th DURHAM wD COLLEGE sucess martes Clinical Skills Passport OTA & PTA Program 2021-2022 Student Name: Viadysiav Martynchuk Instruetions: Students are to indicate the level of skill demonstrated and initial when a skill has been experienced in placement. Preceptors are to review the form and validate at the end of the student placement. Please note NOT ALL skills will be achieved in each placement, the curriculum provides teaching and learning in these areas — some skills will be more applicable to PTA placements and others, OTA placements. ‘Skill Level Legend: 1= Independent A= Assisted (not yet independent) = Observed Direct Client Care: y Field Placement 1 Interventions i i fy Skill Level, Block Placement eptor initials | as authorizato ited Bindu Bathing ‘Communication Dressing T Eating T ‘Grooming Iq Life skil training ies Meal prep Toileting Cane/canes A Crutches ° Quad cane Stair practice Walker—standard | 0 Walker—wheeled | 0 ‘Walking endurance Walking practice o ‘Assisting with | Balance Inventories collection of | (eg. BERG) Objective _[ Goniometry Data Timed activities Timed up and go ADIs Ambulation >I) Version 1.3 Revised June 7, 2021Tue) Pain Scales, oO Rating of Perceived Exertion Vital signs — Blood pressure Vital signs — Heart rate Vital signs — Respiratory rate Vital signs ~ Sp02 ‘Communication A Devices, Assistive Computer ° Technology | Training/support Dressing aids Feeding aids ‘Assisted coughing | & Breathing exercises Cardio- Incentive Spirometry respiratory | Percussion Postural drainage Vibration I ‘Attention process ing. t 4 Cognitive behavioural {\ therapy Cognitive intervention Cognition and | sessions Perception | Cognitive training Perceptual intervention Perceptual Training. Visual perceptual intervention GRASP intervention Fine motor Hand Exercises ° Handwriting Program Handwriting Training _ ‘Active ROM. A Desensitization Edema control Exercise devices x Hand therapy | Gorey Hand activities lol> Passive ROM Sensory re-education Independent _| Leisure skils RIE Version 1.3 Revised June 7, 2021‘Community | Meal planning Living skills. [Medication routine Money management Public transport/travelling Vocational skills jofeedback Electrical muscle stimulation Hot packs A Ice packs A Modalities =o x : Interferential Mechanical traction Other (specify) Paraffin wax TENS >>] Ultrasound iteral motor coordinator Fine motor Gross motor \ activities Proprioceptive [ { I Tactile l ca Vestibular balance 4 Visual motor I ‘Ata table for eating For an activity Positioning | ina bed and Ina chair or A Repositioning | wheelchair B Ona bed and/or mat_| A ‘Standing frame Equipment education reinforcement Family education Providing [pain control strategies education lofo’ Relaxation strategies Splint education ‘Wheelchair education |] J ‘Attendance at A Inservices/Education Receiving | chart review education >|> Consulting with other ‘team members Rounds Splints) Bandages Version 1.3 Revised June 7, 2021splinting Casting for orthotics — assistance Putting on/off Ry Splint cleaning Splint fabrication/assistance Splint finishing Therapeutic Exercise ‘Active Assisted ROM | O le Active Assisted ROM | O UE ‘Active ROM LE oO ‘Active ROM UE oO Balance ° practice/training Coordination training | © Core stabilization ° Exercise tubing Falls prevention 0 exercises Free weights o Hydrotherapy Joint protection ° Large fixed exercise equipment ‘Managing spasticity Passive ROM LE oO Passive ROM UE oO Pulleys: A slings Strengthening Stretching. >|>|> Work conditioning/ hardening Transfers Mechanical lift ‘Standing plvot transfer Toilet transfer I ‘Transfer belt \ Transfer board \ Tub transfer Wheelchairs ‘Manual wheelchair maintenance, { ‘Manual wheelchair setup | Manual wheelchair training Power wheelchair Version 1.3 Revised June 7, 202%maintenance Power wheelchair set up Power wheelchair training Other: Documentation — Client Chart or Record Equipment Preparation - Vendor Setup/Assistive Devices Setup Group planning ‘Group set up/take down Intervention/assessment Preparation/set up ‘Shadowing Other Professionals ‘Attendance at Inservices/Education Event/Presentations CAOT Activities CPA Activities Filing ‘Gathering/organizing resources Inventory ‘Maintenance of assessment kitchen/bathroom ‘Maintenance of equipment Photocopying/Printing. Reading/Reviewing Resources Record keeping Resource development Sewing Statistics Student Project/presentation Version 1.3 Revised June 7, 2021Field Placement 1 Name of clinical site: MedRehab Group Date: March 30 Preceptor Signature: 3 Field Placement 2 Name of clinical sit Date: Preceptor Signature: Block Field Placement Name of clinical site: Date: Preceptor Signature: ‘Version 1.3 Revised June 7, 2021