Health Occupation Education

Clinical Specialty Mentorship Module

Cluster:

Physical Therapy

Description

of Cluster:

Physical therapists provide services to patients/clients who have impairments, functional limitations, disabilities, or changes in physical function and health status resulting from injury, disease or other causes. Students will work under the direct supervision of a physical therapist or a physical therapist assistant to gain experience in the management of patients with conditions identified within the physical therapy practice patterns of: neuromuscular, musculoskeletal, cardiopulmonary and integumentary systems. Students my work in a variety of settings including hospital based, outpatient, home health, school based or rehabilitation to gain experience in the five elements of patient/client management: examination, evaluation, diagnosis, prognosis, and intervention.

Mentorship

Agreement:

Domains:

I. Technical/Clinical Knowledge

II. Cultural Awareness

III. Analytical/Decision-Making Skills

IV. Interpersonal/Communication Skills

Domain I:	Technical/Clinical Knowledge
Prerequisite Knowledge and Skills		References and Resources
Information covered in Unit L		Textbook Chap
Physical therapy Lecture and Demonstrations: ROM, Transfers, Manual Muscle Testing , Reflexes, Sensation, Posture, Balance, Vital Signs, Integumentary Evaluation and Treatment		CD-ROM WebSites: : www.nismat.org/orthocor/exam/mmt.html http://medstat.med.utah.edu/neurologicexam/ http://medicine.ucsd.edu/clinicalmed/vital.htm www.webhealer.com/WndWebPlain/indexPV.htm www.org/ptcor/ergo/index.html
Understanding SOAP notesà Basic medical terminology and knowledge of common abreviations		Handout

Domain I:

Technical/Clinical Knowledge

Prerequisite Knowledge and Skills

References and Resources

Take Cultural Diversity Quiz

Describe major cultural differences between Afro-American, Hispanic, Latino and European cultures as relates to health care

www.erc.msh.org/quality&culture

Domain III:	Analytical/Decision Making
Prerequisite Knowledge and Skills		References and Resources
Case Studies

Domain IV:	Interpersonal/Communication Skills
Prerequisite Knowledge and Skills		References and Resources

Domain I: Technical /Clinical Knowledge
OBJECTIVES	STUDENT ACTIVITIES	EVALUATION METHODS	References and Resources
Competency: Range of Motion
Demonstrate passive range of motion for all four extremities and identify limitations	View ROM links Observe ROM of extremities on a peer Readings from Health Occupations Text	Evaluated by teacher or clinical mentor	Websites: www.tlbrooks.com/rom.htm Health Occupations Text:

Identify normal ranges of active and passive goniometric measurement for a specified joint	View ROM reference links Observe goniometric measurement by a PT	Self Study Quiz	http://www.lhup.edu/~yingram/jennifer/webpage/homepage2.htm

Competency: Muscle Strength
Observe active range of motion in a patient and describe its relationship to general gross muscle strength.	View reference links Observe AROM by a PT	Self Study Quiz	http://medstat.med.utah.edu/neurologicexam/ (motor exam) www.nismat.org/orthocor/exam/mmt.html http://www.lhup.edu/~yingram/jennifer/webpage/homepage2.htm http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/dissector/mml/mmlregn.htm Text: Diversified Health Occupations 4^th ed Unit 13

Perform and grade muscle strength by manual muscle testing of a selected muscle group.	View reference links Watch a MMT performed by a PT discussing score	Evaluated by mentor Self Study Quiz	http://www.nismat.org/orthocor/exam/mmt.html

Discuss a functiional activity differentiating concentric, eccentric and isometric muscle contractions	View reference links Observe with clinician various muscle contractions utilized by client during functional activity	Evaluated by mentor Self Study Quiz	Types of muscle contraction http://academic.uofs.edu/faculty/kosmahle1/default.htm

Competency: Sensation
Observe sensation testing following dermatomal patterns	View reference links Review Dermatome Chart	Evaluated by mentor Self Study Quiz	http://medstat.med.utah.edu/neurologicexam/ (sensory exam) http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/learnem/dermat/main_der.htm http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/learnem/cutaneous/main_cut.htm http://academic.uofs.edu/department/pt/students/dermatom.htm

Discuss proprioceptive/kinesthetic testing as performed by the mentor	View related reference links Practice proprioceptive testing on a peer Observe proprioceptive testing videos	Explain results of testing to mentor Self Study Quiz	http://medstat.med.utah.edu/neurologicexam/ (sensory exam)

