Syllabus - Mercer County Community College

Mercer County Community College Physical Therapist Assistant Program

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

PTA 210: PTA Techniques & Modalities

Fall 2013

Fall Office Hours: Mondays 1:00 – 4:00

Wednesdays 12:00 to 2:00 **Other availability by appointment**

Holly Beinert Course Director

MS 157 [email protected]

609-570-3478

Course Syllabus

Course #: PTA 210

Course Title: PTA Techniques

Credit Hours: 3/2

Contact Hours in Semester: 45/30

Number of weeks: 15

Number of Clinical weeks: 00

Clinical Contact Hours: 00

Pre-requisite Course(s): PTA 101 Intro to PTA PTA 112 Pathology

Co-requisite Course(s): PTA 211 Physical Agents (opt)

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Course Grading

Domain Assessment Timeline Possible

Points

Cognitive Written Exam #1

Week 3 Tues - Sat (testing center)

6

Written Exam #2 Week 5 Mon – Sat (testing center)

6

Written Exam #3 Week 7 Tues – Sat (testing center)

6

Written Exam #4 Week 10 Monday (in class)

6

Written Exam #5 Week 15 (in class)

6

Psychomotor 4 SOAP Notes with SOAP Note Assessment Form

Due by Thursday Week 9 10

5 Competency Tests** Weeks 3,4,6,8,9 10

1 Practical Examination* Week 10 25

Affective Generic Abilities Assessment Ongoing 20

TOTAL: 100

* In the event that a student/learner is unsuccessful in passing the Practical on the second attempt, 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

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.)

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)

Responsibility & Professionalism: 4. 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.)

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SOAP NOTES Learners will be required to hand in four (4) SOAP notes prior to Thursday of week 9 during the semester. SOAP notes will be completed at the end of lab experience. Before any SOAP notes are handed in to be graded for the psychomotor component of the course grade, they must first be reviewed by a classmate. To get the most out of your peer review, it makes sense to have the classmate who was your patient during your lab experience perform the peer assessment. SOAP note assessment forms (yellow) can be found in the lab in the top bin. The peer assessment form must be completed. This provides the clinician with the opportunity to improve his/her SOAP note before handing it in. Please note that the SOAP note assessment form needs to be handed in WITH the final SOAP note.

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 equivalent to 77 or higher. In recognition of this standard, set by a board that is external to MCCC, the PTAP will adopt 77 as the minimal passing grade. Other grade ranges are as follows:

A = 93-100 B = 83-86 C = 70 – 76

A- = 90-92 B- = 80-82 D = 60 - 69

B+ = 87-89 C+ = 77-79 F less than 59

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 PTAP courses may be attempted only twice.

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.

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

Form” that is provided to you. This form indicates your grade and which test questions you got

incorrect. Keep this form.

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

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.

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Required Texts Johansson, C., Chinworth, S.A., (2012), Mobility in Context: Principles of Patient Care Skills. F.A. Davis:

Philadelphia, PA. ISBN 978-0-8036-1527-4

Kisner, C., Colby, L.A., (2007), Therapeutic Exercise: Foundations and Techniques, 5th ed. FA Davis: Philadelphia, PA. ISBN 978-0-8036-1584-7

Fruth, S.J., (2014), Fundamentals of Physical Therapy Examination. Jones & Bartlett: Burlington, MA. ISBN 978-1-4496-5268-5

*Mansfield, P.J., Newmann, D.A., (2009), Essentials of Kinesiology for the Physical Therapist Assistant, Mosby: St. Louis, MO. ISBN 978-0-323-03616-0 OR Lippert, L.S. (2011). Clinical Kinesiology and Anatomy, 5

th ed., Philadelphia, PA: FA Davis. ISBN 978-0-8036-

2363-7 **Behrens, B.J., Michlovitz, S.L., (2006), Physical Agents: Theory & Practice 2nd ed., FA Davis Co: Philadelphia. ISBN 0-8036-1134-X **Behrens, B.J., (2006), Laboratory Manual for Physical Agents 2nd ed., F.A. Davis Co: Philadelphia. ISBN 0-8036-1135-8 *Kinesiology text previously used in PTA 105 Kinesiology. ** Texts required for PTA 211 Physical Agents

Course Description:

Addresses patient care and handling, including patient positioning and bed mobility, vital signs, transfers, gait and posture, massage, aseptic techniques, wound care and bandaging, edema management, and continuous passive motion devices. Students develop their skills through practice with each other. Competencies evaluated throughout the course.

