Palliative care patients may benefit from occupational therapy (OT) and physical therapy (PT) intervention. Rehabilitation specialists are skilled at working with patients to set realistic and meaningful functional goals. Further study on rehabilitation treatment to improve quality of life among patients in palliative care is needed.

Objective 1) To identify English Language published patient-reported upper extremity outcome measures used in breast cancer research and 2) To examine construct validity and responsiveness in patient-reported upper extremity outcome measures used in breast cancer research. Data Sources PubMed, CINAHL and ProQuest MEDLINE® databases were searched up to February 5, 2013. Study Selection Studies were included if a patient-reported upper extremity outcome measure was administered, the participants were diagnosed with breast cancer, and published in English. Data Extraction Eight hundred and sixty-five articles were screened. Fifty-nine full text articles were assessed for eligibility. A total of 46 articles met the initial eligibility criteria for aim 1. Eleven of these articles reported mean and standard deviations for the outcome scores, and included a comparison group analysis for aim 2. Data Synthesis Construct validity was evaluated by calculating effect sizes for known group differences in 6 studies using the Disabilities of Arm, Shoulder and Hand (DASH), Penn Shoulder Score, Shoulder Disability Questionnaire-Dutch, and 10 Questions by Wingate (Wingate). Responsiveness was analyzed comparing a treatment and control group by calculating the coefficient of responsiveness in 5 studies for the DASH and Wingate. Conclusions Eight different patient-reported upper extremity outcome measures have been reported in the peer-review literature for women with breast cancer, some (n=3) were specifically developed for breast cancer survivors and others that were not (n=5). Based on the current evidence we recommend administering the DASH to assess patient-reported upper extremity function in breast cancer survivors because the DASH had most consistently large effects sizes for construct validity and responsiveness. Future large studies are needed for more definitive recommendations.

Introduction. High-fidelity simulationbased learning experiences (SBLEs) can improve student confidence for clinical practice, but there are several barriers to incorporating these activities into physical therapy program curricula. Review of Literature. Studies have explored high-fidelity acute care SBLEs in simulation laboratories, but little is known about the effectiveness of low-cost classroom-based SBLES in physical therapy education. Additionally, there is a gap in the literature related to the role of the active observer during SBLEs in physical therapy education. e purpose of this study was to uncover student perspectives about participating as both participant and observer in classroom-based SBLEs and the impact of this experience on preparedness for acute care clinical practice. Subjects. Subjects included a convenience sample of first-year doctor of physical therapy (DPT) students. Methods. Students participated in a series of classroom-based SBLEs as part of a firstyear DPT course. is mixed methods study included focus groups to qualitatively analyze student perspectives of classroom-based SBLEs and a pre-post quasi-experimental design to evaluate changes in perceived self-efficacy for acute care clinical practice before and after a series of classroom-based SBLEs using the Acute Care Confidence Survey (ACCS).Results. Quantitative data analysis (n = 60) revealed a statistically significant increase in perceived self-efficacy for the total ACCS (Z = 26.250, P < .000) and all 4 subscales from presimulation to postsimulation. Qualitative data analysis (n = 22) revealed 4 primary themes related to participating in classroom-based SBLEs: (1) psychological fidelity-it felt real; (2) promotes clinical reasoning for participants and observers;(3) stimulates self-reflection and observational learning; and (4) fosters self-efficacy for future clinical practice. Conclusion. Classroom-based SBLEs can provide a high-fidelity and cost-effective means of exposing students to a range of clinical situations that engage all participants in experiential learning through both direct participation and active observation.

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