Remote Occupational Therapy Assessment for Stroke: Administering the MMSE

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

This simulation focuses on assessing cognitive functions in a patient with stroke using the Mini Mental State Examination (MMSE) within a telerehabilitation setting. Designed for intermediate to advanced occupational therapy students, it allows learners to practice conducting cognitive assessments remotely, interpret findings, and communicate results professionally and empathetically. Students take on the role of an occupational therapist, working with a standardized patient in real time, and must navigate ethical, technical, and clinical reasoning challenges throughout the session.

Modality: Digital Student roles:

Student roles	Number of students	Extra information
Occupational therapist	1	Plays the active role; administers MMSE
Participant	1	Played by a trained peer or actor with background script
Other simulated participant Please specify in extra information	Optional caregiver	Included if interprofessional dynamic is desired
Observer	Up to 10	Observes silently; participates in debrief

Learning outcomes:

Learning outcomes (simOT Framework)

Domain A: Knowledge and attitudes supporting OT competence	Students demonstrate understanding of cognitive assessment concepts (e.g., memory, attention, orientation) and their relevance in post-stroke rehabilitation using the MMSE.
Domain B: Managing and conducting OT process	Students conduct and score the MMSE in a telerehabilitation setting while adhering to professional and ethical protocols.
Domain C: Developing and maintaining professional relationships and partnerships	Students communicate respectfully and empathetically with the client, ensuring understanding and consent throughout the session.
Domain D: Professional autonomy and continuous professional development	Students reflect on their performance and identify areas for improvement in assessment delivery, communication, and clinical reasoning.
Domain E: Promoting and advocating for the enhancement of the profession and social change	Students demonstrate the potential of telehealth technologies in improving access to cognitive rehabilitation services.
Domain F: General professional skills and competencies	Students manage time, technology, and documentation accurately and professionally in a remote clinical setting.

🛠️ Preparation for the Simulation

Prerequisites:

Competencies	Specific description of prior knowledge, attitudes and skills
Cognitive assessment knowledge	Students understand the MMSE’s purpose, structure, domains (e.g., orientation, attention, memory), and scoring.
Occupational therapy theory	Familiarity with how cognitive function affects occupational performance, particularly in stroke rehab contexts.
Ethical and professional practice	Awareness of ethical standards for cognitive testing (e.g., informed consent, confidentiality, avoiding test bias).
Communication and client-centered care	Ability to adapt language, check understanding, and build rapport with clients with cognitive impairments.
Technological proficiency	Basic use of Zoom/Teams, including screen sharing, muting/unmuting, and troubleshooting common issues.
Clinical reasoning	Ability to link MMSE findings with occupational challenges and to plan next steps accordingly.

📦 Actions and Materials

Action	Materials
Test technical setup	Computer, webcam, microphone, stable internet; pre-loaded Zoom/Teams; MMSE form (print or digital)
Brief students on simulation objectives and roles	Simulation briefing sheet, learning objectives summary
Assign roles and distribute materials	Role cards for OT and simulated patient; observer checklist (if applicable)
Prepare MMSE assessment materials	Printed/digital MMSE form, pen and paper, shape copying sheet, sentence “Close your eyes”
Launch simulation	Zoom/Teams link; screen sharing tools ready
Monitor simulation and observe performance	Observation rubric/checklist, timer
Facilitate debriefing session	PEARLS debriefing script; flipchart or virtual whiteboard
Provide written or verbal feedback	Performance checklist; optional individual feedback form

Learning objectives (observable behaviour)

Domain A	Accurately describe the purpose, structure, and scoring criteria of the MMSE; identify which cognitive domains are assessed and their relevance to occupational performance.
Domain B	Conduct the MMSE in correct sequence, ensure ethical practice (e.g., no prompting during memory phases), and interpret results in relation to OT goals.
Domain C	Use empathetic and client-centered communication to build rapport, explain the process clearly, and check for understanding throughout the assessment.
Domain D	Reflect in writing on personal strengths and challenges experienced during the simulation and suggest one area for clinical improvement.
Domain E	Articulate the advantages and limitations of using telehealth to deliver cognitive assessments in underserved or remote populations.
Domain F	Navigate the video conferencing platform, share necessary materials (e.g., MMSE sheet), take notes, and submit an accurate and timely assessment report.

Name	Merve Kaya
Age	44 years old
Sex	Female
Personal factors	Highly motivated, positive attitude, strong desire to regain independence; lives with supportive spouse and children.
Ethnicity and cultural context	Turkish; homemaker; family-oriented; accustomed to collaborative decision-making with spouse.
Reason the participant is seeking OT service and concerns related to engagement in occupations	Post-stroke cognitive and physical rehabilitation; challenges with memory, attention, fine motor coordination, and daily functioning in household tasks.