Course Goals: The student/learner will be able to:

1. Explain and demonstrate the importance of the utilization of safe body mechanics for transporting, transferring, and/or lifting patients.

2. Describe the characteristics of a patient’s vital signs at rest and in response to exercise, and appropriately measure and document vital signs.

3. Describe the components of normal gait, and typical abnormalities of gait dysfunction. 4. Formulate a general program of therapeutic exercises to increase ROM, improve strength, and

promote endurance for the upper and lower body regions. 5. Measure an ambulatory assistive device for a classmate and instruct the classmate in the appropriate

use of that device. 6. Discuss and demonstrate the therapeutic benefits of soft tissue massage within the physical therapy

plan of care. 7. Describe the benefits of CPM, mechanical compression, aseptic techniques, wound care, and/or

pulmonary techniques for specific patient diagnoses within a physical therapy plan of care.

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Course Objectives: Following the successful completion of this course, the student/learner will possess skills in the following domains:

Cognitive/Knowledge: The student/learner will be able to successfully: 1. differentiate between clean and sterile techniques and describe the difference between them 2. describe the principles and components of a therapeutic exercise program 3. describe the sequence for postural drainage for the lobes of the lungs and differentiate between the need

for one position versus another based upon lung sounds 4. describe the sequence for tissue healing 5. describe the differences between normal and abnormal tissue healing characteristics 6. identify the components of tissue healing that need to be documented in a patient record 7. describe the principles of body mechanics that would prevent injury to self and others 8. differentiate between safe and unsafe patient handling techniques and demonstrate safe patient handling

techniques 9. identify therapeutic exercises to strengthen prime-mover muscles that have been tested and identified as

needing strengthening 10. question a patient to determine his or her subjective complaints suitable for the patient record 11. list the possible ambulatory assistive devices that can be utilized for a patient with compromised weight

bearing status 12. define the levels of assistance for patient activities and transfers 13. describe non-pathologic gait patterns and differentiate them from pathologic gait patterns 14. describe the components of vital signs (heart rate, respiratory rate, blood pressure) 15. list the components of a continuous passive motion device for the knee 16. describe the use of intermittent compression as a therapeutic intervention for edema 17. describe chest wall expansion and excursion during inspiration and what may limit it 18. describe the characteristics of cough and sputum differentiating normal from infected sputum 19. describe the components of an aerobic conditioning therapeutic exercise program 20. describe the difference between strength and endurance 21. recognize major groups of medications prescribed for musculoskeletal conditions

Psychomotor: The student/learner will be able to successfully: 1. demonstrate appropriate aseptic techniques to control the spread of disease 2. perform safe dependent and assisted patient transfers utilizing appropriate body mechanics 3. demonstrate body mechanics principles, assessment of vital signs and patient positioning & draping

techniques that are consistent with clinical practice 4. perform clean and sterile dressing techniques 5. perform a therapeutic massage to the cervical and lumbar musculature to relieve muscle guarding 6. prepare a patient for the application of continuous passive motion or intermittent compression 7. measure a patient for ambulatory assistive devices to accommodate altered weight bearing status 8. demonstrate interpersonal skills to teach therapeutic exercises to patients and family members 9. demonstrate and teach ambulation with assistive devices (walkers, crutches, canes) on all surfaces (level,

curbs, steps, ramps, carpets, tile and outdoor surfaces) 10. perform manual postural drainage techniques 11. document treatment techniques utilized with classmates in the formulation of a SOAP note

