This semester, my most challenging class is physiology with Dr. Fleet and abnormal psychology with Dr. Qualls. I feel like physiology is one of my most difficult classes because Dr. Fleet’s teaching style is very different from my learning style. She shows us a lot of diagrams, charts, and pictures, and writes the majority of our notes on the chalkboard during class. I have issues with retaining the information as she teaches off of the picture on the powerpoint presentation. Additionally, the way her notes are structured makes it difficult for me to remember and absorb while in class. I prefer lists and notes that are separated by subheadings depending on related topics. I realized that her teaching style was not working for me when I started reviewing for the first test because I had retained very little information from the class periods. This class is also difficult for me because of the relationship to chemistry. I find it hard to talk about ions, channels, gradients, etc. because it is hard for me to visualize them. I enjoy anatomy and my AT classes because I can physically see and touch what we are learning about; therefore, making it easier to make connections while I learn. I’ve always had a hard time learning about what I couldn’t see or visualize. Because of these obstacles, I have spent a considerable amount of time thinking about how to improve my learning. I have found that when I relate what we are learning about in class to real life situations, such as diseases, injuries, and everyday life processes, I can understand the concepts much easier. Additionally, I plan on going through my notes and rewriting the information in class in ways that I can comprehend it better.
Abnormal psychology is hands-down my favorite class that I have taken so far, despite it being difficult. I retain the information well in class, and I haven’t been this excited about a class since I got to college. I stay engaged during class (and it’s an 8am class, so that’s big news), write detailed notes, participate when I can, and actually enjoy reading the textbook each week. The part of the class that makes it difficult is the amount of information that we are supposed to know. I feel almost behind in the class because the majority of the class has had multiple psychology classes, so their background of psychology is more extensive than mine, but that only pushes me to do better. For the next test, I plan on reviewing my notes much more frequently and rewriting information multiple times when I have trouble remembering it. I would also like to watch videos of mental illness interviews to practice diagnosing the patients. This class requires a lot of work, but I know it will be helpful to my future career.
The little clinical question for this semester is: In endurance athletes, what is the most effective program to prevent medial tibial stress syndrome?
My partner, Laura, was the mastermind behind this question, and it originated from her past experiences with athletes that she has worked with. Even though she had the original idea for this question, it resonated with me in a different way. My roommate’s boyfriend had a chronic injury that put his future career at risk. He was training to be an officer in the Marines when he was in college, and thankfully is now continuing to pursue that career now after his graduation. He had quite a scare for his future while running cross country in college. He had experienced leg pain for quite a while, but did not think it was too much of an issue. Eventually he went to get the pain evaluated, and it turned out to be a stress fracture in his femur. This stress fracture lead to the finding of a tumor in his femur. Thankfully, the stress fracture healed and the tumor has not proven to cause many more issues since its original finding, and the doctors say at the moment that it does not need to be removed. Stress injuries hit a soft spot for me, partly because of watching my friend become so worried, regardless of how related the stress fracture and tumor. Additionally, at the beginning of football season, we tried to implement a program to help prevent ankle injuries. For most of the preseason, the athletes were showing up to participate in the prevention program and the numbers were high. Unfortunately as practices went on, fewer and fewer people would show up to complete the steps of the program. It was very difficult to create buy-in from the athletes. I believe it would be extremely helpful to look at a program and its effective, while also digging into how to create buy-in from the athletes, so they do not become weary and burn out from the program.
Beth Funkhouser was selected as one of our committee ATCs, Joe Lynch was selected as an ATC, and Mike Caro, CSCS, was also selected. All the members of this committee are heavily involved with current literature, and I believe that they will have very insightful and up to date information to offer. I am excited to see what helpful information can be found and hopefully implemented to Emory’s athletic training setting.
When thinking about what we have learned in textbooks, I try to remember that that condition is the perfect example of its kind. The history, mechanism of injury, observations, palpations, special tests, will all point directly toward that injury if it is a textbook injury. Typically in a textbook, the author will not mention other signs or symptoms the patient may have from other pathologies because we are being taught about just that injury. This is the reason we speak of “textbook answers” because the textbook presentation of an injury or condition is perfect, without any doubt. However, in reality those cases are few and far between. It reminds me that it is necessary to treat the individual, not the injury.
