CC3 Reflection - First Year Self Assessment and Learning Plan
For me the most surprising aspect of this program was its ability to create a community. By working with the faculty and students on various projects I have come to develop relationships that are supportive, reliable, fun, and encourage growth for me and the other person. This has created an environment that I genuinely look forward to being a part of every day. I get excited to be a part of group projects because I know that in the end I am going to learn something about myself and I might even contribute to the development of my peers; all of this on top of the knowledge gained from the project itself. This principal holds true if the project went well or not. There was one project I had with a partner that, even though we received a good grade, we struggled to work well together. From this I gleaned pitfalls I had in my work strategies and ways to improve. To help me with that process I had a faculty meeting. In all honesty, when I went into this meeting I was very apprehensive about what would happen. Instead, I found a faculty member, among many, that just wanted to know what went wrong and how to fix it. I was surprised there was no reprimanding, no punishment, and I left feeling I had not only made the right adjustments but excited to show improvement on future group and partner projects. I used the word community earlier because I now know that my class mates and the faculty only want the best for me whether I am performing excellently or poorly. Failure is no longer an end but rather a sign that something along the way went wrong and we, on my own and as a community, will find a way to fix it. This has made me open to speaking my mind when answering questions, to listening to others, and taking initiatives to contribute as much as I can. The program has developed this sort of community through many group/partner projects, various feedback forms (both anonymous and known) and motivating students at their best and worst. The support I have from faculty and class mates has been surprising to me, but incredible to my development...
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CC2 E-portfolio Reflection
After working through these cases I have made improvements in some areas and found opportunities for improvements in others. Skills I feel proficient with are utilizing, fitting, and demonstrating proper technique with assistive devices including wheelchairs. Safety is always on my mind and is most important to me as a practicing student. This has been reinforced from last semester through the cases and SPI practice. Many of the details of safety, ambulating, and using stairs/curbs come naturally now. My ability to write plans of care and type out notes or documentation have become quicker and easier to do. I am much more familiar with short hand notes that are commonly used, and the vocabulary and technical language also come much more naturally. On that note, understanding and interpreting important parts of patient histories, doctor referrals, or notes written by other people also much more easily to me now too. I am also much better at creating an outline about how my interactions with patients should go. I am much more capable of developing a plan for treating a patient but need to work on my execution. Performing goniometer measurements are still awkward and much to slow for me especially ones that begin in a 90 degree position. I also have a difficult time selecting appropriate MMTs on the spot. I need to critically think through which MMTs I perform more quickly and accurate. Testing in and out of gravity minimized/maximized can also be difficult for me to come up with in the moment. I think with clinical practice I can become more familiar with Goniometer measurements and MMT selection and execution in new positions. In general, I tend to execute all my clinical skills slowly and I believe this is because I still unfamiliar and need to practice. Confidence is another factor I want to enhance. Confidence in my abilities would allow me to move more quickly while remaining accurate. I also think that having more confidence would greatly improve my ability to develop rapport and trust with a patient which is still awkward for me.
I learned in the Doris Latham case that I am more unfamiliar and uncomfortable with in-patient settings than I previously realized. I wanted to rush through my MMTs and move on to ambulating with the patient, but MMTs need a lot more consideration in this scenario. In the supine position, many MMTs become gravity minimized or need to be attained in another position. My skills with bed mobility needed a serious refresher during this case. I could practice safely but had to really stop and think about what the best method would be. The important part of a patient session should be getting the patient out of bed and ambulating if possible. I did not like that fact we spent a lot of time in the bed gathering MMT and moving slowly. I think the majority of time spent in the session should be spent exercising out of the bed if possible to do so safely. I was also surprised to discover during the Doris Latham case that my ability to react to emergencies or unplanned situations is limited. When she needed to go number two I froze and had to rely on my team mates to grab the bed pan. This surprises me because my last jobs were fast paced, required quick and smart reactions, and often had emergency situations due to the nature of the work. There is higher than average rate of injury in construction and laborer positions and I take a lot of pride in never being injured or inflicting injury on someone else in my 5 years working that field. My confidence and leadership abilities has been shook by personal issues outside of school, the newness of material, and unfamiliar situations like the in-patient setting. I want to develop more confidence through time and practice in an in-patient setting. I’m going to keep this in mind for my next ICE experience.
My biggest contribution to the group I think was encouraging others to participate and willingness to jump in. I like the actual practicing of skills and performing with the guidance of a professor. In writing documentation I think I provided a lot of good ideas for documenting, developing plans of care, and provided a good backboard to help others develop their ideas more. I could improve in both the group process and the pair process with better communication. Some people prefer to work much differently than I. Communicating my weaknesses and strengths early on will help me work with all types of learning styles more smoothly and be more flexible. This would also allow my partner to work better with me and create an opportunity to tell me their needs. I also need to work on actively listening to others before including my own input. I tend to overlook details sometimes and by paying more attention to other’s input, the group’s and my partner’s, I can catch those details and be more efficient in my efforts. I also think creating a schedule of when to have certain assignment parts done and when we need to meet up in person with my partner and group first thing will help avoid unnecessary stress or friction. I need to be vocal about my weaknesses very early on and allow others to help me turn them into strengths. Keeping a positive attitude throughout the case and doing the assignment is important to me and setting expectations first thing would be a great way to retain that positivity. With these specific communication strategies I can be more flexible with different kinds of partners and be more efficient with my productivity.
My ability for clinical reasoning has also changed for the better. I take a lot more details into account. Details such as how much time a certain activity should take, setting up environments with the end in mind, and considering patient comfort. There are often many solutions or methods for working through a problem and some are much better than others. For example, how to approach a chair or wheel chair while ambulating with a patient that is utilizing an assistive device. Before these cases I would often just try to get close to the chair. I now think about where will I be when we reach the chair, can I continue to remain in the safest position when I reach there, will the patient have to perform unnecessary actions (like performing an MMT that does not tell me any extra information), what will I do if an emergency arises and we need to stop immediately, what could go wrong with my plan, or what is really important to the patient’s goals and what do I feel is most important for the patient too. All of these are important ideas to consider and when taken into account leads to a much smoother and efficient session. By premeditating, my clinical decisions in the moment will be quicker, safer, and I can make that decision confidently. There are many elements I take into consideration now that I was not before and running through this unofficial check list in my head will help me catch details I was not thinking of before.
Overall I have made some progress but I need a lot more practice to gain confidence, work with all types of patients and partners, and become smoother with skills. I look forward to developing these elements with more cases, assignments, and in the clinic.
I am a first year student in the Doctorate of Physical Therapy program at George Washington University. I hail from St. Mary's County in Southern Maryland. I grew up picking crabs and paddling my kayak. I paddled my kayak up the potomac river and moved to Washington, D.C. to go to school. I'm enjoying expanding my horizons literally and in my abilities as a PT!