Mercer County Community Collegebehrensb/documents/PTA216OrthoinPTASpring2015.pdf · Mercer County...

Mercer County Community College

Physical Therapist Assistant Program

Course Handbook

PTA 216 Orthopedics in PTA Spring 2015

Danielle Liegl, PT, MPT, OCS

Course Instructor [email protected]

Barbara J. Behrens, PTA, MS Course Director

[email protected]

Course Syllabus Form

Course #: PTA 216

Course Title: Orthopedics in PTA Credit Hours:(Lecture/Lab) 1/1

Number of weeks: 10 Pre- requisite courses: PTA 106 Therapeutic Measurement

PTA 112 Pathology PTA 210 PTA Techniques

Required Text(s) Dutton M, (2012) Orthopaedics for the Physical Therapist Assistant, Jones & Bartlett, ISBN# 978-0-7637-9755-3

Cook C, Hegedus E, (2013) Orthopedic Physical Examination Tests, 2nd edition. Pearson. ISBN# 978-0-13-254478-8

Recommended Text(s)

Shankman G, (2004), Fundamental Orthopedic Management for the Physical Therapist Assistant, 2nd ed., Mosby.

ISBN# 978-0-323-02002-2

Jarmey,(2008), The Concise Book of Muscles, 2nd ed., Lotus. UK ISBN# 978-1-55643-719-9

Other learning resources

Primal Pictures Interactive Functional Anatomy Software www.primalpictures.com ISBN# 1-90247089-3 www.anatomy.tv

Trail Guide to the Body DVD, Books of Discovery ISBN# 978-0-9777006-7-7 A goniometer is required and additional handouts are provided by the instructor.

Course Description: A study of orthopedic conditions and their underlying pathology. Emphasis on physical therapy interventions utilized in the rehabilitation of specified conditions. Required course for all PTA majors.

mailto:[email protected]


http://www.primalpictures.com/

http://www.anatomy.tv/

TOPICAL COURSE OUTLINE: I. Professional Behaviors

II. The Cervical and Lumbar Spine III. The Lower Extremity IV. The Upper Extremity V. Management of Patients with Orthopedic Disorders

VI. Professional Literature and Orthopedic Conditions

Evaluation of student/learner progress:

% of grade Activity # per semester

45 Exams 3

10 Presentations 1

10 Generic Abilities Continuous

15 Competency Tests 3

20 Practical Exam 1

Generic Abilities Assessment Generic abilities include a collection of behaviors that in addition to knowledge and skills are considered

important for student/learners to be successful as future employees in the healthcare environment. Adapted from May, et. al. Journal of Physical Therapy Education, 9:1, Spring, 1995

10 pts Category Requirement

2.5 Commitment to Learning

Consistently attends the entirety of all classes and/or lab sessions and if unable to attend class, proactively assumes responsibility for learning by contacting the

course instructor via email to alert him/her of the absence or reason for early departure which would result in disruption of the learning for that day

2.5 Communication Skills

Is respectful to classmates, guest speakers, and faculty members in all forms of communication (verbal, non-verbal, written, email, etc.)

- uses correct grammar, accurate spelling and expression, writes legibly

2.5 Professionalism Comes to class prepared to start on time and if unable to start class/lab on time then proactively contacts the course instructor via email to alert him/her of the

lateness and finding out whatever work might need to be made up from a classmate

2.5 Responsibility Is aware of and accepts responsibility for his/her own work and progress within a course which includes awareness of the impact of assignment grades on

overall course grade Discusses confidential concerns with course instructor including but not limited

to grades having considered potential strategies for self-improvement

PTAP Policy: COURSE GRADING One of the goals of the MCCC PTAP is to prepare student/learners to ultimately practice as PTAs after

completing the PTA program. 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, which has a

normalized passing score above what Mercer uses as a passing score.

A 93-100 B 83-86 C 70-76

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

B+ 87-89 C+ 77-79

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.

Course Competencies/Goals: Following the successful completion of this course with a grade of C+ or higher, the student/learner will be able to:

1. Demonstrate continued development of professional behaviors in the classroom. 2. Integrate knowledge and clinical skills to develop effective manual skills for orthopedic conditions for

the purpose of screening, assessing patient progress or assisting the PT in the determination of whether or not further testing is required for the peripheral joints and/or spine.

3. Demonstrate the ability to access professional literature for continued development of knowledge and skills in the management of orthopedic conditions.

Course Objectives: Cognitive/Knowledge:

1. Describe normal and abnormal responses to orthopedic assessment screening tests for peripheral joints and/or cervical and lumbar spine

2. State the findings from orthopedic assessment screening tests for peripheral joints 3. State the findings from orthopedic assessment screening tests for the cervical and lumbar spine 4. Identify and describe orthopedic assessment screening tests for the peripheral joints and cervical and

lumbar spine 5. Describe the concepts behind various soft tissue techniques including: muscle releases, Passive Range

of Motion (PROM), joint distraction, open and closed packed joint positions, and muscle stretching techniques.

Psychomotor: 1. Demonstrate competence in the performance of documenting patient results as reported by the

evaluating PT from selected orthopedic assessment screening tests for peripheral joints 2. Demonstrate competence in the performance of documenting patient results as reported by the

evaluating PT from selected orthopedic assessment screening tests for the cervical and lumbar spine 3. Distinguish between normal and abnormal patient responses when observing or performing

orthopedic assessment screening tests for peripheral joints and/or the cervical and lumbar spine 4. Recognize when orthopedic assessment screening tests for peripheral joints and/or cervical and

lumbar spine should not be performed due to contraindications or a change in the patient’s status 5. Demonstrate competence in the performance of various soft tissue techniques including: muscle

releases, Passive Range of Motion (PROM), joint distraction, open and closed packed positions and muscle stretching techniques for selected muscles.

Affective:

1. Recognize when assessment results need to be verified, consulting with the physical therapist and current literature if appropriate

2. Accept responsibility for assessment skills and seek assistance from the physical therapist and guidance for continuing education courses for further development of these skills

3. Recognizes the importance of clinical affiliations where orthopedic assessment skills can be practiced and refined and seeks clinicals and employment for that purpose

Course-specific General Education Knowledge Goals and Core Skills. General Education Knowledge Goals Goal 1. Communication. Students will communicate effectively in both speech and writing. Goal 3. Science. Students will use the scientific method of inquiry, through the acquisition of scientific knowledge. Goal 9. Ethical Reasoning and Action. Students will understand ethical issues and situations.

MCCC Core Skills Goal A. Written and Oral Communication in English. Students will communicate effectively in speech and writing, and demonstrate proficiency in reading. Goal B. Critical Thinking and Problem-solving. Students will use critical thinking and problem solving skills in analyzing information. Goal C. Ethical Decision-Making. Students will recognize, analyze and assess ethical issues and situations. Goal D. Information Literacy. Students will recognize when information is needed and have the knowledge and skills to locate, evaluate, and effectively use information for college level work. Goal F. Collaboration and Cooperation. Students will develop the interpersonal skills required for effective performance in group situations. Goal G. Intra-Cultural and Inter-Cultural Responsibility. Students will demonstrate an awareness of the responsibilities of intelligent citizenship in a diverse and pluralistic society, and will demonstrate cultural, global, and environmental awareness.

Units of study in detail 1. Unit I Professional Behaviors

The student/learner will be able to… Demonstrate continued development of professional behaviors in the classroom.

1.1 Be responsible for having demonstrated professional behavior patterns which include, but are not limited to, adhering to designated times for each educational experience, following a dress code, being adequately prepared, participating in class discussions, following laboratory and safety rules and displaying appropriate interpersonal dynamics, and communication skills including an oral presentation. (Gen Ed Goals: 1, Core Skill Goals A,&G)

2. Unit II The Cervical and Lumbar Spine

The student/learner will be able to… Integrate knowledge and clinical skills to develop effective physical therapy interventions for the cervical and lumbar spine (Gen Ed Goals: 3, Core Skill Goals B, D & F)

2.1 Compare/contrast normal movement patterns of cervical and lumbar spine 2.2 Define scoliosis as either functional or non-functional. 2.3 Identify primary and secondary curves. 2.4 Compare and contrast kyphosis vs. lordosis as a pathological entity. 2.5 Deduce from a patient problem, likely structural abnormalities associated with scoliosis. 2.6 Discuss acute or chronic mechanical sprains and strains of the low back in terms of signs and symptoms. 2.7 Diagram anatomy of the intervertebral disk, changes with age and pathology at the disk level. 2.8 Differentiate between herniation and bulge. 2.9 Define spondylolisthesis as either stable or unstable and define a treatment approach for each. 2.10 Define and discuss various exercise approaches appropriate for spinal conditions in the cervical and

lumbar spines including but not limited to: degenerative disc disease, degenerative joint disease, fusions, sprains & strains, thoracic outlet syndrome, flexion versus extension, laminectomies, stenosis, surgical and non-surgical fractures, microdiscectomies, piriformis syndrome, and sacroiliac dysfunction.

2.11 Demonstrate the ability to correctly instruct an individual in exercise treatment for conditions of the spine within the plan of care established by the PT.

3. Unit III The Lower Extremity

The student/learner will be able to… Integrate knowledge and clinical skills to develop effective physical therapy interventions for the lower extremity. (Gen Ed Goals: 3, Core Skill Goals B, D & F)

3.1 Define the etiology, pathology, clinical picture, and treatment of the following lower extremity conditions of the hip including but not limited to: a) iliotibial band syndrome b) labral repair c) hip fracture d) resurfacing procedures

3.2 Define the etiology, pathology, clinical picture and treatment of the following lower extremity conditions of the knee including but not limited to surgical versus non-surgical options, standardized protocols for operative procedures involving: A) ligamentous injury of the knee B) osteochondritis dessicans C) dislocation of patella D) patello femoral syndrome/chondromalacia E) degenerative joint disease F) lateral release surgery G) tibial fracture H) meniscal lesions

3.3 Describe the etiology, pathology, clinical picture and treatment of the following lower extremity conditions including but not limited to surgical versus non-surgical options, standardized protocols for operative procedures involving ligamentous and other injuries of the foot and ankle for: (Gen Ed Goals: 3, Core Skill Goals B, D & F)

3.3.1 Plantar fasciitis 3.3.2 Achilles rupture 3.3.3 Compartment syndrome 3.3.4 Morton’s neuroma 3.3.5 Heel spur 3.3.6 Metatarsalgia 3.3.7 Deep vein thrombosis 3.3.8 Identify common deformities of the foot including: pes planus, hallux valgus, hammer toe, claw

toe, mallet toe, etc…

3.4 Demonstrate the ability to correctly instruct an individual in an exercise program for conditions of the lower extremity within the plan of care established by the PT.

4. Unit IV The Upper Extremity

The student/learner will be able to…

Integrate knowledge and clinical skills to develop effective physical therapy interventions for upper extremity conditions. (Gen Ed Goals: 3, Core Skill Goals B, D & F)

4.4 Describe shoulder pathology, etiology, clinical picture, and treatment of the following upper extremity conditions which may be surgical or non-surgical and involve specific protocols including but not limited to: a) Tendonitis (rotator cuff, supraspinatus, bicipital) b) bursitis

c) adhesive capsulitis i. surgical manipulation

d) rotator cuff tears e) shoulder/hand syndrome f) dislocations of the shoulder g) labral tears

i. Slap ii. Bankart

h) thoracic outlet syndrome i) impingement syndromes j) Proximal humeral fractures k) Distal clavicular resections l) Acromioplasties m) Bicipital tendon repairs n) Total Shoulder Replacement

4.5 Describe the etiology, pathology, clinical picture and treatment of the following upper extremity conditions which may be surgical or non-surgical and involve specific protocols including but not limited to:

a) lateral and medial epicondylitis b) myositis ossificans c) carpal tunnel syndrome d) microfracture surgery e) fractures

4.6 Demonstrate the ability to correctly instruct an individual in an exercise program for conditions of the upper extremity within the plan of care established by the PT.

5. Unit V Management of Patients with Orthopedic Disorders

The student will be able to…

Demonstrate ability to identify and perform effective interventions in the management of patients with orthopedic disorders. (Gen Ed Goals: 3, Core Skill Goals B, C, D & F)

5.1 Demonstrate the ability to integrate previous classroom and laboratory knowledge and skills (including but not limited to therapeutic exercise, data collection, transfers, gait training and documentation) to obtain proposed goals for patients with orthopedic disorders.

5.2 Demonstrate ability to assess patient’s response to treatment and identify appropriate treatment modifications within the plan of care.

5.3 Describe how the PTA assists the PT with discharge planning. 6. Unit VI Professional Literature and Orthopedic Conditions

The student will be able to… Demonstrate the ability to access professional literature for continued development of knowledge and skills in the management of orthopedic conditions. (Gen Ed Goals: 1, 3 &9 Core Skill Goals A, B,C, D, F&G)

Confidentiality Expectations 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 right not to do so.

Volunteers will be solicited for laboratory demonstrations. Information obtained during 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 participate in lab activities to the best of his or her ability. This participation may involve the removal of minor articles of clothing. In the event that clothing is removed, draping techniques will be employed to preserve the dignity of the individual. 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 volunteer to be “patients.”

Exams in the Academic Testing Center (ATC)

Mercer County Community College has an Academic Testing Center on campus in the Student Center which makes it possible for exams to be administered outside of class time, allowing student/learners the ability to schedule their own time for testing. This also permits more judicious use of class time for lectures and labs rather than testing. The following list represents some things to remember when using the (ATC) 1. Anyone taking "Scantron" exams in the testing center will need to keep the “Testing Center Report

Form” that is provided at the completion of the exam. a. This form indicates the grade that was earned and which test questions were incorrect. b. This form should be retained as a record of the exam.

2. Anyone taking an exam in the testing center is required to present a current Mercer ID a. one that has a sticker on it indicating the current semester

i. issued by the security office in the student center 3. The Academic Testing Center typically is open on the West Windsor Campus as follows:

Semester Days Times

Fall and Spring M-R (closed on Fridays) 9am-7:30pm

Saturdays 9am-2:30pm

Summer Sessions M-R (closed on Fridays) 9am-7:30pm

Saturdays 9am-12:30pm

a. It is the responsibility of the student/learner to make sure that he/she has verified the operating hours for the Academic Testing Center

i. This is subject to change from semester to semester

Recording an Instructor:

1. Audio recording of the instructor during lecture and lab will only be permitted for those

student/learners who have documentation stating that audio recordings are a reasonable accommodation for that student/learner.

a. Information regarding Documentation for Reasonable Accommodation can be obtained from Arlene Stinson the Director of Academic Support Services. Ms. Stinson’s office is LB216, and she can be reached at (609) 570-3525 or via email at [email protected] .

2. Audio recording under these circumstances will be permitted once a copy of the appropriate documentation has been provided to the instructor.

3. Video recording of the instructor during lecture and lab are not permitted under any circumstance without prior written approval from the instructor.


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 are maintained.

2. Attendance is required for all courses for all learners. If someone is going to be absent from a

scheduled class, it is the responsibility of the individual to notify the course instructor in writing to inform him or her of the absence and how the work for that day will be made up. Copies of any class handouts that might have been distributed will be available in the course folders within the classroom. It is the responsibility of the learner to check the folder for the class that was missed to see if there was a new handout. It is not the instructor’s responsibility to attempt to keep track of who might have been present or who might have missed something that was discussed in class.

3. Official college closings or delayed openings are broadcast via several different mechanisms including

local radio stations, the college radio station WWFM, 89.1 and MAlert which will text smartphones and send emails to registered users affiliated with Mercer County Community College. It is the student/learner's responsibility to observe these notifications when they occur 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.

No PTAP course may be attempted more than twice.

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.

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 LB216, and she can be reached at (609) 570-3525.

http://www.mccc.edu/

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.

Spring 2015 PTA 216 Orthopedics in PTA

Course Schedule: Spring/2015 Location: MS 352

Week Date Topics Objectives Chapter(s)

1 1/20/15 Course Handbook Review/Introduction to Orthopedics/Spine

C1, C2, C3, C4, C5, P2, P3, P5, A1, A2, A3

Dutton Ch. 1,2,4,5,8-15

Cook Ch. 4,9-11

2 1/26/15 Spine

C1, C3, C4, C5, P2, P3, P4, P5, A1, A2, A3

Dutton Ch. 12-15 Cook Ch. 4,9,10,11

3 2/2/15 Hip C1, C2, C4, C5, P1, P3, P4, P5, A1, A2, A3

Dutton Ch. 19 Cook Ch. 12

2/2-2/7 Written Exam #1 in Testing Center

2/2 Competency Test #1 (Spine)

4 2/9/15 Knee C1, C2, C4, C5, P1, P3, P4, P5, A1, A2, A3


5 2/16/15 Ankle and Foot C1, C2, C4, C5, P1, P3, P4, P5, A1, A2, A3


6 2/23/15 Shoulder C1, C2, C4, C5, P1, P3, P4, P5, A1, A2, A3


2/23-2/28 Written Exam #2 in Testing Center

2/23/15 Competency Test #2 (LE)

7 3/2/15 Shoulder/Elbow/Wrist & Hand C1, C2, C4, C5, P1, P3, P4, P5, A1, A2, A3


3/4/15 Competency Test #3 (Shoulder)

8 3/9/15 Elbow/Wrist & Hand/Review C1, C2, C3, C4, C5, P1, P2, P3, P4, P5, A1, A2, A3

Dutton Ch. 1,2,4,5,8-21

Cook Ch. 4, 6-14

3/23-3/24 Practical Exams

9 5/4/15 Presentations C1, C2, C4, C5, P1, P3, P4, P5, A1, A2, A3

Dutton Ch. 17-18 Cook Ch. 7-8

10 5/11/15 Review C1, C2, C3, C4, C5, P1, P2, P3, P4, P5, A1, A2, A3

Dutton Ch. 1,2,4,5,8-21

Cook Ch. 4, 6-14

5/12/15 Written Exam #3 in MS352

Presentations: Case Study: Select a patient during your clinical affiliation and prepare a short overview presentation (10-15 min) for your classmates where you: • Introduce the diagnosis of your patient to your classmates • Include description of diagnosis and a brief past medical history including mechanism of injury • Explain and demonstrate the special test(s) performed during the examination • Outline the original treatment plan • Document the progress and outcome of the patient • Review the literature to find a journal article supporting or conflicting with the treatment plan • Sign up for a time to present your Case Study in the sign-up book in the classroom Your presentation is worth 10% of your overall course grade and is based upon the possible total of 100 points. Your grade is determined for this presentation based on the following criteria: Points Criteria Description

30% Organization/Content An outline is created and shared. Main ideas and sequence follow purpose of presentation. Review of diagnosis, mechanism of injury, past medical history, Special Test reviewed/demonstrated, treatments reviewed, progress of the patient is explained

30% Presentation Delivery Speaker was relaxed, well-articulated, and maintained good eye contact with the audience

20% Incorporation of Research

Information was included from various resources which were included in the reference list.

10% Interaction There were opportunities for discussion and sharing of ideas.

10% Handouts/Visuals The handouts were aligned with the presentation, and showed main ideas clearly and concisely.

Academic Integrity The faculty members of the PTA program at Mercer County Community College believe in the ability of student/learners to succeed honestly, fairly and free from fraud or deception without inappropriate assistance. We also expect that student/learners enrolled in PTA program classes accept responsibility for their own work and exhibit honesty with all submissions of their academic work. The PTA program faculty members have a zero tolerance policy for failure to abide by this philosophy and will strictly adhere to the College's Academic Integrity Policy which can be found in the MCCC Student Handbook. OMB 210

Consequences for Violations of Academic Integrity in PTA 216 If an instructor has found that any student learner has violated the Academic Integrity policy: • The offending assignment will earn a grade of zero without the ability for resubmission • The faculty member will hand deliver the assignment (when possible) with the supporting

documentation in writing to the student/learner and explain the consequences of the violation of the academic integrity policy to the student/learner.

• A copy of the violation notification to the College Academic Integrity Committee will be provided to the student/learner

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.

COMPETENCY TESTS:

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. All PTA program student/learners both administer and receive care with fellow classmates as 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. Competency tests for these skills take place prior to the Practical Exam in each of the semesters so that a minimal level of competence can be established prior to the start of the next clinical education course.

1. What is a competency test? a. a 15 or 30 minute “appointment” by the student/learner with a clinician tester b. an opportunity for the student/learner to demonstrate skill level by performing the identified

procedures on a fellow classmate in the presence of a tester

c. a method for the clinician tester to assure competence, safety, and skill level for a specific procedure or technique

Competency Tests consist of:

i. course # ii. title of the test

iii. skill demonstration items iv. critical safety indicators

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

a. A notebook labeled “PTAP Competency Testing” is located on the bookshelf inside MS352.

b. The notebook has a calendar of available testing times for student/learners to select from. Appointments may be made by other means at the discretion of the PTA Program faculty member.

c. If a learner is absent during a competency test sign-up date, his/her name will be added to the last remaining slot. The learner will need to check the competency binder after an absence.

d. If a learner is required to re-take a comp test, he/she should place his/her name in a slot labeled “re-take.”

3. What should a student/learner do if a true emergency prevents the ability to show up for a scheduled

comp test? a. If a leaner has a true emergency that causes him/her to have to cancel a competency test at

the last minute, he/she needs to email Holly Beinert and inform the classmate for whom he/she was scheduled to be a patient.

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

particular task?

a. Student/learners have a “Comp Test Sign-Off Sheet (CTSOS) Packet” (blank copies are located in the competency testing notebook) that the competency tester must sign once the objectives for the test have been satisfied. It is the responsibility of each of the student/learners to obtain the signature of their competency tester once each of the objectives has been met.

b. It is NOT the responsibility of the comp tester to remind the student/learner to supply the

CTSOS packet to be signed.

c. Once the CTSOS Packet is complete for a given course, it must be handed in to the ACCE (Academic Coordinator of Clinical Education).

d. Receipt of the completed CTSOS Packet by PTA Program Faculty/ACCE establishes eligibility to

take the practical exam for a course.

e. Failure to hand in the completed CTSOS Packet will result in penalties dependent upon the circumstances and discretion of the course director and PTA program coordinator.

f. Each comp test has a list of skills that need to be demonstrated. Some of those skills are identified with an asterisk (*) as Critical Safety Indicators. Critical Safety Indicators (CSI) are skills that have been determined to impact the safety of a patient, and are therefore a minimum requirement to be considered “competent” by the competency tester.

5. How is a grade for competency testing calculated?

a. There are two requirements to pass a competency test. The first requirement is that the

student/learner demonstrates all critical safety indicators (CSI) during the competency test. The second requirement is that the student/learner earns a minimum of 77% of the skill demonstration list provided for each competency test.

b. If a second attempt is required to successfully complete a competency test, the highest grade

possible for that competency test is a 79. c. If a third attempt is required to successfully complete a competency test, the highest grade

possible for that competency test is a 77. d. The overall competency test grade for each course will be the average of all final individual competency

test grades 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. 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.

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

During a competency test: During a practical exam: the comp tester interacts freely with the student/learner being tested

the practical exam proctor does not interact with the student/learner, they take notes

the student/learner may ask for clarification from the comp tester

the practical exam proctor provides no additional information to the student/learner being tested

the student/learner may submit their documentation the day after the test has been completed

the documentation for the test is due at the completion of the test

Student/learners sign up for competency tests in advance

Student/learners are assigned a specific testing time.

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

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

Student/leaners may “switch” spots with a classmate Practical Exam times are determined by program faculty, not student/learners and student/learners may not “switch” times with a classmate.

1. What are the responsibilities of the PTA student/learner?

a. signing up in advance to take a competency test b. arriving 30 minutes prior to his or her scheduled competency test, for those competency tests

that require a patient, to act as a patient for the classmate who is scheduled at that time.

c. preparing and cleaning up the appropriate treatment environment d. having the competency tester sign off that he or she performed the test in a safe and

competent manner e. submitting the completed & signed CTSOS Packet to the appropriate faculty member by the

due date listed on the CTSOS Packet.

2. Where would a student/learner find information about competency tests for a specific course? a. Each semester, students are given a Comp Test Sign Up Sheet (CTSOS) Packet, containing all of

the competency tests for the semester. b. The competency testing notebook in MS352 has a copy of all of the competency tests for all of

the lab courses.

3. What remedy is there for a student/learner who does not successfully complete a competency test on the first try? a. Clinician testers work with student/learners to help them refine skills. If the student/learner is

able to demonstrate the basic foundation of the skill, then the tester will work with the student/learner for the allotted comp test time.

b. In PTA laboratory courses, the student/learner is capable of retaking the competency test up to 2 times as they need to. However, points will be deducted for each unsuccessful attempt.

c. Prior to the third attempt, the learner must first meet with the course instructor. d. If a learner is required to re-take a comp test, he/she should place his/her name in a slot

labeled “re-take”.

Terminology

Term Forms of use Explanation Competency Testing Comp Tests,

Comps skills that will be tested for courses that have a lab component

Comp Test Check This refers to the number of attempts for each competency test for each of the individual skills that have been identified by the course instructor. The skills must be demonstrated to a level of competence to pass the test in addition to demonstrating competence with each of the critical safety indicators

Critical Safety Indicators

CSI minimum skills that must be demonstrated for patient safety during competency testing and practical exams and all interactions with patients

SOAP Notes Documentation, SOAP Note

Documentation in a patient record to indicate the treatment intervention that took place. If the intervention was one that was done in a lab, then the SOAP note would be a mock SOAP note but would still be referred to as a SOAP note. The acronym refers to: S-subjective patient information, O-objective patient information (tests and measurements), A-assessment following the treatment intervention during that session regarding the potential change that might have taken place as a result of the intervention and P-plan for the next session based upon the " A" as it relates to the O and S from that treatment intervention for that patient and the overall plan of care.

Patient pt. During competency testing and/or practical exams, the patient is a PTA program classmate who is currently enrolled in the professional phase of the PTA program or a PTA program faculty

member.

clinician During competency testing and/or practical exams, the clinician is a PTA program classmate who is currently enrolled in the professional phase of the PTA program.

Physical Therapist Assistant

PTA Either the acronym or full spelling may be used however it is understood that this refers to the individual

Physical Therapist PT Either the acronym or full spelling may be used however it is understood that this refers to the individual and not to a department or to physical therapy

Competency Tests for PTA 216 Ortho for PTAs

PTA 216- Spine Equipment:

Treatment plinth

Draping sheet as needed

Pillows

Paper and pen with black ink

Exercise "equipment" as appropriate for this patient based upon the PT evaluation

Setting the Scene: The competency tester will ask you to explain and/or demonstrate Special Tests and different Manual Techniques for the cervical, thoracic, and/or lumbar spine. You will be expected to explain what constitutes a positive vs. negative special test and/or the goals and rationale for manual techniques and what they mean clinically. You may also be asked to demonstrate 3 exercises that would be appropriate for a patient with specific diagnosis.

You will need to demonstrate competence with the following:

CSI

Skill Demonstration

Comp Test Check

1st 2nd 3rd

Perform safe and appropriate hand washing prior to touching patient 1 1 1

Introduce yourself to your patient 2 2 2

Gather relevant subjective information prior to initiating treatment 3 3 3

* Review and discuss relevant contraindications and or physician restrictions to treatment

4 4 4

* Provide patient education regarding session goals and modalities both prior to and during treatment as needed

5 5 5

* Position the patient appropriately for modalities and techniques to be completed

6 6 6

* Perform requested modalities with appropriate hand placement and patient positioning to ensure patient safety

7 7 7

* Maintain awareness of patient comfort through communication and visual cues 8 8 8

Review of treatment and patient education regarding post treatment expectations

9 9 9

Document the treatment with the patient in SOAP note format 10 10 10

Identify which CPT Code(s) you would bill for and the rationale for billing such codes

11 11 11

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All CSI must be demonstrated to pass each Competency Test.

PTA 216- Lower Extremity

Objectives: P1. Demonstrate competence in the performance of documenting patient results as reported by the evaluating PT

from selected orthopedic assessment screening tests for peripheral joints

P3. Distinguish between normal and abnormal patient responses when observing or performing orthopedic assessment screening tests for peripheral joints and/or the cervical and lumbar spine

P4. Recognize when orthopedic assessment screening tests for peripheral joints and/or cervical and lumbar spine should not be performed due to contraindications or a change in the patient’s status

P5. Demonstrate competence in the performance of various soft tissue techniques including: muscle releases, Passive Range of Motion (PROM), joint distraction, open and closed packed positions and muscle stretching techniques for selected muscles.

Equipment:

Treatment plinth


Pillows


Exercise "equipment" as appropriate for this patient based upon the PT evaluation

Setting the Scene: The competency tester will ask you to explain and/or demonstrate Special Tests and different Manual Techniques for the lower extremity. You will be expected to explain what constitutes a positive vs. negative special test and/or the goals and rationale for manual techniques and what they mean clinically. You may also be asked to demonstrate 3 exercises that would be appropriate for a patient with specific diagnosis.


CSI

Skill Demonstration

Comp Test Check

1st 2nd 3rd




* Review and discuss relevant contraindications and or physician restrictions to treatment

4 4 4


5 5 5


6 6 6

* Perform requested modalities with appropriate hand placement 7 7 7

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and patient positioning to ensure patient safety

* Maintain awareness of patient comfort through communication and visual cues

8 8 8


9 9 9



11 11 11


PTA 216- Upper Extremity

Objectives: P1: Demonstrate competence in the performance of documenting patient results as reported by the evaluating PT

from selected orthopedic assessment screening tests for peripheral joints

P3: Distinguish between normal and abnormal patient responses when observing or performing orthopedic assessment screening tests for peripheral joints and/or the cervical and lumbar spine

P4: Recognize when orthopedic assessment screening tests for peripheral joints and/or cervical and lumbar spine should not be performed due to contraindications or a change in the patient’s status

P5: Demonstrate competence in the performance of various soft tissue techniques including: muscle releases, Passive Range of Motion (PROM), joint distraction, open and closed packed positions and muscle stretching techniques for selected muscles.

Equipment:

Treatment plinth


Pillows


Exercise "equipment" as appropriate for this patient based upon the PT evaluation Setting the Scene: The competency tester will ask you to explain and/or demonstrate Special Tests and different Manual Techniques for the upper extremity. You will be expected to explain what constitutes a positive vs. negative special test and/or the goals and rationale for manual techniques and what they mean clinically. You may also be asked to demonstrate 3 exercises that would be appropriate for a patient with specific diagnosis.


CSI Skill Demonstration

Comp Test Check

1st 2nd 3rd




* Review and discuss relevant contraindications and or physician restrictions to 4 4 4

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treatment


5 5 5


6 6 6

* Perform requested modalities with appropriate hand placement and patient positioning to ensure patient safety

7 7 7

* Maintain awareness of patient comfort through communication and visual cues 8 8 8


9 9 9



11 11 11


SPRING 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. Appropriate patient attire includes the ability to expose the distal half of the humerus. You should have shorts, tank tops, etc. Bring a black pen.

Your first arrival to the lab CLINICIANS:

It is your responsibility to enter the lab on time. Enter the room 15 minutes prior to your scheduled time and store your belongings in the front of the room (by the wall hooks). 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.

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 perform your hand hygiene.

PATIENTS:

You will have time to read a summary of the patient problem while you are waiting in the waiting room, so that you are aware of the situation.

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:

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You have one hour to treat your patient and to clean up your treatment area. You should ideally “release” your patient at quarter of and use those 15 minutes to clean up your treatment area and complete your documentation.

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 Reflections are to be completed and either placed in the bin in the lab, or emailed to Holly (Holly only!) or

[email protected] by the time indicated on the Reflections form provided on practical exam day.

Check for Results 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.

Spring 2015 Practical Examination Grading Rubric

Mercer County Community College Learner:

Physical Therapist Assistant Program Patient:

Practical Examination Rubric Scenario:

Date: Course(s):

Instructions: The learner will have 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.

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 213 216 Equivalent to: Observations

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 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 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 Inappropriate Did not use a sheet on the treatment plinth during Rx

2 2 Unsafe left the patient unsupported when going to retrieve something needed for treatment

1 1 Fraudulent N/A

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 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 213 216 Equivalent to: Observations


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


20


hot water, towel to turn on and off water, 15 second scrub with soap, sleeves away from wrists, name tag

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 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 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 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 213 216 Equivalent to: Observations


My name is “NAME.” 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. (name can be repeated by pt. name tag fully visible to pt.)


as above but the volume, speed or clarity could be improved

3 3 Nervous but safe as above but Physical Therapy Assistant Student and/or the volume, speed or clarity could be improved

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 Unsafe N/A

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: 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 213 216 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 Nervous but safe N/A

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 Unsafe N/A

1 1 Fraudulent N/A


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


N/A

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 213 216 Equivalent to: Observations


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 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 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

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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

1 1 Fraudulent N/A


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 213 216 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 Nervous but safe Self-corrected errors in body mechanics during Rx session, More than one omission from a “10”

7 7 Inappropriate Bending at the waist to remove w/c parts, retrieve various items throughout session

6 6 Unsafe Bending at the waist to transfer pt. with a narrow BOS

5 5 Fraudulent N/A


N/A


N/A

Comment: 7. to see that things are explained to the patient in terms that he/she is capable of understanding Scores 213 216 Equivalent to: Observations


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 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 Inappropriate the SPTA explained all activities in medical terminology and did not demonstrate or ask pt if he/she had any ?s

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

5 5 Fraudulent N/A


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 213 216 Equivalent to: Observations


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 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

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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 Unsafe N/A

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 Scores 213 216 Equivalent to:

Please refer to the Critical Safety Indicators Document which is

attached.



15 15 Nervous but safe

12 12 Inappropriate

9 9 Unsafe

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 Scores 213 216 Equivalent to:

Please refer to the Critical Safety Indicators Document which is

attached.



15 15 Nervous but safe

12 12 Inappropriate

9 9 Unsafe

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 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

that the patient wears appropriate attire, including the ability to expose the distal half of the humerus

that the patient enters the lab 10 minutes prior to the scheduled start time

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.” To achieve a

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score of 15 or higher on categories 9 & 10, the student/learner must demonstrate all critical safety indicators outlined for the course. Critical Safety Indicators demonstrated will be marked with a checkmark and those that are not demonstrated will be marked with an “X”. Additionally, a minimum score of 77 must be earned to pass the practical exam, consistent with all PTA program courses.

Summary Possible

Points

213 216 Total Score for the Clinician:

Review Date:

1 5 2 10 3 5 Point Deductions (as a

patient):

Learner Initials: 4 5 5 5 6 10 7 10 PTA 213 Final Score =

Safe/Unsafe

Pass/Fail

PTA 216 Final Score =

Safe/Unsafe

Pass/Fail

8 10 9 20

10 20

Total 100

Tester(s):

BJB 3/12 rev

Rev 11/13 PTAP fac

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