I decided to post my clinical observation reflection because I enjoyed completing the hours needed. I felt that this assignment gave me a great idea of what I was getting into. This is something that I wish they would have done when I received my bachelors degree at the University of Utah. By the time I was finished I had little interest in what I was studying. I now feel that it was partially a waste of my time and money. Knowing before hand what the practice of PTA entails, I have that much more of an assurance that I am pursuing my career and not just some job. I enjoyed observing and asking questions that either clarified a concept in class or I could ask if certain practices are similar or different to how the curriculum of the class included. This really helped me understand that progress takes time. I think that they way that PT is portrayed in movies or stereotype makes it seem as if it is some kind of "one stop shop". I was only able to go to the PT clinic on Tuesday's which was nice because I was able to see the progression of about 4 different patients. They all has similar problem areas but all from different situations. One gentlemen had voiced his concern about not feeling as if the therapy was working. Once he did that it seemed to help him progress in his therapy and about two weeks later was back riding his bike after a terrible bike accident about 4 ago. I didn't really have any challenges to complete this assignment, usually I am pretty nervous about going into situation like shadowing or observing but I quickly open up. I had already interviewed and talked with one of the PTA's and that really seemed to help me feel comfortable from day one.
Clinical Observation Reflection
I completed my clinical observation hours at an outpatient clinic called Cutting Edge Physical Therapy. At Cutting Edge, they deal mostly with people who have musculoskeletal problems. I was able to observe both Cheryl Farnsworth, the physical therapist who runs the clinic, and her excellent PTA’s, Kara Duffin and Allie Gold. Their knowledge and depth of understanding of the body that they possess provides their patients the most optimal opportunity to improve their functional ability.
I wanted to get the most out of this experience to get a clear picture of what physical therapy is, why it is important and if I truly wanted to pursue becoming a physical therapist assistant. Each day as I observed, I tried to think of meaningful questions that would give me more insight. I tried applying concepts that were taught in class and that I read in our text book to see if they were being followed and if quality care was being given. I was very much impressed at the abilities of the therapists, both at their responses to my questions and to the way the carried out their responsibilities to the clinic and to their patients.
During my observation for the required 20 hours, I was able to connect the things that we learned in class to the actual practice of physical therapy. Each day that I went in to observe, I would try to watch for specific ways in which our course material was integrated. Communication was one area in which Cutting edge thrived. Before going in with each patient, the SOAP notes from the previous visit were read to know where each patient was in their progression. I noticed that detail was very important, sometimes the same PTA was not available for the same patient each time. If notes on the patients were not up to date, then the standard of care might not be carried out in the way that would be beneficial for the recovery of the patient.
Each provider had their own unique personality and it was interesting to see how each interacted with their patients. Verbal and nonverbal ques were exchanged in each visit and allowed for the PTAs to tailor their care for each individual. If they were working an area too hard, they could tell by the patient’s body language. Each patient knew that if something was too painful that they could let them know, it was not the goal to induce pain. During a first time visit it was important that during examination portion of the visit that the physical therapist listened to what the patient had to say. She listened to the patient’s symptoms and limitations. What was interesting to see was how well she listened but also noticed how the patient was postured. Communication is nonverbal as well. Based off of how well the PT could communicate she already had ideas in her head of what the problem with the patient was. Once she had a good idea, tests were performed on the patient that checked alignment, joint mobility, posture, range of motion and muscle performance. Based off the examination the PT made a clear clinical judgement with what needed to happen for the patient to begin the process of healing. The communication then was passed along to the PTAs for the next time the patient would be seen. The chemistry between coworkers allowed the PT and PTAs to defer to each other’s judgment and to have the autonomy to know that the interventions taking place would be the correct ones.
Each patient was different from the next. Some had a longer road to full recovery, others only needed a few visits and some would need to be deferred to other specialists. I asked what the hardest part of the job was and receive the same answer from each therapist, “Not being able to see the patient get better.” The case was usually some other underlining issue. I was told that with manual therapy a therapist sees with their hands they had to know the anatomy and what structure they were feeling underneath the skin. “once you know the anatomy you can fix anything; you won’t be second guessing your work” I was told. Each person is unique, some tall, short, petite, overweight or muscular. Because of this a PTA must be very good at differentiating one structure from another. This is why I think manual therapy is a skill every PTA should have. Evidence based practice continued to help them enhance their knowledge and perfect their craft so they could carry out exceptional care and provide positive result to the patients.
