pta 211 physical agents fall 2012 - mcccbehrensb/documents/handbookfall2012.pdfpta 211 physical...

Mercer County Community College Physical Therapist Assistant Program

Course Handbook*

*to be used in conjunction with PTA Student/Learner Handbook

PTA 211 Physical Agents

Fall 2012 Barbara J. Behrens

MS 350 Course Director 609-570-3385

[email protected]

Office Hours

M, W 9-11am, W 4-5pm Other days and times by appointment

Course Syllabus Form

Course #: PTA 211 Course Title: Physical Agents Credit Hours:(Lecture/Lab) 4/3 Number of weeks: 10 Clinical Contact Hours N/A Number of clinical weeks: N/A Pre- requisite courses: PTA 106, MAT elective as specified Co-requisite courses: PTA 210, PTA 224

Course Grading:

% of grade Activity # per semester

30 Exams 3

0 Quizzes 0

0 Papers 0

15 Presentations 1

5 Class/lab participation Continuous

20 Competency Tests& 4

30 Practical Exam** 1 ** In the event that a student/learner is unsuccessful in passing the Practical on the second attempt, the student/learner will not receive a passing score for the course. Please refer to the “Practical Examinations” section of the PTAP Student/Learner Handbook. & Please note that competency tests are scheduled outside of regularly scheduled class time

mailto:[email protected]

Required Text(s): Behrens BJ, Michlovitz SL, (2006), Physical Agents: Theory & Practice 2nd ed. Philadelphia: FA Davis Co.

ISBN 0-8036-1134-x

Behrens BJ, (2006), Laboratory Manual for Physical Agents 2nd ed. Philadelphia: FA Davis Co. ISBN 0-8036-1135-1

===========================================================

Course Description: This course is designed to introduce the student/learner to the use of physical agents and therapeutic modalities in physical therapy practice. Lecture and laboratory activities develop problem solving skills and critical thinking in the use of electrical stimulation, and therapeutic heat & cold, traction, hydrotherapy and aquatics to accomplish therapeutic treatment goals. Skills will be tested for competence throughout the semester. Students are expected to both receive and administer each of the therapeutic interventions discussed. Restricted to approved PTA majors. ===========================================================

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

1. Safely and appropriately apply physical agents and electrical stimulation for the accomplishment of therapeutic treatment goals including: the reduction of pain, edema, joint stiffness and muscle guarding and increasing circulation, muscle strength and tissue extensibility.

2. Determine what the potential causes and remedies would be for undesirable patient responses to the application of physical agents and electrical stimulation for the accomplishment of therapeutic treatment goals and make appropriate decisions and adjustments in the application to maintain patient safety.

3. Critically discuss the available literature dealing with physical agents relating the relevance of what is published with current practice patterns in the clinical setting.

4. Safely and appropriately apply cervical and or lumbar mechanical traction for the accomplishment of therapeutic treatment goals including the reduction of nerve root radiculopathies and disc compression.

5. Differentiate between the advantages and disadvantages of a buoyant environment for a therapeutic exercise program versus a land environment and how one could safely progress a patient working on an endurance program in the aquatic environment, who had partial weight bearing status.

Course Objectives: Following the successful completion of this course the learner will possess skills in the following domains: Cognitive/Knowledge The learner will be able to successfully:

1. describe the properties of electricity (conductance, resistance, capacitance) and how this would impact the application of electrical stimulation with a patient

2. describe the mechanisms for heat transfer and how this applies to the application of heat or cold in different forms to patients

3. identify commonly accepted treatment goals for the application of physical agents & therapeutic modalities

4. identify the appropriate parameters required to accomplish treatment goals with electrical stimulation and ultrasound

5. cite potential adverse responses to the application of a therapeutic modality or physical agent and how to remedy those responses should they occur

6. outline the appropriate information necessary to document a treatment with physical agent or therapeutic modality

7. cite the indications, contraindications & precautions to the application of electrical stimulation, ultrasound, superficial and deep heating agents

8. describe the various pain pathways and potential ways to block pain perception utilizing physical agents and therapeutic modalities

9. describe the importance of pain as a perception and how pain may be indicated other than verbal by expressions

10. describe the expected visual and palpable responses of the skin to a therapeutic intervention with a physical agent modality

