1. Invests in the acquisition of evidence through participation in workshops, continued education and pursuit of additional degrees.
There were workshops provided weekly at Methodist South during lunch period that I had the opportunity to attend. The workshops were held by the rehab director and students at the facility. The in services were very informational and provided evidenced based practice on various topics such as assessments, aphasia, unilateral neglect, therapeutic use of self, and collaboration with various disciplines. I had the opportunity to provide a workshop on an assessment that was new to the facility which was The REAL (the roll evaluation of activities of daily living). I enjoyed this learning experience, because it allowed me to complete additional research and pursue more knowledge in regards to pediatrics, which I am very passionate about. The workshops given by the rehab director have provided me with continued education from a professional standpoint by understanding the various aspects of a rehab team such as: team building, unity, collaboration, and flexibility. I am grateful that I experienced the workshops during my first rotation, because it provided me with knowledge not only regarding the facility but also about collaboration of disciplines and evidence based practice as a whole.
2. Is a knowledgeable consumer of global research related to occupational therapy and utilizes an evidence based approach to practice.
During all three of my rotations, I exhibited utilization of evidence based approach to my practice. The first rotation at Methodist South outpatient my fieldwork educator advised me to research diagnosis on our caseload each day. I focused my research specifically searching for evidence of most effective interventions for the specific diagnosis and outcomes. This assisted me to become a knowledgeable consumer of research. I understood approaches/interventions that were recommended through research for diagnoses that were presented on our caseload. I presented my findings to my Fieldwork Educator, and had the opportunity to implement findings for specific patients. The implementation of approaches that I researched were: PNF patterns, Constraint Induced Movement, and the Rood approach. I had various research opportunities at St. Jude as well. There was one specific patient that has led me to research treatment ideas due to the complexity of his deficits and behavioral challenges during therapy sessions. Through my research and collaboration with my fieldwork educator we utilized evidence based practice preventing secondary disabilities for children who are wheelchair users. I have provided links and referenced multiple articles that guided interventions through my level II fieldwork journey. The research I completed assisted me to become more focused towards an evidence based approach.
https://www.degruyter.com/downloadpdf/j/hukin.2012.31.issue--1/v10078-012-0011-y/v10078-012-0011-y.pdf
http://www.journalofphysiotherapy.com/article/S0004-9514(05)70003-9/pdf
platy_deprivation_in_children_with_physical_disabilities.pdf
Reference
Hakkennes, S., & Keating, J. L. (2005). Constraint-induced movement therapy following stroke: A systematic review of randomised controlled trials. Australian Journal of Physiotherapy, 51(4), 221-231. doi:10.1016/s0004-9514(05)70003-9
Hindle, K., Whitcomb, T., Briggs, W., & Hong, J. (2012). Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function. Journal of Human Kinetics, 31(-1). doi:10.2478/v10078-012-0011-y
Missiuna, C., & Pollock, N. (1991). Play Deprivation in Children With Physical Disabilities: The Role of the Occupational Therapist in Preventing Secondary Disability. American Journal of Occupational Therapy, 45(10), 882-888. doi:10.5014/ajot.45.10.882
3. Integrates individual clinical expertise and patient values with the best available external clinical evidence.
Integrating patient values and clinical expertise with the best external clinical evidence is an area that I completed during my time at St. Jude. There was a specific patient during my time at this facility who was from Turkey. The patient and her family decided to return to St. Jude after treatment was completed to receive rehabilitation services. When I was educated on this case I was shocked this patient and her family returned to the United States to receive therapy services at St. Jude. As I began to build rapport with this patient I began to understand her Turkish values and beliefs. Each session this patient tested my knowledge by questioning the purpose of exercises and activities we completed. I discussed with my educator the most appropriate evidence based approaches for this patient. After much research and collaboration with my educator we knew one of the main priorities we would focus on would be neuromuscular re-education. The research that I completed provided me with the best available external clinical evidence to address the patient's values of understanding the theory and evidence of treatment being provided. Also, another aspect that I applied clinical expertise was psychosocial areas related to the patients’ values. This patient was followed by psychology since beginning her time at St. Jude. The patient had difficulty understanding the process of Americans in certain situations, and a difficult time with building relationships with other children her age. Upon arrival to a treatment session this patient was extremely emotional. My educator and I were able to break down the issues the patient was having with “American people”. We utilized our knowledge of the patients’ values and verified her feelings. The occupational therapy mindset assisted the patient in times of distress. Both of these experiences assisted me to understand the importance of the patients’ values and applying the best external clinical evidence possible.
