preparation prior to lab and class (5 points) (Lab preparation includes wearing appropriate lab attire, fingernails and hair. For weeks 1, 2, 3, 7, and 14, it also includes a small amount of preparatory work, located in the lab manual that accompanies this course handbook)

Communication Skills:

3. Communicates with classmates and guest speakers appropriately in class, lab and small groups (5 points) (see Ground Rules for Class Discussion and Participation)

4. Discusses grades and other concerns with the instructor appropriately (5 points) Responsibility & Professionalism: 5. Comes to class on time (5 points)

(In an effort to prepare for clinical experiences and a career in health care, it is expected that student/learners will arrive on time for class. If a student/learner is unable to, professional behavior would include contacting the course instructor via email.)

Ground Rules for Class Discussion and Participation Respect: no verbal or physical abuse, no sexist, ageist, racist language or behavior is acceptable. Space: people should have time and space to say what they need to, that means no interrupting, shouting down or hogging attention. Care: people should do their best to be sensitive to the needs of the other members of the group; for example, listen quietly when difficult issues are being spoken about, be encouraging and positive, and frame critical remarks constructively. Confidentiality: people should be free to say things that they wish to remain confidential and would say so if this is the case. Others need to respect the confidentiality.

Exams in the Testing Center 1. When you take exams in the testing center using “Scantron” sheets, you will need to keep the

“Testing Center Report Form” that is provided to you. This form indicates your grade and

which test questions were incorrect. Keep this form.

2. Taking exams in the testing center requires that you bring your current Mercer ID with you.

This means that there must be a current academic year sticker on it from the security office in

the student center.

3. Make sure that you are aware of the days and times that the testing center is open, as that

changes from semester to semester. Plan on arriving so that you have plenty of time to take

your exam, leaving yourself at least an hour before the closing time for the testing center.

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How to Avoid Plagiarism When information utilized in a paper is taken “word-for-word” from a source, 3 things are required to avoid plagiarism:

1. quotation marks, 2. in-text citations and 3. a reference

When information is paraphrased in a paper, 2 things are required to avoid plagiarism:

1. in-text citations and 2. a reference

The format for in-text citations changes depending on whether the information was used word for word or paraphrased.

Consequences of Plagiarism If all three items are omitted,

the student/learner will receive a grade of 0 and a report will be submitted to the Academic Integrity Committee (AIC).

If two items are omitted,

a report will be submitted to the AIC, the student/learner will receive a grade of incomplete and given 1 week to correct the paper.

If one item is omitted,

the student/learner will receive a grade of incomplete and given 1 week to correct the paper. Inappropriate reference and in-text citation formats will result in a grade of incomplete. The student/learner will be given 1 week to provide the appropriate format(s) to the course instructor for grade completion. HB 5/2013

PTAP Policy: Course Grading One of the goals of the MCCC PTAP is to prepare student/learners to practice as PTAs. In New Jersey, as in many other states, PTAs are required to be licensed. Licensure is granted following the successful completion of a standardized licensing exam, with a score of 77 or higher.

A 93-100 B+ 87-89 C+ 77-79 F less than 59 A- 90-92 B 83-86 C 70-76 B- 80-82 D 60-69

Grades below 77 are not considered passing grades for PTAP courses, and are therefore considered unacceptable. All

PTAP courses must be completed with a grade of “C+” or higher. All PTA program courses may be attempted only twice.

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Required Text(s):

Author Title Ed Publisher Date ISBN

Martin S Neurologic Intervention for PTA 4th Elsevier/Saunders 2007 0-7216-0427-7

Fruth** Fundamentals of the Physical Therapy Exam 1st Jones & Bartlett 2014 978-1-4496-5268-5

** Was a required textbook for the Fall 2013 semester as well.

A lab book will be provided to you. This lab book should be brought to all PTA 213 lectures and labs

(Mondays, Wednesdays and Thursdays) for use as a learning tool.

Recommended Text(s)

Author Title Ed Publisher Date ISBN

OSullivan & Schmitz

Improving Functional Outcomes in Physical Rehabiliation FA Davis 2010

978-0-8036-2218-0

Course Description: Therapeutic interventions for conditions arising from cerebral vascular accidents, traumatic brain injury, spinal cord injury, amputations, joint replacements, cardiac disease, and neurologic dysfunction. Emphasizes activities to promote optimal functional outcomes. Lab develops decision-making skills involving assistive devices, orthotics and prosthetics. Competencies evaluated throughout the course.