Competency: Reflexes
Recognize normal and abnormal reflexes; understand grades	Observe deep tendon reflexes (DTR’s) as performed by a mentor	Self study quiz Grade reflexes with mentor	http://medstat.med.utah.edu/neurologicexam/ (motor exam) Myotatic Stretch Reflex http://academic.uofs.edu/faculty/kosmahle1/default.htm http://nawrot.psych.ndsu.nodak.edu/Courses/Psych465.S.02/Movement/Reflex.html Biceps reflex http://academic.uofs.edu/department/pt/students/dermatom.htm brachioradialis reflex http://academic.uofs.edu/faculty/kosmahle1/courses/pt351/lect351/../lab351/reflx-c6.htm Triceps reflex http://academic.uofs.edu/faculty/kosmahle1/courses/pt351/lect351/../lab351/reflx-c7.htm Quadriceps reflex http://academic.uofs.edu/faculty/kosmahle1/courses/pt351/lect351/../lab351/reflx-l4.htm Gastro soleus reflex http://academic.uofs.edu/faculty/kosmahle1/courses/pt351/lect351/../lab351/reflx-s1.htm muscle stretch reflex testing http://academic.uofs.edu/faculty/kosmahle1/courses/pt351/lect351/../lab351/reflx-s1.htm

Competency: Posture/Body Mechanics
Analyze patient’s sitting and/or standing posture	View links regarding ergonomics Observe peer/patient postures	Provide written summary of postural deviations in patient or peer.	http://www.nismat.org/ptcor/ergo/index.html
Demonstrate correct posture/body mechanics during lifting	View related links; Observe peer/people in community performing daily activities	Demonstrating to or on mentor correct body mechanics during lifting

Competency: Balance
Observe mentor perform balance testing	View related links Practice balancing on one foot, tandem, eyes open eyes closed; on cushion or rocking surface	Self Test Quiz	Web Sites http://www.uclm.es/inabis2000/symposia/files/178/session.htm http://www.onbalance.com/index.cfm?action=prevalence http://www.uclm.es/inabis2000/symposia/files/178/session.htm http://www.onbalance.com/index.cfm?action=prevalence : www.vard.org/va/o2/htm/rvds_feb_2002confriol01.htm http://r-sports.hp.infoseek.co.jp/siryou/balance/dgi.doc http://physicaltherapy.about.com/c/ht/How_index.htm http://www.onbalance.com/index.cfm?action=elder Textbooks O’Sullivan S, Schmitz, T; Physical Rehabilitation Assessment and Treatment, Fourth Edition, Chp 8, F.A. Davis Company , Philadelphia 2001. Davies P, Steps to Follow, Second Edition, Chp 2, pps 43-44 Springer 2000. Shumway Cook A, Woolacott M; .Motor Control: Theory and Practical Applications. Baltimore, Williams and Wilkins, 2000.

Competency: Gait
Identify deviations of gait in observed client or video.	Observe pathological gait pattern in a client or video	Provide written paragraph describing two deviations for specific patient diagnosis seen in clinic or on video.	Web sites: http://www.frontiernet.net/~imaging/gait_model.html Simmers, L Diverse Health Occupations, Fourth Edition Unit 20:2, Delmar Publishers,1996. Umphred, Darcy, Neurological Rehabilitation, Third Edition, Chapter 28, Mosby Co. 1995

Competency: Thermal Modalities
Discuss the physiological rationale for the use of a modality on a particular patient observed in the clinic.	Observe patient treatment with thermal (hot/cold) modalities	Written within clinical log book	Website links in specialty module

Competency: Electrical Modalities
Discuss the physiological rationale for using electrotherapy modalities on a particular patient	Observe patient treatment with the use of electrotherapy modalities	Written within clinical log book	Website links in specialty module

Competency: Integumentary
.Describe conditions that can cause open wounds	Examine with mentor open wound assessment	Written in clinical log book/self study quiz	www.woundcarestrategies.com/consumer.htm http://www.worldwidewounds.com/1997/july/Thomas-Guide/Dress-Select.html http://www.medicaledu.com/ http://www.woundcare.org/

Provide the rational for observed treatment related to the promotion of healing	Observe treatment of open wound in the clinic or on line	Written in clinical log book/self study quiz

Competency: Cardiopulmonary
Examine and record heart rate and respirations and relate findings to normal values	Monitor a peer’s heart rate and respirations Review related links to cardiopulmonary testing	Log Book and self study quiz,	: http://medicine.ucsd.edu/clinicalmed/vital.htm Health Occupations Text:

Perform blood pressure measurement and relate findings to normal values	Assess blood pressure at rest and during exercise of a peer of family member	Log Book, self study quiz	: http://medicine.ucsd.edu/clinicalmed/vital.htm

Domain II: Cultural Awareness
Activities	Student Accomplishments	Evaluation Methods	References and Resources

