STANDARDIZED PATIENT SIMULATION REGISTRY
Pre-built, de-identified clinical cases. Evaluated on OTPF-4 clinical reasoning, skilled necessity, and payer compliance
CASE-NEU-B-4812
Beginner
Neurological
Cerebrovascular Accident (CVA) - Left Hemisphere Acute Infarct
Scored Evaluation Rubric
-
Clinical Reasoning Accuracy — OTPF-4 rationale and pathophysiology linkage
-
Skilled Necessity Justification — skilled intervention vs. caregiver/aide log
-
Audit-Defense & Payer Compliance — Medicare/payer denial resistance
Learning Objectives:
-
Document dynamic neuromuscular re-education strategies
-
Justify skilled necessity of upper-extremity tone reduction tasks
Show Objectives
CASE-ORT-I-9034
Intermediate
Musculoskeletal
Total Knee Arthroplasty (TKA) - Post-Surgical, Right Knee, POD 10
Scored Evaluation Rubric
-
Clinical Reasoning Accuracy — OTPF-4 rationale and pathophysiology linkage
-
Skilled Necessity Justification — skilled intervention vs. caregiver/aide log
-
Audit-Defense & Payer Compliance — Medicare/payer denial resistance
Learning Objectives:
-
Restore functional range of motion for stair negotiation and safe sit-to-stand transfers
-
Justify skilled necessity of therapeutic exercise and manual technique vs. a generic home exercise program.
Show Objectives
CASE-GER-A-1107
Advanced
Geriatric
Fall-Related Hip Fracture (Post-ORIF) with Mild Cognitive Impairment
Scored Evaluation Rubric
-
Clinical Reasoning Accuracy — OTPF-4 rationale and pathophysiology linkage
-
Skilled Necessity Justification — skilled intervention vs. caregiver/aide log
-
Audit-Defense & Payer Compliance — Medicare/payer denial resistance
Learning Objectives:
-
Improve functional transfers and standing balance to reduce fall risk
-
Document cognitive-linguistic considerations in skilled intervention planning and caregiver training
Show Objectives
FORCED REASONING ARCHITECTURE
Exemplar: Generic Free-Text Note
Forced Clinical
Reasoning Architecture.
Students cannot submit a passive free-text note. Every entry demands structured OTPF-4 justification before submission is accepted.
Without PraxisSim™
Session Notes
Worked with patient on shoulder exercises.
Patient did well. Will continue next session.
Goals: improve ROM. Patient tolerated treatment.
PraxisSim™ Structured Entry
✓ Skilled necessity of intervention must be explicitly stated
✓ Functional goal linkage required before submission
✓ Payer audit-defense language enforced at entry level
✓ OTPF-4 domain rationale mapped to every clinical action
OTPF-4 Performance Area: Upper extremity reaching for overhead ADL tasks requiring skilled OT analysis
Skilled Necessity Justification: Active-assisted AROM requires skilled OT for realtime neuromuscular feedback, activity grading, and tone normalization
Functional Goal Linkage: Client will demonstrate 90° shoulder flexion with sufficient motor control for overhead dressing tasks within 4 sessions
Payer Audit-Defense: Intervention addresses documented functional deficit in ADL performance. Skilled OT services medically necessary.
STUDENT DOCUMENTATION
Gibbs Reflective Cycle Framework.
Six structured sections guide every student entry post-simulation. No passive summaries. No unstructured free text.
01 Description —
What happened in the session?
02 Feelings —
What were you thinking and feeling?
03 Evaluation —
What was good and bad about the experience?
04 Analysis —
What sense can you make of the situation?
05 Conclusion —
What else could you have done?
06 Action Plan —
What will you do differently next time?
Add Reflective Note (Gibbs Template)
CASE-NEU-B-4812 · Student: M. Okafor · Session #14
Note Title *
Neuromuscular Re-Education Session Following Left Hemisphere CVA
Description
During this simulated session, I worked with a de-identified training case involving a client with left hemisphere acute infarct resulting in right-sided upper extremity hypertonicity and impaired motor planning
Feelings
Before the session, I felt uncertain about balancing facilitation and patient independence during neuromuscular re-education tasks. I was concerned about reinforcing compensatory movement patterns.
Evaluation
One positive aspect was the integration of functional movement tasks rather than isolated exercises. Incorporating reaching tasks related to dressing increased engagement while supporting occupation-based principles
3 - AXIS SUPERVISOR MICRO-RUBRIC
Faculty Evaluate in Under 90 Seconds.
Three axes mapped to essential entry-level skills. Each scored 1–5 against OTPF-4 Clinical Rationale, Skilled Action Distinction, and Payer Audit-Defense Compliance.
Axis 1 — OTPF-4 Clinical Rationale
Entries are scored on their ability to defend why on OT — not any caregiver or aide — is required to deliver the intervention.
Axis 2 — Skilled Action Distinction
Entries are scored on their ability to defend why a licensed OT — not any caregiver or aide — is required to deliver the intervention.
Axis 3 — Payer Audit-Defense Compliance
Documentation is scored against the language standards that survive Medicare and private payer review.
Supervisor Evaluation Panel
Student: M. Okafor - Entry #14 - Neurological Case 07
STUDENT ENTRY EXCERPT
"Facilitated active-assisted AROM of L shoulder (90° flex, 45° ABD) to address impaired reach patterns limiting client's ability to perform overhead ADL tasks. Intervention requires skilled OT for analysis..."
AXIS 1 - OTPF - 4 CLINICAL RATIONALE
1
2
3
4
5
Examplary
AXIS 2 - SKILLED ACTION DISTINCTION 12345 Pfiient
1
2
3
4
5
Proficient
AXIS 3 - PAYER AUDIT-DEFENSE COMPLIANCE
1
2
3
4
5
Examplary
COMPOSITE SCORE
4.67/5
LONGITUDINAL TRAJECTORY GRAPHS
Identify Performance Gaps Before Fieldwork Begins.
Dashboards automatically highlight students trending below critical target benchmarks — giving faculty time to intervene before a live clinical placement.
Early Warning System
Students flagged below benchmark 2+ weeks before their fieldwork placement window — giving faculty time to intervene
Programmatic Benchmarking
Compare cohort performance across semesters to document continuous program improvement for ACOTE self-study cycles.
ACOTE Evidence Export
In active development — available to pilot institutions before end of pilot term.
PLATFORM AT A GLANCE