Almost Done reflections

It feels incredible for most of us to have completed the three major clinical placements. I got up Friday morning and felt excited for the very first time in a long while. Feelings such as excitement and euphoria have been hiding dormant, suppressed by the stress of living under the microscope for far too long. Now it is onto the PCR for Curtin to find that final straw to break our backs. Sorry, I am just dragging things out here.

I was very happy with my last placement being neural. Of all three placements, I feel neural brings out the most Bobby Flynn in all of us. Cardio made me feel like a technician, musculo is where my interest lies and brought out the pragmatic in me, but neural required that I dig deep and quickly develop astute observational skills and a high degree of touch. I had to really feel for patient’s movements (or lack thereof) and reciprocate further movement such that it would achieve the outcome I wanted, almost like a dance. I found that to be as near an art form as anyone can hope for as a physiotherapist. Overall, it was a positive experience.

A correction is also is order. Earlier, I discussed a couple articles that came to the conclusions Bobath techniques were either less or equivalent in effectiveness compared with motor relearning. After using Steve’s methods to analyse the articles, design flaws marred the researching findings. In short, both studies were unable to adequately ensure one group received true expert Bobath or motor relearning approaches. That teaches me to jump to conclusions too quickly, whether it be out of frustration or not.

Thanks for the interesting forum discussions everyone.

Real Time Ultrasound

On the last day of clinic we got a small going away present. Our tutor took us over to the real time ultra sound lab to give us a demo, and to let us use the machine so that if we encounter one later in our careers we'll know how to use it. It works really well as a feedback tool for TAs multif and pelvic floor, so I it was good that we got to learn how to use it.

Giving supervisors feedback

Being the last week of clinic....I'm sure we've all received feedback on how we've performed. Some of our supervisors may have even asked us for feedback as mine did.....

I personally haven't had a problem with the supervisor on the clinic.....the first week she really spoke very 'patronisingly' to us...to which I took offense...but then realised that's how she speaks to everyone - literally...so then I decided not to care. She also didn't ask us what we've done before or anything like that.....which again I didn't care...but the other student on prac with me did.

I was a little concerned giving her feedback.....as I think SOMETIMES it can be useful....SO when she asked for some feedback I just very politely let her know that with the GEMs it might be an idea to have a brief discussion of what we've done before.....to which she replied when she has had that discussion and people have told her what they've done or what skills they have....they've been 'full of shit' (direct quote). I really appreciated her honesty - and I think it's true that some of us are guilty of thinking we're the bees knees having held certain positions in our previous 'careers' if we got that far. So - just to let you know and also it's a word of warning not to be 'full of shit' as new grads...cos somehow, at sometime...they'll catch you!!

Mads

P.S. I was too scared to tell her she speaks to people in a very patronising manner!! but if she was my student I certainly would have! isn't the power difference great? M

Supportive Supervisors

I just wanted to take this opportunity to reflect on how much a clinical supervisor can positively impact your method of learning. I just finished my most recent placement and could not believe how much I had learned from my clinical tutor. The amount of time and effort she put into each student was beyond the call of duty. She always made time for each of the six students on this placement and never once made any one feel like he or she was interrupting if a question needed to be answered. She was always available and provided an array of excellent resources for the students to consolidate our learning. It was such a refreshing change from the usual “go and learn this” attitude that so often comes across on clinic. My clinical tutor took the time to really help sort things out if we had a question and never made it seem like something was too silly to ask. I think what I learned most though from her on this clinic is to keep feeding my drive to learn and to ask questions from those who are more experienced so I can (as she put it today) “soak up the knowledge”.
Good luck with PCR study and see you at the grad dinner!

Bribes

I'm sure that title got your attention. Quick quesiton. Is it standard practice to get a little something for your clinical supervisor after your clinic?
Calvin
ps it's not really a bride cause you give it to them on the last day after your assessment is done.

Musculo Placement Comparison

I'm on my musculo now at the Curtin Clinic, and from what I've been hearing the placement there is quite different from other musculo placements. On our placement we have a 1 hour time slot for ongoing patients and 1.5 hours for new patients. Before we see our patient we have to go through the plan for our subjective and objective assessment with our supervisor. We do our subjective which is about 5-10 mins and have to ask specific questions about their pain (present, since last Rx, aggravating factors, easing factors, time to ease/increase) post Rx effect, and how they coping with their home exercise program. After the subj we pop back out to talk to our supervisor about it, and then discuss what we're going to do on our obj.
The objective consists of AROM (PROM) with P1 P2 R2 and the rest of that good stuff. Then PIVM, PAVM, NTPT, appropriate musc length and any other stuff that may be appropriate (eg neuro testing, specific tests), then an assessment of how they perform their home exercises. After that you pop back out to talk to supervisor, and tell her what you want to do as Rx, and how you want to progress your home exercises. She makes her suggestions, and you use a combination of them and your own (mostly hers) :)
After EVERY Rx you reassess something. If your Rx is left and right PAIVM you reassess after your left and then again after your right. After the Rx you write up their home exs and make a photo copy of it to put in their notes, and you book them in for their next appointment. That pretty much takes 45-60 mins and then you find time to do your notes.
Other than Minh and Nicole (who have had the same placement) does anyone else do anything comparable to that on thier musculo. If heard that some people only have to do 1 paragrapg of notes, and don't have to check in with their supervisor during their Rx, or only have 30 min for Rx.
Enjoy studying for the PCR.
Calvin

Hey people,
Hope everyone’s last week of prac is going well.
This week Ive had 3 new patients all with impingement/frozen shoulder type disorders. The 3 of them each presented in a similar fashion; decreased AROM, pain and weakness. I have found that these presentations are hard to treat and often respond slowly to treatment. However I just wanted to say how surprised I was went I tried using slings and pulleys. They actually work!! Each patient I have used them with have increased both their PROM and AROM significantly during the treatment. Its such a simple concept and I think all to often we over think things. I really thought back in first year, learning those techniques was a waste of time but I have been pleasantly surprised!!! (Aren’t I good finishing on a positive note)
Luv Jess
PS Good luck with PCR and have fun on rural!!!