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.
Penny Goldberg, PT, DPT, ATC is the assistant director and sports physical therapist at ReQuest Physical Therapy in Gainesville, Florida. Penny earned her doctorate in Physical Therapy from the University of Saint Augustine in 2012 and completed an American Physical Therapy Association (APTA) credentialed sports residency at the University of Florida in 2014. At UF she provided physical therapy services for varsity athletes from all sports. She became a Board Certified Clinical Specialist in Sports Physical Therapy in 2017.
She completed a Bachelor of Science degree in Kinesiology with an emphasis in Athletic Training and a Master of Arts degree in Physical Education with an emphasis in Biomechanics from San Diego State University in 2001 and 2004, respectively. Her Master’s Thesis was on preventing concussion and dental injuries in Division I Women’s Soccer players and prevention of athletic injuries has continued to be a major focus of her career.
Prior to physical therapy school, Penny worked as a Certified Athletic Trainer at the University of San Diego, California State University at Northridge, and Butler University where she worked extensively with athletes from the volleyball, baseball, soccer and softball teams. She also has substantial experience working with swimmers as she was a competitive swimmer and later spent several years coaching in the club she grew up in.
Penny is an active member of the APTA, a credentialed clinical instructor, and a Clinical Athlete Provider. She has presented at national meetings on Kinesiophobia in Outpatient Physical Therapy, Differential Diagnosis of Ankylosing Spondylitis, Transient Osteonecrosis of the Femur in an Active Female, and Tibial Plafond Fracture in a High-level Distance Runner. She has also published on topics including returning to sports after anterior cruciate ligament reconstruction and fear of movement/re-injury across the spectrum of outpatient physical therapy diagnoses. She is currently serving on the committee that is developing the assessment tool to be used in physical therapy residency training as well.
Penny has focused her continuing education on running gait analysis, biomechanics of the shoulder in overhead athletes, strength training for runners and youth athletes, post-surgical rehabilitation and return to sport testing protocols, and training the female athlete.
She has recently become more active in building relationships between physical therapists and athletic trainers to improve the overall experience for athletes with injuries after noticing the divide between the professions was growing rather than coming together. She has started a Facebook group called “PT/AT Connection- Physical Therapist and Athletic Trainer Mentoring” that is open to students and professionals that are PTs, ATs, and dual credentialed PT/ATs where she hopes to foster inter-professional collaboration and provide mentoring for physical therapy and athletic training students and young professionals. Additionally, she recently launched her website- oPTimal-educATion.com (but it’s still very much under construction!) where she will house educational materials and resources. The blog is up and running at www.oPTimal-educATion.com/blog with posts directed at addressing some of the most common struggles that students encounter during their clinical experiences. Additional topics to be covered in the blog include building inter-professional relationships, leadership skill development, and mentoring of students and young professionals from both disciplines.
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