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The clinical induction week proved to be incredibly useful! I saw eight new patients and carried one of them out myself. One of the most striking aspects of the process was to do with the patient interaction, informed consent and how to structure the interview process. In theory it was easy to do, in practise it was a completely different ball game. The key for me is to be aware of this difference and to keep working on it with each successive patient. Over time it will flow naturally. My case history writing style was awful as well and the needs to be rectified as soon as possible. At least I was able to be polite and courteous throughout!
OPS A1-A7, B4, C2

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Having a two hour tutorial with Mr X on the knee proved to be very helpful. I learn so much about how to evaluate a patient with a knee complaints, and more specifically how to differentiate between ACL, PCL or a vascular problem. He demonstrated that it is the questioning that will separate the three and that you only really need three or four questions to separate them out.
OPS B1-B4

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Mr X's two example patient run throughs. 

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Mr X's two example patient run throughs. 

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Mr X's induction talks and two example patient run throughs were an eye opener for our start in clinic. Watching Mr X carry out two new patients gave us a whole lot of contextual information to take in. Examples include copying and pasting specific routines together to better suit  patient complaints (enabling a more accurate, and efficient diagnosis), questioning why we are asking certain questions and what real data do they give us? (which turns out not to be very useful data) And how and why we need to contextualise information so that patients understand what is going on and are as much part of the process as we practitioners are.
One tip that really stood out was the idea to put your pen down and just let the patient talk for the first few minutes.
OPS A1-A4, B1-B2, C1, C4, D3

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ASIA - INTERNATIONAL STANDARDS FOR NEUROLOGICAL CLASSIFICATION OF SPINAL CORD INJURY

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ASIA - INTERNATIONAL STANDARDS FOR NEUROLOGICAL CLASSIFICATION OF SPINAL CORD INJURY

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Mr X made us aware of this ASIA protocol for neurological evaluation. This document is an incredibly useful way of classifying  neurological assessments not only for yourself but for other practitioners who may have your patients or even as a standardised benchmark with your own patients going forward. This provided quite useful in clinic whereby I was able to identify progressive neurological deficits in a patient and thus onward referral.
OPS C1, C6, D10

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Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices

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Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices

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This research paper provides tremendous amount of detail with regards to managing patients with acute lumbar disk pain. For me, this paper provides an evidence based grounding on which to act upon. Not only does it help me decide how to act to keep my patients safe, but it also helps me manage my differentials, understand how to evaluate more efficiently with (hopefully) better outcomes and the importance of patient referral. I will be collecting many papers of this nature in order to better inform me of magnum my practise.
OPS C1, C4, C6

Gregory, D., 2008. Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices. American Family Physician, 78(7).

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Today Mrs X taught me the Still technique!

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Today Mrs X taught me the Still technique!

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This philosophy of technique was a real game changer for me. I instantly understood the principles behind this technique and will definitely be using this a lot with my patients! I found this video to use n the future incase I forget anything!
OPS B1, B3, B4

Youtube.com. 2016. Instructional Video on Application of the Still Technique With Narration. [online] Available at: <https://www.youtube.com/watch?v=GzPP42Aqz10>

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The Journal of the American Osteopathic Association

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Instructional Video on Application of the Still Technique With Narration

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This research article helped a lot to guide my management plan for one of my new patients and help me stay within my scope and boundaries of practice.
OPS B1-B2, C2-C3, C7

Pollard, H., 2008. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. The Journal of Canadian Chiropractic Association, 52(4).

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Loudon, J., 2016. BIOMECHANICS AND PATHOMECHANICS OF THE PATELLOFEMORAL JOINT. The International Journal of Sports Physical Therapy, 11(6).

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Absolutely amazing neuro screen reference!

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Absolutely amazing neuro screen reference!

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References like these were so important for clinic. Neuro exams are obviously very important and reading up on various different approaches gives me a wider use for my toolkit, thus enhancing patient care and safety. They are also useful for benchmarking to my own progression. Allowing me to analyse and reflect upon information directly relevant to patient care.
OPS B1, B3-B4

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My first patient encounter and reflections below. Overall, positive due to good communication on my part.
OPS A1-A7

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The feedback gained from being observed is invaluable. There are certain elements you won't ever see yourself, especially being new to osteopathy. Such things include not   giving understandable/relevant information to patients, explaining the consent process in a way that was not understandable, and general lack of awareness of the clinical space and its impacts (not mentioning observers may be present etc).
OPS A1-A3, A4-A5, A7, B1, B2, B4, C1-C2

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Consent across language/cultural barriers is much more difficult to achieve. Observing this case was very helpful in terms of understanding from an outside perspective and to acknowledge its complexity and importance.
With this difficult scenario, it is also important to understand that patient dignity and modesty may mean different things across different cultures.
OPS A1-A7

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Helping patients manage conditions with day to day products!

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Helping patients manage conditions with day to day products!

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Observing a patient who manages his IBS with turmeric and ginger was an eye opener. It shows that simple advice can really help patients in the long run. Advice and information are so important for patient management.
OPS A5

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A fellow student had a new female patient that had directly requested a male practitioner. My immediate reaction was to assume there was a "dodgy" reason for this. My tutor kindly pointed out that there may be other reasons for this and to not hold these kinds of thoughts before the patient practitioner interaction. An easy lesson to learn....
OPS A7

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My handwriting has always been a challenging issue for me. I get so immersed in the patient that I don't take my time writing things in a legible fashion. It is an issue I am working hard to resolve bit by bit. Slowing down is an important aspect I am working on in many areas.
OPS C2

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Being honest and acting with integrity is important for patient safety. 

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Being honest and acting with integrity is important for patient safety. 

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Sometimes it is important to be honest in order to be safe with a patient. Even if it means challenging previous medical assumptions that contradict your own examination findings i.e. fracture in this case.
OPS C1, C4, D1

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Observing a colleague take a new patient case history from a 1st year student who had no pain or presenting issues really brought home the idea that boundaries. Without these boundaries, patient care would; be greatly sacrificed.
OPS D2

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Had a lengthy discussion with one of my clinic tutors about many aspects of osteopathy. It is very interesting to hear how osteopathy is regarded so differently and just how important it is to be honest about how osteopathy can help. Following on from the previous point, duty of candour was something I had learned more about today.
OPS D1, D3

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ESO's complaint policy - a good framework

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ESO's complaint policy - a good framework

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I would hope to follow a similar complaints procedure outlay in my own practice once I graduate.
OPS D4

ESO - European School of Osteopathy. n.d. Patient Complaints Procedure | ESO - European School of Osteopathy. [online] Available at: <https://www.eso.ac.uk/eso-clinic/feedback/patients-complaints-procedure/#1556728698554-194cfe32-6a17>

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Whether the feedback is positive or you wish to offer a suggestion as to how you feel we could improve the service we offer, we would value your input. This can be done by completing a Patient Feedback Form which can be found in the ESO clinic reception, or by emailing clinic@eso.ac.uk. It is always preferable to know who has provided the feedback so we would appreciate you providing your details. However, we do understand if you would rather provide feedback anonymously. Please note that any feedback or suggestions provided will not have a detrimental effect on the treatment or service we continue to provide for you here at the clinic.

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Patient Complaints Procedure | ESO - European School of Osteopathy

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Whether the feedback is positive or you wish to offer a suggestion as to how you feel we could improve the service we offer, we would value your input. This can be done by completing a Patient Feedback Form which can be found in the ESO clinic reception, or by emailing clinic@eso.ac.uk.

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Respecting patient confidentiality, privacy and protection of information

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Respecting patient confidentiality, privacy and protection of information

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Tricky situations in clinic whereby one has to be very careful in maintaining patient confidentiality and privacy. Reflecting upon these situations is what solidifies the need to constantly assess these situations in real time.
OPS D5

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Learning how to treat patients fairly and recognise diversity and individual values is hard...

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Learning how to treat patients fairly and recognise diversity and individual values is hard...

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Reflecting further on this new patient I had in clinic really brings home the issue of recognising the individuality in each patient and the fairness that is portrayed in their  eyes. It took the whole of year three for me to understand this in practice. This is why these reflections are so vital for ones own development.
OPS A2, A7, D6

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Papers like these really helped me understand the context of regulations and the importance of such stipulations placed upon student osteopaths.
OPS D7

Kaptein, M., 2019. Prescribing Outside-Work Behavior: Moral Approaches, Principles, and Guidelines. Employee Responsibilities and Rights Journal, 31(3), pp.165-185.

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This assignment really helped contextualise the professional financial dealings one must get to grips with in practice. Up until this points, I had not thought about this aspect much.
OPS D8

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During year 3 observations we all took the time to feedback to each other with regards to our new patients in clinic.This feedback was invaluable not only for ourselves but for the development of our colleagues a student osteopaths.
OPS D9

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Another way/method of looking after yourself.

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Another way/method of looking after yourself.

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A research article on the idea of "grounding" - which is taught a lot in year 3. It is an interesting view upon a very complex way of organising your own energy/body/mind away from that of the patients - to be neutral so to speak.
These methods also allow me as a practitioner to step into a "practitioner role" before seeing patients. Minimising any potential interference between my own well-being and theirs.
OPS D11

Chevalier, G., Sinatra, S., Oschman, J., Sokal, K. and Sokal, P., 2012. Earthing: Health Implications of Reconnecting the Human Body to the Earth's Surface Electrons. Journal of Environmental and Public Health, 2012, pp.1-8.

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First Aid course requirements before starting clinic.

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First Aid course requirements before starting clinic.

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An example of complying with regulatory requirements.
OPS D12

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This presentation is a good example of responding effectively and appropriately to requests for the production of written material and data. I had to deliver a complex idea in a short presentation style conference with Q&A at the end - a mini VIVA.
OPS C3

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A strong example making sure that my practice is safe, clean and hygienic, and complies with health and safety legislation.

OPS C5

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Chevalier, G., Sinatra, S., Oschman, J., Sokal, K. & Sokal, P., 2012. Earthing: Health Implications of Reconnecting the Human Body to the Earth's Surface Electrons. Journal of Environmental and Public Health, 2012, pp.1-8.

ESO - European School of Osteopathy. n.d. Patient Complaints Procedure | ESO - European School of Osteopathy. [online] Available at: <https://www.eso.ac.uk/eso- clinic/feedback/patients-complaints- procedure/#1556728698554-194cfe32-6a17>

Gregory, D., 2008. Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices. American Family Physician, 78(7).

Kaptein, M., 2019. Prescribing Outside-Work Behavior: Moral Approaches, Principles, and Guidelines. Employee Responsibilities and Rights Journal, 31(3), pp.165-185.

Loudon, J., 2016. BIOMECHANICS AND PATHOMECHANICS OF THE PATELLOFEMORAL JOINT. The International Journal of Sports Physical Therapy, 11(6).

Pollard, H., 2008. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. The Journal of Canadian Chiropractic Association, 52(4).

Youtube.com. 2016. Instructional Video on Application of the Still Technique With Narration. [online] Available at: <https://www.youtube.com/watch?v=GzPP42Aqz10>