Determining What You Know (& What You Don’t)

If you’ve just tuned in: I am studying to take the ATP exam (the practice one, since I don’t have the hands-on experience to take the real RESNA exam).
My mentor this issue is Phil Wegman, ATP, CRTS, of Halls Medical in Centralia, Wash. Phil shared his own experiences with the exam, in keeping with our theme of the month: Identifying what exam topics you’ll need to learn and tapping into the knowledge you already have.

What I Learned from the Exam Review Course
I’ve now completed an online ATP exam review course offered by the University of Pittsburgh’s Department of Rehabilitation Science & Technology and presented by Mark Schmeler, Ph.D., OTR/L, ATP, and Kendra Betz, MSPT, ATP.

There are other review courses — check for possibilities — but I chose Pitt’s because Mark and Kendra have both taken and passed the exam, and their review course’s format worked for me. Once you submit payment, you get a log-in url and a password good for unlimited access to the course for two weeks. The course is broken into four parts running roughly two hours apiece, and I liked the flexibility of being able to “pause” the presentation to jot down notes or grab a snack. I also liked the downloadable pdfs — copies of the presentation shown during the course — that I could use as notes later.

To prepare for part one of the review course, I grabbed a notebook, a pen and a cup of tea, got comfortable in my chair, fired up my laptop and took a cleansing breath. During his turn as mentor in January/February, Mark had said the course was a tool to help me determine what I did and didn’t know. No need to panic if I wasn’t an expert on what I was about to hear.

A Humbling Start, Then Good News
Turns out that cleansing breath wasn’t deep or long enough. The first part of the review course covered anatomy — not a strong suit for an English major like me. Some of the material about bones, joints and muscles sounded familiar, in a high school biology class kind of way. But I sank lower in my chair as I heard terms like “macular degeneration.”

“Why,” I demanded of my laptop, “do I need to know about macular degeneration for a seating and mobility exam? Why?”
Enter: Phil Wegman, mentor of the month.
“There were aspects of the RESNA exam that most ATPs will never see in their careers,” he agrees. “Still, just as a general-practice MD must know something about areas of specialized medicine such as neurology, an ATP should have at least a basic understanding of the more complex aspects of assistive technology, as well as funding issues. Perhaps more importantly, a good understanding of these makes an ATP invaluable to therapists and even physicians, who often depend on the ATP to explain how something works or what the benefit to the patient might be.”

I remembered Phil’s words of wisdom later, when the review course touched on additional unfamiliar topics, such as augmentative communication. And I kept an open mind when Kendra Betz, in the review course, explained that if an ATP understood macular degeneration, he or she would be better equipped to build an effective mobility system. (By the way: Macular degeneration, a common cause of blindness in seniors, causes loss of vision in the center of the patient’s visual field, though peripheral vision often remains intact. A provider who knows that might consider different types of electronic displays for the client’s power chair!)

The good news: As the review course went on, the content did sound more familiar. I seemed to know the basics, and sometimes more, about pressure ulcers, medical conditions that affected mobility, and types of wheelchairs (power vs. manual, dependent propulsion vs. independent propulsion). I will have to brush up on some details about spinal muscular atrophy. But do I understand that a wheelchair’s ideal armrest length is determined not just by positioning needs, but also environmental needs, such as whether the armrests will bump up against a table or desktop? Yes!

I was also familiar with wheelchairs used as seating in motor vehicles. To my pleasant surprise, I even knew some of the assistive technology content involving interfaces, input and access. Hooray!

What You Know vs. What You Don’t
Mark had explained that a review course’s goal is not to teach the content, but to identify a candidate’s strong and weak knowledge areas. And the Pitt review course delivered that, big time: I figured out what I need to really study (anatomy and most of the assistive technology material) and what I just need to review (medical conditions, seating & mobility equipment, etc.).

I asked Phil which exam topics had been familiar to him, and which had required more study.
“Wheelchair types and specialized seating and positioning were the most familiar parts of the test,” he says, “followed by options for funding. Medical terminology and progression of disease states also came rather easy, due to my history in medical transcription and quite a bit of hands-on experience in the field.”

On the other hand, “The augmentative communication and environmental controls portion required some study and was the most difficult part for me, as I had only dealt with this in a small way prior to taking the test,” Phil says. “Since then, I’ve had the opportunity to help several clients with special communications needs, so the study required for the test really helped me.”

