REHABILIATION ASSISTANTS PROGRAM (OTA and PTA) TA2710 ... · 2 4 Exceeds Expectations this specific practice setting. Thus the student is able to work independently and Exceeds expectations

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PERSONAL FO TIO

Student Name: Student Number:

Placement Site: Placement Dates:

Type of Rotation:

REHABILIATION ASSISTANTS PROGRAM (OTA and PTA)

TA2710 CLINICAL PLACEMENT III FOR

THE REHAB ASSISTANT (OTA & PTA) Evaluation Form

Lucy Miller B.Sc. OT(c), M.Ed. and Frank Knox B.Sc. PT, FCAMT

Rehabilitation Assistants Program, College of the North Atlantic

P.O. Box 1693, St. John’s, Newfoundland, CANADA A1C 5P7

Phone: 1.709.758.7683 Fax: 1.709.758.7634

Email: [email protected] / [email protected]

COMMENTS

INSTRUCTIONS

Students should retain a copy of the completed from.

Return this form to the instructor(s) above via mail, email or fax.

TO BE COMPLETED BY THE PLACEMENT SITE

Contact Name:

Supervising Therapist Name: Supervising Therapist Role: OT ___ PT ___

Supervising Assistant Name: Supervising Assistant Role: OTA ___ PTA ___ RA ___

Final Grade: Pass _________ Fail _________

# Hours Missed:

Reason(s) for Absences/Missed Hours:

Were missed hours worked in? (Y/N):

mailto:[email protected]

mailto:[email protected]

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4 Exceeds

Expectations

Exceeds expectations as an entry level Rehab Assistant (RA). Student requires minimal supervision to perform this competency/skill following instruction within this specific practice setting. Thus the student is able to work independently and requires infrequent assistance and guidance to perform his/her assigned tasks.

3 Meets

Expectations

Consistently meets expectations of an entry level RA. Student carries out competency/skill following instruction and with moderate supervision by the RA/OT/PT The student requires occasional assistance and guidance to perform his/her assigned tasks.

2 Working Towards

Inconsistent in meeting expectations of an entry level RA. Student requires assistance and guidance to perform competency/skill. Note if due to lack of ability or lack of experience/practice.

1 Unsatisfactory

Difficulty meeting expectations of an entry level RA. Requires direct supervision to perform competency/skill safely.

N/A Not

Applicable

This competency/skill does not relate to this level of student or to this placement.

OBS Observed

Only

Student experience with this competency/skill was entirely observational. No opportunity for hands on experience.

CLINICAL PLACEMENT COMPETENCY EVALUATION FORM

Rating Scale Definitions

NOTE: Students must achieve a minimum of 3 on all relevant competencies by the final evaluation, in this

clinical placement.

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1.0 PROFESSIONAL BEHAVOIUR MID-TERM FINAL

RATING COMMENTS RATING COMMENTS

1.1 Reliable (punctual, notification of lateness or absences)

1.2 Appearance/Hygiene (cleanliness, appropriate professional attire)

1.3 Time-Management (meets deadlines, utilizes time appropriately)

1.4 Accountability (follows directions, seeks appropriate direction, accepts and responds appropriately to limits of the assistants role)

1.5 Accepts and profits from constructive feedback

1.6 Participates in professional development/continuing education

1.7 Accepts and responds appropriately to limits of assistants' role/scope of practice.

1.8 Employs conflict resolution strategies

1.9 Employs organization and stress management strategies

1.10 Assists OT/PT/RA with volunteers and students

1.11 Demonstrates ethical and legal behavior (Code of Ethics PT/OT Acts, workplace policies)

1.12 Participates appropriately on teams.

COMMENTS:

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2.0 PROFESSIONAL ATTITUDE MID-TERM FINAL


2.1 Establishes and maintains therapeutic rapport

2.2 Demonstrates client centeredness

2.3 Demonstrates empathy and respect

2.4 Ensures confidentiality and dignity

2.5 Displays enthusiasm (interest in work environment, interactive)

2.6 Demonstrates initiative (uses spare time wisely, organizes/schedules time appropriately)

2.7 Demonstrates problem solving (uses available resources)

2.8 Establishes and maintains effective working relationships with staff, clients, and their families.

COMMENTS:

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3.0 COMMUNICATION MID-TERM FINAL


3.1 Verbal (appears confident in interactions, appropriate self-disclosure, language appropriate to listener). Provides appropriate directions/explanations.

3.2 Non-verbal (effective listening, eye contact, appropriate body language)

3.3 Documentation. This includes:

a. Proper use and understanding of the appropriate format of note writing for facility

b. Documentation of observations

c. Documentation of specified objective measures

d. Documentation of the treatment provided

3.4 Therapeutic terminology (comprehends and utilizes appropriate terminology)

3.5 Observation/Reporting Skills (observes and reports changes in physical, functional, behavioral status. Gives verbal and written observations in concise fashion)

3.6 Provides clients with constructive feedback, adapts communications to meet needs.

3.7 Uses presentation skills effectively in presentations to other staff, clients and families

3.8 Demonstrates group leadership skills (encourages participation, deals with disruptions/distractions, facilitates individual expression)

COMMENTS:

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4.0 SAFETY

MID-TERM FINAL


4.1 Demonstrates safety in all client interactions (handling, positioning, set-up)

4.2 Recognizes and responds to clients stress reactions (patient safety factors/precautions, contraindications)

4.3 Demonstrates safe body mechanics (lifting, transferring, and use of equipment)

4.4 Demonstrates use of universal precaution and infection control. This includes:

a. Proper hand-washing technique

b. Proper donning/removing of gloves, masks, gowns

c. Initiates proper precautions when treating patients utilizing standard, droplet, airborne, and/or contact precautions

4.5 Demonstrates knowledge of emergency procedures (i.e. crisis intervention responding appropriately to ensure self and patient safety)

4.6 Demonstrates knowledge of health and safety policies (i.e. WHMIS)

4.7 Demonstrates knowledge of safe use, storage and maintenance of equipment

4.8 Maintains safe work environment (storage, cleanliness)

COMMENTS:

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5.0 PROGRAM SUPPORT

MID-TERM FINAL


5.1 Participates in meetings & committees

5.2 Performs clerical tasks

5.3 Performs reception functions

5.4 Maintains workload measurement data (patient and non-patient care statistics)

5.5 Organizes & maintains physical resources to ensure safety & efficiency (supply & equipment: cleanup, storage, ordering, maintenance, maintains inventory/supply levels, maintains loans/rentals)

5.6 Uses computers and technology

COMMENTS:

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6.0 THERAPEUTIC INTERVENTIONS

6.1 GENERAL MID-TERM FINAL


6.1.1 Provides assistance with patient pre and post treatment. This includes:

a. Assistance of therapist with patient assessment

b. Obtaining consent/agreement from patient.

c. Ensuring patient privacy and dignity

d. Transferring patient onto treatment surface

e. Assistance with undressing/dressing patient

f. Assistance with application and removal of orthotic and prosthetic devices

g. Assistance with application and removal of bandages/dressings

h. Positioning of patient for comfort and treatment

6.1.2 Practices using background knowledge (i.e. disabling conditions, anatomy, communication disorders, psychiatric disorders)

6.1.3 Performs preparatory activities for intervention. This includes:

a. Obtaining and placement of equipment

b. Proper set up of equipment (including modalities)

c. Ensuring treatment area is free of any potential risks and hazards

d. Preparation and changing of linens

e. Returning equipment and supplies after use

6.1.4 Portering:

a. Portering patients to and from treatment area

b. Portering equipment to and from treatment area

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6.1 GENERAL MID-TERM FINAL


6.1.5 Participates in assessment & ongoing evaluation of individuals & groups

6.1.6 Conducts intervention components with individuals

6.1.7 Assists in therapeutic group activities (plan, facilitate, co-lead, lead)

6.1.8 Positions patients to optimize treatment, function and comfort. This includes:

a. Demonstration of knowledge of normal body alignment

b. Recognition of deviations from the normal

c. Application of principles of positioning

d. Modification of treatment positions to ensure patient comfort.

e. Proper positioning of patients with low or high tone to prevent skin breakdown (i.e. Amputees, joint pain/swelling).

