OT Geriatric Fellowship: A Mid-Year Report

By Jenna McGowan MS, OTR/L

Geriatric Fellow

Why would you want to pursue a geriatric fellowship? Do you have a passion for working with older adults? Are you committed to providing clinically excellent care? Are you looking for mentorship and to expand your knowledge? I started the journey as an OT Geriatric fellow with FOX for all of the above reasons. Knowing the why behind your choice to enter into a fellowship is vitally important to keep you motivated throughout the year-long process. Some people thought I was crazy to take on a fellowship. Maybe I was? But as a geriatric fellow, I can truly say that I learn something new every day and that I am a way better clinician than I was six months ago.

The Best Part of the Fellowship? The Mentorship

The best part of the fellowship so far has been the mentorship. I get to learn from two highly trained and experienced mentors. I aspire to one day have as much knowledge about geriatrics and occupational therapy as my mentors do. My mentor days are my favorite days because we get to break down the most complicated cases on my caseload and work together to come up with the best plan of care for the patient.

Initially, I thought of mentorship similar to clinical fieldwork experience, but they are much different. The mentorship is not set up using a supervisory model but is more of a supportive environment that encourages greater professional autonomy. My mentors treat me like a colleague, not a student. I get to guide our mentor sessions and chose areas of practice that I would like to focus on. They work beside me and provide hands-on training so that I can grow as a clinician. I get to learn from their specialty areas, which is something I didn’t get to experience as a student. The fellowship is not just a repeat of school. The experiences that I am gaining with the one-on-one mentorship has transformed my practice and provided me with more confidence and clinical skill.

Tying Evidence-Based Practices to Patient Outcomes

Another exciting part about the fellowship is that I am working with a reduced caseload so that I can dedicate more time to evidence-based practice. Each month I have online modules and didactic classroom learning experiences. I get to spend time focusing on the research and literature to provide a better plan of care for my patients.

You may find it difficult to implement evidence-based practice into your daily treatment routines as I did before starting the fellowship. It’s been very exciting that I can see firsthand how my patient’s outcomes have improved since implementing evidence-based practice. Additionally, I am noticing that my patients are improving at a faster rate because I am more aware of what is contributing to their functional decline. I love that I am making more of an impact on my patients and their caregivers.

How to Build Confidence during Fellowship

One thing that I have experienced that I did not expect was the Dunning-Kruger effect. This is a cognitive bias when a person who knows little about a subject actually thinks they know more and are very confident. Then the more they do learn about a subject the less confident they become. When I started the program I had no idea this would have an effect on me. I was learning so much new information that I felt less confident. It took some time to work through the process of how I was treating for the past two years and how I am treating differently now. I almost felt like I had to go backwards to strengthen up all of my foundational OT knowledge before I could jump ahead.

My awareness has expanded so much that I feel like I am seeing my patients through a new lens. This new lens has opened me up to provide better quality and more targeted treatments. My improved confidence proves to me that pursuing the fellowship was a good decision.

I’m sure these next six months will go by just as fast as the first six months. I am looking forward to working with the PT residents on our Capstone project related to quality improvement and then presenting on our findings. I am also excited to attend AOTA’s annual conference in Boston, Massachusetts. But, I am most eager to see how I will grow and what new things I will learn about myself during the second half of the fellowship.