Neuro Aspects Post-Simulation Report

    I am extremely blessed to be a part of the Occupational Therapy (OT) Program here at UTHSC. As part of the Neuro Aspects course I'm taking in OT school, I participated in a clinical simulation encounter today during which I administered a cognitive screening to a person with a recent history of a stroke. This simulation is known as the Saint Louis University Mental Examination (SLUMS). It is not referred to as a 'test,' but more of an assessment. This assessment gauges the individual's cognition, especially pertaining to their memory. In my personal terms, I see 'cognition' as the ability to perceive (take input) things in the environment and the ability to mentally process the words, thoughts, objects, and/or events. As an OT, my role would consist of: installing routines/habits that can aid the individual with visual cues for everyday activities, educating the individual and family members about the details of the diagnosis and safety precautions, recommending adaptive equipment to complete certain tasks, and home modifications for safety measures.  

    The client that I administered the SLUMS to was named Mr. Harper Henshaw. He was a 61 year old retired school teacher that recently had a stroke. Finalizing his score, Mr. Harper scored a total score of 16. Which in this assessment, falls under the category of a risk of experiencing dementia symptoms (1-20 = Dementia). Common challenges or barriers someone in this category could experience are some of the following: forgetting medical appointments, forgetting locations of certain objects around the house, forgetting family members and events, misplacing objects, getting lost while driving, and becoming easily agitated. In my simulation, I failed to meet the requirement of stating what OT is and what our roles consist of in therapy. During my initial greeting, I expressed my name and that I was his occupational therapist. Then, I assumed too much through his nonverbal cues: raised eyebrows, nodding head up and down, and widening of the eyes, which made me think that he already understood what occupational therapy does for a client. However, I do believe my 'elevator speech' has morphed into a sound definition. If I were to go back in time, I would say this to describe OT, " Occupational therapy is a therapy that is shaped for the individual. OT will figure out your desired occupations/activities that you find joy in everyday. Then, we will figure out ways to aid you to overcome your obstacles, meet you in the middle, or use adaptive equipment to aid you into doing the things you love!" Based on the conversation I had with Mr. Henshaw, I believe he would have been pleased with this definition, because he was a teacher and I could sense he had a great understanding of adapting oneself to help another. 

    In my simulation with Mr. Henshaw, I believe I did the following really well: kept the conversation flowing, got personal even during a timed assessment, adapted to his conditions, and I felt more focused on making him comfortable and to enjoy the assessment as we were going through it. There are multiple things that I would like to re-do if I had the opportunity. For example, I would like to have: not controlled the conversation as much, not assume too much based on cues, explain what OT is to the patient, and to check the patient's wristband to clarify that it is the right client. My take-away from this simulation was truly a magnificent experience. I learned that no matter how much I study to prepare, the actual in person interaction is the most crucial thing. Even though it is a timed assessment, you want to be diligent as an OT to complete it; however, you still want to gain that connection during the screening, whether that's through giving them opportunities to talk, physical touch, or with words of affirmation. Moving forward, I will remember how far I have came since last January, and remind myself that I WILL BE AN OT! The people I am surrounding myself with have helped push me forward, and are always aiming to better shape me into a phenomenal OT that I know I was born to be. I will always prepare for liability reasons, but I will go froward always making sure the client enjoyed the experience with me.