4. Applies the domain of occupational therapy in gathering, evaluating, setting goals, planning and implementing occupational therapy.
During my time at St. Jude I have applied the domain of occupational therapy by gathering, evaluating, setting goals, planning and implementing interventions. On my past rotations I have not had the opportunity to see this full process with the same patient. I have observed the entire process, but with various patients at various complexities. I completed an initial evaluation on a patient who was diagnosed with Medulloblastoma. Prior to completing the initial evaluation, I completed an extensive chart review gathering information. I read through the following discipline notes: neuro-oncology, child life specialist, social work, physical therapy, and speech therapy. This chart review allowed me to gather information to provide a baseline of expectations and assessments to administer during the evaluation. When I completed this evaluation the child was 2 weeks post-operative. He was a 7-year-old boy experiencing slight hemiplegia, minimal ataxia, and much difficulty with bilateral coordination activities. I evaluated this patient and performed the following assessments: range of motion, manual muscle testing, 9-hole peg test, grip and pinch strength, and clinical interviewing regarding ADLs/IADLs. Through the results of the assessments I utilized clinical judgement to create goals when I documented the evaluation. I created goals to address the following areas: endurance/activity tolerance to participate in age appropriate leisure, increased grip strength in order complete IADL task such as opening water bottle, and to participate in bilateral coordination activity to increase use of right upper extremity. Through treatment planning I utilized the sources at St. Jude, which provided a plethora of knowledge that discussed effective approaches to implement. I provided the father with education from the knowledge I gained from the sources provided by St. Jude. I implemented various interventions such as: weight bearing through right upper extremity, quadruped position while engaging in a fine motor game, handwriting activities, exercises for upper extremities, yoga, and many more. Through the process I explained it is evident that I implemented the domain of occupational therapy from gathering information to implementing the interventions.
5. Contributes to the knowledge base of OT practice by mentoring students, performing research, publishing, presenting and/or teaching.
Throughout my level two fieldwork rotations I mentored students, presented, as well as participated in research. My first opportunity was presenting at Methodist South outpatient clinic. I presented on The REAL assessment to all disciplines at the facility. Another example was the experience of mentoring COTA students during my second rotation. I assisted in teaching them the computer system, oriented them to the facility, and educated them on treatment sessions. This mentorship continued for approximately four weeks. The COTA students observed my treatment session where we debriefed after each session where I explained my clinical judgement on sessions. Throughout my rotations I engaged in performing research through Dr. Mitchell’s research. I attached my blackboard submission form to provide evidence of my submissions to the research project. Lastly, at St. Jude the lead occupational therapist was contributing to a text book on the topic of pediatric oncology. I assisted her by inserting information into a table format for various types of chemotherapy and the potential side affects. These experiences listed have facilitated my knowledge base of OT practice significantly by forcing me out of my comfort zone. These experiences have prepared me to continue this aspect in my future career in occupational therapy.
dr._mitchells_research.jpg
6. Incorporates continued education as a lifelong practice with the commitment to remain up-to-date and well-informed.
Toward the end of my second rotation at Baptist Health the census of the patients began to decrease due to holidays closely approaching. There is a detox program on the psychiatric unit where patients can voluntarily admit themselves. During the holidays enrollment into this program decreases extremely due to patients wanting to be with family. Due to the low census there was more free time and my fieldwork educator began to complete online continuing education courses. As she completed the courses we discussed the variety of courses, topics and submission options. Although I could not submit the courses I had the opportunity to complete questionnaires and check my answers to learn from the sessions. I plan to keep this website for future continuing education courses. This specific website was beneficial for me, because it discussed many brain injuries and the recovery process of the brain. This was beneficial, because the majority caseload I was assigned to at St. Jude were children with brain tumors. I have attached the website for the courses that I completed questionnaires. It was an exceptional opportunity for me to understand there are multiple options for continuing education courses that are simple yet extremely beneficial to learning.
http://www.neurorestorative.com/knowledge-center/neuro-institute/
Reference
“Neuro Institute - NeuroRestorative - Free CEU Credits.” NeuroRestorative, www.neurorestorative.com/knowledge-center/neuro-institute.
There were workshops provided weekly at Methodist South during lunch period that I had the opportunity to attend. The workshops were held by the rehab director and students at the facility. The in services were very informational and provided evidenced based practice on various topics such as assessments, aphasia, unilateral neglect, therapeutic use of self, and collaboration with various disciplines. I had the opportunity to provide a workshop on an assessment that was new to the facility which was The REAL (the roll evaluation of activities of daily living). I enjoyed this learning experience, because it allowed me to complete additional research and pursue more knowledge in regards to pediatrics, which I am very passionate about. The workshops given by the rehab director have provided me with continued education from a professional standpoint by understanding the various aspects of a rehab team such as: team building, unity, collaboration, and flexibility. I am grateful that I experienced the workshops during my first rotation, because it provided me with knowledge not only regarding the facility but also about collaboration of disciplines and evidence based practice as a whole.
2. Is a knowledgeable consumer of global research related to occupational therapy and utilizes an evidence based approach to practice.
During all three of my rotations, I exhibited utilization of evidence based approach to my practice. The first rotation at Methodist South outpatient my fieldwork educator advised me to research diagnosis on our caseload each day. I focused my research specifically searching for evidence of most effective interventions for the specific diagnosis and outcomes. This assisted me to become a knowledgeable consumer of research. I understood approaches/interventions that were recommended through research for diagnoses that were presented on our caseload. I presented my findings to my Fieldwork Educator, and had the opportunity to implement findings for specific patients. The implementation of approaches that I researched were: PNF patterns, Constraint Induced Movement, and the Rood approach. I had various research opportunities at St. Jude as well. There was one specific patient that has led me to research treatment ideas due to the complexity of his deficits and behavioral challenges during therapy sessions. Through my research and collaboration with my fieldwork educator we utilized evidence based practice preventing secondary disabilities for children who are wheelchair users. I have provided links and referenced multiple articles that guided interventions through my level II fieldwork journey. The research I completed assisted me to become more focused towards an evidence based approach.
https://www.degruyter.com/downloadpdf/j/hukin.2012.31.issue--1/v10078-012-0011-y/v10078-012-0011-y.pdf
http://www.journalofphysiotherapy.com/article/S0004-9514(05)70003-9/pdf
platy_deprivation_in_children_with_physical_disabilities.pdf
Reference
Hakkennes, S., & Keating, J. L. (2005). Constraint-induced movement therapy following stroke: A systematic review of randomised controlled trials. Australian Journal of Physiotherapy, 51(4), 221-231. doi:10.1016/s0004-9514(05)70003-9
Hindle, K., Whitcomb, T., Briggs, W., & Hong, J. (2012). Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function. Journal of Human Kinetics, 31(-1). doi:10.2478/v10078-012-0011-y
Missiuna, C., & Pollock, N. (1991). Play Deprivation in Children With Physical Disabilities: The Role of the Occupational Therapist in Preventing Secondary Disability. American Journal of Occupational Therapy, 45(10), 882-888. doi:10.5014/ajot.45.10.882
3. Integrates individual clinical expertise and patient values with the best available external clinical evidence.
Integrating patient values and clinical expertise with the best external clinical evidence is an area that I completed during my time at St. Jude. There was a specific patient during my time at this facility who was from Turkey. The patient and her family decided to return to St. Jude after treatment was completed to receive rehabilitation services. When I was educated on this case I was shocked this patient and her family returned to the United States to receive therapy services at St. Jude. As I began to build rapport with this patient I began to understand her Turkish values and beliefs. Each session this patient tested my knowledge by questioning the purpose of exercises and activities we completed. I discussed with my educator the most appropriate evidence based approaches for this patient. After much research and collaboration with my educator we knew one of the main priorities we would focus on would be neuromuscular re-education. The research that I completed provided me with the best available external clinical evidence to address the patient's values of understanding the theory and evidence of treatment being provided. Also, another aspect that I applied clinical expertise was psychosocial areas related to the patients’ values. This patient was followed by psychology since beginning her time at St. Jude. The patient had difficulty understanding the process of Americans in certain situations, and a difficult time with building relationships with other children her age. Upon arrival to a treatment session this patient was extremely emotional. My educator and I were able to break down the issues the patient was having with “American people”. We utilized our knowledge of the patients’ values and verified her feelings. The occupational therapy mindset assisted the patient in times of distress. Both of these experiences assisted me to understand the importance of the patients’ values and applying the best external clinical evidence possible.
