Year 2 by 21614233

First problem based learning task.

658070 — 2018-10-05 16:55:17 UTC

The group project was about the change in epidemiology of atherosclerosis from 1950 to the present day. The group had to choose a topic area (being exercise) and I chose specifically to look at steroid use and its influence on the epidemiology of atherosclerosis. I learned a lot from this task aside from the topic itself, especially about how to manage a group, communicate effectively, work in partnership and how to relay information that is relevant to the target individual/audience. This translates to my osteopathic journey specifically by learning how to synthesise information quickly, and accurately whilst allowing adaptability to enable patient expressions'.
OPS A1-A3, A5, B1-B2, B4, D2-D3, D8-D9

First case history mock example in clinical integration

658070 — 2018-10-05 17:37:49 UTC

I was very flustered and stressed taking the first few case histories as I had no idea how to link anything together! My writing was pretty awful and the form made no sense in the end...
My communication style wasn't so great and neither was my ability to establish my theoretical patients concerns and preferences. Perfectly normal at this stage (teachers reassuring words) but definately a huge improvement to be made before year 3.

Good amount of time to practice before clinic..

OPS A1-A3, C8

Clinical observation reflection.

658070 — 2018-10-05 17:41:03 UTC

The tutor I was with specifically asked his student practitioners to rule out lower back issues before diagnosing a dysfunctional SI joint and visa versa.
OPS B1-B2, C1-C2

An interesting article on the clinical biomarkers of atherosclerosis.

658070 — 2018-10-29 19:11:47 UTC

OPS B1-B2

Brown, T. & Bittner, V. 2008. Biomarkers of atherosclerosis: Clinical applications. Current Cardiology Reports, 10(6), pp.497-504.

I passed my sports massage exam!

658070 — 2018-10-29 19:21:24 UTC

This now means I can go out and practise sports massage on the public. Im looking forward to improving my communication skills in particular.
OPS A1-A6

My osteopathic technique is improving considerably!

658070 — 2018-10-29 19:35:50 UTC

I feel as though my practical skills are improving in osteopathic skills and everything seems to be clicking together nicely (sorry for the bad pun..).
OPS B1-B2

An introduction to the biopsychosocial model.

658070 — 2018-10-30 09:28:44 UTC

Today in osteopathic concepts and evaluation, we were introduced to the biopsychosocial model. I was very excited as I have a great interest in human behaviour and how it affects patient care. Applying these models during clinical observation is an important part of my self development.
OPS A1, B1-B4

Havelka, M., Lucanin, J. & Lucanin, D. (2009). Biopsychosocial Model – The Integrated Approach to Health and Disease. Coll. Antropol., 33(1), pp.303-310.

Getting familiar with the Framingham Heart Study.

658070 — 2019-07-13 11:12:28 UTC

Getting to grips with the insights of the study was and is essential to our knowledge as clinical practitioners. It is also very interesting to see such a robust study depict such helpful information over the years, with regards to possible sequela and aetiology of cardiovascular disease across the three generations studied and what it might mean for the rest of the population.
OPS A3, A6, B2-B4, C3

O'Donnell, C. & Elosua, R., 2008. Cardiovascular Risk Factors. Insights From Framingham Heart Study. Revista Española de Cardiología (English Edition), 61(3), pp.299-310.

The almighty Cranial Nerves!

658070 — 2019-07-13 15:14:47 UTC

Learning about the cranial nerves was not easy at all for me. After continuous research on youtube and the wider web, I came across this helpful guide. Although there are better and more comprehensive guides, this one really stuck in my head and helped me through my exams. I will also be sure to keep it in my folder ready for clinic next year! Knowledge like this helps you stay within the boundaries of your competence, ultimately keeping the patient safe.
OPS B1-B4, C1

Clinical integration group presentation based upon real case in clinic.

658070 — 2019-07-13 15:48:21 UTC

This group based exam was about justifying patient management, treatment, ongoing informed consent and patient handling. Taking apart a real case a few months before clinic provided to be a very useful exercise. Not only did I learn what ongoing consent should look like, but also where it fitted in. Justifying another practitioners management and treatment plans are also invaluable learning tools as it helps contextualise your knowledge and progress.
OPS A4, A6, B1, B3, C2, C7, D1, D9

The infamous 'Back Page" (of the form used in clinic).

