Hand Therapy Fellowship Program: Evaluation

Hand Therapy Fellow Evaluation


It is expected that the candidate will practice in a client centered manner at all times, and will function as an integral member of the team, demonstrating excellent communication skills and practice as per the standards of the College of Occupational Therapists of Ontario (COTO) or the College of Physiotherapists of Ontario (CPO). Furthermore, the Fellow will consistently demonstrate the values of St. Joseph’s Health Care London: respect, excellence and compassion.

Each candidate who applies to the fellowship program will determine and document specific and individualized objectives based on their learning needs and what they expect to achieve through the fellowship program.

The fellow’s learning objectives should coincide with the competencies listed below. Evaluation and evidence of achieving their learning objectives can be monitored and measured in consideration of these competencies.

Through providing assessment and treatment plans to patients, and through dialogue and consultation with surgeons and colleagues, the fellow must be able to clearly demonstrate the indicators for the following competencies by the end of their fellowship program:

Practice Knowledge

  • Demonstrates an understanding of detailed anatomy of the upper extremity
  • Demonstrates the ability to effectively articulate clinical knowledge of the specific conditions stated in their learning objectives
  • Articulates and demonstrates principles of orthotic fabrication for both dynamic and static orthoses
  • Applies the principles of logic and the scientific method to practice:
    • Presents concise arguments and/or rationale for clinical decisions
    • Utilizes information from multiple data sources to make clinical decisions
    • Seeks disconfirming evidence as appropriate
    • Describes sources of error in the collection of clinical data
  • Demonstrates the ability to perform detailed upper extremity examination of conditions outlined in the learning objectives

Clinical Reasoning

  • Demonstrates clear and sound clinical reasoning skills, incorporating hand therapy or procedural practice guidelines/protocols when designing treatment plans related to the specific conditions articulated in the learning objectives
  • These reasoning skills would include incorporating knowledge of bone/tissue healing, being able to explain the sequelae, understanding the implications of the stages of wound healing to hand therapy interventions
  • Demonstrates the use of evidence to support clinical reasoning
  • Evaluate clinical findings to determine a clinical diagnosis/disorder and outcomes of care:
    • Synthesizes examination data and interprets clinical findings
    • Identifies the potential differential diagnoses,
    • Identifies other medical or psychological problems that may influence therapy
    • Evaluates changes in patient status

Facilitating Change with a Practice Process


  • Demonstrates efficiency and competency in performing an upper extremity assessment, particularly of those conditions outlined in the learning objectives
  • Clearly demonstrates effective decision making and clinical reasoning choosing appropriate tools/screens


  • Demonstrates a comprehensive understanding and incorporation of practice knowledge in formulating treatment plans, particularly those articulated in the learning objectives.
  • Demonstrates practice knowledge and clear rationale in implementing, progressing, and modifying treatment plans.
  • Adjusts the plan of care in response to changes in patient status and phases of wound healing.
  • Establishes a plan of care designed to produce the maximum patient outcome(s) utilizing current evidence and resources

Professional Development

  • Identifies skill areas for further development relative to the client population
  • Assumes accountability to ensure learning needs are met
  • Completes one project in an area of interest to improve care to the clients of the Roth McFarlane Centre team, or to enhance the learning of the fellow of a specific condition, assessment or intervention

Orthotic Principles and Fabrication

  • Demonstrate clear and precise reasoning as to the type of orthosis required based on the client’s condition and presentation
  • Demonstrates ability to select appropriate orthotic fabrication materials
  • Demonstrates application of orthotic fabrication principles including:
    • Pressure and force distribution
    • Angle of pull
    • Designs to minimize the compressive forces placed on the involved joint
  • Demonstrates understanding of orthotic purpose and wearing schedule
  • Interprets clinical findings to determine further need or adaptations which may need to made to the orthosis wearing program
  • Evaluates changes in patient status to determine discharge of orthosis

Goals identified by the fellow should be formatted using the SMART Method (Specific, Measurable, Achievable, Realistic and Time oriented). As noted above, the goals should encompass the competencies described above.

The fellow’s progress toward achieving the learning goals will be evaluated by the fellow’s mentor/supervisor at a mutually determined mid-way point throughout the fellowship (midterm evaluation) and at the end of the fellowship (final evaluation).

Any concerns with regard to the fellow’s progress toward his/her identified goals and/or his/her ability to demonstrate the core competencies must be brought to the attention of the program coordinator and relevant professional practice leader as soon as possible for resolution.