PT 726
Examination, Evaluation, Diagnosis, and Prognosis
Fall 2003
Course Assignments & Clinical Site Visit
Course/Homework Assignments Clinical Site Visit
These assignments are designed to be done outside of class time and are structured to be completed either at home or on campus. All will require some use of the internet and a computer. There are a total of four assignments due throughout the course of the semester. The specific requirements and grading criteria for each assignment will be made available on line at the course website. The specific assignments are as follows:
Assignment 1. Course Mailing List and Online Grading Access Sign-up. Successful completion of this assignment will require a visit to course web page to sign-up for the class mailing list and online grade accessibility.
The mailing list is being hosted by Topica (www.topica.com) and there is a subscription form on the website that automates the task. You can also subscribe to the course list serve by sending a blank email to the following address pt726-subscribe@topica.com. If you are successful in subscribing to the course mailing list, Topica will automatically send you a confirmation message. You must reply to the confirmation message to be added to the list.
If you are successful in completing the assignment, you will receive an email from me confirming your eCollege and Topica registrations. If you do not receive confirmation before Tuesday, September 9, 2003, please see me as credit for the assignment will not be given after that date. Due date for completion of the assignment is Tuesday, September 9, 2003. Percent of Final Grade = 1%.
Assignment 2. Documentation of Findings from a Medical Interviewing. For this assignment, please conduct a medical interview with either a friend or a family member. The purpose of the assignment is to provide you with an additional experience in performing and documenting the findings from a medical interview. The interview must be done with someone, who given their chief complaint, could be a potential candidate for physical therapy. The assignment can be completed by interviewing someone who either currently has a musculoskeletal problem or who recently had an experience with a musculoskeletal problem. The person may or may not have elected to pursue treatment for the problem. The assignment cannot be completed using persons enrolled in the current PT class or the class of 2001. The documentation portion of the assignment will be graded and must include (1) a summary of the findings from the medical interview (CC, HPI, PMH) and (2) an evaluation of the findings. Findings from the interview are to be documented as discussed in class. The use of abbreviations is encouraged. The completed assignment must be submitted electronically and is limited to a maximum of one third of a page (81/2 x 11), 10 or 12 point type and 1 inch margins on the top and sides. Due date is 12:00 PM Tuesday, September 23, 2003. Percent of Final Grade = 5%.
Samples of previous assignments are available by clicking here.
Assignment 3. Screening for Musculoskeletal Dysfunction. For this assignment, you will need to perform an initial physical examination that screens for musculoskeletal dysfunction. The examination can be performed on a family member or a friend. The findings must be documented in a manner that supports your recommendations for care and must include (1) a summary of the findings from the medical interview, (2) documentation of any relevant objective findings, (3) and an evaluation. Remember, choosing to not see a client for care is a recommendation for care. Due date for the completion of the assignment is Friday, October 17, 2003. The assignment is limited to 1 type written page, 10 or 12 point type. Submission of the completed assignment must be via email. Percent of Final Grade = 5%.
Samples of previous assignments are available by clicking here.
Assignment 4. Establishing a Physical Therapy Diagnosis and Prognosis. To complete the assignment, please visit the highlighted link in the previous sentence. Instructions for completing the assignment are listed. Due date for the completion of the assignment is Friday, November 7, 2003. The assignment is limited to type written page, 10 or 12 point type. Submission of the completed assignment must be via email. Percent of Final Grade = 5%
Assignment 5. Examination, Evaluation, and Diagnosis of Gait Dysfunction. The purpose of this assignment is to provide an opportunity for additional practice in identifying gait related problems. There is a video of a client post-stroke on the course web site that is to be used for the analysis. Click here to go to the assignment.
The final report must include the following elements organized in readable and logical manner:
- Identify 3 gait deviations or problems that appear to have the greatest impact on the person ability to function independently. The problems identified will be based on the client's clinical presentation and must be problems that you think should be treated;
- Identify the phase of gait where the deviation is occurring. Be specific when identifying the phase of gait. For example, identifying stance as the place where a gait deviation is occurring is too general - is the deviation occurring at weight acceptance, during midstance, from weight acceptance through all of stance.;
- Briefly list the reason why you selected the deviation or problem that was identified;
- List the potential cause (s) for each identified gait deviation or problem (up to a maximum of three causes will be accepted and graded for each problem.) When listing the cause of the deviation, please only list the most likely causes given the client's diagnosis and clinical presentation;
- Identify an appropriate outcome measure that could be used to assess changes in patient function for each of the gait deviations or problems identified.
