21817263_OS746_CW1 by ESO https://padlet.com/21817263_/v4k2fdufirzn2pse en-us 2023-04-23 13:37:38 UTC 2023-06-08 00:01:40 UTC hello@padlet.com 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. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2564616439
In September of 2021, during the first weeks of clinics as a third year, I was amongst the first to have their first patient, I had been apprehending this during my time off in summer as I had no prior professional experience dealing with clients paying money and expecting a service in a certain amount of time, I did not really know what to expect from my first patient.
After I finished to explain the process of the consultation and as I was going to ask what her complaint was, my patient told me that she was Punjabi, which is an ethnic group from Pakistan and the north of India, explaining this meant there was little to no undressing allowed in public in her culture, certain parts of her body could not be touched, and she could not remove big metal bracelets she had on her wrist or her headscarf. This added significant pressure to me as I was used to models undressing down to boxers or shorts without batting an eye at school, and this is not something I expected to encounter with my first patient. Her complaint was pain at the right ankle, and because she couldn’t roll up her trousers as it was part of her culture and they were very tight, it was challenging for me to assess her knee and hip as her jeans were restricting movement. 
This lead me to being stressed when diagnosing, interpreting findings and treating efficiently, and also because the patient didn’t communicate very much. As the consultation ended though, the patient thanked me for a good first experience with an osteopath. 
This first patient experience highlighted how vital respecting patient’s preferences and assuring their mental and physical comfort is during each consultation, and it is my duty as a future osteopath to adapt my knowledge and skills to each individual patient in order to assure this.]]> 2023-04-23 13:38:21 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2564616439 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. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567737960 In October 2021, after a few months in clinic, I got assigned my first foreign patient, he was a young Polish lorry driver who had jumped from his truck with a kitchen set. He presented to the clinic with lower back pain and shooting pain down his left leg, from his facial expressions it was clear he was in a lot of pain, however when asking him what type of pain he was feeling, when he was feeling it, there was a very clear language barrier, when asked a question that the patient wouldn’t understand, he would politely nod along or say “yes, pain here”, most of the communications were accompanied by hand signals and facial expressions which made process of gaining informed consent and partnership particularly challenging.
After a few months, the patient was in less pain, and being much more familiar with each other and our accents made communication and support much easier. 
This experience highlighted how critical adapting to every individual patient is, and how appreciative people can be when time is taken to make sure their needs and concerns are taken into account.
In the future, this will be a key element of my practice, working in partnership with every patient and making sure they understand the tests, treatment, diagnosis and management as well as the support there is around them in order to establish a healthy patient-practitioner partnership and the best overall possible support for every individual patient.]]> 2023-04-25 19:26:57 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567737960 B1. You must have and be able to apply sufficient and appropriate knowledge and skills to support your work as an osteopath 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567738793 2023-04-25 19:27:53 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567738793 C1. You must be able to conduct an osteopathic patient evaluation and deliver safe, competent and appropriate osteopathic care to your patients 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567740238 2023-04-25 19:29:27 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567740238 D1. You must act with honesty and integrity in your professional practice 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567741035 During the second term of the fourth year, a fifteen year old patient came in complaining of multiple pains at different areas of the body, which at this age with no trauma rang a little bell in my head thinking this was unusual. After further questioning , I learned his mother had been diagnosed of muscular dystrophy only a few years prior to the consultation, which had started with a rectal prolapse, which the fifteen had just suffered from only a few weeks again prior to this appointment. The patient and his mother were suspecting he may be suffering from the same condition but nothing was confirmed, and the patient’s mother wanted her son to choose whether he wanted to do the relevant testing or not. The patient’s expectations from the consultation was to get a diagnosis, and to get a professional’s point of view on wether he was maybe suffering from muscular dystrophy. 
After three treatments no improvement was found, being honest with this patient with the suspicions even-though he was so young, and this would affect his whole life. When explaining findings to the patient, it was important to explain everything very simply, being careful with the words used to not panic the patient, it was important to keep in mind the patient was looking for an explanation for his pain and would ultimately overall benefit from knowing how to manage his condition from a young age. The patient appreciated the honesty and reacted in a very mature way although affected by the news, he is still getting treatment at the clinic for his MSK presentation, for neck pain and soreness due to a previous trampoline trauma and will be investigated for muscular dystrophy in the summer of 2023 as he will then be 16 which is the legal age to be put on the waiting list.
Keeping honest and being integral with every patient no matter the consequence is very important, without significant data it is sometimes better not to say anything as the patient may over interpret what is said, this decision is easier to make with a tutor beside me. This clinical decision will be have to be done autonomously in future practice, and discretion, empathy and sensitivity will be vital components of handling any kind of situation of the kind.]]> 2023-04-25 19:30:19 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567741035 A3. You must give patients the information they want or need to know in a way they can understand 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567741878 Being clear and adapting to the recipient’s level of knowledge on the matter, and checking the understanding of the patient regularly is vital for every consultation. For example in this letter the word “dysfunction” was interpreted as the guardian’s son being “dysfunctional” however the patient’s guardian kept this to herself until writing the letter. If the theoretical practitioner had addressed the issue during the consultation, by understanding the guardian’s confusion through non verbal communication, like a facial expression of surprise, or asked if everything that was said made sense, this issue could have been avoided in the first place.]]> 2023-04-25 19:31:07 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567741878 A4. You must receive valid consent for all aspects of examination and treatment and record this as appropriate 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567742154 Being a foreign student at the ESO, and being new in clinic, gaining informed consent was originally a big concern for me, as I was unsure wether I was being clear explaining the aims of testing and treatment, due to my english, but as well due to the transition between medical lingo with tutors, lecturers and peers, and layman’s terms for patients. Additionally, I was not sure the treatment I was doing would have a tangible effect on my patient, therefore I did not want to “oversell” my treatment due to my lack of practice. This was a challenging step as this required me to gain a much more deep understanding of conditions, and the benefits of treatment.
Originally, trying to get informed consent from patients would be an uncomfortable moment for me as I would be reciting some lines I had learned in order not to blank in front of patients. Over time, and after having worked on anatomy, my english, differential diagnosis, I feel more and more confident with patients gaining and recording consent in a more fluid and natural way. In future practice, it will be key to further work on this aspect as for example patients in different countries have different expectations of treatment, different levels of understanding of anatomy, osteopathy and english, and it is the practitioner’s role to facilitate communication and the gaining of informed consent, for the safety of both the patient, but also the practitioner and/or their practice.]]> 2023-04-25 19:31:29 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567742154 A5. You must support patients in caring for themselves to improve and maintain their own health and wellbeing. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567742493 2023-04-25 19:31:50 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567742493 A6. You must respect your patients’ dignity and modesty. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567743163 My previously mentioned first patient came in with a complaint a the ankle, and due to my lack of experience in clinic and working over clothes, I potentially visibly felt uncomfortable during treatment doing soft tissue on the patient’s tibialis anterior over their trousers, I didn’t want the situation to seem uncomfortable but also could not help myself, this was due to my own “inexperience” however this could be misinterpreted by the patient.
Having improved my palpation skills and also practiced on multiple patients (pregnant, elderly, acute etc..) with all their clothing still on.
