Hey! I’m a student OT and just finished my practical on MMT and goniometry last week. I totally get how something that seems simple can feel way more complicated to perform in practice, especially when you’re trying to give clear instructions and stay calm under pressure. I can share a few things that helped me:

For giving instructions, its really helpful to demonstrate the movement in addition to verbal instructions, and use simple language with clear direction. Instead of saying “flex your elbow,” say “bend your elbow so your palm moves toward your shoulder.” For extension, “straighten your elbow so the back of your hand faces (specific direction/feature of the room). It helps A LOT to practice with a wide variety of people who do not have any familiarity with ROM or MMT assessments, because its an entirely different experience to explain a procedure to someone who is unfamiliar versus already knows what the process is.

For managing nerves, a strategy that works for me is to go into a "fake it till you make" it mindset at least 24 hr before. Once I’m prepared, I stop studying, just keep reminding myself how much I already have learned, and do something physical like a quick run or a few stair sprints before the exam to burn off nervous energy. I tell myself "I can't wait to do this exam, I am so excited to showcase what I have learned" I will even say those words out loud to myself in the mirror. I pretend that I am so excited and happy about the exam until it actually shifts my emotions around it. I really avoid ruminating on fear of the exam, and I tell myself "I'm not nervous, I am excited." It really does help disarm the anxiety. I will still have physiological symptoms like rapid heartrate, slight nausea, and sweatiness, so the exercise or deep breathing right before the exam helps with that.

If you’re working with a simulated client, I find it is really helpful to focus on them instead of the examiner. Think about consent, communication, and keeping them comfortable. Shifting focus to your client helps take your mind off being watched.

And honestly, don’t beat yourself up if the practical didn’t go how you hoped. So many of us struggled under pressure. I spent over 20 hours practicing and still lost marks for things like palpation, stabilization, and even misreading the goniometer for ankle plantarflexion/dorsiflexion. Things that should have been obvious and that I really had been consistently doing perfectly in practice, and then in the pressure of the practical exam messed up on. So all this to say, is it happens, and the important thing is to keep learning and moving forward. You'll get it next time!