2- FOXcast PT: Straight From The Clinical Instructor, How To Nail Your Clinical Rotation

Welcome to FOXcast Physical Therapy, a Podcast for clinicians made by clinicians. It’s brought to you by FOX Rehabilitation. Find out more at foxrehab.org.

Jimmy: Welcome to FOXcast PT. I’m your host, physical therapist Jimmy McKay. The show is brought to you by clinicians, for clinicians from FOX Rehabilitation. Today, we’re directing our conversation at physical therapy students who are looking to go into their first clinical rotation, or really any clinical rotations since they’re all vastly different. On the show today: Dr. Thomas Edger. Thomas, welcome to the show, sir.

Thomas: Hey, Jimmy, thanks for having me.

Jimmy: So, you’ve done this obviously as a former PT student and now full-time practicing physical therapist with FOX Rehabilitation and now we bring you on as an expert because I bet you’ve seen your fair share of SPTs coming to you bright eyed, bushy tailed but sometimes they have that deer-in-the-headlights look.

Thomas: Absolutely. Yeah, I’ve been on both sides of the spectrum here from student perspective and now a CI’s perspective.

Jimmy: We want to go through a list of things to do before that clinical or maybe early in that clinical to set you up for success. There are always students asking, “What books should I read? Should I take a class before my clinical?” We just want to dispel some of those myths and really just keep it simple, so we’ll go with a nice top six things we want to focus on before you head into your first clinical rotation. So what would be the first?

Thomas: The first thing I want my students to focus on, and I’m drawing this one from personal experience, is: Do not get stressed before your first rotation or any rotations really. I promise you your CI is probably more stressed out than you are, maybe. You know?

Jimmy: We hear this a lot. But it’s so hard. I’m glad you know. You’ve been practicing for what five, six years?

Thomas: This is my fifth year.

Jimmy: Yeah. So it’s good to hear. Knowing that you know you’re five years in but you can still relate to that, “Man there’s going to be a lot of stress but try to get rid of it.”

Thomas: At least from my perspective when I take students. Honestly, the first day I don’t really want to throw a lot at my students. I just want to get them in. Let’s do a quick orientation of where we work, what we work with, meet some of the patients. Here’s our documentation system, and let’s go from there. I don’t really expect much of you on your first day. I just want to kind of get you in and get your oriented so to speak. And then, we’ll go from there and talk about expectations and things like that.

Jimmy: It is a learning experience, at least it was from mine. I was going into it with that stress so I was one of those students. But, I guess I was personally nervous about, “Am I going to be quizzed? What do I already know?” When really looking back on it, my CI was like you explained with how you are with your students. You’re there to teach and my job is to sit there and listen a lot.

Thomas: Exactly. Yeah, I went in the same way my first rotation. I hadn’t slept the night before. I was nervous. I came out after the first day and I was like, “That was it?” There was so much ado about nothing. There’s no reason to be nervous for that, ya know? It was so enjoyable. You know that you’re finally doing the thing you want to do.

Jimmy: All right. Now that we have the stress out of the way: What should we focus on next as students going into the clinical rotation?

Thomas: To find your own style. And, what I mean by that is: Don’t simply do as your see CI, right? I think students come in and a lot of times, obviously observed their CI do treatments, take notes, watch them do evals, and then try to parody their CI, right? And, that’s good. You know your CIs are obviously very knowledgeable. They’re CIs for a reason. But, you have to develop your own way of doing things, and your own style and your own way of talking to patients and things like that. That’s what I like to see from students. I learn things from students all the time. I still use treatment interventions from students that I’ve observed. I was like, “Oh, that’s really cool. I’m going to use that,” you know? The best part of having students is you get another perspective from a CIs perspective. So, I want my students to kind of find their own voice, find their own style. Be you.

Jimmy: I like that a lot: Be You. What’s up next? After we’ve relaxed and we’ve found our own style?

Thomas: Get in the habit of doing that point-of-service documentation. At least from FOX’s perspective, we’re doing one-on-one clinical care, right? So as you’re doing your treatment, as you’re talking to your patient, as you’re checking vital signs, it’s really important to make sure you’re documenting as you go along. It’s going to save you time down the line. That’s going to ensure that your documentation is as crisp and as accurate as possible. And, I think that’s a great habit to get into when you are student. If you practice that now, when you become a clinician, it’s not going to be as difficult for you to develop that habit.

Jimmy: That’s a habit to form as a student, especially once you graduate and are practicing on your own and there isn’t someone looking over your shoulder. That’s a good habit. That’s a good thing to now be your default.

Thomas: Yeah, that’s normal for you then when you start working for your employer. Whoever that is, you know. If it’s FOX and they’re going to start talking about point-of-service documentation. “Well, that’s easy I did it when I was a student. I know how to do this.” Establishing those good habits early leads to good habits when you become a clinician.

Jimmy: I like that. Where are we going next?

Jimmy: OK. The fourth one I got, and it’s an important one for me and I think it’s a really important one for this job with FOX, is to be social.

It’s a tough job to be quiet I think. It’s really important to interact with your patients, talk with your patients, get to know them. Find out some things about them: Where are they from? Where did they go to college? What did they do for a living? What do their kids do? Where do their kids live? Find out things about people and that only enhances that patient-client connection. I think that leads to better outcomes. Because, if a patient really likes you and they like being around you and talking with you, that makes them want to come to therapy and work with you and do everything you ask of them and things like that. And that’s another habit I think you have to kind of start to work on when you’re a student: being used to sharing with patients.

Jimmy: Yeah. Tim Fox said it best in one of the orientation sessions that I attended: “Physical therapist: We are in clinically-excellent care and that’s our model, but really, we’re in a service industry. And if you’re not paying attention to what makes your patient or your client unique, you’re not providing a great service.” So, that’s a great point.

Thomas: Every patient is unique, and you communicate with everyone differently. So it’s really important to kind of find out what makes that person tick.

Thomas: What’s number five on your list?

Thomas: Pick your CI’s brain. Sometimes when you’re a student, you don’t want to annoy your CI or you don’t want to ask too many questions. You want to ask questions, but you don’t want to ask them too much. You’re worried you’re, you know, going to be annoying or anything like that. At least, that’s how I thought when I was a student. But now that I’m a CI, I really like students asking questions as I really like talking about what I do: explaining a treatment intervention or going over a certain idea of what we’re doing. I love that stuff when I’m a CI. So, don’t be shy when your students ask questions. You know, “Why are we doing this? Or what’s the theory behind that? Another way we can address that issue?” Pick the coworkers’ minds, too. I work with an OT and an SLP, and they’ve both been in the field action longer than I have. So they are wealths of information and are more than willing to share. People love talking about what they do.

Jimmy: Especially therapists in PT, occupational therapy, and SLP. And the thing is, not every PT is going to be a clinical instructor. That’s what students should realize. It’s not this thing that you get tagged with. It’s something you went out of your way to become credentialed in.

Thomas: Right. Exactly. It’s not just like everyone’s up. You’re here because you want to be.

Jimmy: So those are the types of people who definitely, as you said, really want to talk about what they love.

Thomas: Exactly.

Jimmy: All right. Number 6 on the list?

Thomas: I have self study now. By saying this, I don’t mean like you’ve got to be asking your CI for homework every day. I try not to do that when I have my students, but I do like to give them a little bit of work. I have plenty of studies in my bag and on my computer where I think they can help educate the students on different ideas and different treatment interventions in geriatric PT. I like that aspect of it to give students. Obviously, I’m not giving them something to do every night, but maybe once a week saying, “Here, check out this study. See what you think. What’s the big takeaway?” I actually have a Word document of a bunch of studies I want to get to and some of them I just give my students and say, you know, “What are we getting at here? What can we learn from this?”

Jimmy: And that’s one thing I think students should pay attention to. That time element you just mentioned and you having a Word document of studies you eventually want to get to as a student. You do have that time element, so take advantage of that. Now we can go back to one of your previous points, which is, “Hey, go read that study because you also have access to journals as students that might go away,” which is big one. But, you can come back and you can discuss that particular study with somebody who has clinical experience who may or may not have experience in that particular study. You’re both going to learn something from that.

Thomas: Yeah. It kind of leads to a discussion. It’s like, “OK. We’ve learned something. Now, let’s try with one of our patients, right?” It’s putting it into action and I think that’s a really nice environment to set up when you’re on a clinical rotation. You know, it’s about that sharing of abundance and sharing of information that I think is really important.

Jimmy: I like that a lot. So to review: Relax, find your own style, prioritize point-of-service documentation early to make it a good habit, be social – we’re here to work with people, and people like to be social – make sure to pick your CI’s brain along with the other therapists’you might be working with, and self study. Take some time for yourself to figure out some things that you can look deeper into while you are a student and still have that time plus access to not only journals but a clinical instructor with some great clinical experience.

Thomas: Yeah, that’s what I got.

Jimmy: I like it. Tom, I appreciate your time helping students as they get ready to go into their first clinical rotation.

Jimmy: Jimmy, thanks, this was fun!

Jimmy: Thanks for listening to FOXcast Physical Therapy, a clinically-excellent podcast. It’s brought to you by FOX Rehabilitation. Listen to other episodes or read articles and position papers at foxrehab.org