I would feel much more comfortable handling a similar situation. Going forward, respecting patient’s modesty and dignity should be done throughout the consultation and outside of practice If this were to impact the treatment or findings for example by clothing, it is important to inform the patient so they can make an informed decision on the matter, alternatives should always be presented such as a modesty gown, a modesty towel or the options of still having treatment or no treatment. The patient’s dignity and modesty should always come first.]]> 2023-04-25 19:32:34 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567743163 B2. You must recognise and work within the limits of your training and competence. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567745504 “Being an osteopath” is a very broad term due to the number of approaches and the combination of approaches, but it is important to consider the limits of each field and of our competence as osteopaths, to consider the limits in research in every field. Additionally, staying informed on the advancements and the new research in other health and care to not only be able to present different options when osteopathy is not beneficial for a patient, but also when another option could be more beneficial to them or even in concurrence with osteopathy.]]> 2023-04-25 19:35:09 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567745504 B3. You must keep your professional knowledge and skills up to date. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567745840 This first barefoot talk for me was a real eye opener in that osteopathy is a non-stop learning experience, there were osteopathic students even from year 1, up to 4 and osteopaths that had graduated 10+ years ago. After talking to some osteopaths and attending the day long presentation/practice session, I got a big motivation boost, the anxious side of me was relieved to see even after years of graduating, you can still learn a lot from the body, through constant practice and reviewing of theory.
This was the first lecture I was attending that did not take into account which level of osteopathy you are, and this reassured me as even-though I did not understand everything, this was also the case for most people in the room, seeing the whole room being very interactive and every one completing each other’s knowledge reinforced my passion for osteopathy and changed my view on “learning” significantly. Additionally due to the “isolation” resulting from going into private practice when compared to being around peers and osteopaths daily for 4 years, CPD will be a vital part of remaining at the forefront of research as well as remain in communication with other osteopaths.]]> 2023-04-25 19:35:28 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567745840 B4. You must be able to analyse and reflect upon information related to your practice in order to enhance patient care. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567746052 2023-04-25 19:35:43 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567746052 C2. You must ensure that your patient records are comprehensive, accurate, legible and completed promptly. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567746453 My handwriting historically has always been a little rushed, and my note taking very personal. Coming into third year, handling patients and writting down notes consistently, I noticed that sometimes I was unable to understand my own notes or even handwriting. Additionaly, on more than one occasion, I had to cover a colleague’s patient because they were out, and was unable to understand their notes, which lead to wasting time asking questions to the patient again, or having to do extra tests which sometimes lead to a bit of frustration from the patient.
I found especially moving away from the SOCRATES model it was challenging to make the most important aspects of the case stand out which was the next step to making notes as legible and thorough as possible.
With final exams approaching tutors push us to be more thorough with our notes. However in future practice assessing notes will have to be done autonomously and on a regular basis to make re-reading recent and old case files as straightforward as possible for me or in case another osteopath in the practice needs to cover for me, or in case of any complaint one day.]]> 2023-04-25 19:36:10 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567746453 C3. You must respond effectively and appropriately to requests for the production of written material and data. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567746671 In the initial few months of my clinical experience at the ESO clinic, writing referral letters was a big apprehension as if not good enough, it could impact my patients in a negative way so I would heavily rely on tutors for every letter. 
Over time getting accustomed to the lingo, as well as learning to be quick and effective with letter writing has proved to be vital for patient outcome as waiting lists are long especially in post-covid times where NHS waiting lists are very long and not every patient can afford private care. Therefore regularly going back to the guide to letter writing, being to the point but thorough when writing the letter as well as being quick in sending it is going to be vital for patients to get the help or imaging they need as soon as available in future practice.]]> 2023-04-25 19:36:24 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567746671 C4. You must take action to keep patients from harm. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567746895 2023-04-25 19:36:39 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567746895 C5. You must ensure that your practice is safe, clean and hygienic, and complies with health and safety legislation. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567747114 The recent Covid pandemic has left a big impact in our society, and with the guidelines changing every few weeks/months, when it got to the end of the pandemic, some of my peers and I felt a little uncomfortable just returning to normal life not worrying about covid, and it potentially affecting our friends, families, friend’s families. Consequently, we were still thorough in wearing masks in and out of clinic, cleaning the couch with covid spray between every patient, opening windows, The pandemic showed how protecting everyone around us can be done by everyone through personal and professional hygiene. This pandemic gave us all a sense of responsibility with hygiene to keep everyone safe around us and on a personal level made me realise the direct impact this could have on someone’s life. This will have to be kept on top of for every patient in future practice and following national/local guidelines should always be done, as well as staying updated with them as we have seen during the pandemic.  ]]> 2023-04-25 19:36:55 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567747114 C6. You must be aware of your wider role as a healthcare professional to contribute to enhancing the health and wellbeing of your patients. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567747603 Due to osteopathy becoming part of primary healthcare and osteopaths in the UK seeing more and more patient who would normally see their GP, it is important to be able to interpret common imaging as well as blood tests and medical diagnoses.
One day in clinic, a patient asked me to help him interpret, after some hesitant and quite rough explanations I went to fetch my tutor who was able to explain everything with much more detail, this situation was particularly uncomfortable, as it is quite normal for my tutor to know more about imaging however from a personal point of view this made me feel quite incompetent, seeing such a clear limitation in my knowledge of that area showed me that it would be challenging to work within the healthcare profession if not able to interpret anything from them that comes my way. This will limit my knowledge of the patient, and result in being less safe a certain treatments or recommendations may indeed not be advised for this patient.
Additionally this will allow them to understand what they are dealing with, as well as if they should seek further medical attention for their safety.

]]> 2023-04-25 19:37:27 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567747603 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. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567748142 During the start of my clinical experience, a patient that I had seen once previously for a lower back / hip complaint, who had come in appropriate clothing started coming in less and less covering clothing. The patient’s underwear was less and less covering as well as transparent, this situation had to be addressed after multiple times, as I felt uncomfortable testing/palpating certain areas like the hip or when palpating for muscle tension. 
This situation had to be handled with sensitivity and with professionalism however in a natural way so the patient would understand what clothing is appropriate for a consultation without potentially feeling ashamed as she did not do anything wrong. This was situation where I felt myself grow, I handled this situation with a lot more confidence and maturity than I would have in the past, this experience showed me how setting limits/boudaries should not be viewed as a confrontation but actually like a mutual understanding which should be respected by both parties for both their comfort.]]> 2023-04-25 19:37:59 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567748142 D3. You must be open and honest with patients, fulfilling your duty of candour. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567748365 One day in clinic at the end of third year, I got assigned a last minute patient, she was in agony since the day before, following a thoracic manipulation from a colleague. Following the manipulation, the patient was left stuck on the couch, with immense amounts of back pain and pins and needles down both her arms. The patient was obviously worried when this happened however she had been made aware of the risks before, as well, when this happened, my colleague explained what happened to her and what she can do to get pain relief.
To my surprise, with the amount of pain the patient was in, the patient was not mad at all, she explained to me she had been “briefed before” and accepted to have the manipulation done.
She mentioned multiple times how she was not mad at the colleague or the clinic, this is due to transparence before and after a technique, no matter if the news is good or bad, the patient deserves to know what is going on or what they are putting themselves and their body through. For future practice, its important to notice that if the patient hadn’t been made aware of all the risks of manipulation, or did not get adequate support following it, this situation could have escalated much more.]]> 2023-04-25 19:38:14 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567748365 D4. You must have a policy in place to manage patient complaints, and respond quickly and appropriately to any that arise. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567748803 In second year, we were asked to respond to a complaint letter, where a whole previous consultation was being misinterpreted by a patient due to lack of clear communication at the time of the appointment. This coursework highlighted how vital being able to explain the treatment aims, risks and benefits to patients in the first place. 
Additionally, being clear and adapting to the recipient’s level of knowledge on the matter, and checking the understanding of the patient regularly. For example in this letter the word “dysfunction” was interpreted as the guardian’s son being “dysfunctional” however the patient’s guardian kept this to herself until writing the letter.
Additionally being able to respond to a complaint in due time, considering the plaintive’s arguments and answering with professionalism and sensitivity and adapting the lingo to who is being addressed is key to resolving a misunderstanding or complaint.]]> 2023-04-25 19:38:40 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567748803 D5. You must respect your patients’ rights to privacy and confidentiality, and maintain and protect patient information effectively. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567749030 The Data Protection act of 2018 states that anyone using personal information or data should thoroughly respect the “data protection principles”, ensuring that data is used transparently, fairly and lawfully. ]]> 2023-04-25 19:38:57 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567749030 D6. You must treat patients fairly and recognise diversity and individual values. You must comply with equality and anti-discrimination law. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567749355 In healthcare, discrimination can impact the prognosis, mental and physical health, some marginalised “communities” are still not understood by all which may in turn affect their health and safety. Therefore in any case of potential prejudice by a medical professional, it is probably in both party’s interests to be referred. This situation has never happened to me as I have always had an indiscriminate will to care for all, however in the event this were to ever happen, referring to another competent medical professional would be beneficial for the sake of the patient’s health and my professional safety.]]> 2023-04-25 19:39:19 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567749355 D7. You must uphold the reputation of the profession at all times through your conduct, in and out of the workplace. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567749616 Before coming into clinic, I did not have much professional experience, especially managing patients and having to uphold the reputation of a practice. This experience has taught me the importance of managing certain personal aspects such as nails, hair, beard and clothing in and out of clinic. Additionally the importance of managing sleep, conduct when going out in public, as this has an impact on patient’s perception of me but also on my workplace and on osteopathy as a whole. 
Maidstone being a relatively small town, seeing current and old patients outside of clinic is quite a common occurrence, some patients will want to talk more than others outside of clinic, some patients have even asked colleagues for their phone numbers or social media, which over time has taught me to keep a balance between good manners and professionalism with patients in and out of clinic.
]]> 2023-04-25 19:39:38 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567749616 D8. You must be honest and trustworthy in your professional and personal financial dealings. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567750009 As outlined by my business plan, prices will be determined based on the average pricing of the market around my practice, with some allowances made for less financially free patients. I will never take advantage of a patient and make them come back more than they need to for financial gain.]]> 2023-04-25 19:40:00 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567750009 D10. You must consider the contributions of other health and care professionals, to optimise patient care. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567750563 2023-04-25 19:40:39 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567750563 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. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567750823 Towards the end of my first year in clinic, I started getting some signs of irritation of my sinuses and feeling low in energy, at the time I did not think much of it since a lot of my classmates were experiencing similar symptoms. I went to clinic wearing a mask just in case for patients and peers, however when I got home and even more the day after, I got a headache, runny nose, and lost my smell and taste shortly after, I decided to take a test and it turned out positive. 
Being positive for Covid and unknowingly spreading it was one of my biggest fears during the pandemic, thankfully after telling my peers and patient I saw that day, none of them were tested positive. Even though no one was tested positive apart from me, and my symptoms were not very significant, I should not have only relied on my own judgment and should have tested prior to going to clinic. This way of handling situations for any health concern will have to be done consistently in the patient’s best interest, some patients have a low immune system therefore it is important to treat every patient the same and not taking unnecessary risks.]]> 2023-04-25 19:40:57 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2567750823 A5 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2611722289 Being at the ESO clinic and being around knowledgeable tutors is the perfect opportunity to explore rehab options and observe with time, what sort of exercise is suited to each type of patient. There is a large amount of exercises available in the literature, which is still exponentially growing alongside the evidence based approach of osteopathy. Exercises are a very useful tool to begin to put the patient’s health into their own hands and manage their condition, their symptoms, are or pain levels on their own, and additionally, lowering the likelihood of re-injury. It is vital to keep updated on new exercises in order to tailor exercises to each individual patient’s needs in future practice and be able to explain them in the clearest way possible.]]> 2023-06-01 11:42:16 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2611722289 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613060129 In contrast, this was a big high for me, I used all the feedback my tutors had given me over the two years in clinic. Contrary to other cases in the past, preparing this patient was quite straight-forward as little to no further exploration was needed (systemics, medication, diagnosis), as I have gotten into the habit of reviewing and understanding every patient’s case when getting in in clinic every session, this allows me to refresh knowledge and makes every appointment, as well, this makes certain patients feel heard and supported when learning that their case is regularly reviewed even outside of consultations. This will prove more challenging in future practice as there will be more patients than currently at the ESO clinic, however will certainly remain essential.]]> 2023-06-02 15:26:10 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613060129 4th Year, 3rd Term CEX 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613061840 2023-06-02 15:28:21 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613061840 3rd Year, Term 2 CEX 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613064903 This was a particular low for me in clinic, I had prepared myself a lot for the theory aspect of the CEX however I had not practiced enough at that point of the course, I was still hesitant when doing a test as to the exact position of the patient, and getting caught up with which next test or treatment would be more convenient or best. Developing a routine for both aspects was an essential part for me to start to feel more relaxed with patients, and allowed me to listen to the patient more, look at for non verbal signs, and be able to apply and demonstrate my knowledge with much less pressure.]]> 2023-06-02 15:32:22 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613064903 Comparing two CEXs 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613136698 During my first attempt at first year, I was often concerned with what people thought of my technique and how much I knew, over time, as my confidence grew I saw how feedback is a vital aspect of being an osteopathic student, and it is up to me to change my view of feedback, to not see it as something personal but an opportunity to grow and better myself, I appreciate how welcoming feedback and even asking for feedback from tutors and peers has allowed me to grow a lot as an osteopath, in my confidence with different techniques such as manipulations (HVTs) but also how and which exercises to suggest to patients, the way I express myself, the way I present myself.
The two CEX feedback papers posted above have a year and a half of interval between them. I was was very happy to see at the end of fourth year was when I got my best result for a CEX ever! I applied all the feedback I had got over the two last years and clinic and used it to grow in confidence especially in an exam setting. Something I observed quite early on in the course for people in clinic and am also guilty of, is always asking what I could have done better, when also asking what was done well should not be discarded, recognising strengths contributes to overall confidence as a healthcare professional. ]]> 2023-06-02 17:16:35 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613136698 C1. From the SOCRATES model to symptom oriented questioning 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613269124 Being new to patient handling and having to remember all the important questions can be stressful. The SOCRATES model is a very convenient way of starting to take case histories to remember the must ask questions, however over time when developing a system to distinguish between conditions, which is different from one joint to the other, in order to gain clarity and efficiency in the practitioner’s mind both questioning and note taking change.
Similarly, examinations go from practiced routines from boxley to specific examinations being combined to discern from one diagnosis to the next, depending on each individual patient.
Observing limitations or gaps in knowledge is easier when being surrounded and observed daily by peers and osteopaths, in future practice, this will have to be done autonomously and regularly to ensure the safety of patients.]]> 2023-06-02 21:44:09 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613269124 C2 My handwriting/note taking (3rd Year, 1st term) 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613524567 2023-06-03 13:21:20 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2613524567 D3. The Duty of Candour 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2616914202 The Duty of Candour indicates that every health and care professional should be open as well as honest when something goes wrong with treatment, whether it causes harm, distress.]]> 2023-06-07 09:05:44 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2616914202 C4. 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2617016427 2023-06-07 11:11:42 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2617016427 D10. Guide to Letter Writing 21817263_ https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2617040809 With osteopaths now being being a primary healthcare professionals, and the NHS being saturated following covid, the profession is seeing more and more patients with undiagnosed pathologies as they are not able to see their GP. 
Even though it is not our role to treat these pathologies, it is expected of us as osteopaths to look out for undiagnosed  pathologies or progression, and be aware of which medical professional to refer to, and the lingo and format to use when writing to them. Referring a patient should be done in due time, but can also involve the patient getting treatment at the same time as being investigated for something else, this clinical judgment will have to be done autonomously in future practice, but can only happen through knowing what the investigation (from the GP or specialist) and pathology involve, if it is safe to treat the patient at the same time or in their best interest.]]> 2023-06-07 11:43:11 UTC https://padlet.com/21817263_/v4k2fdufirzn2pse/wish/2617040809