Expertise and Affils (Full Version)

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Cmari -> Expertise and Affils (March 22, 2001 7:09:00 PM)

Hello! I hope this topic is appropriate. I'm finishing up my second year, and I'm headed out to my second affiliation soon.(orthopeadic) I'm reading a book entitled:"Expertise in Physical Therapy Practice" by Jensen,Gwyer et al.
Although I feel what we've been taught in school is extensive, I still feel that I lack the skills of 'putting it all together'. I'm concerned about this as I start my second affil. Can any of the seasoned PT's here take a minute to comment on how they felt going into thier affils, and what they feel they've learned from each? This book seems to center on 'experts' being less concerned with diagnosis and more concerned with function and family or caregiver education and patient communication skills - at least to the point of the book that I'm up to already.
Again, I'm sorry if this is not an appropriate topic, but I'd be interested in knowing whether I'm alone in feeling this way, or if this is a common phenomenon.
Thanks!
Cmari



Andrew M. Ball, MS, PT -> Re: Expertise and Affils (March 22, 2001 8:06:00 PM)

Sadly, you are correct. Most of the qualifiers that experienced CI's use to judge the competency of their students haven nothing at all to do with clinical practice, but rather communication skills.

As for Dr. Gwyer . . . I suggest that you contact her about this issue (she's director of Graduate Education at Duke). I tend to tear apart clinicians and researchers that are based in art rather than science . . . but I also give credit where credit is due. Hats off to Dr. Gwyer.

Maybe I'm a little biased in the fact that my researc focuses upon allied health education, and the fact that I know Dr. Gwyer personally, but she's earned her place in the "inner circle" of PT. She's pretty amazing.

Drew



mcap -> Re: Expertise and Affils (March 23, 2001 7:48:00 AM)

Cmari:

There is nothing inappropriate about your question. Here are my thoughts:

1. No one feels like they are ready or have it "all together" before, during or after an affil.
2. Just be prepared to work hard and to read, read, read, to improve your skills.
3. Please don't fall into the common trap of thinking that your CI knows it all. Many out there do very little to further their knowledge. Keep an open mind but also a critical perspective. Be prepared to challenge what he/she tells you sometimes.
4. In terms of challenging, you must feel out your situation. Your questions must be repectful, tactful, private and you should have a basis for them. Some CIs do not take well to discussion even if it is repectful so you will have to tread lightly.
5. Good luck........ [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG]

mcap



Ron -> Re: Expertise and Affils (March 23, 2001 12:18:00 PM)

I would be more concerned if you did NOT feel this way, even 20 years down the road I remember stepping into my "advanced" rotations with apprehension and worry. Fortunately my CI's were great and recognized this and worked with me to overcome my fears.
I disagree with your book, interpetation of your clinical findings to enable proper diagnosis is critical in formulating an acurate and comprehensive treatment plan. The great clinicians are then able to communicate that effectively to both patients and associated caregivers, including the referring MD. Have fun....



Rose -> Re: Expertise and Affils (March 23, 2001 1:16:00 PM)

How sad to think that a CI "would not take well to discussion even if respectful". I have had approximately 7 student affiliations and with each student I made every effort possible to make that student feel comfortable, answer their questions and make their experience in my clinic a memorable one and a wonderful learning experience. We all know what a lousy feeling it is to start a new job and not know even where the paper clips are...and scared to death about making the mistakes that WILL happen. It just flares my anger to think any therapist would take on a student with an expected and normal fragile
feeling about the clinical experience and not try to do anything but build confidence, comfort and self assurance.

I have heard absolute horror stories about CI's as well as some therapists with the same attitude towards PTA's. It stinks. Schools should not allow that demeanor of CI and dump them if they have them.



dawn -> Re: Expertise and Affils (April 16, 2001 5:17:00 PM)

Amen, Rose! I'm a full year away from my first clinical and I'm already scared to death that I'll have an awful experience or a CI that doesn't care to teach me just because I'm only a PTA student. Right now, I'm trying to learn,learn,learn everything I can and have so much enthusiasm for the job and the training that when I do get into clinicals, I won't feel so scared. Sort of a "knowledge is power" thing. I really wish I had the time to get my B.S. and then my MPT, but that's 6 years of education, and I am a single mom working in a factory (let me tell you, I have seen more men and women with carpal tunnel and lateral epicondylitis in 6 years of working...it's scary when you think about how debilitating repetitive stress injuries are.), and I just don't have the time to go through a 6 year program right now. Eventually I will go on to get my MPT, but not now. I just want to get out of the factory and do something that makes me want to get up in the morning! My work in a factory is a unique perspective that I hope to bring into clinic, but will my CI even listen to me or care about what I say? I'm sure this is not a unique feeling among both PT and PTA students, but it's still scary. I want to be able to get out of my clinicals feeling like I've learned a lot, not come out more fragile than I went in...



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