uwm 6 aug 2010

NBCOT Review Session for OTR

University of Wisconsin-MilwaukeeAugust 6 2010

Ben Atchison, PhD, OTR, FAOTAWestern Michigan University

ben.atchison@wmich.edu

Agenda• General Strategies

• Organization/Management

• Physical Dysfunction

• Pediatrics

• Mental Health

9:00-5:00

Very First Question

• Why is it just ONE PERSON doing this review..

• Where are experts to review specialized content?

• Whats Up? Who does this guy think he is?

Objective of this review session:

• Try to sort out the galaxy of items to review from the universe of items

• To try to get an idea of what’s important for the EXAM

First Thing to Consider

Before you began the OT Program how much did you know (really) about OT?

The student will understand the basic concepts of occupational therapy…define occupational therapy…..recognize basic tools of occupational therapy…define occupation, activity, and purposeful activity as it relates to the profession….define terms associated with occupational therapy (Occupational Therapy Practice Framework…explain the domain of concern of the profession as it relates to health and wellness….explain the role of occupational therapy in health promotion and disease prevention and historical awareness of occupational therapy…summarize the history and philosophy base of the profession…demonstrate awareness of trends of the profession….demonstrate awareness of goal development and selection of purposeful activities to support goals….define clinical reasoning strategies….explain steps involved in occupational therapy process….understand roles of occupational therapy personnel, including OTR, COTA, and OT Aides as they relate to service delivery….explain the COTA/OTR relationship, including supervision requirements and service competency.Identify various practice areas and services provided by occupational therapy professionals….demonstrate understanding of occupational therapy as a profession….identify international occupational therapy organizations, programs, and contributions….discuss political issues related to occupational therapy and their influence on the profession…..understand the roles of occupational therapy professional organizations on a local, state, and national levels.Explain the concept of interdisciplinary teams and identify the roles of the teammembers.…practiceframework…framefreference…usingresources…cerebral palsy…analyze activities across the life span using a variety of methodsprinciples of activity selection..use principle of static splints in fabrication…use of dynamic splints…use principles of wheelchair modification…use the principles of home assessment…understand and use the principles of upper limb prosthetics…procurement of durable medical equipment…principles of body mechanics, body positioning, and transfer techniques…use principles of adaptation and accommodation for leisure, vocation, education, self-care, and community…explain the effects of health and disability on the individual, the family and society including the prevention of disease and significant developments in the health care arena including….knowledge of social, economic, political, environmental, and demographic factors that influence delivery of health care and the provision of services…design and develop a service program for a specific client or patient group utilizing appropriate service models including, but not limited to medical community, or school-based….incorporate the various management functions including planning, organizing, staffing, coordinating, and controlling in the development of a service program….develop a marketing plan for promoting and sustaining a service program, recognizing the necessity to promote the program by educating other professionals, consumers, third party payers, and the public.

…conduct needs assessment, develop a program evaluation system, and utilize the principles of resource management, including staffing, cost, equipment supply needs, and space utilization…understand current reimbursement issues related to the profession….demonstrate understanding of the profession’s ethics and values….demonstrate awareness of the code of ethics stated by AOTA….demonstrate awareness of the standards of practice stated by AOTA. Exhibit the ability to analyze tasks relative to performance areas, performance components and performance contexts…understand the need for and use of compensatory strategies when desired life tasks cannot be performed

demonstrate the ability to use safety precautions with clients during the screening and evaluation process, such as standards for infection control that include, but not limited to universal precautions……demonstrate the ability to grade and adapt tasks related to performance areas and performance components for therapeutic intervention…demonstrate the ability to teach compensatory strategies such as use of technology, adaptations to the environment, and involvement of humans and nonhumans in the completion of tasks....demonstrate the ability to use safety precautions with the client during therapeutic intervention, such as contraindications and use of infection control standards that include, but are not limited to, universal precautions……understand the models of healthcare, education, community and social systems as they relate to the practice of occupational therapy…practice framework…frame of reference…using resources…cerebral palsy….left hemiplegia…analyze activities across the life span using a variety of methods…use principles of activity selection….use principle of static splints in fabrication.understand use of dynamic splints…

…use principles of wheelchair modification….use the principles of home assessment….use the principles of upper limb prosthetics...approaches to procurement of durable medical equipment…….principles of body mechanics, body positioning, and transfer techniques…principles of adaptation and accommodation for leisure, vocation, education, self-care, and community….

AND MUCH MORE.

What Have You Heard?

Share one thing that you have heard about regarding the exam…

10 ways to Really Ruin Your Exam Day…

10. Not eating anything before9. Not going to be bathroom before you start8. Trying to study the night before 7. Not knowing exactly where you are supposed to go for the

testing site6. Not being on time5. Not wearing earplugs7. Not bringing your I.D.3. Talking to anyone who is taking the exam …the night before

you are scheduled to take it 2. Talking to anyone who also took the exam ..right after you have

taken it1. Getting married and having a new name..a different one than

you used when you applied for the exam

2010 NBCOT EXAM CANDIDATE HANDBOOK

Castle Practice Test Ordering Site

Prior to being deemed eligible to take the NBCOT certification examination, OTR® and COTA® applicants must:•Graduate from an accredited occupational therapy assistant or occupational therapist program recognized by NBCOT. Applicants who have not yet received their Occupational Therapy degree but are “cleared for graduation” are considered by NBCOT to have met the academic criteria. “Cleared for graduation” means that all grades have been recorded, the thesis is complete (if required), and there are no outstanding financial obligations to the institution.

•Complete all fieldwork requirements.

•3. Submit the examination application and receive authorization by NBCOT to take the examination. Please Note:The application should not be submitted until the applicant has graduated or is cleared for graduation.

4. Request that the school registrar confirm the applicant’s eligibility to examine by submitting the official final transcript or an NBCOT Academic Credential Verification Form (ACVF).

5. Agree to abide by the NBCOT Candidate/Certificant Code of Conduct N).

Study Guides??

USE ONLY THESE!

NBCOT Review Book

NBCOT Practice Exams

General Tips

• The actual test atmosphere can be intimidating– Two pieces of ID are required– Testing is monitored through video surveillance– Finger printed when leaving the room– Picture taken– Finger printing is used– No hats or jackets– Will issue a dry erase board and markers to be used

in the testing area.– Will provided noise cancellations headphones

What Exam Writers for NBCOT are trained to do:

• Question has a premise, correct answer, and three distracters

• Premise is complete and clear expression of the problem. You should be able to supply correct answer without reading the correct answer or distracters.

A child with hyperactivity and a severe articulation disorder is referred to OT:

c. The initial evaluation should consist of an oral motor assessment

d. The initial evaluation should consist of a clinical neuromotor assessment

e. The initial evaluation should consist of a range of motion measurement

f. The initial evaluation should consist of a play inventory

A child with hyperactivity and a severe articulation disorder is referred to OT. The initial evaluation should consist of

b. an oral motor assessment

c. a clinical neuromotor assessment

d. a range of motion measurement

e. a play inventory

EW’s trained to do..

• Avoid use of a negative premise. Questions are phrased so that you are required to supply correct solutions only

During a treatment session, a patient complains of chest tightness, pain radiating down the left arm, shortness of breath, and a feeling indigestion. What should the OTR NOT DO LAST?

a. Check the patients vital sign

b. Report the incident to the OTR supervisor

c. Call the patients family

d. Call the medical emergency team

During a treatment session, a patient complains fo chest tightness, pain radiating down the left arm, shortness of breath, and a feeling indigestion. What should the OTR DO FIRST?

a. Check the patients vital sign

b. Report the incident to the OTR supervisor

c. Call the patients family

d. Call the medical emergency team

EW’s trained to..

• Only one choice is correct and is written so it is clearly correct and defensible

By what age should a child be able to point with an isolated

index finger:

a. 6-10 months

d. 8-11 months

e. 7-11 months

f. 10-12 months

By what age should a child be able to point with an isolated index finger:

• 2-3 months

b. 4-5 months

d. 6-8 months

d. 9-11 months

EW’s trained to..

• If premise is a statement, should be possible to read the premise, and each choice, as a complete sentence

• If premise is a question, each choice should make grammatical sense as an answer to that question

EW’s trained to…

• Correct choice and distracters parallel in terms of grammatical structure, use of terminology and length

• Distracters are to be absolutely incorrect while still presenting plausible choices to someone who doesn’t know the correct answer

EW’s trained to…

• Never use “all of the above” or “none of the above”

• Do not write questions re: local issues or regulations

• Not write questions re: developing trends might explain the 30 questions that don’t count

Realities & Myths of the OTR® examination

Margaret Bent, PhD, OTRManaging Director, Competency Assessment, NBCOT®

How much time do you have?

• On your blank page, make a list #1 to #5

1. An OTR who receives a referral for a 5 year old child who has pervasive developmental disorder should FIRST gather background information on the child by:

c. Screening for self care abilities

d. Discussing the child’s history with the caregiver

e. Completing a standardized motor test

f. Interviewing the child

2. A patient who has COPD and mild dementia has been admitted to a hospital for treatment of pneumonia. It would be BEST for an OTR to observe the patient’s grooming skills in the:

b. morning in the patient’s room

c. morning in the OT clinic

d. afternoon in the patient’s room

e. afternoon in the OT clinic

3. A patient who has had a CVA has recently been discharged from inpatient services to a skilled nursing home. The patient becomes confused when trying to find the way from the dayroom to the dining room The OTR should further assess the patient for deficits related to:

b. Topographical orientation

c. Simultaneous multiple attention

d. Ideomotor praxis

e. Implicit memory

4.A patient who had a recent ulnar collateral ligament repair of the thumb MCP joint is referred to OT for fabrication of a splint. The MOST EFFECTIVE type of splint for the OTR to fabricate is a/an:

a.) dynamic flexion.b.) forearm-based ulnar gutter.c.) wrist immobilization.d.) hand-based thumb spica.

5. A patient who has had a right CVA has been referred to OT. Prior to completing a visual-perceptual evaluation, the OTR should FIRST measure the patient’s:

a. visual acuity

b. spatial relations

c. scanning ability

d. visual memory

1. An OTR who receives a referral for a 5 year old child who has pervasive developmental disorder should FIRST gather background information on the child by:

• Screening for self care abilities

• Discussing the child’s history with the caregiver

• Completing a standardized motor test

• Interviewing the child

2. A patient who has COPD and mild dementia has been admitted to a hospital for treatment of pneumonia. It would be BEST for an OTR to observe the patient’s grooming skills in the:

• morning in the patient’s room

• morning in the OT clinic

• afternoon in the patient’s room

• afternoon in the OT clinic

3. A patient who has had a CVA has recently been discharged from inpatient services to a skilled nursing home. The patient becomes confused when trying to find the way from the dayroom to the dining room .The OTR should further assess the patient for deficits related to:

• Topographical orientation

• Simultaneous multiple attention

• Ideomotor praxis

• Implicit memory

4.A patient who had a recent ulnar collateral ligament repair of the thumb MCP joint is referred to OT for fabrication of a splint. The MOST EFFECTIVE type of splint for the OTR to fabricate is a/an:

a.) dynamic flexion.b.) forearm-based ulnar gutter.c.) wrist immobilization.d.) hand-based thumb spica.

5. A patient who has had a right CVA has been referred to OT. Prior to completing a visual-perceptual evaluation, the OTR should FIRST measure the patient’s:

a. visual acuity

b. spatial relations

c. scanning ability

d. visual memory

Recent Candidates Say…

Physical Disabilities

Mental Health

Pediatrics

Management/Administration

Equipment Needs/Orthotics?

Equipment/Orthotics Needs?

Peripheral Nerve Injury

High median nerve injuries=loss wrist flexion strength; ulnar deviation of the wrist, loss of thumb opposition, and loss of flexion of the thumb, index and long finger interphalangeal joints.

When making a fist, the ring and small fingers flex while the long and index tend to stay straight.

In low median nerve injuries the fingers are still able to flex, but thumb opposition is often lost.

•Abnormal sensations in the 4th or 5th fingers•Numbness, decreased sensation•Tingling, burning sensation•Pain

Injury to the radial nerve results in loss of extension of the wrist, fingers and thumb.

C Bar Splint

Thumb Spica

Functional Hand Splint

Foam Finger Separator

Hand Cone

Thumb Splint

Dynamic Extension Splint

CTS Splint

MP Flexion Spring

Thumbkeeper Splint

Finger Extension Assist

Buddy Splint

Pneumatic Armband

Hemi Sling

Ankle Foot Orthosis

Flexor Tendon Repair

Functional Resting Splint

Thumb Spica for Skiers Thumb

PIP Extension Splint

Forearm Thumb Spica

Static Progressive Finger Splint

Mental Health Review

OnLine Test Review