OT 5120 - Professional Issues - Fall 2019

At the beginning of my journey through OT school, I thought that OT was just another cookie cutter job. I had no idea that there were endless job opportunities out there in the world, job positions that may not even be in existence yet! It excites me to know that as an OT, I can be in control of my destiny and that my work is what I make of it. I prepared myself to follow a roadmap by writing down some goals myself at the beginning of my journey. As I moved along in the program, I made changes wherever necessary. I realized that I have changed over the years as a person, therefore, my goals should change too to best meet my needs/wants.

The course sequence has prepared me to be an entry-level occupational therapist by ensuring that I have a solid foundation before I move on to the next course in the sequence. Each class had its own form of rigour and challenged me to think outside the box. I learned over the years to work with different professors and colleagues. Everyone has their style and set of expectations and it is important to work with that. I learned that I need to also be able to voice out my needs and concerns in order to support the group process. Along the way, I also realized that I am a heavy visual and kinesthetic learner, therefore, I had to make changes to how I took notes in order to best meet my learning needs.

All of the core courses in the sequence helped to support my learning during my fieldwork I and community practice labs. The integration of fieldwork experience and lab created an opportunity for me to apply my own skills and coursework material with guidance from both my professors and clinical instructors. I appreciate the small class sizes and opportunities to connect with the professors for additional help. I think it was really helpful that this program offers more practice time rather than just focusing on theory.

Although there were a few bumps along the way over the years, I was able to realize a few of the goals that I had set for myself at the beginning of this journey. By the end of my journey as an occupational therapy student, I will have presented both of my capstone projects at AOTA and OTAC. As a step further, I hope to also have my honors capstone paper accepted by AJOT.

As a future occupational therapist, I want to continue to use a roadmap to guide my career in order to ensure that I keep growing as a professional. I want to keep contributing to this wonderful profession and explore different practice areas. I believe that my journey as a future occupational therapist includes being a lifelong learner. I hope that whatever job I end up with will help support that.

At the beginning of my journey in physical rehabilitation, the extent of my clinical reasoning was limited to knowing the characteristics of the client’s medical condition and following a strict checklist of things to look out for. I was more interested in finding out more about the condition and that was where I got stuck when it came time to write a SOAP note or formulate goals for the client.

The human movement class was where I was really challenged to break down a task into individual components and really think about the muscles that go with every movement. Prior to this, I thought that only physical therapists and doctors were the ones that needed to know and understand the musculoskeletal system extensively. It was definitely a challenge initially to see past the point of just memorizing the individual muscles and bone structures and how that related to what an occupational therapist does. I did not think about this at first but, reflecting back now, I think this course paired up well with the fundamental skills course. From this course, I was able to see how complex the human body is and how the structures come together to support engagement in occupation. I learned that as clinicians, we need to not only understand the muscles and bones and how they come together to form movements for a task analysis, but also remember to relate it back to function and what it means to the client.

Fundamental skills class was one of the first classes that challenged me to think about the client in front of me. I had to give lots of thought to what I said and how I presented myself to the client. During this class, the client was no longer just a theoretical case study to be discussed among the class during a lecture. Since this class had a lot of hands on components, I was given the opportunity to think about my own body mechanics in relation to that of my client’s during transfers and assessments. Although I knew that the clients were paid actors, I still treated them as if they were my real clients. I tried my best to look and be as competent as possible.

OAS I marked the beginning of my journey in re-evaluating my own study methods and reflecting back on my own unique style of learning. I quickly realized that at this point in the program, exams were no longer just for fact checking, it was also a means to further develop my own critical thinking skills. I also realized that my old study methods were not efficient and as effective as I originally thought. I began to incorporate the case studies included in the textbook to hone in the concepts that I have learned in the course. Reading those case studies aided me in visualizing a client and gave me the opportunity to apply my knowledge to the given scenarios. This course challenged me to apply my knowledge to case scenarios and practice thinking like a therapist. Through this course, I learned that the rehabilitation process is almost never a linear trajectory and that changes along the way are necessary. It is vital to go back and reassess the client’s progress throughout the intervention process in order to make sure that interventions are still benefiting, meaningful, and necessary for the client.

