Posted in Occupational Therapy

-Using Rubrics to Measure Patient Progress in All Practice Areas

Taken from the handout "Putting on Socks with One Hand" from Ohio State's Wexner Medical Center
Taken from the handout “Putting on Socks with One Hand” from Ohio State’s Wexner Medical Center

The following example of using a rubric in a rehab setting was developed from the handout “Putting on Socks with One Hand” available on Ohio State’s Wexner Medical Center site.   The rubric contained in this post was developed from this handout so that the directions that are provided to the patient match the expectations of the therapist as set forth in the assessment rubric.  If you have read my book, “Using Rubrics to Monitor Outcomes in Occupational Therapy”,  you would know:

 “Various dictionaries define a rubric as a set of rules.  In this case, rules that are used to make a judgment regarding a student’s level of performance.  Rubrics identify the standard of performance.  It is a way of communicating what is expected, describing a level of performance and the associated quality.”

So now we can see how the handout becomes a rubric and how a rubric is more clear and more transparent as a method of documenting patient progress than any other.

The rubric contains not only the steps to follow [listed as criteria] but also contains descriptors [as a graded judgment of attainment].  In this example, level of attainment or goal progress is assessed through the number of trials [red].  This method of documenting goal progress can be monitored and judged by any other therapist working with the patient when the primary therapist is not present.  The criteria is measurable and can be measured.  This meets the IDEA criteria.  By outlining the rules for judgement, consistency between raters [therapists] is possible.  Does each therapist [measuring progress] find the same areas of deficit?  More than likely, yes.  The potential for inconsistency can come from the therapeutic activities conducted prior to the task.  For example, did the primary therapist apply heat, but the covering therapist did not?  Did the primary therapist perform stretching exercises differently than the covering therapist?  While there are many variables between therapists, a consensus in deficit areas should be judged to be similar.  Please keep in mind that the rubric contained in this post is an assessment rubric [a standard based on the handout provided to the patient].  Once the patient’s deficits or limitations have been identified, the rubric will need to be modified to meet the individual needs of the patient.  Initially, developing a rubric can be time consuming.  However, once you have developed your rubric and saved it to use again, it can easily be modified for each individual patient.

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One Hand Sock Data Sheet


I am an occupational therapist with 18 years of experience in the pediatric sector, much of that time as an independent contractor. I am very passionate about my work and my writing. My degrees include a Bachelor’s of Science in Health Sciences and a Master’s of Science in Occupational Therapy from Touro College. Since graduating as a non-traditional student, I have worked in a variety of settings throughout the life span but settled in the area of school-based therapy. My interests lie in the area of using technology to support independence and I often train students to use programming not only to monitor their own goal progress but also support educational, vocational and life skills. Another area of particular interest is documentation. As an independent contractor for many years, I feel that it is important to align methods of documenting goal progress with educators for greater consistency and understanding when writing for an IEP. It is better to plan a format for documentation used in the IEP, such as for assessment and goal progress and that a rubric, in many ways, fulfills the need for consistency in documentation across all domains. Combining my interest in technology and documentation, I use Microsoft OneNote to maintain all documentation. I create a digital notebook for each student or patient with any forms required uploaded as templates which can then be completed, and saved automatically. I strongly believe in student centered approach to therapy. Students must be active participants in developing goals and documenting progress. In order to help students understand their progress, I teach my students to develop electronic portfolios and to use spreadsheet programming with graphs to collect data and view progress, whenever possible.

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