CVR Physiotherapy › Technique cards › Exam skills
Answer writing: the paper, ICF, goals and documentation
Every one of the 20 papers (2016–2026) had the same shape, and almost every long answer asks for ICF, a functional diagnosis or impairments, goals and management. Marks follow structure as much as knowledge. This page turns the notes into answers that score.
- Syllabus
- Ch 5 Application of ICF model: short- and long-term goals; patient-specific goals with time frames and clinical reasoning; documentation
- Priority
- Essential. ICF and goals are asked in nearly every long answer; structure decides marks in all sections.
- Asked as
- Nearly every long answer (ICF, goals)
- Usual split
- Applies to every question
- Checked against
- WHO ICF (2001); MUHS question papers 2016–2026; SOAP documentation conventions. Full list under Sources.
- Content checked
- 19 October 2026. Next review due October 2027.
- My revision
-
1The paper and a time plan
All 20 papers from 2016 to 2026 used this pattern (no MCQs, although the syllabus prints a different scheme): 80 marks in 3 hours, one answer book.
| Question | Choice | Marks | Time to spend |
|---|---|---|---|
| Read and choose | Tick your choices; plan the long answers | – | 5 min |
| Q1 short answers | Any 5 of 6 | 5 × 3 = 15 | About 6 min each (30 min) |
| Q2 short answers | Any 5 of 6 | 5 × 7 = 35 | About 14 min each (70 min) |
| Q3 and Q4 long answers | Any 1 of 2 each (patient cases) | 2 × 15 = 30 | About 30 min each (60 min) |
| Revise | Underline keywords, add missing doses and precautions | – | 15 min |
- About 2 minutes a mark. Never spend 20 minutes on a 3-mark answer.
- If you write slowly, do the two long answers first, so 30 marks are safe; never leave them for the last 20 minutes.
- Choose the long-answer option whose condition you know best, not the shorter-looking question.
2Short answers: 3 and 7 marks
3 marks (about half a page)
- One-line definition.
- Three to five points, a small table, or a labelled sketch (numbers, values, names).
- One line of physiotherapy relevance if it fits.
Definition: ratio of ankle to arm systolic pressure, measured with a Doppler. Formula: highest ankle ÷ highest brachial pressure, for each leg. Interpretation: 0.91–1.40 normal, 0.90 or less PAD, below 0.40 severe, above 1.40 non-compressible arteries. Use: diagnosis of PAD and a check before compression bandaging.
7 marks (1.5–2 pages)
- Definition or introduction (2 lines).
- Principle, classification or "why" (a flowchart is ideal).
- The main body as 6–8 headed points or a table: technique with dose, or management by phase.
- A labelled diagram where one exists (cycle, positions, curve, timeline).
- Precautions and contraindications.
- One concluding line (evidence or outcome measure).
Each technique card and condition page has an answer skeleton with marks for the questions actually asked.
3Long answers: the 15-mark case
- Read the split (for example 5 + 5 + 5 or 3 + 4 + 8) and give each part space in proportion.
- Underline the case clues: age, occupation, earning role, home (stairs, lives alone), day after surgery, drains, settings, test results, what the patient wants.
- Functional diagnosis in one sentence, then the ICF table with a "clinical reasoning" column (section 4).
- Problem list in order of priority.
- Goals: short-term and long-term, SMART, with time frames (section 5).
- Management: by phase or by impairment, with technique, dose and reason; precautions and stop criteria; education and home programme.
- Outcome measures and discharge or progression criteria in one or two lines.
Write doses with units (repetitions, sets, times a day, minutes, RPE, % HRR); a plan without doses loses marks.
4Applying the ICF model (Ch 5)
The WHO International Classification of Functioning, Disability and Health (ICF) describes a person's health as the interaction of the health condition with body functions and structures, activities and participation, and contextual factors. The model diagram is drawn on the IHD page, section 10; draw it in every long answer.
| Component | Meaning | Typical clues in the question |
|---|---|---|
| Health condition | The diagnosis and its stage | "CABG 3 days back", "post-Koch's bronchiectasis", "40% burns" |
| Body functions and structures (impairments) | Problems in body parts or functions | Pain VAS 6, breathlessness, sputum, reduced expansion, weakness, stiff shoulder, oedema, low SpO₂ |
| Activity limitations | Difficulty doing tasks | Cannot sit or sleep, cannot climb stairs, cannot walk to the field, difficulty with self-care |
| Participation restrictions | Difficulty in life roles | Cannot work as a driver, teacher or cook; only earning member; misses school; embarrassed to meet people |
| Environmental factors | Facilitators and barriers around the person | 2nd floor with no lift, lives alone, family support, cost, dusty job, distance to hospital |
| Personal factors | The person's own features | Age, smoker, motivation, fear, "wants to resume job early", "ignored advice" |
"[Age]-year-old [occupation] with [health condition, day or stage], presenting with [3–4 key impairments], leading to [activity limitations], restricting [participation], with [main facilitator] and [main barrier]."
Common mistakes: listing symptoms as participation; leaving out contextual factors; writing a disease description instead of function; not linking each impairment to a treatment.
5Goals with time frames (Ch 5a, 5b)
Goals should be SMART: Specific, Measurable, Achievable, Relevant to the patient, Time-bound. Write them as what the patient will do.
| Type | Time frame | Example |
|---|---|---|
| Short-term | Days to about 2 weeks (in hospital, or early rehab) | "Clears sputum independently with ACBT within 3 days"; "walks 100 m on the ward with RPE below 13 by discharge" |
| Long-term | About 6–12 weeks or more (end of the programme) | "Returns to driving to work (1 hour) by 6 weeks"; "climbs to the 2nd floor with one rest by 8 weeks" |
| Case | Long-term goal |
|---|---|
| Bank manager after angioplasty who drives 1 hour to work (S20) | Drives to work and completes a full working day without symptoms by about 4 weeks, after clearance |
| Tiffin cook after mastectomy (S19) | Cooks for ten clients twice a day, lifting cooking vessels with the operated arm, by about 8–12 weeks, with lymphoedema precautions |
| Farmer with COPD (S17) | Walks to the field and does light farm work with pacing, without an exacerbation, by 12 weeks |
| Milkman after below-knee amputation (S19) | Delivers door to door with a prosthesis, managing stairs, within the rehabilitation programme |
| Schoolchild with asthma (S23, W22) | Attends school every day and joins outdoor play with a warm-up and reliever plan |
Clinical reasoning: link each goal to an impairment and each treatment to a goal ("because...").
6Documentation (Ch 5c): SOAP notes
| Part | What to write | Example: day 3 after CABG |
|---|---|---|
| S: Subjective | What the patient reports | "Wound pain 4/10 on coughing; slept 4 hours; wants to walk to the toilet." |
| O: Objective | Measured findings and treatment given | HR 92, BP 130/84, SpO₂ 95% on air; reduced breath sounds at the left base; walked 40 m with RPE 12; ACBT 3 cycles |
| A: Assessment | Your interpretation and progress towards goals | Left basal collapse improving; tolerating Phase I progression |
| P: Plan | Next steps | Continue ACBT 2-hourly; walk 3–4 times a day, progress to 80 m; stairs trial tomorrow |
Also record consent, precautions, adverse events and outcome measures with dates. The practical-exam journal (5 marks) follows the same headings plus ICF, prognosis and intervention.
7Presentation that earns marks
- Headings, numbered points and tables; one idea per line.
- Underline the keywords listed in each exam corner (for example ICF, FITT, RPE, sternal precautions).
- Labelled diagrams: ICF model, ACBT cycle, drainage positions, CR phases timeline, rule of nines, spirogram.
- Always include precautions and stop criteria in management answers.
- Keep pathology short unless it is asked; spend the space on physiotherapy.
- Leave a few lines after each answer for additions during revision.
Checklist before you hand in
- Every part of every split answered?
- Doses with units? Time frames on goals?
- Precautions written? Diagram labelled?
- Question numbers written correctly in the margin?
Sources
- MUHS BPTh syllabus (2012), CVR Ch 5; MUHS IV BPTh question papers 2016–2026 (muhsonline.com, unofficial archive; Dhole Patil College of Physiotherapy past-paper page).
- World Health Organization. International Classification of Functioning, Disability and Health (ICF), 2001.
- Weed LL. Medical records that guide and teach (problem-oriented record and SOAP notes). N Engl J Med 1968.
Educational notes for exam preparation.
Version 1. Content checked 19 October 2026. Next review October 2027.