Mercer County Community College

Mercer County Community College

Physical Therapist Assistant Program

Course Handbook

PTA 106 Therapeutic Measurement

Summer 2012

SUMMER 2012 OFFICE HOURS:

Tuesdays and Thursdays: 11:15 – 12:15 (MS 352)

Tuesdays and Thursdays: 2:30 – 3:00 (MS 352)

Tuesdays and Thursdays 3:00 – 4:00 (MS 157)

Mondays by appointment

Holly Beinert, PT, MPT

Course Director

MS 157

[email protected]

609-570-3478

Barbara Behrens

Course Coordinator

Course Syllabus:

Course #: PTA 106

Course Title: Therapeutic Measurement

Credit Hours: 1

Contact Hours in Semester: 0/2

Number of weeks: 6

Number of Clinical weeks: 00

Clinical Contact Hours: 00

Pre-requisite Course(s): PTA 101 Introduction to PTA PTA 105 Kinesiology

Co-requisite Course(s): PTA 112 Pathology

Course Grading: % of grade Activity Number within course

30 Written Exams 2

15 Quizzes** 8

NA Article Reviews 0

NA Papers 0

NA Presentation(s) 0

20 Class/Lab Participation Continuous

25 Practical Exam 1

10 Competency Tests** 4

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

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CLASS/LAB PARTICIPATION

Your class participation grade is worth 20% of your course grade and is based upon possible total of 100 points. It is

determined for this course is based upon the following:

_____ Attendance (absence and lateness) (20%)

Everyone is expected to be on time and present for all class activities.

_____ “Lab” participation and enhancing class discussions (40%)

Depending upon what is covered in class, opportunities for demonstrations or “lab” activities will arise. Your participation

in these activities is a required component of the class. All class discussions are intended to spark dialogue. This includes

active participation with the asking of appropriate questions, the addition of pertinent material brought in to share to

enrich the discussion. However; inappropriate disruptions caused by learners during class time for whatever reason will

result in point deductions.

_____ Preparedness (40%)

1. It is expected that all materials that have been outlined in the course handbook have been read prior to the class

meeting time.

2. You are responsible for filling out all “blanks” in the Goniometry PowerPoint Handouts located in your Lab Manual

PRIOR TO the applicable class. This starts week 3.

3. For all lab classes (and clinical affiliations), fingernails must not extend past the tips of the fingers, hair must be pulled

back, clavicles must be covered, closed toed shoes must be worn, and appropriate clothing to expose the joints being

measured.

PTAP Policy: COURSE GRADING

One of the goals of the MCCC PTAP is to prepare students 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 75 or higher.

A 93-100 B+ 87-89 C+ 77-79 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.

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TEXT(S): Required:

Norkin, Cynthia C. & White, D. Joyce. Measurement of Joint Motion: A Guide to Goniometry, 3rd ed. 2003. F.A. Davis Company. Philadelphia, PA. ISBN: 0-8036-0972-8

Hislop, Helen J. & Montgomery, Jacqueline. Daniels and Worthingham’s Muscle Testing: Techniques of Manual Examination, 8th ed. 2007. Saunders Elsevier. St. Louis, MO. ISBN-13: 978-1-4160-2350-0

Recommended:

Biel A, Trail Guide to the Body 3rd ed., Books of Discovery Publishers, Boulder CO, 2005. ISBN 0-9658534-5-4 Santé Learning Systems, & Books of Discovery. Trail Guide to the Body DVD. Books of Discovery, Boulder, CO, 2008. ISBN: 978-0-9777006-7-7

**Discuss checking the program website before selling books back**

COURSE DESCRIPTION:

This course is restricted to students of the Physical Therapist Assistant program, ONLY. It is a required course for PTA majors. This laboratory course is designed to develop measurement skills for joint range of motion (ROM) and muscle strength for all of the peripheral joints. Course material will also develop student skills for volumetric, circumferential and posture assessments, and documentation skills. Students/learners will be performing manual muscle tests (MMTs) and ROM measurements utilizing a goniometer. Students/learners will be tested for competence to perform the assessments on their classmates.

COURSE GOALS:

Following the successful completion of this course with a grade of C+ or higher, the learner will be able to: 1. Observe the available range of motion in a specified joint of a classmate and verbally report whether or

not the motion looks like it is within normal limits, functional limits or is limited and then objectively measure the motion with a goniometer and document the range of motion.

2. Observe the size of a peripheral extremity and compare it with the opposite extremity and assess whether

or not there is a size differential in girth and length and then objectively measure the area to determine whether or not there is a difference.

3. Manually assess the strength of a peripheral muscle group against gravity and in gravity eliminated

positions to determine how much muscle strength is present in the prime movers for that muscle group and whether or not the test position needs to be changed.

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COURSE OBJECTIVES: Cognitive/Knowledge The student/learner will be able to successfully:

1. identify synergistic muscle groups that initiate and continue motion for the peripheral joints 2. differentiate between gravity assisted, gravity resisted and gravity eliminated testing positions for

MMT 3. identify muscles that will try to substitute for weak muscles to maintain or perform a specified motion 4. differentiate between the advantages & disadvantages of various measurement techniques for

strength, ROM and extremity size or volume 5. identify the components of measurements that need to be documented in a patient chart 6. recognize normal and abnormal joint movement, as well as commonly accepted “normal” values 7. describe the difference between active ROM, passive ROM, and active assisted ROM 8. describe the normal end feel during joint ROM for a specific joint 9. differentiate between the various muscle grades using “5/5” and “trace-normal” terminology 10. identify which anatomical plane each motion of the peripheral joints occur within 11. identify alignment of the fulcrum, stationary arm and moving arm of a goniometer using bony

landmarks for all motions of the peripheral joints 12. identify proper stabilization, clinician hand placement, and patient instruction for all motions of the

peripheral joints 13. identify recommended (standard) patient positions for all motions of the peripheral joints for both

goniometry and manual muscle testing Psychomotor The student/learner will be able to successfully:

1. perform manual muscle tests for all grades for the prime movers 2. perform goniometric measurement of joint range of motion for all peripheral joints 3. perform a volumetric measurement for the hand and foot/ankle 4. perform circumferential measurements for an upper extremity 5. perform a postural assessment for a seated and standing patient 6. document objective measurements in the patient chart 7. recognize normal and abnormal muscle length

Affective The student/learner will be able to successfully:

1. defend the importance of licensed clinicians performing and documenting ROM, MMT and volumetric measurements in the patient record

2. recognize the importance of explaining measurements in a manner that the patient can understand 3. defend the inclusion of objective measurements in a patient record 4. recognize the importance of using measurement techniques that are considered both reliable and valid

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COURSE OUTLINE:

I. Posture

II. Bony Landmarks

III. Measurement Tools

IV. Edema

V. Introduction to Goniometry

VI. Introduction to MMT

VII. Cervical

VIII. Thoracic & Lumbar

IX. Shoulder

X. Elbow

XI. Wrist

XII. Hip

XIII. Knee

XIV. Ankle

XV. Hand & Foot

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 is intended

to be used for educational purposes only. Under NO circumstances, should this data be identified with a

particular 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

record of PT visits physical therapy documentation

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 their 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 students 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 MCCC staff who elect to be “patients”.

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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. Tops must cover the clavicles.

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. 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 student/learners

and the PTA faculty members. 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.

What is a competency test?

A 30 minute “appointment” made by the student/learner with a clinician tester

An opportunity for the student/learner to demonstrate their skill level by performing the identified

procedures on a fellow classmate in the presence of a tester

A method for the competency tester to assure competence, safety, and skill level for a specific procedure

or technique

Competency Tests are Composed of:

Course #

Course Title

Title of the Test

Objectives for the test, which include

o Preparation of the patient and the treatment area

o Observation of the indications, contraindications & precautions

o Implementation of the procedure or technique

o Termination or completion of the technique or procedure

o Documentation of what was observed, performed, and/or measured, as well as pre/post

assessments

o Questions

Clinical or medical complications and the impact that they might have on the procedure

or technique performed (“what if” questions)

How do student/learners “sign up” for Competency Tests?

A binder labeled “PTAP Competency Testing” is located on the counter inside MS352. The notebook

has a calendar of available testing times for student/learners to choose from. A lottery system may be

utilized to ensure fairness during the sign up process

How to student/learners prove that they have been tested and are “competent” to perform a particular

task?

* Student/learners have a “Sign Off Sheet” that they are responsible for having their clinician tester sign once

the objectives for the test have been satisfied

* Once the “Sign Off Sheet” is complete for a given course, the student/learner returns the form to the PTA

course director.

* All tests for a given course must be completed and the “Sign Off Sheet” must be turned in to the course

director to establish eligibility to take the practical exam for the course.

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Where would a student/learner find information about competency tests for a particular course?

