What Would You Do?
You are running 15 minutes behind schedule because your previous patient required unexpected extra assistance. You begin your next OT session late and only treat for 30 minutes instead of the full 45 minutes scheduled. What would you do when documenting and billing?
What is bill only for the skilled treatment time actually provided and document the shortened session?
Your fieldwork educator asks you your opinion on an intervention plan for a patient’s case. You use your knowledge of the patient and skills that you’ve gained working in the clinic to create an intervention plan catered to this patient.
What is clinical reasoning?
You are observing a session where a patient is getting out of bed on a smooth surface with normal socks on. What is the most important red flag in this situation?
What is patient needs grippy socks
You are working with an 82-year-old soft spoken women in a SNF that you’ve built great rapport with. You’ve been working with them for 3 weeks, and you walk into their room. They have forgotten who you are, are searching for their glasses that are on the top of their head, tell you they don’t want to see you, and push you away when you go to sit next to them. What medical emergency may you expect?
What is delirium?
You enter a patient’s room for a scheduled OT session. The patient is awake, medically stable, and says, “I’m not doing therapy today. I’m tired. Come back later.” They turn away from you and stop responding. What would you do?
What is respect their refusal and schedule for later?
You’re working with a patient in acute care. You do a transfer with this patient and your fieldwork educator tells you that your handling technique is unsafe for you and the patient. You thank them for the feedback, ask for a demonstration, and practice the technique with them after the session.
What is taking feedback?
You are in week 4 of fieldwork and you are still observing all of your fieldwork educator’s sessions. You express that you feel ready to start trying to plan some parts of the session and your educator says “you are doing great, let’s keep observing for now”. What is the red flag in this situation?
What is lack of progression and opportunities. How would you address this?
You are working with a pediatric client on tolerating various positions. You place them in prone position and they leave their face into the blanket. You then pick them up and hold them in a prone position expecting them to extend their neck and extremities, but they don’t. What reflex is absent?
What is the landau reflex
Your clinical instructor tells you to “do something functional” with your next patient but is called away before giving more direction. You review the chart and see general ADL goals but are still unsure what intervention they expect or what level of assistance is appropriate. What would you do?
What is have multiple intervention activities and seek client’s goals?
You’re on your 8th week in your fieldwork rotation and your fieldwork educator has not allowed you to work directly with any patients yet. You approach them with this, asking if you would be able to work with the patients and complete interventions.
What is advocating for yourself?
Your patient’s goal is to return to cooking for her family. Your fieldwork educator uses interventions that increase upper extremity strength and ROM. You suggest a cooking intervention and your fieldwork educator responds “she will work on cooking at home, in therapy she needs to work on the foundations”. What is the red flag in this situation?
What is lack of occupation-based interventions
Most commonly torn rotator cuff muscle
What is supraspinatus
400 Points: A patient asks to get from the bed to their wheelchair so they can go to the bathroom. You check the chart and see they are listed as a two-person assist for transfers. No second staff member is available right now, and the patient insists they can do it with just you. What would you do?
What is wait for assistance to avoid unsafe transfer?
Your fieldwork educator is using an intervention approach that you learned differently in school. You ask what method they are using and what research articles they found that support the intervention.
What is using evidence-based practice?
You are starting your 6th week of fieldwork and your fieldwork educator tells you that you are really catching on and will be taking over their caseload this week because they are going to start a project for the clinic. What is the red flag?
What is inadequate supervision
The ACL of the wrist
What is the scapholunate ligament (SLL)?
500 Points: You are working with a patient on dressing tasks when a family member enters the room and says, “This therapy is pointless—they need rest, not this.” The patient becomes quiet, avoids eye contact, and stops participating. What would you do?
What is remain professional, include client in conversation, and provide education?
Throughout your fieldwork rotation, you ask your fieldwork educator if there is anything you can improve on. They provide you with feedback, you ask questions, and approach the situations with the advice that they have given you.
What is applying feedback?
You prepared a session for a client based on their abilities two days ago. When you arrive to their room the nurse tells you that they are having a bad day and are much more fatigued than they have been. Your CI says, “you already planned this session, lets implement it and just see how they do”. What are two red flags in this scenario AND the best next action?
What is dismissing the patient’s current status and ignoring client safety. Best next action= modify the plan after reassessing the client’s current functional and cognitive status.
You are working with a client that has experienced a R ischemic CVA and has L LE weakness. Where would you have expected their clot?
What is the R anterior cerebral artery?