COMMENTS:

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6.2 OTA and PTA MID-TERM FINAL


6.2.1 Performs and facilitates performance of therapeutic exercises as assigned by therapist (ROM, strength, dexterity, sensory integration)

6.2.2 Monitors patient status during intervention. This includes:

a. Measurement and recording of vital signs (i.e. BP, HR, and RR)

b. Recognition of the cardinal signs of distress

c. Indicates proper treatment protocols when patient in distress

d. Observation and reporting of patient’s response to treatment e) Performance of objective measures as specified by the therapist

6.2.3 Performs and teaches clients & care-givers safe transfers (pivot, sliding board, and mechanical lift), mobility and positioning strategies.

6.2.4 Demonstrates safe operation & management of wheelchairs and other mobility devices. This includes:

a. Demonstration of knowledge of components of wheeled chairs and other mobility devices.

b. Ability to transfer patient into and out of the chair ensuring patient safety

c. Ability to position patient properly in the chair

d. Instruction to patient on using chairs properly and safely

6.2.5 Communicates client performance to supervising therapist

COMMENTS:

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6.3 OTA MID-TERM FINAL


6.3.1 Practices using occupational therapy philosophy, beliefs and models for service

6.3.2 Uses techniques to maximize occupational performance (enablement; autonomy, empowerment; rapport, trust and empathy)

6.3.3 Demonstrates understanding & the use of occupational analysis/activity analysis (physical, cognitive, psychosocial demands; grading and sequencing; and modifications of tasks). This includes:

Assigned programs, client abilities and limitations

Instruction/guidance in: upper extremity programs; ADL tasks; cognitive activities

Observes, monitors and assists OT in selection and grading

6.3.4 Provides interventions in occupational performance areas (instructs, assists, monitors performance in self- care, productivity & leisure). This includes teaching:

Use, parts and maintenance of wheeled mobility devices

Use of adaptive self-care devices

Meal preparation and use of adaptive mealtime equipment

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6.3 OTA MID-TERM FINAL


6.3.5 Demonstrates effective use of and instructs in the use of: assistive devices; compensatory techniques; adaptation and adjustment for:

Cooking, dressing,transfers, self-care,adaptive clothing

Manages supplies andequipment and inventoryrecords

6.3.6 Fabricates adaptive equipment as assigned by therapist:

Proficiency in use ofsewing machine

Adapts clients personalitems (ie. clothing and self-care tools)

Fabrication of slings legstraps etc,

COMMENTS:

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6.4 PTA MID-TERM FINAL


6.4.1 Measures, fits, & trains patients in the use of gait aids. This includes:

a. Demonstration ofknowledge of the varioustypes of weight bearingand gait patterns

b. Adjustment of gait aid tothe height and size of thepatient

c. Instruction anddemonstration of theproper use of the gait aidto the patient

d. Instruction anddemonstration of how tomaneuver around barriersand obstacles (i.e. stairs,curbs, etc.)

e. Instruction &demonstration of properways to fall and rise fromfalling while using the gaitaid

6.4.2 Performs & coaches therapeutic exercises. This includes:

a. Instruction of patient inexercise program

b. Demonstrates hands-onskills in exercise programs

c. Supervision of patientsduring exercise programs

d. Motivation &encouragement of patientsto perform exerciseprogram

e. Demonstration of theunderstanding of thepurpose of the exerciseprogram

f. Proper progression ofexercise program underthe direction of the PT

g. Correction of faultyperformance or technique

h. Conducting grouptherapeutic exerciseclasses

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6.4.3 Applies and administers physical modalities, i.e. superficial heat and cold, to patients appropriately. This includes:

a. Demonstration of an understanding of the indications of the treatment.

b. Demonstration of an understanding of the contraindications and precautions associated with the treatment

c. Positioning patient in a comfortable position while exposing and inspecting the area to be treated

d. Preparation of the equipment and modality

e. Explanation to the patient concerning the treatment and what is to be expected in terms of sensation and response

f. Timing and monitoring of treatment and patient to ensure patient safety and comfort

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6.4.4 Applies and administers select electrical modalities, i.e. TENS and muscle stimulation, to patients appropriately. This includes:

a. Demonstration of anunderstanding of theindications for treatment

b. Demonstration of anunderstanding of thecontraindications andprecautions associatedwith treatment

c. Positioning of patient in acomfortable position whileexposing and inspectingthe area to be treated

d. Preparation of modality,electrodes, leads, gel, etc.for treatment

e. Inspection of modality toensure that it isfunctioning properly

f. Ensures treatmentparameters are thosewhich have beenprescribed by thephysiotherapist

g. Application of modality tothe patient

h. with the electrodes in theposition as indicated bythe physiotherapist

i. Explanation to the patientof the purpose of themodality and what is to beexpected in terms ofsensation and response

j. Timing and monitoring ofthe treatment and patientto ensure patient safetyand comfort

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6.4.5 Applies electrical modalities and mechanical traction apparatus to patients appropriately. This includes:

a. Portering of the modalityand/or patient to thetreatment area

b. Positioning of the patientin a comfortable positionwhile inspecting andexposing the area to betreated

c. Application of the modalityto the patient as indicatedby the physiotherapist

d. Informing thephysiotherapist that thepatient has been set up sothat the treatment can beinitiated

e. Timing and monitoring ofthe treatment and patientto ensure patient safetyand comfort

f. Removal of the treatmentmodality from the patientonce the treatment hasbeen completed

6.4.6 Applies electrical modalities and mechanical traction apparatus to patients appropriately. This includes:

a. Provision of manualsupport and cues duringactivities

b. Assistance and coaching ofpatients with bed mobilityactivities

c. Assistance and coaching ofpatients with transfers

d. Assistance and coaching ofpatients with ambulationactivities

COMMENTS:

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Was evaluated as follows:

FINAL RATING:

SUMMARY:

ONGOING STUDENT EVALUATION(To be completed by all evaluators at the end of Clinical Placement II and at midpoint and end of Clinical Placement III )

STUDENT:

EVALUATED BY EVALUATED ON

Evaluator’s Full Name/Title Initials Date Clinical Site

Strength’s Identified Evaluator’s Initials Date

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Student: (please check the appropriate box and sign)

I agree

I disagree with this evaluation

Student’s signature: ________________________________ Date: ________________

Skill’s Requiring Improvement Evaluator’s Initials Date

FINAL STUDENT EVALUATION(To be completed at the end of Clinical Placement III)

Upon final review and completion of the Clinical Placement Evaluation Form it is my professional opinion that this student

__________________________, _____ HAS ACHIEVED, or _____ HAS NOT ACHIEVED performance at an entry-level

RA standard in the required 70% of the skills listed. All skills marked “C” are critical and MUST ALL be passed.

Final grade achieved (circle one): PASS FAIL

Evaluator’s signature: _______________________ Title: _______________________ Date: _________

ONGOING STUDENT EVALUATION(To be completed by all evaluators at the end of Clinical Placement II)

Documents

REHABILIATION ASSISTANTS PROGRAM (OTA and PTA) TA2710 ... · 2 4 Exceeds Expectations this specific practice setting. Thus the student is able to work independently and Exceeds expectations