* Course Handbooks have a copy of the requirements for the course

* A listing of the competency tests and their content can be found in the “PTAP Competency Testing” binder

located on the counter in MS352.

*In PTA 106, the student/learner is capable of retaking the competency test up to 2 times as they need

to however, if more than 2 attempts are needed, then the student/learner must notify the course director before

continuing.

For PTA 106, PTA 210, PTA 211, PTA213 & PTA 216:

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.

If a second attempt is required to successfully complete a competency test,

5 points will be deducted from the 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 any one competency test.

If a third attempt is required to successfully complete a competency test,

10 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.

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.

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

During a competency test:

o The tester interacts freely with the student/learner being tested.

o The student/learner may ask for clarification from the tester.

o The student/learner must submit their documentation the day 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.

During a practical exam:

o The tester does not interact with the student/learner, they take notes.

o The tester provides no additional information to the student/learner being tested.

o 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:

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

all student/learners are expected to be the “patient” for a fellow student/learner during each competency test.

Student/learners are expected to arrive 30 minutes early to be the “patient” for the student/learner scheduled

before them. All “patients” should be dressed in a manner that allows the technique to be performed

unrestricted by jewelry or extraneous clothing

preparing and cleaning up the appropriate treatment environment

having the competency tester sign off that he or she performed the test in a safe and competent manner

When you are testing, you will be expected to wash your hands properly, introduce yourself to the patient

correctly, and to demonstrate the skill that you have been assigned.

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Competency Tests

Testing Tools and Girth Measurements

Objectives-

The student/learner will successfully be able to demonstrate competence in the following skills:

descriptions for each of the listed measurement or testing tools

goniometer

tape measure

volumeter

differentiate between the uses for different sizes of goniometers

describe the purpose of a volumetric assessment for edema

contrast and compare a tape measure with a volumeter for edema assessment

demonstrate documentation of measurements taken with a goniometer, a tape measure and a volumeter

Cervical & Trunk Measurement

Objectives-


measurement and documentation of cervical and/or trunk ROM flexion/extension, L & R rotation and lateral flexion utilizing

either a tape measure or a goniometer

differentiate between the advantages and disadvantages of the goniometer versus the tape measure

assessment and documentation of Manual Muscle Tests (MMT) for cervical musculature, abdominals and erector spinae

The student/learner will also be prepared to answer questions regarding any of the following:

Anatomical planes in which the motion is occurring

The prime movers responsible for the motion

Positioning: gravity assisted, against gravity, gravity eliminated

Normal ROM values according to the American Academy of Orthopedic Surgeons

Identify the type of contraction that is occurring (concentric, eccentric, isometric)

Indentify the type of motion that is occurring (AROM, PROM, AAROM)

Upper Extremity Measurement

Objectives-


measurement and documentation of the tester’s choice of shoulder, elbow, forearm, and/or wrist ROM (within 50 of the tester)

assessment and documentation of Manual Muscle Tests (MMT) for grades of fair, good and normal for the tester’s choice of:

1. shoulder ABD

2. shoulder extension and flexion

3. shoulder internal and external rotation

4. elbow extension and flexion

5. forearm pronation and supination

6. wrist extension and flexion

7. wrist radial and ulnar deviation








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Lower Extremity Measurement

Objectives-


measurement and documentation of the tester’s choice of hip, knee, and/or ankle ROM (within 50 of the tester)

assessment and documentation of Manual Muscle Tests (MMT) for grades of poor, fair, good and normal for the tester’s

choice of:

1. hip extension, flexion and abduction

2. hip adduction, internal and external rotation

3. knee extension and flexion

4. ankle dorsiflexion and plantar flexion

5. ankle inversion and eversion








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Summer 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.

Your first arrival to the lab CLINICIANS:

Enter the room 10 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 five 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 10 minutes prior to your scheduled time.

Enter the lab 5 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.

