Preparing for clinical experiences is probably the hardest part of Physical Therapy (PT) school and Athletic Training Education Programs (ATEP). Classroom learning is infinitely easier than practical application. Don’t mistake my message- I’m not saying classroom learning for PTs or ATs is easy by any means, just that learning to APPLY knowledge is much harder than learning to RETAIN knowledge. Application of knowledge is what happens when classroom learning meets clinical training- until you get comfortable with being uncomfortable, this can be a scary place.
When it comes to learning to apply knowledge, the phrase I like to hear the least from students is “would it be okay if I do the subjective and then I watch you do the objective?” Nope. Nope. Nope. Spoiler alert: I don’t say no just because I’m mean.
What I’ve found in nearly 20 years of working with students during clinical experiences is that not wanting to participate in the objective portion of an exam has little to do with an inability to perform strength testing or a particular special test, and a lot to do with not wanting to choose the wrong tests and then have the wrong data lead to the wrong assessment. Here’s what you need to know to start being comfortable with being uncomfortable:
1) It’s okay to be wrong.
2) If you do the subjective and then watch your CI or preceptor do the objective, when do you get to engage in critical thinking to improve your evaluation skills?
Critical thinking is not an easily learned skill. It is developed over time and the only way to facilitate that development is to practice. Arguably, critical thinking is your most important clinical skill and should be the task you seek out the most. Welcome opportunities to synthesize information. Be eager to share your thought process and embrace the feedback about what your instructor would have done differently or how they came to a different conclusion.
How do you do that without also living in constant fear of being wrong? If you are nervous about some part of the objective examination, tell your CI or preceptor. What would I love to hear? “Hey, I saw we have a shoulder evaluation coming in- I’m a bit nervous about choosing the right special tests so would it be okay if I run my choices by you before I do them on the patient?” From there, you can make a plan that you feel comfortable with which allows you to go into your evaluation knowing that even if you reach your knowledge limits, you won’t be there alone.
For those of you who like to review clinical skills before you see a patient, I’ve found this line of pocket guides to be super helpful. Ortho Notes are the ones I used most often but there’s something for everyone there.