VirtualPT V2 Clinician Student Manual
Contents
1. 2 Click an exam tool to the right of the patient image The top box Exam Tool under the patient image displays the name of the exam tool you have chosen 3 Click on any of the small four body view images located above the exam tools to display the part of the patient s body to be examined When your patient image ap pears move your cursor over the patient image The body part will be displayed in the text box Body Part under the patient image then click the location to get pa tient results 4 Review the results that appear in the window to the right of the patient picture Some results may be text only some may be graphics and still others may be heart or breath sounds for you to listen to Such sounds are best heard through head phones 5 Specialized exams are found beneath the exam tools Click functional mobility mental status or tests and measures to access exams in these categories Repeat the process described above for each exam you would like to conduct When you are finished conducting exams click the button corresponding to the section of the case you would like to access next SCANNING tendonitis Hypothesis Being Investigated Select All That Apply head gt abdomen Body Part Shoulder Right www vptclinician com You may be asked to select a hy pothesis to associate with each item you select from the interview exam and diagnostic tests sec tions BEFORE you will be able to add that it2. sections If you are not ready to enter your final diagnosis click Cancel to re turn to the patient investigation sections of the case Enter your diagnosis in the text box at the top of the screen 2 Justify your diagnosis in the second text box by typing in findings from your investigation that support this diagnosis 3 Select your level of confidence in your diagnosis Cancel Click Cancel to cancel your entries and close the Diagnosis screen Click Enter Final Diagnosis to save and enter your final diagnosis pain with raising right arm over head Step 3 Review Problem List After your final diagnosis is entered you will have the opportunity to re view your problem list and compare it to the problem list expected by your instructor Review the instructor list carefully As you proceed to Management all of your management plan selections should be based on the Instructor s problem list alone Step 4 Mode of Treatment Select the mode of treatment that you think is appropriate for this patient Your choices are Treat Patient Treat Patient and Refer or Refer Prior to Treatment If you choose to refer a patient you must select the type of specialist to whom you would refer the patient Click Continue when you are satis fied with your mode of treatment Step 5 Prognosis Depending on your instructor s choices you will enter your prognosis for SS ae Figure 6 Diagnosis entry Enter Final Diagnosis Fi
3. Carbondale Illinois 62903 9919 Licensee of the software has permission to duplicate the printed manuals and to print and dupli cate manuals downloaded from the DxR Development Group website Macintosh and Safari are registered marks of Apple Inc Windows and Internet Explorer are registered marks of Microsoft Corporation QuickTime is a trademark of Apple Inc DR Development Group Inc is a licensed distributor of QuickTime QuickTime and the QuickTime logo are trademarks used under license Firefox is a registered trademark of the Mozilla Foundation Google and the Google Chrome are registered trademarks of Google Inc Portable Document Format PDF and Acrobat are trademarks of Adobe Inc Brands and product references noted are the trademarks of their respective companies 2 Tech Support 800 453 8040 GETTING STARTED Accessing aVirtualPT Patient Case Make sure you have the Web site location and the name of the case you have been assigned to work on Navigate to that location in your browser 2 Find the case on the Web site address provided by your instructor or in VirtualPT s waiting room Click on the case file See Figure 1 3 Enter your assigned name and password in the spaces provided Click Enter If there has been a log in error a warning message will appear Check to make sure your as signed name and password are entered exactly as your instructor requires Once your assigned name and password are prope
4. O tendonitis Note If you delete a problem that has unique hypotheses associated with it those hypothe ses will also be deleted However if you delete a problem that has associated hypotheses that are also associated with other problems those hypotheses will remain in your list Figure 3 Entering Problems 6 Tech Support 800 453 8040 INTERVIEW amp EXAM SECTIONS Interview Section Questions in the Interview section are divided into 7 different categories listed on the left side of your screen Depending on your instructor s choice you may not be able to access questions in categories other than the HPI Summary or the Present Illness until after you ve entered or reviewed your Problem Hypothesis List To pose a question select the interview category A list of questions within that category appears Select your question and the hypothesis you are investigation see note Click Ask or double click the question to see the patient s response to your inquiry Repeat this process for each interview question you would like to pose When you are done with the Interview section click the button corresponding to the portion of the case you would next like to access Exam Section Most physical exams are defined by the body part being examined and the exam tool you use See Figure 4 Select the hypothesis you are investigating for each exam item or select SCANNING if you aren t investigating a particular hypothesis
5. 3 Locate the QuickTime control panel and click to open it 4 At the top of the QuickTime window select the Browser tab 5 Click the MIME Settings button at the bottom of the window 6 Scroll to locate the item MP3 in the list Click to expand that item displaying two selections MP3 Audio and MP3 Playlist Both should have a checkmark beside them meaning they are activated If both MP3 items don t have a checkmark as sociated with them click the checkbox Once the checkmark appears preceding each item they are enabled 7 QuickTime has now been re enabled to play MP3s Click OK to close the window 12 Tech Support 800 453 8040 D R DEVELOPMENT GROUP INC FOR MORE INFORMATION PLEASE CALL TOLI 866 599 1140 OR VISIT US ON THE WEB WWW DXRGROUP COM
6. Tests list first select ne Search the hypothesis you are investigating then click the test name you would like to order Your patient s results will be displayed Click the Nor mal button to compare your patient s results with normal results Search Figure 5a Common Lab Tests If the diagnostic test you want to order isn t in the Common Tests list and you don t know which category it would be listed under use the search function see Figure 5 lower Enter a key word or phrase in the space provided and click SEARCH or Return Enter 2 Select the hypothesis you are investigating then select your selected test in the window showing your search results 3 Click TEST INFO for a test description normal values and what Abnormal Indi cates or click ORDER to order the test immediately Your patient s results will be displayed Click the Normal button to compare your patient s results with normal results Categories amp Lists If you know what category your diagnostic test is likely to be listed under use the Cate gories option to find your test Select the category most likely to contain your test Figure 5 Proposed Dx Test Orders 2 Find the specific test in the list that ap pears to the right of the category list optional Click TEST INFO to see a test description normal values and what Abnormal Indicates 3 Click the Order button to get your patient s results Click the Normal but ton to compare your p
7. VIRTUALPT CLINICIAN Instructor Manual MA Student Manual BA CONTENTS Copyright ssessssnenessenssnsssnesessnnenessnnesensnnesensnnnsenunensenunnnssnesensnnnsenssnsssssnnnnesssneseneee 2 Getting Started sssesssnesessnsennssesssnssensnsssnenessessnnenensensnnssensnsunnnnnnsensnnesensenenensenened Accessing a V irtualPT Patient Case 3 Working Through the Case osssssssesssnnnuonsunnnuonnunnnnnnsnnnennnsnnnsnnnsnnssonssnnssnnenonee A The Patient s Presenting Situation eseseesesessesesnsnenennsnennnnenennnnsnennsnenennnnenennenenensenesnsnenennnnenenen 4 CONOR BUCO ee re 5 Entering Problems Sc Hypotneses u u uunennan a 6 Interview amp Exam Selen engen 7 Bo AE A E A A EEA A A E E A EAE ners 8 Diagnosis and Prognosi S see ee 9 GATS Se Management een ee 10 Ina SeEI Assessment ne ee ee I Browser and Technical Requirements ccccccsecececcccososocececcocococeceososososeoo l 2 www vptclinician com 1 COPYRIGHT 2014 D R Development Group Inc 1840 Innovation Drive Carbondale Illinois 62903 9919 for software template and icons All rights reserved No part of this software program including artwork and text may be utilized reproduced stored or transmitted in any form by any means electronic or mechanical or by any information storage or retrieval system without permission in writing from the copyright holder Address inquiries to DxR Development Group Inc 1840 Innovation Drive
8. atient s results with normal results Hypothesis Being Investigated select All That Apply Common Tests Test Info Justifying Diagnostic Test Orders Order After ordering a diagnostic test you may be asked to justify your request before you can see the test results Type in your justifi cation and then click Enter You will then be allowed to access the results elke I Le eee Reviewing Diagnostic Test Results Some results will consist only of text but other tests results may include graphics Make a note of anything you think is important to the case Click the Normal button to com pare your patient s results to normal results 8 Tech Support 800 453 8040 DIAGNOSIS AND PROGNOSIS Diagnosis and Manage the Patient Problems Click the Rx Management button when you are ready to diagnose and manage the pa tient problems You will follow a linear path to develop the appropriate management plan for your patient Step I Prioritize the Problem List You will be given a final opportunity to review your problem list and prioritize the problems in your list To prioritize your problem list se lect an item in the list and click either the UP or DOWN button to move that item in the list Click Continue when you are satisfied with the priority order of your Problem List Step 2 Diagnosis Please note once you enter your final diagnosis you will no longer be able to access the patient history exam or diagnostic tests
9. eady to enter a diagnosis a prognosis goals and interventions for the patient when you click the Management Rx button ANUDMEN Click the Notes button to see or add notes to help you as you proceed through a case You may also review any of the investigation items you ve selected so far You can add to your notes by typing in text or by copying and pasting text into Physical Exam Buttons the Notes field Click Save to preserve your entry Click IL View Printable and your Notes are available in a print Vital Signs Flashlight Ophthalmoscope View Accessory Motion Strength Thermometer Palpate ROM Stopwatch Percussion Stethoscope Sphygmomanometer Pin Hammer Cotton Tuning Fork Functional Mobility Mental Status Tests amp Measures PROBLEMS amp HYPOTHESES Entering Problems and Hypotheses You may be asked to supply a list of patient problems with associated hypotheses before you are allowed to proceed in your investigation If you are not ready to supply a list of Problems and Hypotheses you will be advised to go to the Interview section use the Interview button In the Interview section you may ask the patient questions ONLY from the Present Illness category prior to developing your problem hypothesis list Once you have asked enough questions in the Present Ill ness category to enter at least one problem with an associated hypothesis click the red Click Here link text or click the Problem Hyp List but
10. em to your investiga tion If you are not investigating a particular hypothesis select SCANNING from the hypothesis list at the top of the screen To se lect multiple hypotheses to associ ate with your investigation selection press the command CTRL key while clicking on the hypotheses you would like to asso ciate You will see a warnihg when you are within 3 of the total number of questions exams or diagnostic tests deemed acceptable to com plete this case efficiently You will be warned again when you are within of that number You may continue requesting items in that category beyond the limits but if you do so your clinical reasoning score will be affected Figure 4 Exam screen Dx TESTS On the Diagnostic Tests screen you may order tests to further your clinical investigation of a patient case You have three methods of ordering diagnostic tests Each is described and pictured below You will also be able to see the results of the tests you order You may also be asked to justify your diagnostic test requests Ordering with the Common Diagnostic Test buttons Look for the diagnostic test you want to order in the list of 10 common tests see Figure 5 upper displayed on your screen 2 optional To get information a test description nor mal values and what Abnormal Indicates on a Com mon Test before you order it click Test Info and then click the name of the test 3 To select a test in the Common
11. ems and associated hypotheses with the standards set by the instructor You will be able to assess how your list compares with the instructor by selecting either Mostly Somewhat A little or Not at All The instructor will be able to review your self assessment as he she evaluates your performance in the case study Investigations Assessment The Critical Investigations screen allows you to see whether or not you selected the appropriate investigative items for this virtual pa tient encounter A star will appear next to the name of each item that you selected that is correct To see the information that you missed in your investigation click the items with no star The table at top of the screen allows you to see the number of required items as compared to the number of items you selected Prognosis Assessment The prognosis screen displays the responses to the two multiple choice questions Your instructor s selections are shown and your selec tions will either have a star in front of it if you matched the instructor s selection or an X if you did not If your prognosis was a free text entry no initial assessment was made Your instructor has the opportunity to assess your entry as he she evaluates your performance in the case study Interventions Assessment The Interventions screen allows you to review your se lected interventions and see an assessment of whether your selections were appro priate for your virtual patient If your intervent
12. gure 7 Problem List review Figure 8 Prognosis g unable to do recreational activities cant saillunable to play tennis cant play sports this patient in one of two ways either by typing your prognosis in a text roimis 2222222 eros noun rou box in narrative form or by answering two multiple choice questions Review the instructor s problem list at the top the screen before you enter your prognosis 2 If your instructor has chosen to have you select your prognosis by an swering two multiple choice questions select the best option for each question and click Continue 3 If your instructor has chosen to have you enter your prognosis as a free text entry enter your prognosis in the Enter expected prognosis box When you are finished click Continue www vptclinician com GOALS amp MANAGEMENT Step 5 Goals On the Goals screen you will be required to type in goals for each patient problem identified by the instruc tor dec ROM dec of motion ired ROM limited ROM Select a patient problem in the Instructor s Prob sec srengin weakweakness impaired strength pain with dressing pain with ADLs unable to do recreational activities cant saillunable to play tennis cant play sports em List 2 Type in your goals for the selected problem and click Save You may also link a previously entered goal to additional problems At the bottom of the screen click the arrow next to Link this goal to another proble
13. ions were correct a star will appear next to the item name www vptclinician com 11 BROWSER AND TECHNICAL REQUIREMENTS Browser Requirements Cookies and Javascript must be enabled Your browser must also have the latest ver sion of the Apple QuickTime player plug in installed Make sure you select a full in stall of QuickTime We support these standard Web browsers e Microsoft Internet Explorer e Google Chrome e Firefox Safari Screen Size and Monitor Resolution VirtualPT Clinician requires a minimum monitor resolution of 1024 x 768 pixels If your monitor is not set for 1024 x 768 pixels or higher resolution portions of your screen may be cut off and a warning message may appear when you try to log in to the case Your monitor must also be set display at least 16 bit color thousands of colors If your monitor is not set to display 16 bit or higher color images and movies may appear dis torted pixilated or washed out on your screen Sound Your computer must have a sound card installed Heart and breath sounds will sound best when heard through headphones Re enabling QuickTime to play MP3s on Windows If QuickTime is not enabled to play MP3s on your Windows machine the following directions will help you restore the settings to properly play sounds in the case studies 1 Locate the Start Menu icon in the menu bar across the bottom of your screen 2 Click the Control Panel to open it
14. m to display a drop down menu containing the Instructor s expected problems After you have selected the problem to link your existing goal to click Save 3 Repeat this process for each problem in the In a structor Problem List 4 Click Continue when you ve entered goals for each problem in the Instructor Problem List Link this goal to another problem Step 6 Patient Management In this section you will develop a management plan de signed to meet your identified goals for the patient Instructor pain wih reaching overoad Select one of the Management categories that ap RR coc roroi weakiwoaknessimpared stergh p pain with dressing pain with ADLs pear Interventions Collaboration Education Counseling Select the patient problem you are managing If you select the Interventions category Funcional Traning you may need to select from several sub categories Prserpon appicaten of equpme that will appear 2 Repeat this process until you have selected all the management choices you think are necessary for this patient You are not required to select manage ment for each problem in the Instructor Problem List When your management plan is complete click Evaluate gthening ange of moton Step 7 Frequency and Duration You will be asked to recommend the frequency and duration of treatment for your pa Figure 10 Patient Management tient Under Frequency click one of the five possible selections t
15. o best manage your pa tient 2 Under Duration click one of the three possible selections to best manage your patient Click Done when completed Step 8 Management Confidence When you click Evaluate on the Patient Management screen the Management Con fidence window appears Answer the four questions posed to indicate your level of confidence in your management plan selections Click Done when you ve completed all questions Congratulations If your instructor has turned on the Initial Self Assessment fea ture you may now view your results Follow the steps under Initial Self Assess ment 10 Tech Support 800 453 8040 INITIAL SELF ASSESSMENT Initial Self Assessment Following the Management Confidence screen the program will perform an initial evaluation of your entries Depending on your instructor s preferences you may be able to review the initial assessment of your work Click Review Results to access the Self Assessment Diagnosis Self Assessment The diagnosis screen allows you to compare your diag nosis with the expected diagnosis listed by the instructor You will be able to assess how you think your diagnosis compares to that of the instructor by selecting either Mostly Somewhat A Little or Not at All The instructor will be able to review your self assessment as he she evaluates your performance in the case study Problem Hypothesis List Self Assessment This screen allows you to compare your list of probl
16. rly entered click Start If this isn t the first time you ve accessed this case follow the steps above and click Continue Case x VIRTUALPT CLINICIAN Evaluate Eval of R P d 1 shoulder pi Hemipares p 4 Figure Case files in a Waiting Room As you enter aVirtualPT Clinician case keep in mind instructors and case authors can design cases and criteria as they wish The following instructions take into account all case options available to the instructor Your instructor may have chosen some or all of those options for this case www vptclinician com 3 WORKING THROUGH THE CASE The Patient s Presenting Situation This window introduces you to the patient and the patient s stated reason for seeking help from a physical therapist See Figure 2 Read the information carefully then click one of the three buttons under What would you like to do next Your choices are the Interview button for asking the patient questions the Exam button for conducting a physical exam or the Dx Tests button for ordering diagnostic tests If there is a patient referral it will appear on this screen You can access these sections in any order you like Your patient today will be Chester Abadie A fifty eight year old retired banker who presents with complaints of right shoulder pain What would you like to do next interview Figure 2 Presenting Situation 4 Tech Support 800 453 8040 COMMON BUTTONS Before yo
17. ton If you believe you can provide an initial list of Problems and Hypotheses Enter the reported patient problems in the text box marked Concise statement of the patient s major problem 2 Enter a patient problem in the text box add problem and click add problem Con tinue adding all your problems that you see at this time You may prioritize your problems by using the up and down arrows on the right side of the problem hy pothesis box Select a problem and click DELETE if you want to remove an item from your list Next you must enter at least one hypothesis to associate with any patient problems you have entered Follow these steps Enter your hypothesis in the text box add hypothesis 2 Check the box in front of any problem with which you wish to associate your new hypothesis 3 Once you have associated your hypothesis with all problems that you think appro priate click add hypothesis To delete a hypothesis check the box in front of that hypothesis and click delete Click done when you are finished entering your list of patient problems with associated hypotheses The Problem Hypothesis List screen may appear after each section of the VirtualPT case You may also access this screen from any section of the case by clicking the Problem Hypothesis List button Patient reports pain in his right shoulder after sanding over the weekend pain reaching behind O tendonitis difficulty dressing
18. u start your clinical investigation review the buttons common to all screens within aVirtualPT Clinician case as well as the exam buttons shown on the right of this page These buttons Interview Exam Diagnostic Tests and Problem Hypothesis List appear at the top of most screens and allow you to access the major portions of theVirtualPT case Click one of those buttons to go to the corresponding section of the case The Learning button allows you to make note of any learning issues you would like to further study or in vestigate after completing aVirtualPT case Cate gories include Anatomy Behavioral and Social Science Biochemistry Clinical Medicine Microbiol ogy Pharmacology and Physiology Type your entries into the appropriate text box and click SAVE The SOAP button allows you to enter notes for Subjective Data Objective Data Assessment Data and Plan Type the text in the appropriate box and click SAVE functional mobility When the Web Links button is displayed Web based resources are available to assist you as you work through the patient case Click Web Links then click the link text which opens a new browser tab or window displaying the additional information www vptclinician com able form A 23 SELECT BODYVIEW Head Chest Abdomen Body full The Management Rx button allows you to enter a management plan for the patient You should have completed the patient investigation and be r
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