Pass The CHT The First Time by Knowing The Domains
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[00:00:00] So the, uh, the focus framework really, you know, helps you to stay focused and not, not veer off track. Right? So there is four domains that they test you on, right? Evaluation, prognosis, and treatment, right? If you think of evaluation, prognosis, and treatment as a triangle, right? Um, the evaluation portion is 26 percent of the total score, right?
You're looking, you're looking for the problem. You've got to, you've got, you're locating the problem. How do you locate the problem? What are the aspects of an evaluation that you should be paying attention to?
The patient's symptoms. Okay. Um, [00:01:00] the, the posturing of the hand. Okay. So, let's, let's, let's just take it real broad right now because this fast focus framework applies for everything, right? So, uh, uh, posturing. So, you can have posturing in the hand. You're gonna posturing in the elbow. You'll have posturing in the wrist.
You're posturing if you have a nerve issue, right? Very good. Mechanism of injury. Yep, that's right. Mechanism of injury. What else? Anyone else? Seeing what their baseline is. Yep, your baseline. So, so testing, right? Testing. So you have your general testing, right? Your general measurements. Which is sometimes we take it for granted, but like, how do we evaluate for edema?
How do we evaluate for range of motion? How do we evaluate for grip, strength, sensation? All those fall under testing. Oh, once you identify the problem, you can then now take it to prognosis. Prognosis is, um, 20% of your total [00:02:00] score, 20%. So prognosis is what's wrong, right. What's, what's the problem? Is it decreased motion?
Right? Is it instability? Or stability or instability? Right? Um, what are, what are the complications?
Now all of this falls on a prognosis because once you've identified the problem you have to know what's wrong so you can start to have an idea of how to fix it. Treatment is 32 percent of your total score. Now, if there is anywhere to focus You need to know how to treat, you need to know how do we as a certified hand therapist, how do we solve their problem?
You're not focused on here, and you're not taking the evaluation of the problem, knowing when you're allowed to do what, and then actually [00:03:00] thinking about how would I, How do I fix their problem? How do I fix their problem? Do I splint them?
Prognosis goes back to when I can splint them. Treatment is, which splint would it be? When, how, you know, it goes hand in hand. But treatment is, how do I, what do I tell them to do with their splint? How long do they wear? When do I get rid of it? When do I progress to the next splint and the next splint? Or, you know, whatever else, right?
How, how do I? If I found out that they have problems with range of motion, I said they are stable enough, but they don't have any motion. How do I get their motion? What are the things that I need to do to get their motion? Is it a splint? Is it exercises? Is it whatever functional activities? that I need to give them?
What are their phases, you know, that we take them through in treatment? Their phases, because it's not just all about range of motion and edema and scar massage. It's like I get their motion [00:04:00] and then I get more motion. You know, I start with active, I progress to, I'm allowed to do passive. Now I'm going to push them on them.
In which direction do I push on them? How hard do I push on them? And then when can I strengthen them? When am I allowed to do, yeah, can I do? What is proprioceptive? What does proprioceptive exercises actually look like? Right? What does it actually look like? You got to take them through. Now the key thing here is in order to be able to do all of that, right?
You've got to do what Jameel was just talking about. Which is your general knowledge. You have to know your anatomy. You have to know the names of, you know, fractures or whatever, you have to know the names of tests. You have to know the names of surgery, things like that. So there's a certain amount of memorization that you have to have.
In order to be able to really fully take them through an evaluation, [00:05:00] take them through their prognosis, and then provide treatment. Now, you might have to go this way. The treatment, and then it goes back to, well, what's wrong? And then go back to treatment. I found this treatment stalled out. Can't do anything.
Well, what am I allowed to do? Oh, I'm allowed to do X, Y, and Z. Okay, then I go back to treatment. But along the way, how many times do we ask us as the OT, as a PT, as a certified hand therapist, we're reevaluating all the time. I'm gonna tell you what, 32 percent of the total score resides in treatment, right?
So it's, it's how you're thinking through so that you can, you can be able to answer any question. You won't be surprised on the exam. There's lots of stuff. You just won't be surprised by it, right? Because you have the fundamental, you have the dirt, you have the grit of all the [00:06:00] information that we'll get you through, right?