11. describe how two or more physical agents can be utilized together to accomplish a therapeutic treatment goal

12. describe the components of mechanical traction devices for spinal traction and provide the rationale for each of the those components and their therapeutic application to accomplish stated treatment goals

13. list the parts of a whirlpool for a therapeutic intervention with hydrotherapy, describing the variables and rationale for their selection

14. differentiate between an aquatic pool and a hydrotherapy tank for a therapeutic intervention with a patient stating advantages and disadvantages for both forms or treatment

15. describe the physical principles of water and how they may be used to in a therapeutic intervention with a patient to affect a positive outcome

Psychomotor The learner will be able to successfully:

1. display and explain the appropriate application techniques for therapeutic superficial and deep heat 2. demonstrate the appropriate application of therapeutic cold, light and electrical stimulation 3. describe the use of EMG biofeedback as a therapeutic intervention 4. respond appropriately to unexpected physiologic responses to a therapeutic intervention with a

physical agent 5. demonstrate and defend the importance of proper patient positioning and draping techniques 6. perform pain assessment skills for treatment documentation 7. describe the rationale for the selection of physical agents and therapeutic modalities based on clinical

goals and patient responses 8. perform the application of electrical stimulation to accomplish: pain reduction, muscle guarding

reduction, and a motor response 9. document treatment techniques for physical agents and therapeutic modalities in SOAP format 10. recognize, respond and document normal and abnormal responses to treatment interventions with

physical agents and therapeutic modalities 11. assess patient sensation prior to and after the application of a physical agent or therapeutic modality

and determine what types of responses need to be documented in the patient’s chart and how they should be documented

12. prepare a patient for the therapeutic application of hydrotherapy or spinal traction to accomplish a stated treatment goal

Affective The learner will be able to successfully:

1. recognize the importance of pain as both a physical and psycho-social factor by the approach that they use when describing treatment techniques and expected treatment outcomes with a patient

2. defend the establishment of a safe and effective working environment by performing safety checks on the equipment that they will be utilizing before they apply it to a patient

3. enforce the safe and efficacious utilization of physical agents by assessing and re-assessing each patient prior to and following the application of a physical agent

4. recognize the importance of clinically based research by utilizing some of the research articles in their class presentation

5. recognize the significance of and defend the establishment of communication among members of the Health Care Delivery Team by discussing topics with other members of the team and communicating these conversations back to their classmates and instructors

6. recognize the importance of documentation skills as a quality assurance tool and document patient treatment in the patient record

7. defend the importance of skin assessment prior to, during and after therapeutic interventions with physical agents and therapeutic modalities

=========================================================== Course Outline: I Inflammation & Tissue Repair A. Responses to therapeutic interventions with Physical Agents & Therapeutic Modalities B. Clinical observations to therapeutic interventions (Assessment techniques) II Therapeutic Heat & Cold III Ultrasound IV Electrical Stimulation A. Terminology B. Treatment Goals 1. Sensory analgesia 2. Motor responses C. Treatment devices V Soft Tissue Treatment Techniques: Traction VI Hydrotherapy & Aquatics VII Therapeutic Use of Light VIII Regulatory Issues with the development of new modalities IX Integration of therapeutic interventions and modalities

=========================================================== Course Schedule: Fall 2012 Location: MS 352

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PTA Program Policy: Course Grading

One of the goals of the MCCC PTA Program is to prepare learners to practice as PTAs. 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, with an equivalent score of 77 or higher. In recognition of this standard, set by a board that is external to MCCC, the PTA program will adopt 77 as the minimal passing grade. Other grade ranges are as follows:

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

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

B+ = 87-89 C+ = 77-79 F = 0-59

Grades below 77 are not considered passing grades for the PTA program courses, and are therefore considered unacceptable. All PTA program courses must be completed with a grade of “C+” or higher. PTA program courses may be attempted only twice.

PTA Program Attendance and Deportment Policy Statements Physical Therapy is a respected profession. Members of the profession abide by the Code of Ethics for Professional Conduct and the Guide for Professional Conduct. The MCCC PTA Program faculty members believe that professional conduct and deportment are essential components for success as a Physical Therapist Assistant. Enrollment in a PTA Program course will be viewed as a commitment that is made between the learner and the instructor. Enrollment in PTA Program courses is viewed as a similar agreement to the one that exists between an employer and an employee. Both parties agree and understand that:

Attendance is expected for every scheduled lecture, laboratory and clinical education course.

Excused absences of didactic courses may be permitted at the discretion of the Course Director, if the absence is discussed in advance of the occurrence.

It is the responsibility of the learner to leave a message with B. Behrens, PTA Program Coordinator, if the learner is going to be absent from a scheduled lecture, laboratory or clinical education course [email protected]. This message is to be left prior to the absence of the learner or promptly thereafter.

Lateness to a scheduled lecture, laboratory or clinical education course is unacceptable. The learner and the Course Director will negotiate based upon the frequency and circumstances, to determine what action will be taken.

Repeated lateness may adversely affect learner performance and progression within the PTA Program.

Learners and faculty members are expected to behave at all times in a manner that is consistent with the behaviors of their chosen profession and those of a civilized society. (Nothing in this statement should be construed to prohibit an individual from having an individual lifestyle outside of the clinic environment that may differ from the expected behaviors in the clinic or classroom.)

Failure to exhibit behaviors consistent with this policy may result in the need for Program counseling to determine the appropriateness of the choice of major.

Continued matriculation following acceptance in the PTA Program indicates that the learner has agreed to accept and uphold their commitment to these policies. 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 PTA program coordinator prior to the due date for any course examinations or assignments to discuss what accommodations might be necessary. If you require special accommodations, it is your responsibility to meet with the course coordinator for any course in which you are requesting that those accommodations be made. You also need to supply a copy of the documentation to support your request. A list of Essential Functions for the PTA program students and graduates is available to all learners by request, from any PTA program faculty member.

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 LB221, and she can be reached at (609) 570-3525.

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.

Competency Testing 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 students and the PTA faculty. All PTA program student/learners experience both administering care and receiving care, classmates are 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. • In PTA 211, 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. Penalties are outlined as follows: Success on the 2nd attempt Unsuccessful 2nd attempt Successful on 3rd attempt Unsuccessful with 3+ attempts

5 points deducted from competency grade for that course

It is the responsibility of the student/learner to contact the course instructor if more than a second attempt is required for competency testing.

10 points deducted from competency grade 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.

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

the tester interacts freely with the student/learner being tested.

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

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

Student/learners sign up for competency tests when they feel that they are ready to take them.

Student/learners know exactly what test they will be demonstrating competence with. During a practical exam:

the tester does not interact with the student/learner, they take notes.

the tester provides no additional information to the student/learner being tested.

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

Student/learners are assigned a specific testing time.

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

Responsibilities of the PTA student/learner:

signing up in advance to take a competency test, once he or she feels that the skill has been mastered

providing a suitable patient upon whom to perform the skill (This is most often a fellow PTA program student/learner, who is dressed in a manner that allows the technique to be performed unrestricted by jewelry or extraneous clothing

preparing and cleaning up the appropriate treatment environment

providing the appropriate documentation for the competency tester to sign off that he or she performed the test in a safe and competent manner


Fall 2012 PTA 211 Physical Agents

Week Date Topics Objectives Chapter(s)

1 8/27 From Injury to Repair: Pain and Inflammation

C8, C9, C10, P6, P11, A1, A2, A3, A7

1

2 9/5 Observable responses to therapeutic treatment interventions

C2, C5, C6, C9, C10, P1, P4, P5, P9, P10, P11, A3, A7

2

3 9/10 Therapeutic Heat & Cold

C2, C3, C5, C6, P1, P2, 3

4 9/17 Therapeutic Ultrasound

C2, C3, C4, C5, C6, C7, C8, C10, P1, P7, P9, P10, P11

4

9/24-9/27 (M-R) WE #1 (in the testing center)

5 9/24 Foundations for Electrical Stimulation Physiologic Basis of Electrical Stimulation

C1, C7, C8, P10, A2 10, 11

5 9/28 Neuromuscular Electrical Stimulation

C1, C3, C4, C5, C6, C7, P2, P8, P10

12 & 16

6 10/1

Pain Management with ES

C1, C3, C4, C5, C6, C7, C8, P2, P6, P8, P10

14 & 16

7 10/8 Electrical Stimulation Devices

C4, C5, C6, C7, C8, P2, P3, P7, P8. P10, P11,A2

15

10/15-18 (M-R) WE #2 (in the testing center)

8 10/15 Aquatics & Hydrotherapy

C13, C14, C15 ,P12, 5

9 10/22 Soft Tissue Treatment Techniques: Traction

C12, P12, A2, CG4 6

10 10/29 Modality Integration C11,A1, A2, A3, A6, A7 17

10/31 & 11/1 Practical Exam (tentative) CG1, CG2, CG3, CG4, CG5

Weeks 11,12,13 & 14 (November 5-December 5, 2012)

PTA 225 Clinical Education I

15 12/7 Aquatic Lab (tentative) A4, A5, CG3

12/7 Presentations

12/10 Presentations C14, C15, P12, CG5

12/12 Presentations A4, A5

12/17 WE #3 in MS 352

Mercer County Community College 2012 Learner:

Physical Therapist Assistant Program Patient: Practical Examination Rubric Scenario: Date: Course:

Instructions:

The learner will select 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. *PTA 106 learners have 5 minutes prep for 30 min test

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

Equivalent to: Observations

5 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 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 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 2 Inappropriate Did not use a sheet on the treatment plinth during Rx

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

1 1 1 Fraudulent N/A

1 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 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



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


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

8 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 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 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 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 Equivalent to: Observations


My name is “”I am a Physical Therapist Assistant Student and I will be working with you today. Slow, clear, easily audible, looked for acknowledgment by pt.


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

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

2 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 2 Unsafe

1 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



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 3 Nervous but safe

2 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 2 Unsafe



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


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



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 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 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

2 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



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

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

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



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



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 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 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 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



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



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 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

7 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 6 Unsafe N/A

5 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 Comments:

Scores Equivalent to:




12 12 12 Inappropriate

9 9 9 Unsafe

6 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

Comments: Scores Equivalent to:




12 12 12 Inappropriate

9 9 9 Unsafe

6 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 try to 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

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.” Additionally, a minimum score of 77 must be earned to pass the practical exam, consistent with all PTA program courses.

Summary Total Score for the Clinician:

Review Date:

1 2 3 Point Deductions (as a patient):

Learner Initials:

4 5 6 7 Final Score:

Safe/Unsafe

Pass/Fail 8 9

10 Tester(s): Total

BJB 3/12 rev

PTA 211 Physical Agents Presentation Assignment

Step 1 Identify your partners for this presentation and select a thermal agent, traction, aquatics or an electrotherapeutic modality for your topic.

Step 2 Locate at least 1 peer reviewed journal article that deals with the application of that physical agent modality. (It must have been published within the last 5 years. Case studies are acceptable.)

Clear the article with the Course Director before you leave for clinical!

Step 3 Speak with a practicing clinician about the article to determine what their thoughts were regarding the techniques that were employed.

Step 4 Prepare a presentation for your classmates regarding your findings. Be prepared to address the

following questions:

1. Where did the clinician(s) that you interviewed go to physical therapy school? a. This can be a nice “ice breaker” when discussing something with other clinicians and

some schools are stronger in this area than others. 2. How comfortable would you say that the interviewed clinicians are with physical agents &

therapeutic modalities? a. Did he or she use them often or not at all? b. Was the frequency of use related to the patient population or comfort level of the

clinician? 3. How comfortable were your interviewees with your questions regarding the use of the physical

agents & therapeutic modalities mentioned in the article? a. Did the individuals that you were interviewing “enjoy” speaking with you about what

they had read? b. Did they seem defensive or were they genuinely interested in the exchange of

information and the discussion? 4. Did the article have any impact on the way that the clinicians practice? 5. Do the clinicians that you selected for interview routinely utilize physical agents & therapeutic

modalities in their practice setting? 6. What specialty areas of practice that you feel the “modality” investigated would be of the most

potential benefit? 7. What are your thoughts regarding the “modalities” mentioned in the literature?

a. Did you think that the article utilized them appropriately based upon what you have learned and the experience that you have had?

b. Would you have changed anything about the use of the modality and if so what would that have been?

c. Did you discuss anything else with the clinicians you spoke to that the article sparked a discussion about? If yes, what was it?