Because each patient is different so it their recovery. Many of the patients that are seen at Cutting Edge have problems with their lower back, hips, pelvis and SI joint dysfunction that stem from improper posture, trauma or pregnancy. Patients who are pregnant or have had trauma seemed to have the most difficulty with progressing. One of the key elements of manual therapy after PNF or muscle energy interventions were performed to get the patient aligned, strengthening was needed. Strengthening muscles that surround a structure need to get stronger to hold that structure in its correct place. Patients who were pregnant are having their body shift in many ways to adjust for the growing fetus. This makes interventions difficult and change every day the therapist would have to adapt to new problems and come up with evidence based exercises to help. The same was true with patients who had dealt with trauma. Some of the exercises to strengthen needed to be completed to reinforce the work that was done. Some of the exercises would be difficult for the patient to do or because of the specific injury would be too painful. Then the PTA or PT would have to find other exercise with the same benefit for the patient.
Education for the PT and PTA does not stop once they graduate from their designed courses. It is important for them to always be searching out new and more effective ways to optimize functionality in their patients. It is their role to educate their patients on the importance of proper technique in exercises done in clinic and at home. Patients who did not do recommended therapies at home progressed in their treatments at a slow pace. Each PTA did well in expressing that importance and made sure they did home exercises in clinic at least once to insure proper form would be practiced. One of the patients was not progressing that I observed each time I went in. Her indication for her visits was knee pain. She had a prior history of arthritis in her opposite knee and had a total knee replacement performed. During her visits as the PTAs would try to work through her inflammation even a small amount of force would give her pain. The clinical judgement of the PTA indicated that there was more to the pain, she deferred to her PT who then suggested to the patient to get further work up from an orthopedic specialist. They had to autonomy of judgement to know that other underlining problems were making progress impossible. The patient did so and was informed that her other knee would have to be replaced.
I learned a great deal in the small span of time that observed. I was able to see many different modalities that were used to help promote healing. I was able to ask patients about them and how they have noticed even small changes when combine with their therapy. I learned why they are used and when they decide that one modality is better than another.
I came to appreciate the importance of physical therapy and the positive influence it has on people. Some of the patients indicated that they look forward to these visits each week and how much they have improved. One gentleman had shattered his pelvis in a bike accident. It was his goal to be able to get back on a bike and enjoy his recreational activities. I saw his progression for 5 weeks. He had a great respect for his PTA and even voiced his concerns when he felt he was not progressing. By my last observation day, her had been able to ride his bike with only minor discomfort. This was a perfect example of physical therapy benefiting someone’s life. He was given back the opportunity to spend time with his children doing activities they enjoyed and to get back to functioning as he did before his accident. He was not finished with his therapy, but had made marked progress.
This experience solidified my desire to continue in the SLCC PTA program. The PTA that I observed most competed her schooling through SLCC and she had nothing but positive experiences. I was impressed with how smart she was and how well she composed herself. Each of her patients said they would not want to see anyone else. She had a great deal of trust with her patients and respected each one of them. I look forward to incorporating what I have learned in my class along with the experiences gained while observing physical therapy in a real setting. I looked through the notes that I took while observing and compared them to what we have learned in class each topic and chapter has been integrated into practice. With this understanding I am certain that becoming a PTA and working with patients to improve their functional condition is something that I was meant to do.
Clinical Observation Reflection
I completed my clinical observation hours at an outpatient clinic called Cutting Edge Physical Therapy. At Cutting Edge, they deal mostly with people who have musculoskeletal problems. I was able to observe both Cheryl Farnsworth, the physical therapist who runs the clinic, and her excellent PTA’s, Kara Duffin and Allie Gold. Their knowledge and depth of understanding of the body that they possess provides their patients the most optimal opportunity to improve their functional ability.
I wanted to get the most out of this experience to get a clear picture of what physical therapy is, why it is important and if I truly wanted to pursue becoming a physical therapist assistant. Each day as I observed, I tried to think of meaningful questions that would give me more insight. I tried applying concepts that were taught in class and that I read in our text book to see if they were being followed and if quality care was being given. I was very much impressed at the abilities of the therapists, both at their responses to my questions and to the way the carried out their responsibilities to the clinic and to their patients.
During my observation for the required 20 hours, I was able to connect the things that we learned in class to the actual practice of physical therapy. Each day that I went in to observe, I would try to watch for specific ways in which our course material was integrated. Communication was one area in which Cutting edge thrived. Before going in with each patient, the SOAP notes from the previous visit were read to know where each patient was in their progression. I noticed that detail was very important, sometimes the same PTA was not available for the same patient each time. If notes on the patients were not up to date, then the standard of care might not be carried out in the way that would be beneficial for the recovery of the patient.
Each provider had their own unique personality and it was interesting to see how each interacted with their patients. Verbal and nonverbal ques were exchanged in each visit and allowed for the PTAs to tailor their care for each individual. If they were working an area too hard, they could tell by the patient’s body language. Each patient knew that if something was too painful that they could let them know, it was not the goal to induce pain. During a first time visit it was important that during examination portion of the visit that the physical therapist listened to what the patient had to say. She listened to the patient’s symptoms and limitations. What was interesting to see was how well she listened but also noticed how the patient was postured. Communication is nonverbal as well. Based off of how well the PT could communicate she already had ideas in her head of what the problem with the patient was. Once she had a good idea, tests were performed on the patient that checked alignment, joint mobility, posture, range of motion and muscle performance. Based off the examination the PT made a clear clinical judgement with what needed to happen for the patient to begin the process of healing. The communication then was passed along to the PTAs for the next time the patient would be seen. The chemistry between coworkers allowed the PT and PTAs to defer to each other’s judgment and to have the autonomy to know that the interventions taking place would be the correct ones.
Each patient was different from the next. Some had a longer road to full recovery, others only needed a few visits and some would need to be deferred to other specialists. I asked what the hardest part of the job was and receive the same answer from each therapist, “Not being able to see the patient get better.” The case was usually some other underlining issue. I was told that with manual therapy a therapist sees with their hands they had to know the anatomy and what structure they were feeling underneath the skin. “once you know the anatomy you can fix anything; you won’t be second guessing your work” I was told. Each person is unique, some tall, short, petite, overweight or muscular. Because of this a PTA must be very good at differentiating one structure from another. This is why I think manual therapy is a skill every PTA should have. Evidence based practice continued to help them enhance their knowledge and perfect their craft so they could carry out exceptional care and provide positive result to the patients.
Because each patient is different so it their recovery. Many of the patients that are seen at Cutting Edge have problems with their lower back, hips, pelvis and SI joint dysfunction that stem from improper posture, trauma or pregnancy. Patients who are pregnant or have had trauma seemed to have the most difficulty with progressing. One of the key elements of manual therapy after PNF or muscle energy interventions were performed to get the patient aligned, strengthening was needed. Strengthening muscles that surround a structure need to get stronger to hold that structure in its correct place. Patients who were pregnant are having their body shift in many ways to adjust for the growing fetus. This makes interventions difficult and change every day the therapist would have to adapt to new problems and come up with evidence based exercises to help. The same was true with patients who had dealt with trauma. Some of the exercises to strengthen needed to be completed to reinforce the work that was done. Some of the exercises would be difficult for the patient to do or because of the specific injury would be too painful. Then the PTA or PT would have to find other exercise with the same benefit for the patient.
Education for the PT and PTA does not stop once they graduate from their designed courses. It is important for them to always be searching out new and more effective ways to optimize functionality in their patients. It is their role to educate their patients on the importance of proper technique in exercises done in clinic and at home. Patients who did not do recommended therapies at home progressed in their treatments at a slow pace. Each PTA did well in expressing that importance and made sure they did home exercises in clinic at least once to insure proper form would be practiced. One of the patients was not progressing that I observed each time I went in. Her indication for her visits was knee pain. She had a prior history of arthritis in her opposite knee and had a total knee replacement performed. During her visits as the PTAs would try to work through her inflammation even a small amount of force would give her pain. The clinical judgement of the PTA indicated that there was more to the pain, she deferred to her PT who then suggested to the patient to get further work up from an orthopedic specialist. They had to autonomy of judgement to know that other underlining problems were making progress impossible. The patient did so and was informed that her other knee would have to be replaced.
I learned a great deal in the small span of time that observed. I was able to see many different modalities that were used to help promote healing. I was able to ask patients about them and how they have noticed even small changes when combine with their therapy. I learned why they are used and when they decide that one modality is better than another.
I came to appreciate the importance of physical therapy and the positive influence it has on people. Some of the patients indicated that they look forward to these visits each week and how much they have improved. One gentleman had shattered his pelvis in a bike accident. It was his goal to be able to get back on a bike and enjoy his recreational activities. I saw his progression for 5 weeks. He had a great respect for his PTA and even voiced his concerns when he felt he was not progressing. By my last observation day, her had been able to ride his bike with only minor discomfort. This was a perfect example of physical therapy benefiting someone’s life. He was given back the opportunity to spend time with his children doing activities they enjoyed and to get back to functioning as he did before his accident. He was not finished with his therapy, but had made marked progress.
This experience solidified my desire to continue in the SLCC PTA program. The PTA that I observed most competed her schooling through SLCC and she had nothing but positive experiences. I was impressed with how smart she was and how well she composed herself. Each of her patients said they would not want to see anyone else. She had a great deal of trust with her patients and respected each one of them. I look forward to incorporating what I have learned in my class along with the experiences gained while observing physical therapy in a real setting. I looked through the notes that I took while observing and compared them to what we have learned in class each topic and chapter has been integrated into practice. With this understanding I am certain that becoming a PTA and working with patients to improve their functional condition is something that I was meant to do.