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A1. You must listen to patients and respect their individuality, concerns and preferences. You must be polite and considerate with patients and treat them with dignity and courtesy.

I used the Gibbs reflective model to reflect on A1.4

Description:

I got a patient who requested a female only practitioner, in which I was assigned the case. In these instances we usually suspect there is a reason to which they may prefer a particular gender (TheBMA 2024b), however I didn't ask a reason as well I didn't mention to my patient that the tutor was male and if she was happy with him coming in and being a part of her appointment. Baring in mind she would at some point most likely be somewhat uncovered during examination. A stage in which the tutor most likely would've come into the room.

When my tutor walked into the room, the patient clearly looked uncomfortable but continued with the appointment. Only when I noticed a change in attitude with my patient did I realise that she might not have been comfortable with the male tutor being present.

Feelings: I feel bad about the situation and disappointed that I was't able to provide a comfortable environment for my patient even though she had specified that she might not have been comfortable with any male presence in the room.

Evaluation: It was good that at first I was able to build up a good rapport with my patient and make her feel comfortable before the examination process. She trusted me in the Case Hx to tell me her personal health issues and conditions. But then she became a bit closed off after the male tutor came in and I feel she felt uncomfortable knowing her personal information was shared to a male. This became a bad experience for the patient as she felt uncomfortable and a bad one for me as it changed the dynamic in the treatment room and that the feedback received during the rest of the appointment was altered due to potential insecurities.

Analysis: Of the situation I made that if the patient requests a particular gender practitioner, in my case female, that they may not want any male clinic tutors or observers in the room, due to their personal reasons.

Conclusion: I could've warned my patient that the tutor was male and that she was happy for him to come in, baring in mind she might be undressed. If the patient was unhappy then I could try and find a female tutor to assist on my patient.

Action plan: Should I get a patient requesting a female practitioner I would make sure that if I had a male tutor, the patient would be aware at the beginning. If they're not happy with them coming in I would see if I could get an out of slot with a female tutor if there were any available, or with Sarah Jane/ Julie Palmer if they were in to assist me on the consultation and book returning (if applicable) with female tutors only, even if it meant another female practitioner taking over from me if I wasn't grouped with any in when I was in clinic.

TheBMA (2024b) Exceptions, The British Medical Association is the trade union and professional body for doctors in the UK. Available at: https://www.bma.org.uk/advice-and-support/equality-and-diversity-guidance/discrimination-guidance/managing-discrimination-from-patients-and-their-guardians-and-relatives/exceptions (Accessed: 13 May 2025).

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A2. You must work in partnership with patients, adapting your communication approach to take into account their particular needs and supporting patients in expressing to you what is important to them.

I used the DIEP model to reflect on A2.5

I had a patient in clinic who had come in with no expectations from me in regards to what I could do/not do for them within the initial consultation, so was happy with whatever the outcome was.

This particular patient had hip pain that radiated into the groin, had started fairly recent to when I first met him. However, as an active 69 year old male, was impacting his quality of life.

I knew his goal was to remain as active as possible and reduce the amount of pain he was in for his long visit to Australia where he knew he would be doing lots of walking.

Due to this fact, I wanted to try and give him some treatment that would alleviate his symptoms and make his active lifestyle and upcoming holiday possible. Treatment had however, plateaued in effectiveness and by the time he had returned from Australia we needed to rethink his treatment and potentially look at other options.

It was then discussed between myself and a tutor, after reflecting on his file, knowing the amount of visits and physical assessments on the day that he would most likely need a hip replacement (Wexford Osteopathic Centre 2024).

Ultimately, I should've presented this idea to him earlier and made that option aware from the very beginning as we know the NHS has long waiting times from start to finish. Luckily, this patient had health insurance so knew if he needed the surgery he would be able to get it done quicker. However, I was not originally aware of this and shouldn't have changed my timeline in offering alternative treatment/management of his hip pain.

Using the DEIP reflective model I can now say this was a learning experience to always remember and make available to patients the other options they may require. I shouldn't take referring patients away personally and see it as a lack of my own skills.

In the future I will definitely behave a more of a collaborative practitioner and welcome patients back to me once they have received the care from the practitioner that is most appropriate to them at that time.

Wexford Osteopathic Centre (2024) How an osteopath can help you, Osteopaths Wexford. Available at: https://www.osteopathswexford.com/how-an-osteopath-can-help-you/ (Accessed: 13 May 2025).

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A3. You must give patients the information they want or need to know in a way they can understand.

Using Driscolls reflective model for A3 1.1...

What?

Usually when seeing a patient on an initial consultation I would explain what would happen during the appointment and I originally thought I was doing well with this as patients understood and didn't have any questions regarding what I had explained. However, I had learnt that I was missing out the step of offering a chaperone during the appointment (GMC no date).

So what?

I feel embarrassed to say I missed out a very important step and am unaware if any of my patients would've wanted a chaperone during any of the appointments. During the time I didn't know any different but now I do, I wonder if any of my patients might have wished they'd had one.

Now What?

Now I know and have already began informing patients they have a right to a chaperone during the appointment and asking if they'd like one and confirming they are happy to continue without if they say no. All said lighthearted so they don't feel like they need one if they truly don't want one, but still making them aware it is their right and a reasonable and easy request.

GMC (no date) Intimate examinations and chaperones - GMC. Available at: https://www.gmc-uk.org/professional-standards/the-professional-standards/intimate-examinations-and-chaperones/intimate-examinations-and-chaperones (Accessed: 13 May 2025).

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A4. You must receive valid consent for all aspects of examination and treatment and record this as appropriate.

I used the DIEP model to reflect on A4.2

When doing manipulations on patients I would get consent for the first time I was using that technique. However, a tutor explained to me that I needed to obtain consent each time I was going to do a manipulation on the patient (Shah, P. 2024).

Reflecting on this using the DIEP model, my interpretation means I wasn't able to reinforce the patient of the risks which I know is a crucial aspect of our treatment sessions. I felt like I had let so many of my patients down as they may have lost an opportunity to ask about the technique and be reassured they're safe to have it done.

Evaluating this I know it's a learning experience and I'm grateful to have had it now as not only does it protect the patient but it also protects me which is incredibly important. If something were to go wrong or the patient experienced one of the risks of the treatment, I could get into a lot of trouble for not being able to document the consent I didn't receive on that day.

My plan to continue what I have already started would be to run through the consent before each manipulation that I can then document on the patient file that the patient had consented to the technique and given the opportunity to hear the risks.

Shah, P. (2024) Informed consent, StatPearls [Internet]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430827/ (Accessed: 13 May 2025).

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A5. You must support patients in caring for themselves to improve and maintain their own health and wellbeing.

Regarding a patient I saw once I'm using the Gibbs reflective model to reflect on how I advised a patient in terms of his drinking in line with OPS A5 1.1

The patient came in with lower back pain that was reoccurring and I had no issue in understanding his back pain. However, this patient was a heavy drinker and it seemed that his drinking habits may have predisposed him to the issues he was facing (Admin, N. 2022).

