Fourth Year - Rotation 2 - Musculoskeletal Initial Entry

This has probably been the most nervous I have ever been before starting a placement! Musculoskeletal outpatients seems the most daunting out of all of the placements I have been assigned! This is because I believe there is so much content to cover and every patient is actually going to have a completely different problem unlike other placements where I would be seeing a total knee replacement followed by another total knee replacement patient. This time I have to be prepared to jump from treating a post surgery rehabilitation to managing a chronic lower back problem to working on an acute ankle injury while keeping in mind co-morbidities at the same time! On the other hand, I'm keen to get started as I believe this rotation I will be learning so much, especially about time management, putting my skills into practice and thinking on my feet. I'm very excited to be gaining experience in the field of physio which I’ve always imagined myself working in post graduation.

My expectations for this placement are of managing a full caseload of my own patients in a suitable amount of time. I believe I will have to be very patient goal focused with treatments especially to encourage them to do their exercises/stretches on their own. I will also get another chance to work in a hydrotherapy pool every Monday and running total knee replacement classes twice a week. As this is my second placement in 4th year, I expect to be given further responsibilities (being left on my own more often and run classes independently sooner than my last prac) and have my supervisors expect more from me.

I am very anxious about this placement as unlike the typical hospital situations that I have been placed in previously, my treatments aren't going to be routine for every patient as if I'm following a protocol prescribed by the surgeon. I will have to be able to formulate a diagnosis and clinically reason every action I take. Other concerns include making sure I cover all contraindications, knowing how all the electrotherapies work, having great technique in all of my mobilisations/treatments, making sure I’m able to communicate my ideas/diagnosis/treatments to all patients of different ages and from different backgrounds and just generally know enough (anatomy/treatments/tests) for this musculoskeletal placement. Prescribing exercises will also have to fit in with the patient’s everyday life as these patients actually are going home and have busy lives unlike most people I’ve seen in inpatients at previous hospitals.

Throughout the next 5 weeks, I know that I will have to work on my time management (from feedback from my last placement) and also I know I still have to improve my subjective and objective assessments – especially with the flow of how I ask the questions.

My supervisor from this placement has provided a little check list of things to cover before starting on Monday and it has been very helpful with revision! I feel like I will be constantly learning throughout this rotation. From previous students, I have heard this is a great musculoskeletal placement and the physio crew are very helpful and encourage you to learn as much as you can. They seem to be very good at teaching students with lots of diagrams and models around. This will be very useful in educating patients as well so hopefully I'll remember to use them as props!

Like I’ve said in previous posts, I’m a very kinesthetic learner so this prac may be difficult for my learning style as my supervisor can’t demonstrate how to assess and treat every patient before I have a go. Luckily I will be getting my patient caseload the day before I see them so I can studying up on the tests and treatments I may encounter the following day!

This placement should definitely be a HUGE learning curve for me and I know I will come out of here a greater, more knowledgeable physio with fabulous assessment and treatment techniques!