P4R5W1: PSW Tertiary Edition

Beginning of St James Walkway, Lewis Pass.

This is our last professional studies week (PSW) of the year (or for the degree, for those graduating in December). This week begun with presentations from student's who had community placements in the last rotation. We had a range of presentations including: use of acupuncture for tennis elbow, effect of respiratory muscle training for patients with spinal cord injuries, psychosocial factors impacting return to work, appraisal of clinical guidelines for management of spasticity and associated MSK conditions in children with cerebral palsy,  elbow extension restoration in tetraplegics, adverse neural tension in hamstring strains, and physio management of fatigue for patients following mild traumatic brain injury or concussion. My presentation was on Cupping therapy in MSK and Sports Physiotherapy... I came in feeling prepared, but I'm not the most confident public speaker (especially when there's a clock ticking and a few dozen eyes beaming back). 

Tuesday began early with an area preparation tutorial for my next placement, physiotherapy in a tertiary setting. Christchurch students were given placements in paediatrics, orthopaedics, medical respiraotyr, burns and plastics, cardiology/cardiac surgery, general medicine and surgical wards. Nelson students are privileged to get a mixture of surgical and medical wards... I'm not exactly sure what my placement will look like, so I'll tell you more about this next week. A highlight of the tutorial was listened to a mannequin's chest to identify different lung sounds, both normal and abnormal. I'm excited to get to put my stethoscope to use next week.

Later that morning we had a three minute presentation on our PHTY459 research project. Again, there were some interesting studies done by my 4th year peers and their supervisors. One included evaluating public spaces, namely gyms/pools, for usability for persons with a disability. Another project evaluated the use of a Troidometer II in measuring elbow extensor strength in tetraplegia. Tagged onto the end of this was a presentation about post-graduate study opportunities at the University of Otago (acupuncture, neurorehabilitation, occupational health, sports physiotherapy, orthopaedic manipulative therapy as well as research pathways)

Tuesday afternoon was especially entertaining and informative; we had two presentations. The first was from a neonatal acute care physiotherapist about "navigating the teenage brain". One key message from this presentation was to target your communication to the stage of brain development. Fun fact, the female brain matures at the age of 23, whilst the male brain matures at the age of 25. A mature brain can better 'access' the prefrontal cortex and 'over-ride' the earlier-developed limbic system. This explains differences in risk-taking behaviours and logic thinking between males and females during teenage years. We also discussed how stress (catecholamines) can influence how easily we can access our prefrontal cortex (i.e. a mental block). The second presentation was on the physiotherapy management of haemophilia. I hadn't given much thought to managing haemophilia until this lecture... and I was surprised how important the physiotherapists role was in diagnosis of a bleed vs other injury (particularly chronic or severe bleeds... arthritis in joints or myositis ossificans in muscle tissue!)

Wednesday was likened to job shopping. There were a number of representatives from private practices pitching potential jobs for their clinics to us, as well as describing what they expected from new graduate physiotherapists. Next up were representatives from the Physiotherapy Board of New Zealand, they gave us a run down on registering as a physiotherapist and obtaining an annual practicing certificate. Then the Board ran a session on ethics. There was one hysterical moment from a class member who made a fairly inappropriate joke given the seriousness of our ethics discussion. I'll elaborate. In groups, we were given situations where a physiotherapist was in a bad situation that had professional consequences. The group in question had a situation like 'a physiotherapist treated an 18 year old female for a shoulder injury. The day after the client was discharged, they were engaged in a sexual relationship. The mother of the client found out and lay a complaint with the Physiotherapy Board of New Zealand'. What ethical concepts are woven into this situation? Well, it's unlikely to be justice (fairness), but my peer had a crack at making it relevant (for humerus effect; nobody should be offended by this). My peer suggested that there was an injustice made because the physiotherapist did not share sexual relationships with all of their clients. I'm not going to get politically correct, the joke is what it is. You can reach your own conclusions as to what the most relevant ethical principles are that makes that a poor situation.

Thursday morning we had a session on the cervical spine from an orthopaedic manipulative physiotherapy approach which reinforced what the Nelson placed crew had learned from Michael Monaghan. The lecturer from Otago had recently been to a workshop / conference in the US led by Stanley Paris. Thursday finished with a group of first year graduates working in a range of physiotherapy practices came to share their experiences from their first year working as a physio, as well as sharing the inside scoop on selecting a job.

Back to Nelson for round five!