I felt that I didn't want to embarrass the patient but I knew it was something that needed addressing.

I explained what I had thought was occurrin to the patient as well as the impact the amount he was drinking was having on his back pain and that would also be occurring to the rest of his body but he just hasn't experienced yet. We spoke about how he felt about the drinking and if there was anything else he was experiencing that he hadn't previously told me. More was unravelled and it was decided that I would help him however he had to alter his drinking habits.

I gave him some treatment and at home lifestyle changes but he never came back.

Evaluating this he may have made some big changes to his lifestyle regarding his drinking and exercise at home and felt like he didn't need to come back.

Alternatively he may have taken my advice the wrong way and not wanted to come back due to what I had said about his drinking.

Analysing this, I think I could have made it clearer that I was happy to help him manage his back pain and made it clear there was no judgement about the drinking. At the time I thought I had handled it very well as it was my first time addressing an issue of such with a patient.

Concluding this I would always make sure the patient is okay during the discussion and reassure them that there is no judgement regarding their lifestyle habits and where some adjustments can be made.

Going forward I would definitely keep elements of what I had done originally but adjust it to try and make the patient more comfortable and feel confident leaving the appointment.

Admin, N. (2022) Is alcohol causing my back pain?, New York Bone & Joint Specialists. Available at: https://nyboneandjoint.com/alcohol-causing-back-pain/ (Accessed: 13 May 2025).

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A6. You must respect your patients’ dignity and modesty.

Using Schon's reflective model without thinking about it, I reflected on an appointment with a patient as it was happening regarding A6 2.1

When it happened I was actively reflecting as I hadn't informed my patient at the start that they may be required to undress during the appointment for examination and treatment. When it came to examination and I offered to wait outside for them to undress the patient seemed surprised and a little caught of guard. I instantly knew I hadn't mentioned that part and possibility at the beginning.

After my patient had left I instantly reflected with myself on the action and had learnt that I would need to inform patients of undressing and their modesty options before we start the consultation in the future (Ilkley osteopaths 2019).

Ilkley osteopaths (2019) The Ilkley Osteopathic Practice | Ilkley Osteopaths. Available at: https://www.ilkleyosteopaths.co.uk/patient-information/ (Accessed: 13 May 2025).

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A7. You must make sure your beliefs and values do not prejudice your patients’ care.

In this reflection I will use the Gibbs' reflective cycle to reflect on A7.2

Description:

I had an appointment with a patient whose attitude and communication towards me were challenging. Despite feeling frustrated, I maintained a professional tone, completed the appointment thoroughly, and ensured the patient understood the next steps. Afterwards I asked my clinic tutor for feedback and advice.

Feelings:

I felt disrespected, undermined, and initially upset by the patient's behaviour. However, I also felt a sense of responsibility to remain composed (L;, M. 2017) By the end of the session, I felt proud for not reacting emotionally and prioritising patient care over personal feelings.

Evaluation:

This situation was difficult but handled appropriately. I maintained a professional approach, which helped avoid conflict. However, I did struggle internally to stay focused, and I recognised that such interactions could affect my emotional energy and clinical judgment if not addressed. Discussing it with my clinic tutor helped validate my response and gave me new strategies for handling similar situations.

Analysis:

This experience clearly reflected GOsC OPS A7.2. In practice, knowledge, skills and performance isn't only about technical skills - it also means managing personal reactions in challenging situations. The patient's attitude may have stemmed from previous negative experiences or frustration with their condition. By keeping my emotions in check and treating them respectfully, I upheld professional standards and preserved therapeutic rapport.

Conclusion:

I learned that personal incompatibility can occur even in clinical settings and that maintaining professionalism is essential not just for patient care, but for personal integrity. I now understand the importance of emotional regulation, setting boundaries, and reflecting on difficult interactions.

Action plan:

My action plan would be to develop better strategies for emotional resilience through mindfulness or debriefing after difficult sessions. And to continue to seek feedback and support from clinic tutors in challenging interpersonal scenarios.

L;, M. (2017) Conflict management: Importance and implications, British journal of nursing (Mark Allen Publishing). Available at: https://pubmed.ncbi.nlm.nih.gov/28132555/ (Accessed: 13 May 2025).

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B1. You must have and be able to apply sufficient and appropriate knowledge and skills to support your work as an osteopath.

I will be using the Driscoll's reflective model to reflect on how I compromised my own posture to accommodate a patient's comfort regarding B1 1.11

What:

I experienced physical strain in my lower back during a treatment session because I prioritised the patient's positioning over my own ergonomics. Despite discomfort, I chose to continue the treatment instead of pausing to adjust. As a result, I had back pain that lasted into the next day. I later reviewed the session with my tutor and learned strategies to prevent similar issues.

So what?

This situation highlighted a key part of sage and sustainable osteopathic practice: protecting the practitioner's own body. I realised that working in poor postural alignment, even briefly, can lead to real physical consequences - especially with repetitive treatments. It also showed me that I have a tendency to put patient comfort ahead of my own, which can become a longer-term risk to my health and professional longevity. It reminded me that protecting my musculoskeletal health is a professional responsibility, not just a personal one - consistent with GOsc OPS, which requires maintaining our own health to practise safely.

Now What:

Going forward I will always assess the treatment setup from both the patients and my own perspective before beginning. I will also adjust the plinth height, use stools, or reposition the patient when necessary, even if it takes a few extra moments.

This experience taught me that safe practice means sustainable practice -protecting the patient and myself equally.

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B2 - Working within levels of competence 

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B2 - Working within levels of competence 

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B2. You must recognise and work within the limits of your training and competence.

Using the DIEP model I will reflect on how I was unable to use a visceral technique on a patient regarding B2.3

Describe:

A patient reported suffering with digestive issues and I was considering using a visceral technique that I had seen demonstrated but not yet practiced and received any sort of feedback from. Meaning I lacked the practical competence as well as confidence to use such technique (David Didau 2021). So I chose to use other musculoskeletal techniques instead and Tod my clinic tutor what I would've liked to have done had a had a better competence level regarding the visceral technique.

Interpret:

This scenario indicated a clear ethical and professional boundary. Visceral techniques require not just anatomical understanding but advanced palpation and safety awareness due to the sensitivity of the area. Performing it without proper supervision could risk patient discomfort or harm, and violate the GosC's standard about practicing within competence. My decision reflected maturing in recognising that theoretical knowledge alone doesn't equal readiness for clinical application. It also showed respect for patient safety and trust, which is core to osteopathic values.

Evaluate:

I initially felt frustrated that I couldn't offer more specialised treatment. However, I was reassured when the patient reported feeling better after treatment focussed on the diaphragm release and thoracic mobility. I received positive feedback from my tutor for making a safe, considered decision. this experience reinforced the idea that working within competence is a protective measure - not only for patients, but also for practitioners developing their skills responsibly.

Plan:

I will only use techniques once I've had supervised practice and feedback and will continue developing clinical reasoning to choose appropriate alternatives when needed.

Once graduated I will then seek tutorials or CPD courses to further extend a safe scope of practice.