5 minute Preparation CLINICIANS:

After you select your patient problem, take 5 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:

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 30 minutes to perform your skill, clean up the treatment area, and document the session. 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.

mailto:[email protected]

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Mercer County Community College 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 __5___* 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 __30___* 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 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,

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


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 from Mercer County Community College 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 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. history 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 history in waiting area or pushing pt. to Rx area, or not permitting able pt. to perform tasks (one of these) not allowing the pt. to perform transfers 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


as above but the initial position may need to be changed resulting in more than one position change

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

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

2 2 2 Unsafe the SPTA repeatedly had the pt change position and failed to guard the changes



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 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 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:

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7. 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 Equivalent to: Observations


The SPTA used SOAP note format, was accurate, documented the side, # sets, # reps, Rx, pt. comments, outcome etc. and signed leaving no blank spaces


as in “10” but the side, # of reps, etc. OR professional designation may have been left out. (only one omission)

8 8 8 Nervous but safe there was more than one omission of information OR the measurements were not in agreement with the tester

7 7 7 Inappropriate Parameters for the application of a modality or exercises were left out of the documentation

6 6 6 Unsafe an adverse response to the application of a treatment intervention was left out of the documentation

5 5 5 Fraudulent something was documented that was not done during the treatment session



The documentation was unsigned

Comment: 8. to see that the documentation is meaningful and accurate, using correct abbreviations, spelling, and

documentation format in black ink Scores



All activities were documented in the appropriate format with appropriate abbreviations and the note was legible, signed and neat in black ink


As above but something could have been improved upon and would be with experience S: too lengthy or not quoted when it should be, etc.

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

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 within the correct area of the SOAP note etc.

6 6 6 Unsafe N/A

5 5 5 Fraudulent Statement of test results that did not take place


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


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



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

17

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 4/11 rev

18

Exam Error Analysis Course: Exam: Date: Error Type

Misread the

question

Didn’t read the question

Didn’t know the information

Didn’t read all the choices

Changed my answer

Just answered it in correctly

Place a checkmark for each time you:

Total for this exam Course: Exam: Date: Error Type

Misread the

question

Didn’t read the question

Didn’t know the information

Didn’t read all the choices

Changed my answer

Just answered it in correctly

Place a checkmark for each time you:

Total for this exam

Schedule of Competency Tests (Week of _):

Week 2 (5/29) Tools and Girth Measurements

Week 3 (6/5) Cervical Spine and Trunk measurements

Week 4 (6/12) Upper Extremity measurement

Week 5 (6/19) Lower Extremity measurement

QUIZZES: You will have a quiz prior to every class from day 2 (Thursday, May 24) to day 10

(Wednesday, June 26). These quizzes will not take up class time. It is the student/learner’s

responsibility to arrive up to 15 minutes early to take each quiz.

EXAMS: Exams will be given in the testing center.

19

Mercer County Community College

Physical Therapist Assistant Program

PTA 106 Therapeutic Measurement

Summer 2012

Week Date Topic(s) Objective(s) Required

Reading

1 5/22 Postural Assessment

Bony Landmarks

P5, A1, A2, A3 Read Norkin

Chapters 1 & 2

before Thurs

5/24

1 5/24 Measurement Tools

Edema

C4, P3, P4, A1, A2,

A3

Read Hislop

Chapter 1 before

Tues 5/29

2 5/29 Goniometry

Goniometry Procedures

Intro to MMT

Start cervical ROM

C2, C4, C7, C8, A1,

A2, A3

Reading Norkin

chp 1 & 2,

Hislop chp 1 a

second time, is a

good idea

2 5/31 Cervical & Trunk ROM

Cervical & Trunk MMT

C1, C2, C3, C6, C8,

P1, P2, P6, P7, A1,

A2, A3

Read

corresponding

chapters in both

Norkin &

Hislop, filling in

the blanks in

your lab manual

PRIOR to

covering that

material in class.

Exam #1 in Testing Center Tuesday 6/5 – Thursday 6/7

3 6/5 Shoulder ROM & MMT

Elbow ROM

C1, C3, C6, C8, P2,

P6, p&, A1, A2, A3

3 6/7 Elbow MMT

Wrist ROM & MMT

Hip ROM

C1, C2, C3, C6, P1,

P6, A1, A2, A3

4 6/12 Hip MMT

Knee ROM & MMT

C1, C2, C3, C6, C8,

P1, P2, P6, P7, A1,

A2, A3

4 6/14 Ankle ROM & MMT

Hand/Foot ROM

Review ROM entire body

C1, C2, C3, C6, C8,

P1, P2, P6, P7, A1,

A2, A3

5 6/19 Hand/Foot MMT

Review MMT entire body

C1, C2, C3, C6, P1,

P6, A1, A2, A3

5 6/21

Exam #2 in Testing Center Monday 6/25 – Wednesday 6/27

6 6/26 Practical Preparation

Comp Tester Feedback

Course Feedback

C1, C2, C3, C6, C8,

P1, P2, P6, P7, A1,

A2, A3

6 6/28 Practical Examinations

Documents

Mercer County Community College