Through my experience in the program, I have learned that an injury will hardly ever look the same between two different patients. Each patient has different anatomy, different prior conditions, different skill and experience levels, and all of these factors can effect how the injury presents itself. I believe this concept is also hard with illnesses, not just injuries. Some individuals can present with only a few symptoms of an illness, while another patient will have all of the symptoms. Additionally, pain tolerance plays a role in reconciling textbook information with real life situations. For example, a football player this year experienced a grade 2 hamstring strain on the first day of practice will eccentrically contracting his hamstrings. That individual had never had an injury before, and his reaction to the injury was much more intense than other reactions to hamstring strains I have seen during my clinical experience.
Overall, I think the most important thing I have learned from reading the textbook to personal experience is that we don’t treat injuries, as I mentioned early. The person is of utmost importance, not just treating a specific pathology like the textbook suggests. A patient consists of that injury, but also an emotional component, pain tolerance, past medical history, other pathologies, etc. My goal is to help the patient become better than he or she was before they walk into the clinic in whatever area I can help with, injury related and also not injury related. I believe making relationships with the athlete helps us understand that the person we are treating isn’t just a scenario from a textbook or from class, but they have become our friend (with professional implications, of course).
This semester I was able to do an on field evaluation for a football player who landed on his shoulder during practice. Once he got off the ground, he kneeled for a while holding his arm. As I started walking over to him, he got up and started making his way to the opposite sideline. I ran to catch up to him and finally caught him at the sideline to ask what happened. He said that he landed directly onto his shoulder after a tackle, and he was experiencing fairly intense pain towards the back of his shoulder. We struggled to remove his shoulder pads to get a better evaluation of the injury, but when we did, he said his pain had moved from the back of his to the anterior portion of his shoulder along the biceps tendon. He was tender along the short head of the biceps tendon, but was not at all tender in the posterior portion of the shoulder. I went through manual muscle testing for both the rotator cuff and biceps, and he was only experiencing some muscle weakness with testing of the biceps. Additionally, he was positive for pain and some weakness during special testing for the biceps. After the on field evaluation, the initial diagnosis was biceps tendinitis that was irritated from the fall.
The next day when I arrived for practice, the initial diagnosis had changed. It had shifted to shoulder impingement, and he was experiencing pain in the posterior portion of his shoulder again. It was not severe enough to keep him out of practice that day. I was surprised at the change in diagnosis because he insisted the pain was in the anterior shoulder and he was not at all tender near the end of the acromion. I also learned that the football player had a history of prior shoulder injuries and impingement. If I could go back and do the on field evaluation again, I would ask many more questions about the athlete’s history. If I had been aware of the past shoulder injuries, I would have also performed more special tests for impingement and rotator cuff injuries. I learned that no matter where I am, whether it be in the field house or on the field, that I should take the time to ask the important questions. If on the field, I should keep the questions clear and specific to what I need to know to be efficient, but I should not cheat myself the past medical history to make an accurate diagnosis.
As of right now, I know that I eventually want to pursue physician assistant studies. I feel like that field is something that the Lord has definitely called me to, and I am always interested in general medicine, so I feel confidently about pursuing this field. I can also get involved with medical missions, which would be a dream for me to be able to do. Originally, I wanted to be a pediatric physical therapist, but that quickly changed when I did my rotation in the physical therapy clinic last Fall. I am so grateful that I was placed there despite it not being my favorite rotation because it made me realize that PT was not what I wanted to study. I had a hard time with staying excited and eager to learn in the physical therapy, my interest was just not spiked in that setting. I was comparing my PT experience with my rotation in the emergency room when I was a sophomore, and it was completely different. Even though I was at the ER until 2:00 AM, I stayed continually intrigued by everything that was going on and still remember that rotation today. Additionally, I shadowed a PT the summer before my junior year, and I feel like I learned so much information in such a short period of time. The majority of that information I can still recall because I was just so genuinely interested in what was going on. I can’t imagine how excited I would be to shadow in a specialty that I am leaning towards, such as cardiology or pediatrics. I am taking the first steps in making connections with PAs right now to look into some more shadowing experience in different fields.
When I graduate, there are few PA programs that I could get accepted into because I am missing two classes that are required for the majority of programs. I am looking into what schools offer these classes over the summer so that I can get them out of the way and focus on applying to schools. I have also invested into a study manual for the GRE to ensure that I am preparing properly to get an adequate score for the PA programs that I am interested in. Lastly, because I am getting married next year and don’t know where my fiance and I will be located geographically, I am researching programs all across the U.S. to prepare for any place that we could land.
Going into my senior ATS year, my strengths and weaknesses have become something that I ponder often. I believe that partially comes from the prompting of my preceptors and many of my professors, but it also may come from a desire to be more introspective as I get older and gain maturity. Many of my flaws have been revealed through introspection, which usually results in me trying to grow and work through those shortcomings both by myself and with the help of others. I believe that my communication and relational skills with the athletes has consistently been one of my strengths. It is so easy for me to create relationships with the athletes that are definitely friendships, but also hold the adequate amount of professionalism in the clinic. For the majority of the time, there is a mutual respect that is between the athletes and me while in the clinic; they respect me and my knowledge, and I respect their privacy, preferences, and modesty. Another strength that I have this year compared to years past is the motivation to stay busy in the clinic. I want to be the first person to offer my help as an athlete walks through the door, I want to be the person who runs out on the field, and I want to be the first one to join in on cleaning the coolers or stocking the shelves in the clinic. As mentioned in my previous journal, I believe this is largely due to the leadership that I am under. I feel that this fact can highlight how good leadership can pull out others’ strengths, and I hope to be a leader like that in the leadership roles I am in now and in the one’s I will be given in the future.
On the other hand, I am struggling this year with being confident in my rehabilitation choices. I have always struggled with rehabilitation progressions, and it is quickly becoming real to me that it is time to buckle down and start growing in this area. I recognize how important it is to be able to plan a successful rehabilitation that will create buy in from the athletes, but also ensure that they are getting better. I was thinking today while running a rehabilitation for a football player with a sprained ankle that there could potentially be a problem with creating rehabs because I struggle with creativity. I have a desire to be innovative and offer exciting, new exercises to rehab patients, but I find it very difficult. To improve this weakness, I plan on pushing the borders of creativity and trying to grow my confidence in what I can create.
This pre-season has been substantially different than the past two pre-seasons that I have been through. When I first got into the program, I was very timid and unsure of myself, but I learned so much. The second year, I dreaded it to be honest. I was at a point in my education where I knew that athletic training was not what I wanted to pursue in graduate school, the physical therapy clinic where I was placed was not one I found very exciting, and my enthusiasm for the field was completed drained. This pre-season, however, has been the complete opposite. I always found myself dreading working with football, but I am loving being with this team. I feel like I am eager to be in the clinic and on the field again, excited about game days, and ready to grow in my knowledge. I think a major contributor for feeling this way is who I am surrounded by and even the athletes. When in the clinic now, I feel like I have freedom to ask as many questions as I need to without the fear of feeling inadequate. My preceptors encourage me and offer me guidance when it is needed all while being so easy to communicate with. This pre-season has taught me a lot about leadership and how those skills can make a difference in whatever setting I am in. Watching the leadership of my current preceptors makes me want to be a better athletic training student alongside the desire to be a better leader in the current leadership positions I am in. There is something to say about gaining experience, whether it be work experience or clinical experience, under leadership that supports you and you truly enjoy being around.
What has continued to still be a hindrance for me is the rehabilitation aspect of athletic training. This will be an area of AT that I will have to consistently be reviewing and growing in regardless of whether my current classes demand it. I feel as if this is the area where I struggle the most because it is the least interesting to me. I am fascinated by emergency care, evaluating, diagnosing, and treatment for acute issues, but chronic issues that call for in depth rehab is where my interest begins to drop. I take that fact as a prompting to lean into this topic to get better. Lastly, I feel like my growth as an AT student has made me understand that communication with my preceptors is key to having the best interactions with them. My growth as an AT student has also shown me that the psychological aspect of dealing with athletes is just as important as their physical state. If I respond the same to an athlete’s turf toe as I do with an athlete’s tib-fib fracture, the turf toe can suddenly become much more painful. I’ve found that it is best to approach each injury with a calming, relaxed demeanor.
This week, I was gaining clinical experience at a softball game. We were relocated to the field at Abingdon High School because the game was later in the evening and lights were going to be needed to finish the game. We were about half way through the first game of the double header, and there was an opportunity for a double play. An ball was hit to an infielder, the infielder threw through the ball to the third baseman, and then the third baseman made a throw to first. The throw to first base soared over the first baseman’s head because the third baseman experienced an injury at the end of the throw. The runner from second took a late slide into third base, slid up over the base, and took out the third baseman’s ankle. The player hit the ground and started rolling because of the pain. Melissa and I ran onto the field and saw that there was an obvious deformity of her ankle. Part of her ankle popped back into place on its own, but the ankle was still extremely displaced. Her foot looked as if it was dangling from the rest of her leg. I ran back to the dugout, grabbed melissa’s kit, and starting pulling out supplies to begin splinting the ankle. It was obvious that her ankle was at the least dislocated, but also a possible break. The ankle and lower leg were stabilized while the SAM splint was applied. I wrapped the ace wrap around the SAM splint to secure the splint, and then we lowered her leg and waited for EMS to arrive.
The x-ray from the hospital showed that her fibula was broken along with her medial malleolus. Up until this point, the most serious injury that I had seen during clinical was an ACL tear. This experience truly drove home how a calm disposition during emergency situations is crucial for the athlete and the mental processes for the clinician. After I saw her ankle, I had just a moment where I wanted to freak out, but instincts quickly set in. I knew that it was important to stay calm so that I could think clearly and keep the patient calm.
This week, I received approximately 25 masteries. I did multiple scenarios with my preceptors, and also was able to receive mastery from therapeutic interventions that I performed in the clinic
I do believe that my communication skills have gotten better this semester! Not only do I feel like they have improved with the team that I am placed with, but I feel that they have improved with all of the athletes that are in the clinic. I have been able to create much deeper relationships, especially with the softball team, through clinical experience. One example of this is a softball player who I somewhat knew prior to being placed with the softball team. I used to have classes with this player, but we have not had one together for about a year. This player has recently went through a traumatic death in her family, and she has been struggling with healing from that loss. She was never hesitant about mentioning the death to me, but she has opened up even more since I have been placed with her team. We have had quite a few conversation about this person in her life, and she has been able to open up to me about how she has been feeling, which included confusion, shock, guilt, responsibility for the death, but also happiness because she knows her loved in is in a better place. This was a big turning point in athletic training for me personally. I have often thought about being able to be a person that an athlete could turn to for issues that aren’t always physical, but I have never been able to practice it to this extent. The athlete admitted to me that she enjoys talking about her loved one, but sometimes feels as if she can’t talk about the loss to friends because she’s does not want pity. She also feels as if she can’t express her feelings to other family members because they do not want to speak of the event. It brought my understanding of the weight of this profession to a new level.
Additionally, I feel that I was able to improve my communication skills with my supervising preceptor. My schedule for tennis has been extremely sporadic, and it has caused changes to occur often in my availability for clinical experience. I have had to continually communicate about these changes, and also have discussed other opportunities outside of practices to receive clinical hours. Even though the cause of this increase in communication wasn’t ideal, it was beneficial in the grand scheme of things.
This week, I was able to finish my attempts in my packet.
I think for this journal I will start with the more negative and end on the positive. My biggest weakness in regards to my major is probably my lack of passion for the major. When I first began the major, I was very eager to be involved, and my passion was through the roof. However, as my desire for different career paths have increased, my passion for athletic training has decreased. I still very much enjoy the material that we learn, but being in the clinic has become more of a perceived responsibility than a potential learning experience even though I am still learning while I’m in the clinic. I am unsure about how to change this perception that has weaved it’s way into my academic life. I would love to still have the same passion that I had when I began in the program, and i do still enjoy helping the athletes, but I feel like I am at a standstill. Another weakness that has made its way into my life this semester was my inability to plan efficiently. My planner has slowly made its way out of the picture when it should have been becoming more important. Through this, I have missed important meetings or forgotten about other assignments or studying. This is solely a lack of discipline that I take responsibility for. To fix this, I just need to be more intentional about planning, whether it be through my planner or another resource like Google Calendar. I believe that I have mentioned this weakness before, but I believe I have a weakness in rehab progress. I can continue to improve in this domain by practicing with real rehabs, speaking with preceptors, and studying example protocols.
On the other hand, I believe that one of my strengths is interpersonal skills. I love making new relationships and getting on the same level as others. I feel like I can easily relate with most other people, which I find helpful during treatments with those who I do not know very well. Additionally, I feel like strength and conditioning aspects of athletic training is a strength for me (no pun intended). I have always been very interested in strength and conditioning, and I have a fairly strong background in regards to proper form for exercises. I can continue to get better by playing into my strengths and continuing to pursue knowledge in those areas.
This week, I received attempts from Beth’s PBL, and received attempts while talking with Chaypin during the tennis match.
Write something about yourself. No need to be fancy, just an overview.