David Didau (2021) Skill = knowledge + practice, David Didau. Available at: https://learningspy.co.uk/learning/you-cant-teach-skills/ (Accessed: 13 May 2025).

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B3 - keeping up to date with research and developments 

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B3 - keeping up to date with research and developments 

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B3. You must keep your professional knowledge and skills up to date.

I will be using the Driscoll's reflective model for B3 1.2.3.

What:

Being an osteopath means keeping up to date with new developments within the medical world and research that not only applies to osteopathy but with as much as we can (Jerry Draper-Rodi a b et al. 2022). This is because we need to understand conditions that patients may come in with as well as developments on special tests as well as our own treatment. Within clinic I am part of group discussions as well as observe and listen to conversations others may be having and it made me realise that I hadn't done as much research as I needed to do in order to stay aware and safe in practice.

So what:

This made my confidence drop and I felt like I had a lack of competence in clinic when it came to certain guidelines and relevant information that was being published.

I knew that it was impacting my skills as a practitioner at that point because my knowledge relied on that of what had been handed to me by other people rather what I was reading and educating myself on.

What now:

Since then I have subscribed to the Medscape emails that send newly published articles within the medical field and actively revise the NICE guidelines. I also check the guidelines on common things such as the blood pressure guidelines that have recently changed.

I will continue to refresh my knowledge and stay updated with new research so I can be as competent and as safe as I can be. I know that I can't know it all but I can do my best to know as much as research what is relevant to my patients who walk through the door with conditions or medications, I can admit to them that I will learn about.

Jerry Draper-Rodi a b et al. (2022) 4 M’s to make sense of evidence – avoiding the propagation of mistakes, misinterpretation, misrepresentation and misinformation, International Journal of Osteopathic Medicine. Available at: https://www.sciencedirect.com/science/article/pii/S1746068922000220 (Accessed: 13 May 2025).

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B4- Analyse information and reflect upon own practice

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B4- Analyse information and reflect upon own practice

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B4. You must be able to analyse and reflect upon information related to your practice in order to enhance patient care.

I will be using the Gibbs cycle to reflect on B4.1 with one of my CEX results.

Description:

I had my first maternity patient as a CEX and whilst I did well there were of course areas to improve on. My piece of feedback was to get all questions answered first time round. This was because I had come out the room and whilst having five minutes to get ready to present I informed my tutor who was examining me that I needed to go back in to get a couple more questions asked and answered. These were questions that would influence or add more confirmation to any working diagnosis I would have and be testing for.

Feelings:

I felt very nervous on this occasion as during a CEX you don't get any guidance from the tutor meaning that all the decisions were mine to make and I had to back up my diagnosis at the end with information from the case history as well as examination findings. There was added pressure due to the fact this was my first maternity patient and it was an exam at the same time. Conjointly this made me feel underprepared and at times questioning myself.

Evaluation:

I'm proud that I was able to identify the areas in which I needed to fill in and then present the case with all relevant information without any help or hints.

The bad aspect is that I know in a normal situation had I felt less pressure I would've been able to take more time to make sure I had all the information I needed before leaving the room after the case history for the first time.

Analysis:

Of this situation I know that when I'm fresh into working there are likely going to be a lot of patients with conditions or presentations I haven't seen before, meaning I will have to think within the situation a lot just like this one. As well, in the near future I will always be on my own in the treatment room with no one to discuss with until the appointment is over and I can ask for guidance from the senior/other practitioners. In this instance I know I won't be able to allow nerves to let me rush or miss out key questions that need to be asked.

Conclusion:

I should've had a review of the information the patient gave me before leaving the room and perhaps repeated it back to her so I could've identified at that point if I was missing any key information from questions I didn't ask.

I could've also reviewed the questions I would want to ask in more detail before having this patient to make it clearer in my mind and also to try and calm the nerves as I would've felt more prepared.

Action plan:

Learn to be prepared to face new situations everyday and treat everyday like an exam day to help prepare for my CCA so a similar situation doesn't happen. However, continue to be able to identify my own imperfections and strive to correct them without prompt and continue to strive towards more autonomously in practice.

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C1. You must be able to conduct an osteopathic patient evaluation and deliver safe, competent and appropriate osteopathic care to your patients.

I will be using the DEIP model to reflect on a clinical experience that is in regards to C1 1.7.

Describe:

After providing what seemed like a routine treatment, I was informed that the patient experienced an unexpected increase in pain and new symptoms the following day. I recognised that this could represent an adverse reaction and immediately informed my tutor. Together, we contacted the patient, monitored their symptoms, and took steps to ensure safe ongoing care.

Interpret:

This situation highlighted the unpredictability of clinical care - even gentle techniques can sometimes trigger adverse responses. Initially, I felt anxious that I had caused harm, but I understood that part of professional practice is recognising, responding to, and learning from these reactions. My quick response and willingness to escalate the issue demonstrated that I took the situation seriously. I also recognised the importance of post-treatment safety-netting - something I hadn't fully appreciated until this event (NHS 2024) .

Evaluate:

The patient recovered well, and the event became a valuable learning experience. I learned how to assess an adverse reaction, communicate appropriately with a concerned patient, and work with a supervisor to manage the situation responsibly. One weakness was that I hadn't advised the patient thoroughly enough about possible post-treatment flare-ups or when to seek help. That lack of pre-emptive safety-netting may have increased their anxiety. However, I followed the correct procedure when informed and kept the patient's safety central throughout.

Plan:

In the future I will always provide clear post-treatment advice, including potential adverse effects and what to do if they occur. Ensuring patients know how and when to contact the clinic if symptoms worsen unexpectedly.

I will also see adverse reactions not as personal failures but as opportunities to strengthen my clinical skills and patient communication.

NHS (2024) Adverse reactions: Talking to patients, Medicines Learning Portal. Available at: https://www.medicineslearningportal.org/2018/01/adverse-reactions-talking-to-patients.html (Accessed: 13 May 2025).

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C2. You must ensure that your patient records are comprehensive, accurate, legible and completed promptly.

C2 1.11 regarding having copies of any correspondence, reports, test results, etc relating to the patient and how I didn't receive important records to make sure the patients records were completed. I will be using the Driscolls reflective model to reflect on this.

What:

I had a patient come in who reported he had had a disc herniation and repair but was unsure of which level. I said it's okay but didn't ask for a copy of the report of the scan or the reports of the surgery and which level he had operated on.

So what:

This means that my notes were incomplete and whilst not all patients come in with all evidence and records, it's easy enough to ask the patient for the to send them over when they've left the appointment so that I can have all the necessary information in their file (NHS 2022). It will also support my reasoning behind diagnosis and treatment and that the patient was safe to treat. This would also protect me in a court of law if anything was to happen then the patient records would be complete.

Now what:

I have reflected the severity of my mistake and know that having all their necessary documentation in their file is so important, at least to be able to know which levels of the spine have been operated on as this could impact their treatment. I know how this will also protect me if anything was to happen and I needed to back up my reasonings in a law situation.

NHS (2022) NHS choices. Available at: https://www.england.nhs.uk/long-read/high-quality-patient-records/ (Accessed: 13 May 2025).

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C3 - referrals with effective time management 

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C3 - referrals with effective time management 

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C3. You must respond effectively and appropriately to requests for the production of written material and data.

Here I will be reflecting on an instance that highlights C3 1.1 that applies to the time I forgot to write a referral letter for a patient, using the Gibbs cycle.

Description:

I assessed a patient who presented with upper thoracic discomfort and vague symptoms suggestive of possible cardiovascular involvement. After discussing the case with my tutor, we agreed that the patient should be referred to their GP for further investigation. I was tasked with writing the referral letter that day.

However, due to a busy schedule and multiple follow-up tasks, I forgot to write and send the referral letter before I left clinic that day. The issue was only discovered at the patient's next visit a week later, when they mentioned they hadn't heard from their GP. I immediately informed the tutor, apologised to the patient, and completed the referral letter that same day. The patient was understanding, but I recognised the potential risk caused by the delay.

Feelings:

I felt embarrassed and disappointed in myself for forgetting such a crucial task. I also felt anxious about the possible consequences of the delay - both for the patient's health and my professional accountability. At the same time, I was relieved that no urgent harm had occurred and that the patient remained understanding and cooperative.

Evaluation:

The negative aspect of this experience was the delay in the referral, which could have impacted the patient's access to further care. It also undermined the efficiency and professionalism of the clinic. On the positive side, I responded appropriately once the error was identified - I took responsibility, completed the task, and apologised sincerely to the patient. I also received support and constructive feedback from the tutor rather than criticism, which helped me view the situation as a learning opportunity.

Analysis:

This incident made me realise how critical documentation and follow-through are in clinical care. Producing accurate and timely referrals isn't just administrative - it's directly tied to patient safety and continuity of care (RCGP, no date). My oversight stemmed from poor task management and an over-reliance on memory in a high-pressure environment. I recognise the importance of integrating habits and systems (like written checklists or electronic task logs) to manage tasks effectively and prevent errors. It also highlighted that producing reports and referrals in the correct format - and on time - is an essential clinical skill, not just a clerical task.

Conclusion:

This situation taught me that no matter how good my clinical reasoning may be, failing to document and follow up appropriately can compromise patient care. I also learned the value of transparency, accountability, and having systems in place to manage tasks consistently. I'm now more aware of how essential communication and documentation are to effective practice management, as outlined in the GOsC OPS.

Action Plan:

In the future I will use a written or digital checklist at the end of each session to ensure administrative tasks are completed. I will also treat written communication as an active clinical responsibility - not an afterthought - in line with the OPS standards.

RCGP (no date) Quality patient referrals - right service, right time. Available at: https://www.rcgp.org.uk/getmedia/e3c078c8-962f-4d4c-8bc1-382eee35653a/RCGP-referral-management-feb-2018.pdf (Accessed: 13 May 2025).

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C4. You must take action to keep patients from harm.

Regarding C4.2 I will reflect using Driscolls model how my first aid course helps me stay aligned with the OPS.

What:

In second year before starting clinic we all took part in a up to date first aid course that would then last the three years it holds value for. We learnt what to do in emergencies and how to use defibrillators which was useful.

So what:

Although I had previously done my first aid course multiple times it was a nice refresher before going into clinic. It helped me regain the confidence needed to act in an emergency if there ever was one. It also means I can use this training in public or offer advice to patients should they ever question any first aid knowledge (Oast First Aid 2022).

Now what:

Now I can redo my first aid training every three years and it allows me to keep practicing osteopathy and keep patients from harm. It also means I can manage any emergency situations that need to be handled by someone first aid trained. I can also put up certificates of my training in treatment rooms to reassure patients that they are safe in the room and allow help them trust me more.

Oast First Aid (2022) First aid training for osteopaths, Physiotherapists & Wellness Professionals, The Oast First Aid. Available at: https://oastfirstaid.co.uk/first-aid-training-for-osteopaths-physiotherapists-wellness-professionals/#:~:text=And%20when%20you’re%20dealing,should%20they%20ever%20need%20it. (Accessed: 13 May 2025).

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C5- Complies with health and safety legislation

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C5- Complies with health and safety legislation

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C5. You must ensure that your practice is safe, clean and hygienic, and complies with health and safety legislation.

I will be reflecting using the DIEP model about a time I was observing in first year and the clinic was aligning with OPS C5.5.

Describe:

While observing in clinic in first year I followed all the infection control protocols required: I wore a mask, apron and gloves (RCN 2024) when entering treatment rooms. Even though I wasn't physically treating the patient, I followed full PPE protocols to reduce risk to patient, practitioner and myself.

Interpret:

At first, the protocols felt overly strict, especially as I wasn't providing hands-on care. However, I quickly understood that COVID-19 could be transmitted by asymptomatic individuals and that protecting vulnerable patients was critical. This experience helped me see infection control as a proactive act of professionalism, not just a reactive one. The level of precaution also modelled the kind of responsibility expected of a healthcare professional - even in an observational role.

Evaluation:

I believe I handled going to clinic following the pandemic well by following instructions and showing respect for the protocols in place. I asked for clarification where needed and ensured I donned and doffed PPE correctly. A strength was my willingness to adapt to new procedures even when they felt unfair. A weakness was that I initially underestimated the importance of these measures for non-treating team members, which shows I had room to grow in understanding the full scope of infection control in practice.

Plan:

In the future I will always treat PPE and infection control protocols as a critical part of clinical professionalism, even outside of pandemic contexts. I will also proactively stay informed about current public health guidance from NHS England and GOsC.

RCN (2024) PPE at work: Royal College of Nursing, The Royal College of Nursing. Available at: https://www.rcn.org.uk/Get-Help/RCN-advice/ppe-at-work (Accessed: 13 May 2025).

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C6- Discussing public health issues and concerns with patient 

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C6- Discussing public health issues and concerns with patient 

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C6. You must be aware of your wider role as a healthcare professional to contribute to enhancing the health and wellbeing of your patients.

C6.1 and the DIEP model allows me to reflect on a patient I had in clinic who was a heavy smoker and seeing slow results.

Describe:

The patient I was treating for chronic neck and shoulder tension mentioned they were a smoker. Given their slow progress and the evidence linking smoking to poor healing, I brought this up in a sensitive and balanced way. I explained how smoking may be affecting their musculoskeletal recovery and offered to signpost them to trusted NHS resources. I also made sure to discuss this with my clinic tutor afterwards.

Interpret:

This situation helped me understand how important it is to integrate public health awareness into osteopathic care. I wasn't telling the patient what to do - instead, I gave them clear relevant information and respected their autonomy. I realised that my role as an osteopath includes recognising when lifestyle factors may be contributing to the patient's condition and confidently, but compassionately, addressing them. I also recognised that knowing what to say is only part of it- how you say it makes all the difference.

Evaluate:

I think I handled the situation well. I didn't make the patient feel judged or lectured, and they seemed open to the information I shared. A strength was that I linked the public health message directly to their musculoskeletal complaint, making it clinically relevant. One area I could improve is developing a stronger familiarity with local support services, so I can more confidently direct patients to accessible, practical resources (HCPC 2014). I also might have asked more open-ended questions to explore how the patient felt about their smoking, to support a more in-depth motivational conversation.

Plan:

In the future I will continue to build my knowledge of common public health issues that intersect with osteopathy (e.g. smoking, obesity, physical inactivity). I will also maintain a resource folder or digital links for local or national health services (such as smoking cessation, physiotherapy, or mental health support).

HCPC (2014) Professionalism in healthcare professionals. Available at: https://www.hcpc-uk.org/globalassets/resources/reports/professionalism-in-healthcare-professionals.pdf (Accessed: 13 May 2025).

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D1. You must act with honesty and integrity in your professional practice.

Unknowingly I was prolonging treatment in my first year treating so reflecting D1 1.4 with the Driscoll's model.

What:

When I was treating in clinic in third year I was filling up my patient's whole appointment slot till the end with treatment and giving them as much as I could as I felt like that is what I was there for. I also felt and do still feel that patients want as much treatment as they can get because they're paying for the full session and they enjoy getting as much treatment as they can.

So what:

After patient's were beginning to receive a lot of treatment and different techniques within their appointments I got a few comments from tutors mentioning after reading my patient forms saying I was doing too much (Dainty, G. 2024). We had a discussions about where things were going wrong and how expectations from patients and how we know and need to know how to treat and perform a successful treatment plan need to blend, I started to understand where I was going wrong. Whilst patient's are paying and can voice their opinions, I as a practitioner need to realise my influence and knowledge should be a big wager in the appointment and structure of their treatment. I learnt that patient expectations and what will help them won't always align however, ultimately if there's a block to accommodate occurs we still should not go against what we believe having had the training and access to research.

Now what:

Since the discussions I started implementing these changes and invited discussion into appointments. When finishing early saying lightheartedly that that would be enough, or, I don't want to do anymore/too much as I don't see any benefit. As well as saying there is such a thing as too much treatment has helped me justify finishing early and prevent patients from feeling like they were missing out. I've found this has improved not only patient recovery between sessions but also in discharging patient's.

Dainty, G. (2024) How often should I have physiotherapy: Blog, Physio Action. Available at: https://www.physioaction.com/2024/12/04/how-often-should-i-have-physio/#:~:text=Unfortunately%2C%20you%20can%20overdo%20physiotherapy,and%20treatments%20for%20improved%20outcomes. (Accessed: 13 May 2025).

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D2 - treating family and self reflection

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D2 - treating family and self reflection

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D2. You must establish and maintain clear professional boundaries with patients, and must not abuse your professional standing and the position of trust which you have as an osteopath.

D2 5.9 speaks on treating family or friends and this is something I have reflected on myself since joining the course and I have now properly reflected using the Gibbs cycle.

Description:

Recently, I spent time reflecting on whether I would feel comfortable treating close friends or family as a qualified osteopath in the future. Although I understand that in some settings - especially small communities - this can be unavoidable, I've realised that I personally do not feel comfortable doing so. This reflection came up after a conversation with peers during a clinic session.

Feelings:

Initially, I felt conflicted. A part of me wanted to help my family if they were ever in pain or in need of care. But I also felt uneasy at the thought of having to remain professionally objective with someone I care deeply about. I recognised that emotional closeness could cloud my clinical judgement, and I might struggle to make unbiased decisions - or even feel pressured to treat outside my scope or availability.

Evaluation:

On the positive side, I believe it's a strength to reflect honestly on this issue before it arises in practice. It shows self-awareness and a commitment to maintianing professional boundaries, which aligns with the GOsC's expectations. However, I also recognise that in rural areas or family-run practices, these situations are sometimes inevitable. The downside of my current stance is that I may need to find appropriate ways to manage requests from family or close friends compassionately, without making them feel rejected.

Analysis:

This reflection deepened my understanding of professional boundaries and how blurred lines can affect objectivity. The OPS highlights the importance of maintaining the same level of care for all patients, regardless of social connection. I realised that familiarity could cause me to unconsciously skip parts of a thorough assessment, or hesitate to have difficult conversations. I also considered the emotional strain it might cause if a family member didn't respond well to treatment. All of these factors led me to conclude that for me, it's safer and more ethical to avoid treating people I'm closely connected to - at least in most situations.

Conclusion:

I concluded that while treating friends or family may sometimes be necessary in specific contexts, it's not something I feel personally comfortable with at this stage. I would rather refer them to another trusted practitioner to ensure they receive objective care - and to preserve both my clinical standards and personal relationships. Making this decision now helps me stay consistent with my values and with the expectations of the profession.

Action Plan:

In the future I will develop a clear personal policy about treating friends and family and discuss it openly with them if needed. And if approached by someone close to me, I will be prepared to refer them to a trusted colleague or clinic.

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D3- warning the patient about post-treatment soreness

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D3- warning the patient about post-treatment soreness

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D3. You must be open and honest with patients, fulfilling your duty of candour.

This will be reflecting D3.1 using the Gibbs cycle.

Description:

During a treatment session in the student clinic, I was performing soft tissue and articulation techniques on a patient with chronic lower back pain. After the treatment, the patient reported increased discomfort in their hip, which hadn't been present prior to the session. The discomfort seemed to worsen over the next 24 hours. When they returned for their next session, they seemed concerned and unsure whether they wanted to continue treatment. I discussed this with the clinic tutor, and together we explained to the patient that this may have been a post-treatment reaction (Bingel, U. and Wiech, K. 2024), which can happen, but acknowledged that it wasn't something they were expecting or warned about clearly.

Feelings:

Initially, I felt anxious and guilty. I was concerned that my treatment had caused the patient harm, even though I had used techniques I was trained in and that had previously gone well. I also felt nervous about how to talk to the patient about it - I didn't want them to feel dismissed or that their discomfort wasn't being taken seriously.

Evaluation:

A positive aspect of the experience was that I immediately sought support from my tutor and did not ignore or minimise the patient's complaint. Together, we addressed it promptly and honestly. I ensured the patient received reassurance, an explanation, and space to share how they were feeling. A negative was that I hadn't been clear enough in preparing the patient for possible post-treatment soreness, which likely contributed to their distress. I also recognised that I was hesitant at first to initiate the conversation, which could have delayed resolution if not for the tutor's guidance.

Analysis:

This experience underscored the importance of openness, communication, and consent. Patients need to be informed not just of the benefits, but of the possible adverse reactions - even minor ones. by not emphasising this, I inadvertently set up unrealistic expectations. The GOsC standard emphasises that if something goes wrong, it's our responsibility to acknowledge it, explain it clearly, offer an apology where appropriate, and ensure the patient is supported. This wasn't about proving I was right - it was about helping the patient feel safe and respected, even when things didn't go to plan.

