Download EVALUATION FORM

EVALUATION FORM
PTH850 NAIOMT Supervised Clinical Practice
LEVEL I and LEVEL II SKILLS
1. Performs medical screening and systems review, correctly identifies “red flags”, and follows
indications for immediate or timely medical referrals.
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2. Displays skilled communications during history (subjective examination) to determine the nature
of severity and irritability of the condition.
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3. Performs screening/scanning examinations of the spine and extremities with emphasis on
precision and prioritization of areas to facilitate the decision making process.
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4. Practically applies detailed anatomy, neuroanatomy, neurophysiology, biomechanics, applied
medical science (healing process, aging, etc), and applied exercise science to the evaluation
process, analysis of the results of the evaluation process and the interventions.
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5. Recognizes common movement dysfunctions/patterns or clusters for both extremity and spinal
dysfunctions.
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6. Interpret and analyze both acute and chronic presentations so as to develop hyposthesis and
diagnoses to provide safe and effective intervention plans for both conditions.
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7. Displays a practical application of knowledge of indications and contraindications for most
extremity and spinal dysfunctions with regards to intervention strategies.
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8. Displays advanced and proficient manual therapy documentation skills and functional outcome
measures.
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9. Displays proficiency in each of the following skills:
a. Manual and mechanical traction
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b. Deep transverse friction massage
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c. Specific palpation
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d. Segmental and specific joint testing of the spine to include: passive intervertebral motion
testing and assessing hypo or hyper mobility; and ligamentous stability testing, and
treatments to address capsular vs. non-capsular problems, disk pathology, foramimal
compression, stenosis, and neural and vascular compromise.
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e. Segmental and specific joint testing of the peripheral joints to include the evaluation and
treatment of hypo or hypermobility, instability; bursitis; tendonitis; muscle and ligaments
injuries, neural and vascular compromise.
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f. Specific joint mobilization techniques
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g. Basic locking techniques of the spine
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LEVEL III SKILLS
1. Displays advanced patient interview skills.
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2. Can plan the content and sequence of the physical examination to be most efficient but
comprehensive in order to refine the hypothesis(es) and develop intervention strategies in both
acute and chronic presentations with both single and multiple areas of dysfunction.
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3. Displays advanced practical application of knowledge of indications and contraindications.
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4. Displays advanced skills in interpreting and analyzing the results of the examination so as to
develop effective, efficient and comprehensive intervention strategies for both acute and chronic
conditions of the spine and peripheral joints with both single and multiple areas of dysfunction.
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5. Displays advanced practical knowledge of indications and contraindications for intervention
strategies for both single and multiple areas of dysfunction.
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6. Displays proficiency in the following skills:
a. Development of correlative/special tests
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b. Advanced specific traction with adjacent hypermobility
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c. Advanced specific or segmental mobilization techniques i.e. muscle energy, PNF,
combined movement.
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d. Mobilization of the neural system
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e. Advanced spinal locking; preparation for thrust techniques
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f. Peripheral joint manipulation techniques
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g. Advanced soft tissue techniques
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Signed: ______________________________________
Clinical Supervisor
Date: ______________________
______________________________________
Student
Date: ______________________
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