4. Applies the domain of occupational therapy in gathering, evaluating, setting goals, planning and implementing occupational therapy.
During my time at St. Jude I have applied the domain of occupational therapy by gathering, evaluating, setting goals, planning and implementing interventions. On my past rotations I have not had the opportunity to see this full process with the same patient. I have observed the entire process, but with various patients at various complexities. I completed an initial evaluation on a patient who was diagnosed with Medulloblastoma. Prior to completing the initial evaluation, I completed an extensive chart review gathering information. I read through the following discipline notes: neuro-oncology, child life specialist, social work, physical therapy, and speech therapy. This chart review allowed me to gather information to provide a baseline of expectations and assessments to administer during the evaluation. When I completed this evaluation the child was 2 weeks post-operative. He was a 7-year-old boy experiencing slight hemiplegia, minimal ataxia, and much difficulty with bilateral coordination activities. I evaluated this patient and performed the following assessments: range of motion, manual muscle testing, 9-hole peg test, grip and pinch strength, and clinical interviewing regarding ADLs/IADLs. Through the results of the assessments I utilized clinical judgement to create goals when I documented the evaluation. I created goals to address the following areas: endurance/activity tolerance to participate in age appropriate leisure, increased grip strength in order complete IADL task such as opening water bottle, and to participate in bilateral coordination activity to increase use of right upper extremity. Through treatment planning I utilized the sources at St. Jude, which provided a plethora of knowledge that discussed effective approaches to implement. I provided the father with education from the knowledge I gained from the sources provided by St. Jude. I implemented various interventions such as: weight bearing through right upper extremity, quadruped position while engaging in a fine motor game, handwriting activities, exercises for upper extremities, yoga, and many more. Through the process I explained it is evident that I implemented the domain of occupational therapy from gathering information to implementing the interventions.
5. Contributes to the knowledge base of OT practice by mentoring students, performing research, publishing, presenting and/or teaching.
Throughout my level two fieldwork rotations I mentored students, presented, as well as participated in research. My first opportunity was presenting at Methodist South outpatient clinic. I presented on The REAL assessment to all disciplines at the facility. Another example was the experience of mentoring COTA students during my second rotation. I assisted in teaching them the computer system, oriented them to the facility, and educated them on treatment sessions. This mentorship continued for approximately four weeks. The COTA students observed my treatment session where we debriefed after each session where I explained my clinical judgement on sessions. Throughout my rotations I engaged in performing research through Dr. Mitchell’s research. I attached my blackboard submission form to provide evidence of my submissions to the research project. Lastly, at St. Jude the lead occupational therapist was contributing to a text book on the topic of pediatric oncology. I assisted her by inserting information into a table format for various types of chemotherapy and the potential side affects. These experiences listed have facilitated my knowledge base of OT practice significantly by forcing me out of my comfort zone. These experiences have prepared me to continue this aspect in my future career in occupational therapy.
dr._mitchells_research.jpg
6. Incorporates continued education as a lifelong practice with the commitment to remain up-to-date and well-informed.
Toward the end of my second rotation at Baptist Health the census of the patients began to decrease due to holidays closely approaching. There is a detox program on the psychiatric unit where patients can voluntarily admit themselves. During the holidays enrollment into this program decreases extremely due to patients wanting to be with family. Due to the low census there was more free time and my fieldwork educator began to complete online continuing education courses. As she completed the courses we discussed the variety of courses, topics and submission options. Although I could not submit the courses I had the opportunity to complete questionnaires and check my answers to learn from the sessions. I plan to keep this website for future continuing education courses. This specific website was beneficial for me, because it discussed many brain injuries and the recovery process of the brain. This was beneficial, because the majority caseload I was assigned to at St. Jude were children with brain tumors. I have attached the website for the courses that I completed questionnaires. It was an exceptional opportunity for me to understand there are multiple options for continuing education courses that are simple yet extremely beneficial to learning.
http://www.neurorestorative.com/knowledge-center/neuro-institute/
Reference
“Neuro Institute - NeuroRestorative - Free CEU Credits.” NeuroRestorative, www.neurorestorative.com/knowledge-center/neuro-institute.