Conclusion: I concluded that discussing potential outcomes - both positive and negative - is essential for fully informed consent. I also realised that mistakes or unexpected outcomes are not the end of trust, but how we handle them determines whether trust can be maintained. I learned that honesty, empathy, and professional transparency go a long way in safeguarding patient care and therapeutic relationship.

Action Plan:

In the future I will clearly explain the range of possible post-treatment responses to patients during consent discussions. I fancy adverse reaction does occur, I will take initiative in raising it with the patient openly and promptly.

Bingel, U. and Wiech, K. (2024) Informing about side effects: Putting patients (preferences) first, Pain. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10785051/ (Accessed: 13 May 2025).

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Whilst I have been lucky to not have had any complaints in clinic yet I will be reflecting on a piece of coursework that involved a response to a complaint in year two, using the Driscolls model.

What:

We were given a complaint letter in second year in which we had to write a response to. I had read the letter and we had gone through it in class as well discussing aspect of the letter and learning how to potentially structure the letter when we were writing our responses. It was based from a mum writing in about her child's treatment they would've received from us.

So what:

I found this piece difficult as on top of having not had a complaint but I had also yet not gone into clinic. It was also difficult because it was based on a treatment I hadn't done. I felt that I struggled with it as I would personally have chosen to call the parent and have a discussion with them rather than write a letter in response. Although I passed the mark wasn't great which means that I had many areas to improve upon. One of my areas of feedback was adding more clarity to my reasonings and justifications, however, I think my imagination with this coursework ran low so writing justifications for a fake complaint was difficult.

Now what:

In the future if I were to get a complaint I would make sure to fully and clearly justify my treatments and reasonings behind what I was doing. I would also opt to have an active conversation, either in the clinic or on the phone so that we can perhaps have a better understanding of each other and the patient/complainer feels seen and heard. Mostly, I would work to the standards that would reduce the chances of me getting any complaints but I'm sure there will be some in my working career which I need to be prepared for in how to respond.

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D5 - patient confidentiality, with peers

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D5 - patient confidentiality, with peers

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D5. You must respect your patients’ rights to privacy and confidentiality, and maintain and protect patient information effectively.

I will be reflecting on D5 1.5 using the DIEP model and how I asked a peer to respect my patients confidentiality when out of clinic.

Describe:

While chatting with a peer after clinic hours in a public, I noticed hey were talking about their clinic cases and referred to one of their patients by full name. This concerned me, as it breached confidentiality protocols by identifying a patient outside of a clinical context. I politely asked them not to use patient names when discussing cases and reminded them of our responsibility to protect patient information (TheBMA 2024). They immediately understood and agreed, and we continued the conversation using general descriptions instead.

Interpret:

This situation made realise how easy it can be to accidentally slip into informal habits, even with good intentions. Although we were both discussing clinic for learning and reflection, using a patient's name outside of the clinical environment could be overheard, leading to improper disclosure or personal data. I recognised that part of my role as a student and future osteopath is not just to uphold confidentiality myself, but to promote it among my peers. Saying something respectfully helped reinforce shared professional standards.

Evaluate:

I was glad I spoke up. A strength of this interaction was that I acted promptly and respectfully, and my peer responded positively. it helped us both reflect on our responsibilities around patient confidentiality. One weakness is that I initially hesitated, unsure whether I'd come across as overstepping or critical. But the positive outcome reinforced that it's worth speaking up when ethical standards are at risk - even in subtle ways.

Plan:

I will continue to uphold confidentiality by never discussing patients by name outside of appropriate clinical settings. I'll always encourage peers to do the same by modelling good habits and addressing concerns constructively.

TheBMA (2024) Confidentiality as a medical student - ethics toolkit for medical students - BMA, The British Medical Association is the trade union and professional body for doctors in the UK. Available at: https://www.bma.org.uk/advice-and-support/ethics/medical-students/ethics-toolkit-for-medical-students/confidentiality (Accessed: 13 May 2025).

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D6 - religious clothing and adapting treatment

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D6 - religious clothing and adapting treatment

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D6. You must treat patients fairly and recognise diversity and individual values. You must comply with equality and anti-discrimination law.

This scenario is related to D6.2 and reflected using the Gibbs cycle.

Description:

During clinic, I was treating a new patient who wore religious clothing and requested to keep certain body parts covered during treatment due to their beliefs. Another student made a comment in private suggesting that the patient might not be "suitable for treatment" if they weren't willing to fully expose the treatment area. I felt uncomfortable with this comment. Later, I spoke to my clinic tutor about it and sought reassurance about how to best respect the patient's wishes while still delivering safe and effective care. The tutor supported the patient's right to access treatment and helped us adapt the session with appropriate draping and communication.

Feelings:

At the time, I felt uneasy and disappointed by the other student's comment. I understood that delivering care sometimes requires physical access, but I also felt strongly that is should never override a person's right to dignity, religious beliefs, or identity. I was also unsure how to raise the issue without creating conflict. Speaking with the tutor helped me feel more confident and supported in acting ethically.

Evaluation:

The positive aspect of this situation was that the patient's care was not compromised - they received treatment that respected their needs. I was also able to ask for help and reinforce inclusive practice. A negative was that the comment made by the peer could have led to bias or exclusion if it hadn't been addressed. It also made me realise how easily unconscious bias or assumptions can surface in a clinical environment.

Analysis:

This incident helped me appreciate the equality in healthcare is not just a legal duty but a reflection of professional integrity. The GOsC OPS clearly states it is illegal to deny service based on protected characteristics. Patients bring diverse identities and needs, and as osteopaths, we must find ways to adapt while preserving care quality (Swihart, D.L. 2023). Making respectful accommodations is not a barrier to treatment - it's part of what makes it ethical and person-centred.

Conclusion:

I concluded that raising awareness about unconscious bias and equality should be a regular part of osteopathic education and practice. It also showed me that professionalism includes speaking up when you notice attitudes or comments that could lead to discriminatory practice. Most importantly, I saw how inclusive communication and flexible thinking can meet both clinical and ethical needs.

Action Plan:

In the future I will always listen to patients' preferences and cultural or religious needs without judgement and I'll continue to seek guidance from tutors or colleagues if unsure how to adapt treatment respectfully.

Swihart, D.L. (2023) Cultural religious competence in clinical practice, StatPearls [Internet]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK493216/ (Accessed: 13 May 2025).

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D7. You must uphold the reputation of the profession at all times through your conduct, in and out of the workplace.

Reflecting D7.1 using the Gibbs Cycle.

Description:

While scrolling through instagram, I came across a peer's story that included a video of us during a recent university social event. In the video, I was joking around and making exaggerated impression of different patient complaints - something that had felt harmless in the moment but was clearly mimicking real life cases we had see in clinic. Even though no patient details were mentioned, I realised this could easily come across as mocking or disrespectful, especially if seen out of context. I immediately asked my peer to remove the video, and they did without hesitation. I then reflected on how such content could damage both my personal and professional image (Wellness, T. 2024)

Feelings:

At first, I felt embarrassed and slightly ashamed. I hadn't meant to be unprofessional and the impersonations were never meant to mock real patients - but watching the video back, I saw how it might appear that way. I also felt worried that someone from clinic might have seen it. It made me feel more cautious and aware of how I represent myself, especially on public platforms.

