Clinical Course Overview Quiz

Course Information

• Course title: Foundations of Rehabilitation Science
• University: Western University
• Days: Mondays
• Time: 6:30-9:30
• Location: FNB 1270

Course Faculty

• Jen Van Bussel (PT)
• JP Raman (PT)
• Josh Campbell (OT)
• David Sindrey (CSD)

Course Structure and Assessments

• Three blocks (each 3 weeks long) for PT, OT, and CSD
• Each block followed by an MCQ (20% each) completed on Brightspace. CSD MCQ scheduled during final exam period.
• Individual Assignment (20%): Case Review
• Group Assignment (20%): Knowledge Translation Video

Individual Assignment: Case Review

• Practice reflective writing and demonstrate understanding of clinical roles, scope of practice, and common approaches of PT, OT, SLP, and Audiology.
• Apply understanding to a clinical case study (Meet Jay).
• Tasks involved:
  • Review case information about Jay.
  • Describe the role or scope of practice for each profession.
  • Describe one assessment or treatment each profession may perform to address Jay's care needs or in preparing Jay for discharge home.

Group Assignment: Knowledge Translation Video

• Collaborate in small groups (maximum 5 students) to demonstrate knowledge on a chosen course topic.
• Create a short video (<5 minutes) summarizing group knowledge on chosen topic.
• Topics can be chosen from any of those learnt through the course.
• Learners will demonstrate time management, teamwork, oral communication skills, and knowledge of course content.
• Deliver skills by creating an instructional video.
• Email group details to the course manager by February 7th.

Learning Objectives

• Foundational definitions and frameworks in rehabilitation sciences and practice.
• Introduction to ICD (International Statistical Classification of Diseases and Related Health Problems), ICF (International Classification of Functioning, Disability and Health) model of disability functioning from the physical therapy perspective.
• Scope of physical therapy practice
• Essential competencies of a physical therapist
• Review of the Physiotherapy Code of Ethics
• Current employment market for physical therapists

Rehabilitation Process

• Identify problems and needs
• Relate problems to modifiable and limiting factors
• Assess effects
• Plan, implement, and coordinate interventions
• Define target problems and mediators, select appropriate measures

Rehabilitation Outcomes/Goals

• Goals depend on various factors such as condition being treated, patient age, and availability of resources.
• General goals include: prevention of loss of function, improvement/restoration of function, slowing the rate of loss of function, compensation for lost function, and maintenance of current function.

Rehabilitation Categories

• Rehabilitation medicine
• Therapy
• Assistive technologies

Rehabilitation Medicine

• Improves function through the diagnosis and treatment of health conditions, reducing impairments, and preventing/treating complications.
• Doctors with expertise in Medical Rehabilitation include physiatrists, rehabilitation doctors, and physical and rehabilitation specialists.
• Other specialists involved in rehabilitation medicine include: psychiatrists, geriatricians, paediatricians, ophthalmologists, neurosurgeons, and orthopaedic surgeons.

Assistive Technologies

• Devices that improve/maintain functional capabilities.
• Examples include: crutches, prostheses/orthoses, wheelchairs, canes/walkers, hearing aids/cochlear implants, ocular devices/talking books, communication boards, speech synthesizers, etc.

Therapy

• Focused on preventing/slowing decline in functioning, restoring and compensating for loss of function, and maintaining current functioning levels.
• Personnel involved include physical therapists, occupational therapists, orthotists, prosthetists, rehabilitation and technical assistants, social workers, and speech and language therapists.
• Therapy measures include training, exercises, compensatory strategies, education, support and counselling, modifications to the environment, provision of resources, and assistive technologies.

Physical Therapy or Physiotherapy

• A primary care, autonomous, and client-focused health profession dedicated to improving quality of life by promoting optimal mobility, physical activity, and overall health and wellness.
• Involves disease/injury prevention, management of acute/chronic conditions, and participation restrictions, improving physical performance, rehabilitation from injuries and disease, and educating on maintaining function.

Physical Therapy—what do we use?

• Physical agents like mechanical force/movements (bio-mechanics or kinesiology), manual therapy, exercise therapy, electrotherapy, and other modalities (like hydrotherapy).

Physical Therapy—how do we apply?

• Examination, diagnosis, physical intervention, and patient education.

Foundational Rehabilitation Concepts - Rehabilitation Framework

• Family of International Classifications including WHO Family of International Classification (FIC) consists of integrated classifications for health information across the world, including Reference Classifications.
• ICD-11 is the international standard diagnostic tool for epidemiology, health management, and clinical purposes, used for health care classification systems. It has 17000 categories, 80000 concepts, 120000 terms.
• ICF is a WHO framework for measuring health and disability. it complements the ICD-11.
• The framework provides areas like: health condition, body functions and structures, Activities, Participation, Environmental factors (contextual factors), and Personal factors.

ICD-11

• Health care classified system, global standard for health data
• Scientifically up-to-date, multilingual design
• 17000 categories, 80,000 concepts, 120,000 terms, over 1.6 million clinical terms interpreted
• Foundation for identification of trends and statistics
• International standard for reporting diseases and health conditions.
• Provides system for classifying diseases
• Maps health conditions to corresponding generic categories

ICF

• Standard language and framework for the description of health and health-related domains.
• WHO framework measuring health and disability, both individual and population levels.
• Complements ICD-10, containing information on diagnosis/health condition but not functional status.
• Includes environmental and personal factors as disability occurs in a context.

