ASSESSMENT 1 Practical Assessment – orthosis fabrication for upper limb

This assessment requires you to design an orthosis to address the specific needs of the client described in your case study, taking into consideration the knowledge gained from the theory content supplied in class, the workshop activities, as well as that gained from independent research.  There are three key components to the assessment which occurs as part of the dynamic intensive day.  These are: 1) fabrication of the orthosis which is pass/fail; 2) creation of the relevant orthosis pattern, presentation of that pattern to the examiner and clinical reasoning of same; and 3) oral presentation to the examiner discussing and evaluating your orthosis and the clinical reasoning associated with it.  

The components of the task will cover each of these elements:  

1) A pattern pre-fit drawn on paper as though you were going to transfer it to the thermoplastic. On this pattern, you are required to note all relevant anatomical markings for your orthosis and all spatial elements must be managed. Please include details/clinical reasoning for your design, for example, why certain joints were included/excluded, why the design is the length/width it is, etc. You will need to reflect upon the impairment/pathology, as well as basic orthosis design principles, in order to complete this. Please see Appendix B of the Assessment Piece Moodle document. 

2) fabrication of the orthosis with a reflection of what went well and what you would improve or change with more practice as a clinician 

3) A narrative detailing the rationale for the orthosis/splint.  The rationale must be well substantiated by theory and current best practice as evidenced by referencing from your understanding in class, notes you have made from required readings and texts. You will prepare this in the lead-up to the assessment intensive and refine it on the day based on interactive feedback from your instructor/examiner.  This will inform the oral discussion you have with the instructor/examiner. 

a. An explanation of the impairment/pathology

b. The impact on occupational performance and participation

c. A description of how an assistive technology such as the assigned orthosis will enhance occupational performance and participation

d. A rationale for why the specific orthosis you will construct/fabricate is the best orthosis to achieve that. Please include details of, and justification for, how you will position the included joints, for example re: the pattern post Dupuytren’s fasciectomy (as used in week 2 workshop slides): “I would record that the MCP, PIP and DIP joints would be positioned in extension. This is to ensure that healing tissues are maintained in a lengthened position to prevent recurrence of joint flexion contractures.” You may include specific joint positions (eg. from the prior example: “the MCP, PIP and DIP joints were in neutral/0°extension) if you find this specific information in your research, but it is also okay to just provide a basic position (eg. full extension). Please also include some information about what wearing regime you would recommend for your orthosis, with justification for same.

e. Describe what thermoplastic you choose and why, analysing the unique characteristics of the thermoplastic that makes it suitable. Consider properties such as rigidity, thickness, bonding, drape, perforations etc. Thermoplastics trialled during the practical sessions in class are made by ROLYAN and ORFIT. You can limit your selection to thermoplastics made by these companies.

The entire task description and rubric will be made available to you on your OCCT12006 Moodle site. 

The assessment criteria are as follows: 

• fabrication of the orthosis (pass/fail) 
• knowledge of the rationale for the orthosis and materials used (oral presentation to examiner)  (10 marks)
• technical design of the orthosis prior to fabrication (10 marks) 

ASSESSMENT 2 Presentation Assessment

Assessment Overview: This presentation assessment further develops your knowledge of the way in which environmental adaptations and assistive technology support occupational performance and participation. It builds on the knowledge you have obtained in your first year of studies and requires you to deeply explore barriers and facilitators in a person's environment, and ways in which we can adapt that environment through equipment, modifications, and assistive technology. There is a group component and an individual component.

Grouping Details: You will prepare and deliver a 20-minute group presentation to your peers. Group numbers for this assessment are dependent upon enrolment numbers and will be determined in week 1. You will undertake this assessment in groups of 3-4 (depending on enrolled numbers), with groups determined in week 1 of term.

Task Details: A comprehensive case study will be presented to you at the commencement of term. This will include a written summary, a range of videos of the client performing daily activities, and depending on his availability, a classroom visit from our client. The client is a young man who has many productive, self-care and leisure occupations that he wishes to participate in as fully as possible. He has a functional impairment which is cerebral palsy with spastic quadriplegia, mild kyphosis and some of the mild sensory, cognitive and neurological issues that can be associated with that diagnosis.

Your primary task as a group is to select and prescribe an appropriate assistive technology for him - specifically, a wheelchair. The wheelchair may be manual or powered or a hybrid, justified by your professional reasoning.  You must use your developing professional reasoning to select the most appropriate assistive technology (wheelchair) for him with full justification of your decisions. This may include but not be limited to the following:

• understanding the client profile - his preferences, goals, priorities, and the nature of his functional impairments
• family-centred practice - a consideration of the goals that his family has for him
• an exploration of the barriers and facilitators in his environment (consider all elements of the environment)
• financial considerations and subsidy schemes available e.g. NDIS
• the features required in the assistive technology, the shortlisting and selection process - this may involve visiting your local supplier, trying out and taking photographs of the relevant assistive technologies
• comprehensive consideration of any accessories required for the assistive technology as well as additional assistive technology/daily living aids that may be required in his home

Students will learn about the relevant NDIS General Assistive Technology Assessment Template in classroom lectures and tutorials but there is no requirement to complete the NDIS template for this assessment.

Note: Presentations must be comprehensive yet concise and fall within +\- 2 minutes of the allowable 20 minutes. Penalties will be applied for presentations falling outside of those limits.

Individual component: The individual component of this task is to submit a 500-750 word reflection (guided by prompts on a template) on your own individual experience of the professional reasoning process and decision-making about the assistive technology. Consider the OT Process within the framework of use of either the CMOP-E model or the PEOP model.

• complete and correct description of the assigned functional impairment (10 marks)
  
• analysis of the relationship between the functional impairment and the environmental barriers and facilitators to occupational performance (10 marks)
  
• generation of appropriate intervention solutions to optimise occupational performance and participation (20 marks)
  
• professional verbal and non verbal communication (10 marks)
  
• effective use of multimedia and skilled organisation of content (10 marks)
  
• use of evidence-based literature to support presentation content, inclusive of correct APA  7th in-slide citations and reference list (10 marks)
• individual reflection (10 marks)
  

ASSESSMENT 3 Written assessment - Home Assessment and Modification

Home assessment and recommending assistive technology devices and home environmental modifications are all common practice areas for occupational therapists. This may occur across the lifespan for our clients.

This assessment task is designed to replicate the clinical reasoning and assessment process used by occupational therapists in this practice area. State and federal government funding initiatives such as the Medical Aids Subsidy Scheme (MASS) and the National Disability Insurance Scheme (NDIS) permit new graduate occupational therapists to select and recommend a range of AT and basic home modifications for clients. Students therefore need to develop the skills to assess, modify, research, locate, price and compare options.

Task

This group-based written assignment is worth 40% of the final subject mark. It requires your group to:

1. develop a client profile in which you will consider all aspects of the impact of the diagnostic presentation on ADLs and IADLs

2. conduct an assessment of an actual home environment

3. make recommendations for environmental modifications and assistive technology products (AT) attending specifically to a) access to the house via one entrance and b) client use of the bathroom and toilet

4. justify your recommendations

5. explain your professional reasoning guided by the PEOP or CMOP-E models as studied within classes in OCCT12006

6. ensure APA 7th referencing is adhered to throughout your written assessment and an evidence-based reference list is supplied

Detailed guide sheets and templates are available to you in the assessment section of your Moodle site. 

• development of the client profile (10 marks)
• recommendations and rationale for access at entryways to the physical environment (10 marks), modifications to the bathroom/toilet spaces (10 marks), and access/modifications/independence in the bedroom (10 marks) 
• execution of technical drawings (10 marks)
• written expression and communication of ideas (5 marks)
• APA 7th referencing -style, format, adherence (5 marks) 
• individual component (10 marks) 
• attendance (10 marks) 

Please note:  80% on-campus attendance is required at lectures and workshops for OCCT12006.  The rubric of this final assessment piece contains the marks allocated for attendance.