Y3S2W14-16: We made it.

I'm pleased to announce that we all survived the examination period... some of us more worse for wear. Here's a look at how these last couple of weeks went for me.

On day one, the very first day of  the examination period (Monday) I had my practical exam for PHTY354. This was split between cardiopulmonary (CVP) and integrated studies (IS). Stress and anxiety has some weird and not-so-wonderful effects. I spent the afternoon of Sunday and Monday morning avoiding all study related material and trying to quieten my inner voice. Deep breathing, relaxation exercises and distractions were only somewhat useful. The stress upset my stomach a bit too, and although I felt like vomiting on Monday morning, I couldn't... probably because I skipped lunch on Sunday and could only bring myself to eat soup on Sunday evening (and even a bowl of that took over an hour to eat). It's fair to say, I was stressed. Why are these exams so stressful? It's because we've got a whole lot of knowledge to regurgitate, adapt and apply to practical settings with examiners whom we highly respect observing us. Furthermore we're expected to have the competence and knowledge because it's exactly what could arise in our physiotherapy careers. It's important to get it right. After a quick prayer to whomever was listening to my thoughts, I rocked up a little bit early to the practical exam. 

The exam was set out between two rooms, the first room for CVP and then we progress to the second room for IS. We've got 15min in each room to read, prepare and complete the tasks. CVP had both a written question component and the practical component whereas IS only had a practical component. I think the physio gods were listening because my questions were straightforward. The examiners also ask additional questions regarding the case to find the extent of our knowledge - I won't list these questions though...

Here were my questions:

Written: late stage pregnancy, restricted or obstructed lungs?
CVP: Person with diabetes is referred to you for PVD programme. Perform tolerance test and prescribe exercises.
IS: Person with an unknown chronic condition needs exercise pacing to help them achieve their goals (e.g. walking to supermarket, making bed, mowing the lawns). Then give positive feedback to this patient.

My peers had written questions where they were given values and they had to determine whether the profile given was type 1 or type 2 respiratory failure; read PEFR graphs and decide what condition it is consistent with; Or state the respiratory capacity for the selected respiratory volumes. On the practical side of CVP they had a good variation which included suctioning procedures, treating shortness of breath whether it be atelectasis or children with asthma, and mobilising people after various surgeries. Integrated was even more varied! My peers had to assess hand and do a differential diagnosis (thank goodness we studied that last week in our prep... see last week's blog post), interpret questionnaires we may use e.g. the McGill Pain Questionnaire, assess and treat injured nerves, oh and there were some return to work programmes, pelvic floor training and pregnancy related questions too.

Later that week (Thursday) we had our PHTY355 written exam. Okay, so I had plenty of prep time for this exam - except my stomach/absent appetite hadn't changed at all and I ended up sleeping through most of Tuesday and the morning of Wednesday. Thursday morning came around fairly quickly. That morning I resorted to a liquid breakfast from the supermarket along the way as I walked to the examination. I was in Castle 1 lecture theatre... comfortable seats, plenty of leg room, good ergonomic set-up, a recipe for comfort (and success)! The exam was two hours. It covered content on business, legislation, discharge assessment, Health & Disability Commission processes, evidence based practice... a real mixed bag. After this exam I took off to Waitati to relax until the sun went down... so not a lot of study has happened this week yet.

To our disgust (although we're over it now), we had a Saturday afternoon exam to finish the week. This was PHTY354 Part A written exam covering IS and CVP. I arrived early (as I usually do) to the exam, it was a sunny day and I was prepared having stopped via Subway for lunch... my eating habits seemed to have resolved themselves. For a three hour exam, the time went very fast! I didn't even notice my hands getting tired... maybe I didn't write as much as I thought I had, ha! Just joking - the exam consisted of 16 pages of short answer questions (no essays! Yay!!). I won't give away any of the questions details away, other than to say if you studied well or if you engaged in the content throughout the year then you would do alright. It's a day off tomorrow, starting with the Rugby World Cup All Black versus France quarter final (wait... have I had a day of study since my practical exam at the start of the week... ummmm).

Our last exam was the following Tuesday afternoon. It was PHTY354 (everything examinable). Apparently that was the last external exam of our BPHTY degree. Woohoo!! So this exam was based on two case studies and covered major components of MSK, Cardio and Neuro. I found this exam was a real squeeze to fit in two hours - I rushed it a little. It was the only exam where everybody stayed in the exam until the last minute! So now, I'm done for the year! Woohoo!! A couple of mates and I went for a burger after the exam. The exec organised an end of year piss-up too - nothing has changed there.

Lab group C got together for a group photo as evidence that we survived our third year of undergraduate physiotherapy.

On a different note... last year I made up my own neuro test. This year (during my cardiorespiratory placement) I dreamed up a product that doesn't yet exist (to the best of my knowledge) for people with COPD. It's a chest compression device that is synergistic / coordinated with the patients breathing mechanics. The device would take neurophysiological input (EMG) and be perhaps offer different levels of assistance through a micro-computer. Sounds pretty good right! Well, how about if it could read blood saturation and adjust breathing mechanics too? How has this not been invented already? So, if you see something like this in the clinical field in the future, then you'll know that it wasn't me who did the hard job of putting it together and the research determining its effectiveness!

If you read my blog from the beginning of the year, you'd know that I grew a mango tree from a pit (having eaten the mango flesh in January). The final update on it's growth is, that it is no longer growing. Around August I changed its position to a sunnier spot in the kitchen and I think the sun burnt its leaves (suspected cause of death)... so the message for summer is to be sun smart. Slip, slop, slap & wrap... and if you've got a seedling, find out what optimal conditions are for its growth.

Provided I pass the exams, I'm set to complete my final year of physiotherapy in Nelson in 2016. Nelson is known for its warm climate, stunning beaches and photogenic surrounds.  It isn't a main centre, so it's unlikely that I'll get any specialisation experience (spinal care units etc) rather I'll get a good grounding in the basics.

 

I'd like to thank my place of work, the team at Knox Rehabilitation Clinic, for their support over the year. I've learned a lot working as a massage therapist. Furthermore it was good to have access to a MSK clinic for weekend group preparation for our individual practical exam.

Surviving physiotherapy has largely been about the social support of your peers and teaching staff (as much as it is your own study and self-directed learning). Thus, a big thank you to them - I'll miss you all next year. I'll even miss Graeme and the sport injury clinic... between Graeme and Helen, the sport injury clinic is an amazing place to volunteer. Anyway, I don't doubt that I'll see everyone around graduation in a years time (after we pass our placement and research year).

Physiotherapy Undergraduate Year Three Done!!
Year four begins early February 2016

Catch you all next year!

Y3S2W13: Y3 Summed & Summarised

 Final Week of Y3 Lectures & Labs.

University 2015 is coming to an end...
Graduation 2016, we're almost there. One year to go, bring it on!

I've attended some self-directed group learning sessions... one session was especially productive. We focused on conditions of the posterior upper limb. First off, we used the whiteboard to compare/contrast each of the conditions, then we split into smaller groups to be patient and practitioner... not having the condition required us to know how the condition presented... and we needed to know how to diagnose the condition. So both of us needed to know everything - good way to study! 

When I say I've attended "some" self-directed practical group sessions... I really mean, "I've attended a group practical session nearly every day this week." Compared to second year, the scales, in terms of self-study/notes and practical study/verbalising, have taken a large swing toward practical revision. The timetabled labs this week were also revision. I found these especially helpful because we had access to equipment. The more I think about clinical situations that could arise, the less prepared I feel - however, when we break the situation down and apply some logical thinking (physiotherapy clinical reasoning), then we can't go too far wrong. And, because there are situations where we can actually do a lot of harm, it's good to know when to do nothing at all. Knowing when treatment is indicated and contraindicated is the key to surviving third year of undergraduate physiotherapy. Not having extensive clinical experience is probably the biggest barrier to being a productive physio student in fourth year... but this is why we have fourth year before being unleashed unsupervised on the public. Having said this, it doesn't make us any more confident for our practical exam next week!

"We have to fill our brains up [with knowledge]... even the spaces that we know will only hold info for a few weeks" - third year student.

"When you're not sure what to do with a patient, refer them on. Got some cultural barriers, refer them on. Can't fix the problem with a single manip, refer them on..." - third year physio with a sense of humour.

"Knowing there are things that you don't know is a problem. Knowing there are other things that you don't know to know, things that you need to know, is a bigger problem" - another third year student.

By the end of third year we know useful rehabilitation science, anatomy, physiology, pharmacology, pathology... the foundations of healthcare practice. Furthermore, we know how do assess and treat many musculoskeletal, cardiopulmonary and neurological conditions in various settings (hospital, private practice, community)... the foundations of physiotherapy practice. Moreover, we have a good grounding in many speciality areas in physiotherapy practice (paediatrics, sports physio, mental health, occupational health etc). Having said this, physiotherapists treat the person and not just the condition. Thus it's important to know that there is other knowledge from other areas of physiotherapy to draw upon... imagine a person a plethora of different medical, social and psychological conditions, then put them in a social, political and physical context... and know physiotherapy can help them live better lives.

If you're a current second year student wondering when you're going to learn physiotherapy... there's a good chance that you need to pay more attention in class. However, you'll need to wait until the second semester of third year, and in particular attend 'integrated studies' labs/lectures as this is when all the missing pieces of the puzzle 'what is physiotherapy, and how do we do it' are brought together.

Our final week ended with class photos in front of the University Registry building / clock tower on Friday around noon. This was a good way to finish the academic year!

I would like to thank all who have taken the time to read my blog this year. I look forward to continuing my journey through undergraduate physio and sharing my experiences of the final year of the BPhty programme with you in 2016. I wish to extend my thanks to the students and staff who have contributed to the excitement had thus far - it's a frightening thought knowing that we're almost ready for the big wide world.

I'm only going to write one more post this year to cover my experience through the exam period.
It's time to put knowledge to practice!

Wish us luck!