My reflection for CC6. This one was fun to write because I got to review a lot of improvements I made at school and got excited to improve even more at clinic!
Integumentary Dysfunction Observation Reflection
I expected this experience to be very serious and a somewhat dismal place. I imagined many persons in a lot of pain and very agitated or irritable. I expected that the therapists there would also be a little down-trodden having to work with a population that was always in pain or always irritable about their situation. To be honest I did not expect this to be a very enjoyable place to work. When I arrived I was introduced to several staff member that were bright, cheery, and funny people. This helped to set me at ease and made me feel more excited to observe there the next few hours. We started by viewing the hyperbaric O2 chamber which was nice to see in person and know they really do exist. As we moved through the day most of the patients we saw were also fairly chipper and happy to converse. I noticed the relationship between therapists and patients was always positive. It looked and felt similar to watching old friends catch up with each other. Even with patients that had more severe wounds carried a happier attitude. This aspect of the my wound care experience was surprising and refreshing compared to being around my constantly stressed/anxious classmates in school.
The hardest part of this experience was towards the end where we had one patient that did meet some of my fears – he was clearly in extreme pain with a large, serious wound caused by radiation therapy (needed to treat his CA) in the perianal region. Our therapist quickly prescribed low-frequency, non-contact ultrasound with a saline solution spray for pain relief which we were able to observe. His pain relief was instant and this was immediately noticeable on his face. During and after the treatment he actually became very talkative and told us a lot about the personal struggles he was enduring because of his wound. I learned a lot from him about the hardships of having and treating his wound had his family. I felt lucky he was willing to share so much.
On the other hand, we also had patients that gave me tips on cooking or were quick to share a joke. These examination/treatment sessions were the easiest part of the experience because the there was a casual conversation going on at the same time. Looking at wounds or even palpating tissues around it did not bother me, but the idea of patients being in pain or causing them pain did. My therapist was very skilled at keeping things light building rapport with patients; even when while she was debriding. Having the ability to work and talk the way my therapist did must have taken practice, but it made the whole experience much more enjoyable. This was especially true for the patient.
Although I was expecting a tough observation I got one that was probably more like a rollercoaster. Each patient brings something different to the plinth and the staff were experts at adapting in the moment. Its hard to know what to expect each session. My one take away would probably the individuality of each case. When treating these wounds it was apparent that taking into account how the patient is going to treat the wound at home, will they be compliant with their HEP, will they be able to wear the clothes/shoes they prefer with their new bandages, what goals are most important for them, what other difficulties are they dealing with in life directly/indirectly related to the wound, and plenty of other factors to consider. It is apparent that all of this information is necessary to collect to provide the best treatment for each patient. My therapist made that clear because of the sort of rapport she had build with each patient over time. She seemed to know everything about each patient and the patients always responded with gratitude and kindness. My impression is that this field can be fun to work at times or emotionally difficult at times, but always rewarding.
CC4 Reflection Part 1 and 2
Here are both parts of my CC4 reflection. The entire reflection is written below and the following is a link to the document. --> CC4 Reflection Eport.docx
Part 1 - Learning situation
My ICE 2 placement at Children’s National Hospital I had the opportunity to work with young patients that had some severe neurological disorders. This experience was especially meaningful to me because it helped me to decide the direction I want to take my career path. I had been considering between a neurological or an orthopedic focus for my clinical internships and specializations later on. I hesitated with choosing a more neurological focus because I’ve begun to understand the past few semesters that neurological disorders can be severe and emotionally tolling for patients, caretakers, and health professionals. Due to the emotional context of the setting, even though I was interested, I thought pediatrics or neurology might not be the best option for me. My ICE placement was a perfect opportunity to give it an honest try and help guide my decision. I found that working with children in this hospital allowed me to see a lot of the positives I didn’t necessarily expect and dispel some of those worries. Specifically, I liked that the whole setting was filled with people that maintained an upbeat attitude and I felt the treatments we were performing were very meaningful. I was able to help a patient stand up independently for their first time, I was able to help another progress their rehabilitation after having a right hemispherectomy performed, and another patient that was deaf and learning to walk. It seemed every session our patients were progressing and were thrilled to come visit us. The severity of their impairments were often significant but this made our progress and our treatment time that much more valuable. It was extremely valuable to the patients, their caretakers, and to me personally. It brought me a lot of joy to be part of the process that improves quality of life for the patients, help families come together, and learn from their experiences as well. Through this experience I realized I should more seriously consider pursuing a career in the neurological or pediatric setting.
The APTA Core Values defines Compassion as the ability to identify with or sense something of another’s experience. Although I have never had a severe health condition I feel I can relate to overcoming challenges at a young age and keeping a positive attitude about it. Part of this also extends from my twin brother who did have some health issues growing up. For these reasons I do feel I can identify with many of these patients and have compassion for them. Compassion is a requirement for Caring which is the concern, empathy, and consideration for the needs and values of others. By identifying with the experiences of these patients I also feel concern, empathy and have innate desire to help. For these reasons I am able to learn from my patients as much as they learn from me. I also believe this is the reason that I am so happy being part of their rehabilitation.
Part 2
A)
Goal 1: Improve my study skills/productivity
This goal I have definitely made some massive improvements on. In my previous reflection from CC3 I decided to begin making more charts, to move through material concept by concept, and learn some new strategies. The chart idea has improved my memory with both learning the details and with grasping the bigger picture. By having a side-by-side comparison I can more easily visualize the nuances of concepts. Specifically this has been helpful with health condition in Neuro and MSK. By comparing I can remember what is similar between conditions instead of trying to memorize each one separately. I find that even remembering parts of one condition can now lead me to facts about another. For example overuse is a common cause for tendinosis and tendinitis and so they can both be present with health conditions related to overuse. Then remembering the differences also allows me to separate why conditions are different. Tendinosis is related to overuse but has no inflammation and therefore can be more related to gradual onset while tendinitis does have inflammation and is likely more related to trauma or acute onset. Creating charts has helped me build these sort of word maps in my head and sped up the quantity I can study in less time. Studying always takes a long time for me and was my biggest complaints, but charts have certainly helped with this.
Another strategy I employed to help me cut down time needed to cover subjects is moving through material concept by concept rather than slide numbers. This has helped me solidify material before moving on and need less review to get the same concepts down later on. This also helps me to keep my notes more organized and easier to find some information.
A strategy I learned is from my feedback on the previous assignment called the Pomodoro technique. I study for about 25 minutes, short break, then another bout of 25 minutes. After 3 or 4 bouts I take a longer break. This has allowed me to build some mental “endurance” and stay focus for more than an hour at a time. As someone who struggles with long study sessions and staying focused for long periods of time this has been a huge help to me. I have an app I downloaded called “Forest” that helps me keep track of the time bouts and rewards me with another tree in my little forest for every successful bout of 25 minutes. The official Pomodoro technique utilizes bouts of 20 minutes, but has my ability to focus improves I hope to slowly increase the length of bouts.
Goal 2: Stick to a daily routine
This goal I have improved on, but have not met. Part of this is due to the fact that I get overwhelmed by keeping up with assignment deadlines, study schedules, and varying class times/ICE schedule. I have been able to go to bed and wake up on a fairly regular schedule during the week. I’m in bed by 8 or 9 and wake up between 4 or 5. I find that I can be much more effective during the morning than at night so I have been using this schedule to take advantage of that. In the future, I want to stick to a regular work out routine and eating schedule. I tend to prioritize school work over when I eat and when I work out. This goal is also a little difficult because the program requires a high degree of flexibility. Next semester I hope to have more discipline with sticking to a schedule. I hope to accomplish this by planning each day of the next week so as not to miss a work out and to cook more than buying meals.
B)
Goal 1: Marty will ask two peers a question about assignments before going to a professor to improve interprofessional communication with peers.
Goal 2: Marty will work with 3 different people in every open lab to improve manual skills with different body types.
C)
Learning to Learn
My learning strategies have evolved tremendously since I started the program. I now have a system put into place to keep myself organized and on schedule. I utilize the Pomodoro technique for longer study sessions and try to repeat those sessions at the same time every day. These sessions can include review of previous materials, chart creating, refilling in charts from memory, reorganizing notes with different color highlights, and taking time to visualize materials. These are new techniques that have allowed me to cover more material thoroughly and with less time. The only study strategy that has stayed the same for me is discussing any confusing topics with peers, but even this has evolved to be more common. The learning situation that has challenged me the most is having to balance my time between assignments, studying, psychomotor skills practice, going to class, and finding time for self-care. It was the lack of time and quantity of work combined together that forced me to learn how to learn quickly and productively. Although I have made some huge improvements I still struggle with efficiency. I find that I often spend to much time one part of an assignment or question and it delays my progress in other classes. To help with this I have recently begun task switching and resting when I hit a wall. Getting stuck on a question or part of an assignment is often a sign that my brain has spent enough energy for now. With rest I can usually speed through that question much more quickly. Testing continues to be a struggle for me as I am still switching answers in my head and selecting the wrong one by mistake. This has been an issue since semester one and I have tried to address it by underlining important parts of the question as well as quietly mouthing the words to ensure I don’t skip any part. This has helped but I have two new strategies to help me as this is still a problem. I’m going to eat fruit and have at least a 20 minute workout to improve cognitive function before a test. I believe this will help me focus and catch my mistakes before handing in my tests.
Reflection on our Interprofessional Community Practicuum Course
Specifcally I talk about my experience working at Music on the Monument.
I learned about myself that I have trouble expressing complicated ideas to people outside the medical field. This is a skill I need to work on and can have a lot of value. The details of anatomy or what is happening biomechanically during exercise are not the important part of the message I want to send. I need to better prioritize the information I give in a way that is meaningful to people I am advocating towards or educating. I also learned that people do not necessarily want all the details. We would perform balance activities with people that walked by our booth and I learned quickly I had to keep my pitch short. It was easy to see people tune out when you talk to long about why a dynamic stretch is better before exercise or how being able to balance on one leg can have functional benefits for walking. At a table in public it’s best to keep answers short and to ask about the person. I really started to reach people when I started asking about their interests and relating one of our activities to them. I had a runner stop to ask what I was up to and was able to keep his attention by relating all our activities to running in some way. In the future I want to keep my answers concise and always be thinking about why this person in front of me will care. People were generally very kind and willing to share a lot if I showed some interest...
Read more at...
Here is the link to my reflection on Assistive Device day.
Here is a link to my reflection on the Interview Practice