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.

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.

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)?

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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Blog 16: Answer 2

1. My EQ: How can a physical therapist best ensure a patient is effectively cared for in an outpatient P.T program?

2. First Answer: A thorough initial assessment by the physical therapist is the cornerstone of effective care in any kind of therapy, physical or otherwise.

3. Second Answer: Proper patient education will ensure the most effective care in a physical therapy program.

4. Justification:

• When the patient knows what is happening in their body and how it correlates with the interventions they've been prescribed, they are more likely to carry out their treatment and be active in the healing process
• Knowing how the body works (what it can do and how it can do it) is key when it comes to preventing injury in the first place. Educating the public on the the vehicles their consciousness operates will help to prevent accidents.
• When a patient is well informed about their condition and injury, it decreases the chance that they will perform their prescribed exercises wrong and injure themselves further.

5. So far, the meeting brief of "Capturing Value: Increasing Efficiency in Health Care" by the National Institute for Health Care Management

6. My mentor straight up told me that education in physical therapy is more valuable than the therapy itself. Without proper education you could very well be running in place when it comes to the healing process

7. As of right now, I've barely scratched the surface of my second answer. I know just from reading the NIHCM brief that the depth of research I can do on this answer is pretty vast. I'm looking forward to my next interview to see if I can gain some insight on the topic of health care education.

Blog 15: Independent Component 2 Approval

1. For my 2nd independent component, I'll be taking a free online course in anatomy and physiology provided by Carnegie Mellon University's Open Learning Initiative. The class consists of 15 units and a total of 57 different modules to work on. If I spend 30 minutes a day studying and going through the course, I'll have well over 30 hours before the independent component is due.

2. Each of the modules has little quizzes and the units have tests, so I'm planning on taking screenshots and/or printing out my tests and quizzes to show that I actually completed the course.

3. I figure this is a great way to supplement my knowledge on physical therapy while simultaneously going to mentorship each week and applying that knowledge to some extent. I've found that a good amount of the things my mentor shares with me take some time to settle in my brain before I can wrap my head around the concepts, and I think it's because I haven't really taken a straight up anatomy course yet. I had some basic anatomy in sophomore year, but not enough to make me confident in my knowledge.

4. See Senior Project Hours

Blog 14: Independent Component #1

LITERAL
a.)"I, Ian Kam, affirm that I completed my independent component which represents 30 hours of work."

b.)My mentor Andrea Haston DPT, ATC, helped me complete this component by allowing me to shadow her at Casa Colina.

c.) See hours log.

d.) My independent component was 30 extra hours of mentorship.

INTERPRETIVE
There's only so much you can get out of looking up articles and reading medical journals. Nothing really beats the real thing when it comes to medical knowledge. Annie is very passionate about what she does and is very accommodating when I tell her the requirements of my senior project. Every time I go in to do mentorship I learn a little more about anatomy, patient care, and patient relations, all of which are invaluable to forming answers to my EQ. I don't really have physical evidence of my experience, but you can contact my mentor and confirm with her that I put in the hours.

APPLIED
Well the foundation of PT lies in education, and applying knowledge of the body and it's systems to help people get better. I'm not really sure how to provide an example of how my understanding was improved; I'm guessing that would be reflected in my Lesson #2 and Final Presentation grades? I've learned that patient education is key, and that effective care in PT is dependent on both the health care professional's intervention and the health care consumer's compliance and understanding of what's going on. I don't know if that's a good answer. I guess because ALL knowledge pertaining to physical therapy is applied knowledge it's sort of difficult to answer.