Intro to PT chapter 7 Flashcards
Leadership, Administration, Management, and Professionalism (LAMP)
APTA section Health Policy and Administration (HPA) holds three LAMP leadership conferences a year.
Lamp skills
basis for developing leadership behaviors and political activism. Better communication.
Better communication
better patient outcomes and better adherence.
Communication
a process by which information is exchanged between individuals through a common system of symbols, signs or behavior.
types of communication skills
verbal, nonverbal, reading, writing, listening and electronic communication (I used to communicate through video as a videographer, I don’t see that listed in the chapter.)
Verbal and non-verbal communication
auditory and visual systems. Hear and observe. Are what they saying matching their body language.
Self-talk
Internal communication. constant feature of our mental landscape. The content of our mental landscape may manifest to others in conveyed emotion.
external communication
communication with one or more other people
First impressions
trustworthiness impression occurs in 33 milliseconds.
Reading
Critical skill essential for developing effective physical therapy evaluations
Health literacy
ability to understand and utilize health-related written information. 80 million Americans have poor health literacy. (I think they mean U.S. citizens and not people who live in north and south America.)
Due to health illliteracy
Check for understanding with patients for any written information you provide. Invite them to summarize or teach back.
Newest Vital Sign
Health literacy test.
Writing
Essential communication skill. Determines reimbursement. Ensures more seamless transition between therapists.
Active listening
High level cognitive skill. Verbal and non-verbal. Ongoing commitment to being present without judgement.
Restatement, reflection, clarification, and summary
Restatement (part of active listening)
Repeating the words of the speaker “…did I get that right?”
Reflection (part of active listening)
verbalizing both the content and the implied feelings of the sender.
Clarification (part of active listening)
Use of questions to check for understanding such as “Let me be sure I have this right” Or “tell me more” Open ended questions.
Summaries (part of active listening)
Convey the key elements of a conversation to ensure mutual understanding.
Medicare mandate for meaningful use of electronic communication for electronic health records
Requires secure technologies for electronic health record untilization to improve patient engagement, care coordination, and efficiency.
social media
Many orgainizations use this to convay meaningful information to their patients. Reasearch findings are often shared on X (twitter).
Communication “soft skills”
“success skills” that enance interactions in every sphere of influence.
Professional behaviors for the 21s century
Critical Thinking
Evaluate, differentiate, distinguish, utilize, and anaylize logical arguments, facts and scientific evidence. Identify and determine impact of bias on decision-making process.
Professional behaviors for the 21s century
Communication
ability to communicate effectly for varied audiences and purposes.
Professional behaviors for the 21s century
Problem-solving
the ability to recognize and define problems, analyze data, develop and implement solutions, and evaluate outcomes
Professional behaviors for the 21s century
Interpersonal skills
The ability to** interact effectively** with patients, families, collegues, another health care professionals, and the community in a culturally aware manner.
Professional behaviors for the 21s century
Responsibility
The ability to be accountable for the outcomes of personal and professional actions and to follow through on commitments that encompass the profession within the scope of work, community, and social responsibilities.
Professional behaviors for the 21s century
Professionalism
The ability to exhibit** appropriate profesional conduct** and to represent the profession effectively while promoting its growth and development.
Professional behaviors for the 21s century
Use of constructive feedback
the ability to seek out and identifyhigh -quality sources of feedback, reflect on and integrate the feedback, and provide meaningful feedback to others.
Professional behaviors for the 21s century
Stress manaagement
the ability to identify sources of stress and to develop and implement effective coping behaviors; this appliles to interactions for self, patients/clients and their families, members of the health care team, and in work/life scenarios.
Professional behaviors for the 21s century
Commitment to learning
the ability to self-direct learning to include the identification of needs and sources of learning, and to continually seek and apply new knowledge behaviors, and skills.
Professional behaviors for the 21s century
begninning, intermediate, entery level and post-entry level
Begninning - initial phases of professional pt education understand english
Intermediate- learner after first clinical experience Restates, reflects, and clarifies message
entry level - able to independently manage a caseload with consultation from a clinical instructer. Maintains open and constructive communication
Post-entry level - consistent with those of an autonomous practitioner beyond entry level. Mediates conflict
Three domains of learning
Cognitive domain
Knowledge, application, analysis, synthessis, evauluation
Three domains of learning
Psycomotor domain
Perception, guided response, complex overt response, and adaptation (hands -on skills)
Three domains of learning
Affective Domain
Attitudes, values, and character development that influence all the other professional skills.
hardest to teach
Communication falls within this domain.
self-assessment
using the professional behaviors assessment and guided discovery during advisory sessions with a faculty member.
Mindfulness
the ability to recongnize thougths, feelings and behaviors as they occur int the present moment - promote self-awareness and self-mentoring.
Build report with auditor learners
By matching the client’s verbal pace, tonality, intent , and speed.
Non-verbal communication
Haptics, Proxemics, gestures, postures and Oculesics.
Haptics
the use of touch as part of communication
Proxemics
Distance between speaker and the listener.
Ocuolesics
Use of eye contact or eye avoidence.
Matching posture, gesture, haptics, proxemics and oculesics
sychrony - mirror neurons. occurs naturally between individualps who are connecting in a positive manner.
Rapport
interaction marked by mutual collaboaration and respect but not necessarily agreement. syncronize.
First of three types of rapport
Cultural Rapport
using form of dress or greeting appropriate to the setting.
second of three types of rapport
verbal rapport
use the same or similar descriptive phrases and conversational content as the person with whom you are speaking.
third of three types of rapport
Behavioral rapport
when you mirror the posture and body movements of the person with whom you are speaking to create synchrony.
The building of rapport and the brain
oxytocin (bonding hormone) and mirror neurons.
Altruism
the act of putting the welfare of others before your own.
Cultural competence
promotes positive and effective interactions between diverse cultures.
cultural humility
preceeds cultural competence. acknowledges patients authority in relation to their own lived experience.
Culturally affirming practices
is a skill in the affective domain that involves awareness of the impact of sociocultural factors. more accessible to patients of all cultures. hetrogenity. recongnition of personal bias.
Stages of the cultural continum 1
Cultural destructiveness
People are treated in a dehumanizing manner and denied services on purpose.
Stages of the cultural continum 2
Cultural incapacity
Health care system is unable to work with patients from other cultures effectively; patients treatment is subject to biases, paternalism and sterotypes.
Stages of the cultural continum 3
Cultural blindness (neutral)
Health care system is based on a presumption that all people are the same and that biases do not exist. Services are ethnocentric and encourage assimilation.
Stages of the cultural continum 4
Cultural competence
Cultral differences are accepted and respected. There is continuousexpansion of cultural knowledge and adaptation of resources and services. There is constant vigilance regarding the dynamics of cultural differences.
Stages of the cultural continum 5
Cultural proficiency
Cultural differences are highly regarded. The need for research on cultural differences is acknoledged, and new approaches are developed to promote culturally competent practice.
Cultural continuum
levels of sensitivity to cultural behaviors
iplicit bias
attitudes or sterotypes that affect our understanjding, actions, and decisions in an unconscious manner.
implicit bias test
developed by Harvard. online tool to measure subconsious attitudes. https://implicit.harvard.edu/implicit/takeatest.html
gaze aversion and direct eye contact
Culturally determined modes of respect that the practitioner must come to recognize.
High-context communicators
sensitive to the social rules of deference and avoid conflict with those in a superior position
speak arround the point to avoid confrontation
Low-context communicators
asssume the individual is more important than the group.
meaning based on explicit cues. less nuance. More likely to speak up and express their views in a work setting.
High and low context communication in Culture of medicine
low context assumptions. but patients have their own assumptions.
Patient culture of medicine** explanatory model**
assumptions about the nature and consequences of illness and injury and impacts their receptivity to health information and treatment options
Hich-context communicators as patients
often silent. tend to speak around main point. meaning is assumed based on implicit cues. nuances such as posture , gaze and gestures are considered important. less likely to speak up.
Cultural miscommunication in health care
can be lifethreatening.
Baby boomers
50% living with arthritis by 2030 and 40% of knee and hip replacements.
Gen x
Me. many are underinsured or uninsured (ACA got me)
dislike beurocracy (true) likely to question treatment rationals (true)
Millenials
optimistic collaboratyive and civic minded.
mental health, obesity and substance abuse.
Generation Z
school shootings - 2008. digital native. value of dialogue to solve conflict.
vision loss
people who report having trouble seeing even when wearing glasses. and those who are blind. mild to severe.