Evaluation:

The positive part of this situation was that I took responsibility quickly and the content was removed before it caused harm. It also sparked important reflection. The negative aspect was my initial lack of awareness - I hadn't considered how even a light-hearted video could be misinterpreted and impact the reputation of the profession. I realised that even offhand behaviour, when shared publicly, can leave a lasting impression.

Analysis:

This experience highlighted the importance of maintaining professional boundaries online, not just in clinic. As students, we are still representatives of the osteopathic profession, and social media blurs the lines between personal and professional life. While intent matters, perception matters just as much. If the public sees conduct that appears to mock patients, it could damage their trust in osteopaths generally. The GOsC rightly expects osteopaths to be mindful of their behaviour at all times.

Conclusion:

I concluded that professional conduct doesn't end when I leave the clinic or classroom. in the digital age, everything posted online becomes part of a public image - and as a future healthcare professional, I have a duty to uphold the values of respect, dignity, and integrity, both on and offline.

Action Plan:

In the future I will avoid sharing or participating in any content that could be perceived as unprofessional. I will also reflect more carefully on how my behaviour - in person and online - aligns with the professional image I want to project.

Wellness, T. (2024) Importance of maintaining professionalism on social media, Truworth Wellness - India’s Leading Health & Wellness Engagement Company. Available at: https://www.truworthwellness.com/blog/maintaining-professionalism-on-social-media/#:~:text=Wellness%20Engagement%20Company-,Networking,with%20peers%20and%20industry%20professionals. (Accessed: 13 May 2025).

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D8. You must be honest and trustworthy in your professional and personal financial dealings.

I will be reflecting on D8.4 using the DIEP model.

Describe:

While working in the student clinic, I treated a patient with chronic upper back and neck tension linked to their desk-based job. They mentioned they'd seen online ads for posture braces and massage devices, and asked if I thought they would help. Rather than recommending a product outright, I explained how these devices work, discussed evidence limitations, and focused on active self-management strategies such as exercise, stretching, and workstation adjustments. I only recommended an ergonomic chair cushion that I had personally found useful in similar cases, but stressed it should support - not replace - active postural habits.

Interpret:

This situation highlighted the importance of using clinical judgement when patients ask about commercial health products. I recognised that patients often look for quick solutions, but it's my role to guide them toward safe, evidence-informed choices. Recommending something simply because it's popular - or I've used it - without considering their unique presentation would have been inappropriate. This scenario reminded me that even when a product seems harmless, the recommendation carries weight when it comes from a healthcare professional.

Evaluate:

What went well was that I took the time to understand the patient's concerns and provided advice tailored to their lifestyle and condition. I avoided promoting products unnecessarily and made sure that any suggestions were backed by a clear clinical rationale. A weakness was that I felt unsure about the clinical evidence for some of the products the patient mentioned. This prompted me to reflect on the need to stay up to date (Kalena 2023) with current guidelines and research around commonly marketed tools and devices.

Plan:

In the future I plan to review the evidence base for commonly asked-about health products to feel more confident in my recommendations. And I will also avoid making suggestions that could be interpreted as promotional or based on personal preference without clinical justification.

Kalena (2023) The power of staying informed in Health Care, CareAparent. Available at: https://careaparent.com/the-power-of-staying-informed-in-health-care/ (Accessed: 13 May 2025).

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D9. You must support colleagues and cooperate with them to enhance patient care.

I've reflected on D9.1 using Schon's reflective model.

Context:

During my student clinic rotation, I needed to hand over the care of a patient I had been treating for sacroiliac joint dysfunction. The patient had responded well to treatment but still required ongoing management. Due to changes in clinic scheduling and the patient needing that session time, another student would be taking over the case.

Reflection-in-Action

Anticipating the handover, I created a clear, concise handover sheet. This includes:

A summary of the presenting complaint

Any medications or systemic concerns

Any red flags or relevant psychosocial factors

Treatments used and the patient's response

The agreed treatment plan

Specific goals discussed with the patient.

When the handover took place, I used. this sheet to guide a verbal discussion with the incoming student. I noticed that the written structure helped me present the information in a more confident and coherent manner. It also allowed the receiving student to ask more targeted questions, which improved the clarity of the exchange.

I also made a note in the patient's clinical records documenting that the handover occurred, what was discussed, and who the case was passed to.

Reflection-on-Action:

After the handover, I reflected on how much smoother the process was compared to previous informal or rushed transitions I'd experienced. The written handover helped ensure nothing important was missed and gave the incoming practitioner a clear starting point. It also reassured me that the patient's continuity of care was being respected and maintained (Ghosh, S., Ramamoorthy, L. and Pottakat, B. 2021)

By documenting the handover formally in the clinical notes, I followed best practice and contributed to transparent and safe communication within the healthcare setting. It also demonstrated accountability in case of any future issues or follow-ups.

Learning and Development:

This experience reinforced that good communication is more than just talking - it includes preparation, documentation, and clarity. A written handover:

Supports the safety an the continuity of patient care

Helps colleagues feel more confident in taking over

Reduces the likelihood of clinical errors or omissions

Going froward, I will continue to use structure handover sheets and ensure all handover are clearly recorded in the clinical notes. I also plan to refine my handover template with tutor feedback, to improve its clarity and usefulness for future cases.

This reflection strengthened my appreciation for collaborative care and showed how professional communication supports effective practice management and patient outcomes.

Ghosh, S., Ramamoorthy, L. and Pottakat, B. (2021) Impact of structured clinical handover protocol on communication and patient satisfaction, Journal of patient experience. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC8205370/ (Accessed: 13 May 2025).

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D10- Respecting other healthcare professionals 

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D10- Respecting other healthcare professionals 

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D10. You must consider the contributions of other health and care professionals, to optimise patient care.

I will be reflecting on D10 1.1 using Schon's reflective model.

Context:

While in clinic, I treated a patient who had recently seen a physiotherapist for persistent knee pain. During the initial consultation, the patient expressed frustration, saying the physiotherapy "didn't help" and asked if I thought the physio had misdiagnosed their problem. They also suggested they were considering complaining. I was aware of the need to respect other professionals, even if the patient was unhappy, so I took a careful and professional approach in my response.

Reflection-in-Action:

As the patient spoke negatively about the physiotherapist, I recognised the importance of not undermining another professional's role or actions. Instead of agreeing with the patient's frustration or making assumptions about the physiotherapist's treatment, I acknowledged their concerns while remaining neutral.

I explained that different practitioners may have different approaches based on their clinical reasoning and training. I also reassured the patient that their decision to seek further care was reasonable and that I would assess them independently, focussing on their current presentation rather than commenting on previous management.

In doing so, I consciously maintained professional respect for the physiotherapist, while validating the patient's right to seek further opinions.

Reflection-on-Action:

After the consultation, I reflected on how easy it would have been to unintentionally criticise another healthcare professional, especially when trying to build rapport with the patient. However, I was glad I stayed professional, avoided speculation, and didn't contribute to any negative perception of the physiotherapist. I also documented the patient previous care accurately in the notes without making judgemental remarks.

This scenario reinforced the importance of inter-professional respect, even when patients present with dissatisfaction about past care. negative or speculative comments could not only damage patient trust in the wider healthcare system but also reflect poorly on my own professionalism.

Learning and Development:

This experience helped me better understand how to navigate complex conversations about other practitioners. It strengthened my awareness that:

Respect for colleagues across disciplines supports patient trust and integrated care

Patients benefit when healthcare professionals avoid criticism and focus on constructive, patient-centred solutions

Comments about other practitioners must be based on fact, not assumption or emotion

In future I will continue to take a neutral and respectful stance when patients discuss previous care. If concerns about other professionals arise, I will direct patients appropriately (e.g. to speak directly with that provider or pursue formal feedback channels), rather than becoming involved in negative commentary.

This reflection deepened my appreciation of professional integrity and collaboration which are essential for ethic osteopathic practice (Coulter, A. and Oldham, J. 2016)

Coulter, A. and Oldham, J. (2016) Person-centred care: What is it and how do we get there?, Future hospital journal. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6465833/ (Accessed: 13 May 2025).

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D11-  Mental health and Clinical practice

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D11-  Mental health and Clinical practice

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D11. You must ensure that any problems with your own health do not affect your patients. You must not rely on your own assessment of the risk to patients.

I will be reflecting on D11 1.1 using the Gibbs Cycle.

Description:

During a particularly intense academic term, I experienced a period of high stress and anxiety due to looming, back-to-back clinic shifts, and personal challenges. Despite this, I continued attending clinic, thinking I could manage it on my own. However, during one appointment, I noticed I was struggling to concentrate fully during the consultation, and I felt mentally foggy when trying to recall the patient's history and decide on a treatment plan. I completed the session safely but felt unsettled afterward, realising I may not have been providing the highest standard of care.

Feelings:

At the time, I felt anxious and ashamed. I worried that acknowledging my mental health might be seen as a weakness or lack of resilience. I also felt guilty - knowing I wasn't entirely present during the treatment session and this could have affected the patient's experience. After the session, I felt heavy with self-doubt and realised I needed to do something before it impacted my future practice or someone's safety.

Evaluation:

The positive outcome was that I recognised the issue early and no harm came to the patient. I took the right step shortly after by discussing how I was feeling with my clinic tutor and accessing the university's wellbeing support. The negative was that I didn't act sooner, and I risked allowing stress to impair my ability to make clinical decisions. I also recognised that pushing through without seeking help could lead to burnout or a serious lapse in care (WHO,2025)

Analysis:

This situation made me realise how easily mental health can affect professional performance, even when you feel you're managing. As an osteopath, I have a duty to provide safe, competent care - and this includes knowing when to step back. The GOsC OPS is clear in requiring practitioners to seek medical advice and modify practiced if needed. Had my stress escalated further without intervention, I could have made a mistake that would compromise patient care. I learned that awareness, honesty with myself, and early action are key.

Conclusion:

I concluded that looking after my mental health is not separate from my clinic responsibilities - it is central to them. Taking steps to seek support is a sign of professionalism, not failure. I also realised the value of tutors and peer support in recognising when something is not right.

Action Plan:

In the future, I will monitor my mental health more closely, especially during demanding academic periods. I will also ensure that if ever my capacity to treat safely is affected, I take a temporary step back and follow appropriate medical advice on modifying my practice.

WHO (2025) Mental health at work, World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/mental-health-at-work (Accessed: 13 May 2025).

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D12. You must inform the GOsC as soon as is practicable of any significant information regarding your conduct and competence, cooperate with any requests for information or investigation and comply with all regulatory requirements.

I will be using the DIEP model to reflect on D12 1.1

Describe:

During a university professionalism session, we reviewed a case of a registered nurse in the UK who was subject to disciplinary action by the Nursing and Midwifery Council (Tooley, D. 2025). The nurse had been convicted of driving under the influence and received a criminal conviction. Although the offence occurred outside of work and didn't involve a patient, the regulatory body launched proceedings to assess the impact on public trust in the profession. Ultimately, the nurse received a suspension due to concerns about fitness to practise and professional judgement.

Interpret:

This case made me realise that regulatory accountability extends beyond the clinic. Even when a crime is unrelated to clinical care, it can affect how the public views health professionals. As an osteopathic student, this helped me understand that our conduct outside of work is still seen as a reflection of our professional character. It also raised questions about how I would respond if a similar issue affected a colleague or peer.

Evaluate:

This case was impactful because it showed how important it is to maintain professional standards both in and out of practice. What I valued was the discussion around professionalism, trust, and the responsibility to act as a role model in the community. However, I also found it challenging - it showed how one mistake can jeopardise a whole career. While the nurse accepted responsibility and sought support, it was clear personal actions can have serious professional consequences.

Plan:

Reflecting on this, I plan to be mindful of how my personal choices can reflect on me professionally, even outside of clinical settings. I will also seek advice early if I ever face a situation that could impact my registration or reputation.

Tooley, D. (2025) Nurse suspended after drink drive crash on way to work as Alcohol Misuse Specialist, Shropshire Star. Available at: https://www.shropshirestar.com/news/health/2025/02/04/nurse-suspended-after-drink-drive-crash-on-way-to-work-as-alcohol-misuse-specialist/ (Accessed: 13 May 2025).

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Admin, N. (2022) Is alcohol causing my back pain?, New York Bone & Joint Specialists. Available at: https://nyboneandjoint.com/alcohol-causing-back-pain/ (Accessed: 13 May 2025).

Bingel, U. and Wiech, K. (2024) Informing about side effects: Putting patients (preferences) first, Pain. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10785051/ (Accessed: 13 May 2025).

Coulter, A. and Oldham, J. (2016) Person-centred care: What is it and how do we get there?, Future hospital journal. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6465833/ (Accessed: 13 May 2025).

Dainty, G. (2024) How often should I have physiotherapy: Blog, Physio Action. Available at: https://www.physioaction.com/2024/12/04/how-often-should-i-have-physio/#:~:text=Unfortunately%2C%20you%20can%20overdo%20physiotherapy,and%20treatments%20for%20improved%20outcomes. (Accessed: 13 May 2025).

David Didau (2021) Skill = knowledge + practice, David Didau. Available at: https://learningspy.co.uk/learning/you-cant-teach-skills/ (Accessed: 13 May 2025).

Ghosh, S., Ramamoorthy, L. and Pottakat, B. (2021) Impact of structured clinical handover protocol on communication and patient satisfaction, Journal of patient experience. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC8205370/ (Accessed: 13 May 2025).

GMC (no date) Intimate examinations and chaperones - GMC. Available at: https://www.gmc-uk.org/professional-standards/the-professional-standards/intimate-examinations-and-chaperones/intimate-examinations-and-chaperones (Accessed: 13 May 2025).

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