Teaching Workshop (10/16a) [Integrative] Flashcards
Long Term Goals
Timeframe: the end of the episode of care, multiple weeks
Examination — when you figure out what the patient’s goals are
Prognosis — helping to determine how long it will take to reach goals
Short Term Goals
Time Frame: several sessions, 1-2 weeks
Diagnosis — part of determining what the patient can’t do that they used to do
Intervention — motivation by demonstrating progress in short term goals
When to Update Goals
Regularly, depending on the length of the episode of care
Whenever there is a change in the patient’s progress or medical status
Why Do We Write Goals?
To define/communicate the purpose of your plan of care
To facilitate the management of pt progression
To determine the intervention efficacy
Reimbursement and standards of accrediting bodies
Types of timed goals
Long Term Goals
Short Term Goals
Session Goals
SMART Goals
Specific
Measurable
Achievable
Relevant
Time-bound
Criteria for Creating Useful and Effective Goals
Patient Centered — customized to the unique needs of the individuals
Objectives — unbiased and based in fact, based on data you collect from initial exam
Measurable — quantifiable
Functional — relating to a particular use/purpose
Time Dependent — held accountable to a determined interval
ABCDs of Goal Writing
Audience — who
Behavior — what
Condition — when/how
Degree of mastery — how well/how much
The Guide to Physical Therapist Practice promotes
Patient-centered approach
Focus on function
Why focus on patient-centered & functional goals?
meaningful to patients
health care policy
reimbursement practices
standards of accrediting bodies require it
Components of Well Written Goals
Identification of the pt who is receiving therapy and carrying out the program (usually pt, sometimes also family/caregiver)
Description of the movement/activity the pt will be able to perform
Connection of the movement/activity to a specific function
Specific conditions in which the movement/activity will be performed, such as WB status or use of ADs
Factors for measuring performance, such as assistance level or with pain levels
Timeframe for achieving the goal
Goal Writing for Patient/Caregiver Education
Determine what you want/need to teach
Get to know barriers and factors influencing patient learning
Consider the method/mode
Allow practice, use, application
Assess your teaching
What to Teach — Goals/Objectives
Goals — final outcome, multidimensional
Session Goals/Objectives — session outcome, unidimensional
Goals are like cake, session goals are like ingredients
What to Teach — 3 Learning Domains
Cognitive — understanding why they need to do something
Psychomotor — being able to physically do something
Affective — their attitude about doing something
What to Teach — Cognitive Learning Domain
HIERARCHY (moves from simple to complex)
- Knowledge — list, describe, name
- Comprehension — summarize, discuss
- Application — demonstrate, distinguish
- Analysis — order, classify
- Synthesis — create, design
- Evaluation — assess, recommend
What to Teach — Psychomotor Learning Domain
HIERARCHY (skill acquisition)
- Perception — detects, distinguishes
- Set — shows, begins
- Guided response — copies, reproduces
- Mechanism — organizes, performs
- Complex overt response
- Adaptation — alters, revises
- Origination — composes, creates
What to Teach — Affective Learning Domain
HIERARCHY (learner attitudes, appreciation, and values)
- Receive — identify, recognition
- Respond — comply, perform
- Valuing — consistently demonstrates
- Organization — justify, modify
- Characterization — displays, serves
What to Teach — Psychomotor Levels of Skill
Lower level — can set up what is required and begin activity, or observes
Mid level — can repeat process independently
Advanced — can perform on multiple joints, and body types, and conditions
Barriers/Factors
Age/Generational considerations
Teaching/Learning Theories
Literacy Levels and Language
Cognitive and Sensory Status (hearing/eyesight)
Motivation and Self Efficacy
Barriers/Factors — Behavioral Learning
Focus on simple tasks, repetition
Shapes behavior through reward & punishment
Barriers/Factors — Sociocultural Learning
Learning as cognitive and social experience
Peer interactions, community-based
Barriers/Factors — Cognitive Learning
Encourages reflection, explores connections
Includes: Experiential/Problem-based Learning
Barriers/Factors — Kolb’s Wheel
Some ways to address are:
Scientist – why, personal connection
Professor – what are the facts
Friend – implications on well being
Inventor – what if, will adapt information
Literacy Levels and Language — Assess Target Readability
FOG and SMOG readability calculators
Average level of education in the US is 8-9th grade
- Medicare is closer to 5th grade
Literacy Levels and Language — Assess Preferred Language
Provide access to Certified Medical Interpreters
Patient Education Materials in multiple languages
Cognitive and Sensory Status (hearing/eyesight)
Conducted as part of Systems Review
Informal and formal screen
- Informal = ask, observe
- Formal = Mini Cog, MOCA, MMSE; Visual screening; Hearing screening
Motivation and Self Efficacy — Prochaska’s Stages of Change
A continuum of behaviors associated with an individual’s desire to create change
Motivation and Self Efficacy — Readiness Ruler
At this moment, how important is it to you to…?
0 = not important at all
50 = about as important as most of the other things I would like to achieve now
100 = most important thing in my life now
Motivation and Self Efficacy — Self Efficacy
The confidence one has about their capability to produce certain results
Method/Mode — Variability with Method
Method will vary based on target domain (cognitive, psychomotor, affective)
Retention rate varies based on the method
Highest to Lowest Retention: Teaching others → Practicing → Discussion → Demonstration → Audiovisual presentation → Reading → Lecture
Method/Mode — Methods
Provide written materials and pictures
Use simple, concrete, specific terms
Ask patients to repeat the advice
Personalize instructions
Use acronyms (to help remember)
Tailor the delivery
Offer audio-recorded information
Practice/Application — Active Learning Principles
Have learners work with the content
Include reflecting, interacting with the
content
Help the learner do the learning
Follow content delivery with interaction time
Practice/Application — Active Learning Strategies
Reciprocal teaching
Action learning
Role plays
Debriefing
Assessing Teaching — Ongoing vs Summative Assessments
ONGOING
- Progress toward accomplishments of objectives
- Feedback to the instructor about teaching
SUMMATIVE
- “Final” assessment
- Has the goal been met?
SEGUE Checklist
used to structure and assess a patient encounter
S – Set the stage
E – Elicit information
G – Give information and treatment plan
U – Understand the patient’s perspective
E – End the encounter
