1. Positive: I'm most proud of the fact the I pretty much talked for 90 minutes non-stop. I had a bunch of content and I feel that I definitely kept the energy up the entire time. I think I spoke well and gave an entertaining and informative presentation. I also think it's really cool that I talked passionately about a topic I have zero passion for. It's boosted my confidence in my presenting skills and it feels good to know that I could easily do it again if I had to.
2.a I'd give my block presentation a P+. I think I hit all the necessary points pretty well and I easily reached a full hour of pure content so that's where the + comes in.
b. I'd give myself a P. I did what I was expected to and I did it effectively.
3. During my senior project I really hated my topic so I think I did a bang-up job setting that aside and grinding it out to deliver a quality presentation in the end. It worked out well that I presented the first day because I've been ready to finish senior project since day one.
4. If I had to go back in time and change something I'd change my topic entirely. Probably something about music because then I could research something I'm actually passionate about and for my independent components I could've done some recording like I've always wanted to.
5. Senior project has definitely made me confident in my ability to hunker down and deliver solid work when I'm required to. I think I budgeted my time better than I did in past years, and I've gotten so used to the stress of long term deadlines that at this point I'm not even worried about college or anything. My senior project definitely helped me narrow down my career options. I know for a fact now that I will never want to be a physical therapist, but I also know that I could really thrive in a medical career if I decided to pursue one. This project has made me realize I have the interpersonal skills and intellectual capacity to talk fluently to pretty much anyone and also digest monumental amounts of information. Even though I went through the process kicking and screaming I feel that senior project has actually changed me for the better and helped me hone skills that were on the back burner for a while.
Wednesday, May 20, 2015
Thursday, May 14, 2015
Blog 22: Mentorship
Literal:
Hours log - See link on blog
Contact name and place of mentorship - Robbie Faustino, PT aide, Casa Colina Centers for Rehabilitation.
Interpretive:
The most important thing I learned during my time at Casa Colina was probably the flow of hospitals. I watched so many evaluations and saw so many plans of treatment play out that towards the end it became easy to predict the way things would turn out. One of the most interesting things I've taken from my senior project is how the human body is a machine like any other, and can be treated as such in physical therapy. There are treatments with such high rates of proven clinical effectiveness that once the PT gets that eval out of the way, the finish line is already in sight. Even though patients will come in presenting very different problems to the PT, the treatment flows the same way for the most part. The first portion of treatment always begins with tentativeness and anxiety on the patient's part, but later on treatment goes more smoothly as the patient gets more and more comfortable, falling into the routine of performing their prescribed exercises. This kind of thing is good to know and gives insight on why hospitals do things the way they do.
Applied:
The 50+ hours I put in at Casa Colina gave me a lot of insight on how exactly the healthcare system works, and what we need to do to improve it. PTs like Annie, Dave, and Manny have been working in physical therapy for a long time and gave me their views on streamlining medical records and improving patient education in hospitals. Cinnamon and Robbie, PT Aides who did more of the hands on stuff with the patients, showed me how to effectively treat and maintain the body in the event of injury/disease. I talked with a lot of patients about what they thought of their experiences in Casa Colina, which as cool, but a lot of the time I could tell what they thought just based on body language alone. A lot of the first time patients gave off incredible vibes of anxiety and fear, and I think the hectic nature of a physical therapy ward is not very conducive to stress-free treatment. More than one patient also told me that they wished they could have consistency with their physicians, and that having PTs constantly changing in and out with their schedules was tiresome. All this combined with my research on healthcare policy improvements made it clear to me that patient centered care was probably the best answer to my EQ. This care model addressed everything I had learned regarding patient needs and the required conditions for effective care. If I just did research using online sources and print resources, I doubt I would've arrived at the same answer. The PTs and PTAs at Casa Colina were very helpful in nudging my research in the right direction.
Hours log - See link on blog
Contact name and place of mentorship - Robbie Faustino, PT aide, Casa Colina Centers for Rehabilitation.
Interpretive:
The most important thing I learned during my time at Casa Colina was probably the flow of hospitals. I watched so many evaluations and saw so many plans of treatment play out that towards the end it became easy to predict the way things would turn out. One of the most interesting things I've taken from my senior project is how the human body is a machine like any other, and can be treated as such in physical therapy. There are treatments with such high rates of proven clinical effectiveness that once the PT gets that eval out of the way, the finish line is already in sight. Even though patients will come in presenting very different problems to the PT, the treatment flows the same way for the most part. The first portion of treatment always begins with tentativeness and anxiety on the patient's part, but later on treatment goes more smoothly as the patient gets more and more comfortable, falling into the routine of performing their prescribed exercises. This kind of thing is good to know and gives insight on why hospitals do things the way they do.
Applied:
The 50+ hours I put in at Casa Colina gave me a lot of insight on how exactly the healthcare system works, and what we need to do to improve it. PTs like Annie, Dave, and Manny have been working in physical therapy for a long time and gave me their views on streamlining medical records and improving patient education in hospitals. Cinnamon and Robbie, PT Aides who did more of the hands on stuff with the patients, showed me how to effectively treat and maintain the body in the event of injury/disease. I talked with a lot of patients about what they thought of their experiences in Casa Colina, which as cool, but a lot of the time I could tell what they thought just based on body language alone. A lot of the first time patients gave off incredible vibes of anxiety and fear, and I think the hectic nature of a physical therapy ward is not very conducive to stress-free treatment. More than one patient also told me that they wished they could have consistency with their physicians, and that having PTs constantly changing in and out with their schedules was tiresome. All this combined with my research on healthcare policy improvements made it clear to me that patient centered care was probably the best answer to my EQ. This care model addressed everything I had learned regarding patient needs and the required conditions for effective care. If I just did research using online sources and print resources, I doubt I would've arrived at the same answer. The PTs and PTAs at Casa Colina were very helpful in nudging my research in the right direction.
Wednesday, May 6, 2015
Exit Interview
1.) My EQ is "How can a physical therapist best ensure a patient is effectively cared for in an outpatient physical therapy setting?" My first answer was a thorough initial evaluation, my second answer, proper patient education, and my third, patient-centered care. It was fairly obvious even before I got to my third answer that patient-centered care would be my best answer.It’s easy to see why patient-centered care would be the biggest asset to outpatient physical therapy. PCC brings some of the most important aspects of very effective care models and condenses them into one package. There’s no bells and whistles, and no filler. Every component of patient-centered care has a purpose, and all parts are designed to aid in providing the most effective care possible. The comprehensive care model is tailored to human nature and accounts for medical interventions, access to information and education, environment of care, family involvement, and patient preferences and education. Much like the human body it is working to repair, patient-centered care functions as a well oiled machine, precise in its movements towards effective care and greater than the sum of its parts.
2.) It dawned on me about halfway through my research that patient-centered care actually includes many of the care philosophies related to my other findings. For example, while studying techniques for patient evaluations, I learned that communication is a critical factor to consider while performing a systems review. In the 2006 NIHCM Meeting Brief, the foundation proposed to increase their focus on healthcare-consumer education in order to yield more effective care in medical practices. Their goal was to combine better patient education with consumer-engagement techniques to ensure patients had every opportunity to make well-informed decisions regarding their health. By looking at the entire picture instead of isolating specific parts of my research, it becomes very clear just how comprehensive patient-centered care is. It feels as though every article I read in the last eight months was leading me right to PCC as the best answer to my essential question. It is without a doubt the best way to effectively provide care for outpatient physical therapy patients.
3.) There weren't too many problems I faced while arriving at my best answer. Like I said, I felt as though the whole research process was sort of leading me to some sort of conclusion. I had this thought like "there's an exact answer to my EQ out there somewhere," and I knew just as soon as I had read the words "patient-centered-care" that that was the one. It became real clear to me almost instantly, and then after that I spent a lot of time researching that one answer. There was plenty of articles on the subject as well so it wasn't too difficult.
4.) The Picker Institute's Practical Approaches for Building a Patient Centered Culture
and Donald M. Berwick's article "What Patient Centered Should Mean" were my most valuable sources. These helped me confirm that patient-centered care was my best answer and provided a lot of other helpful articles/literature in their works cited that helped me expand my knowledge on the topic of PCC and physical therapy in general. Practical Approaches gave me a lot of information on the necessary conditions for PCC to be effective, which makes up a good portion of my paper. Berwick's article gave doctor's opinions on PCC and explored it's strengths and weaknesses, which was helpful in deciding if it was my best answer or not.
Sunday, April 26, 2015
Blog 19: Independent Comp 2
a.) I, Ian Kam, affirm that I have completed my independent competent which represents 34 hours of work.
b.) While going through the course I frequently visited Dartmouth's website to get a better understanding of what I was learning. I was going through the course kind of quickly to make sure that I'd finish it by the time the assignment was due, so the extra source of info was real helpful.
"Basic Human Anatomy: A Regional Study of Human Structure (online version)." -
Ronan O'Rahilly, M.D.
Fabiola Müller, Dr. rer. nat.
Stanley Carpenter, Ph.D.
Rand Swenson, D.C., M.D., Ph.D
http://www.dartmouth.edu/~humananatomy/index.html
c.) See Hours Log
d.)
For my independent component I completed the free online course "Anatomy + Physiology" offered by Carnegie Mellon's Open Learning Initiative. It was a weighty course that ended up being more time consuming than I thought, I ended up having to put in a little more time than I anticipated, even while trying to rush through the course the last week or so.
OLI Homepage^
"Anatomy + Physiology" Homepage^
INTERPRETIVE :
The course consisted of 15 Units that contained a total of 57 modules. Each Unit focused on one particular body system and generally had around 4 modules detailing the structures and functions of the system, the levels of organization, the way that the system achieves homeostasis, and the way it integrates with the rest of the body. Every module outlined the learning objectives at the beginning and came with practice questions and interactive bits that checked for understanding of the content. The class as a whole was not graded, but there were three scored tests in the program.
Examples of Learning Objectives (Cardiovascular system) ^^
Practice Questions^^
I don't know why the three scored portions of the program were in the last 3 modules. I guess the program is fairly new. At least I know a lot about the nervous system now.
Scored Portions of the program ^^^
APPLIED:
Above all, taking this course has reinforced my belief that the human body, with all it's complexities and difficult-to-pronounce structures, is a machine like any other. With science and technology we're able to predict to a T how the human body will react in virtually any situation, and with that knowledge we as humans can control these vessels with frightening accuracy and confidence. This component has also brought to light how powerful the brain is in it's ability to essentially coordinate every possible function in the body. I can apply what I've learned here to all three of my answers, which is kind of exciting. For one, my first answer is about initial evals and how they are vital to the care process. I now know that most every system in our body integrates with the others, and neglecting to thoroughly examine one part of the body could harm the others.
This also helps my third answer in a mind-blowing way. The brain is an unbelievable muscle. It's self-aware; it knows that it's a brain. So, as humans we're also able to learn about and comprehend the mechanics of our brain's vessel, the human body. I can eat a piece of toast and step by step explain exactly what's going on in my digestive system, what chemicals and hormones my endocrine system is sending out, and also how my central nervous system is responding. The fact that one person can be conscious of all that is crazy enough, so the phrase "two minds are better than one" is especially true. The basis of patient centered care is basically to bring multiple individuals together to solve one individual's problem. It's like pooling intellectual and cognitive capitol together, which I've concluded will yield the best possible care. Science has made it so all humans have the capacity to become experts on the body, so it makes sense that multiple experts on the human body would provide better care than simply one expert.
b.) While going through the course I frequently visited Dartmouth's website to get a better understanding of what I was learning. I was going through the course kind of quickly to make sure that I'd finish it by the time the assignment was due, so the extra source of info was real helpful.
"Basic Human Anatomy: A Regional Study of Human Structure (online version)." -
Ronan O'Rahilly, M.D.
Fabiola Müller, Dr. rer. nat.
Stanley Carpenter, Ph.D.
Rand Swenson, D.C., M.D., Ph.D
http://www.dartmouth.edu/~humananatomy/index.html
c.) See Hours Log
d.)
For my independent component I completed the free online course "Anatomy + Physiology" offered by Carnegie Mellon's Open Learning Initiative. It was a weighty course that ended up being more time consuming than I thought, I ended up having to put in a little more time than I anticipated, even while trying to rush through the course the last week or so.
"Anatomy + Physiology" Homepage^
INTERPRETIVE :
The course consisted of 15 Units that contained a total of 57 modules. Each Unit focused on one particular body system and generally had around 4 modules detailing the structures and functions of the system, the levels of organization, the way that the system achieves homeostasis, and the way it integrates with the rest of the body. Every module outlined the learning objectives at the beginning and came with practice questions and interactive bits that checked for understanding of the content. The class as a whole was not graded, but there were three scored tests in the program.
Scored Portions of the program ^^^
APPLIED:
Above all, taking this course has reinforced my belief that the human body, with all it's complexities and difficult-to-pronounce structures, is a machine like any other. With science and technology we're able to predict to a T how the human body will react in virtually any situation, and with that knowledge we as humans can control these vessels with frightening accuracy and confidence. This component has also brought to light how powerful the brain is in it's ability to essentially coordinate every possible function in the body. I can apply what I've learned here to all three of my answers, which is kind of exciting. For one, my first answer is about initial evals and how they are vital to the care process. I now know that most every system in our body integrates with the others, and neglecting to thoroughly examine one part of the body could harm the others.
This also helps my third answer in a mind-blowing way. The brain is an unbelievable muscle. It's self-aware; it knows that it's a brain. So, as humans we're also able to learn about and comprehend the mechanics of our brain's vessel, the human body. I can eat a piece of toast and step by step explain exactly what's going on in my digestive system, what chemicals and hormones my endocrine system is sending out, and also how my central nervous system is responding. The fact that one person can be conscious of all that is crazy enough, so the phrase "two minds are better than one" is especially true. The basis of patient centered care is basically to bring multiple individuals together to solve one individual's problem. It's like pooling intellectual and cognitive capitol together, which I've concluded will yield the best possible care. Science has made it so all humans have the capacity to become experts on the body, so it makes sense that multiple experts on the human body would provide better care than simply one expert.
Tuesday, March 31, 2015
March Post
March has been pretty uneventful regarding senior project. There weren't very many research checks because of powderpuff and other stuff, and I've been ahead on sources for a while now so research hasn't been very intense. I've been going to mentorship at Casa Colina pretty regularly lately, but it's getting really boring. I do the same thing every time I come in and I've pretty much lost all interest, but I'm halfway done with hours so I guess I'm happy about that.
For my last interview I think I'm going to talk to my aunt. I never knew I had a physical therapist in my family so I'm kinda stoked. I think it'll be a fun interview, plus I won't have to go into Casa Colina to get it done. I'm starting to hate that place.
I'm fairly confident about the I-Search paper coming up. I've done a ton of research this year, and I think I'm a decent writer so I'm sure it'll be a cakewalk. Things are starting to wrap up this year which is pretty exciting. I just want to do my 2 hour presentation already and be finished with it all. Waiting around is killing me.
For my last interview I think I'm going to talk to my aunt. I never knew I had a physical therapist in my family so I'm kinda stoked. I think it'll be a fun interview, plus I won't have to go into Casa Colina to get it done. I'm starting to hate that place.
I'm fairly confident about the I-Search paper coming up. I've done a ton of research this year, and I think I'm a decent writer so I'm sure it'll be a cakewalk. Things are starting to wrap up this year which is pretty exciting. I just want to do my 2 hour presentation already and be finished with it all. Waiting around is killing me.
Thursday, March 12, 2015
Blog 18: Interview 4 Prep
Answer 3
1. What works in our current healthcare system?
2. What doesn't work in our current healthcare system?
3. From your experience, what would you change about the current system? And why?
4. What are your thoughts on patient-centered care?
5. Why do you suppose healthcare has not shifted into this model of care yet?
6. What do you think the long term effects of a shift into patient-centered care will be?
7. Are there any other healthcare models/theories that may start popping up in the future?
Answer 2
8. What difference does good patient education make in the final outcome of treatment?
9. What would you say qualifies as "good" patient education?
10. What are some outcomes of poor patient education?
11. What would be considered inadequate patient education?
Answer 1
12. What makes the initial systems review so important in physical therapy?
13. Is there any part of the systems review that requires closer attention to detail? Why?
14. Was there ever an eval that you did that went pretty badly? What circumstances made it difficult?
15. How can a PT ensure their initial eval is as comprehensive as possible?
Other questions
16. How can a physical therapist best establish good communication with a patient?
17. Is there any singular factor that will, for lack of a better term, "make or break" the effectiveness of a patient's care?
18. How does patient/P.T relationship affect the overall care experience? How does it compare to the relationship between patient/doctor?
19. What would you say is the difference between "effective care" and "efficient care?" Could you pick one over the other if you had to?
20. (EQ) How can a physical therapist best ensure a patient is effectively cared for (in an outpatient p.t. program)?
1. What works in our current healthcare system?
2. What doesn't work in our current healthcare system?
3. From your experience, what would you change about the current system? And why?
4. What are your thoughts on patient-centered care?
5. Why do you suppose healthcare has not shifted into this model of care yet?
6. What do you think the long term effects of a shift into patient-centered care will be?
7. Are there any other healthcare models/theories that may start popping up in the future?
Answer 2
8. What difference does good patient education make in the final outcome of treatment?
9. What would you say qualifies as "good" patient education?
10. What are some outcomes of poor patient education?
11. What would be considered inadequate patient education?
Answer 1
12. What makes the initial systems review so important in physical therapy?
13. Is there any part of the systems review that requires closer attention to detail? Why?
14. Was there ever an eval that you did that went pretty badly? What circumstances made it difficult?
15. How can a PT ensure their initial eval is as comprehensive as possible?
Other questions
16. How can a physical therapist best establish good communication with a patient?
17. Is there any singular factor that will, for lack of a better term, "make or break" the effectiveness of a patient's care?
18. How does patient/P.T relationship affect the overall care experience? How does it compare to the relationship between patient/doctor?
19. What would you say is the difference between "effective care" and "efficient care?" Could you pick one over the other if you had to?
20. (EQ) How can a physical therapist best ensure a patient is effectively cared for (in an outpatient p.t. program)?
Thursday, March 5, 2015
Blog 17: Answer 3
EQ: How can a physical therapist best ensure a patient is effectively cared for in an outpatient P.T program
Answer 3:
Implementing the "patient-centered care" model will ensure high-quality care for a consumer participating in an outpatient P.T. program.
- In the past, patient involvement was limited to physicians giving patients the opportunity to ask questions. But if a doctor rattles off a whole lot of confusing medical terminology and follows up with "Any questions?", the patient is overwhelmed and will be inclined to say "no." The patient-centered approach to this involves "inviting" patients to participate in the thought process as to enhance clarification and put everyone on the same page.
- Since patients rely on caregivers to take them through the healing process, it's crucial for all members of the healthcare team to have open lines of communication with both the patient and other team members. A patient's perception that their multiple caregivers are not talking to one another about the plan of care can lead to frustration and feelings of exasperation. In the patient-centered model, care is highly coordinated among healthcare professionals, the patient, and the patients family, with open communication ensuring the care is consistent and thorough.
- Patient centered care places heavy emphasis on the environment in which the care is taking place, and the technology used to facilitate the flow of information. A physical therapy facility with a good design that supports and nurtures the healing process goes a long way. Quality supportive technology engages patients and family members by submerging them in the flow of information and communication.
Sources:
"Patient Centered Care: What Does it Take?" - Dale Shaller
"The Value and Values of Patient Centered Care" - Ronald M. Epstein, MD, and Richard L. Street Jr. PhD.
"Practical Approaches for Building a Patient-Centered Culture." - patientcenteredcare.org
This answer seems like it could be my strongest answer. The amount of research out there and the pressure to shift to this model of care is really intense, so I think this is definitely the right direction to head in.
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