Introduce yourself by name when you enter the room. Use everyday words but ask if they ned assistance moving from one place to another.
Use large font for written communication. Check into putting program in braille.
% of population
Deafness, auditory impairments and other communication disorders
15% of US population have hearling loss severe enough to make communication diffucult.
Communicating with people with auditory imparements
speak clearly and look directly at them, facing them, so they have a clear view of your lips.
articulate and use natural tones.
shouting may reduce effectiveness of hearing aids.
Confirm understanding. videos should have subtitles.
Use a light tap on the shoulder to get the
person’s attention.
TTY
LGBTQIA
Direct exploration of patients and clients individual preferences will assure use of the appropriate pronoun. Some may feel unconfortable disclosing. Offer your own first.
Families, caregivers
introduction and ask each individual how they like to be addressed. assess need for caregiver training (the quality of the caregiver training I was given by PT and OT made me want to be a PTA) Communication should be clear and simple. repeat if confusion. teach back. Teach only manageable amounts. Ask the patient or client about his or her personal goals. lay terminology.
Collaborate with health care team
Interdisciplinary team meetings and working closely with OT, Speach , respitory therapy, physicians and others. Raport skills useful here too.
Situation Background Assessment-Recomendation (SBAR
technique provides a framework for communication patient-related findings, concerns and requests.
SBAR S
Situation
A consise statement of the prolem:
Identify self
Identify problem.
SBAR B
Background
Pertinent and brief information related to the situation.
SBAR A
Assessment
analysis and considerations of options.
SBAR R
Recommendation
Action requested/recommended.
Communicating through delegation
PTA are more likely to be delegated too… but use raport skills.
Know the legal the legal boundaries regarding supervision and delegation in your state.
Succeeding on Social Media
Ethical conduct
Use social media following code of ethics for the physical therapistss and standards of ethical conduct for the physical therapist assistant.
Succeeding on Social Media
Professionalism
no harrasing statements and unprofessional language.
Succeeding on Social Media
Patient and client protection
remember privacy and confidentiality extend to social media.
Succeeding on Social Media
Accountability
follow policies by employeers, and edicational institution and training sites. may need to consult legal conunsel before engaging in social media (example given is appropriation of stock photos without permission.)
Succeeding on Social Media
Collegiality
mutual accountability to check each other’s social media for unprofessional or inaccurate content.
10 behaviors necessary for PT. Including communication
Critical thinking
Communication
Problem solving
Interpersonal skills
Responsibility
Professionalism
Use of constructive feedback
Effective use of time and resources
Stress management
Commitment to learning
three domains of learning
Cognitive domain
Knowledge, application, analysis, synthesis, evaluation
(didactic learning)
three domains of learning
Psychomotor domain
Perception, guided response, complex overt response, and
adaptation (hands-on skills)
three domains of learning
Affective domain
- Attitudes, values, and character development that influence
all the other professional skills - Hardest to teach
- Communication falls within this domain!
OPEN assessment
Self-assesment of spirtuality. I couldn’t find it.
HOPE assessment tool
assess a patient’s spirituality.
FICA asks about the role of spirituality
(I couldn’t find this. Just the federal payroll tax.)
SPIRIT
asks patients about rituals and terminal
events planning (end of life care)
Communication and English as a
Second Language
Use a trained medical interpreter when possible
Video and telephone interpreter services are
available as an alternative.
Build a rapport with patient, not the interpreter.
Work with family decision maker.
Be open to work collaboratively with culturally
accepted caregivers (e.g., shaman).
Watch body language of the patient and family
to help determine understanding.
Communication as a Student
Professional communication skills are modeled
in the classroom by faculty and staff.
Classroom allows students to practice their
professional communication skills in a safe
environment.
During clinical education, you will practice your
professional communication skills with
constructive feedback from your CI, CCCE, and
ACCE.
CI, CCCE and ACCE
CI stands for Clinical Instructor, the person who directly supervises and mentors you during your clinical placement.
CCCE stands for Center Coordinator of Clinical Education, the individual at the clinical site responsible for organizing and coordinating clinical education for students.
ACCE stands for Academic Coordinator of Clinical Education, who is the faculty member at your school in charge of overseeing the academic side of your clinical education and ensuring it aligns with your program.
