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  • Curriculum

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  • Learning Objectives

    Comprehensive list of learning objectives for this course found below

  • ACOTE Standards

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Description

In this interactive case scenario you assume the role of fieldwork student in an outpatient orthopedic clinic setting assisting with the assessment and treatment of a person with a primary diagnosis of Carpal Tunnel Syndrome, and secondary diagnoses of CMC Arthritis and Lateral Epicondylitis

Course Curriculum

  • 2

    Client Performance Skills: Outpatient Evaluation

    • Chart - History of Present Illness (HPI)

      FREE PREVIEW
    • Chart - Requisitions

    • Chart - Precautions

    • Chart - Social History

    • Chart - Work History

    • Chart - Past Medical History

    • Chart Review Questions Preparation

    • Chart Review Questions

    • Evaluation Tool Selection

      FREE PREVIEW
    • Initial 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 PREVIEW
    • Grip 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

  • 3

    Client Treatment

    • Paraffin

    • Paraffin Question

    • Manual Therapy of the Wrist and Hand

    • Manual Therapy of the Wrist and Hand Questions

    • Therapeutic Massage of the Forearm

      FREE PREVIEW
    • Therapeutic Massage of the Forearm Question

      FREE PREVIEW
    • Stretching/ 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

Meet Your Instructor

OTR, CHT

Sarah Ezerins

Sarah practices occupational therapy at UW Health. She specializes in treatment of patients with hand-to-shoulder orthopedic conditions. Sarah holds a Master's of Science degree in Occupational Therapy from Mount Mary College in Milwaukee and a Bachelor of Arts degree in Sociology from UW-Milwaukee.

Learning Objectives:

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

ACOTE Standards Addressed:

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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