- Complete an evaluative that summarizes the relationship between the problems and the causes relative to the person's clinical presentation in the video and the diagnosis. The evaluation should make a link between impairments, functional limitations, and disability. The evaluation is limited to a maximum of 100 words.
- Assign a Physical Therapy Diagnosis using the Guide to Physical Therapy Practice 2nd Edition.
The assignment is limited to 1 type written page. Due date for completion of the assignment, which must be submitted via email, is Friday, November 28, 2003. Percent of Final Grade = 9%
The site visit is tentatively scheduled to occur on Thursday, November 20, 2003 and will be held at Kendall-Crosslands in Kennett Square, PA.
Kendal-Crosslands policy for student site visits requires a Manitou/TB Test and Hepatitis B vaccination. In order to attend the site visit, you must have a certificate indicating a recent Manitou/TB Test and Hepatitis B vaccination. Arrangements will be made with student health services to provide TB testing and Hepatitis B vaccination.
For the site visit, you will work in groups of three. Group assignments will be made at the site. The purpose of the visit is to provide you with an opportunity to practice your examination and evaluative skills on individuals with musculoskeletal dysfunction. For this assignment, each group will be performing an initial examination. The site visits have been very helpful in the past and will be useful in clarifying concepts covered in this and other courses this semester. The assignment associated with the site visit will help you prepare for your first clinical affiliation by giving you a chance to practice interviewing skills and examination techniques on individuals with a history of musculoskeletal dysfunction. In addition, the assignment will provide each group with an opportunity to practice documentation of the findings from an initial examination.
The initial physical examination should address the following areas: reviewing the medical record for past and present medical history or a subjective interview, vital signs, a musculoskeletal assessment - goniometry, flexibility testing & MMT, sensation assessment, coordination testing, and a functional assessment. You will have approximately one hour to work with a patient which means that your evaluation must be focused and directed toward the specific area or areas in which the patient reports impairment or disability. In some cases, the initial examination will be a screening for impairment and disability. The supervising clinicians will assist you with the process of conducting an examination. However, the members of the group are responsible for performing the actual evaluation. You should think about a plan of attack prior to going on the site visit.
When writing up the evaluation, each group is to summarize their findings using SOAP note format. Please organize your findings in a logical and concise manner. Each group must produce a document that includes all of the following elements:
- The results of a subjective interview and or medical record review - please include those aspects of the evaluation which are most relevant to how the patient previously functioned and must function
- Past and present medical history,
- Diagnosis - medical and physical therapy,
- Relevant Objective findings - functional status, sensation, orientation and cognition, goniometry, MMT, skin & soft tissue, and posture (if relevant),
- Problem list,
- Long and short term goals/outcomes - addressing each of the problems identified,
- Evaluation - summarizes the relationship between the problems and justifies the need for intervention if warranted .
The problem list should address only those issues which you consider most relevant to the person's level of impairment, disability, and handicap.
The written assignment is due on Wednesday, December 3, 2003 and is limited to 2 type written pages. The assignment must be submitted electronically.
Directions to Kendall: I-95 South to Rt 322 West. From Rt 322 make a (L) onto Rt 1 South. You will be on Rt 1 for approximately 8-10 minutes after crossing Rt 202 and going past the Brandywine River Museum and an abandoned Quaker meeting house. The Quaker meeting house is located at a light and Kendall's driveway is marked by a sign just after the light. If you cross route 52 or see Longwood Gardens, you have gone too far on Rt 1. Phone # 610 388-5013 ask for Jim Herlihey, MPT.
Directions to Crosslands: I-95 South to Rt 322 West. From Rt 322 make a (L) onto Rt 1 South. You will be on Rt 1 for approximately 8-10 minutes crossing Rt 202 and going past the Brandywine River Museum and a abandoned Quaker meeting house. The Quaker meeting house is located at a light and Kendall's driveway is marked by a sign just after the light. Go past Kendal to the second light and make a right onto Rt 52. Take Rt 52 to the next light, Rt 926 and make a right. Crosslands is located approximately 3/4 of a mile down. The entrance to Crosslands is located on the right side of the road. Follow the driveway to the main building and visitor parking. Once inside the main building, the receptionist can provide directions to PT. If you see Longwood Gardens, you have gone too far on Rt 1. Phone # 610 388-1441 x 245, ask for Kathy Ciolek, MPT.