44 fo u n d th a t to u c h in g th e p a tie n t w as th e se c o n d m o st c o m m o n ly u se d a f te r fa c ia l e x p re ss io n . B y to u c h in g (lie p a tie n t th e p h y s io th e r a p is t c o m m u n ic a te s a c c e p ta n c e e.g. to u c h in g th e stu m p o f a n a m p u ta te d leg d e m o n ­ s tra te s th a t th e d e fo rm ity is a c c e p ta b le to h e r; to u c h in g th e p a tie n t w ith se v e re skin d ise ase o r b u rn s d e m o n ­ s tra te s t h a t th e p a tie n t is n o t re p u ls iv e a n d a n o u tc a st. W e u se o u r h a n d s as p ro fe s sio n a l to o ls to sta b ilise , to s tim u la te a n d a t th e s a m e tim e to re a s s u re a n d to c o m ­ fo rt. In a n o n to u c h in g so c ie ty to u c h in g as a f o r m of a c c e p ta n c e a n d s u p p o rt is a p riv ile g e g iv en to p h y s io ­ th e ra p is ts. P roxim ity A n o th e r u n iq u e a sp e c t o f th e p h y s io th e r a p is t/p a tie n t re la tio n s h ip is t h e p ro x im ity o r in tim a c y o f th e t r e a t ­ m e n t se ttin g . S o c iety , o r a t le a st t h a t o f th e w h ite p o p u la tio n , d o e s n o t a c c e p t c lose p h y sic a l e n c o u n te rs e x c e p t b e tw e e n e m o tio n a lly close p e rso n s. In th e tre a t­ m e n t se ttin g , p h y sic al c lo sen e ss ev en to th e p o in t of to u c h in g c a n n o t b e a v o id e d . J a n P e rry (1975) s ta te d : “ T h e m e s sa g e p o te n tia l of c lo sen e ss d u rin g tre a tm e n t c e rta in ly s h o u ld n o t b e used c are le ssly ; e v en m o re e m p h a tic a lly , it sh o u ld n o t be ig n o re d o r go u n re c o g n is e d by th e p h y s io th e ra p is t. T h e in fo rm a tio n a v a ila b le to th e p a tie n t a t th is d is ta n c e is so v iv id a n d c o u ld b e so b e n eficia l, t h a t th e th e ra p is t w o uld a p p e a r to b e d o in g an in ju s tic e to th e p a tie n t if s h e is u n a w a re o f th e sig n ific a n ce o f th e p h y sic al c lo s e ­ ness d u rin g t r e a tm e n t a n d fa ils to use th is m essage system e ffe c tiv e ly .” F acial E xpression T h e fa c e is th e p rim a ry c o m m u n ic a to r o f e m o tio n sta tu s . In th e stu d y c a rrie d o u t b y J a n P e rry (1975) fa c ia l e x p re ss io n s a n d m o re sp ecifically e y e c o n ta c t and sm ilin g m a d e u p 4 0 % o f th e n o n v e rb a l c o m m u n ic a ­ tio n b e tw e e n p a tie n t a n d p h y s io th e ra p is t a n d w as seen to e sta b lish r a p p o rt a n d e n c o u ra g e m e n t. T h e p h y s io ­ th e r a p is t m a y c o n v e y by h e r sm ile th a t she is frie n d ly a n d well d isp o se d to w a rd s th e p a tie n t a n d h e r eyes m ay c o m m a n d tru s t a n d c o n fid e n ce . A v o id in g a n o th e r ’s g la n c e a n d a v e rtin g y o u r g aze m a k e s fo r p o o r in te r ­ a c tio n a n d c o m m u n ic a tio n . W ritten C om m u n ication P e rh a p s th is is a n a re a o f c o m m u n ic a tio n w h e re p h y ­ s io th e ra p is ts a re a t th e ir a b s o lu te w orst. T h e p ro fessio n al C o m m u n ic a tio n U n it a t th e U n iv e rs ity o f C a p e T ow n in c o lla b o ra tio n w ith th e S c h o o l of S ocial W o rk have th is to say a b o u t w ritte n c o m m u n ic a tio n : “ P ro fe ssio n a l c o m m u n ic a tio n d e m a n d s th a t y o u r p u rp o s e sh o u ld b e c le a rly defin ed if y ou wish to c o m m u n ic a te effectively. I t is e sse n tia l to d e te rm in e w h a t re sp o n se y o u w ant fro m y o u r re a d e r. D o y o u w a n t h im to u n d e rs ta n d a n d a c c e p t new in fo rm a tio n ? D o you w a n t h im to c h a n g e h is v ie w p o in t to y o u rs a n d d o s o m e th in g as a re su lt? D o y o u w a n t to c o n v e y to h im o r h e r w hat y o u h a v e b e en e x p e rie n c in g ? ” O n e a sp e c t o f m e d ic a l re c o rd s I w o u ld lik e to m e n ­ tio n is th a t fro m th e legal p o in t o f view , m ed ical re c o rd s m u s t b e a c c u ra te a n d o b je c tiv e , as it is possible th a t y o u r re c o rd s m ig h t be u sed as e v id e n c e in a c o u rt case. T h is is a lre a d y h a p p e n in g in N o r th A m e ric a . C O N C L U S IO N D iffe re n t fa c e ts o f c o m m u n ic a tio n a re b e in g usedf d a ily b y p h y s io th e ra p is ts . M o re tim e s h o u ld b e s p e n t irf s tu d y in g c o m m u n ic a tio n f o r o u r p a tie n ts a n d ourselves. F in a lly I w o u ld lik e to finish w ith th is q u o ta tio n : O n e c a n n o t n o t c o m m u n ic a te A c tiv ity o r in a c tiv ity w o rd s o r silen c e A ll h a v e a m essage v alue. (H o o p e r, 1979) R E F E R E N C E S C o n in e , T . A . (1976). L iste n in g in th e h e lp in g re la tio n ­ sh ip . P hys. T h e r., 56, 1 5 9 - 162. D e rito , J. A . (1980). T h e in te rp e rs o n a l c o m m u n ica tio n b o o k . H a r p e r & R o w . N ew Y o rk . H is lo p H . (1975). T h e n o t-so -im p o s sib le d re a m . Pliys. T h e r., 55, 1 0 6 9 - 1080. H o o p e r , R. (1979). T h e h u m a n m essage system s. H a rp e r & R o w . N e w Y o rk . L o rb e r, J. (1975). G o o d p a tie n ts & p ro b le m p atients: c o n fo rm ity & d e v ia n c e in a g e n era l h o sp ita l. J. of H e a lth & S o c ia l B e h a v io u r , 16, 213 -2 2 5 . P e rry , J. F . (1975). N o n v e rb a l c o m m u n ic a tio n during p h y sic a l th e ra p y , P h ys. T h e r., 55, 5 9 3 - 6 0 0 . P u r tilo , R . B. (1976): S im ila ritie s in p a tie n t re sp o n se to c h ro n ic & te rm in a l illness. P hys. T h e r., 56, 279 -284. P u rtilo , R. B. (1978): H e a lth p r o f e s s i o n a l/p a ti e n t in ter^ a c tio n . S a n d e rs, U S A . JUNIE 1981F I S I O T E R A P I E A REAPPRAISAL OF EVALUATION OF FINAL YEAR STUDENT PERFORM ANCE’ J E N N I F E R M . H I L L B .SC . (P H Y S IO ) (S T E L L .) D .T .E . ( U N I S A ) t S U M M A R Y T h e a u th o r ta k e s a lo o k a t e v a lu a tio n o f the p h y s i o ­ th era p y s tu d e n t. S h e d isc u sse s the c riteria necessary f o r e v a lu a tio n a n d g iv e s so m e su g g e stio n s as to m e th o d s w h ich c an be used. * T h is p a p e r is a m o d ific a tio n o f an a ssig n m e n t as p a rt o f th e D .T .E . (U N IS A ) c o u rse, t W as J u n i o r L e c tu re r, U n iv e rs ity o f S te lle n b o sc h and T y g e rb e rg H o s p ita l. N o w D ir e c to r O x f o r d R e h a b ilita ­ tio n P ro je c t, Z im b a b w e . R e c e iv e d 5 M a rc h 1980. O P S O M M IN G D ie s k r y w e r gee 'n oorsig van die e v a ln e r in g van die fis io te r a p ie s tu d e n t. S y b e sp re e k d ie k rite ria w at nodig is v ir evaliteriitg en ste l m e to d e s w a t g e b r u ik k a n word, voor. A s a c lin ica l th e ra p is t in a te a c h in g h o sp ita l o r as a m e m b e r o f th e te a c h in g staff, th e p h y s io th e ra p is t is re g u la rly c a lle d u pon to assess th e c o m p e te n c y o f u n d e r­ g ra d u a te stu d e n ts . T h is is a n ‘a w e so m e ta s k ’ (Davis (1979). T h e a v e ra g e th e r a p is t h a s little b a c k g ro u n d in th e th e o ry a n d m e th o d s o f s tu d e n t e v a lu a tio n . F o rs te r a n d G a lle y (1978) h a v e p re s e n te d a u se fu l a p p ro a c h R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) JUNE 1981 P H Y S I O T H E R A P Y 45 to th e a sse ss m e n t o f clin ica l c o m p e te n c e b u t th e ro le o f e v a lu a tio n in th e tra in in g o f p h y s io th e ra p is ts has n o t been a n a ly se d . T h is p a p e r re p re s e n ts a n a tte m p t to p re s e n t th e c u r re n t th in k in g on e v a lu a tio n a n d th e re le v an c y of th e s e c o n c e p ts to th e p h y s io th e ra p y situ a - tion. T h e fo llo w in g q u e stio n s n e e d to b e a sk e d : W h a t is a se ssm e n t? W h y is it n e c e ssa ry a n d w h a t is its p u rp o se ? In w h a t w ays c a n th e s tu d e n t b e e v a lu a te d ? W h a t a re the e sse n tia l c h a ra c te ris tic s o f th e m e a s u re m e n t te c h n i­ ques? G r o n d lu n d (1976) sees e v a lu a tio n as a p p lie d to e d u c a tio n as “ a sy s te m a tic p ro c e ss o f d e te rm in in g th e e x te n t to w h ic h e d u c a tio n a l o b je c tiv e s a re a c h ie v e d by p u p ils.” T h is d e fin itio n is in c o m p le te as it ig n o re s th e lea rn in g p o te n tia l in h e re n t in th e te s t s itu a tio n . E lb e (1977) says th a t “ le a rn in g th e o ry su p p o rts tests as a m ean s o f p ro v id in g fe e d b a c k , a c o n firm e d e sse n tia l of le a rn in g .” T a k in g b o th th e s e view s in to a c c o u n t e v a lu a ­ tion co u ld b e se e n as “ a n o n g o in g , re g u la r a sse ssm e n t of e ac h s tu d e n t’s p e r fo r m a n c e in te rm s o f th e o b je c tiv e s k in d c rite ria set, so th a t le a rn in g m a y b e fa c ilita te d a n d 't h a t b o th th e s tu d e n ts ’ c a p a b ilitie s a n d th e efficacy o f the tea ch in g m e th o d s m a y be d e te r m in e d .” USES E v a lu a tio n c a n b e used f o r th e fo llo w in g p u rp o se s: • T o e n su re th a t th e c u rric u lu m is re a lis tic a n d a d e ­ q u a te ly ta u g h t. I f larg e n u m b e rs o f s tu d e n ts fa il e le c tro th e ra p y , it is u n lik e ly th a t th e s tu d e n ts a re a t fa u lt. It c o uld m e a n th a t th e o b je c tiv e s n e e d re v isio n o r th a t th e te a c h in g is n o t e ffe c tiv e . C lin ic a l th e ra p is ts a n d tea ch in g staff h a v e a m u tu a l re sp o n sib ility to m o n ito r e ach o th e r s ’ te a c h in g a n d to r e p o rt a n y in ad e q u ac y . ® T o d e te rm in e w hich s tu d e n ts a re c o m p e te n t to g r a d u ­ ate. T h e u n iv e rs ity is a c c o u n ta b le to so c ie ty as re ­ gards th e s ta n d a rd s o f its g ra d u a te s . “ T o th e so c iety a t large, e x a m in a tio n s f u rn is h a g u a r a n te e o f c o m p e ­ tence in th o se e x a m in e d to p e rfo rm th e task s d e ­ m an d e d o f th e m by th e o c c u p a tio n th e y tu rn u p ” (Behr, 1977). T h e u n iv e rs ity says to so c ie ty th a t X is a sa fe a n d e ffective p h y s io th e ra p is t. • T o p ro v id e f e e d b a c k to th e s tu d e n t in o r d e r to im p ro v e h e r p e rfo rm a n c e . It is im p o rta n t, esp e cially in the clin ica l s itu a tio n , to c o rre c t a n d g u id e s tu d e n ts a t re g u la r s h o r t in te rv a ls. A s tu d e n t s h o u ld s to p using ineffective, m is d ire c te d o r p o ss ib ly d a n g e ro u s tr e a t­ m en t m e th o d s on h e r p a tie n ts as so o n as p o ssib le . 1 he a v a ila b le lite ra tu re reflects c o n flictin g a ttitu d e s . R ow ntree (1977) sees “ a sse ss m e n t p rim a rily as d e v e lo p ­ ing th e re la tio n s h ip be tw ee n th e s tu d e n t, th e m se lv e s a n d the su b je ct m a t te r by giv in g th e s tu d e n ts a n d th em se lv es m ore in fo rm a tio n a b o u t th e p re s e n t s ta te o f th e s tu d e n ts ’ u n d e rstan d in g ; b u t is in c a p a b le o f p ro v id in g v alid in- lo rm a tio n a b o u t th e s tu d e n t to o u ts id e p a rtie s o r a b o u t his long term p o te n tia l to a n y o n e a t a ll.” O n th e o th e r hand, m an y A m e ric a n a u th o r s su c h as G r o n d lu n d (1976) ;md l^ e rc e (1977) stress th e n e ed l o r a n o b je c tiv e a n d ■ e n ab le m eth o d o f e v a lu a tio n th a t e n a b le s th e s tu d e n ts to be a c c u ra te ly g ra d e d a n d ra n k e d . I t a p p e a rs th a t c o m p e titio n f o r a d m iss io n to tra in in g c e n tre s a n d fo r jobs is so g re a t th a t p la c e m e n t c o u ld be d e p e n d e n t on J lew extra p e rc e n t g a in e d in a n e x a m in a tio n . OBJECTIVES O F P H Y S IO T H E R A P Y T R A IN I N G Bel o re e v a lu a tio n te c h n iq u e s a re c h o se n th e c o u rse c h i i JV5 S s*J0U' cl b e c le a rly defin ed a n d th e c u rric u lu m ould be p la n n e d w ith th e s e in m in d , ihp m ftefines o b je c tiv e s as “ e x p lic it f o rm u la tio n s of ways in w hich s tu d e n ts a re e x p e c te d to b e c h an g e d b y th e e d u c a tiv e p ro c e ss . . . O b je c tiv e s a re n o t o n ly g o a ls to w a rd s w h ic h in s tru c tio n is g u id ed , b u t th e y a re a lso th e g o a ls th a t p ro v id e th e d e ta ile d sp e c ifica tio n fo r th e c o n s tru c tio n a n d u se o f e v a lu a tiv e p ro c e d u re s .” (B row n, 1971). T o b e o f a n y use o b je c tiv e s m u st be c le ar, re a lis tic , m e a s u ra b le a n d sta te d in te rm s o f th e le a rn e r (M a g e r 1972). T h e o b je c tiv e s o f th e p h y s io th e ra p y c o u rse s h o u ld in c lu d e c h a n g e s in th e s tu d e n t’s b e h a v io u r w ith re g a rd to c o g n itiv e (in te lle c tu a l), affe c tiv e (e m o tio n a l a n d m o ra l) a n d m o to r skills. E a c h o f th e s e skills c a n b e s u b ­ d iv id e d . T h e c o g n itiv e d o m a in in le a rn in g can b e c a te g o rise d u n d e r th e h e a d in g s o f k n o w le d g e , c o m p re h e n s io n , a p p lic a tio n , a n a ly sis, sy n th e sis a n d e v a lu a tio n . T h e s e ra n g e fro m re la tiv e ly sim p le b e h a v io u rs to m o re c o m ­ plex o n e s. T h e c o g n itiv e skills a re sim p le st to e v a lu a te , a n d o f th e s e th e m o re b a sic o n e s su c h a s k n o w le d g e a re th e e asie st. A s c o g n itiv e sk ills a re e a s ie r to q u a n tify , a ffe c tiv e a n d m o to r sk ills a re o fte n n e g le c te d a n d it is p o ss ib le fo r a s tu d e n t to be a d m itte d to p h y s io th e ra p y on th e b a sis o f a c a d e m ic a c h ie v e m e n t a lo n e . L o o k in g a t o t h e r a sp e c ts o f e v a lu a tio n , it can be seen th a t q u a litie s o f th e a ffective d o m a in , su c h as re ce iv in g , r e ­ s p o n d in g , v a lu in g , o rg a n is in g a n d c h a ra c te ris a tio n a rc im p o r ta n t re q u is ite s f o r p h y s io th e ra p is ts . So too, a rc th e m o to r sk ills w h ic h h a v e n e v e r b e e n sp ecifically classified b u t w hich in c lu d e a c o g n itiv e , a p e rc e p tu a l a n d a m o to r c o m p o n e n t. fn c h o o sin g o b je c tiv e s fo r a tra in in g c o u rse it is im p o r ta n t to use th e a b o v e c la ssifica tio n f o r it e n a b le s o n e to in c lu d e all th e a sp e c ts o f le a rn in g . E a c h o f the o b je c tiv e s can be a c h ie v e d by specific m e th o d s o f te a c h in g a nd will h a v e a m a rk e d in flu e n ce on th e ty p e o f e v a lu a tio n to be used. In fa ct, th e v e ry c h o ic e o f o n e te c h n iq u e o v e r a n o th e r s h o u ld d e m o n s tra te o n e k in d of s tu d e n t a b ility r a th e r th a n a n o th e r. U n f o r tu n a te ly “ s o m e tim e s th e k in d s o f e v a lu a tio n p ro c e d u re s a v a il­ a b le w ill ten d to g o v e rn a n d d e te rm in e th e c h o ic e of o b je c tiv e s, c o n te n ts o r m e th o d s, r a th e r th a n to m e re ly offer a d d itio n a l in fo rm a tio n to th o se se le c tin g th e m on o th e r g r o u n d s ” (K elly 1977). M E T H O D S O F E V A L U A T IO N “ In th e p a st th e o n ly u n iv e rs a l e v a lu a tio n te c h n iq u e w as th e final e x a m in a tio n . T h e re is a d e m a n d to d a y fo r m o re v a rie d ty p es o f a sse ss m e n t to m ee t th e v a rie ty of aim s in te a c h in g , as well as fo r m o re e v a lu a tio n of le a rn in g a n d te a c h in g d u rin g th e c o u rs e ” (B e ard , 1971). This is p a rtic u la rly tru e ol m ed ic al tra in in g d u rin g w h ic h so m a n y ty p es ol sk ills n e ed to be le a rn e d a n d teste d . S e v e ral a u th o rs , such as F le m in g (1976) a n d H e r d e r (1979) h a v e c o m m e n te d on th e a sse ss m e n t o f m ed ic al stu d e n ts . T h e r e a re v a rio u s ty p es o f e v a lu a tiv e p ro c e d u re s a v a ila b le . C e rta in c rite ria need to be m et b y th ese p r o ­ c e d u re s in c lu d in g th e p ro b le m o f s tu d e n t ra tin g . T Y P E S O F E V A L U A T IO N (R o w n tre e , 1977) Su nim ativc or F orm ative S u m m a tiv e e v a lu a tio n c o n c e rn s th e g ra d in g of s tu d e n ts a t th e e nd o f th e c o u rse . It is on th is b asis th a t s tu d e n ts a re a d m itte d to u n iv e rs ity , o b ta in b u rs a rie s a n d a re allo w e d to p ra c tic e p ro fe s sio n a lly . It is n o t p a r t o f th e le a rn in g p ro c ess a lth o u g h th e “ th r e a t ” o f e x a m in a ­ tio n s m ig h t p ro v id e m o tiv a tio n fo r so m e stu d e n ts . It is c h a ra c te ris e d by v ery little fe e d b a c k to e ith e r th e s tu d e n t or, in so m e cases, to th e le c tu re r, e.g. m a tr ic u la ­ tio n e x a m in a tio n s . F o r m a tiv e e v a lu a tio n h a s as its m ain p u rp o s e “ to im p ro v e th e in s tru c tio n a l m e th o d s a n d m a te ria ls so th a t g r e a te r s tu d e n t le a rn in g will o c c u r ” R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) 46 F I S I O T E R A P I E JUNIE 1981 (G ru n d lu n d , 1976). T h e s e e v a lu a tio n m e th o d s s u p p ly th e s tu d e n t w ith as m u c h fe e d b a c k as p o ss ib le as so o n as p o ssib le . F requ en cy, C on tin uou s and T erm inal A ssessm en t T h is c la ss ific a tio n d o e s n o t n e c e ssa rily im p ly th a t s u m m a tiv e e v a lu a tio n is alw ay s te rm in a l o r th a t c o n ­ tin u o u s a sse ss m e n t is a lw ay s fo rm a tiv e . M a rk s o b ta in e d th r o u g h o u t th e y e a r c a n a lso c o n trib u te to , o r m a k e u p , th e fin a l m a rk . I t is p o ss ib le to c o m b in e b o th m e th o d s in o r d e r to g ra d e th e s tu d e n t. T h is h a s th e a d v a n ta g e o f re d u c in g final e x a m in a tio n stre ss w h ich c a n e asily lea d to d e c re a s e d p e rfo rm a n c e . I t a lso e n a b le s a w id e r s p e c tru m o f e v a lu a tiv e p ro c e d u re s to be e m p lo y e d . C oursew ork or E xam inations T h e s tu d e n t c a n b e e v a lu a te d o n th e w o rk w h ic h sh e h a s p ro d u c e d d u rin g th e y e a r, on o n e te rm in a l e x a m in a ­ tio n o r on b o th . P rocess or P rod uct T h e r e is a d iffe re n c e b e tw e e n a ssessing th e ta n g ib le re s u lts o f s tu d e n t w o rk a n d th e w a y in w h ic h th e w ork is p ro d u c e d . T h e s tu d e n t w h o g a in s a n in c re a s e o f 90 d e g re e s ra n g e o f m o tio n m ig h t h a v e a c h ie v e d a goo d “ p r o d u c t” , b u t if th e tr e a tm e n t w as v e ry p a in fu l h e r “ p ro c e s s ” m ig h t le a v e m u c h to b e d e sire d . I t is v ita l in p h y s io th e ra p y t h a t th e p ro c e ss b e e v a lu a te d th ro u g h th e u se o f e.g. o b s e rv a tio n o r v id e o ta p e . P ro c e ss e v a lu a ­ tio n is m o re s u b je c tiv e a n d difficult. C on vergen t or D ivergent C o n v e rg e n t th in k e rs te n d to d o v e ry well w hen fo c u ssin g o n a c le a rly defin ed ta s k w ith n o sin g le c o rre c t a n sw e r. D iffe re n t fo rm s o f e v a lu a tio n te n d to fa v o u r d iffe re n t ty p e s o f th in k e rs . T h e s e q u e s tio n s a ris e . W h a t ty p e o f t h in k e r m a k e s th e b e st th e ra p is t? D o p h y s io ­ th e ra p y te a c h e rs e n c o u ra g e d iffe re n t s tu d e n t o p in io n s o r a re th e y d o g m a tic in te a c h in g t h a t th e r e is o n ly o n e rig h t w ay o f d o in g th in g s ? D o th e m e th o d s o f te stin g fa v o u r th o se w h o c a n r e p ro d u c e c o rre c t a n sw e rs to p ro b le m s r a th e r th a n th o se w h o c a n see v a rie d im p li­ c a tio n s to p ro b le m s? T E C H N IQ U E S O F M E A S U R E M E N T D iffe re n t te c h n iq u e s o f m e a s u re m e n t assess d iffe re n t sk ills a n d s o m e tim e s m o re t h a n th e d e s ire d skills. A lo n g t h e o ry p a p e r, e.g. m a y b e in te n d e d to te s t th e k n o w le d g e o f p h y s io th e ra p y t r e a tm e n ts b u t, “ th e tr a d i ­ tio n a l th r e e h o u r e x a m in a tio n tests th e s tu d e n ts a b ility to w rite a t a b n o rm a l sp e e d , u n d e r u n u s u a l stress, on so m e o n e e ls e ’s to p ic , w ith o u t re fe re n c e to h is c u s to m a ry so u rc e s of i n fo rm a tio n , a n d w ith a p re m iu m o n q u e stio n - sp o ttin g , (and) lu c k y m e m o r is a tio n ” (R ovvntree, 1977). Is th is w h a t th e p h y s io th e ra p y te a c h e r w a n ts to test? H e re a re so m e su g g e ste d te c h n iq u e s. K n ow led ge Sk ills A ttitud es p a p e r & p e n c il p a p e r & p e n c il p a p e r & p e n c il tests te s ts tests in te rv ie w s o b s e rv a tio n in te rv ie w s o b s e rv a tio n p ra c tic a l o b s e rv a tio n o ra l e x a m in a tio n s e x a m in a tio n s in v e n to rie s a n e c d o ta l re p o rts A d a p te d f r o m A .P .T .A . (1967) p. 224 P aper and P en cil T ests P a p e r a n d p e n c il te s ts a re th e m o s t u se d o f a ll tests. T h e y c a n b e used to te s t e ith e r su m m a tiv e ly o r fo rm a - tiv e ly . T h e y c a n b e d o n e re g u la rly a n d c a n fo rm p a r t o f th e c o u rse w o rk o r th e e x a m in a tio n . G e n e ra lly th e s e te s ts m e a s u re th e p r o d u c t r a th e r th a n th e p ro c ess. T h e r e a re tw o m a in ty p es o f p a p e r a n d p e n c il tests, viz. th e s h o rt a n s w e r /m u ltip le c h o ic e te s t a n d th e essay ty p e test. T h e first fa v o u rs o b je c tiv e m a rk in g , th e se c o n d c re a tiv ity a n d in itia tiv e o n th e p a r t o f th e s tu d e n t. I f th e su b je c t m a tte r is su c h t h a t th e re is ro o m f o r d isc u ssio n a n d f o r differin g in te r p r e ta tio n s o f th e fa c ts, e ssa y ty p e q u e s tio n s a re th e m o s t s u ita b le . I f th e le c tu r e r ’s m a in o b je c tiv e is th e tr a n s f e r o f h is k n o w le d g e th e n m u ltip le c h o ic e q u e s tio n s w o u ld p ro b a b ly b e th e b e s t te s t o f w h e th e r th is o b je c tiv e h a d b e e n a ch iev e d . T e s tin g o f all th e d iffe re n t ty p e s o f in te lle c tu a l skills s h o u ld b e in c o rp o ra te d in to th e p a p e r. Q u e s tio n s sh o u ld b e se t t h a t re q u ire th e s tu d e n t to a n a ly s e a n d to e v a lu a te th e s u b je c t m a tt e r o r to p re s e n t n ew id ea s a n d in te r p r e ­ ta tio n s . T h is is d ifficult as m o st q u e s tio n s c all f o r p u r e r - f a c tu a l re c a ll. \ P h y s io th e ra p y tr e a tm e n t p a p e rs s h o u ld b e c o m e m o re p a tie n t-o rie n te d . L ittle o f th e d e m a n d s o f th e c lin ica l s itu a tio n a re te s te d . O n e se ld o m -sees q u e s tio n s c a llin g f o r e x a m p le s o f p a tie n t e v a lu a tio n fo rm s o r f o rm u la tio n o f tr e a tm e n t p ro g re s s re p o rts f o r u se b y o th e r staff m e m b e rs . Oral E xam in ation s and Interview s T h e s e tests te n d to b e m o re o p e n -e n d e d a n d s u b ­ je c tiv e . T h e y e n a b le th e s tu d e n t to g ive m a x im u m o u t­ p u t in th a t q u e s tio n s c a n b e m o d ifie d d e p e n d in g o n th e s tu d e n t’s level o f re sp o n se . T h e s e m e th o d s a re u sed re g u la rly in th e c lin ic a l s itu a tio n w h e n th e s tu d e n t is re q u ire d to r e p o rt b a c k d a ily on p a tie n ts ’ p ro g re s s. T h e c lin ic a l s u p e rv is o r m u s t b e a w a re o f th e le a rn in g p o t e n ­ tia l in th is situ a tio n . O fte n th e s u p e rv is o r is u n s u r e of w h a t to lo o k f o r a n d w h a t ty p e o f q u e s tio n s to ask. H e / s h e m a y n o t k now th e b e s t w ay o f a id in g th e s tu d e n t in th e tr a n s f e r o f k n o w le d g e f r o m th e a c a d e m ic to p ra c tic a l situ a tio n . R e s e a rc h in to th e re q u ire m e n ts fo r stu d e n t-in te rv ie w s a n d -re p o rtb a c k c o u ld b e u se fu l. T h e in te rv ie w is o n e o f th e b e s t w ays o f m e a s u rin g a ffe c tiv e skills. T h e s tu d e n t’s a ttitu d e to h e r p a tie n ts a n d h e r w o rk is b e s t a ssessed u n d e r th e s e c o n d itio n s. O bservation S o m e sk ills a re im p o ssib le to m e a s u re th ro u g h p r o ­ d u c t a lo n e . T h e s e , a c c o rd in g to G r o n d lu n d (1976), in ­ c lu d e sk ills su c h as w o rk h a b its , so c ial h a b its , m o to r skills, s c ie n tific a ttitu d e s , in te re s ts, a p p re c ia tio n s a n d a d ju s tm e n ts . T e s tin g o f th e s e sk ills te n d s to b e re la tiv e ly s u b je c tiv e , b u t th e c h o ic e h a s to b e m a d e b e tw e e n u sin g s o m e w h a t u n re lia b le m e th o d s o r n o t to e v a lu a te th e s e sk ills a t all. S pecific te c h n iq u e s o f o b se rv a tio n in c lu d e th e u se of a n e c d o ta l o r c ritic a l in c id e n t re p o rtin g . T h e s e fa c tu a l re p o rts o f sig n ific a n t in c id e n ts in a s tu d e n t’s p e r f o r ­ m a n c e in c lu d e p o sitiv e a n d n e g a tiv e b e h a v io u r. A n u m ­ b e r o f a n e c d o te s s h o u ld b e c o lle c te d b e fo re d ra w in g in fe re n c e s. R a tin g sc a le s c a n b e u se d . A sy s te m a tic p ro c e d u r e is fo llo w e d f o r o b ta in in g a n d r e p o rtin g ju d g e m e n ts . T h e r a te r m u s t n o t o n ly assess w h e th e r q u a lity is p re s e n t b u t a lso to w h a t d e g re e it is p re s e n t. D e s p ite so m e d is a d v a n ta g e s to th is sy ste m su c h as s u b je c tiv ity , v a g u e f o r m u la tio n o f tr a its a n d th e ‘h a lo -e ffe c t’ (a s tu d e n t’s r e p u ta tio n in flu e n ce s th e m a rk s a ssig n e d h e r), “ if p ro p e r p ro c e d u re s a re fo llo w e d in te rm s o f th e c o n s tru c tio n , tra in in g o f ra te rs , a d m in is tr a tio n a n d a n aly sis, ra tin g R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) JUNE 1981 P H Y S I O T H E R A P Y 47 scales m a y b e th e b e s t m e th o d a v a ila b le to o b ta in in ­ f o rm a tio n in th e skill a r e a ” (A .P .T .A ., 1967). A c o m b in a tio n o f a n e c d o ta l re p o rtin g a n d ra tin g scales is o f te n u se d in c lin ic a l a sse ss m e n t b u t th e a p p ro a c h to a n e c d o ta l re p o rtin g is o f te n in fo rm a l and u n d isc ip lin e d . C h e c k lists c a n a lso b e u se d as g u id e lin e s fo r o b se r­ v a tio n . T h e y c o n s is t o f w o rd s d e sc rib in g specific b e ­ h a v io u rs w h ic h c a n b e tic k e d o ff w h ile w a tc h in g th e s tu d e n t a t w o rk . C h e c k lists a re u se fu l b e c a u s e th e y c a n te a c h b o th s u p e rv is o r a n d s tu d e n t w h a t to lo o k fo r in p a tie n t tre a tm e n t. P ractical E xam in ation s P ra c tic a l e x a m in a tio n s in c o rp o ra te all th e o b se rv a tio n skills. B o th th e s tu d e n t a n d th e e x a m in e r s h o u ld k now w h a t is b e in g te s te d a n d w h a t th e c rite ria f o r success are. A w ide ra n g e o f te c h n iq u e s a n d c o n d itio n s c a n b e tested b u t p a tie n t fe e d b a c k is lac k in g . C a re m u s t be taken th a t s tu d e n ts d o n o t b e c o m e m e re te c h n ic ia n s b ecause o f o v e re m p h a s is o n th e p ra c tic a l a n d n o t e n o u g h o n th e p a tie n t. T h is s itu a tio n c a n b e a v o id e d to a c e rta in e x te n t b y th e in tro d u c tio n o f ‘P a p e r -p a tie n ts ’. T h e s tu d e n t is n o t c o n fro n te d w ith an a m o rp h o u s ‘P a rk in s o n s D is e a s e ’, b u t is p re s e n te d w ith a defined p a tie n t w ith specific p ro b le m s . T h is m o v e s th e e m p h a sis fro m m e m o ry w o rk to logical re a so n in g . Projects and C lassw ork P ro je c ts a n d c la ssw o rk can c o v e r a w id e r v a rie ty of skills th a n is p o s s ib le in th e e x a m in a tio n situ a tio n . T h e y a re a lso re a lis tic as b o o k s a n d re s o u rc e p e o p le c an b e c o n su lte d . T h e y te s t th e w h o le ra n g e of c o g n itiv e fu n c tio n s a n d a re id ea l fo r th e d iv e rg e n t s tu d e n t. S he le a rn s to re s e a rc h p riv a te ly a n d it s h o u ld e n a b le h e r to b e c o m e c o n s tru c tiv e ly c ritic a l o f e x is tin g ‘d o g m a s ’. T h e d a n g e r o f u sin g p ro je c ts as a te s tin g m e th o d lies in th e s u b je c tiv ity o f th e m a rk e r. C r ite ria sh o u ld b e c le a rly s p e lt o u t a n d d is trib u te d to b o th s tu d e n ts a nd sta ff m e m b e rs w ith a s ta n d a r d sy ste m o f m a rk in g . Peer and S e lf A ssessm en t I n so m e h o s p ita ls a sy ste m o f p a tie n t c a re a u d it a n d p e e r re v ie w h a s b e e n in s titu te d a lo n g th e lin e s su g g e ste d by K h a n (1976). U n f o r tu n a te ly p e e r- a n d se lf-a sse ssm e n t has n o t re c e iv e d m u c h a tte n tio n in th e tra in in g o f th e ra p is ts. B y in tro d u c in g s e lf-a ss e s sm e n t in clin ica l w ork th e fa c u lty w o u ld n o t o n ly o b ta in u se fu l in f o r m a ­ tio n a b o u t th e s tu d e n t b u t th e s tu d e n t w ill b e c o m e c o n ­ s tru c tiv e ly s e lf-c ritic a l. O n g ra d u a tio n th e s tu d e n t b e ­ co m es re s p o n s ib le f o r h e rs e lf a n d h e r s ta n d a r d of p a tie n t care. S e lf-a p p ra is a l co u ld p r e p a r e h e r to c o n s ta n tly c h a lle n g e th e q u a lity o f h e r w o rk . E S S E N T IA L C H A R A C T E R IS T IC S O F M E A S U R E M E N T D E V IC E S O bjectivity T o s a tis fy th is re q u ir e m e n t a g e n e ra l a g re e m e n t m u s t b e re a c h e d a b o u t th e s ta n d a rd o f th e s tu d e n t’s re sp o n se b y e v e ry o n e q u a lifie d to assess it. S o m e tests, as sh o w n a b o v e, a re m o re o b je c tiv e th a n o th e rs b u t, b y sta tin g specific o b je c tiv e s a n d c r ite r ia f o r e a c h s itu a tio n , u n i­ fo rm ity c a n b e o b ta in e d . R eliab ility “ A r e lia b le te s t m e a su re s c o n s is te n tly a n d a c c u ra te ly each tim e it is u se d . I t ’s re su lts a re n o t u n d u ly influ e n ce d b y c h a n c e ” (B ro w n a n d T h o r n to n , 1971). V alid ity T h is m a y b e th e m o st i m p o r ta n t c h a ra c te ris tic o f a test. D o e s it m e a s u re th e ty p e o f b e h a v io u r w h ic h is re q u ire d ? A v a lid test sh o u ld m e a s u re th e e x ac t d e g re e to w h ic h th e sta te d o b je c tiv e h a s b e e n a c h ie v e d . F o r e x a m p le , a q u e s tio n is se t w ith th e a im o f te s tin g th e a p p lic a tio n o f th e p rin c ip le s o f n e u ro -d e v e lo p m e n ta l th e r a p y (N .D .T .) to th e t r e a tm e n t o f a n a th e to id c h ild . In a n sw e rin g th e s tu d e n t c o u ld h a v e m e m o riz e d th e re p ly (m e m o ry is b e in g teste d ), th e s tu d e n t c o u ld b e s h o rt o f tim e a n d u n a b le to fin ish th e p a p e r (speed o f w ritin g a n d th in k in g b e in g te s te d ), th e q u e s tio n c o u ld b e f o r m u la te d in su c h a w ay t h a t th e s tu d e n t is u n a b le to u n d e r s ta n d w h a t is re q u ire d (in te r p r e ta tio n o f la n g ­ u a g e b e in g teste d ) etc. D e s p ite th e d ifficulties, v a lid ity is a n e sse n tia l a im . “ In th e final a n a ly sis th e v a lid ity o f te s t re s u lts is b a se d on th e e x te n t to w hich th e b e h a v io u r e lic ite d in th e te s t­ ing s itu a tio n is re p re s e n ta tiv e o f th e b e h a v io u r b e in g te s te d ” (K elly, 1977). P racticality P r a c tic a lity in c lu d e s su c h c o n s id e ra tio n s as e c o n o m y o f tim e , e ase o f a d m in is tra tio n , sc o rin g a n d costs. A b a la n c e b e tw e e n p r a c tic a lity a n d v a lid ity is so m e tim e s difficult to ach iev e . D iscrim in ation T h e te s t p ro c e d u re m u s t b e a b le to d is c rim in a te b e ­ tw e e n th o se w h o h a v e a c h ie v e d th e o b je c tiv e s se t a nd th o s e w h o h a v e n o t. G R A D I N G G ra d in g in p h y s io th e ra p y is g e n e ra lly d o n e a c c o rd in g to th e o b je c tiv e s se t r a th e r th a n a c c o rd in g to th e n o rm (g ra d in g b y th e n o rm a l d is tr ib u tio n c u rv e). A p ro b le m o c c a sio n a lly a rises in te rm s o f th e re la tiv e v a lu e o f th e y e a r m a r k a n d th e fin a l e x a m in a tio n m a rk . S h o u ld th e s tu d e n t fa il on th e g ro u n d s o f a p o o r p e rfo rm a n c e in h e r final e x a m in a tio n w h e n sh e h a s re g u la rly a c h ie v e d r e a s o n a b le m a rk s d u rin g th e y e a r? If so, is th e final e x a m in a tio n v a lid ? I f n o t, w h a t is th e p u rp o s e o f th e final e x a m in a tio n ? S im ila rly , c a n e x te rn a l e x a m in e rs fa il s tu d e n ts t h a t th e in te rn a l e x a m in e rs w o u ld lik e to p a ss a n d v ice versa? I t c o u ld b e t h a t th e p u rp o s e o f th e final e x a m in a tio n s is n o t well e n o u g h d efined. T h e fo llo w in g c o u ld b e ta k e n as th e g o a ls o f th e te rm in a l e x a m in a tio n : • T o assess th e s ta n d a rd o f th e d e p a r tm e n t, th e te a c h ­ ing a n d th e sy llab u s. 0 T o m o tiv a te th e s tu d e n ts to c o n s o lid a te th e b o d y of k n o w le d g e b e fo re lea v in g u n iv ersity . • T o e n a b le th e p o o r s tu d e n t to im p ro v e h i s / h e r m a rk s . I n o th e r w o rd s, th e e x a m in a tio n is insu fficien t in te rm s o f d e te rm in in g th e a v e ra g e s tu d e n t’s c a p a b ilitie s a n d th e y e a r m a rk , w h ic h is m a d e u p o f class tests, p ro je c ts a n d c lin ica l re p o rts , is se e n to b e a m o re v a lid re fle c tio n o f th e s tu d e n t’s a b ility to p ra c tic e as a th e ra p is t. C O N C L U S IO N S A N D S U G G E S T IO N S T h e p h y s io th e ra p y s tu d e n t is c o m p re h e n s iv e ly assessed d u rin g h e r tra in in g b u t c e r ta in a re a s co u ld b e im p ro v e d . H e r e a re a few su g g e stio n s. T heory Papers T h e s e a re u sed a t p r e s e n t to te s t c o g n itiv e skills. T h e y c o u ld b e m o d ifie d to in c lu d e th e a sse ss m e n t of R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) 48 F I S I O T E R A P I E JUNIE 1981 w ritte n c o m m u n ic a tio n sk ills a nti to c a p ita lis e on the le a rn in g p o te n tia l ol: th e test situ a tio n . A ty p e d set of m o d e l a n sw e rs c o u ld be d is trib u te d on c o n c lu sio n ol: th e test. (It is u n d e rs to o d th a t o th e r a n sw e rs w o u ld be a c c e p ta b le a n d w e lc o m e d if c o rre c t.) C linical Reports on Student P erform ances in the H ospital T h e s e a re th e m o st v a lid tests o f a s tu d e n t ’s a b ility as a th e ra p is t b u t th e y te n d to be su b je ctiv e. M o re g u id a n c e on specific m e th o d s is n e ed e d . C lin ic a l w o rk c o u ld a lso be assessed by th e s tu d e n t. S h e s h o u ld be c a lle d u p o n to w rite a re p o rt on h e r own w o rk as well as c o m m e n tin g on th e su p e rv isio n th a t sh e w as given. C linical E xam inations A t p re se n t it w o uld a p p e a r t h a t e x a m in a tio n o f the p a tie n t a n d tr e a tm e n t p la n n in g a re n o t a sse ssed . Jt m ig h t b e c o n s tru c tiv e to in c lu d e a p a tie n t e v a lu a tio n d o n e in th e p re se n c e o f th e e x a m in e r. P ractical E xam inations T h e s e tests co u ld be m a d e m o re m e a n in g fu l a n d valid if ‘p a p e r - p a tie n ts ’ r a th e r th a n c o n d itio n s w e re p re se n te d . T h e im p o rta n c e o f tests sh o u ld b e d e -e m p h a s is e d . P ro je c ts se e m to be re c e iv in g m o re a tte n tio n . It s h o u ld be stre sse d th a t re se a rc h is n o t c o n fin e d to s tu ­ d e n t life a n d th a t in p ra c tic e e v ery p a tie n t can p ro v id e in fo rm a tio n fo r im p ro v in g a n d in v e s tig a tin g tre a tm e n ts . T h e p ro fe s sio n , a n d m o re e sp e c ia lly th e lea c h in g h o sp ita ls m u s t striv e to find m o re v a lid , re lia b le , o b je c ­ tiv e a n d p ra c tic a l w ays o f te stin g stu d e n ts . In th is w ay th e q u a lity o f th e g ra d u a te s c a n o n ly in c re a s e a n d the p ro fe s sio n w ill tru ly be a b le to ta k e p rid e in th e s ta n ­ d a rd o f p a tie n t c a re d e liv e re d . R E F E R E N C E S A m e ric a n P h y s ic a l T h e ra p y A s so c ia tio n (1967). H a n d b o o k f o r p h ysical th e ra p y te a c h e rs. A .P .T .A . N ew Y o rk . B e a rd , R. (1971): R e se a rc h in to tea c h in g m e th o d s in h ig h e r e d u c a tio n . 2nd E d . Society fo r R e se a rc h in to H ig h e r E d u c a tio n , L o n d o n . B e h r, A. L . (1977): A te x tb o o k o f e d u c a tio n a l m eth o d . 2nd E d . J. L. van S chaik. P re to ria . B ro w n , J. W . a n d T h o r n to n , J. W. (1971). C ollege te a c h in g ; a sy s te m a tic a p p ro a c h . M a c G ra w -H ill. N ew Y ork. D a v is, C . M ., (1979). C o m p e te n c y : T h e w h a t, w hy, a n d h ow o f it. P hys. Tlier., 59, 1088 - 1094. E lb e , K . E. (1977). T h e c r a f t o f tea ch in g . Jossey-B ass. San F ra n c is c o . F le m in g , P . R . e t al. (1976). E x a n tin a tio n s in m edicine. C h u rc h ill-L iv in g sto n e . E d in b u rg h . G a lle y , P. a n d F o rs te r, A. (1978). A sse ssm e n t o f p ro fe s ­ sio n a l c o m p e te n c y . A u s t. J. P h y s io ., 24, 53 - 59. (J G ro n d lu n d , N . E. (1976). M e a s u re m e n t a n d e v a lu a tio n in tea ch in g ; 3rd ed. M a c M illa n . N e w Y o rk . H e rd e r, R . M. (1979). A sse ssm e n t o f clin ica l c o m p e te n c e u sin g a n o b je c tiv e s tru c tu re d c linical e x a m in a tio n . M e d . E d. 13, 4 1 - 5 4 . K h a n , A. U. a n d H o w ro y d , II. A . (1976). P h y s io th e ra p y c a re a u d it a n d p e e r review . P h y s C anad, 28, 1 63- 167. K elly, A. V. (1977). T h e c u rric u lu m : th e o ry a n d p ra ctic e . H a r p e r a n d R o w . L o n d o n . M a g e r, R. F. (1962). P re p a rin g in stru c tio n a l objectives. F e a rs o n P u b lis h e rs , Inc. P a lo A lto. P ie rce , W . D . a n d L o rb e r, M . A . (1977). O b je ctiv es a nd m e th o d s f o r se c o n d a ry tea ch in g . P re n tic e -H a ll. E n g le ­ w o o d CliTs. R o w n tre e , D . (1977). A ssessing stu d e n ts : H o w sh a ll we k n o w th e m ? H a rp e r a n d R o w . L o n d o n . THE THERABATH a light, p o rta b le , e c o n o m ic a lly -p ric e d W ax Bath Therabath p ro v id e s e ffe c tiv e p a ra ffin heat tre a tm e n t fo r a rth ritis , c h ro n ic jo in t inflam m ation, s tiffn e s s , m uscle spasm and a th le tic o r o th e r in ju rie s. Hands, fe e t o r e lb o w s are im m ersed p a ra ffin is b ru sh e d on o th er areas. T h e rm o s ta tic a lly c o n tro lle d to hold the sp e cia l T h e ra ffin w ax at a b e n eficial 5 2 °C - 54°C . P ortable fo r use a ny­ w here. Uses less than 25 w a tts of e le c tric ity ; o perates fo r less than ten cents a day. Initial su p p ly o f T he ra ffin w ax included. Price R147.50 in c lu d in g wax plus G.S.T. M E D I C A L D I S T R I B U T O R S ^ bpk P O Box 3378 Johannesburg 2000 P O Box 195 Cape Town 8000 P O Box 5298 Durban 4000 Phone : 29-0611 Phone : 47-4440 Phone : 37-1501 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) JUNE 1981 P H Y S I O T H E R A P Y 49 CORRESPONDENCE D e a r M a d a m , In troductory C irculars and D irectory o f P rivate P ractitioners P e rm it m e th ro u g h th e m e d iu m o f y o u r J o u r n a l to ex p la in a few fa c ts w hich p e r ta in to th e so m e w h a t c o n tro v e rsia l m a tte rs m e n tio n e d a b o v e . In tr o d u c to r y C irculars'. T h is re fe rs to i n fo rm a tio n w h ic h p h y s io th e ra p is ts s ta rtin g in p r iv a te p ra c tic e a re p e rm itte d to c irc u la ris e to d o c to rs , m e d ic a l in s titu tio n s a n d h o s p ita ls a c c o rd in g to G o v e rn m e n t n o tic e N o . R 1838 o f 16 S e p te m b e r 1977. I t is g e n e ra lly a c c e p ta b le t h a t a n o tific a tio n o f th e n a m e , a d d re s s a n d te le p h o n e n u m b e r o f a new p riv a te p r a c titio n e r , o r c h a n g e s in a n e x is tin g p ra c tic e m ay b e c irc u la te d to d o c to rs . O u r A s s o c ia tio n fe lt, h o w e v er, t h a t m o re i n fo rm a tio n is s o m e tim e s n e c e s­ sa ry in o rd e r to fa c ilita te p a tie n t se le c tio n a n d c o rre c t r e fe rra l b y g e n e ra l p ra c titio n e rs . I t w a s th e r e f o r e a g re e d b y th e S o u th A f r ic a n S o c iety o f P h y s io th e ra p y a n d a c c e p te d b y th e P ro fe s s io n a l B o a rd f o r P h y s io ­ th e ra p y t h a t c e r ta in “ sp e c ia l i n te re s ts ” m a y b e n a m e d . T h e list o f a p p ro v e d in te re s ts in c lu d e d sp in a l a n d p e rip h e ra l m o b ilis a tio n /m a n ip u la tio n . Specific “ s c h o o ls ” m a y b e m e n tio n e d e.g. C y ria x , M a itla n d etc. T h is a lso a p p lie s to n e u ro lo g y (B o b a th e tc .). T h is w as d o n e as a n in te rim m e a s u re to a c q u a in t d o c to rs w ith c u r re n t sc h o o ls o f t h o u g h t in p h y s io th e ra p y , u n til such a tim e a s a s p e c ia lis t r e g is te r m a y b e e sta b lish e d in re s p e c t o f th e p h y s io th e ra p y p ro fe s s io n . T h e D ir e c to r y o f P r iv a te P ra c titio n e rs : T h is is s e n t to a ll m e d ic a l p ra c titio n e r s a n d o r th o ­ p a e d ic a n d o th e r sp e c ia lis ts . T h e s a m e ite m s o f sp e c ia l in te re s t a re u se d h e r e f o r th e i r in fo rm a tio n , in o rd e r to f a c ilita te re fe r r a l to th e p h y s io th e ra p is t in th e ir a r e a w h o is a b le to o ffer th e tr e a tm e n t r e q u ir e d . T h is is, o f c o u rse , n o t lim ite d to m a n ip u la tio n b u t in c lu d e s a re a s su c h a s I P P V tr e a tm e n ts , a n te - n a ta l in s tru c tio n a n d g y m n a s iu m fa c ilitie s. P h y s io th e ra p is ts a re a llo w e d to lim it th e ir p r a c tic e to specific field s s u c h a s o b s te ­ trics, c h e s ts o r n e u ro lo g y w h e re a n a d e q u a te p o o l o f “ g e n e ra l p h y s io th e r a p is ts ” is a v a ila b le i.e. in th e la rg e r c e n tre s . T h e s e sp e c ia l in te re s ts a re n o t c o m ­ p a ra b le to m e d ic a l sp e c ia litie s a t p re s e n t, a n d th e . q u a lific a tio n s a re n o t re g is tra b le . ■ I a c k n o w le d g e th a t th e p o s itio n a t p r e s e n t is n o t w e a l, b u t I s u b m it t h a t it is w o rk a b le a s a n in te rim m e a su re . C e r ta in re c o m m e n d a tio n s h a v e b e e n fo rw a rd e d b y o u r A s s o c ia tio n to th e S o u th A f r ic a n S o c ie ty o f P h y s io th e ra p y a n d t h e S.A . M e d ic a l a n d D e n ta l C o u n c il fo r a p p ro v a l, w h ic h s h o u ld in th e lo n g te r m im p ro v e m a tte rs . I h o p e th is c le a rs u p th e s e m a tte r s so m e w h a t. M IS S B. W I N T E R H o n . S e c re ta ry (P riv a te P ra c titio n e r s A s s o c ia tio n ) N U W E L Y S V A N G E R E G 1S T R E E R D E M E D 1E SE S K E M A S B o g e n o c m d e lys is in S ta a ts k o e r a n t N o 7404 van 13 F e b ru a ric 1981 g c p u b lise e r. N E W L IS T O F R E G IS T E R E D M E D IC A L SC H E M E S T h e a b o v e list h a s b e e n p u b lis h e d in G o v e rn m e n t G a z e tte no. 7 404 o f 13 F e b r u a ry 1981. P .P .A . E X E C U T IV E C O M M IT T E E A t th e A n n u a l G e n e ra l M e e tin g h eld in J o h a n n e s b u rg o n 26 M a rc h 1981 th e fo llo w in g w e re ele cte d : P re sid e n t: M r. W. E . G . V a u g h a n C h a irm a n : M r. P. K ilb ey 1st V ic e c h a irm a n : M rs. P. Sw illing 2 n d V ice c h a irm a n : M r A . W eil H o n o r a r y S e c re ta ry : M iss B. W in te r H o n o ra ry T r e a s u r e r /R e g is tr a r : M r. J. J a a k k e H o n o ra ry A d v e rtis in g M a n a g e r: M rs G . B otha M iss S. O o s th u iz e n is H o n o r a r y L ife P re sid e n t a n d all B ra n ch C h a irm e n a re ex-cfficio m e m b e rs o f the E x e c u tiv e C o m m itte e . M rs P ilk in g to n w as m a d e an H o n o ra ry L ife M e m b e r. NEW APPARATUS E le c tro -M e d ic a l S u p p lie s (G re e n h a m ) L im ite d of W a n ta g e , U n ite d K in g d o m , h a v e d e v e lo p e d a new u ltra s o n ic th e ra p y u n it, th e E M S T h e ra s o n ic 1030 on w hich th e y su p p ly th e fo llo w in g in fo rm a tio n . T h e T h e ra s o n ic 1030 is a te c h n ic a lly a d v a n c e d u ltra s o n ic th e ra p y u n it a n d p ro v id e s th e P h y s io th e ra p is t w ith a c o m p le te ra n g e o f tre a tm e n t fa c ilitie s fo r th is m o d a lity . It in c o rp o ra te s th e fo llo w in g fe a tu re s . T w o o p e ra tin g fre q u e n c ie s 1 M H z fo r a d e e p e r p e n e tra tio n o f tissue (a p p ro x n ia e ly 5 0 % re d u c tio n in e n erg y a t a d e p th o f 5 cm in h u m a n so ft tissue) a n d 4 M H z w ith an a p ­ p ro x im a te ly 5 0 % re d u c tio n a t a d e p th o f 1,5 cm . 3 M H z is th e re fo re in d ic a te d fo r s p o rts in ju rie s a n d sc a r tissu e tre a tm e n ts . By in c o rp o ra tin g th e la te st e le c tro n ic c o n ­ s tru c tio n te c h n iq u e s it h a s b e e n p ossible to p ro v id e th ese tw o o u tp u ts o f 1 a n d 3 M H z fro m th e o n e f r e ­ q u e n c y h e a d a n d th e o n e c ry stal. F re q u e n c y se lec tio n is c a rrie d o u t by d e p ressin g illu m in a te d b u tto n s o n th e c o n tro l p a n e l. T h e re is no n e c e ssity to c h a n g e tr e a tm e n t h e a d s o r c ry sta ls to e ffe c t a c h a n g e o f fre q u e n c y . O u tp u t w hich is c o n tin u o u s ly v a ria b le is in d ic a te d on a d ire c t re a d in g o u tp u t m e te r sh o w in g b o th th e to ta l w a tts a n d th e w a tts p e r sq. cm b e in g d e liv e re d to th e p a tie n t. A n illu m in a te d d ig ita l tre a tm e n t tim e r is in c o rp o ­ r a te d w h ic h gives th e o p e r a to r im m e d ia te in d ic a tio n o f th e tim e le ft fo r a p a r tic u la r tre a tm e n t to be c o n ­ c lu d e d . A s m e n tio n e d p re v io u s ly th e re a re 3 p u lse d ra tio s of 1:2, 1:4 a n d 1:7 a v a ila b le in th e p u lse d m o d e on the T h e ra s o n ic 1030. A lig h tw e ig h t, e rg o n o m ic a lly -d e sig n e d tre a tm e n t h e a d is in c o rp o ra te d w h ic h h o u se s th e sp e c ia l tw in -fre q u e n c y c ry sta l; th is can be used in a p e n g rip o r w ith in the p a lm o f th e h a n d a n d is e x tre m e ly easy a n d c o m f o r t­ a b le to u se a n d a pply. T h e T h e ra s o n ic 1030 w h ic h is b u ilt to the la te st w orld sa fe ty s ta n d a rd s , has a sta in le ss ste el c o n tro l p a n e l, illu m in a te d c o n tro l b u tto n s a n d a n u n c lu tte re d c le a r la y o u t. A p a n e l so c k e t is fitte d to e n a b le a n y m a k e o r type o f m u sc le s tim u la to r to b e p lu gged in to th e T h e ra s o n ic 1030 so t h a t a c o m b in a tio n o u tp u t m ay b e u se d c o n ­ sistin g o f u ltra s o n ic a n d a low fre q u e n c y o r d ia d y n a m ic w a v e fo rm (e.g. e x p o n e n tia l c u rre n ts , fa ra d ic stim u la tio n , s q u a re w a v e g a lv a n ism , d ia d y n a m ic th e ra p y , etc.). S o le d is trib u to rs in th e R e p u b lic o f S o u th A fric a a re M e d ic a l D is trib u to rs (Pty) L im ite d . R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )