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Jeanine Wagner

Dr. Hammill

Senior Seminar

28 November 2017

Practicum Reflection

Advantage Physical Therapy and Sports Performance will be my fourth internship

location site since June of this past year. Walking into the clinic for the first time I had a good

idea of what to expect. I had spent a significant portion of my time in an outpatient clinic and felt

comfortable with the general flow of how things went. Nevertheless, being in this clinic for

several weeks has been one of the best experiences to date and I am grateful for the connections I

have made with the people there.

Prior to my internship experiences, I had only been exposed to physical therapy during a

brief shadowing experience to complete my graduation project in high school and when I was in

physical therapy for my thoracic outlet syndrome. I had very minimal roles and nowhere near

enough knowledge when I completed my shadowing experience to do much other than observe,

but still I was fascinated by the processes I saw taking place. In addition, the role of the patient is

quite different than that of the therapist, and yet I was still amazed at the progress I made simply

by using nerve glides and strengthening specific muscles. This allowed me to start to believe in

the process and look further into the profession to see if it would be something I wish to pursue.

My preconceptions going into this phase of internship experiences were tailored

specifically to the type of environment I was going into. I already mentioned being in an

outpatient clinic, but I also spent time in a rehabilitation hospital and an inpatient/outpatient

clinic within a retirement community. Going into the outpatient facility I expected that I would
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get to observe the treatment of multiple different patients a day while also helping the therapists

by retrieving any equipment needed and keeping the clinic clean and organized throughout the

day. At the rehab hospital I was expecting to see fewer patients who do various types of

exercises to regain strength as they transition from being in the hospital to outpatient therapy. In

addition, I thought we would still be visiting each patient in their respective rooms. When

entering the retirement facility, I thought that we would be seeing the same few cases in all the

patients which would include joint mobilization and strengthening, stroke rehabilitation, and

exercises that help to maintain as much of the patient’s independence as possible.

While I may have had a general idea of what to expect, there was a lot that I learned and

even more I was retaught while in these settings. At the outpatient clinic I was correct in my

assumption of what I would be required to do; however, there were a lot of opportunities where I

could learn new skill sets because of the added knowledge I had gained so far in my college

experience. I was able to learn some manual muscle tests and other various indicators of injury

and what muscle groups may be affected based on certain results. In addition, I was able to

interact more with the patients as I became more comfortable in the clinic which has helped me

to strengthen my interpersonal skills. One of the biggest struggles I have had to overcome is

shyness, so I take advantage of every opportunity I have to further develop theses skill to

enhance my relationship with others.

I was very excited to start at the rehab hospital because I had an interest in the more

intensive therapy required for this setting. I was correct to assume that each therapist only had

about six patients to personally see in a day, while the physical therapy assistant they were paired

with saw the other six that were under this therapist’s care. I thought it was very interesting how

the physical therapists and occupational therapists worked so close together on each case to make
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sure that they were remaining consistent in the patient’s treatment process. I was incorrect in

thinking we would be visiting each patient in their rooms. The patients either brought themselves

down to the therapy gym (if they were deemed safe) or had a technician or nurse bring them

down. This freedom was a goal for many patients and contributed to their therapy.

After being in the outpatient facility and the rehab hospital, I was not sure what to expect

for the retirement community setting. This was probably the most diverse setting I had the

opportunity to be in. While the patients were all geriatrics, I was able to see therapy for the

greatest variation of illnesses. I saw stroke patients, amputees, those with cardio-pulmonary

weakness due to cancer, joint replacements, dementia patients, chronic pain and more in the

short time I was there. While some of each session was devoted specifically to maintaining their

mobility and independence, there was also a significant portion that directly helped to improve

their points of weakness. In the inpatient aspect of this setting, we mainly wen to the patient’s

room. This was partially due to the vastness of the facility, because if we were required to help

everyone to the therapy gym that would take up the entire therapy session.

This practicum experience was also in an outpatient facility which was very similar to my

first internship. The facility was an extremely inviting place to work and it was apparent that

they were a positive presence in their community. The therapists were willing to help explain

their treatments to the students and further our education as we helped them out in the clinic.

Specifically, I was able to further improve my bedside manner which is an important aspect of

being a therapist that is not something that can be taught easily. Comfort around patients and

being personable help, but it takes lots of experience around patients to make them feel

comfortable with you almost instantly. It includes the ability to establish a relationship with the

patient by simply getting to know them and make them feel as if their concerns are heard. I also
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was exposed to new ways to help a patient understand what is wrong with their strength and how

to reassure them that doing the exercises will help in the long-term. One of the strengths of this

facility was their ability to make the most of the equipment they had. The previous outpatient

facility was also a wellness center sot it had a lot of the typical machines you would see in a

gym. Advantage PT had a leg press, treadmill, two stationary bikes, and elliptical, and free

motion modifiable weight machine that could be modified to do a variety of different exercises.

The innovation used to complete the same exercises made the atmosphere in this facility seem

more creative than the first setting I was in.

My learning was mostly observational; however, the therapists would often quiz the

students on what exercises might be used to work specific muscle groups or rehab injuries. I

liked to frequently ask what the therapists were looking for as they watched patients performing

exercises which typically had to do with gait abnormalities. The information required for me to

answer the questions came mostly from kinesiology and some from basic anatomy. If I had to

make any suggestions, it would be to include more names of exercises that are used to strengthen

certain muscle groups. Unless someone is familiar with lifting weights, they may not be able to

come up with these exercises on their own. A lot of the information that I used came from

previous experiences I had during my observation or similar cases that I had already seen. Some

of the psychological knowledge that is needed to interact with individuals and help to motivate

them came from my health and exercise psychology class. Finally, personal and community

health helped me to understand the various populations I was working and how to relate to them

in the best way I can. Some of these differences include race, economic status, political

affiliations, language barriers, and physical limitations.

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What made this experience so great was the people I had the privilege to work with. My

specific supervisor was interesting because he is in a position I hope to be one day, practicing in

the field and owning my own clinic. He was able and available to answer any of the questions I

had about this process and his story is even more unique in that this is his second career. I am

fortunate to have his perspective and know that if I ever need a reference or career advice I can

contact him. In addition, the other therapists there were extremely helpful when Kevin was not

around by allowing me to ask them questions and sit in on their treatments. This facility teaches

not only prospective students, but also those in physical therapy school already. One of Murphy

Deming’s students were doing a clinical rotation there this semester, so it was extremely helpful

to get his take on graduate school and what I can be expecting. By the end of my time there I felt

like I was a part of their community and no longer a visitor. The staff and patients alike were

very welcoming and patient as I was learning more about the field I hope to be a part of

someday. I am grateful for the opportunity I had to volunteer and Advantage Physical Therapy

and am excited to continue to learn how to be a better physical therapist.