Course Goals Following the successful completion of this course with a grade of C+ or higher, the learner will be able to: 1. Differentiate the physical therapy needs of a patient at different stages within the rehabilitation

program, establishing a therapeutic exercise program in accordance with the physical therapy plan of care to address the multiple needs of the patient.

2. Discuss the indications for use of ambulatory assistive devices, treatment interventions, wheelchairs, and orthotic and/or prosthetic devices for patients with specific impairments and/or functional limitations which include patients who have been diagnosed with spinal cord injuries (SCI), cerebral vascular accidents (CVA), traumatic brain injuries (TBI), and neurological dysfunctions.

3. Perform selective therapeutic interventions within the physical therapy Plan of Care for patients with complex conditions including total hip replacement or total knee replacement (THR/TKR), cardio-pulmonary disease, SCI, CVA, TBI, or degenerative neurological disease.

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PTA 213 Course Objectives: Spring 2014 Cognitive/Knowledge: the learner will be able to: 1. explain the differences between left and right hemiplegia 2. describe the levels of spinal cord injury and the effect that they will have on their ability to perform

activities of daily living (ADLs) 3. recognize safety and barriers in home, community, and work environments by reviewing

measurements of the physical environment and physical space 4. discuss architectural barriers for patients who use wheelchairs, walkers, crutches and canes 5. recognize the differences between various orthotic and prosthetic devices and their applications 6. recognize changes in skin condition while using orthotic and prosthetic devices 7. recognize safety factors while using orthotic and prosthetic devices 8. identify the individual’s and caregiver’s ability to care for orthotic and prosthetic devices 9. recognize levels of patient cognition and orientation to self, time and location 10. correlates results of standardized questionnaires (or outcome measurement tools) to the patient’s

level of function 11. identify the detrimental effects of poor posture to a patient 12. explain interventions appropriate for the improvement of postural alignment while in various

positions 13. define muscle tone and contrast normal from abnormal muscle tone 14. explain factors that influence muscle tone and describe how to adjust treatment interventions

based on changes in tone 15. discuss the safety status and progression of patients while engaged in gait, locomotion, balance,

and wheelchair management/mobility training 16. identify which subjective and objective data may indicate the need to hold physical therapy

interventions until the physical therapist has been consulted.

Psychomotor: the learner will be able to: 1. teach patients about post-operative care and potential complications following joint replacement

surgeries for the hip or knee 2. determine which lower extremity exercises can be performed by a patient with total hip

precautions 3. educate a patient on proper diabetic foot care, including skin inspection, foot care and footwear. 4. determine whether or not there is evidence of unhealthy pressure areas that result from orthotic

and prosthetic device use by inspecting the patient’s skin and respond accordingly by communicating these findings with the appropriate individuals

5. adjust interventions within the plan of care established by the PT in response to patient clinical indications and report this to the supervising physical therapist

6. demonstrate an exercise plan to a patient to improve muscle strength in a specific muscle group as indicated

7. incorporate current and relevant evidence to identify appropriate PT interventions based on a given patient scenario

8. document treatment techniques utilized with classmates in the formulation of a SOAP note 9. Identify which CPT Code(s) you would bill for and the rationale for choosing the code(s). 10. consult the supervising PT (or clinical instructor when appropriate) when there is a question about

an unanticipated patient response to a therapeutic intervention to preserve patient safety 11. demonstrate transfers and gait training for a patient with total hip precautions 12. demonstrate safe and effective residual limb wrapping techniques for a trans-tibial amputation

model 13. question a patient to determine his or her subjective complaints suitable for the patient record

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Affective: the learner will be able to: 1. Display communication styles utilized in the clinical setting 2. Appropriately communicate with classmates and guest speakers in class, lab and small groups

demonstrating empathy and professionalism 3. Attend class consistently and punctually 4. Appropriately discusses grades and other concerns with the instructor, demonstrating respect and

listening to feedback when offered 5. Demonstrate evidence of preparation prior to class by reading the required reading

Course Outline I. Pain & Posture II. Outcome Measurement Tools III. Accessibility A. Architectural Barriers Act B. The Rehabilitation Act of 1973 C. Fair Housing Amendment Act D. Americans with Disabilities Act E. Accessibility Requirements IV. Osteoarthritis V. Arthroscopy A. Introduction B. Total Knee Replacement C. Total Hip Replacement VI. Lower Extremity Amputations VII. Prosthetics A. Below Knee Prosthetics B. Above Knee Prosthetics VIII. Orthotics IX. Muscle Tone A. Normal B. Hypertonia C. Hypotonia D. Fluctuating Tone E. Treatment X. CVA (Cerebral Vascular Accident) A. Introduction B. Vascular Syndromes C. Impairments D. Treatment XI. SCI (Spinal Cord Injury) A. Classification B. Incomplete lesions C. Clinical Manifestations D. Complications E. Physical Therapy Intervention XII. TBI (Traumatic Brain Injury) A. Classification

