Angie
Primary Diagnosis: Carpal Tunnel Syndrome, Secondary Diagnoses: CMC Arthritis, Lateral Epicondylitis
"These simulations are a great way to learn and gain insight on what practice looks like with this diagnosis (treatment, interventions, etc.). We're lucky to have these learning experiences to better our knowledge"--OTA Student
"I learned a lot about hand therapy and overall a good review. I liked the splinting part and thought that was beneficial. I feel very confident in doing a session like this after a few practice sessions."--OTA Student
"After going through this case I feel more confident with navigating the assessment and determing where "the problem" lies or where the deficits begin"--OTA Student
By the end of this self-paced course, the learner will demonstrate foundational understanding of outpatient hand therapy evaluations and interventions.
Chart - History of Present Illness (HPI)
FREE PREVIEWChart - Requisitions
Chart - Precautions
Chart - Social History
Chart - Work History
Chart - Past Medical History
Chart Review Questions Preparation
Chart Review Questions
Evaluation Tool Selection
FREE PREVIEWInitial Evaluation Form
Interview
Interview Questions
Pain Interview
Pain Interview Questions
Patient Specific Functional Scale (PSFS) Document
Patient Specific Functional Scale (PSFS)
PSFS Questions
Clinical Examination of the UE Preparation
Clinical Pearl! Accuracy of Provocative Tests for CTS
Provocative Testing
Provocative Testing Questions
Lateral Epicondylitis and Dequervain's Synovitis Screening
Lateral Epicondylitis and Dequervain's Synovitis Screening Questions
Consultation and Activity Modification Recommendations
Consultation and Activity Modification Recommendations Questions
Manual Muscle Testing (MMT)
MMT Question
Clinical Pearl! Grip and Pinch
FREE PREVIEWGrip and Pinch Norms - Female
Dynamometer
Dynamometer Questions
Pinch Meter
Pinch Meter Questions
Sensory Testing (2-Point Discrimination) Preparation
Sensory Testing (2-Point Discrimination)
Sensory Testing (2-Point Discrimination) Question
AROM Measurements - Goniometry
AROM Measurements - Goniometry Questions
Treatment Planning
Treatment Planning Questions
Paraffin
Paraffin Question
Manual Therapy of the Wrist and Hand
Manual Therapy of the Wrist and Hand Questions
Therapeutic Massage of the Forearm
FREE PREVIEWTherapeutic Massage of the Forearm Question
FREE PREVIEWStretching/ PROM
Stretching/ PROM Question
Reassessment
Reassessment Questions
Patient Education
Patient Education Question
Carpal Tunnel Syndrome HEP Preparation
Carpal Tunnel Syndrome HEP
Carpal Tunnel Syndrome HEP Questions
Initial Evaluation Completion
Initial Evaluation Comparison
Clinical Pearl! Importance of Check-In
Check-in Discussion
Check-in Discussion Questions
Splinting
Splinting Questions
Thumb HEP Preparation
Thumb HEP
Thumb HEP Questions
CMC Arthritis Activity Modification Education
CMC Arthritis Activity Modification Education Question
Kinesio Tape
Kinesio Tape Questions
SOAP Progress Note Documentation
SOAP Progress Note Comparison
Completion Checklist
FREE PREVIEWSummative Exam Preparation
FREE PREVIEWSummative Exam
ClinEdWeb Angie Case Scenario: Simulation Effectiveness Tool -‐ Modified *Leighton, K., Ravert, P., Mudra, V., & Macintosh, C. (2015)
By the end of this case scenario, learners will be able to:
❏ Glean salient information from a chart review
❏ Identify safety elements related to outpatient orthopedic practice
❏ Identify terminology and common symptomology pertaining to Carpal Tunnel Syndrome (CTS), Carpometacarpal (CMC) Arthritis, and Lateral Epicondylitis
❏ Recall nerve involvement in CTS
❏ Recall basic anatomy of hand including tendons, carpal bones, and nerves involved in CTS, CMC arthritis, and Lateral Epicondylitis
❏ Recognize role of occupational therapy in outpatient orthopedic practice
❏ Recall common clinical examination assessments of the upper extremity
❏ Identify commonly used evaluation tools appropriate for assessing baseline performance skill level
❏ Complete point-of-service electronic documentation
❏ Identify individual-centered goals from a non-standardized interview
❏ Recognize pain assessment procedures
❏ Demonstrate understanding of the evaluative process and scoring of provocative tests: manual palpation and manipulation of carpal intervals, Tinel’s Sign Test, Phalen’s Test, Phdurkan’s Test, Durkan’s Test, Berger Test, Elbow Flexion Test, Maudsley’s Test, Cozen’s Test, Finkelstein’s Test
❏ Demonstrate understanding of provision and process of administering the Patient Specific Functional Scale
❏ Demonstrate understanding of the evaluative process and scoring of Manual Muscle Testing
❏ Demonstrate understanding of the evaluative and re-evaluative process and scoring of Goniometry
❏ Demonstrate understanding of the evaluative process and scoring of 2-point discrimination
❏ Demonstrate understanding of the evaluative process and scoring of Pinch and Grip Testing
❏ Interpret evaluation data to inform appropriate goal setting and treatment planning
❏ Recommend direct interventions that include occupations and activities, preparatory methods and tasks, education, and training
❏ Recall the use of Occupational Therapy Practice Framework terminology in the context of outpatient orthopedic rehabilitation
❏ Recognize the purpose and implementation of activity modification training, CMC home exercise program (HEP), CTS HEP, Kinesiotape, paraffin, and splinting interventions
❏ Identify purpose of, steps and precautions involved with fabrication of a radial-based thumb spica splint.
❏ Recommend direct interventions, including appropriate home exercise programs and splinting to support independence, function, and decreased symptomology
The following 2018 Accreditation Council for Occupational Therapy Education (ACOTE) Standards are addressed in the “Angie” Case Scenario.
Standard Number |
Skill |
Standard Definition |
Evidence of Standard Met |
B.3.2. |
Interaction of Occupation and Activity |
Apply, analyze, and evaluate the interaction of occupation and activity, including areas of occupation, performance skills, performance patterns, context(s) and environments, and client factors. |
Patient Specific Functional Scale, ROM, strength, sensation, and pain assessments Completion of Case Scenario Formative and Summative assessments |
B.3.5. |
Effects of Disease Processes |
Analyze and evaluate the effects of disease processes including heritable diseases, genetic conditions, mental illness, disability, trauma, and injury on occupational performance. |
Patient Specific Functional Scale, ROM, strength, sensation, and pain assessments in relation to CMC arthritis, CTS, and Lateral Epicondylitis Completion of Case Scenario Formative questions Completion Certificate: Passing score on summative assessment |
B.3.6. |
Activity Analysis |
Demonstrate activity analysis in areas of occupation, performance skills, performance patterns, context(s) and environments, and client factors to formulate the intervention plan |
Treatment Planning video with client Completion of Initial Evaluation document with treatment plan and goals Completion of Case Scenario Formative assessment Completion Certificate: Passing score on summative assessment |
B.3.7. |
Safety of Self and Others |
Demonstrate sound judgment in regard to safety of self and others and adhere to safety regulations throughout the occupational therapy process as appropriate to the setting and scope of practice. This must include the ability to assess and monitor vital signs (e.g., blood pressure, heart rate, respiratory status, and temperature) to ensure that the client is stable for intervention. |
Throughout the case scenario the user is alerted with verbal, visual, and written prompts about safety concerns such as splint fabrication and use precautions, kinesiotape precautions, and safety during therapeutic ex HEP |
B.4.1. |
Therapeutic Use of Self |
Demonstrate therapeutic use of self, including one’s personality, insights, perceptions, and judgments, as part of the therapeutic process in both individual and group interaction |
Practitioner in the case scenario models therapeutic use of self |
B.4.2. |
Clinical Reasoning |
Demonstrate clinical reasoning to evaluate, analyze, diagnose, and provide occupation based interventions to address client factors, performance patterns, and performance skills |
Chart review Interview Assessments addressing client factors, performance skills, and performance patterns Occupation-based interventions addressed in case scenario are based on results of assessments performed to include but not limited to: activity modification education during daily routine activities (performance patterns), stretching (client factors), therapeutic exercise (performance skills), and orthotic training (performance skills) Completion of Electronic Initial Evaluation Form Completion of Case Scenario Formative assessment Completion Certificate: Passing score on summative assessment |
B.4.3. |
Occupation-Based Interventions |
Utilize clinical reasoning to facilitate occupation-based interventions that address client factors. This must include interventions focused on promotion, compensation, adaptation, and prevention |
Occupation-based interventions addressed in case scenario are based on results of assessments performed to include but not limited to: activity modification education during daily routine activities (performance patterns), stretching (client factors), therapeutic exercise (performance skills), and orthotic training (performance skills) Completion of Electronic Initial Evaluation Form and Progress Note Completion of Case Scenario Formative assessment Completion Certificate: Passing score on summative assessment |
B.4.4. |
Standardized and Nonstandardized Screening and Assessment Tools |
Contribute to the evaluation process of (OTA) or evaluate (OTR) client(s)’ occupational performance, including occupational profile, by analyzing and selecting standardized and non-standardized screenings and assessment tools to determine the need for occupational therapy intervention(s). Assessment methods must take into consideration cultural and contextual factors of the client. Explain the importance of using psychometrically sound assessment tools (OTA) or Interpret evaluation findings of occupational performance and participation deficits (OTR) to develop occupation-based intervention plans and strategies. Intervention plans and strategies must be client centered, culturally relevant, reflective of current occupational therapy practice, and based on available evidence. |
Patient Specific Functional Scale, ROM, strength, sensation, and pain assessments Chart review Interview Completion of Electronic Initial Evaluation Form |
B.4.5. |
Application of Assessment Tools and Interpretation of Results |
Select and apply assessment tools, considering client needs, and cultural and contextual factors. Administer selected standardized and nonstandardized assessments using appropriate procedures and protocols. Interpret the results based on psychometric properties of tests considering factors that might bias assessment results (e.g., culture and disability status related to the person and context). |
Patient Specific Functional Scale, ROM, strength, sensation, and pain assessments Chart review Interview Completion of Case Scenario Formative assessment Completion Certificate: Passing score on summative assessment |
B.4.6. |
Reporting Data |
Collect, analyze, and report data in a systematic manner for evaluation of client and practice outcomes. Report evaluation results and modify practice as needed. (OTR) or Under the direction of an occupational therapist, collect, organize, and report on data for evaluation of client outcomes (OTA) |
Completion of Electronic Initial Evaluation Form |
B.4.7. |
Interpret Standardized Test Scores |
Interpret criterion-referenced and norm referenced standardized test scores on the basis of an understanding of sampling, normative data, standard and criterion scores, reliability, and validity. |
Completion of Case Scenario Formative assessment on assessments such as grip, pinch, 2-point discrimination etc. Completion of Initial evaluation form Completion Certificate: Passing score on summative assessment |
B.4.8. |
Interpret Evaluation Data |
Interpret the evaluation data in relation to accepted terminology of the profession and explain the findings to the interprofessional team |
Formative assessment (Occupational Therapy Practice Framework terminology is intentionally embedded in questions and answers) Completion Certificate: Passing score on summative assessment (Occupational Therapy Practice Framework terminology is intentionally embedded in questions and answers) |
B.4.10. |
Provide Interventions and Procedures |
Recommend and provide direct interventions and procedures to persons, groups, and populations to enhance safety, health and wellness, and performance in occupations. This must include the ability to select and deliver occupations and activities, preparatory methods and tasks (including therapeutic exercise), education and training, and advocacy. |
Completion of Case Scenario Formative assessment Completion Certificate: Passing score on summative assessment Completion of Electronic Initial Evaluation Form and Progress note related to education training such as therapeutic ex HEP |
B.4.11. |
Assistive Technologies and Devices |
Assess the need for and demonstrate the ability to design, fabricate, apply, fit, and train in assistive technologies and devices (e.g., electronic aids to daily living, seating and positioning systems) used to enhance occupational performance and foster participation and well-being. |
Occupation-based interventions addressed in case scenario are based on results of assessments performed to include but not limited to: activity modification education during daily routine activities (performance patterns), stretching (client factors), therapeutic exercise (performance skills), and orthotic training (performance skills) |
B.4.15. |
Technology in Practice |
Demonstrate knowledge of the use of technology in practice, which must include: · Electronic documentation systems |
Completion of Electronic Initial Evaluation Form Completion of Electronic progress note |
B.4.18. |
Grade and Adapt Processes or Environments |
Assess, grade, and modify the way persons, groups, and populations perform occupations and activities by adapting processes, modifying environments, and applying ergonomic principles to reflect the changing needs of the client, sociocultural context, and technological advances. |
Ergonomic and activity modification education provided to adapt environment and tools to increase occupational performance in the scenario Completion of Case Scenario Formative assessment |
B.4.21 |
Teaching–Learning Process and Health Literacy |
Demonstrate, evaluate, and utilize the principles of the teaching–learning process using educational methods and health literacy education approaches: · To design activities and clinical training for persons, groups, and populations. · To instruct and train the client, caregiver, family, significant others, and communities at the level of the audience. |
Practitioner in the case scenario models clinical training for person receiving services with health literacy considerations |
B.4.23. |
Effective Communication |
Identify occupational needs through effective communication with patients, families, communities, and members of the interprofessional team in a responsive and responsible manner that supports a team approach to the promotion of health and wellness. |
Effective communication of verbal treatment planning in video Completion of Electronic Initial Evaluation Form Completion of Electronic progress note |
B.4.28. |
Plan for Discharge |
Develop a plan for discharge from occupational therapy services in collaboration with the client and members of the interprofessional team by reviewing the needs of the client, caregiver, family, and significant others; available resources; and discharge environment. |
Completion of Electronic Initial Evaluation Form |
ACOTE Accreditation Standards adapted from: https://acoteonline.org
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