Up until this point in my training to be an occupational therapist, the words “evidence-based practice” didn’t mean much to me in terms of how I went about the development of my treatment approaches. As I immersed myself into the fast-paced hospital environment at El Camino Hospital and seeing how my clinical instructors document, I realized how necessary it was to have evidence supporting the type of work we do. I learned that documenting and utilizing evidence practice is not only a means of getting paid, but it is also a means of advocating for the profession as a whole. It helps to show the insurance companies and Medicare that occupational therapists provide valuable services and have a unique lens. Through fieldwork experience, I learned that it is okay to take things slowly and step back to reassess the situation when something doesn’t look right. As I practiced transferring real clients at the hospital, I became more aware of my own body mechanics by continually readjusting myself with each client to ensure safety for the client and myself as well. I also learned that it is okay to “stop and restart” during client interactions in order to ensure safety and that the focus of treatment is still relevant the goals set.

For the OAS II community practice lab, I was fortunate enough to be selected to practice in a home health type of setting. I was paired up with another occupational therapy student as my partner and assigned to a client. From this unique experience, I was able to really see the big picture and see my client in their natural environment. The client I was assigned to was a 98 year woman who has Macular Degeneration that is causing her vision to rapidly decline. With this client, I had to consider the psychosocial ramifications that comes with rapid decline in vision in addition to the client’s values, beliefs, and spirituality. During this time, I had to practice holding back on my own judgements about her living situation and learn to develop an intervention plan with her needs and desires in mind. Through this experience I learned how to set aside how I think things should go and really listen to what the client wants. If the client doesn’t find what you’re with them as meaningful, they will not want to participate. I had to really think about what was meaningful to the client and use that as a buy in to my services. Towards the end of my 8 weeks with the client, I learned to collaborate with my client and was able to create a list of her priorities. From that list, she prioritized activities such as walking around the neighborhood with her dog, attending community lunches, and leading her exercise classes as important and tasks such as getting mail and cooking as irrelevant. I learned that she was more than happy to hire someone to get the mail and cook for her so that she could focus on doing the things that she enjoyed. This experience overall was a reminder to me that my client is part of the team and that I need to collaborate closely with them when developing goals and intervention plans.

In OAS III I continued refine my study habits through study groups and reflection. Since there were no tutors available for this course, I learned to make the most of group study sessions. I found it powerful to quiz each other and ask each other probing questions about the study material. This made sure that I fully understood the concepts rather than just memorizing it. Through this course in particular, I learned how to work together with my peers and saw the value of picking at each other’s brains. I learned to collaborate with my peers and helping each other study for exams. I have come to understand that everyone has different strengths and weaknesses and that together everyone can succeed if we support each other in those areas of need. One’s strength is another’s weakness, vice versa. Together the two can compliment and balance each other.

As I began to piece together everything that I have learned thus far, everything began to make sense. Slowly I began to realize the value of occupational therapy and now see it as the art in using occupations as a tool for my client’s success. There was a paradigm shift in how an occupational therapist should approach treatment with their clients. Something I like to call “a method to the madness”.

The clinical experience I have so far has increased my understanding of diversity within the community and with different populations. My definition of occupational therapy has changed with each and every course I took in the program. I finally have a firm understanding of what it means to help the client be comfortable with their new self. Occupational therapy is a service and it is important that I do everything that I can to serve my clients in every way possible.

At the beginning of this journey, I thought the term “holistic” meant that I should I always remember that my client is a person, period. Little did I know how far off I was until I progressed further into the realm of physical rehabilitation. I came to learn that the term holistic does not necessarily just mean viewing the patient as a person, it also means to consider all of the factors that make them whole. I learned to consider my client beyond what I see in front of me and what’s in their medical files. As I began asking my clients to tell me about their prior level of function and learning more about their lives outside of the hospital, I was able to better understand their specific needs. It helped me tailor the interventions to their unique needs. Thinking back now, I had a client with dementia during my fieldwork experience who appeared sleepy and lethargic every time we came by for her therapy sessions. I assumed that the client appeared that way because she was heavily medicated and demented. It wasn’t until we met the daughter who told us that her mother loved to dance and used to be a salsa instructor. When my clinical instructor played the salsa music, the client perked up and began to smile. Being able to witness something like this made my heart leap inside and further emphasized the importance of client centered practice and learning about the client as a person beyond the walls of the hospital.

As I approached the end of my time in OAS III, I began to realize how much my definition of occupational therapy has changed. Walking into the program, I had no idea what occupational therapy was. I had a basic idea about what an occupational therapist might do based on things that I observed during my shadowing experience and various descriptions form the textbooks, but nothing concrete. Half way through OAS III was when a light bulb lit up in my head in terms of what I thought occupational therapy really means. Just like that everything just clicked together all of a sudden. From what I have learned this past year, is that occupational therapy is a delicate balance between science and art. Not only does there needs to be evidence behind our treatment approaches, we need to be creative about it as well. As occupational therapists, we need to make sure to never lose sight of the individuality of each of our clients. With the unique lens of occupational therapy, we have insight on I think that is what sets us apart from other professions.

