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Physical Therapy Clinical 1 - A Midterm Reflection

This article provides my thoughts after completing the first 4 weeks of my physical therapy (PT) clinical rotation. It reflects on my challenges, and can hopefully relate to others in a similar situation.

Coming into this clinical I was excited for the opportunity, and glad that I was able to make it here after a challenging first year of PT school. This year has been a difficult balance of PT classes and personal life changes. It was not just learning new study methods to handle the workload but also developing new stress coping mechanisms as my old methods were no longer applicable. This created a lot of new challenges I had not faced before, and brought me to multiple points where I questioned if I was even going to become a PT, let alone make it to my first clinical rotation. So completing my classes with only 2 C’s for the year was actually a celebration, as It meant I was able to head to my first clinical in Seekonk, Massachusetts. The night before my first day I became exponentially more nervous as it was a new environment; and for me being one who takes a while to come out of my shell, I wanted to start anew and not fall back into my old routines. These routines being shyness and giving into social fear through being quiet. I shouldn’t have expected to change overnight as I began my first day and continued the week being quiet and shy. This brought me a lot of frustration, and with not having a good coping mechanism this brought many sleepless nights.

I am being vulnerable about this whole situation because it brings into the light my greatest struggle these first 4 weeks of clinical and for my future as a PT. It is clear from observation of the 2 PTs and 1 PT assistant at the clinic, that a therapist needs to be confident and outgoing with patients. This confidence allows the patients to develop trust in the therapist's treatment, while the outgoingness develops a rapport which furthers the PT’s reputation of being personable and patient centered. I have not expressed either of these traits well on this clinical, which has been clear to my clinical instructor (CI). After a few days into clinical, my CI challenged me to talk with patients more, and had me get the subjective for patients while they warmed up on a bike. I took this on and grew in some comfort in talking with patients by asking how they have been doing with their ailment, functional activities, and past treatment. My CI also had me work on obtaining the history of present illness for patients during initial evaluations. After a few evaluations I transitioned from asking predetermined questions to making it more of a conversation, asking follow up questions that built off their answers.

Although these skills did improve with practice and challenge by my CI, I still lacked a lot of confidence which showed enough for my CI to address to me. This lack of confidence was especially prevalent as I educated a patient on a manual therapy or exercise while I was taking them through treatment. The tone in my voice lacked confidence, which made my CI have to step in and explain with confidence the information for me. There has been improvement in my confidence in a few of the patients that my CI has allowed to do full treatment with. I have focused on speaking louder and more confidently while I obtain a subjective, educate, do manual therapy, take the patient through exercises, and establish rapport throughout. And although I have improved in these areas that my CI has addressed to me, it is through a situation where I am set up to do so. But if I want to lock in these skills as a PT I need to go out of my way to do them myself.

I have learned so much therapeutic knowledge even in these four weeks of my first clinical experience. I have learned a lot about evaluation, manual therapy, stretching, therapeutic exercise, documentation, billing, and more. I have learned much, but I realize I have much to learn. But even with all this information, if I lack outgoingness and confidence then I will not be able to be a successful PT. I recognize my dire need for growth not only for my future profession, but also for my own personal development. By the end of this clinical I hope to have made practical steps to make these changes

UPDATE: During my 4th and 5th weeks I have noticed great improvement in both confidence and outgoingness. It has just taking a daily challenge to step out of my comfort zone and realize there is nothing to fear. I hope for more improvement to come!

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