ADL-training with a neurological client: dressing the upper body

Teacher Guidelines
Student Learning Objectives
Role Simulated Participant

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

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🧩 Simulation Overview

The simulation provides an opportunity to learn, practice and perform a structured observation situation and give verbal instructions on the activity of dressing (putting on a t-shirt and jacket) in a safe and simulated environment of a therapy room in a rehabilitation clinic. The client to be observed has been diagnosed with a brachial plexus injury after a heavy motorbike accident. He also shows cognitive deficits in short-term memory and memorizing ability throughout the rehabilitation stay (which the therapist is not informed yet). The aim of the therapy session is to provide instructions on how to put on a t-shirt and a jacket with one functional hand as well as to provide advice regarding strategies to close the jacket The aim of the therapy session is to provide advice on how to avoid falls in the future, taking into account diabetic retinopathy and the risk of falling due to symptoms of frailty. Possible adaptations should be discussed. The occupational therapist should also convince the husband of the need for adaptations in the bathroom, as he does not want to install any devices (e.g. grab rails / curtains) in the bathroom for aesthetic reasons. Modality: Hands-on Student roles:

Student roles	Number of students	Extra information
Occupational therapist	1
Participant	1	In this scenario, the participant (client) attending the occupational therapy consultation is being simulated by a student.
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 interview protocol, and pose questions and provide feedback during debriefing. They also get specific observations tasks which are given beforehand.

Learning outcomes:

Domain A: Knowledge and attitudes supporting OT competence
Domain B: Managing and conducting OT process	Planning and conducting the occupational therapy intervention of dressing the upper extremity and giving advice in terms of further strategies · B.1. Occupational therapists demonstrate competencies in professional reasoning during the occupational therapy process. · B.2. Occupational therapists demonstrate competencies in managing and conducting the occupational therapy process. · B.2.3. Occupational therapists demonstrate competencies for implementing, monitoring, evaluating, adjusting, and concluding occupational therapy interventions.
Domain C: Developing and maintaining professional relationships and partnerships	Verbal communication skills, client counselling, showing understanding, support and compassion to the client · C.1. Occupational therapists demonstrate competencies in engaging in effective professional communication. · C.2.1. Occupational therapists establish and maintain relationships and partnerships with clients.

🛠️ Preparation for the Simulation

Prerequisites:

Competencies	Specific description of prior knowledge, attitudes and skills
A.1. Occupational therapists possess knowledge about occupation and humans as occupational beings	Knowledge about occupation itself
A.5. Occupational therapists possess general medical and professional knowledge about:	Knowledge about neurological diseases or symptoms like peripheral nerve disorders
B.1. Occupational therapists demonstrate competencies in professional reasoning during the occupational therapy process.	Creative problem-solving strategies in communication in challenging situations
C.1. Occupational therapists demonstrate competencies in engaging in effective professional communication.	Communication skills throughout the occupational therapy process and handling challenging situations

📦 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) · SimOT Compass (prebriefing) · Devices and adaptation options for dressing a t-shirt and jacket in the simulation room · bandages for client in the simulation room
Preparing the environment of the simulation	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 OT is provided with equipment to help him/her get into the role and is also wired and fitted with a headset. · The client is provided with equipment to help him/her get into role (weighted bandage on the left arm) and is also wired and fitted with a headset.

Learning objectives (observable behaviour)

Domain A
Domain B	· Students will be able to instruct the client verbally or tactilely in putting on a t-shirt with one hand. · Students will be able to give advice to the client on strategies or modifications for putting on the jacket with one hand. · Students will be able to pass on for memorising strategies for dressing the upper extremity while using visual, physical or written reminders.
Domain C	· Students will be able to give clear instruction of how-to put on clothing for the upper extremity. · Students show understanding of the unknown situation of undressing oneself in front of a therapist. · Students respond promptly and effectively to questions and concerns raised by the client about how to dress up at home all by himself.

Name	Maximilian Huber
Age	39 years (age can be modified, also possible for paediatrics, e.g. a teenager who just had a moped accident)
Sex	male
Personal factors	The client is an IT specialist working for a mid-sized company. Before the accident, he worked full-time and had built a solid reputation within the company due to his expertise and dedication.
Ethnicity and cultural context	Austrian
Reason the participant is seeking OT service and concerns related to engagement in occupations	OT intervention focussing enhancing self-independence in ADLs like getting (un)dressed by himself after a brachial plexus injury after a heavy motorbike accident