4/22/2019 0 Comments Reflective Journal #7I think being a good consumer of the literature involves understanding when to put what was learned into clinical practice and when not to. Sometimes the study might show phenomenal results, but it can’t be applicable to your patients. Trying to use that literature in your clinical practice would then be a waste of time. Additionally, it is important to understand when the article you read was actually a good article. In research and design, we have learned a lot about internal validity. That examines how well the study shows a causal relationships within itself. If the threats to internal validity are too great, one can not form an accurate causal relationship. It is also important to note when the literature is being biased. It is necessary to examine where the literature is being produced from. If it is an article about the benefits of Gatorade that was produced by the Gatorade company, then it is fair to say that the information in that article is biased and should be taken with a grain of salt. On the other hand, if a study is conducted by a third party and has sufficient internal validity and external validity (generalizability), then it may be worth taking the time to try to implement into clinical practice.
I feel like clinicians should use and engage in research because it helps to continue one’s education. Continuing education requirements are just not enough in the minimum to stay up to date on current research and changes in protocol. If I had not been in classes, I would have never known about the change in the normal blood pressure reading from 120/80 to 115/75. I also think it’s important to stay involved in the literature because we will inevitably run into patients that are not responding to traditional treatments and rehabs. It is important that we continue to grow in the number of tricks we have up our sleeves to be able to accommodate all the different types of patients that we will come in contact with. Lastly, I feel that a good clinician will not have to spend much time in the literature, but a great clinician will always continue to learn and grow. I never want to just be mediocre at what I do, but I want to be the best I can be at whatever I am doing. Staying up to date on the news and current literature will help me to accomplish that.
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I have seen some major shifts in who I am as a person since entering into college. Although all the changes put together make me who I am, I’m thankful they go much deeper than the change from physical therapy to physician assistant. The first thing that comes to mind is how I have a deeper understanding of what is really important. As a freshman, everything school related was of utmost importance - it was more important than sleep, than making friends and creating relationships, than my family, than continuing things I was passionate about. I operated like this for years, and I am really unsure of how I didn’t burn out sooner. Midway through my first semester of junior year, I really began to understand what was really important. The relationships I had created needed more attention, my family was sacrificing for me and they deserved more of my devotion, the church was willing to be there for me and help me grow and it was demanding my time (demanding in a good way). All of these important pieces had been neglected, and it made my time at school honestly quite miserable. I had no balance. However, when I began putting my priorities in line, while still being a good steward of the educational opportunities that had been given to me, that is when I started to experience the fullness of life. I am not going to look back on this experience and remember that assignment I worked so hard on, but I am going to remember my experiences I had, the people I met, and the life lessons I learned while I was here.
Perhaps the most important change occurred in my faith. I knew I had all these passions before really knowing Christ, but I had no idea what to do with them. When I truly began putting Jesus at the center of my life, all those passions began to make sense. He gave me a heart to help people, and that was why I wanted to go into the medical field. Now it isn’t just me striving for a degree (which is really unsatisfying and unfulfilling for me), but it’s me pursuing Kingdom work to honor Jesus. It is totally okay for me to be a doctor and a missionary, I do not have to choose. I knew I was at Emory to show people Jesus, but I didn’t know how to do that. That’s when I realized that I have a heart for college aged women who feel like they don’t have a place. This is where I was able to put my passions into action by putting time into Women’s Bible Study on campus to begin actually relating with women who felt that way. Jesus has pruned me since my being at college to understand that if He is not at the center of my life, I will never be satisfied. I don’t need a big degree, lots of money, or the reputation of success to be fulfilled, all I have to do is follow Him and carry my cross. At the feet of Jesus is where I find purpose. 4/16/2019 0 Comments Reflective Journal #14This past week I was helping Hannah cover a baseball practice. The athletes were playing a curve ball scrimmage in practice, and everything was going very smoothly. A player then hit a ground ball that shot towards second base, and the shortstop went to get the ball when it popped off the ground, went over his glove and hit him in the face. He immediate hit the ground and stayed there. At first, I thought he was just playing around because it didn’t look like he actually got hit by the ball, but it appeared as if he had been able to dodge. After a few seconds of him not getting up, we ran out onto the field and he would not raise his head. At this point his legs were moving around like he was in pain, but he never lifted his head. We asked if he could look up at us, and when he did we saw a bloody mouth and an already very swollen upper lip. We were able to get him up and over to the dugout where he washed his mouth out with a cup of water. When he was cleaned up, we were able to see that there were two fairly deep cuts under his upper lip and another cut on his bottom lip. I grabbed a nose plug that he could put inside his lip to help stop the bleeding and made him an ice bag. As I was getting him ice, I asked Hannah if we should run him through a concussion assessment, and she instructed me to wait a while before doing so. I didn’t really know why I felt that we should perform the assessment, but my intuition said that it was a good idea. Within just a few minutes, he was telling us about dizziness and lightheadedness that he was experiencing. Within just a few seconds of explaining his symptoms, he began to ask us what happened. He said he couldn’t remember getting hit at all. I then understood why I felt the need to run him through a SCAT.