Competency: Cultural Competence
Recognize the impact of cultural diversity on health care management and delivery	Observe evaluation and treatment of at least two patients from different culture backgrounds	Write in journal possible obstacles to effective physical therapy treatment for each patient from different cultural backgrounds	Web Site: Quality and Culture http://erc.msh.org/mainpage.cfm?file=1.0.htm&module=provider&language=English
	Interview patient/classmate from different ethnic/culture background	Document differences in ethnic/cultural background that can influence healthcare delivery

Competency: Cultural Awareness
	Describe the cultural/ethnic makeup of the town where your hospital/clinic is located	Write in journal the percentages of different ethnic/cultural groups in the city and surrounding area where your clinic is located	Web Site:

Domain III: Analytical/Decision-Making Skills
OBJECTIVES	STUDENT ACTIVITIES	Evaluation Methods	References and Resources
Competency: Case Scenario
Describe justification of a selected treatment protocal when given a specific case scenario	Review a patient case scenario and complete questions	Review documented case scenario answers with mentor	Web Sites: Total Hip Replacement: www.osteonics.com/howmedica/products/frames/prod2p2e.htm www.healthpages.org/AHP/LIBRARY/HLTHTOP/THR/INDEX.HTM

Present evidence based literature/research supporting treatment for specific diagnosis”	Discuss evidence based practice with clinician. Review related links/documents regarding evidence based practice.	Written summary of findings with listed references.

Domain IV: Interpersonal/Communication Skills
OBJECTIVES	STUDENT ACTIVITIES	Evaluation Methods	References and Resources
Competency: Medical History
Relate the importance and relevance of the subjective history to developing an appropriate clinical diagnosis and treatment	Observe a clinician take the subjective history of a client and document relevant findings	Written discussion in log book reviewed by mentor/clinician	Simmers, L Diverse Health Occupations, Fourth Edition Unit 5, Delmar Publishers,1996. Web Sites: http://www.nurseweek.com/ce/ce10a.html
Recognize realistic goals and expectations which can b e obtained through physical therapy services	Discuss with client their goals/expectations from therapy	Review and discuss goals with mentor (written/verbal) .

Competency: Communication with Health Related Professionals
Understand the roles of other members of the health care team (MD,PTA, OT, ST, RT, Orthotist/Prosthetist	Observe other members of the health care team. Attend meetings with other health professionsals. Review relevant information in text book and related references.	Provide mentor ( written or verbal) with information describing the role of another member of the health care team including relevant information regarding patients care and progression of services.	Interpersonal communication: http://www.hms.harvard.edu/ombuds/g_overview.htm

Competency: Documentation
Understand the utlization of documenting with the SOAP format	Review related links and references. Observe and review documentation of clinician	Write a SOAP note of a patient you observed and review note with mentor	Simmers, L Diverse Health Occupations, Fourth Edition Unit 5, Delmar Publishers,1996. Web Sites: http://www.nurseweek.com/ce/ce10a.html S.O.A.P. Note http://www.ah.ouhsc.edu/Rehab/courses/OCTH_PHTH7133/soap.htm http://www.ttuhsc.edu/SOM/FamMed/SPA/SOAP.htm

Competency:
Recognize the impact of non verbal communication of therapists and patients during a therapy session.	Observe communication between therapist and client.	Discuss importance of non-verbal communication with Mentor in regards to obtaining relevant information from the client as well as providing treatment. Provide mentor with at least two types of communication which are non-verbal .

Cluster:

References and Resources

1. Title of Publication

1.1 Specific Reference

1.2 Specific Reference

1.3 Specific Reference

2. Title of Publication

2.1

2.2

3. Website

4. etc.

Continued here

Unit L: Therapy and Sports Medicine

Principles of ambulatory assistance
Ambulating a patient who uses crutches
Ambulating a patient with a gait (transfer belt0

Modes of instruction:

Videos of therapist demonstrating correct fit and use of walker, cane, hemi-cane and crutches

Perform Range of Motion exercises

Mode of instruction:

Video of therapist demonstrating correct position and patient handling for PROM all four extremities

Websites: www.tlbrooks.com/rom.htm

Administer oxygen (Respiratory Therapy)
Administer heat/cold applications

Analyze the therapeutic role of massage therapy and sports medicine.

A. Role of Massage Therapist

B. Basic massage therapy techniques

Modes of instruction:

Videos of basic massage strokes.

Web Sites: http://www.meridianinstitute.com/eamt/files/kellogg/kelcont.html

C. Role of athletic trainer

D. Taping an ankle

Modes of instruction:

Videotape of ankle taping.