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12. adjust the level of patient activity with therapeutic exercises to maintain patient safety 13. position a patient in supine, prone, side lying or sitting to decrease weight bearing on bony landmarks and

to improve postural drainage 14. build a therapeutic exercise program that prepares a patient for activities of daily living (ADL), functional

mobility and/or endurance training within the PT established POC 15. demonstrate wheelchair operation for patient education and safety 16. demonstrate wheelchair operation for patient education and safety 17. measure vital signs including blood pressure, heart rate, respiratory rate at rest and during exercise 18. describe the safety and progression of patients while performing gait, wheelchair and mobility activities 19. demonstrate safe patient interaction and support during an emergency episode with a patient

communicating with the supervising PT after ensuring the safety of the patient 20. demonstrate and perform passive range of motion exercises with patients on all peripheral joints 21. recognize positions, activities and postures that aggravate or relieve pain

consult the supervising PT when there is a question about an unanticipated patient response to a therapeutic intervention to preserve patient safety

22. manipulate mobile apparatus that may be attached to a patient in the physical therapy department

Affective:

The student/learner will be able to successfully: 1. defend a patients right to privacy by protecting the patient record 2. act as an advocate for the patient by draping them to maintain patient dignity and revealing only the

treatment area 3. advocate for the value of soft tissue massage as an essential therapeutic tool in the relief of muscle

guarding or lymph edema management when appropriate for a patient appreciate patient privacy and dignity issues without prompting

4. advocate for the documentation of objective signs & symptoms in the patient record 5. weigh patient responses to therapeutic exercise and massage to assess patient progress versus the

patient’s subjective requests 6. internalize professional behaviors when interacting as a clinician 7. recognize abnormal signs including cyanosis, orthostatic hypotension, dyspnea, tachycardia, bradycardia,

etc., and act appropriately to care for the safety of the patient 8. recognize activities that aggravate or relieve edema, pain or dyspnea and preserve patient safety 9. recognize an emergency situation in the physical therapy clinical environment and care for the safety of the patient, consulting others as appropriate Course Outline: I. Aseptic Technique XI. Normal Gait II. Vital Signs XII. Abnormal Gait III. Bloodborne Pathogens XIII. Gait with an assistive device IV. Pharmacology XIV. Massage V. Positioning and Draping XV. Edema & Intermittent Compression VI. Wound Care & Burns XVI. Emergency Procedures VII. Body Mechanics XVII. Radiography VIII. Bed Mobility & Transfers XVIII. Medical Labs and Equipment IX. Wheelchair Components & Fit XIX. Cardiac Pathology & Cardiac Rehabilitation X. Therapeutic Exercise & CPM XX. Pulmonary Pathology & Chest PT

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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: diagnosis prescribed medications age, gender overall medical condition of the patient previous medical history physical therapy plan of care results of tests

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.

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.

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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 the entire body of the sternum. If the body of the sternum is not covered, you will be asked to leave and return with appropriate attire. Chewing gum is not permitted during lab activities.

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.

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:

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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. • 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

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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.

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.mccc.edu/

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Competency Testing

The focus of all health related professions is the patient. As health care providers and educators, we are striving to assure that the safety of our patient is not compromised in any way by the actions of our student/learners. All PTA program laboratory courses involve direct interaction between the students and the PTA faculty. All PTA program student/learners experience both administering care and receiving care, classmates are both “patients” and “clinicians”.

PTA laboratory courses also involve individualized competency testing for specified skills that have been identified as entry level skills student/learners should possess. Competency testing presents a method of assuring the clinical community that the PTA student/learner is competent and safe to perform procedures and techniques with patients.

For PTA 106, PTA 210, PTA 211, PTA 213 & PTA 216 Based upon the number of attempts that are required to fulfill competence, the following potential penalties may be employed.

Success on the 2nd attempt Unsuccessful 2nd attempt Successful on 3rd attempt Unsuccessful with 3+ attempts

5 points deducted from competency grade for that course

It is the responsibility of the student/learner to contact the course instructor if more than a second attempt is required for competency testing.

10 points deducted from competency grade for that course

No more than 3 attempts are permitted for competency tests. Failure to perform at a level of competent indicates that there is a problem and a need for program counseling.

If a student arrives at any competency test without his/her comp sign off sheet to be signed within the

scheduled time slot, 5 points will be deducted from the competency grade for that course.

The following will be expected of the student/learner during each competency test. One point may be deducted per expectation per competency test in the event that the student/learner does not fulfill any of the following expectations: 1. Punctuality: the student/learner must be ready to begin at his or her scheduled time. 2. Lab Coats and Name Tags: As soon as the student/learner has purchased a lab coat and name tag (mid June), they must be worn during all competency tests when acting as the clinician.

3. Handwashing: the student/learner must perform an appropriate handwash utilizing Universal Precautions as illustrated on the cabinet near the main sink in MS 352 during all competency tests.

4. Introduction & Termination of Treatment: the student/learner must use the appropriate introduction as outlined in the practical examination grading rubric and must verbally conclude the treatment session.

What is the difference between a practical exam and a competency test?

During a competency test: the tester interacts freely with the student/learner being tested. the student/learner may ask for clarification from the tester. the student/learner may submit their documentation the day after the test has been completed.

Student/learners sign up for competency tests when they feel that they are ready to take them.

Student/learners know exactly what test they will be demonstrating competence with.

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During a practical exam: the tester does not interact with the student/learner, they take notes. the tester provides no additional information to the student/learner being tested. the documentation for the test is due at the completion of the test.

Student/learners are assigned a specific testing time.

Student/learners select a patient problem at the time of the test. They do not know the content of the problem in advance.

Responsibilities of the PTA student/learner:

To sign up in advance to take a competency test, once he or she feels that the skill has been mastered

To provide a suitable patient upon whom to perform the skill. This is most often a fellow PTA program student/learner, who is dressed in a manner that allows the technique to be performed unrestricted by jewelry or extraneous clothing.

To prepare and subsequently clean up the appropriate treatment environment at the conclusion of the competency test.

To provide the competency tester with the appropriate documentation to sign off that he or she performed the test in a safe and competent manner.

Competency Tests

Vital Signs

Objective: To be able to demonstrate safe and effective treatment technique and competence in the measurement of vital signs including blood pressure, heart rate, and respiratory rate and document the findings in a SOAP note format suitable for a patient record. Equipment:

Watch or clock with a second hand

Stethoscope

Sphygmomanometer

Paper, pen with black ink, to record patient data Preparation:

Prepare your patient to have his or her vital signs assessed in sitting Skill Demonstration: Monitor and record the following vital signs indicating normal values to the tester.

blood pressure

heart rate

respiratory rate

Student/learners must be able to provide a rationale for recording each of the monitored signs, and explain the significance of each. Documentation:

Submit a SOAP note indicating your findings

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Aseptic Techniques

Objective: To be able to demonstrate safe and effective treatment technique in practicing universal precautions, clean and sterile techniques while changing the dressing of a sacral decubitus ulcer and documenting treatment in a SOAP note format suitable for a patient record. The student/learner is expected to be able to:

don and doff sterile and clean gloves

set up a clean environment for the removal of a dressing

dispose of medical waste from a soiled dressing

measure and describe the size of the ulcer utilizing appropriate terminology for documentation in the patient record

set up a sterile environment to apply a clean dressing to a wound

apply a clean dressing to a sacral ulcer The student/learner is responsible for:

providing the rationale for clean and sterile environments

outlining and defending the importance of universal precautions

documenting the treatment intervention utilizing appropriate terminology and measurements in a SOAP note

