simulated patient evaluation 44 points. perform 2 simulations 10 minute time limit for each...

Simulated Patient Simulated Patient EvaluationEvaluation

44 Points44 Points

Perform 2 SimulationsPerform 2 Simulations

10 minute time limit for each scenario10 minute time limit for each scenario 1 scenario on the Upper Extremity1 scenario on the Upper Extremity

Possible 22 ptsPossible 22 pts 1 scenario on the Lower Extremity1 scenario on the Lower Extremity

Possible 22 ptsPossible 22 pts

Rest of TrimesterRest of Trimester

TMJ – Monday – bring TMJ – Monday – bring stethoscopes!stethoscopes!


Simulated Patient Lab - FridaySimulated Patient Lab - Friday October 6October 6thth -13 -13thth Simulated patient Simulated patient

practical (Tuesday to Tuesday)practical (Tuesday to Tuesday)


Jeopardy 2 on Wednesday – review for Jeopardy 2 on Wednesday – review for Final WrittenFinal Written

Final Written – Wednesday October 21st Final Written – Wednesday October 21st 9:05 am in P2049:05 am in P204 35 points – 35 multiple choice questions35 points – 35 multiple choice questions

Purpose of Simulated Patient Purpose of Simulated Patient EvaluationEvaluation

Assess student’s ability to utilize the Assess student’s ability to utilize the information learned in class to:information learned in class to: Demonstrate an extremity evaluationDemonstrate an extremity evaluation Verbalize information related to the scenarioVerbalize information related to the scenario Organize an evaluation proceeding in a least Organize an evaluation proceeding in a least

to most invasive mannerto most invasive manner

Purpose of Simulated Patient Purpose of Simulated Patient EvaluationEvaluation

Assess student’s ability to utilize the Assess student’s ability to utilize the information learned in class to:information learned in class to: Reasonable evaluation relating to the Reasonable evaluation relating to the

scenarioscenario Examination as taught in classExamination as taught in class

Simulated Patient Evaluation Grading Form - Sample

Name: Matric:

Scenario (Dr records which card student pulled):

Points: (circle the amount the student gets credit for)

0 1 2Case History 0 = no questions asked , 1 = asks questions regarding the scenario on the card 2 = asks questions regarding other daily activities (Examiner provides answers to student’s questions)

0 1 2Differential Diagnoses 0 = none given

1 = diff dx 1 subluxation from another subluxation

2 = diff dx subluxation(s) from soft tissue, visceral, or other

0 1 2 3 4 Visual ROM Ortho-Neuro findings 1 = for each area covered (visualization, ROM, Ortho, Neuro)

0 1 Pain Point

0 1 2 Fluid Motion 1 = for FM for actual subluxation 2 = if did FM for any differential dx

0 1 Least to Most Invasive

0 1 2 3 4 Traction Move (graded like on practical)

0 1 2 3 4 Thrust Move (graded like on practical)

0 1 2Post Checks/Patient Instructions FM (if appropriate, pain point, ROM,

neuro, other) Patient instructions (if appropriate)

Total Points

Bring your own patientBring your own patient- -

Tues Oct 6: Conn, Day, Meehan, Salinas, Tues Oct 6: Conn, Day, Meehan, Salinas, StoiberStoiber

Wed Oct 7: Arguello, Fall, Rabideaux, Sallee Wed Oct 7: Arguello, Fall, Rabideaux, Sallee Thurs Oct 8: Cichosz, Fletcher, Micka, ScottThurs Oct 8: Cichosz, Fletcher, Micka, Scott Fri Oct 9: Carr, Gardner, Justice, Stempky Fri Oct 9: Carr, Gardner, Justice, Stempky Mon Oct 12: Groves, Leipold, Schwarting, Mon Oct 12: Groves, Leipold, Schwarting,

SneydSneyd Tues Oct 13: Dague, Gleason, Samson, Tues Oct 13: Dague, Gleason, Samson,

SweleySweley

Evaluation DayEvaluation Day

Place book bags along north wall by HyLoPlace book bags along north wall by HyLo Keep a pen/cilKeep a pen/cil Take 1 grading sheet from table by northeast Take 1 grading sheet from table by northeast

classroom doorclassroom door Put name, matric & date on the sheetsPut name, matric & date on the sheets

Students will wait out in the hallStudents will wait out in the hall

Evaluation DayEvaluation Day

Students will be called in, in pairs (doctor-Students will be called in, in pairs (doctor-patient)patient)

1 pair to Dr. Gindl1 pair to Dr. Gindl 1 pair to Dr. Lipes1 pair to Dr. Lipes Once the pair has been tested by their 1Once the pair has been tested by their 1stst Dr Dr

they switch and move to another Drthey switch and move to another Dr Will perform 2 extremity exams – 1 upper & 1 lowerWill perform 2 extremity exams – 1 upper & 1 lower Ie start with Dr. Gindl for 1Ie start with Dr. Gindl for 1stst scenario, then move on to scenario, then move on to

Dr. Lipes for 2Dr. Lipes for 2ndnd scenario. scenario.

Evaluation GuidelinesEvaluation Guidelines

Examine region as indicated on cardExamine region as indicated on card Case History (2 pts)Case History (2 pts)

Ask questions that are pertinent to the Ask questions that are pertinent to the scenario on the cardscenario on the card

The questions should help you get an idea of The questions should help you get an idea of direction of trauma, any soft tissue damage, direction of trauma, any soft tissue damage, areas that should be examined, items in the areas that should be examined, items in the history that would help guide your examinationhistory that would help guide your examination

The examiner will furnish data in response to The examiner will furnish data in response to the student’s questionsthe student’s questions


Examine region as indicated on cardExamine region as indicated on card Differential Diagnosis (2 pts)Differential Diagnosis (2 pts)

give us some that are appropriate for the give us some that are appropriate for the scenarioscenario

1 subluxation from another subluxation1 subluxation from another subluxation Subluxation from soft tissue, visceral, otherSubluxation from soft tissue, visceral, other

Evaluation GuidelinesEvaluation Guidelines Visual ROM - Orthos – Neuros (4pts)Visual ROM - Orthos – Neuros (4pts)

Visual (1pt) – the student should relate what Visual (1pt) – the student should relate what they might see and/or should look for with this they might see and/or should look for with this scenarioscenario• Then your grader will let you know what you sawThen your grader will let you know what you saw

ROM (1 pt) – student should relate which ROM (1 pt) – student should relate which ROM(s) might be affected with this scenarioROM(s) might be affected with this scenario• Then your grader will let you know what ROM(s) Then your grader will let you know what ROM(s)

have been affectedhave been affected

Evaluation GuidelinesEvaluation Guidelines Orthos (1pt) – which Orthos would help you Orthos (1pt) – which Orthos would help you

differentiate the Diff Dx you gave usdifferentiate the Diff Dx you gave us• Perform some of those Orthos (stick with the ones we Perform some of those Orthos (stick with the ones we

went over in class)went over in class)• Then your grader will let you know what Orthos are Then your grader will let you know what Orthos are

positivepositive Neuros (1pt) – which Neuros would help you Neuros (1pt) – which Neuros would help you

differentiate b: the Diff Dx you gave usdifferentiate b: the Diff Dx you gave us• Perform some of those Neuros (stick with ones we went Perform some of those Neuros (stick with ones we went

over in class)over in class)• Then your grader will let you know the results of your Then your grader will let you know the results of your

neuro testsneuro tests


Pain Point (1 pt)Pain Point (1 pt) Relate where will you look and what would it Relate where will you look and what would it

tell you (while you’re doing it)tell you (while you’re doing it) Then your grader will let you know where the Then your grader will let you know where the

pain point ispain point is


Fluid Motion (2 pts)Fluid Motion (2 pts) Perform FM for the area(s) in questionPerform FM for the area(s) in question

• FM for joint restrictionFM for joint restriction• FM for any differential dxFM for any differential dx

Then your grader will let you know what FM is Then your grader will let you know what FM is restrictedrestricted


Demonstrate:Demonstrate: Your examiner will indicate which of the Your examiner will indicate which of the

following to perform given your findingsfollowing to perform given your findings Traction Move (4 pts)Traction Move (4 pts)

• of grader’s choiceof grader’s choice Thrust Move (4 pts)Thrust Move (4 pts)

• of grader’s choiceof grader’s choice


Post Checks & Patient Instructions (2 pts)Post Checks & Patient Instructions (2 pts) Perform post checks as they relate to your Perform post checks as they relate to your

adjustmentsadjustments Relate patient instructions (if any) as they Relate patient instructions (if any) as they

would pertain to the scenariowould pertain to the scenario

Exam an extremity regionExam an extremity region Students will pull 1 cardStudents will pull 1 card Region to be examined will be determined Region to be examined will be determined

by reading a card with a short patient by reading a card with a short patient complaint/history on it.complaint/history on it.

# of Lower Extremity Scenarios - 11# of Lower Extremity Scenarios - 11 # of Upper Extremity Scenarios - 12# of Upper Extremity Scenarios - 12

Right Shoulder ComplaintRight Shoulder Complaint

Differential DxDifferential Dx Rotator Cuff TearRotator Cuff Tear Subluxation – G-H, A-C, S-T, St-Cl, St-Co, Subluxation – G-H, A-C, S-T, St-Cl, St-Co,

spinal subluxationspinal subluxation Bicipetal TendonitisBicipetal Tendonitis Other shoulder muscle strainOther shoulder muscle strain

Visual inspection - G-HVisual inspection - G-H

What you would look for on visualizationWhat you would look for on visualization Be specific as to what you see and what it Be specific as to what you see and what it

relates to: relates to: If visualize a sulcus sign that would correlate If visualize a sulcus sign that would correlate

with a G-H Iwith a G-H I If visualize a squared off shoulder – possible If visualize a squared off shoulder – possible

dislocationdislocation Examiner will indicate what you sawExaminer will indicate what you saw

ROMROM

G-H PG-H P Internal RotationInternal Rotation Appley’s Scratch on Int RotAppley’s Scratch on Int Rot

G-H IG-H I External RotationExternal Rotation Appley’s Scratch on Ext RotAppley’s Scratch on Ext Rot Scapulo-humeral ratio Scapulo-humeral ratio 1:1 1:1

Ortho-Neuro G-H EvaluationOrtho-Neuro G-H Evaluation

Yergason’s (mild click, maybe G-H I)Yergason’s (mild click, maybe G-H I) Dawburn’sDawburn’s Drop ArmDrop Arm DugasDugas ApprehensionApprehension Muscle TestsMuscle Tests

Anterior Deltoid (weak G-H I)Anterior Deltoid (weak G-H I) Teres major (weak G-H P)Teres major (weak G-H P) Examiner will indicate if there was any pain or Examiner will indicate if there was any pain or

muscle weaknessmuscle weakness

Pain Point G-HPain Point G-H

Location of pain for the possibleLocation of pain for the possible G-H I anterior joint capsuleG-H I anterior joint capsule G-H P posterior joint capsuleG-H P posterior joint capsule Along a muscle (ie supraspinatus)Along a muscle (ie supraspinatus)

Fluid Motion G-HFluid Motion G-H

DecreasedDecreased I-S glide (could be either G-H I or G-H P)I-S glide (could be either G-H I or G-H P) A-P glide (G-H I)A-P glide (G-H I) P-A glide (G-H P)P-A glide (G-H P) Examiner indicates which FM is Examiner indicates which FM is

Demonstrate Traction MoveDemonstrate Traction Move

Examiner prompts student as to which Examiner prompts student as to which move to performmove to perform

For G-H joint traction eitherFor G-H joint traction either SupineSupine SeatedSeated

Demonstrate Thrust MoveDemonstrate Thrust Move

Examiner prompts student as to which Examiner prompts student as to which move to perform move to perform

For thrusting move for G-H jointFor thrusting move for G-H joint G-H IG-H I G-H P ProneG-H P Prone G-H P SeatedG-H P Seated

Post Checks/Patient InstructionsPost Checks/Patient Instructions

Post Checks:Post Checks: Fluid motion - showFluid motion - show ROM – which one?ROM – which one? pain – where?pain – where? Visualizes normal – looks like?Visualizes normal – looks like?

Patient InstructionsPatient Instructions Anything that patient can do to help their Anything that patient can do to help their

situation relating to the history of their situation relating to the history of their problem?problem?

Update on Grading ScaleUpdate on Grading Scale

Grading Standard:Grading Standard: 215.26 - 229 (94%) ............................A215.26 - 229 (94%) ............................A 199.23 - 215.259 (87%) …..................B199.23 - 215.259 (87%) …..................B 183.20 - 199.229 (80%) …..................C183.20 - 199.229 (80%) …..................C Less than 183.20 (below 80%) ….......FLess than 183.20 (below 80%) ….......F

simulated patient evaluation 44 points. perform 2 simulations 10 minute time limit for each...

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