That best-case scenario — in which studying for a pencil-and-paper test actually translated to better results in the real world, and vice versa — became a theme as Phil and I chatted back and forth. For instance, “I did purchase muscular anatomy posters prior to taking the test, mostly to help me in my correspondence with therapists,” he says. “Therapists, nurses, and physicians really appreciate working with a provider who can speak the language of medicine as it relates to our field.”

The Value of Certification in Today’s World
Phil is obviously a staunch believer in continuing education and the need for seating & mobility providers to be able to work and communicate effectively with other health-care professionals.

In addition to holding RESNA ATP certification, he is also a member of NRRTS, the National Registry of Rehab Technology Suppliers. Together, the two credentials “are the perfect pair for those hoping to make a career in this industry,” Phil says. “The NRRTS credential further solidifies and validates the professionalism and experience of the RESNA ATP” in part, he notes, because NRRTS registrants must have three referrals from medical professionals, including PTs, OTs and physicians. (See NRRTS sidebar.)

“The industry as a whole benefits when providers carry both NRRTS and RESNA certifications because it strengthens the overall professionalism of the group, and more importantly, benefits the end-user,” Phil says. “On the political front, carrying both certifications shows politicians and funding sources that we as an industry are serious about being educated, professional, and ethical.”

Resources, as Suggested by Phil Wegman, ATP

Cook & Hussey’s Assistive Technology: Principles & Practice: “The best resource to pass the RESNA exam, in my opinion. Many questions on the exam seem to be taken right off of the pages of this book.”

Visual aids: “I went online and purchased anatomical posters — like you see in doctors’ and chiropractors’ offices — specific to skeletal structure and muscular anatomy. I keep these on the wall of my office and referenced them frequently when studying.”
Medical terminology class at a local community college: “I found this to be invaluable in understanding progress notes and learning how to speak with authority to doctors and therapists.”

Laptop computer, highlighter pen, notebook “also really help. So does some good coffee.”

My Financial Investment So Far — Assistive Technology: Principles & Practice (Albert Cook & Janice Miller Polgar); The Human Anatomy Coloring Book (Margaret Matt); Fundamentals of Assistive Technology (Michelle L. Lange); colored pencils; the University of Pittsburgh’s online exam review course. Total cost, including shipping and sales tax: $346.56.

Q&A: Weesie Walker, ATP, President, NRRTS

Q: What’s the definition of the NRRTS credential?
A: NRRTS offers two credentials: RRTS and CRTS. RRTS is an individual who is a registrant by successfully fulfilling the criteria. CRTS is a NRRTS registrant who has passed the RESNA ATP exam and has been a registrant in good standing for two years.

Q: What are the qualifications to join NRRTS?
A: At least one year of experience as a rehabilitation technology supplier. A rehabilitation technology supplier is a specialist who:
•    is currently working for a medical equipment company that supplies rehabilitation equipment and employs support staff capable of providing ongoing service and consumer support;
•    participates directly in the assessment process by offering product choices from multiple manufacturers, by offering product categories from different product lines, and provides pricing and funding information to the consumer and referral sources;
•    works with manufacturers and/or custom fabricators to combine equipment features to meet specific client needs;
•    provides fittings and deliveries as directed by the referring professional(s);
•    provides clients with instruction in the safe use of the equipment, offers information on maintenance and care, passes on warranty information and supports the equipment supplied with timely, high-quality service.

(RTS’s must also provide) three recommendations from allied health professionals, e.g., physical therapists, occupational therapists, etc., who work in three different facilities; (and complete) at least 15 contact hours of continuing education in the field of seating and wheeled mobility within the 12 months immediately preceding the date.

Q: Is it true that NRRTS was not in favor of combining ATS and ATP certifications into a single Assistive Technology Professional certification?
A: RESNA’s decision to consolidate the AT certification was arrived at after much deliberation on their part. Many people did not see the benefit of the change, but, as we move forward, I believe that by offering an advanced certificate in Seating and Mobility, the benefits will be more obvious. To that end, NRRTS is very involved in the RESNA work group to define this next step. We are convinced that this will carry more weight with funding sources as well. Many people lost sight of the fact that the RESNA credential only demonstrates that an individual possesses a base line of knowledge in the field of AT and does not measure skill.
— Weesie Walker works out of National Seating & Mobility’s Atlanta office.

This article originally appeared in the March 2009 issue of Mobility Management.

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