658070 — 2019-07-13 16:27:05 UTC

At first it may have looked daunting, but on closer inspection it wasn't that bad to understand and fill out appropriately. Learning how to fill the page out helped me understand what to learn more of (justification for treatments, alternative plans and continual informed consent) and to piece all the information together in a synchronous manner.
OPS A1, A4-A6, B1-B4, C2, C8, D2-D4

To Fryette or not to Fryette?

658070 — 2019-07-21 10:47:10 UTC

I spent the best part of the entire second year reading and trying to understand Fryette's three laws in application. I would initially understand the principles and then get lost in their application on the body. This was a valuable teaching point for myself in several ways. Firstly for knowledge to sink in and be usable, I have to cross reference across different materials (YouTube, books, people, research, teachers, class etc). Secondly, it may be an indicative sign that the model or way of thinking may not be suitable for me. Reading and learning about other great Osteopaths such Tom Dummer and Peter Armitage (to name a few) also confirm this. They themselves speak about how certain principles and models did not sit naturally with them and low and behold they found their ways shortly after (finding your craft is in the exposure to many different models and way of thinking, not just a few!).
OPS: B1-B4, D3

Parson, J. & Marcer, N. 2009. Osteopathy. Harlow: Churchill Livingstone, pp.29-39.

Clinical integration case studies.

658070 — 2019-07-21 11:54:12 UTC

Over the course of the second year we were exposed to many different patient cases. We worked through these in our groups (which I found very hard) in order to dissect them and justify/explain what our thoughts were and what we would do. This experience was useful to me and I learned a lot about how to work in groups and so forth, but I would have learned more on my own due to the person I am. Nevertheless, the learning about group dynamics is important as it is a major factor in clinic (peers observing etc).
These exercises are also invaluable for supporting and cooperating with colleagues in their development as osteopaths
OPS A1-A6, C1-C7, D3, D9

distinguishing between radial tunnel and lateral epicondylitis

658070 — 2019-07-30 11:01:41 UTC

site for radial further down + use mills test and chair pick up test to rule out lateral epicondylitis

An Osteopathic take on occupationally related somatic dysfunctions.

658070 — 2019-08-04 09:56:42 UTC

This article from Charles Beck (who talks a lot about his cases etc) really demonstrates the complicated intricacy found between peoples days to day lives and their presenting complaints. Reading this paper and his other commentary on his patient cases really help me understand the underlying osteopathic principles and how to apply them to patient care.

OPS B1-B2, B4, C1

Beck, C. 2014. Camera Lenses and Their Effect on the Cranial/Sacral Mechanism.

Learning how to reply to letters of complaint.

658070 — 2019-08-04 10:37:41 UTC

As part of our coursework assignment, we had to learn how to reply to a letter of complaint. Initially I found this very hard as it was a made up situation (I always find artificially induced situations harder to deal with) and I didn't really have any justification for how the "Osteopath" handled the case. After burying myself into the OPS and all the associated documentation, I found a way to navigate the case, respecting both the practitioner and patient views simultaneously.
This exercise taught me several important things. Firstly, it is very important not to let your own beliefs and values affect patient care. Secondly, it is important not to devalue yourself instantly in order to save face (i.e. refund all payments immediately in fear). Thirdly, you must consider the contributions of other healthcare practitioners (be it good or bad, one needs to be impartial to begin with). Fourthly, it makes me aware of the possible complaints that I may see or have to deal with (as it is common to have a least one complaint in your lifetime as a practitioner).
OPS C3, D1-D9, D14, D16-D18

Understanding yellow flags.

658070 — 2019-08-05 10:39:58 UTC

Understanding and identifying potential yellow flags is an important requirement for clinical practise. Yellow flags can range from mild work related problems to more severe psychosocial ones. They need to be screened for in an initial consultation so that the practitioner better understands how the patient relates to the world and their potential complaint (as this affects many things including the patients prognosis). Yellow flags can also pose a direct threat to maintaining professional boundaries. For example, when patients become inappropriately dependent on you.
OPS C1-C3, C4-C5, D2

Sourced from clinical integration lectures yr2.

Short, sharp and simple.

658070 — 2019-08-05 11:07:41 UTC

Another great example of a medical professional explaining a very complicated subject (diabetic neuropathy) in a simple manner in less than 6 minutes. Very helpful for both my own understanding and how to potentially frame future conversations with patients.
OPS A1, B1-B4, D3

Youtube.com. 2016. #Diabetic #neuropathy explained. [online] Available at:

Identifying extra pyramidal disorders.

658070 — 2019-08-05 11:30:30 UTC

Another fantastic video giving me tons of useful clinical knowledge in under 5 minutes! These kind of videos are going to be very useful in clinic for both myself as a practitioner and patient education.
OPS B2, B4

Youtube.com. 2019. Identifying extrapyramidal disorders with a neurology exam. [online] Available at:

Clinical introduction tutorials by Mr X.

658070 — 2019-08-05 11:42:44 UTC

Mr X did two lectures with us at the end of year 2, one on the shoulder and one on the knee. These lectures were a combination of the most relevant clinical aspects of a good differential diagnosis. They are designed to be quick and accurate and tend to focus on the orthopaedic/medical aspects of the diagnosis. Exactly what I needed before clinic, a good way to tie all the relevant structural information together in a concise format. From my observational experience in clinic, organising and sorting through the case history information to arrive at the 3 DD's is a very challenging part.
OPS B1-B2, B4, C1, D3

Slide sourced from ESO clinic tutor.

There is a real benefit to joining Osteopathic facebook groups...

658070 — 2019-08-05 12:28:50 UTC

These Osteopaths share their accounts of some very close calls. Their accounts of these saved lives will never make me forget what to look for in peculiar emergency cases, or simply that something is not quite right and needs emergency attention.
It really puts into perspective that we have a great responsibility and really need to be aware of our wider role in healthcare and patient wellbeing.
OPS C4, C6

By far the best book I have ever read.

658070 — 2019-08-05 13:43:22 UTC

This book answered so many of the questions I had about Osteopathic principles, techniques, philosophies, founders and so forth. For example, it gave a slightly different account on Fryettes work and as a result my struggle to understand certain elements disappeared instantaneously. There were many, many "ah ha!" moment whilst reading this particular book and as such, has expanded my understand that much further.
OPS B1-B4, C1-C3

A few other books that I have read over the last 2 years.

658070 — 2019-08-05 14:14:08 UTC

OPS B1-B4, C1-C3

A commissioning guide on subacromial shoulder pain.

658070 — 2019-08-05 14:38:03 UTC

This guide provides evidence based research on the management of subacromial shoulder pain.
OPS B1-B4, C1-C2, C7, C9, D1, D3, D8

Systemic questioning is of utmost importance!

658070 — 2019-08-05 14:57:14 UTC

Asking the right questions at the right time can ultimately lead to saved lives. I have witnessed this several times in clinic whilst observing. In conclusion it is best to start with open questions and then ask more concise closed questions if the patient has previously answered yes. I will be keeping a careful eye on my own development with regards to the correct questioning.
OPS A1, C3, C7, C9

Document sourced ESO lectures.

PBL results.

658070 — 2019-08-06 10:25:14 UTC

My main aim from these PBL tasks was to work more efficiently in groups. Communication was the most important aspect to be worked on by all members of the groups. Being aware of how badly people tend to communicate gives one an awareness that it needs to be fixed. Listening in groups was the first step for me on the road to better communication!
OPS A1-A3, A5

Professional skills essay - critically analysing a mini research protocol.

658070 — 2019-08-06 11:22:56 UTC

I utilised critical thinking skills to evaluate and contextualise research articles and other sources of information, and to demonstrate self-reflection.
OPS B1-B4, C2, D1-D3

Anatomy essay on the extrinsic and intrinsic innervation of the gastrointestinal tract.

658070 — 2019-08-06 11:40:22 UTC

The essay topic was a complicated one. It proved useful writing a synthesised account of the GIT innervation as it is clearer in my head as a result. It is also important as a tool in clinic when identifying potential viscerosomatic reflexes.
OPS B1-B2, B4, D2, D3

OSPE PR1.

658070 — 2019-08-06 12:51:10 UTC

These OSPE 's are the most challenging type of exam for me. I tend to be comfortable with all the required knowledge but then go completely blank in the exam. For me, it is handling this issue that is of most importance. At this stage I would say it has improved a little since last year, but a long way to go! I feel the marks are a tad generous given where I am in my development.
OPS B1-B2, B4

Clinical integration presentation results.

