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1.
Am J Phys Med Rehabil ; 100(2S Suppl 1): S40-S44, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33252472

RESUMO

ABSTRACT: Competent neurologic examination and clinical skills are essential components in the care for patients in acute hospital and rehabilitation settings. To enhance the evaluation and education of Physical Medicine and Rehabilitation residents, the authors developed an educational objective structured clinical examination, the Neurological Exam Assessment Competency Evaluation System, and gathered 2 yrs of baseline data. The Neurological Exam Assessment Competency Evaluation System consisted of nine 9-min examination stations, seven with written clinical scenario with instructions for junior residents to complete the appropriate examination (stations: Altered Mental Status, Mild Traumatic Brain Injury, Dementia, Stroke, Falls, and the International Standards for Neurological Classification of Spinal Cord Injury Sensory and Motor Examinations). Examinees provided written responses to posed questions for the other two stations-Modified Ashworth Scale and brachial plexus. The assessment tools for this examination were designed for residency programs to evaluate the basic competencies as outlined by the Accreditation Council for Graduate Medical Education and Physical Medicine and Rehabilitation milestones. Based on the feedback received from the examinees and examiners, the Neurological Exam Assessment Competency Evaluation System can serve as an educational objective structured clinical examination for the improvement of trainee core competencies.


Assuntos
Competência Clínica/normas , Educação Baseada em Competências/normas , Internato e Residência/normas , Exame Neurológico/normas , Medicina Física e Reabilitação/normas , Currículo , Avaliação Educacional/normas , Humanos , Exame Físico
2.
Phys Med Rehabil Clin N Am ; 28(4): 829-842, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-29031347

RESUMO

The incidence of traumatic brain injury (TBI) in older adults is increasing. As the expected life expectancy increases, there is a heightened need for comprehensive rehabilitation for this population. Elderly patients with TBI benefit from rehabilitation interventions at all stages of injury and can achieve functional gains during acute inpatient rehabilitation. Clinicians should be vigilant of unique characteristics of this population during inpatient rehabilitation, including vulnerability to polypharmacy, posttraumatic hydrocephalus, neuropsychiatric sequelae, sleep disturbances, and sensory deficits. Long-term care should include fall prevention, assessment of cognitive deficits, aerobic activity, community reintegration, and caretaker support. Life expectancy is reduced after TBI.


Assuntos
Lesões Encefálicas Traumáticas/reabilitação , Idoso , Humanos
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