Therapeutic Exercise

Objective: To be able to demonstrate safe and effective treatment technique in selecting, instructing and teaching a therapeutic exercise program for a patient as a part of a physical therapy intervention under the direction and supervision of a physical therapist developed plan of care and documenting the treatment in a SOAP note format suitable for a patient record. Equipment: exercise equipment as necessary

free weights

cane

theraband Preparation: assemble the tools that you will need to progress a patient through a progressive resistance exercise program for upper extremity or lower extremity strength and to increase flexibility (ROM) Skill Demonstration:

instruct your patient in a therapeutic exercise program for two of the following muscle groups and their antagonists for strengthening and ROM and progress the exercises as appropriate

shoulder extensors trunk extensors knee extensors elbow extensors hip extensors

teach the activities that you would like your patient to perform

indicate how you would know when to progress the patient and by how much

provide the rationale for teaching progressive resistive exercise activities and how they work Documentation: Document your treatment session with the patient (SOAP)

Identify which CPT Codes you would bill for and why

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Transfers & Gait with Assistive Devices

Objective: To be able to demonstrate safe and effective treatment technique in demonstrating and teaching transfers and ambulation with ambulatory assistive devices for level surfaces and elevation activities and document the treatment in a SOAP note format suitable for a patient record Equipment: Wheelchair Walker Crutches Cane Preparation:

transport your patient to the treatment area in a wheelchair

measure and fit your patient for the assistive device(s) chosen by the comp tester Skill Demonstration:

teach your patient how to transfer into and out of the wheelchair to standing and then how to ambulate using the scenario(s) below, chosen by your comp tester:

* walker NWB on L (15 feet x2) * crutches 50% PWB on L (15 feet x2 + ↑↓ stairs) * cane 50% PWB on L (15 feet x2 + ↑↓ stairs)

Documentation: document your treatment session using SOAP note format & identify which CPT Codes you would bill for and why

Massage

Objective: To be able to demonstrate safe and effective treatment technique in administering a therapeutic massage to the musculature of the back to relieve muscle guarding / pain and to the upper extremity to increase mobility of scar tissue and mobility of adhesions related to tendinitis/osis. Document the treatment in a SOAP note format suitable for a patient record. Equipment: Treatment plinth Linens (sheets for draping, towels) Massage lotion Preparation: Prepare your patient for Cross Friction Massage or Scar Massage to the left forearm

Prepare your patient for soft tissue massage of the right upper trapezius Position & drape your patient appropriately Skill Demonstration:

Forearm: Identify the type of massage that you are administering and its indication o Initiate and terminate the massage appropriately o Instruct the patient appropriately regarding expectations for the massage o Practice safe body mechanics during the treatment intervention

Right Upper Trapezius: Identify each of the types of strokes and their indications o Demonstrating at least 3 types of massage strokes o Palpate to identify areas of muscle guarding, nodules, or trigger points o Administer massage to relieve palpable muscle guarding o Initiate and terminate the massage appropriately o Instruct the patient appropriately regarding expectations for the massage o Practice safe body mechanics during the massage

Documentation: Document what was palpated, performed and the patient response in a SOAP note & identify which CPT Codes you would bill for and why

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Fall Practical Exam Instructions Preparing for Practical Day

LEARNERS: Come prepared with 2 outfits. One should be appropriate attire while in the role of clinician. Hair should be up. You

should also bring attire to be a patient. You should have shorts, tank tops, etc. Bring a black pen.

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 5 of the hour and use that 5 minutes to clean up your treatment area.

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 by 15 minutes after the hour and it will be collected at that time regardless if it is complete or not . 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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Mercer County Community College 2012 Learner:

Physical Therapist Assistant Program Patient: Practical Examination Rubric Scenario: Date: Course:

Instructions:

The learner will select 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. *PTA 106 learners have 5 minutes prep for 30 min test

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: 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.


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

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:

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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 Equivalent to: Observations


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

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



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


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: 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:

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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: 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 Comments:

Scores Equivalent to:




12 12 12 Inappropriate

9 9 9 Unsafe

6 6 6 Fraudulent



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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

Comments: Scores Equivalent to:




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

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Fall 2013 Exam Topics

Exam Topics

1 Aseptic Technique Vital Signs Pharmacology

2 Positioning and Draping Wound Care / Burns Body Mechanics Bed Mobility Transfers

3 Wheelchair Components & Fit Therapeutic Exercise & CPM Normal Gait Abnormal Gait

4 Gait with AD Massage Edema Emergency Procedures Medical Labs & Equipment

5 Cumulative

PTA 210 PTA Techniques & Modalities - Fall 2013 ===============================================================================

Course Schedule: Fall 2013 Monday & Wednesdays: 9-11 Location: MS 352 Thursday: Lab 9 -12 or 1-4

PTA 210 PTA Techniques week

1. Vital Signs Lab Date: 8/29 Test week: 9/9 3

2. Aseptic Techniques Lab Date: 9/5 Test week: 9/16 4

3. Therapeutic Exercise Lab Date: 9/19 Test week: 9/30 6

4. Transfers & Gait with Assistive Devices Lab Date: 10/3 Test week: 10/14 8

5. Massage Lab Date: 10/10 Test week: 10/21 9

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Week Date Assessment Topic(s) Objective(s) Chapter(s) 1 8/26 Aseptic Techniques

Vital Signs

C1, C10, C14, P1, P3, P11, P17, A1, A4, A6

Johansson Ch 4, 5; Fruth Ch 7 section 1, 2

2 9/2 Bloodborne Pathogens (Attendance is Mandatory) Pharmacology

C10, C21, A1, A6

3 9/9 Comp: Vitals Exam 1: 9/10-9/14 test center

Positioning & Draping Wound Care & Burns Body Mechanics

C1, C4, C5, C6, C7, C10, P1, P2, P3, P4, P11, P13, A1, A2, A4, A6

Johansson, Ch 6, 7 (from p158 to end); Fruth Ch8

4 9/16 Comp: Aseptic Bed Mobility Transfers Wheelchair Components & Fit

C8, C10, C12, P2, P11, P15, P16, P18, A1, A4, A6

Johansson, Ch 11, 13

5 9/23 Exam 2: 9/23-9/28 test center

Therapeutic Exercise & CPM Normal Gait

C2, C9, C10, C13, C15, C19, C20, P8, P11, P12, P14, P18, P20, A1, A4, A5, A6

Kisner/Colby ch1, Kines textbook gait chapter, Fruth Ch9 section 2

6 9/30 Comp: Therex Abnormal Gait Gait with Assistive Devices

C8, C10, C11, C13, P7, P9, P11, P18, A1, A4, A6

Johansson Ch 14

7 10/7 Exam 3: 10/8 – 10/12 test center

Gait with Assistive Devices Massage

C10, C11, C13, P5, P7, P9, P11, P18, A1, A3, A4, A5, A6

No required reading

8 10/14 Comp: Transfers & Gait

Edema Management Intermittent Compression (Bring Physical Agents Lab Manual to lab this week)

C10, C16, P6, P11, A1, A4, A6

Behrens Ch 7**, Fruth ch7 section 3

9 10/21 Comp: Massage Emergency Procedures Radiography Medical Labs & Equipment

C8, C10, P19, P20, P2, A1, A4, A6, A7, A9

Fruth Ch 7 sections 4, 5

10 10/28

Exam 4: 10/28 in class PRACTICAL WEEK

M: Exam in class M: CTSOS due 10/28 W/R: Practical Exams

11-14 PTA 225 Clinical Education I

15 12/4 Wed 12/4: Clin Ed Review Thurs 12/5 lecture 9-12 (instead of lab): Cardiac Pathology & Rehab

Kisner & Colby Ch 7, Fruth Ch 7 section 6

16 12/9 Exam 5: 12/12 in class

Chest PT Possible Guest Lecture:

C3, C8, C10, C17, C18, P10, P13, P20, A1, A3, A4, A6, A8

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Lymphedema 12/12: Exam 5 in class

Documents

Syllabus - Mercer County Community College