658070 — 2019-08-06 13:28:55 UTC

Using a real case, we designed a powerpoint presentation breaking down an 80 minute appointment into sections such as justifications for techniques. We each took a section and spoke about it for 2 minutes to our peers. Public speaking is not my strong point at all and thus struggled with that the most. I was surprised about the marks given but will nevertheless work towards a better standard. Communication was the main focus in this role (for me).
OPS A1-A3, B1-B2

Results for complaint letter.

658070 — 2019-08-07 11:08:22 UTC

Reflecting on this piece of work is essential as it is bound to happen at some point in my career and is critically important to know your own limitations, where you lie with respect to certain comments and how to GOsC fits in. It is also a good reflection upon how information is conveyed and helps you understand how different patients will take in information differently.
OPS A1, A2, A3, A5, B3, B4, C8, D4, D8

OSPE PR2 - what a difference!

658070 — 2019-08-07 11:20:10 UTC

I had a significant moment whilst doing this exam - I managed to convey most things in my head without going blank or sweating all over my patients...
This to me is a real milestone as it shows a dramatic shift in the way I interact through exams (and thus clinic?). It could not have come at a better time (just before clinic in third year). However, I need to make sure I continually improve as it is just the beginning - proficiency without thinking is the next step.
OPS B1-B2, B4

Clinical integration exam results.

658070 — 2019-08-08 09:34:51 UTC

This exam was a simulation of a patient encounter divided up into stations (case history, testing etc). I was surprised with the marks as I feel that practically I could have done a lot more. Nevertheless, the written elements and case history are progressing nicely. Communication and explaining the necessary information (i.e. informed consent) is also becoming more fluid.
OPS A1-A6, B1-B2, C1-C7

Passed my written exams + clinical methods!

658070 — 2019-08-08 10:01:02 UTC

Anatomy proved to be very hard to revise for, I'm happy I passed it! Moving forward I need to re focus on revising the most important parts ready for clinic (as discusses in clinic with tutors - the relevant clinical anatomy is most important). This also means gong over all the general medical screening exams done in the clinical methods exam (cardiovascular, respiratory, neuro testing etc).
OPS B1-B2, B4

Clinical induction week.

658070 — 2019-08-12 10:49:31 UTC

During the week we had several tutors talk to us about various aspects of clinical life - ready for September. I personally found the consent and shared decision making lecture the most interesting and thought provoking. I had always had a slight issue with the GOsC with regards to the OPS, similarly, a lot of respected practitioners also seemed to dislike certain elements. However, after our lecture, I finally understood why the OPS was set out the way it was. It is of utmost importance that patients understand and have a say in their patient-practitioner relationship. Informed consent is necessary for everyones benefit!
Other important lectures during the week (but were more obvious to me) included topics such as professionalism in clinic (patient management, time keeping, professional standing etc) to the OPS and handling complaints.
OPS D1-D18

Helping patients remain autonomous in their care is really important!

658070 — 2021-02-05 16:53:05 UTC

I realised the importance of conveying information in an understandable way. Information helps the potential patient to understand and be more autonomous in their healthcare journey. The paper below provides interesting material into the power of information.
OPS A5

Maiers, M., Hondras, M., Salsbury, S., Bronfort, G. & Evans, R., 2016. What do patients value about spinal manipulation and home exercise for back-related leg pain? A qualitative study within a controlled clinical trial. Manual Therapy, 26, pp.183-191.

Clinical observations and reflections

658070 — 2021-02-06 16:36:36 UTC

Using these forms to document observations under the OPS headings really puts into perspective about what beliefs/prejudice you may be subconsciously holding. It is important to highlight these and be reflective as to not allow them to interfere with future clinical encounters.
OPS A7

Data protection and patient confidentiality are a must!

658070 — 2021-02-16 19:05:48 UTC

The ICO provide advice and guidance helping osteopaths comply with data protection requirements.
OPS D5

Ico.org.uk. n.d. Home. [online] Available at:

Audits and keeping up to date with legislation are important aspects of clinical practice.

658070 — 2021-04-12 15:56:39 UTC

Reading documents like these really highlight how important it is to keep up to date with legislation and constantly checking to see if your practice fits within the required ethical parameters. Auditing process like these also illustrate the value they poses in ultimately heading patent care and wellbeing.
OPS B4, C3, D6

It is essential to understand what is required of you from the beginning!

658070 — 2021-04-12 20:27:42 UTC

An essential document outlining your obligations as a student osteopath. It doesn't just start after you graduate!
OPS D7, D10, D12

Case studies are very useful for contextualising knew information!

658070 — 2021-04-13 16:27:09 UTC

This case study on conflicts of interests is real eye opener. I would not have thought about these issues if I hadn't done some extra reading!
OPS D8

Contribution of other healthcare professionals must always be remembered!

658070 — 2021-04-14 14:02:24 UTC

In order to truly care for your patients well-being, one must always understand and act in relation to onward referrals. Papers like these really help consolidate these ideas.
OPS D10

Morley, L. & Cashell, A., 2017. Collaboration in Health Care. Journal of Medical Imaging and Radiation Sciences, 48(2), pp.207-216.

Amidst all the patient care, one has to also be healthy.

658070 — 2021-04-14 15:04:05 UTC

The idea of making sure you as the practitioner are healthy and "okay" never really occurred to me much. However, now I am aware of these issues they hopefully won't ever be an issue. Reading these papers help spot issues that may be appearing in myself before I would otherwise be aware of.
OPS D11

Patel, R., Bachu, R., Adikey, A., Malik, M. & Shah, M., 2018. Factors Related to Physician Burnout and Its Consequences: A Review. Behavioral Sciences, 8(11), p.98.

The NICE guidelines and red flags.

658070 — 2021-05-11 14:47:50 UTC

A very good resources to use in terms of 'evidence based guidelines' and red flags.
OPS C4

Cks.nice.org.uk. n.d. Red flag symptoms and signs | Diagnosis | Back pain - low (without radiculopathy) | CKS | NICE. [online] Available at:

Broken chairs in clinic emphasises the importance of ensuring that your practice is safe, clean and hygienic, and complies with health and safety legislation.

658070 — 2021-05-23 11:19:00 UTC

OPS C5

658070 — 2021-05-27 19:47:44 UTC

Beck, C., 2014. Camera Lenses and Their Effect on the Cranial/Sacral Mechanism.

Brown, T. & Bittner, V., 2008. Biomarkers of atherosclerosis: Clinical applications. Current Cardiology Reports, 10(6), pp.497- 504.

Cks.nice.org.uk. n.d. Red ag symptoms and signs | Diagnosis | Back pain - low (without radiculopathy) | CKS | NICE. [online] Available at:

Havelka, M., Lucanin, J. & Lucanin, D. 2009. Biopsychosocial Model – The Integrated Approach to Health and Disease. Coll. Antropol., 33(1), pp.303-310.

Ico.org.uk. n.d. Home. [online] Available at:

Leach J, Fiske A, Mullinger B, Ives R & Mandy, A., 2011. Complaints and claims against osteopaths: a baseline study of the frequency of complaints 2004–2008 and a qualitative exploration of patients’ complaints.

Maiers, M., Hondras, M., Salsbury, S., Bronfort, G. & Evans, R., 2016. What do patients value about spinal manipulation and home exercise for back-related leg pain? A qualitative study within a controlled clinical trial. Manual Therapy, 26, pp.183-191.

Morley, L. & Cashell, A., 2017. Collaboration in Health Care. Journal of Medical Imaging and Radiation Sciences, 48(2), pp.207- 216.

O'Donnell, C. & Elosua, R., 2008. Cardiovascular Risk Factors. Insights From Framingham Heart Study. Revista Española de Cardiología (English Edition), 61(3), pp.299-310.

Patel, R., Bachu, R., Adikey, A., Malik, M. & Shah, M., 2018. Factors Related to Physician Burnout and Its Consequences: A Review. Behavioral Sciences, 8(11), p.98.

Parson, J. & Marcer, N. (2009). Osteopathy. Harlow: Churchill Livingstone, pp.29-39.

Youtube.com. 2016. #Diabetic #neuropathy explained. [online] Available at: v=b5iUpyf bxZE&feature=emb_logo>

Youtube.com. 2019. Identifying extrapyramidal disorders with a neurology exam. [online] Available at: