PT Exam PT 530 Final Practical Examination Rubric Sensory Examination. 1. Selection of Test Area Selection of Tools required 1 2 3

Transcription

1 PT Exam PT 530 Final Practical Examination Rubric Sensory Examination I. Sensation Examination I (10pts) A. Selection of Test 1. Selection of Test Area Selection of Tools required B. Application and Patient Handling 1. Patient Position Therapist Position Performance of Technique Understanding and Reporting the Test Outcome II. Myotome Examination (10 pts) A. Selection of Test B. Application and Patient Handling 1. Patient Position Therapist Position Performance of Test Reporting Test Results III. Reflex Examination (10 pts) A. Selection of Test B. Application and Patient Handling 1. Patient Position Therapist Position Performance of Test Reporting Test Results IV. Differential Diagnosis (5 pts) A. Name another structure that could mimic this? B. How would you rule in/out your choice vs. this 2 nd structure? 1 2 3

2 PT Exam PT 530 Final Practical Exam Scoring Rubric Student Name Feedback scoring 1.Poor (mostly SD/D) 2. Fair (mostly D/N) 3. Good (mostly N/A) 4. Excellent (mostly A/SD) Clarity of charting 1. Yes 0. No Effective Patient Interview 4. Excellent 3. Good 2. Fair (missing some info) 1. Poor (missing significant info) Working hypothesis is evidently derived from interview material: 1. Yes 0. No Effective documentation of Goniometry (up to 7): All More than ½ Less than ½ None Joint AROM/PROM Movement Symptoms? Quality End Feel Side Effective documentation of Manual Muscle Tests (up to 6): All More than ½ Less than ½ None Muscle (group) Side Grade Effective documentation of Sensory tests (up to 8): All More than ½ Less than ½ None Root/Nerve/pattern listed Side Test description Test result Effective documentation of Motor tests (up to 6): All More than ½ Less than ½ None Muscle/group listed Side Test result Effective documentation of Reflex tests (up to 6): All More than ½ Less than ½ None Reflex tested Side Test result Preferred Practice Pattern(s) listed? 1. Yes 0. No Appropriate? 1. Yes 0. No Assessment reported? 1. Yes 0. No Appropriate? 1. Yes 0. No /50

3 Chapman University Department of Physical therapy PT 531 General Medicine Practice Management Grading Criteria: Practical #1 You will have 5 minutes to read the patient problem, plan your treatment and gather necessary equipment. You will then have 20 more minutes to implement your patient treatment and provide a rationale for your treatment choices. Following the practical you will have 5 additional minutes to document a SOAP note related to the treatment you provided. You will be given verbal feedback at the end of the exam, but will not be given your official grade until the following day. Students are expected to wear lab clothing, and will be expected to stay to pose as a patient for the next group of students taking the practical. The clinical portion of the exam will be stopped after 20 minutes. Points will be deducted for whatever portions of the exam are not completed. If a student scores <73% in any one section, the grader has the discretion to give the student an overall failing grade. They must then schedule a re-take with the instructor before the end of the week. This exam must be passed in order to go to pre-clinicals in June. Points Missed Communication/Professional Behavior (10pts) Presents self in a professional manner Describes purpose of treatment session Delivery (speed, clarity) is appropriate Communicates in a manner that is consistent with patient s cognitive and emotional status Adapts to reflect respect for and sensitivity to individuals Technique #1 (40 pts) Patient Set-up Patient in optimal position/starting alignment Patient is comfortable Equipment Set-Up All pertinent equipment gathered prior to treatment Equipment sized to fit patient Gait belt is used Therapist Position PT guards from correct side of patient Manual contacts appropriate Treatment Selection Optimal transfer is selected Optimal gait assistive device, gait pattern is selected Medical issues considered (appropriate rests, vital sign check) Provides demonstration as needed to enhance learning

4 Technique #2 (10 pts) Correct demonstration of technique Technique done within time frame of 3 minutes Body Mechanics (10pts) Base of support stable (appropriate size BOS, LE s in stride and aligned with movement of pt) Lever arms for therapist and patient are considered (load is close, arms aligned for force application) Safety (10 pts) Guarding appropriate for patient s assistance level Precautions (per diagnosis) are observed Adjustments made if pt c/o discomfort/pain, not feeling well PT plans for potential problems Documentation (10 pts) Complete Includes all SOAP components Includes all pertinent information (activity performed, assist level, assistive device, no. reps, gait distance, type of transfer, etc) Accurate Documentation reflects what was observed by examiner Appropriate abbreviations, terminology, spelling! Rationale (10 pts) Logical thought progression Choice of assistive device, type of transfer, gait pattern is consistent with patient s problems Total Points Missed:

5 Chapman University Department of Physical Therapy PT NPM Criteria for Grading: Practical #1 You will have 30 minutes to take the practical exam: 5 minutes to read a patient scenario and plan the examination, 20 minutes to perform two parts of an exam, and 5 minutes at the end to document a SOAP note. In the examination section you will be asked to demonstrate testing of: One Impairment (eg. sharp/dull, light touch sensation, proprioception, spasticity, tone, patterned vs selective movement, cranial nerves, UMC, etc) AND One Balance Test (TUG, Multi-directional Reach Test, Functional Reach, Romberg, Single Leg Stance Test, Modified CTSIB, individual items on Berg). You should wear professional clothing with your name badge. Please bring your own clipboards and pens/pencils An examiner may be utilized as an assistant if necessary, but they must be given specific instructions The exam will be stopped after 20 minutes. Points will be deducted for whatever portions have not been completed. If a student receives a grade of <73% in any one section the examiner has the discretion to give an overall failing grade, and the student must contact the instructor to re-take the practical exam at a later date. Communication/Professional Behavior (10 pts) Presents self in a professional manner Describes purpose of therapy session, why it s important Delivery (speed, clarity) is appropriate Communicates in a way that is consistent with patient s cognitive and emotional status Adapts to and reflects respect for and sensitivity for individuals Instructions to evaluation procedure include: Patient is told what they should feel and/or do Confirmation that patient understands procedure (Demo done when necessary to ensure patient understanding) Technique (Impairment Test) (25 pts) Procedure is done accurately Patient in optimal position, correct equipment set up PT watches patient s face intermittently to observe response, check for discomfort, etc Technique is performed as outlined in class (hand placement, speed, specific procedures) Procedure is done thoroughly All pertinent body segments examined All aspects of test are completed as outlined in class

6 Technique (Functional/Balance Test) (20 pts) Correct patient starting position Equipment set-up correctly prior to test Test performed accurately Test performed thoroughly Body Mechanics (10 pts) Base of support stable (appropriate size BOS, LE s in stride and aligned with movement of patient) Lever arms for therapist and patient are considered (load is close, arms aligned for force application) Safety (10 pts) PT guards as appropriate for diagnosis, assistance level Patient position/set-up is changed if patient c/o discomfort Rationale (15 pts) Explains clinical implications of test results Logical thought progression Documentation (10 pts) Complete S,O,A,P documented Includes ALL pertinent information (type of test done, etc) Accurate Documentation reflects what was observed by examiner Appropriate abbreviations, terminology, SPELLING!!! Total Points Missed:

7 PT Examination Midterm Practical Exam Rubric Patient Interview 1. AREA (5 pts 1 pt ea) a) Visual image of location b) deep vs. superficial c) constant vs. intermittent d) Description of pain or c/o e) Severity (NPRS) Pain scale (0 to 10) 2. Behavior of symptoms (7 pts) a) Aggravating activities b) Quantity to agg c) Easing activities d) Quantity or time to ease e) 24 hour pattern (specifically AM, Day, Night) 3. Special questions Systems review (8 pts- ½ pt ea) a) General Health b) Systems: CV, Pulm, GI, UroGen, Psych, Endoc, NSys, Integ, MSkel c) Meds d) Tests done e) Special Questions: Cord, CA/wt loss, Osteoporosis, Cauda Equina 4. History a) Current History (5 pts 1 free point) 1. Onset (sudden vs insidious) 2. Mechanism 3. Date of injury 4. Progression (change since onset) b) Past Medical History (5 pts) 1. Related incidents (other times having same c/o) 2. Progression of Sx's (ie: LBP then leg pain, then N/T) 3. Related events: Fractures, Surgeries, etc. that may influence c/o 4. Other complaints (may or may not influence c/o) 5. Contributing Medical Factors (Diabetes, Rheum. Arthritis, etc.) c) Social History (5 pts) 1. Age/Gender 2. Occupation (relevant tasks) 3. Goals, activities 4. Alcohol / smoking 5. Living situation 5. Use of Intake Form Information (2 pts) 6. Hypothesis (5 pts)

8 Chapman University Department of Physical Therapy PT 638 MSPM II Cervical/Thoracic and Upper Extremity Practical Exam 1A Student Examiner General Health Screen : 3 pts. COMMENTS: Did student inquire about general health Y N Posture: /5 pts. Did the student assess posture? Y N Was the posture of the entire lower quarter considered? Y N Was posture reported correctly? Y N Did the student inquire about symptoms during posture? Y N Functional Task/AROM: /10 pts. Did the student ask the patient to perform a functional task? Y N Was the task related to the subjective report provided? Y N Was the assessment of the task correct? Y N Did the student inquire about symptoms during task? Y N Did report include quality, quantity? Y N PROM: /10 pts. Was PROM assessed? Y N Was PROM assessment based on function/arom? Y N Did report include quality, quantity, end-feel? Y N Did student inquire about symptoms? Y N Contractile Assessment: /10 pts. Did the student consider contractile elements for: Strength? Y N Strain? Y N Did student inquire regarding symptom reproduction Y N Was assessment based on function, subjective, etc.? Y N Was assessment appropriate Y N Special Tests: /10 pts. Were appropriate special tests considered? Y N Did student inquire about symptoms? Y N Palpation: /5 pts. Did student perform appropriate palpation? Y N Was palpation based on prior evaluation findings? Y N Did student inquire about symptoms during palpation? Y N

9 Assessement: /10 pts. Did the student make an appropriate assessment based on evaluative findings? Y N Did assessment consider more than just the symptomatic region? Y N Did assessment lead to a logical treatment intervention? Y N Did the student consider more than one scenario for source of symptoms? Y N Organization: /15 pts. Did the evaluation follow a logical progression? Y N Did the student communicate well with the patient? Y N Was the patient moved minimally? Y N Did the student demonstrate good patient positioning? Y N Did the student demonstrate good body mechanics? Y N Did the student require verbal cueing to stay on track? Y N Treatment: /10 pts. Please perform an intervention to address your examination findings from above. You have 5 minutes. Did the student inform the patient of the treatment process? Y N Was the treatment intervention appropriate based on evaluation findings? Y N Did the student ask about symptoms during treatment? Y N Was patient positioned appropriately? Y N Did they demonstrate appropriate force application, duration, etc.? Y N Did student re-assess the patient for changes post treatment? Y N Was a change made as a result of the treatment? Y N Did the student require verbal cueing during treatment intervention? Y N Safety: /5 pts. (Score of 3 or lower indicates failure of exam due to safety concerns) Did the student demonstrate any unsafe behavior/patient management during the practical exam? Please explain unsafe behavior observed in the comments section below. Y N Comments: Highlights: Total Points: /93 pts. Areas needing improvement:

10 Chapman University Department of Physical Therapy PT-640 Neurological Practice Management Practical Exam #2 You will be given 5 minutes to read a patient scenario and plan your intervention. You will then have 20 more minutes to perform TWO different portions of a patient treatment. One of the treatments must be PNF based. You are expected to wear professional attire and name badges. Anyone not wearing appropriate professional attire will give up their time slot and must return at the end of the practical in proper attire before they can take the exam. If a second person is needed to assist you, you may utilize the examiner to be your assistant, but you must give them specific instructions. The exam will be stopped after 20 minutes. Points will be deducted for whatever portions of the exam are not completed. After you implement the treatment you will also be required to justify your rationale for the treatment selected as well as the implications of the intervention. You will also be asked to discuss how you would grade the activity to increase or decrease the difficulty of the task. You will be given feedback at the end of the exam, but will not be given your official grade until Monday when grading forms will be returned to your mailboxes. If a student receives a grade of <73% in any one section the examiner has the discretion to give an overall failing grade, and the student must contact the instructor to re-take the practical exam during finals week. You will not be permitted to go out on clinical until you pass the practical! Points Missed Communication/ Professional Behavior (10 Pts) Presents self in a professional manner Describes purpose and goals of therapy session, why it s important Delivery is appropriate (clarity and speed of information given) Communicates in a manner that is consistent with patient s cognitive and emotional status Instructions to include: O Clear explanation of treatment to be performed O Expected activity/ movement explained to patient, desired outcome, etc. O Confirmation that patient understands intervention and desired outcome (demonstrates when appropriate to ensure patient understanding) Comments:

11 Technique (Treatment # 1) (27 Pts) Treatment is consistent with meeting the functional goal of treatment Treatment is done accurately (appropriate manual contacts/ key points of control) Patient is placed in optimal position, correct starting alignment, correct equipment set-up, etc. PT monitors patient's facial expressions intermittently to observe response, check for discomfort, etc. Demonstrates treatment progression that increases task difficulty and (manual contacts adjusted, task adjusted) Comments: Technique (Treatment # 2) (28 Pts) Treatment is consistent with meeting the functional goal of treatment Treatment is done accurately (appropriate manual contacts/ key points of control) Patient is placed in optimal position, correct starting alignment, correct equipment set-up, etc. PT monitors patient's facial expressions intermittently to observe response, check for discomfort, etc. Demonstrates treatment progression that increases task difficulty and (manual contacts adjusted, task adjusted) Comments: Body Mechanics (10 Pts) Base of support is stable (appropriate size BOS, LE s in stride and aligned with movement of the patient) Lever arms for therapist and patient and therapist are considered (load is close, UE s aligned correctly for force application) Comments: Safety (10 Pts) PT guards as appropriate for diagnosis, assistance level Patient position/set-up is altered if patient c/o discomfort Comments: Rationale (15 Pts) Able to justify treatment choice Able to justify alterations in task, environment Logical progression of thought Able to incorporate motor learning principles into selected treatment Explains clinical implication of treatment implementation Comments:

12 Name Chapman University Department of Physical Therapy PT 641 Rehab Practice Management Practical Exam 7/25/12 Station #1 1. Identify this type of wheelchair frame (be as specific as possible).. 2. List two advantages of this type of wheelchair frame. 3. List two disadvantages of this type of frame. Station #2 4. Identify the type of drive wheel on the power wheelchair in photo A. 5. List one advantage of this type of drive wheel. 6. In what type of environment would a person find this type of drive wheel to be more advantageous than the other types of wheel placements? Station #3 7. Identify the type of frame (be specific as possible) and type of wheel type on this manual wheelchair. Frame: Type of wheel: Type of armrest: 8. Give an example of a situation when you would adjust the axel plate into a slightly more anterior position for a patient.

13 Station #4 9. Identify the orthosis in A. 10. What motions does this orthosis primarily limit? 11. Identify the orthosis in B. 12. What motion(s) does this orthosis primarily limit? Station #5 13. You are setting up an AFO to help a person whose only gait deviation is excess dorsiflexion in mid and terminal stance due to weak plantarflexors. List everything you would put in the anterior channels. 14. Now list everything you would put in the posterior channels. Station #6 15. Identify the category of the prosthetic foot in A. 16. List one feature it has that s an improvement over the old SACH foot. 17. Identify the amputation level in the photo in B. 18. Give one advantage and one disadvantage of this amputation level Advantage: Disadvantage:

14 Station #7 19. What is the type of drive wheel on the wheelchair in the photo? 20. List one advantage to this type of drive wheel. 21. What type of recline mechanism is being used on the wheelchair? 22. What is one advantage of using this type of recline mechanism? Station #8 23. Identify the type of amputation in A. 24. Identify the type of amputation in B. 25. Identify the level of amputation in photo C. 26. Why is the level of amputation in photo C a potential problem for this patient? Station #9 27. Identify the type of AFO on the table (A). 28. List two advantages to this type of AFO. 29. Describe one advantage to using the AFO in photo B rather than the one on the table?

