Year 3 by 21614233

First week in clinic!

658070 — 2019-09-21 10:03:28 UTC

The clinical induction week proved to be incredibly useful! I saw eight new patients and carried one of them out myself. One of the most striking aspects of the process was to do with the patient interaction, informed consent and how to structure the interview process. In theory it was easy to do, in practise it was a completely different ball game. The key for me is to be aware of this difference and to keep working on it with each successive patient. Over time it will flow naturally. My case history writing style was awful as well and the needs to be rectified as soon as possible. At least I was able to be polite and courteous throughout!
OPS A1-A7, B4, C2

Mr X's wise words.

658070 — 2019-09-21 11:13:06 UTC

Having a two hour tutorial with Mr X on the knee proved to be very helpful. I learn so much about how to evaluate a patient with a knee complaints, and more specifically how to differentiate between ACL, PCL or a vascular problem. He demonstrated that it is the questioning that will separate the three and that you only really need three or four questions to separate them out.
OPS B1-B4

Mr X's two example patient run throughs.

658070 — 2019-09-21 11:21:34 UTC

Mr X's induction talks and two example patient run throughs were an eye opener for our start in clinic. Watching Mr X carry out two new patients gave us a whole lot of contextual information to take in. Examples include copying and pasting specific routines together to better suit patient complaints (enabling a more accurate, and efficient diagnosis), questioning why we are asking certain questions and what real data do they give us? (which turns out not to be very useful data) And how and why we need to contextualise information so that patients understand what is going on and are as much part of the process as we practitioners are.
One tip that really stood out was the idea to put your pen down and just let the patient talk for the first few minutes.
OPS A1-A4, B1-B2, C1, C4, D3

ASIA - INTERNATIONAL STANDARDS FOR NEUROLOGICAL CLASSIFICATION OF SPINAL CORD INJURY

658070 — 2019-09-21 11:52:38 UTC

Mr X made us aware of this ASIA protocol for neurological evaluation. This document is an incredibly useful way of classifying neurological assessments not only for yourself but for other practitioners who may have your patients or even as a standardised benchmark with your own patients going forward. This provided quite useful in clinic whereby I was able to identify progressive neurological deficits in a patient and thus onward referral.
OPS C1, C6, D10

Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices

658070 — 2019-09-21 18:08:44 UTC

This research paper provides tremendous amount of detail with regards to managing patients with acute lumbar disk pain. For me, this paper provides an evidence based grounding on which to act upon. Not only does it help me decide how to act to keep my patients safe, but it also helps me manage my differentials, understand how to evaluate more efficiently with (hopefully) better outcomes and the importance of patient referral. I will be collecting many papers of this nature in order to better inform me of magnum my practise.
OPS C1, C4, C6

Gregory, D., 2008. Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices. American Family Physician, 78(7).

Today Mrs X taught me the Still technique!

658070 — 2019-09-21 19:05:00 UTC

This philosophy of technique was a real game changer for me. I instantly understood the principles behind this technique and will definitely be using this a lot with my patients! I found this video to use n the future incase I forget anything!
OPS B1, B3, B4

Youtube.com. 2016. Instructional Video on Application of the Still Technique With Narration. [online] Available at:

Keeping within scope of practice

658070 — 2019-09-22 17:26:04 UTC

This research article helped a lot to guide my management plan for one of my new patients and help me stay within my scope and boundaries of practice.
OPS B1-B2, C2-C3, C7

Pollard, H., 2008. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. The Journal of Canadian Chiropractic Association, 52(4).

knee biomechanics

658070 — 2019-09-22 17:46:32 UTC

Loudon, J., 2016. BIOMECHANICS AND PATHOMECHANICS OF THE PATELLOFEMORAL JOINT. The International Journal of Sports Physical Therapy, 11(6).

Absolutely amazing neuro screen reference!

658070 — 2019-09-22 18:36:00 UTC

References like these were so important for clinic. Neuro exams are obviously very important and reading up on various different approaches gives me a wider use for my toolkit, thus enhancing patient care and safety. They are also useful for benchmarking to my own progression. Allowing me to analyse and reflect upon information directly relevant to patient care.
OPS B1, B3-B4

First patient encounter!

658070 — 2021-02-03 17:25:02 UTC

My first patient encounter and reflections below. Overall, positive due to good communication on my part.
OPS A1-A7

Being observed by fellow colleagues

658070 — 2021-02-03 18:43:15 UTC

The feedback gained from being observed is invaluable. There are certain elements you won't ever see yourself, especially being new to osteopathy. Such things include not giving understandable/relevant information to patients, explaining the consent process in a way that was not understandable, and general lack of awareness of the clinical space and its impacts (not mentioning observers may be present etc).
OPS A1-A3, A4-A5, A7, B1, B2, B4, C1-C2

Culture, consent and dignity

658070 — 2021-02-03 19:42:10 UTC

Consent across language/cultural barriers is much more difficult to achieve. Observing this case was very helpful in terms of understanding from an outside perspective and to acknowledge its complexity and importance.
With this difficult scenario, it is also important to understand that patient dignity and modesty may mean different things across different cultures.
OPS A1-A7

Helping patients manage conditions with day to day products!

658070 — 2021-02-05 17:19:05 UTC

Observing a patient who manages his IBS with turmeric and ginger was an eye opener. It shows that simple advice can really help patients in the long run. Advice and information are so important for patient management.
OPS A5

Be aware of prejudice...

658070 — 2021-02-06 16:52:31 UTC

A fellow student had a new female patient that had directly requested a male practitioner. My immediate reaction was to assume there was a "dodgy" reason for this. My tutor kindly pointed out that there may be other reasons for this and to not hold these kinds of thoughts before the patient practitioner interaction. An easy lesson to learn....
OPS A7

Writing legibly is a challenge...

658070 — 2021-02-08 18:04:59 UTC

My handwriting has always been a challenging issue for me. I get so immersed in the patient that I don't take my time writing things in a legible fashion. It is an issue I am working hard to resolve bit by bit. Slowing down is an important aspect I am working on in many areas.
OPS C2

Being honest and acting with integrity is important for patient safety.

658070 — 2021-02-10 15:24:44 UTC

Sometimes it is important to be honest in order to be safe with a patient. Even if it means challenging previous medical assumptions that contradict your own examination findings i.e. fracture in this case.
OPS C1, C4, D1

Professional boundaries are important..

658070 — 2021-02-10 16:53:09 UTC

Observing a colleague take a new patient case history from a 1st year student who had no pain or presenting issues really brought home the idea that boundaries. Without these boundaries, patient care would; be greatly sacrificed.
OPS D2

Clinical conversations..

658070 — 2021-02-16 15:59:45 UTC

Had a lengthy discussion with one of my clinic tutors about many aspects of osteopathy. It is very interesting to hear how osteopathy is regarded so differently and just how important it is to be honest about how osteopathy can help. Following on from the previous point, duty of candour was something I had learned more about today.
OPS D1, D3

ESO's complaint policy - a good framework

658070 — 2021-02-16 18:25:01 UTC

I would hope to follow a similar complaints procedure outlay in my own practice once I graduate.
OPS D4

ESO - European School of Osteopathy. n.d. Patient Complaints Procedure | ESO - European School of Osteopathy. [online] Available at:

Respecting patient confidentiality, privacy and protection of information

658070 — 2021-02-17 12:24:20 UTC

Tricky situations in clinic whereby one has to be very careful in maintaining patient confidentiality and privacy. Reflecting upon these situations is what solidifies the need to constantly assess these situations in real time.
OPS D5

Learning how to treat patients fairly and recognise diversity and individual values is hard...

658070 — 2021-04-12 16:31:38 UTC

Reflecting further on this new patient I had in clinic really brings home the issue of recognising the individuality in each patient and the fairness that is portrayed in their eyes. It took the whole of year three for me to understand this in practice. This is why these reflections are so vital for ones own development.
OPS A2, A7, D6

An interesting insight!

658070 — 2021-04-12 19:35:48 UTC

Papers like these really helped me understand the context of regulations and the importance of such stipulations placed upon student osteopaths.
OPS D7

Kaptein, M., 2019. Prescribing Outside-Work Behavior: Moral Approaches, Principles, and Guidelines. Employee Responsibilities and Rights Journal, 31(3), pp.165-185.

Business plan assignment.

658070 — 2021-04-13 16:42:51 UTC

This assignment really helped contextualise the professional financial dealings one must get to grips with in practice. Up until this points, I had not thought about this aspect much.
OPS D8

Feedback and supporting fellow peers.

658070 — 2021-04-13 18:17:52 UTC

During year 3 observations we all took the time to feedback to each other with regards to our new patients in clinic.This feedback was invaluable not only for ourselves but for the development of our colleagues a student osteopaths.
OPS D9

Another way/method of looking after yourself.

658070 — 2021-04-14 16:18:57 UTC

A research article on the idea of "grounding" - which is taught a lot in year 3. It is an interesting view upon a very complex way of organising your own energy/body/mind away from that of the patients - to be neutral so to speak.
These methods also allow me as a practitioner to step into a "practitioner role" before seeing patients. Minimising any potential interference between my own well-being and theirs.
OPS D11

Chevalier, G., Sinatra, S., Oschman, J., Sokal, K. and Sokal, P., 2012. Earthing: Health Implications of Reconnecting the Human Body to the Earth's Surface Electrons. Journal of Environmental and Public Health, 2012, pp.1-8.

First Aid course requirements before starting clinic.

658070 — 2021-04-14 18:15:21 UTC

An example of complying with regulatory requirements.
OPS D12

My dissertation protocol presentation.

658070 — 2021-05-11 14:26:15 UTC

This presentation is a good example of responding effectively and appropriately to requests for the production of written material and data. I had to deliver a complex idea in a short presentation style conference with Q&A at the end - a mini VIVA.
OPS C3

PPE in readiness for summer clinic!

658070 — 2021-05-11 14:54:49 UTC

A strong example making sure that my practice is safe, clean and hygienic, and complies with health and safety legislation.

OPS C5

658070 — 2021-05-27 19:49:45 UTC

Chevalier, G., Sinatra, S., Oschman, J., Sokal, K. & Sokal, P., 2012. Earthing: Health Implications of Reconnecting the Human Body to the Earth's Surface Electrons. Journal of Environmental and Public Health, 2012, pp.1-8.

ESO - European School of Osteopathy. n.d. Patient Complaints Procedure | ESO - European School of Osteopathy. [online] Available at:

Gregory, D., 2008. Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices. American Family Physician, 78(7).

Kaptein, M., 2019. Prescribing Outside-Work Behavior: Moral Approaches, Principles, and Guidelines. Employee Responsibilities and Rights Journal, 31(3), pp.165-185.

Loudon, J., 2016. BIOMECHANICS AND PATHOMECHANICS OF THE PATELLOFEMORAL JOINT. The International Journal of Sports Physical Therapy, 11(6).

Pollard, H., 2008. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. The Journal of Canadian Chiropractic Association, 52(4).

Youtube.com. 2016. Instructional Video on Application of the Still Technique With Narration. [online] Available at: