WHAT: Today, I treated a new patient during the first appointment of the morning who presented with nerve-related pain radiating down the left leg and into the gluteal region. Although I completed a thorough case history, it took too long and so did my examination. I became aware that this was likely due to my lack of knowledge and confidence in performing a lower limb neurological (LEx) screen efficiently. After the session, my tutor asked me to go through the LEx screen in the tutor room with my peers. During this, the tutor commented that I was too slow and had missed several elements. I immediately felt like I had let both the patient and myself down. I was especially disheartened because I knew the patient hadn’t received the most confident or efficient assessment possible.

SO WHAT: This experience made me reflect on the importance of competence and confidence in core clinical assessments, particularly neurological screens, which are essential when patients present with nerve-related symptoms. OPS B1 requires me to have and apply appropriate knowledge and skills, and in this case, I realised I hadn’t met that standard. The feedback (though difficult to hear) was necessary. It made me feel disappointed in my performance, but also gave me clarity: if I want to provide safe, effective care, I need to take ownership of the areas where I’m not yet competent. I also realised how my learning gap could affect patient experience, safety, and trust in osteopathic care.

NOW WHAT: As a result of this I took a long look over the key areas which I need to work on as a student and have made a list of testing and examination routines which alongside my peers we will go through and master throughout the next year and a half at the ESO. I will take on board all feedback, no matter how hard to hear at the time to improve and better myself. Not just to pass examinations but to become a better and safer Osteopath for my patients.

WHAT: This morning I had a new female patient who presented with pain across the lateral aspect of the left ribs as well as the costochondral region. When I asked if she was happy to remove the top she was wearing in order for me to examine the area through observation and palpation she was hesitant and didn't want to remove the layer, once I explained the reason and that she didn't have to if she preferred to keep it on I would palpate through the layers the patient did agree to examination but keeping the top on.

SO WHAT: I was still able to provide a thorough examination and diagnose the patients complaint accurately then carry out treatment on this patient without her taking off any layers that she wasn't comfortable removing. therefore listened to her concerns and preferences and treated her with dignity and courtesy.

NOW WHAT: As a result of how well this interaction went I will continue to check with patients whether they are comfortable or not removing layers for examination and I am more confident that I can provide a good service without the patient being made to feel uncomfortable or that they haven't had their concerns or preferences adressed.

SO WHAT: My tutor noted this as a skill which was important for Osteopaths to have because a lot of the time we will be faced with people who present with multiple complaints and we need to work with them to prioritise what is of importance whilst not making them feel like they are not having their thoughts and feelings understood.

NOW WHAT: As a result of this experience I will take into account what happened and how it made the patient feel heard and respected whilst also trying to focus in on what the patient really wants out of the session and what would be most important to improve the patients current complaint.

SO WHAT: This interaction opened my eyes to the importance of being clear in the information which is being given as well as ensuring the information has been understood by the patient. My tutor picked this fact out in my feedback as being one of the best examples of communication skills she has seen which made me feel very proud of myself and happy about how I handled the situation.

NOW WHAT: I will continue to provide my patients with information which they require in a way they understand by adapting my communication style or language I use to ensure that the patient is fully informed and the information is clear and able to be repeated to me by the patient as then I can be certain that they have understood what has been told to them to avoid any confusion which could have an impact on consent.

DESCRIPTION: Today in clinic I had a patient who was quite anxious and came in presenting with upper cervical pain which was causing headaches, after a thorough case history I asked their consent to examine the cervical and thoracic spine which involved removing the top they were wearing, after I explained the importance of why they were happy to remove it just for examination. After examination I proposed the option of cervical manipulation as there were no contraindications. I made sure that my explanation was clear giving the risks (however minimal) and potential benefits from having this treatment as well as alternative techniques we can use and gave the patient time to think and ask questions if necessary, in the end they were happy to continue with the manipulation and treatment plan as proposed with the understanding they could stop at any time.

FEELINGS: At the beginning of the session I wasn't sure how the patient would react to being asked to remove the top and once they were happy to do this, I was more confident that they were engaged in addressing the issue. Once the suggestion of manipulation was bought up the patient seemed somewhat hesitant at first, after speaking through everything with them and offering alternatives I was happy I had done what I needed to in order for them to make an informed choice.