15 Station # Identify the prosthetic foot in A. 31. Identify the prosthetic foot in B. 32. What is one disadvantage of prosthesis B? Station # In what phase of gait is this person s right leg? 34. What gait deviations are present on the right LE during this phase? 35. This patient has a diagnosis of post-polio. What is the most likely reason for these deviations being present in this phase? 36. Bonus: What orthotic (be specific with settings!) would you order for this patient to correct their deviations in this gait phase? Station # Identify the type of AFO on the table. 38. Identify one feature that supports your answer in # If your patient needed this type of AFO what are some likely MMT grades they would likely have for dorsiflexion and plantarflexion? Dorsiflexion: Plantarflexion:

16 Station # Identify the level of amputation in the radiograph in A. 41. This prosthesis in B is designed for individuals with a amputation. Station # Which of these cushions retains heat the most? (State the name of the cushion) 43. How do you know when cushion B is inflated properly? 44. Which cushion requires the most maintenance? 45. Why is the benefit of using cushion A or B rather than cushion C? (What do they provide that cushion C cannot) Station # What is this patient s minimum level of injury based on their method of assuming supine to sit? 47. Give a rationale for your answer in #47 and be as specific as possible. 48. What UE joint ROM s are critical in order to do this successfully? Station # Identify the orthosis in photo A. 50. Identify the labeled component in photo B 51. Identify the labeled component in photo C

17 Station # Identify the term for the angle of the wheels on this wheelchair. 53. The cushion on this wheelchair is made by Ride Designs. Give an example of one other type of cushion that the same concept of pressure relief as this one. 54. Describe the concept of pressure relief for the Ride Designs cushion as you would to an actual patient (in one sentence). Station # This client has a spinal cord injury. What is he demonstrating in the photo? 56. What spinal level must be innervated in order for him to be able to do this? 57. What precautions must be taken so this function won t be diminished over time? Station # Identify the wheelchair category (be as specific as possible) in photo A. 59. In general, how high should the seatback upholstery be in order for the chair to properly fit the client so he/she can push the chair effectively? 60. Describe the type of client (activity level) for whom you would likely order this wheelchair.

18 Station # This child has a diagnosis of cerebral palsy. Her right leg is in initial swing in the photo. Name two gait deviations present during this phase. Deviation #1: Deviation #2: 62. Select one of the deviations mentioned above and list two potential causes Deviation: Cause #1: Cause #2: Station # A. List the lowest and highest levels of complete spinal injury that would benefit from wearing this orthosis List two signs or symptoms an individual (with a Dx from #64) might report when NOT wearing this orthosis Station # Identify A 66. List one advantage and one disadvantage of having A on a KAFO. Advantage: Disadvantage:

19 Station # When an individual with an amputation wears this prosthesis what part of their residual limb is MOST at risk for skin breakdown? 68. Identify A. Please be specific! 69. Name one other type of suspension for this type of prosthesis.

20 Name: Rubric for Midterm Practical PT Examination PT 530 End Feel Assessment End Feel #1 Joint Motion: Patient Positioning Therapist Position/Body Mechanics Therapist Application of Technique End Feel Assessment (grades of 0 and 1 indicate a retake of the exam will be required) /20 End Feel #2 Joint Motion: Patient Positioning Therapist Position/Body Mechanics Therapist Application of Technique End Feel Assessment Description of end-feel + your thoughts on the structure causing the end-feel (grades of 0 and 1 indicate a retake of the exam will be required) /20 Safety: pass no pass Comments: