RESUMO
Occupational therapists have been conducting functional assessments since World War I, and this accumulated experience has taught us several critical lessons. First, a comprehensive profile of a patient's functioning requires multiple assessment methods. Second, assessment content and measurement constructs must change with the times. Third, technology can enhance and extend functional assessment. Fourth, performance-based assessments of everyday activities can also be used to measure body functions/impairments. However, while deconstructing activities into body functions/impairments is possible, the results do not reflect patients' abilities to integrate the cognitive, motor, sensory and affective functions necessary to complete a complex activity. Finally, the differential complexity of everyday activities that a patient can master or successfully complete can also provide a ruler with which to measure progress.
Los terapeutas ocupacionales han realizado evaluaciones funcionales desde la Primera Guerra Mundial, y esta experiencia acumulada nos ha enseñado algunas lecciones importantes. Primero, un perfil comprensivo del funcionamiento de un paciente requiere de mùltiples métodos de evaluación. Segundo, el contenido de la evaluación y los constructos de medición deben cambiar con los tiempos. Tercero, la tecnología puede reforzar y ampliar la evaluación funcional. Cuarto, las evaluaciones basadas en el desempeño de las actividades diarias también se pueden emplear para medir las funciones y deterioros corporales. Sin embargo, aunque es posible la deconstrucción de las actividades en funciones y deterioros corporales, los resultados no reflejan las capacidades de los pacientes para integrar las funciones cognitivas, motoras, sensoriales y afectivas necesarias para completar una actividad compleja. Por último, la complejidad diferencial de las actividades diarias que un paciente puede dominar o completar exitosamente también puede aportar una regla con la cual medir el progreso.
Les ergothérapeutes ont mené des évaluations fonctionnelles depuis la première guerre mondiale et cette accumulation d'expérience nous a enseigné plusieurs leçons essentielles. Tout d'abord, de nombreuses méthodes d'évaluation sont nécessaires pour établir le profil complet du fonctionnement d'un patient. Deuxièmement, le contenu de l'évaluation et les méthodes de mesure doivent évoluer avec le temps. Troisièmement, la technologie peut améliorer et élargir l'évaluation fonctionnelle. Quatrièmement, les évaluations basées sur la performance des activités quotidiennes peuvent aussi être utilisées pour mesurer le fonctionnement du corps (ou les troubles du fonctionnement). Toutefois, bien qu'il soit possible de décomposer les activités du quotidien par fonction, les résultats obtenus ne reflètent pas la manière dont les patients sont capables de coordonner leurs fonctions cognitives, motrices, sensorielles et affectives pour effectuer une activité complexe. Enfin, différents niveaux de complexité des diverses activités quotidiennes qu'un patient peut maîtriser ou exécuter avec succès peuvent aussi fournir une règle permettant de mesurer le progrès.
Assuntos
Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Saúde Mental , Terapia Ocupacional/métodos , Humanos , Transtornos Mentais/psicologia , Saúde Mental/tendências , Terapia Ocupacional/tendências , Telemedicina/métodos , Telemedicina/tendências , Terapia de Exposição à Realidade Virtual/métodos , Terapia de Exposição à Realidade Virtual/tendênciasRESUMO
OBJECTIVE: We describe an educational intervention that involved simulation scenarios of medically complex patients to teach transfer training and promote clinical reasoning. METHOD: Scenarios were developed with practitioner input that described (1) a patient who was acutely ill, (2) a critical medical management event that occurred during a bed-to-wheelchair transfer of the patient, and (3) an occupational need. Transfer training, using the scenarios, occurred in a high-technology laboratory with SimMan(®) and a mock hospital suite. Evaluation was based on student performance and perceptions of simulation effectiveness. RESULTS: On average, students completed 66%-88% of the transfer items correctly. Student performance suggested that the simulation scenarios were more difficult than practitioners rated them. Students rated the simulation scenarios as effective teaching tools. CONCLUSION: Scenario use in simulations for transfer training makes a positive curricular contribution to teaching procedural skills and clinical reasoning simultaneously.
RESUMO
OBJECTIVE: We evaluated the effects of transfer training-after training in the classroom and in the high-technology simulation laboratory (WISER Center)-on students' perceptions of their self-efficacy for knowledge, skill, and safety in executing dependent transfers. METHOD: After classroom training, occupational therapy students were randomized to three teaching groups on the basis of the amount of participation and observation opportunities provided at the WISER Center-observation dominant, participation dominant, and participation only. RESULTS: The participation-dominant group reported an increase in knowledge self-efficacy over time compared with the observation-dominant and participation-only groups. Over time, self-efficacy ratings increased for all students, regardless of group. CONCLUSION: Simulation scenarios implemented at the WISER Center provided a useful adjunct to classroom training in transfer skills. Both participatory and observational experiences contributed to the development of students' perceptions of their ability to manage acutely ill and medically complex patients.