PT CPI Web

Evaluation
Student: Lara Nasser
Clinical Staff: Cara Nawrocki
Site: Team Rehabilitation - St. Clair Shores
Evaluation Name: PTH 634 Summer 2018 - Class of 2020
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1. Professional Practice – Safety

Self Mid-Term — Lara Nasser I try to be conscious of what tasks patients are completing in order to make sure they do not injure
themselves. I want to make sure patients are completing their therapeutic exercises correctly so they do
not aggravate their symptoms. Constantly asking the patient how they feel after a new exercise was
assigned or after manual therapy is important as well.

Self Final — Lara Nasser I have been exposed to patients who require more assistance and present as "fall risks". I have learned to
be aware of their surrounds, make sure there is a chair close by incase they require a break and standby
assist is important. I secure the treatment area and try to make sure there is nothing in the way that may
be a trip hazard.

CI Mid-Term — Cara L. Nawrocki Has demonstrated safe guarding techniques for patients that require it during balance interventions. Asks
assistance from techs for balance interventions while assisting patients. Requires some guidance during
precautions/intervention with patient with integumentary issues and with correction of body mechanics
while performing manual therapy

CI Final — Cara L. Nawrocki Uses safe guarding techniques for patients with balance issues. Has improved with her own body
mechanics as well. Uses interventions and modalities accordingly.

B AB I AI E BE
Self +4
Safety
CI +4

2. Professional Practice – Professional Behavior

Self Mid-Term — Lara Nasser In preparation for evaluations the next day I will research the diagnosis if it was provided and begin to
brainstorm possible treatment routes. This helps to give myself a foundation going into an evaluation. I
try to arrive early in order to review conditions/MMT techniques. I feel as though I listen to the patient
and provide some reassurance throughout their therapy journey.

Self Final — Lara Nasser I have become better at checking the schedule for the next day at the end of the night in order to be better
prepared. I check to see if it's time to change exercises and progress their treatment plan. I continue to
arrive early in case I need to complete any documentation but I try to have that all completed before I
leave.

CI Mid-Term — Cara L. Nawrocki Arrives well before starting time of seeing patients and is ready to work. Comes prepared with outlines
for evals and new exercises for that day from discussion of the previous day. Wears appropriate dress
code for clinic standards. Always willing to accept feedback. Demonstrates professional behavior while
interacting with other PT's/techs in the clinic when discussing patients, treatments.

CI Final — Cara L. Nawrocki Always on time and prepared to work. Is caring and compassionate with all patients. Readily continues to
accept feedback and uses it immediately. Demonstrates professional behavior with all patients and all of
 the staff.

B AB I AI E BE

Professional Self +3
Behavior CI +3

3. Professional Practice – Accountability

Self Mid-Term — Lara Nasser If I feel uncomfortable will a technique or if a patient reports pain/symptoms that I am unfamiliar with I
will ask for guidance and assistance from my CI. If my hand placement needs to be adjusted my CI will
help to correct my mechanics. I abide by HIPPA and the privacy of patient diagnoses.

Self Final — Lara Nasser I continue to abide by the procedures/practices of HIPPA. I will be mindful of how the patient is feeling
and how the therapeutic exercises are feeling and I accept responsibility when necessary.

CI Mid-Term — Cara L. Nawrocki Always spends time working with patients during their treatment session. Abides by all clinic policies
and legal standards. Is dedicated to spending time with patients that are hers while they are in the clinic.

CI Final — Cara L. Nawrocki Adheres to all practice standards. Spends her time in the clinic with her patients and uses her time
effectively.

B AB I AI E BE
Self +2
Accountability
CI +1

4. Professional Practice – Communication

Self Mid-Term — Lara Nasser I am very attentive to how my CI describes and explains techniques, modalities, treatment, etc to
patients. I am beginning to do the same when a patient asks questions. Explaining to the patient their
diagnosis in layman's terms is something I am starting to improve on.

Self Final — Lara Nasser I have become better when communicating with techs and navigating when multiple patients are at
therapy. I continue to be attentive and actively listening when a patient or PT is speaking. I am
continuing to improve on patient education explained in a way that the patient will understand and
accept. When I have a question I always seek out my CI for assistance.

CI Mid-Term — Cara L. Nawrocki
Is an active listener and asks appropriate questions to me to seek feedback and uses feedback
constructively when performing patient care. Communicates with patients about how they are feeling
currently. Needs guidance to help answer patients more difficult questions like "Will this ever get better?"
and needs guidance to ask questions to patients to gauge their current functional status for medical
necessity notes.

CI Final — Cara L. Nawrocki Has improved with communicating with patients and answering their questions without needing feedback
from me. Uses both verbal and non-verbal communication techniques (like demonstrating exercises) to
assist with her patient care. Has gotten more comfortable with educating patients on their diagnosis.

B AB I AI E BE
Self +4
Communication
CI +4

5. Professional Practice – Cultural Competence

Self Mid-Term — Lara Nasser Patients have expressed different beliefs than that of my own and I was able to listen and not partake in

Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
CI Final — Cara L. Nawrocki
B AB
Cultural Self
Competence CI
6. Professional Practice – Professional Development
Self Mid-Term — Lara Nasser
Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
CI Final — Cara L. Nawrocki
B AB
Professional Self
Development CI
7. Patient Management – Clinical Reasoning
Self Mid-Term — Lara Nasser
Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
conversation that may lead to a different conversation. I am more concerned with the patient's progress
and development in rehabilitation.
I am continuing to be mindful of individual beliefs and remain respectful of their opinions.
No issues here. Demonstrates professional and sensitive behavior for all patients no matter their race,
gender, age, religion, etc. Gives equal attention to all patients.
As was on the mid-term. Is professional, respectful and treats all patients the same regardless of age,
race, gender, religion, etc.
I AI E BE
+3
0
I am aware of my limitation and what I need more assistance in. If I feel unsure or need help I feel
comfortable asking my CI. I utilize textbooks and added material in order to research topics that I am
unfamiliar with or if I need more clarification.
I had two goals after the midterm and they were to 1. become more comfortable performing evaluations
and progressing patients and 2. patient education. I feel as though I have improved in those regards. The
more evaluations I perform the more comfortable I become with them. I have developed so much in 6
weeks and I feel my clinical skills have improved immensely from this experience. I have utilized
"physio-pedia" that my CI has suggested for research purposes which has been helpful.
Seeks my guidance to help with answering questions and prepare for initial evaluations and changing
treatment plans. Is eager to learn new treatment techniques and can apply familiar manual treatment
techniques for patients that we practice with each other. Is open to using textbooks/cont ed materials for
further learning. Lara understands that progressing or changing treatments plans for current patients and
coming up with treatment ideas on the day of the patients initial evaluation are areas to improve on.
We have spent some time in the last 2-3 weeks practicing manual techniques and Lara spends any of her
free time practicing these techniques on other staff members and asks for their feedback. Lara
understands both her strength and her weaknesses in her clinical performance. Has improved on being
able to progress exercise programs with minimal guidance or questions.
I AI E BE
+4
+3
I appreciate my CI asking my what I think about treatment plans and I provide rationale for why I want
to perform certain plans. From what I have learned in school and my CI's clinical judgement I am able to
progress my clinical skills.
I have become more comfortable providing rationale for what exercises I would like to utilize and If I
have questions I will ask my CI for assistance. Patient preference and what they feel comfortable with is
also important when selecting interventions and I am continuously learning that.
Lara can present rationale for exercises, manual treatment, and modalities for simple diagnoses. Her
clinical decisions have always been safe. Needs some guidance developing a plan of care and exercise
progression. I have been assisting her with choosing interventions that are in line with best clinical
evidence. I think Lara will be challenged more in the next 3 weeks with modifying her patients programs
since she has now been seeing patients for 1-2 weeks that she helped to evaluate.
CI Final — Cara L. Nawrocki
B AB
Clinical Self
Reasoning CI
8. Patient Management – Screening
Self Mid-Term — Lara Nasser
Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
CI Final — Cara L. Nawrocki
B AB
Self
Screening
CI
9. Patient Management – Examination
Self Mid-Term — Lara Nasser
Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
CI Final — Cara L. Nawrocki
Lara is more comfortable with progressing exercise programs for patients. She has been able to modify
and change exercises for simple diagnosis. Requires some suggestions from patients who are a little more
high level and being creative with challenging them with strengthening.
I AI E BE
+4
+2
I am progressing in the objective portion of an evaluation. I am able to rule in the doctor's prescription
with a little more confidence. I am also able to choose what ROM measurements I would like to assess. I
am progressing in regards to increased confidence while screening a patient.
From the subjective portion I have become more comfortable with deciding what objective screens I
would like to implement. I feel more comfortable with joint mobilizations with the help of my CI as we
practice them as necessary. The more screens I perform I will feel more confident.
Able to perform a chart review independently. Uses FOTO to help check systems review and reviews
patients medications during the initial evaluation to understand their medical history. Uses goniometry
correctly for ROM.
Has continued to use FOTO as a health screening tool to review medical information. Has been several
patients with an involved health history and has been able to gather a complete background and use that
information to help guide safety with treatments. Continues to use a goniometer and girth measurement
correctly.
I AI E BE
+5
+3
After obtaining a patients subjective portion I decide to implement tests and measures to assess what they
have stated as difficult for them or what they reported as signs and symptoms. I am taking into
consideration palpation and MMT. I am learning to modify assessing ROM and MMT if a patient cannot
perform it in the intended position.
As mentioned above, I feel more comfortable addressing the subjective portion and translating that
information into an objective measure. Taking the functional deficit and testing/screening that issue is
something I have began to do more often. Completing myotome screening is also something that I
constantly complete when evaluating a patient. Assessing a patient's gait as they walk into the waiting
room or to the evaluation room is another aspect that I try to implement often.
Able to perform subjective part of the evaluation independently. After the subjective is complete, we
have had discussions about what to include during the objective part of the evaluation and Lara identifies
pertinent tests and measures to take during the objective. Lara is comfortable with simple extremity
evaluation measures such as a knee scope, but is less confident about her skills with spinal diagnoses.
She will be able to perform several re-examinations in the next 3 weeks.
Has been able to perform examinations from start to finish in a more timely manner (about an hour) and
has been independent in figuring out what tests and measures to conduct during the objective part of the
exam without suggestions from me. Is more comfortable to spinal diagnoses as well. Has been able to re-
evaluate several patients, go through FOTO with them and re-evaluate objective measures and goals.
 B AB I AI E BE
Self +4
Examination
CI +3

10. Patient Management – Evaluation

Self Mid-Term — Lara Nasser After taking the patients subjective and objective I am starting to be more comfortable assigning a plan
of care with more independence and confidence. I still require and want input but I am becoming more
comfortable making clinical decisions.

Self Final — Lara Nasser I am feeling more comfortable and confident providing a plan of care based on the patient's complaints
and what they have demonstrated in the clinic. I ask for assistance when necessary but I am trying to
figure things out on my own and challenge myself when creating a plan of care for the patient.

CI Mid-Term — Cara L. Nawrocki Lara is able to use information from the examination to make clinical judgements about what she would
like to incorporate into her plan.

CI Final — Cara L. Nawrocki Lara has gotten better at designing her exercise programs and manual treatments after completing her
examination with less guidance from me.

B AB I AI E BE
Self +3
Evaluation
CI +4

11. Patient Management – Diagnosis and Prognosis

Self Mid-Term — Lara Nasser I am starting to take into consideration exercises plans for patients and their age/co-morbidities because
that affects their performance. I am learning about different diagnoses and how every patient takes to
therapy differently and learning to incorporate that into my clinical judgement.

Self Final — Lara Nasser I continue to keep in mind the patient's health status when determining the patient's physical therapy
management. What can they tolerate, how hard to progress or push them. All of these factors are crucial
for PT prognosis.

CI Mid-Term — Cara L. Nawrocki Able to arrive at a PT diagnosis after completing an evaluation. Understands that prognosis is based on
many factors and we have had discussions about how many factors influence prognosis depending on the
patient. Lara will get better with understanding prognosis the more she works with our patient population
(chronic pain/older population/many health issues present).

CI Final — Cara L. Nawrocki Has continued to be able to reach a PT diagnosis and understand the patients functional limitations in
order to design a plan of care. Has been able to work with several patients who are older and present with
many co-morbities and demonstrates understanding of how they can impact their physical therapy.

B AB I AI E BE

Diagnosis and Self +4

Prognosis CI +3

12. Patient Management – Plan of Care

Self Mid-Term — Lara Nasser I am learning from my CI and beginning to create my own plan of care for patients and what I believe is
needed in order to see positive results. What will benefit the patient is extremely important and by
creating a POC that is tailored to the patients needs is something that I continuing to improve on.

Self Final — Lara Nasser I am improving when creating a plan of care for patients. Continuing to think what will benefit the

CI Mid-Term — Cara L. Nawrocki
CI Final — Cara L. Nawrocki
B AB
Self
Plan of Care
CI
13. Patient Management – Procedural Interventions
Self Mid-Term — Lara Nasser
Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
CI Final — Cara L. Nawrocki
B AB
Procedural Self
Interventions CI
14. Patient Management – Educational Interventions
Self Mid-Term — Lara Nasser
Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
patient and what plan of care will be the most effective is what I am improving on since mid-term. My CI
has helped tremendously to provide me with what is important within a Plan of Care.
Lara has been able to set plan of cares in place for several new patients. She is able to identify areas of
objective limitations for the patient but has some difficulty coming up with interventions to address these
areas. Needs some guidance setting up exercises for the eval day and how to progress exercises for
patients. She will get better at this as she gains confidence in her skills and knowledge. She has been able
to progress patients with exercises that have had positive responses during their therapy and with patients
who are getting better.
Is much more comfortable designing a plan of care for patients and designing an exercise program and
manual treatments if they are necessary with help from me <25% of the time. Still needs minimal
guidance in progressing patients who can tolerate a higher level exercise program, but does have good
clinical judgement of when is a good time to progress a patients exercises.
I AI E BE
+5
+2
Asking the patient how they are doing after their last therapy session is something that I am getting into
the habit of doing in order to gauge if the interventions should be adjusted. I am learning that if they had
no complaints we will stick with the same plan and possibly progress. If they did not feel pain relief or
felt worse then I would change the interventions.
I have improved and am continuing to improve on interventions. The more I see patients the more
confident I feel asking them how they are feeling what is getting better what is not improving in order to
change or progress the intervention portion. If the patient is feeling good I will keep the exercises the
same and may even progress them. It all varies on the patient's progress and I am getting the hang of it.
Lara has been able to carry out interventions in a timely manner and has also been able to multi task
when 2 patients are present in the gym that she is working with spending time with each one. Has been
able to provide rationale for new interventions/exercises for patients.
Continues to carry out interventions in line with plan of care in order to progress the patient to reaching
their functional goals. Adjusts interventions for patients with many co-morbidities (allows them more
rest breaks, sitting breaks, etc).
I AI E BE
+5
+3
I am learning to educate patients on proper body mechanics and how to avoid aggravating symptoms.
Educating patients on the techniques I am performing and why I am doing what i am doing is something
I am trying to improve on and something I always want to incorporate.
I have noticed when patient's ask about their condition or ask what can't they do.. I feel more confident
responding to their questions. I patient has frozen shoulder and she wanted to know how people develop
it. I was able to explain to her the etiology and the different stages. Also explaining Lumbar stenosis has
been something I am more comfortable explaining and what positions are more comfortable and why that
may be.
Uses different learning styles for different patients effectively. Able to give verbal instructions and also
demonstrates exercises to patients when appropriate. Had a patient palpate their own quadricep on
involved and uninvolved sides when teaching a quad set exercise post op for patient understanding and
 learning.

CI Final — Cara L. Nawrocki Is more comfortable educating patients on their diagnosis and answering their questions with less
guidance from me. Also continues to modify interactions for each patient- sits and stays and
demonstrates with patients who have more difficulty understanding exercises and allows more
independence for those ready for discharge.

B AB I AI E BE

Educational Self +4
Interventions CI +3

15. Patient Management – Documentation

Self Mid-Term — Lara Nasser I am becoming more proficient with documentation. Evaluations require the most time and I am starting
to improve the quality of my evaluation documentation. I am learning what information is necessary to
include into documents and what different insurance companies require.

Self Final — Lara Nasser Documentation is continuing to improve, the more I complete documentation the more proficient and
efficient I am becoming at writing them.

CI Mid-Term — Cara L. Nawrocki Completes all documentation in a timely manner after working with each patient. Needs minimal
guidance during "functional reporting" part of the initial evaluation to objectify patients current
functional status to prove medical necessity. Is already getting faster at completing the documentation
portion of initial evaluations.

CI Final — Cara L. Nawrocki Completes all documentation in a timely manner, always having all notes done before leaving the clinic
that day. Has not needed guidance from me in the last week in changing any notes in "functional
reporting" section.

B AB I AI E BE

Self +4
Documentation
CI +3

16. Patient Management – Outcomes Assessment

Self Mid-Term — Lara Nasser After creating goals with the patient's input after a few visits I am learning to ask how tasks are going
with them. How are they feeling and are they able to do more then when they first started therapy. I like
to ask my CI if there is anything that I should add to the patient's plan and if what i am doing is
appropriate for the patient outcome.

Self Final — Lara Nasser I am becoming better at each visit asking how the previous treatment felt to the patient and that helps to
determine their assessment and plan of care. I also know around 6+ visits or so I start think more of a re-
evaluation mindset and ask the patient what has changed since beginning therapy and that I felt has
become more of a smoother transition and I am more aware of of it.

CI Mid-Term — Cara L. Nawrocki Uses our clinic's tablets independently to capture FOTO which is our outcome assessment tool. Will get
more experience in the next 3 weeks in evaluating whether or not her patients have reached their
functional goals she has set during the initial evaluation.

CI Final — Cara L. Nawrocki Has been able to assess patients responses to treatment and modify if necessary. Has continued to use our
FOTO system to re-evaluate patients, assess their satisfaction, and use their scores as outcome measures.

B AB I AI E BE

Outcomes Self +4
Assessment CI +3
17. Patient Management – Financial Resources
Self Mid-Term — Lara Nasser I am learning how to bill for services provided and learning if different insurance companies have
specific requirements.

Self Final — Lara Nasser Billing has improved and I am more aware of the different costs and therapy regulations.

CI Mid-Term — Cara L. Nawrocki Understands how to complete billing in our documentation system. Learned very quickly how to use
"EasyDoc" for documentation. Uses her time in the gym effectively while treating patients and
documenting, sometimes multitasking when she needs to.

CI Final — Cara L. Nawrocki Uses all of her time effectively while in the clinic. Comes prepared in the morning to see evals for that
day. Uses computer system independently. Has been able to adapt to patients who come in early or late
for their appointments without it affecting her treatment quality.

B AB I AI E BE

Financial Self +5
Resources CI +3

18. Patient Management – Direction and Supervision of Personnel

Self Mid-Term — Lara Nasser I utilize the help of physical therapist technician who assist the patient's with their therapeutic exercises. I
ask for their assistance when needed and if I have more than 1 patient that require my attention.

Self Final — Lara Nasser I am able to more confidently as the techs for assistance when I have more than 1 patient in the gym. I
have become better at asking the techs to help set up or assist the patient with exercises while I am
completing manual therapy on another patient.

CI Mid-Term — Cara L. Nawrocki Has delegated tasks to the technicians regarding helping patients through some of their exercises. Will
get more chances in the next 3 weeks about discussing patients with our PTA/other PT's.

CI Final — Cara L. Nawrocki Very good at managing time and can multi task with 2 patients in the gym at one time. Has been able to
delegate to technicians the patient care the patient should be receiving. Provides concise documentation
to PTA if a patient happens to be on his schedule for the day.

B AB I AI E BE

Supervision of Self +4
Personnel CI +3

19. Summative Comments / Caseload / Days Absent

Areas of Strength

Self Mid-Term — Lara Nasser I am expanding my knowledge clinically in regards to taking ROM, MMT and retrieving the subjective
portion of an evaluation. I feel more confident implementing my knowledge from the classroom into the
clinical setting.

Self Final — Lara Nasser I have felt more comfortable with the patient population, I feel more confident answering simpler
questions that the patient may have, evaluations are becoming slightly easier and familiar. Implementing
what I learned in the classroom has continued to help when I am applying that information to the clinic.

CI Mid-Term — Cara L. Nawrocki Executing treatment plans that have already been in place for patients currently. Giving
verbal/demonstrative cues on correct exercise performance. Progressing exercise programs for those
patients who are making improvements going through their PT sessions. Greeting/communicating with
patients, having professional behavior with patients and staff. Capturing a complete subjective during an

CI Final — Cara L. Nawrocki
Areas for Further Development
Self Mid-Term — Lara Nasser
Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
CI Final — Cara L. Nawrocki
Caseload/Other Comments
1) What is the full caseload at your clinical site for a new graduate?
2) Considering the rating anchors, what percent of a new graduate caseload is the student capable of managing at this
time?
Self Mid-Term — Lara Nasser
Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
CI Final — Cara L. Nawrocki
Recommendations
Self Mid-Term — Lara Nasser
Self Final — Lara Nasser
CI Mid-Term — Cara L. Nawrocki
CI Final — Cara L. Nawrocki
Mid-Term Days Absent
Final Days Absent
evaluation. Having documentation completed in a very timely manner. Knowing what objective measures
to take during an evaluation. Was able to complete a full evaluation on a simple condition in one hour.
Professional behavior - very punctual everyday, respectful of all the staff and patients, executing
treatment plans, completing documentation in a timely manner, progressing exercise plans for patients
with simple diagnoses, multi tasking 2 patients at one time in the gym, being prepared for the next day in
the clinic regarding treatments for patients and who the evaluations are that are coming into the clinic.
I can continue to improve on creating a Plan of Care that requires specific exercises and improve on my
knowledge of different treatment plans for a variety of diagnoses.
In general, I can always improve on familiarizing myself with different diagnoses and improving on
differential diagnoses. Becoming comfortable with the unexpected.
Checking the schedule in the evening to familiarize and prepare for the next day independently. Check
the other PT's schedule as well to see if we are sharing patients with them and have discussions with
them about that patients eval/treatment plan. Delegating to technicians/other PT's/PTA your treatment
plans for your patients if you need assistance. Beginning and progressing treatment plans and exercise
prescription for patients independently (especially after the initial eval). Completing an evaluation
independently for a spinal diagnosis. Patient education regarding pathology, understanding disease
process related to their diagnosis, and how physical therapy can help.
Progressing exercise program for patients who can be challenged and who are more high level in what
they can tolerate. Trying to utilize "evidence based practice" and references when unsure of what
treatments and evaluations tools to use with patients.
N/A
N/A
Full caseload is about 15 patients per day. Able to manage about 30-40% at this time.
Caseload for the new grad about 12-15 patients per day. Lara is able to manage 50-60% at this time.
N/A
N/A
Continue to practice thinking about how to progress/change treatment plans based on with the patient
needs. Seek out texts/resources to assist you with ideas for treatments.
Continue to be creative with exercise treatments. Keep practicing manual skills to gain more comfort and
confidence in the hands on skills. Lara has been a pleasure to work with and the whole staff is going to
miss her being in the clinic!
Student: 0 days
CI: 0 days
Student: 0 days
CI: 0 days
 Reason for Absence

Self Mid-Term — Lara Nasser none.

Self Final — Lara Nasser none.

Evaluation Sign Off Dates/Times

Self Mid-Term

[CI] Cara L. Nawrocki - 06/17/18 08:55 PM

[Student] Lara Nasser - 06/03/18 03:37 PM

Self Final

[CI] Cara L. Nawrocki - 06/19/18 02:13 PM

[Student] Lara Nasser - 06/19/18 11:28 AM

CI Mid-Term

[Student] Lara Nasser - 06/04/18 02:05 PM

[CI] Cara L. Nawrocki - 06/03/18 09:23 PM

CI Final

[Student] Lara Nasser - 06/19/18 02:13 PM

[CI] Cara L. Nawrocki - 06/19/18 01:41 PM

Post-Assessment Comments
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