Looking over my previous reflections, one of the common themes that I noticed is the desire to put patients first and be considerate of the personal situations that may be playing a part in their injury or recovery potential. I believe that I have focused on these aspects previously because I have always felt more confident in my ability to relate to and be considerate of a patient than my physical skills and ability to think critically. I am happy to say that I can see major advances in those two areas in the past year, most notably with my second full time internship.
If there were one thing that I would want to change about my work toward the DPT degree, including not only the didactic work but also my other clinicals, it is that I wish I had taken more time to practice hands on materials on a consistent basis, not just in preparation for examinations. I think that if I had been consistently practicing new skills, then layering over them as we continue to progress through the program, my confidence in performing a wider array of techniques would be higher today than it is.
The two aspects of the CPI I wanted to look back on are the areas in which I feel the weakest: clinical reasoning and evaluation. In my first full time internship, my CI mentioned that I excelled at identifying functional limitations and quality of life concerns (evaluation) and that I was able to make discharge recommendations independently (critical thinking). My second CI mentioned that I was improving on my efficiency with clinical decision making, stating “this is one of her stronger skills overall compared to other students I’ve worked with,” and states that I improved over time with considering “the bigger picture” of the cause of an impairment. It is challenging to incorporate the feedback from my 3rd CI as she wrote “good” and “improved” under clinical reasoning and evaluation respectively. However from our verbal communication, she seemed to agree with the other two therapists that my ability to consider the patient as a whole, (whole body system as well as whole individual with needs and concerns beyond their physical pain or limitations) improved over time. I know the PT with whom I’ll be working come May, and we have already worked through a couple of cases together. I know that I will feel comfortable having an easy and open dialogue with him, as he encourages any answer with reasoning behind it and know that my clinical reasoning will only improve in the future.
My biggest concern coming out of internship two was the feeling of not being aware of enough different diagnoses or feeling confident in my ability to distinguish between similar conditions to get to the root of the problem. I have continued to work on this, and tried to embrace all of the knowledge that I could from Amy, who is IOMT trained, utilizing the binders of information that she has collected. In the short time I was there, I do believe that my diagnosing and critical thinking abilities improved but in the long term, I will be starting a 3 year Fellowship program through MIT this fall and am looking forward to continuing to work on this.
Overarchingly, my goal of going back to PT school was to be able to explain to patients why they were experiencing what they were, whether that be pain, weakness, numbness, or any other issue. I whole heartedly feel that my ability to do this has grown over the past three years, as well as I have come to understand that it’s alright to not understand every aspect of each patient’s presentation, as long as you strive to do so and keep searching for those answers. After completing my fellowship, I look forward to becoming a CI myself, donate my time consistently throughout each year to pro bono work, and hope to play a part in promoting increased diversity in the profession. In goals format:
- I will participate in >/= 100 hours of community service / pro bono per year following graduation.
- I will become a member of the Texas state APTA and assist in the creation of a diversity board within that group
- I will strive to have 1 student / year following completion of my FAAOMPT in 2020.