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B. Impairments C. Treatment XIII. Other neurological disorders A. Pediatric 1. Congenital disorders 2. Genetic disorders B. Degenerative Diseases

Confidentiality Expectations Patients: During the academic preparation to become a physical therapist assistant, there will be instances when you will be expected to collect data regarding a patient that you have seen or are seeing. This data will be used for educational purposes only. Do not photocopy patient information or identify the patient or individual by the use of proper names. Sample acceptable data for collection:

Patient diagnosis prescribed medications

Patient age overall medical condition of the patient

Patient gender physical therapy plan of care

Patient previous medical history record of physical therapy visits

Classmates: Periodically during the course of the semester, individuals among your classmates may be asked to share physical anomalies or previous injuries and treatments with the PTAP class. If an individual chooses to share this information with the class, it is NOT to leave the classroom. If an individual does not wish to share a personal diagnosis or anomaly with the class, it is within his or her rights not to do so. Volunteers will be solicited for laboratory demonstrations. Information obtained during these lab exercises is intended for demonstration purposes only. It is the right of every individual NOT to volunteer for a demonstration. However, all student/learners are expected to volunteer to be a patient for their classmates. This may involve the removal of minor articles of clothing. In the event that clothing is removed, draping techniques will be employed to preserve patient dignity. Faculty: Any and all individuals who elect to allow themselves to be the patient during class and lab activities can expect that all information gained during the activity will remain confidential. This extends to all MCCC faculty and staff members who elect to be “patients”. Guest Speakers: All confidentiality expectations and rights are equally extended to all guest speakers. Any information pertaining to and provided by individuals acting as guest speakers will remain confidential and not leave the classroom.

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Policy: Student Injuries during Clinical &/or Lab

1. Advise your Clinical Instructor and Course Instructor (ACCE Holly Beinert) immediately of the. 2. Prepare an Injury Report and an Insurance Claim Form. Copies of both of these forms can be obtained either in the nursing office on the first floor of the MS building, or from your ACCE (Holly Beinert: MS 157). Submit completed copies of the forms to the ACCE (Holly Beinert). Keep the originals for your records. 3. Attach a copy of the incident report to the insurance claim form and follow the instructions on the form to file a claim. Students are responsible for filing all claims and for any follow up necessary, directly with the insurance company.

Expectations for Lab Sessions

Student/learners are to come to lab sessions prepared to perform the lab activities assigned

for that day.

Student/learners are expected to be appropriately attired to participate fully in the lab activities scheduled for that day. Comfortable clothing that allows for full and unrestricted ease of movement, and protects the dignity of the individual (e.g. clothing that does not compromise an individual’s modesty nor expose unnecessary parts of the body) is strongly recommended. These include but are not limited to: sweat pants, gym shorts, tank tops, halter tops, sports bras, sneakers, and rubber soled closed-toe shoes. Clothing worn to labs must cover bilateral clavicles. If bilateral clavicles are not covered, you will be asked to leave and return with appropriate attire.

Student/learners will have locker facilities available for storage of lab clothing and supplies. Student/learners must provide their own combination lock for the lockers.

Student/learners are expected to act the role as both clinician and as patient with lab partners for each scheduled lab session.

Class Philosophy

Participants will be expected to accept responsibility for their learning, and as such will be considered learners. Learners will identify:

• topic areas that are of particular interest to them for the purpose of paper assignments

• topic areas that present challenges to them

• strategies for meeting his or her individual needs to master the information

Learners will also:

• actively participate in the presentation/discussion of course materials

• actively participate in the negotiation of a class schedule that meets the objectives for the course and for the learners

• respect the interests and needs of other learners or faculty

• work together toward a meaningful understanding of the materials presented.

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Reasonable Accommodations

On July 26, 1990, the President of the United States signed the Americans with Disabilities Act (P.L. 101-336). The ADA is intended to remove barriers against the more than 43 million people with disabilities in the United States. If you have a documented learning disability, psychological disability, physical disability, or other hidden disability that requires an accommodation, it is your responsibility to make an appointment to meet with the course director and potentially the PTA program coordinator prior to the due date for any course examinations or assignments to discuss what accommodations might be necessary. A list of Essential Functions for the PTA program students and graduates is available to all students by request, from any PTA program faculty member or through the program’s website. The following link provides generic information about the work environment for PTAs. http://www.onetonline.org/link/summary/31-2021.00

Mercer County Community College & the Americans with Disabilities Act: Any student in this class who has special needs because of a disability is entitled to receive accommodations. Eligible students at Mercer County Community College are assured services under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973.

