formative competency final exam

Beneficence

promoting good and the client's well-being

Ex. providing evidence-based interventions

Nonmaleficence

do no harm

Ex. preventing unsafe mobility

autonomy

respect client choice and privacy

Ex. obtaining informed consent and protecting health info

justice

treat clients fairly and equitably

Ex. providing services without discrimination

veracity

be truthful

Ex. honest documentation and realistic progress

fidelity

maintain professional responsibilities and loyalty

Ex. following through on treatment commitments and collaborating professionally

altruism

concern for the welfare of others

equality

treating individuals fairly and impartially

freedom

respecting each person's right to make choices

justice

providing equitable and objective services

dignity

valuing the worth and uniqueness of every person

truth

being honest, accurate, and accountable

prudence

using sound judgement and professional judgment

NBCOT

National certification organization

Administers the national certification exam

Certification demonstrates entry-level competence

Renew every 3 years

Requires 36 CEUs every 3 years

State requirements

Legal permission to practice within a state

Must have NBCOT certification

Renew annually

10 CEUS for each year

Issues and renews licenses according to state law

Licensure is required to legally practice in that state

OTAs

Provides OT services under supervision of OT

Implements intervention plans developed in collabs with supervising OT

1 hr face-to-face supervision for every 40 work hours by OTA

OT must meet with OTA and each patient monthly

Signed supervision log

Aides

Supervised by OT/OTA

Requires continuous visual supervision

Only delegated supportive tasks

proper body mechanics help...

Prevent injury to the client and therapist

Improve efficiency during transfers

Maintain client safety

principles of good body mechanics

Maintain a wide base of support (feet shoulder-width apart).

Keep the center of gravity low by bending at the hips and knees.

Keep the client close to your body.

Tighten your core muscles before lifting or assisting.

Pivot with your feet—do not twist your trunk.

Face the direction of movement.

Push rather than pull whenever possible.

Adjust the bed, wheelchair, or mat table to an appropriate working height.

Lock wheelchair brakes and remove footrests/armrests as needed.

Use a gait belt when appropriate.

safe transfers

Explain the procedure to the client.

Lock wheelchair brakes.

Position wheelchair at an appropriate angle.

Remove or swing away footrests.

Apply gait belt if indicated.

Ensure the client is wearing non-skid footwear.

Assess the client's strength, balance, cognition, and weight-bearing status.

stand pivot

Client stands, pivots, and sits with assistance.

squat pivot

Client partially stands and pivots without reaching full standing.

sliding board

Used for clients with limited or no lower-extremity weight bearing.

mechanical/hoyer

Used for dependent or medically complex clients when manual transfer is unsafe.

ROM

amount of movement available at a joint

shoulder flexion

0-180

shoulder extension

0-60

shoulder abduction

0-180

shoulder horizontal abduction

0-45

shoulder horizontal adduction

0-140

shoulder internal rotation

0-70

shoulder external rotation

0-90

elbow flexion-extension

0-150

supination

0-80

pronation

0-80

wrist flexion

0-80

wrist extension

0-70

ulnar deviation

0-30

radial deviation

0-20

thumb CM flexion

0-15

thumb CM extension

0-20

thumb MP flexion-extension

0-50

thumb IP flexion-extension

0-80

palmar abduction

0-70

radial abduction

0-80

finger MP flexion

0-90

finger PIP flexion-extension

0-100

finger DIP flexion-extension

0-90

AROM

client moves independently

Used for:

Muscle strengthening

Improve functional movement

Client has adequate muscle activation

AAROM

client moves with assistance

Used for:

Muscle weakness

Fatigue

Early recovery after injury

PROM

therapist moves the joint; client does not assist

Used for:

Prevent contractures

Maintain joint mobility

Client unable to move independently

MMT

evaluates muscle's ability to contract against gravity and resistance

MMT: 5

- Normal

- Full ROM against gravity, maximum resistance

MMT: 4

Good

-Full ROM against gravity and moderate resistance

MMT: 4-

-Good minus

-Full ROM against gravity, less than moderate resistance

MMT: 3+

-Fair plus

-Full ROM against gravity, minimal resistance before it breaks

MMT: 3

-Fair

-Full ROM against gravity, no resistance

MMT: 3-

-Fair minus

Less than full ROM, against gravity

MMT: 2+

-Poor plus

-Full ROM, gravity-eliminated, minimal resistance then breaks

MMT: 2

-Poor

-Full ROM, gravity eliminated

MMT: 2-

-Poor minus

-Less than full ROM, gravity-eliminated, no resistance

MMT: 1

-Trace

-No movement, tension is palpated in muscle/tendon

MMT: 0

Zero

No tension is palpated in the muscle or tendon

OTPF domains

occupations

contexts

performance patterns

performance skills

client factors

domains: occupations

Daily life activities that are meaningful and purposeful

domains: contexts

Environmental and personal factors

domains: performance patterns

Habits, routines, rituals, roles

domains: performance skills

Observable goal-directed actions used to complete occupations

domains: client factors

Values, beliefs, spirituality, body functions, and body structures

occupation

ADLs

IADLs

Health management

rest and sleep

education

work

play

leisure

social participation

ADLs

Bathing, dressing, toileting, eating, feeding, functional mobility, personal hygiene

IADLs

Meal preparation, medication management, shopping, financial management, driving, home management

occupational profile

First step in OT eval

Summary of client's occupational history, experiences, interests, values, priorities, and goals

autocratic

Leader makes decisions independently; efficient in emergencies but little team input.

democratic

Team members participate in decision-making; encourages collaboration and communication.

laissez-faire

Leader provides minimal direction; team has greater independence.

transformational

Inspires and motivates others toward a shared vision and professional growth.

transactional

Focuses on structure, rules, supervision, and rewards for performance.

servant

Prioritizes the needs, growth, and well-being of team members.

situational

Adapts leadership style based on the team's experience, competence, and the situation.

clinical reasoning: scientific

Uses evidence, diagnoses, and research to guide intervention.

clinical reasoning: diagnostic

Identifies the client's strengths, problems, and occupational performance limitations.

clinical reasoning: procedural

Determines assessments and intervention techniques.

clinical reasoning: narrative

Understands the client's story, values, and life experiences.

clinical reasoning: interactive

Builds rapport and therapeutic relationships with the client.

clinical reasoning: pragmatic

Considers practical factors such as time, resources, insurance, and environment.

clinical reasoning: ethical

Applies ethical principles when making clinical decisions.

clinical reasoning: conditional

integrates all reasoning types to predict outcomes and develop individualized intervention plans.

general principles of development

Prone → supine control

Flexion → Extension

Center of gravity moves from upper body → pelvis

Proximal stability → Distal control

Lateral movements → Midline

Ability to move against gravity

Increased dissociation (separating upper/lower body and right/left sides)

Increased stability and freedom of movement for functional tasks

0-3mo

Head control develops, hands mostly fisted → opens hands, tracks objects

4-6mo

Rolls prone→supine, props on forearms, reaches bilaterally, palmar grasp

6-9mo

Rolls both ways, sits independently, crawls begins, transfers objects, radial palmar grasp

10-12 mo

Pulls to stand, cruises, inferior pincer → 3-jaw chuck, puts objects in container

12-18mo

Superior pincer grasp

Scribbles

Builds 2-block tower

Walks independently

18-24mo

Runs

Builds 4-6 block tower

Vertical line

Spoon with some spillage

2-3yrs

Jumps

Circle

Snips scissors

Builds 8-block tower

3-4yrs

Tells if an object is light or heavy

Is able to repeat a simple story

Matches object one to one

Points to long and short objects

If able to sort objects by shape and size

Knows the name of the primary colours

Names 3 shapes

Counts 10 objects with support

4-5yrs

Gallops

Copies square

Cuts circle

Prints letters

5-6yrs

Skips

Rides bike

Ties shoes

Writes name

Dynamic tripod grasp emerges

ASQ

developmental screening