Model of ICF

• Visual representation including health conditions (disease/disorder), body functions & structures, activity, participation, Environmental factors, and Personal factors.

ICF Example using Osteoarthritis/Rheumatoid Arthritis

• Explanation of the ICF model with Osteoarthritis/Rheumatoid arthritis (degenerative conditions affecting joints).
• Describes a health condition as an umbrella term for disease/disorder, injury, trauma, and other circumstances like aging, stress, or genetic predisposition.

Body Functions and Structures (ICF)

• Physiological functions defining body systems, psychological functions included.
• Anatomical parts of the body or components (organs, limbs); impairment defines problems like reduced range of motion, muscle weakness, pain.

Activities (ICF)

• Activities are the execution of a task or action by a person.
• Examples: mobility, handling objects, daily living activities (ADLs), dressing.

Participation in Everyday Situations (ICF)

• Person's involvement, affecting everyday situations/society.
• Difficulty in activity termed as activity limitations, and problems involving everyday situations termed as participation restrictions.

Environmental Factors (ICF)

• Physical, social, attitudinal environment
• Factors outside person, and serve a facilitator or barrier (e.g., workplace, housing, transportation, social attitudes, and health services/insurance).

Personal Factors (ICF)

• Individual's background, life experiences, and living situation.
• Includes features like gender, age, race, health behavior, coping strategies, and multi-morbidity (different illnesses).

ICHI

• International Classification of Health Interventions being developed as a reporting/analysis tool for interventions.
• An intervention definition as an act performed for/with/on a person or population used for assessing, improving, maintaining, promoting, or modifying health/function/health conditions.
• Interventions include diagnostic, medical, surgical, mental health, primary care, allied health/support, rehabilitation, traditional medicine, and public health.

Scope of Practice - RHPA

• Purpose: Protect/serve public interest, a more open governance system, a modern framework, freedom of choice, and improve quality of care.
• Features: Scope of practice statement (what the profession does), controlled acts (procedures/activities under qualified practitioner expertise), Health regulatory colleges (govern regulated professions), Health Professions Regulatory Advisory Council (independent body advising the minister), and Health Professions Appeal and Review Board (independent third party).

RHPA

• The Regulated Health Professions Act (1991)
• Governing framework for regulated health professions in Ontario.

Authorised acts for PTs

• Tracheal suctioning, spinal manipulation, acupuncture (including dry needling), treating wounds below the dermis, pelvic internal exams, and administering substances by inhalation.

Scope of Practice for PTs

• Assessment of musculoskeletal, neuromuscular, and cardiorespiratory systems
• Diagnosis of diseases/disorders associated with physical dysfunction, injury, or pain
• Treatment, rehabilitation, and prevention/relief of physical dysfunction, injury, or pain and promote mobility.

PT Scope of Practice - Musculoskeletal System

• Expertise in treatment of muscle and joint conditions; diagnosis, treatment, and prevention of muscle/joint problems.

PT Scope of Practice - Neuromuscular System

• Assessment and treatment of pain and dysfunction in neuromuscular diseases/injuries like low back pain, osteoporosis, osteoarthritis, rheumatoid arthritis, fibromyalgia, sciatica, scoliosis.

PT Scope of Practice - Cardiorespiratory System

• Prevention, rehabilitation, and compensation of disease/injuries in the heart and lungs where conditions can include shortness of breath, persistent cough, increased work of breathing, and reduced ability to exercise.

CPA Practice Divisions

• List of different practice divisions within the Canadian Physiotherapy Association (CPA).

Regulatory College

• Regulates physiotherapists/physical therapists in Ontario to ensure ongoing improvement of practice and serve the public interest.

Essential Competencies

• Skills required for PT practice.
• This involves: Physiotherapy expertise (client-centered approach, safety, assessment, diagnosis, prognosis, intervention plan, care transitions, and program evaluation), Communication, Collaboration, Management.

Leadership

• Championing clients' health needs, promoting healthcare innovation, and contributing to leadership in the profession.

Scholarship

• Evidence-informed practice, scholarly inquiry, self-reflection and feedback, maintaining currency, and contributing to the learning of others.

Professionalism

• Comply with legal and regulatory requirements, behave ethically, embracing social responsibility, act with professional integrity, and maintain personal wellness aligned with practice needs.

Physiotherapy Code of Ethics

• Ethical responsibilities in professional practice, including the acronym R.E.A.C.H. with emphasis on Respect, Excellence, Autonomy and Well-being, Communication, Collaboration, Advocacy, Honesty and Integrity.
• Consistent ethical decision-making process , with potential variations in decision/outcomes based on situation/opinion.

Employment Outlook

• Number of PTs (2023) with details on total, employed in physiotherapy, employed in other professions but seeking PT employment, employed but not seeking PT employment, unemployed but seeking PT employment, and unemployed and not seeking PT employment
• PTs by province (2023) and age (2023) and gender(2023)
• Employment forecast and job postings available
• Strategies to improve employment chances including resume tailoring, education/experience details, and volunteering.

Next Week

• Licensure and registration requirements
• Areas of practice
• Therapeutic interventions
• Outcome measures.
• Charting approaches for PT practices.

Test your understanding of the key components of the clinical course. This quiz covers the structure, assignments, assessment percentages, and focus areas as outlined by the faculty. Great for students wanting to ensure they grasp the course expectations.