Web sites: www.nismat.org/traincor/ankle_tape.html

www.nata.org/downloads/publicrelations/NATAPRNonEdit.ppt

Unit O: Specialty in Physical Therapy

General;

American Physical Therapy Association

Web site: www.apta.org

Musculoskeletal

Range of Motion

Videotape of therapist explaining and demonstrating goniometry for shoulder, elbow, hip and knee

Website: http://www.lhup.edu/~yingram/jennifer/webpage/homepage2.htm

Manual Muscle Testing

Videotape of therapist exploring and demonstrating manual muscle testing, shoulder, elbow, hip and knee

Explain differences between isometric, concentric and eccentric muscle contractions

Web sites: www.nismat.org/orthocor/exam/mmt.html

http://www.lhup.edu/~yingram/jennifer/webpage/homepage2.htm

http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/dissector/mml/mmlregn.htm

Ergonomics

Web site: http://www.nismat.org/ptcor/ergo/

Neurological

Web sites: http://medstat.med.utah.edu/neurologicexam/

http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/learnem/dermat/main_der.htm

http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/learnem/cutaneous/main_cut.htm

http://nawrot.psych.ndsu.nodak.edu/Courses/Psych465.S.02/Movement/Reflex.html

Cardiopulmonary

Vital Signs: http://medicine.ucsd.edu/clinicalmed/vital.htm

Integumentary

Web sites:

www.woundcarestrategies.com/consumer.htm

http://www.worldwidewounds.com/1997/july/Thomas-Guide/Dress-Select.html

http://www.medicaledu.com/

http://www.woundcare.org/

Cultural Diversity

Web Site: http://erc.msh.org/mainpage.cfm?file=1.0.htm&module=provider&language=English&ggroup=&mgroup=

Interpersonal Communication Website:

http://www.hms.harvard.edu/ombuds/techniques/

Modalities Website:

http://www.healthyroads.com/mylibrary/data/ash_ref/htm/art_therapeuticmodalitieselectricalstimulation.asp

Case Studies

Web Sites: Total Hip Replacement: www.osteonics.com/howmedica/products/frames/prod2p2e.htm

www.healthpages.org/AHP/LIBRARY/HLTHTOP/THR/INDEX.HTM

Sensation

Davies P, Steps to Follow, Second Edition, Chp 4, pps 95-96 Springer 2000.

http://www.uclm.es/inabis2000/symposia/files/178/session.htm (pages 1-2)

www.academic.uofs/faculty/Kosmahlel/courses/pt351/reflex.htm

Gait

http://www.frontiernet.net/~imaging/gait_model.html

Simmers, L Diverse Health Occupations, Fourth Edition Unit 20:2, Delmar Publishers,1996.

Umphred, Darcy, Neurological Rehabilitation, Third Edition, Chapter 28, Mosby Co. 1995

Balance

Web Sites http://www.uclm.es/inabis2000/symposia/files/178/session.htm

http://www.onbalance.com/index.cfm?action=prevalence

: www.vard.org/va/o2/htm/rvds_feb_2002confriol01.htm

http://r-sports.hp.infoseek.co.jp/siryou/balance/dgi.doc

http://physicaltherapy.about.com/c/ht/How_index.htm

http://www.onbalance.com/index.cfm?action=elder

Textbooks

O’Sullivan S, Schmitz, T; Physical Rehabilitation Assessment and Treatment, Fourth Edition, Chp 8, F.A. Davis Company ,

Philadelphia 2001.

Davies P, Steps to Follow, Second Edition, Chp 2, pps 43-44 Springer 2000.

Shumway Cook A, Woolacott M.Motor Control: Theory and Practical Applications.

Baltimore Williams and Wilkins, 2000.

Transfers

Sliding board http://www.ortho.ohio-state.edu/patient_edu/index2_frameset.htm

Stand pivot http://www.ortho.ohio-state.edu/patient_edu/index2_frameset.htm

NWB transfer http://www.ortho.ohio-state.edu/patient_edu/index2_frameset.htm

Textbook

Minor M, Minor S, Patient Care Skills Fourth Edition, Cpt. 8, Appletion & Lange Stamford, CT 1999

Simmers, L Diverse Health Occupations, Fourth Edition Unit 19:2, Delmar Publishers,1996.

Videos

Documentation

Simmers, L Diverse Health Occupations, Fourth Edition Unit 5, Delmar Publishers,1996.

Web Sites: http://www.nurseweek.com/ce/ce10a.html

http://www.ah.ouhsc.edu/Rehab/courses/OCTH_PHTH7133/soap.htm

http://www.ttuhsc.edu/SOM/FamMed/SPA/SOAP.htm

Case Studies

Web Sites: Total Hip Replacement: