Conducting the DASH assessment with a rheumatological client

📄 You can download the full simulation scenario in your preferred language below:

🧩 Simulation Overview
The simulation offers the opportunity to learn, practise and conduct a structured assessment interview in a safe and simulated environment. The client being assessed has a rheumatological disease and mainly has limitations in his/her fingers. This causes many problems in coping with his/her everyday life. The aim of simulation is to carry out a diagnostic interview with the DASH assessment in order to gain a detailed insight into the impairments in everyday life. The simulation’s goal is to fill out the DASH while asking the client verbally since the client can’t fill out the assessment by himself/herself due to limitations of the hand. Calculating the final scoring as well as interpretating the outcome (documentation for e.g. follow-up OT session with the client) is not included in the simulation itself, though it might be used in a post SBL-assignment. 
Modality: Digital Student roles:
Occupational therapist  1   
Participant  1  In this scenario, the participant (client) who is interviewed as part of the occupational therapy process is being simulated by a student – though an actor would be possible for this scenario. 
Other simulated participant Please specify in extra information     
Observer  1<  Students not engaged directly in simulation observe process, make notes of observations, monitor learner’s application of communication skills and conducting an interview, pose questions and provide feedback during debriefing. They also get specific observations tasks which are given beforehand. 
Learning outcomes:
Learning outcomes (simOT Framework) 
 
Domain A: Knowledge and attitudes supporting OT competence 
  • A.1: Students possess knowledge about occupation and humans as occupational beings. 
  • A.2: Students possess knowledge about OT. 
  • A.5: Students possess general medical and professional knowledge about human anatomy and function of the human body. 
Domain B: Managing and conducting OT process 
  • B.2. Students demonstrate competencies in managing and conducting the occupational therapy process. 
  • B.2.1. Students assess occupational participation in all areas of human occupation (e.g. personal care, daily living, work/study/school, play, leisure and rest). 
Domain C: Developing and maintaining professional relationships and partnerships 
  • C.1. Students demonstrate competencies in engaging in effective professional communication. 
  • C.2.1 Students establish and maintain relationships and partnerships with clients. 
Domain D: Professional autonomy and continuous professional development   
Domain E: Promoting and advocating for the enhancement of the profession and social change   
Domain F: General professional skills and competencies 
  • F.1. Students demonstrate general professional competencies important for fulfilling responsibilities. 
🛠️ Preparation for the Simulation
Prerequisites:
Competencies  Specific description of prior knowledge, attitudes and skills 
Knowledge about occupations and theoretical model(s) for understanding occupation (A.1.) and client-centred and occupation-based OT practice (A.2.) 
  • Knowledge of the current evidence-based treatment of rheumatological diseases  
  • Knowledge of the DASH implementation 
 
A5: possess general medical and professional knowledge about human anatomy and function of the human body  Knowledge of background information about rheumatological diseases 
📦 Actions and Materials
Action  Materials 
Printing and preparing all materials 
  • Case study (short client description, general information about the simulation and specific information for the different roles) (prebriefing) 
  • DASH blank sheet, filled-out COPM sheet 
  • SimOT Compass (prebriefing)  
 
Preparing the environment of the simulation (if the scenario is conducted in presence while using the SimStation)  Arrange access to the simulation, control, and debriefing rooms.  Familiarize yourself with the SimStation system: 
  • Test cameras, microphones, and software. 
  • Learn how to record, mark, and replay sessions. 
Conduct a technical check before the session: 
  • Ensure all devices, batteries, and connections are working. 
  • Test audio and video recording/playback. 
Cameras positioned and adjusted: 
  • Microphones positioned and tested 
  • SimStation control console and software ready 
  • Display or projector in debriefing room ready 
Optional: whiteboard/flipchart and markers for debriefing discussion. 
Decision-making about the roles 
  • The simulation is carried out as part of a role play.  
  • The occupational therapist must be played by a student, the client is also played by one student but can also be played by actors. 
  • The student observers do get specific observation tasks for the simulation itself. 
Prepare the client/OT  The teacher prepares the students carrying out the simulation for the upcoming situation, gives them the necessary materials and wires them up. The teacher also instruct the role-playing students about how to communicate and gives instructions on communication rules so that they are well understood when transmitted via SimStation. The students should not sit with their backs to the camera, speak clearly and try not to interrupt each other.    IMPORTANT NOTE: Since Question 21 of the DASH is concerning sexual activity, the teacher must make sure that the students don’t feel overwhelmed/triggered with this question – address the question beforehand! 

Learning objectives (observable behaviour) 

 

Domain A 

The student knows the individual items of the DASH. 

Domain B 

The student conducts the DASH according to the manual and uses the DASH to assess factors that influence the client’s participation and/or activity performance. 

Domain C 

The student communicates with the client in a respectful, appropriate and effective manner and listens actively. 

Domain D 

 

Domain E 

 

Domain F 

The student solves any problems that arise when carrying out the DASH. 

Name 

Mr./Mrs. Christiner 

Age 

63 years old 

Sex 

Male/female  

(gender can be modified) 

Personal factors 

Married, two children who live away from home, four grandchildren 

Ethnicity and cultural context 

Austrian 

Reason the participant is seeking OT service and concerns related to engagement in occupations 

High-grade activated finger polyarthritis on both sides (Heberden/Bouchard), rhizarthrosis on both sides, restrictions in the performance of everyday activities