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11/10/18

I will reflect on this observation following the Rolfe reflective model
What? So what? Now what?

My first clinical observation was not what I expected. first of all, I was completely lost in every possible way. Nothing was explained to me before. I didn't really know the building neither how the reception worked and how we were supposed to go and follow.
Moreover, I didn't know what kind of notes would be efficient for my self-improvement and useful to complete my courses.
- I first followed a 4th-year student who had an old man as a continuing patient. he came with lower back pain with radiation on his left leg probably due to his job (lock keeper). He has to constantly bend forward and to carry heavy things daily.
The student treated him with some techniques I didn't know at the time that I can't remember the names of and some articulation of both hips in a supine position. The purpose was to decrease the patient's pain so that he can continue whit his job.
During the whole session, I was impressed by the student's good communication skills.
I was seated towards the feet of the patient and during the treatment, I was able to see all intimate part of the patient body because he was wearing a large pant. I really felt uncomfortable at that moment.
Except for that, I enjoyed this experience and the practitioner was really nice. Therefore, it was great to be introduced by someone like that. Next time I'll ask to sit near the patient's head.
The practitioner should have put a blanket on the pelvis of his patient either for the patient's well-being and his satisfaction.
(OPS C6)

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16/01/19

I will reflect on this observation following the Rolfe reflective model
What? So what? Now what?

During that observation, I followed a 3rd-year student who had a new patient. The patient was 46 years old working as a finance manager for 28 years (we can conclude that he is mostly sitting all day long), presenting complain of pain in his right low back with numbness in his right leg. The pain first came after a running session but had had it 20 years earlier but it wasn't constant. After some testing, the practitioner found that the pain came from the SIJ and that the L5 was probably compressed. That would explain the patient's lack of sensibility in his left big toe.
THE BODY IS A UNIT.
During the treatment, the student did some soft-tissue, MET and articulation. But I noticed that he didn't adjust the couch as he should have done. His posture was not good for his back. It made me realise that a good posture can provide the necessary motion needed by the practitioner and assure a good use of his body weight. It also helps to give effective treatments to the patient.
(OPS B1; OPS D11)

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21/01/19

I will reflect on this observation following the Rolfe reflective model
What? So what? Now what?

In the course of that observation, I followed a 4th-year student with a continuing case. The patient was 53 years old male. He complained of left neck pain in rotation and a side-bending (possible trap mm). He has been coming for a long time at the clinic and 3 years earlier he had a bike accident that caused him 7 fractures in the skull. Moreover, he had had a stroke two weeks just before the consultation. He has some sequels such as dropping feeling on his left cheek.
He is a police officer and after all those adventures, he is afraid of not being able to continue his job.
I think that this observation has been the most interesting case at the psychological level. I also talked with the student practitioner after the session and she was really sad and touched by this case and she also told me that it was her favourite patient (even if she knew she shouldn't have one) and she was worry about the condition of her patient and was afraid no to see him again. When I came home I still felt bad for the patient and felt helpless.
The practitioner didn't show that she had sympathy for the patient during the treatment which is good because we need the empathy to patient care but we need to hide the sympathy from the patient because it is not professional and can affect the quality of the treatment.

To empathize is to respond to another's perceived emotional state by experiencing feelings of a similar sort. Sympathy, on the other hand, not only includes empathizing, but also entails having a positive regard or a non-fleeting concern for the other person. This would explain why to say, "I sympathize with you" seems to suggest more support and compassion than, "I empathize with you"

Chismar, D. (1988). Empathy and sympathy: The important difference. The Journal of Value Inquiry, 22(4), 257-266.
(OPS A1)

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On successful completion of the module, the student will be able to:

1. Understand basic physiological terminology and how the body is organised at the molecular, cellular and tissue levels including homeostatic control mechanisms.

2. Describe the inter-relationships of bone and muscle tissue and their energy requirements during different levels of physiological demand.

3. Appraise the nervous system structure and function including sensory, motor and autonomic control mechanisms and their inter-relationships.

4. Determine the nature of pathological processes and the cellular response to disease and infection.

5. Demonstrate a broad understanding of the common traumatic conditions and pathologies of bone, joints, muscles and how these relate to pharmacological treatments.

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Indicative Content Pathophysiology-Year 1 : 

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Indicative Content Pathophysiology-Year 1 : 

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Levels of organisation:

Chemical, Cellular & Tissue

Homeostasis

Support and movement

Neural tissue and structural organisation

Sensory, motor and autonomic control

Trauma and diseases of:

Bone, Joints & Muscle

Pathological processes and cellular response to:

Homeostatic challenge & Infective agents

Pharmacological treatment of:

Trauma & Bone diseases.

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Essay 1 : OS416 Professional Skills & Identity CW 1

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Essay 1 : OS416 Professional Skills & Identity CW 1

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Feedback

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Essay 1 : OS416 Professional Skills & Identity CW 1

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Essay 1 : OS416 Professional Skills & Identity CW 1

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2019 Coursework Report

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- Written Exam (including TCA): Multiple choice, 1 hour.
- Learning Outcomes Assessed : 1,2
- Weighting% or P/F : 10
- Indicative Week No. : 12
- My result for OS413 Pathophysiology Exam 1 was 82%.

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- Written Exam (including TCA): Multiple choice, 1 hour.
- Learning Outcomes Assessed : 3,4
- Weighting% or P/F : 30
- Indicative Week No. : 24
- My result for OS413  Pathophysiology Exam 2 was 56%.

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- Written Exam (including TCA): Short & Long answer, 1.5 hours.
- Learning Outcomes Assessed : 4,5
- Weighting% or P/F : 60
- Indicative Week No. : 33
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On successful completion of the module, the student will be able to:

1. Identify using basic anatomical terminology by palpation and/or surface markings the bones; principle joints, identifying gross osteological features; principle muscle groups including testing their function and the major visceral organs.

2. Appraise the joints of key functional areas and the range of normal in the spine, pectoral and pelvic girdles, knees, ankles, elbows and wrists.

3. Distinguish the 4 major tissue types by function, location, palpatory feel and resistance, including the palpatory feel of bone, fascia, tendon, adipose connective tissues.

4. Describe the process of embryogenesis from fertilisation to gastrulation and neurulation with examples of disease processes related to embryological development and common teratogens and developmental disorders.

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- PR1 Practical Exam: Practical
Skills Assessment: OSPE
- Learning Outcomes Assessed :
1, 3
- Weighting% or P/F : 40
- Indicative Week : Term 2, Week 12
- My result for OS412 Anatomy I Practical 1 was 66%.

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- EX1 Written Exam
-  Learning Outcomes Assessed :
1, 2, 3, 4
- Weighting% or P/F : 60
- Indicative Week : Term 3, Week 32
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Term 2 - January

I will reflect on this prosection following the Rolfe reflective model
What? So what? Now what?

I went to my first protection in London at Guy's Hospital with ESO year 1 students. There were several totally different male and female bodies at our disposal as well as some anatomy manuals. It was mainly the lower limbs, the thorax, the back, and a few upper limbs but no neck and head. We were able to see and contact them. I got the chance to compare the bodies with anatomy pictures.
This experience was really good for me to understand concretely the human body and its structure because I used two have some difficulties to imagine muscles, bones, nerve system,... all together. It makes more sense now!
Thanks to this experience I am more interested to learn my anatomy and to spend time on it.
I still manage to make this event bring me some useful knowledge even if I could have learned more if I knew already the basis.
Next time, I will revise my basis before attending a prosection.

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Term 3 - April

I will reflect on this prosection following the Rolfe reflective model
What? So what? Now what?

I went to my second protection in London at Guy's Hospital with ESO year 1 students. This time there were fewer bodies but the subject was different and more specific. It was the thorax, the back, the neck, and the head.
It was really good to visualise how the head and neck are composed. and It was good to see the thorax and back again because I had the chance to learn it since the last prosection. It was an opportunity to review it with a real body.
There were fewer students at that time. Therefore, I could ask questions to assistants about some structures I didn't know their name or even their existence...
Once again I wasn't aware enough about the head and neck anatomy and it reduced my abilities to learn as much as I could have done.
Next year I will study my anatomy for good before going to the prosection.

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Video osteopathic technique-shoulder (scapula)-Term 2 Year 1

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Video osteopathic technique-shoulder (scapula)-Term 2 Year 1

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12/03/19
This video was taken during an Osteopathic Technique lecture. We were in B4 and my model was Jack. We were learning the manipulation of the  (elevation/depression, protraction/retraction & circumduction). It was the first time I was practicing this technique and I wasn’t confident with it yet! As we can see the couch is too low therefore I am lying too much on my patient and my position is wrong. My back is too inclined. Next time I will correct the couch height as well as my posture. Also, I could have used something (like a sheet ou pillow) to place between my sternum and his shoulder. It should have help with my posture, and to have more distance with my model to be more professional.
Moreover, my legs are too straight and I don’t move my whole body as I should. Also, on the video, I circumvented the shoulder anteriorly but I should have brought it posteriorly  for a better outcome of the technique.
Next time I will think about all those mistakes that I’ve done and I won’t repeat those. This video is quite useful for my technique progress!
On the other hand, I didn’t forget to ask consent neither have I forget to ask if my patient was comfortable which is good for my future practice.

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31/01/19

I will reflect on this observation following the Rolfe reflective model
What? So what? Now what?

During this observation, I followed a 4th-year student. The patient I observed was a 35 years old male patient who had a wrists problem, especially the right one. The student did some ROM-passive tests in every vector. For treatment, he practiced some soft tissue on his biceps and some MET. Afterward, the patient complained about the handhold of the student because it left some nail trace that annoyed the patient.
The practitioner shouldn't keep long nails to treat. I also noticed that the practitioner didn't ask consent every time and didn't ask regularly if the patient was comfortable like we thought in class.
Moreover, the patient did a blood test before coming to the clinic and found out that he had a high level of B12 in his blood which is unusual. The practitioner had no clue about a cause and didn't even know that could exist.
It reminded me that we can't know everything and as an osteopath, we always have to learn more and more about everything.
(OPS A4; OPS B2)