# PWR-083 — Thermal discrimination: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 9 min reading; practical time is provider-set Difficulty: Introductory Equipment: Common household or practice equipment — A clinic-approved calibrated thermal sensory device with a contact thermode—a temperature-controlled skin probe—and automatic safety limits.; Provider protocol, response button, skin inspection supplies and a settings/result sheet.; A stable supported position and the learner’s usual communication and mobility aids. Space: Room-scale practice space Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Detailed research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context Thermal discrimination is noticing a controlled change from a declared starting temperature at a named body site. A qualified clinician uses calibrated equipment, protects the skin, randomises trials and interprets thresholds. The learner still learns the response method, reports the first clear change and checks that the configuration stays constant. There is no home heat, ice or tolerance test. Target outcome: With a qualified clinician, the learner completes familiarisation and a declared set of calibrated warm and cool trials, producing separate site-specific detection results with symptoms and equipment settings recorded. ### Authority and setup conditions - Tell the clinician about skin damage, altered sensation, circulation issues, recent injury, medication changes and prior adverse reactions. - The clinician confirms the exact site is intact and suitable and explains warm detection, cool detection and the stop response. - Agree a plain stop word or button that ends a trial immediately without needing to justify it. ### Required or supplied materials - A clinic-approved calibrated thermal sensory device with a contact thermode—a temperature-controlled skin probe—and automatic safety limits. - Provider protocol, response button, skin inspection supplies and a settings/result sheet. - A stable supported position and the learner’s usual communication and mobility aids. ## 1. Declare the clinical question State whether the session concerns warm detection, cool detection or both, at which body site and for what legitimate clinical purpose. Why: A threshold has meaning only in its declared clinical context. Success check: The record names question, site and clinician before contact. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The record names question, site and clinician before contact.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Inspect and configure The clinician inspects the site, verifies the device, sets the starting temperature, change rate and protective limits, and records them. Why: Skin condition and stimulus parameters materially change the result and safety. Success check: Device identity, site, baseline and limits are written before trials. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Device identity, site, baseline and limits are written before trials.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Learn the first-change response During non-scored familiarisation, press the button or say now at the first clear change toward warm or cool. Do not wait for a strong or painful sensation. Why: The task measures detection, not endurance or certainty. Success check: The learner can explain and demonstrate the response before scored trials. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The learner can explain and demonstrate the response before scored trials.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Complete randomised trials Rest the tested part, keep eyes away from the display and respond once per provider-initiated trial. The clinician varies direction and catch trials according to the protocol. Why: Random order and catch trials reduce prediction and response habit. Success check: Every trial has direction, response, temperature and any deviation recorded. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Every trial has direction, response, temperature and any deviation recorded.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Pause and inspect Between blocks, report after-sensation, pain, numbness, anxiety or uncertainty. The clinician checks the site and decides whether to continue. Why: Repeated contact can change sensation or expose a problem that invalidates further testing. Success check: A continue or stop decision is documented after each block. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “A continue or stop decision is documented after each block.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Interpret within the site and protocol The clinician calculates separate warm and cool results, compares them only with suitable references or prior matched tests and explains measurement error. Why: A single number is not tissue safety, pain or whole-body thermoregulation. Success check: The result names direction, site, protocol, uncertainty and non-claims. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The result names direction, site, protocol, uncertainty and non-claims.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.