SELF EVALUATION TEMPLATE
PHYSIOTHERAPY LEARNING OBJECTIVES FOR STROKE CARE
NAME: ___________________________
*Opportunities for baseline, mid, and final assessments are provided in the self-rating column as recommendation only.
Users are encouraged to modify the form and its use to serve their purposes.
Self Rating: Using the rating scale provided below, enter a number that most closely reflects your knowledge/skill/
experience with respect to the learning objectives listed for this Learning Area.
NONE or MINIMAL
Knowledge/Skill/Experience
1
2
3
LEARNING AREA
Principles of Stroke Care
1. There are no physiotherapy learning objectives
for Principles of Stroke Care.
4
SOME
Knowledge/Skill/Experience
5
Date
6
*SELF-RATING
Base Mid Final
EXTENSIVE
Knowledge/Skill/Experience
7
8
9
Comments
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Anatomy and Physiology
of Stroke
1.
Demonstrates knowledge of the penumbra and
its significance to functional recovery, and
factors that influence this area including the
impact on neurological presentation.
2.
Demonstrates awareness of the rationale for the
diagnostic tests used in the assessment and
management of stroke and incorporates results
as appropriate into the plan of care.
3.
Demonstrates the ability to integrate the medical
findings with discipline-specific assessment
findings to develop an appropriate treatment
plan.
4.
Demonstrates knowledge of:
Acute Medical Management
 Thrombolytics

Hypertension (e.g., angiotensin-converting
enzyme inhibitors, or ACE therapies)

Lipid therapy (e.g., Statins)

Antiplatelet and/or anticoagulants (e.g., ASA,
Aggrenox, Clopidogrel)
Surgical-Interventional Treatment
5.

Carotid endarterectomy

Carotid stenting and/or thrombolysis

Carotid angioplasty.
Integrates knowledge of the stroke sequelae and
potential stroke complications into the plan of
care to prevent and/or treat complications.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
2
LEARNING AREA
6.
Date
*SELF-RATING
Base Mid Final
Comments
Demonstrates an awareness of secondary stroke
complications including:

Hemorrhagic transformation

Reperfusion injury

Increased intracranial pressure

Cerebral edema

Seizures

Recurrent stroke
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
3
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Cardiovascular and Respiratory Effects
1.
Demonstrates knowledge of the anatomy and
physiology of normal and abnormal
cardiovascular and respiratory systems.
2.
Demonstrates the ability to identify the signs and
symptoms of cardiovascular and respiratory
systems complications, and an understanding of
the management of:
3.

Deep vein thrombosis

Pulmonary embolism

Myocardial infarctions

Presence of chest pain

Dysphagia and aspiration pneumonia.
Demonstrates the ability to perform a
comprehensive assessment of the
cardiovascular and respiratory systems
including:

Inspection

Palpation

Auscultation

Cough effectiveness

Vital signs

Pulse oximetry

Exercise tolerance.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
4
LEARNING AREA
4.
Date
*SELF-RATING
Base Mid Final
Comments
Demonstrates the ability to perform, reassess
and modify treatment plans for different
treatments to assist with:

Secretion clearance

Bronchial hygiene

Restoration of altered breathing
mechanics and patterns

Improving exercise tolerance

Energy conservation.
5.
Demonstrates an awareness of different oxygen
delivery systems.
6.
Demonstrates the ability to educate the stroke
survivor and caregiver about cardiovascular
and respiratory status and management.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
5
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Psychosocial Effects
1.
Demonstrates the ability to assess the stroke
survivor’s reaction to the stroke that may affect
coping, as well as the signs and symptoms
related to:

Depression

Level of participation and engagement in
activities

Self destructive behaviours

Quality of stroke survivor and caregiver
support systems

Stability of the stroke survivor’s physical
condition and presence of pain.
2.
Demonstrates the ability to identify the factors
that influence effective coping in the stroke
survivor and caregiver.
3.
Demonstrates the ability to identify adaptive and
maladaptive behaviours in the coping response
of the stroke survivor and caregiver.
4.
Demonstrates the ability to adjust assessment
and treatment sessions to facilitate participation
of the stroke survivor and caregiver, given that
their coping strategies and reactions to stroke
may vary.
5.
Demonstrates knowledge of the signs and
symptoms of anxiety, depression and selfdestructive behaviour.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
6
LEARNING AREA
6.
Demonstrates awareness that certain
medications and other medical conditions
besides stroke (e.g., urinary tract infection) can
affect mood and behaviour.
7.
Demonstrates knowledge of the treatment
modalities related to altered psychosocial status:

Pharmacological agents (e.g.,
psychotropic medications, and the
potential side effects)

Non-pharmacological treatments.
8.
Demonstrates the ability to determine the stroke
survivor and caregiver’s understanding of the
effects of the stroke, and their learning needs.
9.
Demonstrates the ability to tailor the education
plan to meet the coping needs of the stroke
survivor and caregiver.
Date
*SELF-RATING
Base Mid Final
Comments
10. Demonstrates the ability to assess the stroke
survivor’s perception of and need for control,
and incorporate this into the plan of care.
11. Recognizes various psychosocial issues that
occur following stroke, and adjusts assessment
and treatment strategies accordingly to meet the
individual needs of the stroke survivor and
caregiver.
12. Demonstrates knowledge of how the
psychosocial effects of stroke affect self-care,
productivity and leisure.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
7
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
13. Demonstrates knowledge of the social
implications of illness (e.g., financial issues,
effect on roles).
14. Demonstrates the ability to identify and
maximize the stroke survivor’s and caregiver’s
coping strengths, and sources of hope.
15. Demonstrates the ability to determine stroke
survivor and caregiver social supports and the
need for further support, and assists them in
accessing these services.
16. Demonstrates knowledge of the support systems
available within and outside the organization for
stroke survivors and caregivers.
17. Demonstrates knowledge of financial programs
available for equipment.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
8
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Communication
1. Demonstrates the ability to screen for
communication disorders that may require further
assessment by speech-language pathology.
2. Collaborates with speech-language pathology
and/or designated team members to implement
and provide feedback regarding communication
strategies and/or devices.
3. Demonstrates the ability to adapt the environment
to allow access to communication devices.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
9
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Independence in Mobility And Prevention Of
Complications Of Immobility
1. Demonstrates the ability to administer the
appropriate assessment tools in relation to the
stroke survivor’s impairment, activity and/or
participation, and uses the results to select the
appropriate treatment intervention. Performs
periodic reassessments and modifies the
treatment plan accordingly.
2.
Demonstrates knowledge of the rationale and
indicators for selecting correct walking aids and
recommends the appropriate walking aid and
assistive devices for the stroke survivor (e.g.,
splints, slings, assistive feeding devices).
3.
Demonstrates an awareness of the rationale and
indicators for selecting appropriate wheelchairs
and seating and positioning equipment.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
10
LEARNING AREA
4.
Date
*SELF-RATING
Base Mid Final
Comments
Demonstrates:

Proper handling techniques during
transfers, positioning and application of
assistive devices (e.g., splints, slings)

Proper positioning of the stroke survivor

Proper and safe transfer of the stroke
survivor using the appropriate transfer
approach or technique

Proper and safe mobilization of the stroke
survivor using walking aids and specific
strategies

Proper and safe gait training on level
ground and stairs

Proper and safe assistance of the stroke
survivor to mobilize himself or herself in a
wheelchair.
5.
Demonstrates the ability to assess the risk
factors for complications, and develop and
implement a treatment program to facilitate
independence in mobility (e.g., muscle
weakness, paralysis, changes in muscle tone,
pain, contractures, loss of balance and
coordination, hemiparetic shoulder and other
joint injuries).
6.
Demonstrates the ability to educate other team
members, the stroke survivor and caregiver
about:

Correct and proper mobility (transfers,
gait, and stairs)

Positioning

Prevention and management of physical
complications.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
11
LEARNING AREA
7.
Date
*SELF-RATING
Base Mid Final
Comments
Demonstrates knowledge of the funding
programs for equipment, and assists the stroke
survivor and caregiver to access these
programs, where appropriate.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
12
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Routine Activities of
Daily Living (ADL)
1.
Demonstrates the ability to perform a task
analysis of the physical, cognitive and
perceptual abilities that are required to perform
ADLs.
2.
Demonstrates knowledge of functional treatment
techniques and their importance in helping
stroke survivors perform ADLs (e.g., cueing,
prompting, hand-over-hand techniques, set up,
positioning), incorporates these strategies into
physiotherapy treatments, and encourages the
stroke survivor to use the affected arm and hand
when performing ADLs.
3.
Uses appropriate assistive devices when helping
stroke survivors perform ADLs.
4.
Demonstrates knowledge of the cognitive,
physical, perceptual, visual, sensory, language
and behavioural deficits that may impact the
stroke survivor’s awareness and performance of
his/her ADLs, and incorporates management
strategies into the care of the stroke survivor.
5.
Collaborates with occupational therapy and/or
other team members to implement and evaluate
a comprehensive plan of care.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
13
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Instrumental Activities of Daily Living (IADL)
1.
Integrates IADL components into treatment
programs, as appropriate.
2.
Demonstrates awareness of stroke-related
impairments that might pose a risk for driving,
communicates observations to the most
responsible physician, and recommends a
referral to a driving assessment centre, as
appropriate.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
14
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Cognitive, Perceptual and Behavioural
Changes Following Stroke
1.
Demonstrates the ability to identify the presence
of cognitive, perceptual and behavioural deficits,
and refers to appropriate team members.
2.
Demonstrates the ability to identify cognitive,
perceptual and behavioural deficits, and
considers possible causes of deterioration that
may be related to pre-existing conditions,
current medical conditions, co-morbidities and
pharmacology.
3.
Demonstrates the ability to implement
management strategies used with stroke
survivors who demonstrate cognitive, perceptual
and behavioural changes following stroke.
4.
Collaborates with team members to implement
and evaluate a comprehensive plan of care.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
15
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Sexuality
1. Demonstrates the ability to assist the stroke
survivor/partner in developing strategies that
address the physical impairments that affect their
sexual function.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
16
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Nutrition
1.
Demonstrates an awareness of how hydration
and appropriate caloric intake are needed for
safe and optimal physical exercise performance.
2.
Demonstrates an awareness of the various
alternative-feeding methods used with stroke
survivors (e.g., tube feeding, total parenteral
nutrition), and the precautions and
contraindications for physiotherapy treatments.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
17
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Dysphagia
1.
Demonstrates the ability to screen the stroke
survivor’s respiratory status and initiates the
appropriate assessment and interventions as
required.
2.
Demonstrates the ability to recommend
positioning of the stroke survivor to prevent
aspiration.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
18
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Skin Care
1.
2.
3.
Collaborates with nursing and/or other team
members to identify various factors that affect
skin integrity such as:

Immobility

Altered sensation

Incontinence/moisture

Aging/poor skin turgor

Friction and shearing

Cognitive impairments

Adaptive devices
Demonstrates the ability to implement,
reassesses and modify strategies for preventing
and managing skin breakdown including:

Pressure reduction

Pressure reduction and relief devices (e.g.,
beds, chair, extremity devices, and
appropriate footwear)

Routine position changes

General measures (e.g., preventative skin
care, consultations with appropriate
resources)

Friction/shear reduction

Bed position

Assistive devices and techniques

Protection of high risk areas

Excess moisture reduction.
Demonstrates the ability to educate the stroke
survivor and caregiver about strategies to prevent
and manage skin breakdown.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
19
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Continence Management
1. Demonstrates basic knowledge of anatomy and
physiology of normal bladder function.
2. Demonstrates knowledge of complications that
can arise from impaired bladder function and
understands the implications that it may have on
the stroke survivor’s physical presentation.
3. Demonstrates an awareness of the various
assessment tools and management strategies as
they relate to urinary incontinence and
implements strategies to promote continence.
4. Demonstrates basic knowledge of anatomy and
physiology of normal and bowel function.
5. Demonstrates knowledge of complications that
can arise from impaired bowel function and
understands the implications that it may have on
the stroke survivor’s physical presentation.
6. Demonstrates an awareness of the various
assessment tools and management strategies as
they relate to bowel incontinence and implements
strategies to promote continence.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
20
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Primary and Secondary Stroke Prevention
1.
Demonstrates the ability to screen stroke
survivors for modifiable risk factors, completes
appropriate assessments as indicated, and
develops an appropriate treatment program
which may include education, behavioural
modification, stress reduction, exercise or
referral to other programs/health providers for
primary or secondary stroke prevention.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
21
LEARNING AREA
Date
*SELF-RATING
Base Mid Final
Comments
Transition Management
1.
Demonstrates the ability to identify when stroke
survivors and caregivers are no longer able to
manage safely and effectively in their current
living environment or situation.
2.
Demonstrates the ability to assess environmental
discharge barriers, and make recommendations
related to modifications and equipment needs.
3.
Demonstrates the ability to refer the stroke
survivor to the most appropriate resources to
meet ongoing physical and mobility needs.
4.
Demonstrates the ability to use assessment
information to assist the stroke survivor and
caregiver in accessing health professionals,
resources, agencies and supports for further
assessment or assistance.
5.
Demonstrates the ability to assess the caregiver’s
ability to manage the stroke survivor’s physical
and mobility care needs.
6.
Demonstrates the ability to assist and support
stroke survivors and caregivers to make
decisions about their physical status and
environmental factors that will affect their ability
to manage in different locations and living
situations.
7.
Demonstrates an awareness of the policies of the
Ministry of Health and Long-Term Care and others
on the long-term care application process.
Interprofessional Learning Objectives for Stroke, Physiotherapy Template
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