Reflection and Beliefs

[Steven Lagasse]

Hey everyone,

I wanted to make a post on reflection and beliefs:

As aspiring OCS board-certified physical therapists, we try not only to uncover the truth but to understand it as well. However, with the amount of information out there, we can easily fall victim to subscribing to other people’s ideologies and/or biases. It is also not difficult to become complacent and practice in comfortable ways that lack consistent reflection. Please only watch the first 2 minutes of the following video ( https://www.youtube.com/watch?v=-aDisCBaK94&feature=youtu.be ) where Dr. Jordan Peterson (professor of psychology) addresses some issues regarding beliefs.

Take a moment to reflect and discuss any once important beliefs, bits of old information, or education that you have chosen to forego or leave behind since the residency experience. Is there something that you are currently grappling with that, as Dr. Peterson states, doesn’t feel quite right or doesn’t make you feel solid when you say it? Can you recall a time where you felt like a marionette being controlled by the ideas that you had not fully fleshed out? This can also take form in your patient education.

Thanks!

[Michael McMurray]

The big thing that sticks out to me, which has been strengthened since starting the residency experience is the use of passive modalities, well rather not using them. I have never been a fan of them and I have had to defend my position on my beliefs over and over for the past 16 months or so that I have been working. My clinical director, area manager, and regional director continue to drill the idea of me using TENs on my patients and have started using the verbiage as “placebo is a strong treatment” and “If it makes them feel better, they will continue to come back” while at the same time telling me that my billing charges are too low (strange coincidence).

I can’t think of a time where I have felt like a marionette being controlled by ideas that I have not fully fleshed out as of yet. The closest thing that I can think of is in PT school, diagnoses, while important, weren’t the major focus in comparison to impairments of the patient. I feel as though before this residency, I had an issue trying to identify patterns of diagnoses and therefore connecting the potential diagnoses and impairments in order to better create a treatment plan and improve outcomes for my patients.

[awilson12]

I definitely try to make reflection a big part of my practice, but the more difficult aspect of this is going beyond just reflection and changing practice patterns. There are for sure things that I have reconsidered and ditched over the past months, and things that I have adopted and changed as well. But there are also still times I find myself doing something that I am not really confident in or don’t have a solid rationale behind just because it is something that I have learned from another PT along the way or because I am at a loss on what to do. It is a work in progress, but being intentional about changing this is something that I have been focusing on.

In particular I feel like my practice patterns when it comes to low back pain and neck pain are something that I have been struggling with because of the amount of conflicting literature, variability in practice patterns, and complexity of many of the cases. I find myself sticking in similar rhythms for a lot of these patients and know that I should be better but struggle on how to get there.

Being reflective and adapting our practice to changes in standards of care is easier said than done, but by not doing this it is doing our patients a disservice.

[helenrshep]

I think we need to believe in our own techniques in order to teach and educate our patients well. A big point is that if we don’t feel good about it, but then we repeat it over and over to patients, then it becomes our norm and then we don’t know how we got there.

It’s tough to not just practice in a well rounded, educated manner. Taking into account clinical experience, research, the individual patient, and what we’ve been learning can be a lot to figure out how to fit into one patient session. I think we continue to strive to make ourselves better, and not just settle into an easy routine, then that’s about all we can ask for.

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