MGH PT and OT Services

Clinical Education Program

MGH Inpatient Exercise Physiology Students
Goals/Evaluation Form
UNDER DIRECTION OF A PT or OT, DEMONSTRATES SAFETY AS THE
HIGHEST PRIORITY AS EVIDENCED BY:

Consistently maintaining an environment that is safe for patient and self in all
clinical interactions
o Maintaining infection control in all situations
1 Protects patient/self from potential contamination according to
hospital and departmental guidelines
2 Performs hand hygiene techniques before and after patients
3 Handles and disposes of materials to prevent contamination
4 Cleans equipment between patient use
5 Using acceptable techniques for all patient handling
6 Demonstrates effective body mechanics while performing assigned
tasks
Describes departments emergency procedures ( fire, code, patient injury,
security, etc) including own role
Asks for assistance when unable or unsure of how to handle a patient situation

COMMENTS:
During his internship, Andres has consistently used appropriate hand hygiene and
cleaned/disinfected equipment between patient use independently. He can explain the
differences between contact vs. contact+ precautions and is aware that he should read any
isolation precautions and follow the directions on the card for new or unknown
precautions.
Over the last few weeks, Andres has demonstrated an improving ability to modify his
body mechanics for physically assisting patients who are severely impaired and those
who are less impaired. Andres benefits from intermittent verbal and tactile cues for
providing physical assistant to patients during mobility tasks often with new patients or a
population he is not as familiar with. He has demonstrated consistent carryover of body
mechanics with patients he has been able to see from day to day and will benefit from
making more connections from one patient to another patient. This will likely continue to
improve and evolve as Andres is exposed to more patients over time
Initially, Andres preferred to take a more passive, step back approach to observe his
clinical instructors. With encouragement, Andres has been more likely to verbalize his
concerns when he is unsure on how to handle a patient situation. We strongly encourage
Andres to continue to do so; we believe we work best when we ensure we are on the

same page. Andres seems to do best with an open line of communication in the room
and should continue to feel comfortable asking CI questions prior to entering as well as
within room if he has concerns re: plan.
FINAL: Andres has continued to consistently demonstrate the same skills in regards to
hand hygiene and precautions during the last portion of his internship. His body
mechanics have continued to improve and for the majority of patients he is able to
modify body mechanics as needed although with patients that are more complex
(different lines/precautions ect) may require some cues from his CIhis ability to ask
these questions and know he needs to modify has improved as well. Improved initiative
in the room and has followed up on plan to ask CI questions re: plan as needed prior to
entering room so that he can be best prepared for each individual setting.
POSITIVELY CONTRIBUTES TO THE EFFICIENY OF THE PHYSICAL OR
OCCUPATIONAL THERAPIST BEFORE, DURING AND POST TREATMENT
BY:

Assisting with documentation by:

o Creating documentation templates each day and adding routine information
into the notes
o During history taking, examination, and treatment scribing the therapists
information into the note ( social history, pain, function, vital signs etc)
Assisting with daily billing
Preparing the patient room prior to PT or OT intervention
o Locating and bringing equipment needed to the patient room
o Organizing space to maximize ease of mobility
o Communicating with the team around the patients readiness for intervention
As directed by the PT or OT, assisting the therapist during intervention by:
o Modifying the EOC ( lines, O2, furniture, etc)
o Entering patient data into the computer
o Providing physical assistance for stabilization, mobility
o Performing therapeutic activities ( ROM, wrapping, etc)
o Creating and printing copies of patient exercises and bedside signs
Following treatment:
o Re-organizing space to maximize patient comfort and safety
o Cleaning and returning equipment to appropriate location

General maintenance:
o Maintaining inventory of appropriate PT/OT equipment/supplies on unit
o Performing routine sweeps of the environment and return equipment to
appropriate sites

COMMENTS

Documentation: Andres has been effectively scribing for his CIs over the last few weeks
including vital signs as well as history during initial evaluation. With guidance, Andres
has been more consistently filling out the sections on patient positioning and activity in
addition to the vital signs asking questions when appropriate. We believe he can continue
to expand on this by consistently and accurately identifying and documentation on the
form of supplemental O2/mechanical ventilator support without CI instruction.
With cuing, Andres is identifying what equipment will be needed for PT sessions and
does well with carryover from one session to another with the same patient. Recently, he
has successfully signed out specialty equipment, obtained the equipment, and updated the
specialty equipment list as needed.
Both CIs have intermittently asked Andres to either voalte or speak directly with an RN
or patient re timing of PT session and he has completed this successfully. Andres is aware
that he needs to bring questions and concerns directly back to his CIs as opposed to
attempting to answer the RNs questions/concerns.
Andres initially adopted an observational style of learning for setting up environments of
care. This has transformed into Andres actively participating in room set up. He often
asks for guidance in this area; his CIs asked Andres to freely ask questions when he was
unsure. Nevertheless, going forward, Andres will work toward independence in this area
including more complex rooms. He will continue to require brief overviews from his CIs
regarding the goals and expectations for the PT interventions so that he can more
independently manage the environment of care.
With regard to the provision of physical assistance, Andres has been more actively
trialing different hand positioning, amount of assist, and body positioning within
treatment sessions. He benefits from visual and verbal feedback at this time. We continue
to expect Andres to continue to develop these skills as he is exposed to patients with
varying degrees of impairments and will benefit from making connections between
sessions in order to self modify the assist he is providing.
FINAL:
Documentation: This has been an area of strength for Andres consistently since the
midtermhe independently enters all vitals and the majority of history information
obtained from CI.
For patients he is familiar with or patients who the CI has provided a plan for the session
Andres is able to obtain appropriate equipmentoccasionally min cues if something has
changed from session to session (ie need for IV pole if pt newly hooked up to more lines
ect)
He has been more confident in talking to the RN regarding setting up PT sessions and
demonstrates appropriate conversations bringing all important information back to his CI
He has demonstrated more initiative in room set up as well as hands on assistance both of
which have steadily improved throughout the course of this internship with improved
comfort with environment and CI
During the second half of his experience, Andres actively participated in problem solving
for the management of the environment of care for the implementation of a new piece of
mobility equipment with his CI and the Surgical Team Clinical Specialist.

DEMONSTRATES EFFECTIVE VERBAL AND NON VERBAL

COMMUNICATION AS EVIDENCED BY:

Appropriately introducing self to the patient and obtaining informed consent

Maintaining appropriate professional boundaries with patients and staff
Displaying respect for patients and maintaining patient dignity
Communicating clearly and accurately with patients and staff using
professional language
Listening actively to what is being said by others
Accepting and using feedback from supervisor
Understanding the basic written language of physical therapy ( vital signs,
ROM, MMT) and record objective data as requested by the PT/OT
Maintaining equipment records as requested by the PT/OT
Developing patient exercise instructions from PC Kits, etc as requested by
PT/OT

COMMENTS:
Andres initially took a more passive role in patient communication. Most recently,
Andres has appropriately provided verbal reassurance and support to patients who were
distressed and upset. This was most recently noted during a session in which a patients
pain was so profoundly increased that he developed a sudden but brief period of
respiratory distress. Andres communications to the patient helped reassure the patient.
Additionally, Andres modified his verbal and body language when interacting with a
patient with a TBI and resulting confused, agitated, and inappropriate presentation.
With regard to being and active listener, there are times when Andres requires verbal
repetition/reminders. To a degree, this can be expected in such dynamic, loud clinical
care environments. However, we do expect that Andres will continue to develop skills in
being able to stop tasks so that he can focus his attention on verbal direction.
Andres knowledge of medical and physical therapy language is improving. He is moving
from basic PT terms to more complex supplemental O2 delivery systems and mechanical
ventilation documentation. We fully expect that Andres will be independent with
recognizing routinely encountered medical terminology and abbreviations by the end of
his experience.
FINAL: Andres has demonstrated steady improvements in communication during his
internship at MGH. He consistently introduces himself and his role to patients without
cues. He has also demonstrated excellent understanding of non-verbal communication
and has demonstrated appropriate body language within a room in order to best relate to a
patientfor example he has been able to observe patients and families who may need
some re-direction. His active listening skills have improved as he has continued to be

more comfortable in this environment and has rarely required repetition of information
over the past weeks.
Andres has demonstrated an ability to develop a rapport with patients and their family
members. He appropriately interacts with these individuals in ways that positively affect
the treatment sessions.
DEMONSTRATES ADMINSTRATVIE AND ORGANIZATIONAL SKILLS AS
EVIDENCE BY :

In collaboration with their PT or OT supervisor, developing and maintaining a

daily schedule
Demonstrate flexibility in schedule in the face of changing situations
Prioritize schedule to meet patient/department needs

COMMENTS:
Andres developed a one page schedule and documentation system. At times, Andres
balances different tasks (i.e. checking specialty equipment signed out by his CIs,
obtaining or returning mobility equipment, updating vitals in eCare) when he has down
time. However, when these tasks are completed, Andres benefits from guidance for
finding other tasks to complete. At this time, he can work on his clinical narrative now
completed. He will also need to identify and complete his project for this experience.
FINAL: Continues to utilize previously created schedule and documentation system
which has been effective in allowing him to manage his day. He has demonstrated
improved use of down time with projects and demonstrated initiative in finding tasks
and projects to do during this time.
DEMONSTRATING PROFESSIONAL BEHAVIORS AS EVIDENCED BY:

Demonstrating initiative to complete all assigned tasks/projects

Initiating communication with supervisor in situations where there is potential for
conflict or difficulty in completing assigned tasks
Demonstrating the ability to problem solve in situations that are appropriate to
assigned tasks and role
Effectively functioning in my role within the team

COMMENTS:
Andres completes the tasks he is assigned. At times, he requires direction to find new
tasks to complete. We anticipate that this will be encountered less frequently as he now
has two projects to address (narrative and project).
Up until this midterm, Andres has relied on his CIs for providing direction in the room.
Now that he has gained several weeks of experience, we expect to see more problem

solving and less questions from Andres, especially as the problem solving relates to
patient handling/assistance and environmental set up.
He will benefit from continuing to ensure there is an open line of communication
between himself and CI both within and outside of the room to ensure goals are
appropriately being met.
FINAL: Andres has demonstrated improving self direction and initiation throughout the
past half of his clinical likely related to increased comfort and confidence in this
environment. With more complex or unknowns in the environment he continues to
require CI for direction however this is appropriate. Benefited from continued open line
of communication which he maintained both inside and outside of the room.
DEMONSTRATING AN UNDERSTANDING OF PT or OT ROLE AS
EVIDENCED BY:

Describing how a physical or occupational therapist develops an effective rapport

with a patient
Describing a general clinical framework for physical or occupational therapy
practice ( patient examination, evaluation, plan of care, intervention, reassessment, and discharge) and how it is applied to the patients.
Describing effective team interactions on the unit
Articulating the basic scope of the PT or OT role in the acute care setting

COMMENTS
:
Andres has asked questions and commented on situations in which patient-provider
communication was challenging. With one particular patient Andre has reflected on
communications with this patient including why communication may be challenging and
reflected on what could be done to improve this patients care.
Andres CIs will reinforce the framework for the delivery of physical therapy.
FINAL: Improving understanding of PT role. Has appropriate questions into
development of relationships with variable patient populations and has good insight into
altering this as needed. His minor in psych has been a topic of communication with CI
and has provided interesting insight into patients who have had more complex psych
needs.