The Complex Hand: A Tool for Function
Embedded Files
I began my clinical journey as an occupational therapist at NYU Langone Health after receiving a Master's of Science in Occupational Therapy from Boston University. At NYU Langone Hospital-Brooklyn, where I first accepted a position, I gained experience in a variety of settings, such as: outpatient pediatrics, hand therapy, seating and mobility, and outpatient adult neurological rehabilitation. I fell in love with hand therapy due to the complexity of anatomy, process of orthotic fabrication and how quickly patients were able to regain function. I transferred to NYU Langone Orthopedic Center so I could focus on specializing in hand therapy. I was promoted to senior occupational therapist and became a member of their established hand therapy department. I was surrounding by intelligent and clinically gifted hand therapists who were eager to provide mentorship. I received training in treating all conditions of the upper extremity, mentored level II students and was provided with opportunities to get involved in research. However, I still wanted to learn more and develop my clinical skills further, and that is why I decided to enroll in NYU's doctoral of occupational therapy program.
While I continued to work and gain experience in hand therapy, I began to question some of the common areas of practice, like my professors taught me to do. I noticed that a specific group of patients continued to come back to the clinic year after year, without any improvement. I began to question why the standard protocol was not helping them. This group of patients had a commonality, they had a comorbidity that affected their healing ability and prognosis, such as: a patient with a scaphoid fracture that never healed because they had Rheumatoid Arthritis, or a patient with chronic wrist pain due to their lymphedema after cancer treatment or chronic thumb pain in a patient diagnosed with SLE. I became interested in figuring out how to help this group of patients that did not seem to improve with standard protocols.
In my clinic, once you pass the certified hand therapy (CHT) exam, you are given the opportunity to work one day a week at the surgeon's office, in which we fabricate orthoses for their patients. Orthotic fabrication is an important tool that occupational therapists use to improve and affect functional outcomes. As I worked with our hand surgeons, I questioned whether there was evidence and research that support the use of these orthoses. I first looked to my clinic for guidelines, but I realized there was no current training to improve orthotic fabrication skills or to educate staff members on the current evidence. Therefore, my goal with my doctoral education is to answer my two scholarly questions: how can I improve outcomes with orthopedic patients with comorbidities, and secondly, can orthotics assist to improve their function?
Thank you in advance for taking the time to read through my professional portfolio. First, you will be introduced to my professional goals that were created to demonstrate the necessary steps to answer my clinical questions. I used a metaphor of intricate hand tools to represent the development of my portfolio. Trowel, pliers and screwdrivers are tools that require finesse, understanding and advanced skill from the person using them in order to be successful in its use. These tools have a functional use that mirror the skills required to develop each artifact and to achieve the corresponding goal. You will read through presentations and papers that culminates with an orthotic fabrication handbook, my competence project, that provides occupational therapists with the knowledge to be confident and competent in orthotic fabrication that follows the most current, available evidence.
Thank you and enjoy!
Professional Goals
Goal 1: Trowel: Hand tool that functions as a spreader
Disseminate knowledge of complex hand impairments to colleagues through professional presentations.
AOTAs Standard for continuing competence: Knowledge, Interpersonal Abilities, & Critical Reasoning
Artifacts: Extensor Tendon Protocol Presentation ASHT E-Poster Presentation
Reflection: Reflection I
Goal 2: Pliers: Hand tool that functions as a gripper
Identify and utilize best practice techniques to assess and treat complex upper extremity conditions.
AOTAs Standard for continuing competence: Knowledge, Critical Reasoning, & Performance Skills
Artifacts: Clinical Tool: Knowledge Translation Systematic Review: Quality of Life following a Mastectomy
Reflection: Reflection II
Goal 3: Screwdriver: Hand tool that functions as a stabilizer
Demonstrate advanced knowledge of orthotic fabrication for complex upper extremity conditions through professional papers.
AOTAs Standard for continuing competence: Knowledge, Critical Reasoning, & Performance Skills
Artifacts: Published Article on Simulated Fusion of Joints of the Thumb Orthotic Fabrication Handbook
Reflection: Reflection III
Continue reading to goal 1: Trowel: Hand tool that functions as a spreader
Unless otherwise noted, images that are in the portfolio and/or artifacts are obtained from Jessica Emberger
Page updated
Report abuse