HAND OCCUPATIONAL THERAPY

ATI THERAPY

Goals & Objectives:

1) Health Assessment (Cognitive Goal):

By the end of my fieldwork experience I will be able to describe elements of the in house evaluation used by ATI Therapy.

I achieved this goal by observing many evaluations and reading over the evaluation manual. The pictures below show a mock-evaluation I performed with another intern to practice measurements. I also wrote a case study that reviewed many components of the evaluation process.

Distal Radius Fracture Case Study

2) Health Planning Goal (Cognitive & Skill Goal):

By the end of my fieldwork experience I will be able to plan and explain a presentation related to a comorbidity health issue

After observing Nelson massage a tight knot in a patient's shoulder and asking how these sensitive areas of muscle form, he suggested I do an in-service on the topic. I shared my research during a lunch meeting to all the ATI therapists. My presentation can be found below.

3) Intervention Development or Implementation Goal (Skill Goal):

By the end of my fieldwork experience I will be able to create several functionally oriented therapeutic techniques.

How well do you think you accomplished the project or dealt with the experience(s)?
- I think I did a great job identifying a patient need and coming up with an original and creative solution. Many patients that came to therapy mentioned they enjoyed gardening, but we did not have any therapy activities to simulate this hobby. After brainstorming what types of motions are involved in gardening I decided to focus on pulling weeds, raking, shoveling, and digging in dirt to plant seeds.
What skills did you use? (e.g. writing, speaking, organizing, interpersonal, counseling, management, research, etc.)
- I had to use a lot of creativity to identify ways to simulate pulling weeds as well as finding a substance that was not as messy as dirt. I decided to use different strengths of magnets to provide various weed pulling resistances and metal wire attached to felt and pipe cleaner flowers as plants. Moon sand was a great substitute to dirt because it sticks together and does not get the patients' hands dirty. I also used interpersonal skills to explain the therapy to patients.
Point out your strengths and weaknesses. What would you do differently?
- I had a lot of trouble finding strong enough magnets to begin with. It was very important to me that the activity could be graded to meet the patients' skill level. After much trial and error, I was able to find suitable combinations of strengths. By color coordinating the magnet location with the flower color, I hope this activity will be easy to understand and replicate even when I leave ATI. One weakness of the activity is the size and sand resistance. I had to keep it within a reasonable range to store, but most gardens would not be this small. I also wish I had different types of sand for different levels of resistance.

4) Intervention Evaluation (Cognitive Goal):

By the end of my fieldwork experience I will be able to explain how practicing OTs stay current in their treatment methods.

While Nelson is not necessarily in school, he is required to participate in 24 credit hours of continued education every two years to keep his state license. He used to travel to conferences around the country, which could be expensive and time consuming, but now different therapists from ATI locations travel to them to give in-services. Nelson prefers conferences over online courses because he enjoys connecting with other therapists and finds meetings in person more hands on and engaging. Nelson attended a continuing education course on joint mobilization when I was interning and he shared the information he learned at the conference with me afterwards.

5) Affect Goal:

By the end of my fieldwork experience I will be able to articulate how I feel about pursuing a career or further graduate studies in hand occupational therapy.

I love that OT is such a relational profession and am postitive I want to pursue occupational therapy as a career, but am still open to various settings. I had the chance to intern in two different locations and enjoyed both for different reasons. All of Nelson’s patients have a story and its a delight getting to know them. Anatomy and physiology was my favorite class at Clemson and you must be strong in this subject to succeed at hand therapy. Overall, this internship did nothing but fuel my fire for grad school.

6) Asses you contribution to the internship site.

I hope ATI enjoyed having me as much as I enjoyed them. It was easy to come in everyday with a smile on my face, ready to learn and interact with patients. I tried to show initiate in greeting patients, getting needed supplies, and even cleaning and organizing Nelson's splinting room. I also wanted to make a therapy activity that was unique and useful for future patients.

7) Relate your internship experience to your academic work on campus. List at least 5 specific courses (by title, not number) in your major that were useful at this site.

Introduction to Public Health: It’s important to see the patient through a holistic lens.
Determinants of Health: There are many factors that could impact a patient’s ability access and accessibility to treatment
Research and Evaluation Strategies & Epidemiology: Very important when reading through peer review articles for my case study and understanding prevalence and incidence data
Community Health Promotion: How to advocate for patients that may not qualify for insurance coverage and need treatments
Anatomy and Physiology: Hand anatomy and response to healing

8) Were there instances at your site where the health literacy training were utilized? Explain.

Yes, we had to explain concepts like lymphatic drainage and tissue repair to patients in simple and easy to understand terms.