Professional and Clinical Development

I write this blog post to illustrate my progress/improvement in my abilities as a physical therapy student and soon to be physical therapist. The first tool I will discuss is called Professional Behaviors Assessment. This assessment tool includes 10 professional behavior criteria and requires the student to rank themselves as beginning, intermediate, entry or post-entry level in each criteria. The student ranks themselves once at the end of their 1st year and again in the beginning of their 3rd year. The professional behaviors criteria include: critical thinking, communication, problem solving, interpersonal skills, responsibility, professionalism, effective use of time/resources, use of constructive feedback, stress management and commitment to learning.

As I went through and reassessed my professional behaviors and compared my current abilities to my abilities from last year, I noticed much improvement in each criteria. Two of the criteria that really stuck out to me, were communication and the use of constructive feedback. Last year, my communication skills were somewhat weak. I often had difficulty explaining procedures and exercise technique to patients. During my recent 8 week clinical in an outpatient setting, I was able to build my confidence communicating with patients and co-workers. I was able to find the right balance between being loud/assertive and respectful. I noticed that it’s important to be confident in what you’re saying because most patients already see you and respect you as a specialist, even though you feel like they don’t because you’re still a student. In the past, I’ve always wanted to do things perfectly, and was often slightly agitated/offended when given feedback from others. I saw this as them criticizing me instead of trying to help me. However, I didn’t realize how I was acting and my overall negative attitude was controlling me. After my 1st 2 week clinical in acute care, I decided to make changes to my life in general by becoming more patient and trying to see the positive in every situation. This new attitude has brought me a long way and has led to me developing great relationships and connections with people. During my 8 week outpatient clinical, not only was I accepting of all sorts of feedback, but I personally sought the feedback. I saw every comment as a guide to improving myself.

As I approach my two 12 week clinicals, I have many goals and areas of improvement in the back of my mind. I want to continue to improve my confidence and knowledge base. One of the things I noticed that I had difficulty with during my 8 week clinical, was explaining physiology/biomechanics of certain disorders or abnormalities seen in patients. Even though I’m still a student and I’m not expected to know everything, I don’t think it would hurt to have an expanded base of knowledge. I believe this can really boost one’s confidence when speaking to patients or even coworkers. Even after I graduate, I plan on getting certified in multiple specialty areas, including wound care, lymphedema, and geriatrics. I also want to continue to increase my involvement with physical therapy events, programs, and groups, including pro bono clinics, APTA, and VPTA. There is a lot to learn and many great people to help you along the process, but it’s important to get involved in order to make those connections. Another area I believe I need improvement in is time management and efficiency, especially when it comes to documentation. I’ve also had some difficulty with my reading and writing skills, but when put into stressful situations when having to keep up with so many patients, it gets difficult to get everything documented efficiently. However, my documentation skills improved immensely over the course my 8 week clinical, thanks to constant constructive feedback from my CI and other coworkers. I will continue to improve my documentation over my next 2 clinicals.

Another tool I filled out at the end of my 1st year and again after my 8 week clinical is the Clinical Experiences Profile. This is a self-assessment tool that will show the student areas of needed improvement/growth. It consists of criteria for evaluation, intervention, outcome measures, documentation, and interdisciplinary work. Each criteria is rated from observation to proficient, depending on independence and consistency.

After recently filling out this tool and reviewing my progress/improvement since last year, I noticed that I’ve improved in almost every criteria, given that I was exposed to it during my 8 week clinical. I feel that my intervention skills in guiding patients through exercise and progressing/regressing them appropriately has greatly improved. My comfort with manual therapy varies with the body part and type of patient diagnosis. I feel very comfortable performing manual therapy, including passive stretching, joint mobilizations, and soft tissue work, on cervical spine, lumbar spine, shoulder, knee, and foot/ankle. I had many great experiences with various patients working on manual therapy on those body parts, and excellent feedback/guidance from my CI and the patients. I still feel a little discomfort when working with post-surgical patients and being a slightly afraid of not pushing them too far and causing any damage to the surgical site. However, I’ve realized that its best to start with mild movements and use the patients verbal feedback and their facial expressions in determining how much to push. I will use all of the skills/knowledge I’ve learned in future clinicals and when working as a licensed clinician. I’m interested in many areas of physical therapy, including outpatient, acute, SNF, home health, travel, aquatic, and lymphedema. I hope to be able to work a little bit in each field when I graduate by doing travel therapy and weekend PRN work.

In my upcoming 2 clinicals, I look to further improve my evaluation, intervention, pt education, clinical reasoning, documentation, interdisciplinary communication and overall knowledge. The areas in which I will require the most improvement are documentation, clinical reasoning, and communication with team members outside of rehab team (physician, pharmacist, social worker). Given that my next clinical is home health and the final clinical is acute care, this should allow me to see patients in different courses of their recovery and be able to perform the duties of a physical therapist with patients in any given time in their recovery process.

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