8. On a scale of 1-10 where ten is very comfortable, how would you rate your current comfort level with physical agents as compared to your first week of class? Has this assignment changed your comfort level at all?

PTA 211 Physical Agents Presentation Assignment

Article:

Interviewee:

Partners:

Question Response

9. Where did the clinician(s) that you interviewed go to physical therapy school?

10. How comfortable would you say that the interviewed clinicians are with physical agents & therapeutic modalities?

a. Did he or she use them often or not at all?

b. Was the frequency of use related to the patient population or comfort level of the clinician?

11. How comfortable were your interviewees with your questions regarding the use of the physical agents & therapeutic modalities mentioned in the article?

a. Did the individuals that you were interviewing “enjoy” speaking with you about what they had read?

b. Did they seem defensive or were they genuinely interested in the exchange of information and the discussion?

12. Do the clinicians that you selected for interview routinely utilize physical agents & therapeutic modalities in their practice setting?

13. Did the article have any impact on the way that the clinicians practice?

14. What specialty areas of practice that you feel the “modality” investigated would be of the most potential benefit?

15. What are your thoughts regarding the “modalities” mentioned in the literature?

a. Did you think that the article utilized them appropriately based upon what you have learned and the experience that you have had?

b. Would you have changed anything about the use of the modality

and if so what would that have been?

c. Did you discuss anything else with the clinicians you spoke to that the article sparked a discussion about? If yes, what was it?

8. On a scale of 1-10 where ten is very comfortable, how would you rate your current comfort level with physical agents as compared to your first week of class?

a. Has this assignment changed your comfort level at all?

b. How?

Other Insights or Comments: bjb/6/12


PTA 211 Physical Agents

Competency Tests

1. Application Techniques for Hot Packs & Paraffin

Lab Date: 9/14 Test Week: 9/24 Test Date:

Part A Hot Pack Application

Your “patient” has been diagnosed with degenerative joint disease in both knees, with the right knee

being more painful and stiff than the left knee. Treatment goals include pain reduction, increased joint ROM and reduction of joint stiffness.

Apply a hot pack to the right knee of this patient. (10 minute treatment time)

You will need to demonstrate competence in the following:

Your introduction to the patient

patient education/orientation

patient positioning & draping

skin inspection

appropriate application technique to accomplish treatment goals

treatment termination

documentation of the treatment in SOAP note format

Part B Paraffin

Your “patient” is receiving physical therapy for their left hand, specifically the left index finger, which

sustained a crush injury in April of last year. The fracture is well healed but the patient has decreased ROM and joint stiffness. Treatment goals include pain reduction and increasing joint ROM.

Apply paraffin to this patient to help reduce the joint stiffness


your introduction to the patient



skin inspection




2. Application of Therapeutic Ultrasound Lab Date: 9/21 Test Week: 10/1 Test Date:

Your “patient” has been referred to physical therapy after a cervical strain. Treatment goals include reduction in

muscle guarding, reduction in pain due to the presence of a palpable fibrocystic nodule in the belly of the right upper trapezius.

Apply ultrasound to the upper trapezius to accomplish the stated treatment goals





skin inspection


parameter selection and rationale

intensity & frequency

duty factor & transducer size

treatment time & coupling agent

treatment area



3. Electrical Stimulation for Muscle Strengthening (NMES)

Lab Date: 9/28 Test Week: 10/8 Test Date:

Your “patient” has been referred to physical therapy with a diagnosis of post operative medial meniscus vastus

medialis weakness in the L LE. Treatment goal: muscle strengthening.

Apply electrical stimulation to the area to accomplish isometric muscle contractions for muscle strengthening.





skin inspection


appropriate parameter and electrode placement site selection



4. Application of Electrical Stimulation for pain relief

Lab Date: 10/5 Test Week:10/15 Test Date:

Your “patient” has been receiving physical therapy treatments to help reduce his/her lower back pain (centrally

located at L4-L5).There is no radiating pain. Treatment goals include pain reduction and pain management techniques.

Apply electrical stimulation to provide sensory analgesia throughout the painful area.





skin inspection


appropriate parameter selection and electrode placement site selection



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