In order to become a full-fledged therapist after graduation, I need to further develop my observation skills and ability to grade the task in response to the client’s abilities. Occupational therapy school has been an overall humbling experience. At least for me, I have become very grateful for everything in my own life, even the little things like getting dressed every morning. It made me realize how much I’ve taken for granted all of these years.

For me, occupational therapy is not just a career, it’s my life. I hope to be able to present the best version of myself to my clients all day, every day. I intend to continue to expand my knowledge in whichever practice area I choose by regularly seeking out continuing education courses or through research online. I want to make sure that I stay up to date with the latest and most effective forms of treatment approaches in order to best serve my clients. I want to make sure that I have the funds aside to get the necessary certifications to expand my skill sets and use it to help even more clients.

The therapist I aspire to be is someone who always ready and open to learn new things to better my practice. I want to be that glue that brings together the different disciplines and learn about what they have to offer. Wherever this journey takes me, I hope to live out my passion and remain humble. I also want to keep in mind that the therapist-client relationship is a collaborative one. I am my client’s advocate and I will do whatever I can to help them establish a new “normal” for themselves. Helping my clients to achieve independence, purpose and satisfaction in life is my goal.

Some of the barriers that I might face while trying to become a responsible practitioner may include working with seasoned occupational therapists who utilizes out of date approaches and do not employ evidence-based practices. Another barrier that I think might affect my ability to become a responsible practitioner would be the insurance billing system. As a responsible future practitioner, I need to not only make sure that I am compliant with insurance billing, but also ensuring that I advocating the clients needs effectively in my documentation. I want to make sure that the clients that I serve get the treatment they need and get the most out of it.

One of the ways I plan to “lead” as a new practitioner is to help drive occupational therapy practice towards an evidence-based approached. I hope to educate my seasoned mentors by honing in the importance of evidence-based practices and how treatment approaches should be unique with the client. I recognize that many practitioners out there get comfortable overtime and may unintentionally lose sight of the uniqueness of every client. I also plan to contribute to this field by sharing my knowledge and skills to the next generation. Another way I can contribute to the field is by adding more to the evidence-based practice literature and sharing it with colleagues.

Prior to this class, I had a hard time seeing myself as an educator, much less standing up in front of a class full of people who aren’t in my cohort to teach a short lesson on the sensory needs of individuals with ASD/ ADHD. My past experiences as an educator was limited to just in-class presentations.

During this semester, I realized that becoming an effective educator doesn’t happen overnight and can certainly be brought out from within with enough practice. I learned that in order to be an effective educator myself, I need to put in some time to practice by myself as well as in front of others. In the past, I used to dread presentations because I didn’t feel comfortable presenting in front of others. Being in the spotlight made me feel uncomfortable. I still get a little self conscious fearing that my anxiety will get in the way of my thoughts. However with the constructive feedback, course material, and encourage from my peers and professor, my confidence has increased greatly. I started out the semester feeling insecure about my skills as an educator, and now feel like I have blossomed to someone who is more confident and comfortable teaching what I know to others. I feel like I did a good job on my final teaching presentation in the Dominican Community after extensive constructive feedback and advice during the practice sessions. During the final teaching presentation, I felt like I was really able to connect with my learners, tune into their needs, and adjust my presentation accordingly. I was able to change my tone and body language to garner the attention and energy from my learners. I hope to continue using this skill that I have developed over the last few months in future education opportunities.

I plan to apply the skills and tools that I have gained in this course in my future career as an occupational therapist. Teaching moments in the workplace can mean educating other professionals on proper care, proper techniques, or explaining the implications of OT assessment findings. As an occupational therapist I will be able to apply my skills as an educator when working with clients and their family members to include them in the interdisciplinary team. Education can be used as a form of advocacy for my future clients, and it is crucial that I understand the appropriate methods of teaching, relevance of material to client, and styles of learning to be an effective educator.

All in all, through my experiences thus far in the course, I honestly believe the core of effective teaching lies in finding out how the learner learns best and making sure the information is relevant to the learner.

I see my purpose as an educator is to empower my learners and give them tools to conquer their future endeavors with what they learn from me. Knowledge is meant to be shared and that everyone has a different learning style. It is important to be aware of this as an educator and extend a welcoming hand out. Help everyone get to the top of the mountain, it's more fun that way.