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56 Cards in this Set

  • Front
  • Back
Patient Interview
The art of establishing a relationship with your patient and of gleeming the information you need to best treat them. The cornerstone of the care process
Patient Interview
The art of establishing a relationship with your patient and of gleeming the information you need to best treat them. The cornerstone of the care process
Critical Components of the Patient Interview
Positive Regard
Appropriate Attitude
Positive self esteem, a locus of control centered on the patient, critical listening skills, acceptance without judgement, and assertiveness skills
Good Timing
Not interupting, using silence appropriately, listening carefully
Artful Phrasing
asking correct questions at the right time
Avoiding slang, jargon, or dialect,
tuning into ones words and gestures
assuring the patient that they will be treated with thoughtfullness and seriousness.
3 Parts to an Interview
Initiation- a statement of purpose
Body or development- gathering information needed
Closure- summarizing
Feedback should be:
1. Positively phrased
2. non judgemental
3. facilitative of learning
aimed at the behavior, not the person.

Use the sandwich technique and always give an example to keep feedback in context.
Determines how a student uses knowledge and what they will need to further develop and grow.

-the self reflection and feedback posrtions of assessment help correct behaviors and make them permenant, thus developing a professional and making them more successful.
Assesment essentials
1. expectations
2. samples of performance
3. judgement of performance
4. goals of the course/curriculum
5. student involvement (done with the student, not to them)
6. methods
Why might someone be resistant to self reflection
!. Rationalize that graduate students don't need to self assess
2. used to having someone else assess them
3. Don't know how
4. DOn't see the advantage of assessing, such as development and success professionally
5. To busy to assess
6. Feel one's own feelings about their performance should be private.
Domains of Learning
1. Cognitive- What we know
@. Psychomotor- What we can do
3. Affective- our values, what we believe, our personality
Generic Abilities
Focuses on the Affective Domain of learning. Certain beliefs, characteristics, and traits that aren't explicitly within a professions range of knowledge, but are still necessary for success in that profession

ex. stress management, problem solving, critical thinking, use of constructive feedback, responsibility, professionalism.
ex. of a taxonomy of generic abilities
stress managemnt
Begginer- recognizes stressors and problems in their self and problems and distress in others

Developing- Able to properly balance professional and personal life, develop effective affective responses to situations

Entry Level- Able to prioritizes multiple commintments, responds well to urgent situations.
Clinical Performance Instrument
uses the cognitive, affective, and phychomotor domains.
Asseses a student from novice to entry level on the visual analog scale based on their performance on 5 performance dimensions

1. Quality- limited skills to high skill performance
2. Supervision required- constant monitoring to independent with consultation
3. Consistency- inconsistent to consistent
4. Complexity of skills and situations- simple to complex
5. Efficiency- High time use to timeliness
what is entry level?
Ablity to independently manage (not treat) a case load
"with distinction"
a student excells at a particular skill within certain academic levels.....not beyond entry level.
what is teh comment session for on the clinical performance instrument?
For feedback. Provides examples of the student excelling and context within which the student needs to improve.
Clinical Performance Criteria (examples)
ethical practice, legal practice, responsible behavior, professional behaviors, safety, communication
effective communication skills
helping the patient to understand their illness so theat they make decisions about their treatment, modify their lifestyle to prevent future problems, and live successfully with the problems that can't be treated.
unhelpful responses
1. Indifference- failure to listen
2. Offering Reassurances-unwillingness to listen to patient's perception of the illness
3. Offering judgemental responses- failure to allow the patient to decide for themselves
4. Defensiveness- personalization and failure to listen carefully
who owns the problem?
the person with the intense feelings
Active Listening skills
1. Restatement- repeating what was said as you heard it
2. Reflection- verbalizing the context and the implied feelings
3. Clarification- summarizing and simplifying your thoughts and feelings.
when the picture and the words match
Power Communication Skills
Pacing- Creating a common experience to diminish the differences between patient and PT
Backtracking- repeating what you think someone has said- shows them you are listening
Clarification- asking who, what, why, when how- confirms understanding
Speaking your intent- saying exactly what you mean- no implications, no guessing
Factors in successful communication
1. Presentation
3. Attitude of the speaker
3. Voice
4. Effective listening
3 types of communication
1. verbal
2. nonverbal-meta communication and demonstration
3. Written
non stop process of taking learned and stored meaning and assigning it to things
-guided by unwritten rules
a difference in the interpretation of meaning
interpersonal skills
good communication skills, responsible, true interest, respect, establishes trust
What needs to be assessed on a patient?
belief system, ability to learn, willingness to learn, history of compliance, knowledge base.
what can detract from patient interactions
lack of trust, anxiety, current physcial and emotional state, motivation
how can patient interest be built?
Relate an interest, use humor, ask comprehension and learning questions, use analogies and anecdotes, state advantages of learning
how can patient interest be maintained?
provide frequent response opportunities, use accountability, use breaks if necessary, clearly state goals and objectives, vary your presentation styles.
transfer activity
any activity that involves the patient moving from one location or position to another.

The goal is to facilitate, not to move, the patient's movement and to educate both the patient and anyone else who might be helping them at home
Primary concern and motto for transfers?
Safety of the patient and the helper.

Set up for success
How to utilize mechanical advantages:
1. take advantage of the patient's size and weight
2. take advantage of your own size and weight
3. Pivot to the person's good side
4. Position chair/comode/etc. at the proper angle of approach
5. work with a count of a clear audible initiation so that all parties can work in unison.
Initial Preperation steps (8)
1. position cushions
2. Cover or drape any surfaces for sanitary reasons
3. Determine if the patient's backside needs to be draped
4. Determine if bracing is needed by the patient
5. Check the lines for any functional problems
6. Know the weight bearing precations
7. Know any surgeical restrictions (i.e. Blood pressure restictions)
8. Brakes on from where they are coming from/where they're going to
Reminders during activity (4)
1. Always use a gait belt- make transfers easier, safer, are required for insurance reasons
2. Communication- pt. has the right/need to know what the final goal is
3. Break down large tasks into smaller, more physically and emotionally manageable.
4. Guidance, Reassurance and praise should constantly be provided....should be in clear, consise, lay terms.
Body Mechanics
Always use the correct posture, Base of Support, and leverage
-they keep you and the patient safe and improve your future viability as a PT
Side to Side or to the head of the bed
Position head of the bed flat

Adjust bed so that it's on an appropriate level of your helpers

Use a sheet or a blanket or chicks under the patient, roll to their sides, grasp with an underhand grip

allow patient to help if appropriate using bridging, trapeize
supine to sidelying
prop up the opposite leg on the bed
cross the opposite arm over the trunk
have the patient look in the direction they will be moving
have the patient push with their propped leg and reach in the direction they are moving, provide support at the illiac crest and the shoulder.
sidelying to sit
pt. laying on the side of the bed, knees flexed

bring legs over the top of the bed by placing your arm over the top of the bent legs behind the knees

Encourage the patient to push up on the bed with their arms, PT assists with their arm behind the patient's neck and shoulders.

pt. facillitates at the illiac crest and shoulder
Sit to sidelying
With PT's arm guiding at the shoulder and neck, pt. leans back and rests their head/shoulder on the bed.

PT uses a scooping motion to assist in bringing their legs back onto the bed.

PT assists as necessary, guards patient's position as necessary
Sit to Stand.
Shift Patient to front of the bed

Position Patient's feet under their knees as much as possible

Patient leans forward shifting weight over feet

Using feet, patient straightens LE's for partial or full standing

Patient should push from the bed, or place arms around a gait belt on PT or on the PT's upper arms

arms to the neck is bad- can injure PT
Considerations for standing
Pt's weight bearing capability of their LE and UE, weight bearing due to pain, buckling threat to pelvis, trunk, knees.
Seated Pivot
Scoot patient to the front of the bed

Position patient's feet at an angle, with their heels facing the direction they are moving in

Lean forward, shifting weight over feet, assist if needed

Using a gait belt for support if needed, lift buttocks from old surface to new surface.
Purpose of a sliding board
A sliding board can be used in a seated pivot to use small movements as opposed to one large one.

CVA's and new amputees have better sucess with small movements, but need their feet repositioned after every movement
Quad Transfers
Place flexed legs onto your upper thigh or waist, grabbing their lower back and buttocks, lean back and bring the patient forward and on a diagnal of the movement onto the PT's thigh, and pivot to new surface.
Halo transfer
Lean the patient from the hips to the non-movement side, place their shoulders on the PT's hips (hips bear weight), Grab their buttocks and lower back lean back and move the pt. onto the new surface.
2 ways to reposition a patient in a wheelchair
1. The patient provides more assistance if they lean forward, and a PT uses their lower back and buttocks to move them back in their chair. they can also push back with their feet.

2. Minimizes patient PT geos from behind the chair and grabs the pt's crossed forearms. Another can grab beneath the pt's knees and using a timed basis, lift and shift back in the chair.
2 person lift
One person goes behind the patient and grabs their forearms, the other scoops beneath their knees.

Lift in sequence and transfer patient from one surface to another
Bed 2 person lift
one person graps forearms around pt.'s knees, the other forms a cradle under the pt's lower back

pt can grap helpers if it doesn't endanger/immobilize

may need to utilize a stool as an intermediate
4 person lift
remember to setup for sucess-position destination at an appropriate angle, determine direction pt. will be carried. each helpers stepping patterns must allign for balance. place forearms under pt, lift up forearms, thus forklifting patient into your bodies. The helper with the greatest mechanical advantage should be placed at the heaviest/lightest place, The patient at the head is called the lead. A practice lift should be done on the bed, adjustments hsould be made if necessary, and then the real lift should be done on the count of the lead
floor transfer
Use a blanket/sheet if able, position helpers on each side of the body and grasp the forearm of the person across from you, 4-6 helpers may be needed. determine who is the lead and the direction to be traveled.
hoyer lift
enables a lift to be done with minimal mmechanical work or risk to the helper

two helpers still are needed

position sling under pt. in correct manner (heavy part under head, torso/buttocks portion under torso/buttocks)
position hoyer over pt., widen hoyer's base of support, place loops of sling into hoyer hooks, rase hoyer so that it clears the surface. One helper opperates the hoyer, the other guards the pt's head and feet.