He couldn’t remember what he had for lunch that day, and even after explaining multiple times what happened, he could not retain the information. I checked his pupils and continued to ask him some recall questions while assuring him that it was okay that he couldn’t remember. We then went inside for a SCAT assessment were he had a symptom score of 25 which confirmed our suspicions of a concussion. This experience taught me that I need to trust my instincts when my gut is telling me something. I often question my intuition, and it was very encouraging that I had the right feeling in this situation. Also, it made me remember just how important it is that we let the athlete know that we are there for them. I was tempted to get impatient when he kept asking what happened, but I knew each time that I explained it that he felt a little better about the situation. His comfort was worth way more than the time it took me to explain what happened a few times. At the beginning of the semester when we first discussed this event, it was so far away that I wasn’t really affected by it at all. For me, it was just another thing to put on my to do list. As we got closer, I didn’t think I was going to be able to participate at all because of my tennis matches. It fell farther and farther off my radar until we were assigned the risk management plan. This assignment was fairly difficult for all of us because there were so many things that we weren’t used to considering. I have never talked about what outsourcing AT work really looks like with any of my preceptors, and I wasn’t sure what to expect. To go even farther, there were so many questions we had because we would be working with young children. Can we splint dislocations? What will parent interactions be like? What if the parents signed a consent form, but tries to deny their child treatment? I feel like once we asked these questions and heard back from Mr. Larkin, a lot of our anxieties were eased.
Unfortunately, I did not get to spend much time at all at the tournament, but I truly enjoyed the time I did have there. At first I was extremely nervous for a few reasons: these are basically babies, parents of young kids make me nervous, I had never been with wrestling before and didn’t really know much about it at all, and being rushed during an eval gave me some anxiety. When I first got there, Amethyst and Audrey were showing me the ropes and telling me the in’s and out’s of how everything worked. Once I got accustomed to the new atmosphere and got an idea of what wrestling culture was like, I felt much better. I thought that having more autonomy would freak me out, but I truly enjoyed it. It allowed me to think much more clearly compared to having someone constantly looking over my shoulder. I didn’t have too many patient contacts, but the one that sticks out to me the most was a child with a busted nose. As I came onto the mat, he was pretty freaked out about it (plus he was losing). While trying to get the bleeding to stop and get the nose plug ready, I was able to talk to him a little bit about how he was doing on the mat. The conversation seemed to calm him down, and the last thing I said before coming off the mat was, “You got this, man. You can do it.” His coached echoed me, and told the athlete, “See! She thinks you can do it. C’mon.” Even though he did not win that match, it was a great experience to speak encourage into a young athlete who had such a strong desire to compete and make his team proud. Looking back, I wish that I had spent more time learning about wrestling before coming to the tournament. I felt unprepared when it came to what types of injuries and conditions to expect, and I wish I would have understood what to get ready to see. I couldn’t help but jump a little as their little necks were moved around, but I soon understood that they practice flexibility and neck strength for a reason. In the future, I will definitely take more time to learn about the sport that I’m covering before arriving. I feel that having the opportunity to practice as a clinician with less supervision truly gave me a confidence boost right when I needed it. We will be hearing very soon about the results of our BOC, and this experience has shown me that if those results are in my favor, I am competent to professionally practice what I have studied for the past four years. 4/14/2019 0 Comments Reflective Journal #13Speaking about strengths and weaknesses is always something I find very interesting, especially when talked about with my peers. For my first strength, I feel like I am very good at listening to my patient. When I am working with the athletes, I always try to create a personal relationship with them so that they feel comfortable while I work with them. I have heard some athletes talk about their time in the clinic, and some often struggle with feeling heard, whether that be about their lives, their treatments, or their pain. I make it a point to always ask the patient about their day, their classes, and what’s going on outside of school. I do this to assure the athletes that they are not a bother to me, and that I do care about them and what’s going on in their lives. Secondly, I always try to speak to my patients about making goals. One example of this was when a baseball player was coming into the clinic with chronic back pain. I asked him what his first goal would be, and he responded with, “I want to be able to sit through an entire class without any pain.” This gave me an opening to gauge his progress and a tangible goal that we could celebrate when it was accomplished. Lastly, I try to ask about once a week what worked that week and what didn’t work that week. If something new in rehab was working, I try to continue to incorporate it. If a treatment did nothing to help them, I try not to waste their time and my time, so I cut it out when I have the option to do so.
I believe my second strength would be diagnosing. I find it very easy to evaluate someone and narrow down my options for a diagnosis very quickly. I am lucky to have a good memory, so that helps me remember signs and symptoms for injuries and conditions. It also helps that I am very interested in pathology, so figuring out what someone has is like a puzzle to me. It may be unprofessional to call diagnosing a game, but sometime I just pretend it’s a game and I need to ask questions to the athlete to find the answer and win the game. My first weakness has been fairly consistent over the last several semesters - rehab. I still do not enjoy making rehabs, which makes it hard for me to want to spend time in that area. However, this semester I have had the opportunity to follow many baseball players rehabs, and we have been able to see some improvement. There is no better feelings than hearing an athlete tell you that what you have been doing for them is working. This has encouraged me to continue to grow and learn in this area. Another weakness I have discovered that I have is being comfortable with autonomy in new situations. This weekend we spent time at the AAU Wrestling National Championship, and I was nervous about it the entire week prior to going. I knew that we would have more freedom than before, and I knew we would be covering children, so I was very scared of messing up or not catching something important. When everything was said and done, there was no reason for me to doubt my ability, and I even had a great time with this new experience. I will be finding out if I am eligible for certification very soon, and I hope that in this last little bit of my time at Emory, I can find the confidence to practice as an autonomous clinician. |
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April 2019
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