EVALUATION: Overall I was happy with the interactions between the patient and myself in this situation as we really communicated well and addressed any concerns which the patient had about both examination and treatment approach and I was able to gain fully informed consent for the above.

ANALYSIS: This above interaction reinforces the importance of gaining fully informed consent for both examination and treatment because if I were to miss out any information or not explain why I wanted to do what I did the patient may feel as though they were taken advantage of or weren't involved in the decision making behind their own recovery as well as opening the door for potential claims/complaints made against me.

CONCLUSION: In conclusion I worked hard to gain informed consent from this patient even more so than normal due to their anxiety which mainly surrounded their health and self image. Respecting their personal views as well as informing them of why it is important, giving them the option to withdraw at any point.

ACTION PLAN: In the future I will use this experience to make sure I am gaining fully informed consent and explain everything to the patient in order for them to be up to date and allowed to ask questions about what is happening in all cases not just those who may be anxious.

FEELINGS: My overall feelings of this session were that I was able to educate the patient in order for them to improve their own health and wellbeing through showing exercises and answering questions in order for them to have a more primary role in their recovery and overall health.

EVALUATION: The session was positive. The patient appreciated the practical and personalised advice. I observed his technique to ensure he could safely perform the exercises. I could have asked him how likely he is to do these exercises between sessions or whether the load is too much.

ANALYSIS: This experience shows the importance of supporting patients to care more for their own recovery and health and wellbeing rather than relying on health care professionals. Teaching them about the importance of exercise and correct posture during work can be vital in reducing return of patients pain.

CONCLUSION: I was able to successfully make the patient realise his role in the recovery and maintenance of his complain as well as improving his overall health and wellbeing.

ACTION PLAN: From now on I will make it a personal goal of mine to provide patients with exercise and fitness plans to improve their general health whilst also targeting the affected areas. I will check patients understanding of the exercises and in the following session make sure they are doing them correctly.

SO WHAT: I managed to examine the hip through the trousers and due to osteoarthritis in the left hip the trousers didn't change the end range anyway just the palpation was hampered but we agreed next time she would come in thin shorts so I can feel through and get a better feel of what is going on.

NOW WHAT: From now on I will respect peoples modesty and dignity and only get them to remove layers which they are happy to remove for examination and treatment to avoid any discomfort or embarrassment for the patient whilst advising for the next visit to wear more appropriate clothing.

SO WHAT: This showed to me that underneath the external views and beliefs people may hold we can still make a meaningful change in these patients complaints and concerns whilst not having to engage in language or behaviour which we do not feel comfortable expressing. If it got too serious I would have referred this patient to one of my colleagues who wouldn't have been the centre of some of the comments.

NOW WHAT: I will always take into account patients beliefs and values and put them to the back of my mind but in terms of their care this will not affect how I treat them, views and beliefs should not affect our performance as an Osteopath and I will treat all patients with the same level of care.

FEELINGS: Once the session had finished and I was reflecting upon it I felt very pleased with my decision and was glad that my tutor had agreed with me to send this patient to their GP to get further investigations. I felt that even though the patient may be upset with the outcome initially, he was on the correct path and I did not overstep the line in terms of trying to treat something outside of my area of expertise and potentially make it worse.

EVALUATION: The correct decision was made and the situation was handled well, I hopefully began the journey for this patient to get the correct care without the possibility of medical neglect or letting my ego take over. I was able to detect that his symptoms didn't quite fit the typical musculoskeletal complaint of shoulder and neck pain and that there may be something systemically wrong.

ANALYSIS: Although to begin with this experience was a negative on due to the fact I couldn't treat and give relief for this patient, it shows the importance of knowing where our limits as Osteopaths lie and that knowing when not to treat is so important for the safety of our patients.

CONCLUSION: This experience shows that I successfully complied with OPS B2 because I knew that this patients presenting complaint was outside of our scope of practice and managed to explain this to the patient with the tutor to get them to get checked before returning.

ACTION PLAN: To improve further in this guideline I will review and keep updated with systemic red flags and once graduated book on to CPD courses which outline pathophysiology to know what to keep an eye out for when a patient walks through the door.

WHAT: I had headache clinic at the beginning of the year, in the first session we ran through common presentations for headaches and variations of headaches with clinical features and symptomology. I quickly realised that my knowledge when it comes to headaches was much lower than I would have liked it to be. Keeping in line with the OPS B3, I spent the next 6 weeks in headache clinic reviewing common presentations for migraines and headaches, alongside referral routes and common treatments. By the end of the 6 weeks I was able to confidently talk through headache types with key characteristics and treatments alongside the typical referral patterns for these. My tutor was thoroughly impressed and my feedback reflected this as she stated that "I was up there with the most sound practitioners" she has ever met and that my "dedication was refreshing"

SO WHAT: This to me indicates the importance of keeping up to date with knowledge and skills in the field of Osteopathy because I was able to go from not knowing the bare minimum about headaches to being one of the most successful in the group through keen research and hard work. This enabled me to give better care to my patients in terms of reducing their symptoms and giving them advice about how to deal with their headaches in their own daily life.

NOW WHAT: I have carried this attitude through my whole degree but even more so from this point forward where I will assess my weakest areas in my knowledge base and work hard to bring those up to a standard that myself and my tutors are happy with to allow better care and service for my patients.

SO WHAT: This showed to me the importance of continually reflecting upon and analysing our performances as Osteopaths because if I hadn't I would have carried on blissfully unaware that I hadn't prescribed exercises and this patient would have continued to have persistent low back pain lowering her trust in Osteopathy as a profession. However, because I did show reflection and analysis she returned 4 more times and then was discharged because her back pain had reduced to the point where she didn't need to see us.

NOW WHAT: The whole situation has prompted me to look more closely into historic case notes from myself and other students whom I may be covering to assess whether or not there are areas which could be improved to increase the quality of the patients care and support.

FEELINGS: My overarching feeling from todays session was how well I managed the case, coming up with appropriate differential diagnoses and able to support my diagnosis clinically to the tutor through my testing whilst also being safe and considerate to the patient. It showed me how far I had come in my studies because I previously struggled with a lower extremity neurological screen and I have learnt from this to improve my skill and safety as a practitioner.

EVALUATION: On the positive side I was able to safely and effectively conduct a case history and examination on a patient who came in presenting with neurological symptoms showing I am developing well as a student. On the down side I may have been too narrow minded and not considered other differential diagnoses which may have also been relevant.

ANALYSIS: This situation shows the importance of using a structured examination and using the patients case notes to carry out specific investigations to rule in or out our differential diagnoses whilst also taking into account the patients safety and wellbeing. Informing them that certain tests may increase symptoms or pain. By doing this you can make sure the patient is receiving the best possible care.

CONCLUSION: In conclusion I believe this whole experience taught me that to carry out a safe and effective assessment and analysis one must consider the information in front of them as well as the patient who presents in front of them. Certain patients may require different tests/examinations which is something as Osteopaths we must be conscious of an adapt as and when needed to ensure the level of care remains high.

ACTION PLAN: I will continue to look at the patient as a whole to include experiences, wishes and the case itself to ensure I carry out the most thorough and effective assessment and allow this to aid in the development of my management plan and treatment of the patient.

WHAT: I had a cover patient today for one of my colleagues, I made sure that I read through thoroughly before going into the session just to familiarise myself with the patients complaint and any systemic issues which may be present that I need to be aware of. After chatting to the patient who came in presenting with neck pain about the techniques I proposed to use which were contraindicated in certain patients i.e. patients with cardiovascular concerns but from reading the notes they seemed fine. The patient then told me that actually they had reported to the previous practitioner that they suffered from an increased blood pressure and so where on blood thinners. I immediately stopped talking through treatment and then noted down the information given to me from the patient to update the case notes and ran through the previous notes to ensure nothing else had been missed.

SO WHAT: The omission of such important information in a patients case notes was rather worrying, if I had not been diligent and double checked everything was okay the techniques I used with the patients consent could have resulted in a dangerous adverse effect leading to potential legal action being taken against the clinic. This highlighted to me the importance of taking accurate case histories and ensuring that ALL information is noted in the case notes about conditions and medications as well as being as thorough as possible about what was done.

NOW WHAT: I make sure now to underline certain pieces of information I believe to be important to the case and make thorough detailed case notes so that if the patient needs to be covered I am able to rest assured that the practitioner covering me will be able to pick up my case notes and realise exactly what has been done, what the patient is coming in with and any contraindications or conditions which make them unsuitable for particular techniques.

SO WHAT: I managed to respond to a patients request for production of written material and data which the patient emailed the next day to thank me for the promptness in which it was sent. They included the fact that they had mentioned my name to a few different friends who either have children they want to get checked for certain issues or they themselves have pain. Therefore my general professionalism and forthcomingness with information has proved to be worthwhile.

NOW WHAT: I will from now on try to get patients requests for written material completed on the same day of request or as soon as practical to make sure they feel like they are a priority and show that their care as important to me.

DESCRIPTION: During my observation session in children's clinic today the patient was a 12 year old who was coming in with his mother and complaining of hip and low back pain, the patient was already wearing shorts and a t-shirt and when asked if it was okay if the boy took off his t-shirt so the student could examine the low back he looked very uncomfortable and looked over to his mother who also seemed very uncertain. The mother then replied "Is it completely necessary?" to which the student then replied "It would be beneficial just so I can see what could be causing the pain your son is experiencing". The boy agreed to as long as he could put it back on for treatment. However when the boy removed his t-shirt, along the upper back were bruises and what seemed like a burn on the left side. When asked what had happened the boy started crying and opened up that his father had been abusing him physically. The mother then also admitted this and was guilt ridden. The student spoke to the tutor and the incident was reported to the necessary authorities. I left the student with the mother, tutor and child to not make it too uncomfortable for anyone involved.

FEELINGS: The overarching emotion felt in this reflection was sadness, sad that the child had been putting up with this abuse and not been able to open up to anyone about it and sad that the mother was also in a similar position to the child and felt powerless to help. However it did make me feel proud of the student who followed their instincts in getting the teenager to remove his t-shirt and asking about the marks on his back leading to him hopefully starting the path towards recovery and care.

EVALUATION: The student done really well here to notice that something wasn't quite right to begin with when the teenager looked uncomfortable and to then delve deeper to find the true cause of the injuries. I would like to think in the same situation I would have handled it in a similar manner, creating a safe space for the patient and getting them the necessary help to protect them from further harm.

ANALYSIS: This incident shows the importance of being diligent with patients and trusting your instincts to make sure the patient is safe not only in the session but in their everyday life as well, asking simple questions such as how certain marks have appeared or whether they know about them can have a truly meaningful impact and potentially save someone.

CONCLUSION: takeaway from this the importance of what is happening outside of the session not just when they are in the room. The student could have just assumed the marks were from sport or falling over but decided to ask and found the true reason.

ACTION PLAN: After seeing this situation I will try and replicate it should I ever assume that a patient is in an unhealthy situation outside of the session which could not only prolong a complaint but could be a harmful environment for them.

WHAT: Treating today was a struggle due to the weather being so hot and the lack of adequate ventilation in the clinic. This was particularly true after one of my patients whom suffered with body odour, we always disinfect the couches and head blocks after every patient anyway but I ensured that the room got ventilated after to ensure no lingering smell was present for the next patient. I also went and changed my top to make sure that my own hygiene was in order for the patients' comfort and out of respect. I made sure the room was an acceptable temperature by opening the window fully and putting the fan on full for a period of 5 minutes after the bed had been disinfected. The result was a clean, fresh room with no lingering odour from the previous session. The tutor came into the room during the treatment and commented that it was "very clean and cool" then mentioned how happy he was that I made sure the room was clean and fresh before taking in my next patient.

SO WHAT: Through compliance with clinical health and safety legislation as well as personal hygiene and cleanliness I was able to provide a safe, clean and comfortable environment for my next patient who seemed appreciative of it. It was nice to have tutor feedback about room layout and cleanliness because as a student I often think this is something which is overlooked by many but has such a large impact on the patients experience as if it is clean, comfortable and aired out they feel much more relaxed and allows you to bond with them better.

NOW WHAT: I always have aired out the room after every patient and as I said above we all spray down the couches and pillows and anything which the patient has come into contact with as well as washing our hands before and after every patient thoroughly to ensure than any contact conditions will not be passed on. This is something I will carry on doing as I believe it is a huge part of the job.

FEELINGS: Initially, I felt slightly unsure about how much lifestyle advice was appropriate to give in an osteopathic setting, especially when deviating from hands-on treatment. However, as the patient responded positively, I felt more confident and encouraged. I began to feel that I was making a broader contribution to their wellbeing, not just treating the immediate symptoms.

EVALUATION: The positive aspect of this encounter was seeing how small behaviour changes, guided by health promotion helped the patient feel more in control of their symptoms. They became more engaged in self-care. However, I could have signposted more specific resources or community programmes to support their goals.

ANALYSIS: As Osteopaths it is our role to educate patients to understand how lifestyle factors like movement, posture, sleep, stress, and nutrition impact musculoskeletal function. The experience taught me that patients often value this advice as much as or more than hands on treatment. It also showed me that integrating such discussions builds rapport and long-term trust.

CONCLUSION: This experience confirmed that I can (and should) use my role to positively influence a patient’s broader wellbeing. Osteopathy isn’t limited to physical techniques — it includes listening, educating, and helping patients take charge of their own health. It also reinforced the need to communicate clearly and without judgment when giving lifestyle advice.

ACTION PLAN: Continue learning about evidence-based lifestyle interventions relevant to common MSK conditions. Develop a bank of resources (exercise sheets, ergonomic tips, etc.) to offer patients. Practise delivering lifestyle advice in a concise and engaging way. Explore local services (e.g. community physio, dieticians, smoking cessation) to improve referral options.

FEELINGS: At the time, I felt embarrassed and slightly anxious. I knew I had made a small but important mistake. However, I also felt relieved that I had caught it in time and corrected it. I was proud that I didn’t try to cover it up or carry on regardless. Speaking to my tutor about it helped me feel supported and learn from the situation in a way which it didn't feel like I was being told off but more helped through an untoward experience.

EVALUATION: The positive part of the situation was that I recognised my error and acted immediately with honesty. I upheld the patient’s autonomy and preserved trust in the therapeutic relationship. The downside was that my oversight reduced my honesty with the patient and could have undermined the patient’s confidence or worse yet, exposed them to treatment without informed consent, which goes against both ethical and legal standards.

ANALYSIS: OPS D1 emphasises honesty and integrity as fundamental professional values. This experience showed me that acting with integrity means acknowledging errors, not hiding them. It also reinforced the importance of clear communication and gaining not only informed consent at the start of the examination and treatment but procedural consent throughout to ensure the patient is up to date with what I am planning. Integrity in practice helps build trust, both with patients and with colleagues. sticking with what you believe to be morally correct shows strength and confidence which increases the respect and trust of patients as well.

CONCLUSION: I learned that professionalism isn't just about clinical skill it’s about being transparent, reflective, and ethical. Even small lapses can become valuable learning moments if approached honestly. By choosing to be open and take responsibility, I strengthened my confidence in acting with integrity, even in potentially uncomfortable situations.

ACTION PLAN: I will double-check that I have obtained and recorded explicit consent before each new High Velocity Low Amplitude Thrust including risks and change in the treatment plan if necessary. I will continue to be open with my tutors and peers when I make mistakes so I can learn from them. I will continue to do reflective feedback on all aspects of the case to ensure I have been following the OPS.

WHAT: I was treating a follow up patient this morning who I have seen many times due to the chronicity of the complaint which she was coming in with. We get on well with one another and tend to be able to have a joke and good open conversation regarding her complaint. However, today I mentioned that it had been my birthday recently to which she asked a few questions about what I got up to. She asked my age and I responded. She then made a few comments which I believed were slightly flirtatious and one rather explicit comment about myself. This made me feel uncomfortable, I bought the conversation back to the reason which she came in for and bought into the conversation in a tactful way about professional and personal boundaries, she apologised for any offence from her comments and reassured me that she would refrain from doing so in the future. I spoke with my tutor who assured me I had done the correct thing and asked if I was happy to continue seeing this patient, which I am.

SO WHAT: I was happy with the way I handled the situation and made it so no one felt any awkwardness at the end of the session. It was clear to me in this situation that there was some confusion between a professional and personal relationship. I was pleased to be able to address the situation to bring it back to where we should be in a professional sense to ensure she got the best possible care.

NOW WHAT: I will be more diligent from now on with how I communicate and be open and honest about the relationship between myself and a patient and limitations to this. I will continue to correct patients if a similar situation ever arises ensuring they are aware of the boundaries so that no lines are crossed and we can maintain a professional practitioner - patient relation.

SO WHAT: I was pleased with how I managed the patient, he was someone who didn't like having to wait and wanted everything done there and then. Naturally with patients like this he was agitated that I told him I couldn't miraculously cure his ankle and that it will be a persistent problem if he does nothing. Once I explained the physiology behind what had happened and what I think that means in terms of prognosis as well as options which are open to him medically he started to actually listen and take on board what I could do to help other than curing the ankle injury. It was important I was open and honest with this patient because they came in with an issue outside of our expertise, I did however say if he gets it scanned and nothing needs surgery then come back and we can treat the surrounding area.

NOW WHAT: I will continue to be open and honest with patients regarding their concerns and complaints to allow them to make an informed decision about what they want to do and whether or not I believe they are in the correct location. I will update my knowledge on patient complaints which are outside of our area of expertise and general recovery times for certain injuries so I can give updated and accurate information to the patient.

As a student it is important we try and manage patients complaints within sessions should they not be too serious and we should also support patients through the complaint process should it be necessary.

SO WHAT: This incident reminded me how easy it is to breach confidentiality unintentionally, especially in casual settings. Although no harm came from it, it was a clear violation of professional responsibility and could have damaged the patient’s trust had they overheard. It made me realise that confidentiality is not just about what we write or record it’s about how we speak and behave at all times.

NOW WHAT: Always check my surroundings before discussing patient information and ensure conversations happen only in private, secure areas. Avoid using any identifiable information when discussing cases with peers. Refresh my knowledge of data protection policies and clinic protocols. Be more proactive in reminding others gently and professionally if I observe similar behaviour.

This experience reinforced that protecting patient confidentiality is an active, ongoing duty, and lapses however minor must be taken seriously and learned from.

SO WHAT: This moment helped me realise how small slips in language can significantly affect a patient’s comfort and trust. In line with the Equality Act 2010, I am professionally and legally obligated to treat patients without discrimination and to acknowledge their identity and individual values. Misgendering, even if accidental, can feel invalidating and may discourage someone from seeking future care. The way I responded with humility, openness, and a willingness to learn was key to preserving rapport and upholding inclusive standards in practice.

NOW WHAT: Ask patients their preferred name and pronouns during case history, and make a note of it. Complete CPD on equality, diversity, and inclusion (EDI) in healthcare. Review my clinic’s documentation to ensure it aligns with the Equality Act 2010, particularly around gender identity. Continue to reflect on unconscious bias and improve my ability to deliver equitable, person-centred care to all patients, regardless of identity, background, or protected characteristics.

Equality act 2010 available at: https://www.legislation.gov.uk/ukpga/2010/15/contents.

FEELINGS: I felt embarrassed and disappointed in myself. I knew I hadn’t given the patient my best, and I worried that I may have impacted their trust in Osteopathy. I also felt frustrated that something as simple as time management had influenced the quality of my conduct and possibly my patient's impression of the profession.

EVALUATION: The negative aspects were that I failed to present myself as calm and professional which could have reflected poorly not only on me but on osteopaths in general. However, the positive was that I recognised this issue quickly, took accountability, and had a constructive conversation with my tutor. The situation served as a reminder that professionalism extends to how we prepare, communicate, and compose ourselves.

ANALYSIS: Showing professionalism includes punctuality, communication style, appearance, and the ability to manage time and emotions under pressure. As healthcare professionals, our conduct even in seemingly minor moments can influence how the public views osteopathy. My actions that day did not reflect the standards expected, but recognising that helped me realign with those values.

CONCLUSION: I learned that every patient interaction is an opportunity to represent the profession well. Even when things go wrong like running late, how I recover, communicate, and learn from those mistakes matters greatly. I now understand that being seen as professional is an active responsibility.

ACTION PLAN: Arrive at clinic with adequate time to prepare mentally and physically for the day. Prioritise calm, clear communication even when rushed. Reflect on situations where my conduct positively or negatively impacted patient care or professional image.

SO WHAT: By doing this not only am I ensuring I am following government legislation through the Income tax act 2007 but also ensuring I am following OPS D8 about being honest and trustworthy in personal and professional financial dealings. I believe it is important to keep in top of finances to ensure you are not in any breach because the results of breaking legislation or OPS could result in a hefty fine or potential loss of employment.

NOW WHAT: I will continue to be open and honest about my personal finances and will make sure that I go through an accountant to assist with financial calculation and if needs be seek advice from a financial advisor to ensure I am doing as much as I can to ensure my finances are all above board.

Income tax act available at: https://www.legislation.gov.uk/ukpga/2007/3/contents.

SO WHAT: This is a clear example of how we as support our colleagues and cooperate with them to ensure that the patient receives the best care possible from our clinic. This falls in line with OPS D9, giving the student a way of contacting yourself via email allows them to ask any additional questions they may have surrounding the case showing additional support.

NOW WHAT: I will continue to fill out these forms as thoroughly as I do now to ensure all relevant information is present for the student taking over. I will continue offering support to lower years as it not only helps them understand the case better but also solidifies the knowledge you have obtained from the case.

FEELINGS: My general feelings from this session is that it went well, I was able to confidently refer this patient on to the relevant health care professional to ensure she got the best care possible.

EVALUATION: A positive of this session is that my communication and decision making was appropriate for the situation. The only negative on the patients perspective is that they didn't get treatment today.

ANALYSIS: This highlights to me how important it can be to consider the work of other health care professionals to optimise patient care.

CONCLUSION: This session indicated to me that caring for a patients health doesn't always mean immediate treatment but potentially guiding them to the correct healthcare professional.

ACTION PLAN: I will continue to work with this in mind to ensure I always do what is best for the patient even if that means referring them to someone else.

SO WHAT: This experience made me realise the risk I would have put my patients and colleagues in by choosing to attend clinic while unwell. OPS D11 clearly states that practitioners must not allow their own health issues to affect their patients and must not rely solely on their own judgment to assess that risk. I had wrongly assumed that because I didn’t feel “that bad,” I could continue. In reality, I risked spreading illness, compromising hygiene protocols, and impairing my decision-making ability all of which could have had serious consequences. I was glad the reception team and my clinic group were so understanding in what could have potentially been a very precarious situation.

NOW WHAT: From this experience, I have learned to: Take early signs of illness seriously, especially in clinical environments. Inform clinic staff promptly if I feel unwell, without trying to push through too much. I will continue to follow health and safety protocols regarding infection control and fitness to practise. Reflecting on the wider responsibility I have as a healthcare professional to put patient safety above personal inconvenience is very important.

This reflection reinforced that professional responsibility includes knowing when not to practise, and that protecting patients sometimes means stepping away from the clinic when we are not well.

SO WHAT: Being aware of the procedures in place allows you to feel comforted and makes you realise you are not isolated but also reinforces the importance of providing safe, effective and high quality care to your patients and makes you more conscious of how you act and your behaviour not only in clinic but also every day life.

NOW WHAT: I will continue to give high quality care to my patients and continue to work in accordance with the OPS to ensure my fitness to practice remains high. I will also do my due diligence and keep an eye out for my fellow students to ensure their fitness to practice is up to standards or whether further support may be required to make sure their mental health and wellbeing is also cared for. This is something I will take into practice when I qualify as well, ensuring I am abiding by clinical guidelines where I am working as well as reviewing the OPS to ensure my standards meet what is expected of me.

GOsC, 2018. Osteopathic practice standards | General Osteopathic Council. Available at: https://www.osteopathy.org.uk/news-and-resources/document-library/osteopathic-practice-standards/updated-osteopathic-practice-standards/ [Accessed May 12, 2025].

Legislation.gov.uk. 2012. Income Tax Act 2007. Available at: https://www.legislation.gov.uk/ukpga/2007/3/contents. [Accessed May 12, 2025].

Rolfe, G., Freshwater, D. and Jasper, M., 2001. Critical reflection for nursing and the helping professions: A user's guide.

UK Government (2010). Equality Act 2010. Legislation.gov.uk. Available at: https://www.legislation.gov.uk/ukpga/2010/15/contents. [Accessed May 09, 2025].

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