Unit rationale, description and aim
OTHY604 offers post graduate students the opportunity to update and enhance theoretical knowledge and clinical skills with the aim of optimising functional assessment of cognition and application of compensatory strategies and rehabilitation techniques to manage or improve the effects of cognitive impairments on everyday activities. Guided practice supported by enhanced understanding of the neuroanatomy leading to cognitive impairment alongside rehabilitation and management techniques will be explored to facilitate occupational therapists in complex assessments and evidenced-based management of cognitive impairments in clients across the lifespan or those with neurological disorders. The aim of this unit is to encourage students to further develop and apply their advanced knowledge and skills and demonstrate critical analysis of functional cognitive assessment, rehabilitation techniques and management; as well as enhance leadership and advocacy skills with professional colleagues and the broader community.
Learning outcomes
To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.
Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.
Explore the graduate capabilities.
Integrate, apply and critically discuss enhanced k...
Learning Outcome 01
Integrate, apply and discuss effective communicati...
Learning Outcome 02
Critically analyse cognitive impairments, and how ...
Learning Outcome 03
Select, apply and interpret outcomes achieved foll...
Learning Outcome 04
Reflect on the application of knowledge, skills an...
Learning Outcome 05
Content
Topics will include:
Structures and function
- Principles of neuropsychological rehabilitation in relation to brain anatomy.
- Neuroanatomy/ processes involved in cognitive functions; reading imaging scans and relating areas of damage to cognitive impairments
- Cognitive impairments and hierarchy of functions; Post traumatic amnesia (PTA), attention, memory, insight and awareness, executive functions; decision making, problem solving, planning.
- Frameworks of cognitive function – classification using the ICF
- Pathophysiology of conditions that result in cognitive impairment and their impact on occupational performance such as dementia, multi infarct, alcohol and drug related, TBI, hypoxia, encephalitis, stroke R versus. L, PD, Lewy Body, MS, Huntington’s.
Assessment
- Framework for assessment and clinical reasoning
- Initial assessment of cognition; bedside assessment, PTA, interviews with patient and significant others, data gathering tools; logs, diaries
- Functional / Occupation focussed assessment / analysis of cognitive function within activity, standardised versus non standardised assessments methods; PPRP, AMPS. Selection and interpretation of results
- Impairment based assessments - Evidence-based review (validity, reliability, utility) of standardised cognitive assessments used by Occupational Therapists; MMSE, Montreal Cognitive Assessment, LOTCA, MEAMS, Rivermead, COTNAB, Cognistat, Multiple Errands Test, Westmead PTA scale. Selection and interpretation of results.
- Cognitive requirements for return to work, driving and more complex tasks and decision making capacity.
Intervention
- Goals for cognitive rehabilitation;
- Critical review of evidenced based interventions for cognition
- Implementing interventions for cognitive rehabilitation and occupational performance; attention training, internal and external memory strategies –evidence-based selection of memory aids for/ with your patient in relation to their cognitive impairments; educative cognitive groups, developing memory and planning systems, use of technology, errorless learning implementation, strategies to build awareness/ insight, limb activation training for inattention, and goal management training.
- Consistent and effective implementation of cognitive strategies in practice - short term/ long term rehabilitation
- Measuring change and goal achievement
Behaviour
- Occupational therapy involvement in assessment of behaviours of concern; physical and verbal, socially inappropriate behaviours related to cognitive impairment.
- Evidence-based practice principles guiding neurobehavioral strategies for managing and changing behaviours of concern and socially inappropriate behaviours, including setting goals and risk assessments.
- Understanding restrictive practice principles in relation to behaviours of concern and development of behaviour support plans for aids or equipment considered restrictive.
Assessment strategy and rationale
OTHY604 assessments have been purposefully designed to replicate authentic clinical practice. Significantly, the unit’s assessments have also been designed from an “Assessment for Learning” approach in order to not only provide evidence for judgement of learning, but also to reinforce, facilitate and support learning and application of learning. The assessment tools have been designed to provide for a broad range of tasks aligned to andragogic principles of adult learning, facilitating choice and self-direction for the post graduate student. The design enables timely judgement to ensure students have appropriate knowledge and skills prior to the workplace application segment of the unit. In addition, the range of assessment activities at the end of the unit encourage application of evidence to practice and embed clinical reasoning, problem solving and implementation of advanced knowledge and skills.
In the first assessment task students will provide a critical analysis of a client with cognitive impairment, demonstrating advanced knowledge of neuroanatomy and neuropathology underpinning cognitive impairment and application to the individual client. The focus of the second and third assessment tasks, is to reflect on personal and collaborative practice, and communicate reflections, evidence-based reasoning and decision making, to management and peers. The second assessment task enables students to demonstrate the application of advanced skills in the delivery on an evidence-based intervention with a client, their clinical reasoning and clinical decision making. In the educational seminar students will analyse the evidence-base for managing a specific cognitive impairment. Students will outline the evidence, appraise the relevant evidence and communicate an implementation plan for this evidence practice gap within their work setting.
In addition to assessing enhanced clinical skills, a major focus of the second and third assessment tasks, is the ability to reflect on personal and collaborative practice, and communicate reflections, evidence-based reasoning and decision making, to management and peers. These assessments incorporate the advanced level of professional knowledge and skills, enhanced critical analysis and professional presentation modes developed throughout the post graduate program. The second and third assessment tasks may presented via remote methods, be delivered and assessed locally and, moderated according to University Policies and Procedures. All assessments will be submitted electronically.
Overview of assessments
Assessment 1 Assignment: Critical analysis of a c...
Assessment 1
Assignment: Critical analysis of a case study
Enables students to reflect on best practice and communicate reflections, evidence-based reasoning and decision making. (1500 words)
20%
Assessment 2 Practical Case Study Examination En...
Assessment 2
Practical Case Study Examination
Enables students to demonstrate advanced practice and communicate evidence-based reflections, reasoning and decision making.
30%
Assessment 3 Educational seminar to peers with re...
Assessment 3
Educational seminar to peers with reflective critique and resource development
Enables students to develop practice knowledge and skills, and communicate reflections, evidence-based reasoning and decision making, to management and peers.
50%
Learning and teaching strategy and rationale
This unit is offered through multi-mode and online delivery for specific on and offshore cohorts. Both modes aim to facilitate learner centred activities. Learning and teaching strategies within this unit are based on a blend of constructivism, social constructivism, and experiential learning. These strategies focus on active participation and developing a community of inquiry. Purposefully designed content and activities that are the same or similar for all students regardless of the mode of delivery have been identified. This has led to the development of purposefully designed learning activities that are transferable and work well across both delivery mediums whilst maintaining the flexibility to create and deliver mode specific activities focusing on inquiry-based learning principles aimed at encouraging critical thinking, application of knowledge and skills, evidence for practice, collaborative peer learning, and critical self-reflection.
In addition, students participate in individual and small group activities based on analysis of current practice, to assimilate application of enhanced knowledge and facilitate translation of learning into practice. Engagement in extended dialogue is encouraged to guide change to a more interprofessional, person-centred practice. Unit activities include, but are not limited to: guided readings, synchronous on-line tutorials, work-based activities with reflection, use of a reflective journal during experiential learning, skill development, and mentoring to enhance practice. To facilitate practical application of knowledge and skills, multi-mode delivery requires participation in online tutorials and discussion of clinical cases on contemporary practice issues. Learning and teaching strategies for online delivery to specific cohorts will be adapted to accommodate different time zones for example as required. Activities are aimed to facilitate acquisition of advanced knowledge and skills in collaborative and assessment and intervention planning strategies. Workplace activities are included to support leaning and application of knowledge gained through the unit.