If you believe you are eligible for services, please contact Arlene Stinson, the Director of Academic Support Services. Ms. Stinson’s office is LB221, and she can be reached at (609) 570-3525.

Attendance for PTA program Courses 1. Mercer County Community College does not have a "cut system." Student/learners in PTA

program courses are required to attend all lecture, lab, competency testing and clinical affiliation sessions. Attendance records will be maintained.

2. If you are going to be absent from a scheduled class, it is your responsibility to notify the course

instructor in writing to inform him or her of the absence and how you will be making up the work for that day. Copies of any class handouts that might have been distributed will be available in the course folders within the classroom. It is your responsibility to check the folder for the class that you would have missed to see if there was a new handout. It is not your instructor’s responsibility to attempt to keep track of what you might have missed.

2. Official college closings or delayed openings are announced on local radio stations, the college

radio station WWFM, 89.1 and Mercer County Community College TV Channel 23. On other stations the college may be referred to by name or Code #922. It is the student/learner's responsibility to listen and act accordingly. Notices of emergency closings are also announced on the college website at www.mccc.edu.

Continued matriculation following acceptance in the PTA program indicates that the student/learner has agreed to accept and uphold his or her commitment to these policies.

http://www.onetonline.org/link/summary/31-2021.00

http://www.mccc.edu/

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Guest Speakers We will be having invited guest speakers throughout the semester to share specific experiences and knowledge with us. Dates of topics are subject to change or modification due to scheduling of these speakers. It is expected that all students will arrive prior to the scheduled class time so that everyone is seated and prepared for when the guest speakers arrive. Students will be allowed to ask the guest speakers questions directly. Students are only allowed to ask questions in which the answers will help the student to become a better PTA. Personal and intimate questions that may cause the guest speaker to feel uncomfortable are to be avoided. Lastly, please be aware that the guest speaker is speaking to the entire class. Students should refrain from monopolizing the discussion and any questions that do not pertain to the entire class can be asked after the scheduled class time.

Academic Integrity Statement: ACADEMIC INTEGRITY OMB 210 Mercer County Community College is committed to Academic Integrity -- the honest, fair and continuing pursuit of knowledge, free from fraud or deception. This implies that students are expected to be responsible for their own work, and that faculty and academic support services staff members will take reasonable precautions to prevent the opportunity for academic dishonesty. The college recognizes the following general categories of violations of Academic Integrity, with representative examples of each. Academic Integrity is violated whenever a student: A. Uses or obtains unauthorized assistance in any academic work. • copying from another student's exam. • using notes, books, electronic devices or other aids of any kind during an exam when prohibited. • stealing an exam or possessing a stolen copy of an exam. B. Gives fraudulent assistance to another student. • completing a graded academic activity or taking an exam for someone else. • giving answers to or sharing answers with another student before, during or after an exam or other graded academic activity. • sharing answers during an exam by using a system of signals. C. Knowingly represents the work of others as his/her own, or represents previously completed academic work as current. • submitting a paper or other academic work for credit which includes words, ideas, data or creative work of others without acknowledging the source. • using another author's words without enclosing them in quotation marks, without paraphrasing them or without citing the source appropriately. • presenting another individual's work as one's own.

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• submitting the same paper or academic assignment to another class without the permission of the instructor. D. Fabricates data in support of an academic assignment. • falsifying bibliographic entries. • submitting any academic assignment which contains falsified or fabricated data or results. E. Inappropriately or unethically uses technological means to gain academic advantage. • inappropriately or unethically acquiring material via the Internet or by any other means. • using any electronic or hidden devices for communication during an exam. Each instructor and academic support service area is authorized to establish specific guidelines consistent with this policy. CONSEQUENCES FOR VIOLATIONS OF ACADEMIC INTEGRITY For a single violation, the faculty member will determine the course of action to be followed. This may include assigning a lower grade on the assignment, assigning a lower final course grade, failing the student in the course, or other penalty appropriate to the violation. In all cases, the instructor shall notify the Chair of the Academic Integrity Committee of the violation and the penalty imposed. When two (or more) violations of academic integrity are reported on a student, the Academic Integrity Committee (AIC) may impose disciplinary penalties beyond those imposed by the course instructors. The student shall have the right to a hearing before the AIC or a designated AIC subcommittee. APPEALS The student has a right to appeal the decision of the instructor or the Academic Integrity Committee. Judicial procedures governing violations of Academic Integrity are contained in the Student Handbook. Approved by the MCCC Board of Trustees March 18, 2004

Spring Practical Exam Instructions

Preparing for Practical Day LEARNERS:

Come prepared with 2 outfits. One should be appropriate attire while in the role of clinician. If you have long hair, you will need to come prepared to put it up while you are the clinician. You should also bring attire to be a patient. You should have shorts, tank tops, etc. Bring a black pen.

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Your first arrival to the lab CLINICIANS:

Enter the room 20 minutes prior to your scheduled time, go straight to the locker room to store your belongings and to get yourself physically ready (lab coat on, etc). It is your responsibility to enter the lab on time.

At a quarter of, sign in on the sign in sheet, (which will be just inside the classroom door on the clipboard) and choose your practical scenario. Otherwise, this will result in a one point per minute deduction from your final practical grade for each class.

PATIENTS:

Be in the hallway at least 15 minutes prior to your scheduled time.

Enter the lab 10 minutes prior to your scheduled time, sign in on the sign in sheet, (which will be just inside the classroom door on the clipboard) and have a seat in one of the wheelchairs in the waiting room. Otherwise, this will result in a one point per minute deduction from your final practical grade for each class. It is your responsibility to enter the lab on time.

15 minute Preparation CLINICIANS:

After you select your patient problem, take 15 minutes to read the scenario, make any notes you need to, and prepare yourself, your patient and your treatment area. You may not leave MS 352 once you have selected your patient problem.

You can take this time to ask your patient to put on a gown, to roll a pant leg up, put on shorts, tie something around a limb, etc.

You will need to give the practical scenario card back prior to getting up from the table.

After you are done preparing yourself, your patient, and the treatment area, YOU MUST inform your proctor that you are starting. This must happen BEFORE you wash your hands.

PATIENTS:

You will have 5 minutes to read a summary of the patient problem while you are waiting in the waiting room, so that you are aware of the situation. The summaries will be collected after 5 minutes.

Your clinician may ask you to don a hospital gown, a pair of shorts, a tank top, roll up a pant leg, etc.

Treatment Time CLINICIANS:

You have one hour to treat your patient and to clean up your treatment area. You should ideally “release” your patient at quarter of and use that 15 minutes to clean up your treatment area and complete your documentation.

PATIENTS:

You will be graded for being a patient. DO NOT assist the clinician with decision making skills, DO NOT give any hints, and stick to the scenario that you read.

Wrap-Up CLINICIANS:

Your SOAP note documentation is due on the hour. All patient related documentation must be handed in to your tester (this means all paper that you took any notes on).

PATIENTS:

When you have been released, you are to quietly retrieve your things from the locker room and leave the lab.

Reflections

STUDENTS:

Reflections are to be completed and either placed in the bin in the lab, or emailed to Barbara (Barbara only!) or [email protected] by 5 pm.

Check for Results STUDENTS:

You will receive either an email or a phone call with the practical examination results once all practical examinations have been performed. Please keep your phone on you and check your emails.

mailto:[email protected]

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Practical Examination Grading Rubric Mercer County Community College Learner: Physical Therapist Assistant Program Patient: Practical Examination Rubric Scenario: Date: Course:

Instructions:

The learner will have one of the possible test scenarios that he or she will need to perform with an assigned patient. The selection will take place approximately __15___* minutes before the actual testing time. During that time notes may be made on a separate piece of paper that may be used during the testing. All papers must be turned in at the completion of the practical. Each test will take a total of __60___ minutes to complete. The tester will be looking for the following: (from the individual being tested)

1. preparation of the treatment/assessment area for the patient (before and after the session) Scores

Equivalent to: Observations

5 5 5 Entry level performance for a PTA

Set up with appropriate equipment, supplies, assistive devices, gait belt, towels, foot stool, all were put away at end of Rx

4 4 4 Competent for a PTA learner at this level

Set up was mostly appropriate with minor exceptions, the learner needed to leave the patient to get something, but the patient was safe & supported

3 3 3 Nervous but safe Set up was appropriate with minor exceptions, learner just forgot several things and left pt.(several times) but pt. was supported & safe

2 2 2 Inappropriate Did not use a sheet on the treatment plinth during Rx

2 2 2 Unsafe left the patient unsupported when going to retrieve something needed for treatment

1 1 1 Fraudulent N/A

1 1 1 Disrespectful to the patient

Not speaking to the patient to explain where/why leaving pt. to retrieve something ,leaving a patient in the treatment area at the conclusion of Rx, not concluding Rx with any type of remark to the pt.

0 0 0 Forgotten or incomplete task performance

Forgetting to clean up Rx area before starting to document or until prompted to do so

Comment: 2. preparation of the clinician, hand-washing before touching a patient, lab coat and name tag Scores



hot water, towel to turn on and off water, 15 second scrub with soap, sleeves away from wrists, name tag with his or her name, coat buttoned & neat


hot water, towel to turn on and off water, 15 second scrub with soap, sleeves away from wrists, name tag

8 8 8 Nervous but safe hot water, towel to turn on and off water, 15 second scrub with soap, sleeves away from wrists, as above, but may have needed to start over

7 7 7 Inappropriate cold water, no towel to turn on and off water, 5 second scrub with soap ,no name tag , continually touching self and re-washing hands (leaving pt.) Circle infraction(s)

6 6 6 Unsafe cold water, no towel to turn on and off water, touching oneself after washing hands and not re-washing hands Circle infraction(s)

5 5 5 Fraudulent wrong name on name tag


no lab coat, or no name tag, exposed tattoos, inappropriate clinical attire, hair in face, colored nail polish, etc.


forgot to wash hands, touched self and forgot to wash hands, forgot lab coat or name tag

Comment:

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3. to see how the clinician introduces him/herself to the patient (name & title), (clarity and speed) Scores Equivalent to: Observations


My name is “”I am a Physical Therapist Assistant Student and I will be working with you today. Slow, clear, easily audible, looked for acknowledgment by pt. (name can be repeated by pt. name tag fully visible to pt.)


as above but the volume, speed or clarity could be improved

3 3 3 Nervous but safe as above but Physical Therapy Assistant Student and/or the volume, speed or clarity could be improved

2 2 2 Inappropriate as above but Physical Therapy Assistant or Physical Therapist Assistant and /or the volume, speed or clarity could be improved

2 2 2 Unsafe N/A

1 1 1 Fraudulent My name is “”I am a Physical Therapist Student (or “I am a Physical Therapist Assistant) and I will be working with you today. Slow, clear, easily audible, looked for acknowledgment by pt.


No eye contact, utilization of poor grammar “Hi, I’m goin’ to be working with you today”


no introduction “Come with me”

Comment: 4. to see that the dignity of the patient is respected by making eye contact at eye level, draping the patient, allowing

the pt. to do as much as he/she can do for him/herself Scores



intro at eye level, greet pt., have pt. propel him or herself to Rx area if capable, pt. Hx in Rx area, drape pt. at all times, pt. is responsible for w/c


as above, may not remember to speak to pt. from the front

3 3 3 Nervous but safe N/A

2 2 2 Inappropriate reviewing Hx.in Rx area or pushing pt. to Rx area, or not permitting able pt. to perform tasks (one of these) not allowing the pt. to perform skills that were practiced to his or her ability

2 2 2 Unsafe N/A



Not draping the pt and more than one of the items from “inappropriate”


N/A

Comment: 5. to see that the pt. is positioned appropriately for what is being done with them and that they are not asked to

change positions un-necessarily. Scores



initially positioning the pt so that he/she can perform all activities that can be formed in one position before having a pt. change positions, pt’s feet are supported


as above but the initial position may need to be changed resulting in more than one position change pt’s feet are supported

3 3 3 Nervous but safe the SPTA realized that position changes were necessary and explained the need for a change to the patient accepting responsibility, pt’s feet are supported

2 2 2 Inappropriate the SPTA had the pt. change position more than 3 times including a return to a position due to poor planning, accepting NO responsibility, pt’s feet are not supported

2 2 2 Unsafe the SPTA repeatedly had the pt change position and failed to guard the changes , pt’s feet are not supported and the PTA left the pt. unattended to retrieve something



the SPTA repeatedly had the pt change position and failed to guard the changes or explain the reasons for the change


The SPTA did not have the pt change positions when it would have been more appropriate to do so

Comment:

17

6. to see that the clinician is demonstrating appropriate concern for the patient and him or herself during the treatment session and as manifested in the treatment environment and the observation and practice of body mechanics that represent good habits and an awareness of the principles for self and others

Scores Equivalent to: Observations


The SPTA practices safe body mechanics techniques throughout the Rx session and explains them to the pt. as appropriate, (w/c, mat table, transfers, pt. positioning, and all aspects of care) Selected an Rx area that was conducive to both pt. needs and clinician needs. Reminded pt. of body mech during session and provided rationale behind it.


As above however, when sitting, The SPTA may need to improve upon personal body mechanics & posture but left something from above out. One omission

8 8 8 Nervous but safe Self-corrected errors in body mechanics during Rx session, More than one omission from a “10”

7 7 7 Inappropriate Bending at the waist to remove w/c parts, retrieve various items throughout session

6 6 6 Unsafe Bending at the waist to transfer pt. with a narrow BOS



N/A


N/A

Comment: 7. to see that things are explained to the patient in terms that he/she is capable of understanding Scores



the SPTA explained all activities in lay terminology and demonstrated activities before expecting pt. to perform task, asked pt if he or she had any ?s


the SPTA used medical terminology and demonstrated activities before expecting pt. to perform task, asked pt if he or she had any ?s

8 8 8 Nervous but safe the SPTA explained all activities in lay or medical terminology and demonstrated activities before expecting pt. to perform task, but may have forgotten involved side

7 7 7 Inappropriate the SPTA explained all activities in medical terminology and did not demonstrate or ask pt if he/she had any ?s

6 6 6 Unsafe the SPTA explained some but not all of the activities OR did it in an inappropriate format for THIS patient OR did not demonstrate the activity before asking the patient to perform it OR did the teaching when the pt was standing, not sitting and supported



Did not ask the patient if he or she had ever performed the activity previously or how, OR did not ask the pt if he or she had any ? before proceeding


No instruction took place prior to the expectation that the pt. would be expected to respond or perform something

Comment: 8 to see that the documentation is meaningful and accurate and meets each of the following criteria:

correct abbreviations, spelling, and documentation format in black ink,

to see that session measurements are accurate and in agreement with the testers visual assessment of the measurements and the session, recording only what is done and planned

Scores



All activities were documented in SOAP note format with appropriate abbreviations, including the side, # sets, # reps, Rx, pt. comments, outcome, etc. and signed leaving no blank spaces and the note was legible, and neat in black ink


As above but something could have been improved upon or was left out and would be with experience (e.g. side, # reps, S: too lengthy or not quoted when it should be, etc.) OR prof. designation may have been left out. Only one omission

8 8 8 Nervous but safe There may have been some items corrected with a single crossed out line that indicated that the SPTA was nervous, spelling errors were present, OR there was more than one omission OR measurements were not in agreement with the tester

7 7 7 Inappropriate Portions of the documentation do not match up with each other or relate to each other. MMT, ROM, Placement of items not within the correct area of the SOAP note etc. OR there might have been parameters for the application of a modality or exercises left out of the note OR illegible words in documentation

6 6 6 Unsafe N/A

5 5 5 Fraudulent Statement of test results that did not take place OR an adverse response of the application of a treatment intervention was left out of the documentation


Statement of assessments that are beyond the scope of practice for a PTA


The documentation was unsigned

Comment:

18

9. Patient Safety: to see that the treatment has been prioritized for the patient with evidence of a physiologically sound and rational plan for the session

Scores Equivalent to:

Please refer to the Critical Safety Indicators Document which is attached.



15 15 15 Nervous but safe

12 12 12 Inappropriate

9 9 9 Unsafe

6 6 6 Fraudulent



10. Patient Safety: to see that the demonstration of the selected tasks with the patient is done with evidence of skill and safety in the techniques performed Scores Equivalent to:

Please refer to the Critical Safety Indicators Document which is attached.



15 15 15 Nervous but safe

12 12 12 Inappropriate

9 9 9 Unsafe

6 6 6 Fraudulent



The tester will be looking for the following from the “patient” during the test:

that the patient does ONLY what he or she is told to do

the patient does NOT try to help the clinician

that the patient does NOT ask questions of the tester

that the patient does NOT prepare or clean up the area

that the patient respects the stress of the clinician and do not try to make it more difficult for the clinician to successfully complete the practical

Please note:

Patient safety is a critical component for the successful completion of this and all PTA program courses within the PTA curriculum. Items 9 & 10 on the list are considered to be skills that must have a score of “15” of higher for the learner to pass this practical examination and be considered “safe.” Additionally, a minimum score of 77 must be earned to pass the practical exam, consistent with all PTA program courses.

Summary Total Score for the Clinician:

Review Date: 1 2 3 Point Deductions (as a patient):

Learner Initials:

4 5 6 7 Final Score:

Safe/Unsafe

Pass/Fail 8 9

10 Tester(s): Total

BJB 3/12 rev Rev 11/13 PTAP fac

Attachments: CSI Fall or CSI Spring

19

PTA 213 PTA Techniques Critical Safety Indicators

The student/learner is required to demonstrate the following to score a fifteen (15) or higher on items nine (9) and ten (10) for Patient Safety on the Practical Examination Grading Rubric:

There may be additional CSI for Practical Examinations (in addition to the CSI outlined for the

competency tests) due to the nature of a Practical Examination being all-inclusive.

1. Provides clear and adequate instructions regarding weight bearing status prior to the first time the patient is required to bear weight, and continue to provide instruction as necessary.

2. Provides adequate guarding to maintain patient safety at all times.

3. Appropriately prepares the wheelchair for safe transfers into and out of the wheelchair, including engaging wheel locks and making sure that foot plates, leg rests, and arm rests are in appropriate positions.

4. Maintains the patient in a safe position while propelling the patient in a wheelchair, which includes having the armrests, leg rests and foot plates in place and in use.

5. Utilizes a gait belt properly for all patient transfers and gait training.

6. Ensures that the patient is wearing appropriate footwear (shoes) during all transfers and gait training.

7. Teaches the patient how to engage and disengage the wheel locks and any other pertinent wheelchair components during wheelchair mobility training, when appropriate.

8. Ensures that the patient is left in a safe position when not guarding the patient.

9. Chooses the most appropriate assistive device to maintain safety (including weight bearing status) and allow for mobility for the patient.

10. Assesses vital signs before and after treatment as appropriate.

11. When appropriate, provides clear and adequate instructions regarding total hip precautions prior to having the patient move.

12. When appropriate, maintains total hip precautions throughout treatment session and maximizes adherence to total hip precautions when leaving the patient.

13. When performing residual limb wrapping, ensures that the limb is completely covered (leaving no “windows”), in an angular direction, smooth and wrinkle-free and secured with tape or Velcro.

14. Provides clear and adequate education regarding diabetic foot care to patients with diabetes.

15. Includes only interventions indicated on the plan of care provided created by the physical therapist in the initial evaluation.

PTA 213 PTA Therapy Clinic Spring 2014

Course Schedule: Spring 2014 Location: MS 352 Lecture: M/W 9-11am Lab: Th 8-12 am OR 1-5 pm

Competency Testing Week 4 Total Hip Arthroplasty 2/10

Week 5 Amputations/Prosthetics 2/17

20

PTA 213 PTA Therapy Clinic Spring 2014

Week Date Course

Objectives

Course Outline Required Reading

1 Wed 1/22 C3, C8, C16,

C17, C18,

C19, A5

ADA and architectural barriers &

outcome measurement tools

Fruth: Chapter 6, sections 3

& 5

Thurs 1/23* Lab: Posture, ADA, and Outcomes

Tools

2 Mon 1/27

& Wed 1/29

C4, P3 Arthroscopy Pathology textbook:

chapter/section re:

osteoarthritis

Thurs 1/30* Lab: Arthroscopy

3 Mon 2/3 & Wed 2/5 C4, C7, P1,

P4, P5, P9,

A3, A4

Amputations

(END OF EXAM #1 MATERIAL)

& Prosthetics

None

Thurs 2/6* Lab: Amputations

4 Mon 2/10 C7, P1, P4,

P5, P9, A3,

A4

Orthotics None

Wed 2/12 Guest Speaker: Orthotics

Thurs 2/13 Lab: Orthotics

PTA 213 Written Exam #1 test center (Mon 2/10 – Wed 2/12)

5 Mon 2/17 Guest Speaker: Prosthetics

Wed 2/19 C4, C5, C9 Muscle Tone M&K, p126 (classification)-

129(diagnosis) &

p341(mngmt of abnormal

tone)-343(prep for d/c)

Thurs 2/20 Lab: Case Scenarios or Faux Practical

6 Mon 2/24

& Wed 2/26

C1, C4, C5,

C9

CVA

(END OF EXAM #2 MATERIAL)

M&K Ch 10

Thurs 2/27 Lab: CVA

7 Mon 3/3

& Wed 3/5

C2, C4, C5,

C9

SCI

(QUIZ MATERIAL)

M&K Ch 12

Thurs 3/6* Lab: SCI

PTA 213 Written Exam #2 test center (Mon 3/3 – Wed 3/5)

8 Mon 3/10 Guest Speaker: SCI

Wed 3/12 & Thurs

3/13

Practical Examinations

PTA 213 Quiz test center (Mon 3/10 – Tues 3/11)

9-13 PTA 235: Clinical Education II

14 Mon 4/28 & Wed 4/30

C4, C5, C9, C10

TBI M&K Ch 11

Thurs 5/1* Lab: TBI

15 Mon 5/5 C4, C5 Other Neurological Disorders M&K Chapter 13

Wed 5/7 Review Practical Exam Rubrics

Thurs 5/8 Guest Speakers: SCI & PPS

Mon 5/12 Written Exam #3 in class, Course Evaluation

* indicates that preparatory work is required prior to Thursday’s lab

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