Mind Mapping: How to Organize Your Thoughts Like a FOX Clinical Resident

By Megan Mitchell, PT, DPT

Geriatric Clinical Resident, Physical Therapist

As Physical Therapists, we know that movement is often the answer to a lot of our patient’s functional deficits. We know that if we were to strengthen their muscles and increase their activity levels, they would get a bit better.

But FOX’s mission is about more than helping our patients get a little bit better. We work hard to get our patients back to their optimal function so that they can get back to living their lives.

We do this by identifying what is contributing to their functional decline and creating a plan of care centered on those findings. And there’s one great tool that enables us to do this well: mind mapping.

What is Mind Mapping?

Mind mapping is a visual-thinking tool used to help effectively organize information. It is a diagram that involves circles and branches stemming from a common theme. It is a visual representation of a geriatric clinical resident’s thought process.

Mind maps allow clinicians to write down all of their findings from their initial evaluation without concern for organization or flow. It serves as a tool to help draw connections through visualization. The best thing about mind mapping is that it allows clinicians to put their ideas down in any order so that they are not constrained by order of thinking.  Their brain will naturally draw conclusions the more they write it out.

How to use Mind Mapping

One of the first things we discussed in the FOX Geriatric Clinical Residency Program is the organization and flow of an initial evaluation.

Our patients are referred to physical therapy because of a functional decline. In the first few minutes of our subjective evaluation, we have an understanding of what functional activities our patient is having difficulty with and would like to restore.

Next, we analyze our patient as they perform that activity. We pay careful attention to when they struggle with that activity and hypothesize what we believe is contributing to their functional decline. Lastly, we measure the body functions and structures that we believe are contributing to their functional decline.

When the initial evaluation is over, but before we finish the treatment note, we grab a piece of paper to begin the mind mapping process. In the middle of the paper, we write down the patient’s biggest goal. What activity would allow them to get back to living their optimal life? Next, we write down the things we observed and measured that are contributing to the decline in that activity.

Keep in mind, their limitations might not just be physical. It can be personal or environmental factors as well such as not having the proper equipment, crowded spaces, living alone, etc.

The beauty of the mind map is that you don’t have to worry about the order in which you write your ideas down. Just let your mind organically sort through all the information you collected during your evaluation and write it down as it comes to you.

Once you have written down all of the different impairments and barriers that you believe are contributing to the patient’s functional decline, you will then start to write how you are going to address them.

This is the fun part for me. What I love about treating older adults in their homes is the amount of creativity that is involved. Being a clinical resident at FOX, I have learned how to create exercises that serve multiple purposes so that I can really maximize my patient’s time. FOX emphasized early on the importance of being deliberate in the interventions you choose and advised that we pick ones that address the goals we’ve established for your patient.

Don’t Underestimate the Power of Reflection

The concept of mind-mapping was one of the first things my mentor showed me when I joined the practice. I loved the concept, but after a few evaluations, I stopped using it. I felt that I knew enough that I didn’t need to write it down.

FOX’s Geriatric Clinical Residency Program has taught me just how important it is to take the time to think about your patient and what they need. Sometimes speed is not the answer and your first hypothesis is not always correct.

For example, let’s say you get a referral for a patient with the chief complaint of gait instability and a history of falls. You gather from the subjective history that the falls typically happen at night when going to the bathroom however your patient doesn’t remember exactly how or why she falls.

In your initial evaluation, you analyze your patient’s gait on both hard floors and carpet, with and without shoes, and with and without the lights on. You also perform a vestibular exam, check sensation on the plantar surface of feet, ankle and foot ROM as well as the Dynamic Gait Index and Modified CTSIB.

Without utilizing a mind map you may feel overwhelmed from the volume of information that you have obtained through the evaluation. By the time you have your next treatment session, you may have forgotten what you wanted to focus on and pick interventions that generally address balance deficits. Or, you may choose to focus on one aspect such as walking on soft surfaces in low light, forgetting the positive results for Unilateral Vestibular Hypofunction.

Mind mapping allows you to reflect on all of the information you’ve gathered, consciously decide what you need to focus on, and deliberately pick interventions that will maximize your time and your patients’ goals. Every 5th treatment session you should look back on your mind map and compare to the interventions you are providing and your patient’s progress. If you are not noticing a significant difference it may be time to reevaluate what is of the highest priority.

We need to make sure that are providing the most appropriate treatment interventions because we don’t just want our patients to get a little bit better. We want our patients to get better, faster.

FOX’s Geriatric Clinical Residency Program has given me the tools, knowledge, and skillset to work as efficiently and effectively as possible, and utilizing a tool such a mind mapping is one thing you can use to help you do the same.