|NEWSRoom | Source: Michael Samsot|
The 10 Abilities You Need to be a Good PT
"Back in 1991, we'd been kicking around some ideas about the development of professional behavior in Physical Therapy education," says Warren May, Program Director for the Physical Therapy program at the University of Wisconsin, Madison. "We ended up identifying ten physical therapy-specific generic abilities that, if well-developed, define behavior in the accomplished physical therapist. What we started was picked up by other PT programs in Wisconsin, then by other PT programs across the country."
The ten generic abilities are these: 1) commitment to learning, 2) interpersonal skills, 3) communications skills, 4) effective use of time and resources, 5) use of constructive feedback, 6) problem solving, 7) professionalism, 8) responsibility, 9) critical thinking, and 10) stress management. As Academic Coordinator of Clinical Education, May is in a position to see how these abilities enhance students' effectiveness in the clinical setting. "Once we [May and his colleagues] had identified these characteristics, though," he says, "the challenge became, 'How do we work them into the curriculum?'"
What the school wound up with, as a teaching method for these abilities, was discussion, self-assessment, and a self-assessment form. Student Natalie Kohn from Milwaukee, Wisconsin, says, "We review the specific generic abilities twice a semester, then there's a third review that we do after we complete a clinical experience, so we're going over it a lot." Steve Kuphal, a student from Kewaskum, Wisconsin, says, "It's something they keep putting on the front burner at the beginning of each semester, and the results are very definite. At the end of the clinical experiences for students in this program, we receive very favorable comments. All the assessments coming back from all clinical sites are along the lines of, 'everybody acted at a very professional level.' There was not a single negative comment about anything in our evaluations rom our last clinical experience.
"What happens," Kuphal continues, "is that by going over these abilities so often and getting coached on how to develop them, we as students begin to react to situations in a professional manner, and it eventually becomes almost second-nature. We don't have to stop and think, 'What is the best way to react to this?' When a student first encounters this list, it doesn't quite seem to click in the beginning. As you start to move into the professional setting, the clinical realm, though, then you begin to see situations where you know how to act because you've been drilled on how to handle them or something similar. Having mastered these qualities turns out to be one of the more important things when you're looking for a job, because you've learned how to think on your feet and how to be flexible."
May, who has been at the University of Wisconsin since 1988, says, "I've always been interested in being the person who helps to bridge the academic and the clinical communities." His background paved the way for him to do just that. He did undergraduate work at Central Michigan University, Mt. Pleasant, Michigan; and earned his BS degree in Physical Education from the University of Colorado, Boulder. At the same time, he was completing the pre-requisites for a degree in Physical Therapy. "I stayed another year at Colorado, did an internship, and received a certificate in 1962," he says. Next, May went into the US Army active reserve and his specialty was working with Viet Nam veterans who were amputees. After that, he returned to school and earned his Master's degree in Public Health from the University of North Carolina, Chapel Hill. Of the academic and clinical areas, he says, "I enjoy explaining each side to the other."
For the last three years, May has been "balancing administrative responsibilities of the PT program, including budgeting, hiring, developing curriculum basically, making sure everything all fits together with teaching. At the end of June, I'm retiring, though, and will move on to something else," he says. That "something else," he says, will most certainly include continuing to work with development and promotion of the ten generic abilities and self-assessment skills that enable PTs to tell how well they have mastered the abilities. He and two colleagues are now at the draft version stage of writing a manual called Facilitating the Development of Professional Behaviors in PT Education.
Another student, Dean Rhode, from Madison, Wisconsin, says the Wisconsin program "kind of gives you a focus on developing an attitude that you will be a professional. I think it has helped me quite a bit in interpersonal communications with both other professionals and patients. The opinion here seems to be that while these aren't quite things that can be taught in a traditional manner, they are things that students can learn.
One of the other concepts that is stressed in Wisconsin's program one that Rhode thinks is extremely important is encouraging students to look at patients with an open mind. "We're taught to look at the whole patient," he says, "not just at an arm or a knee or a shoulder that isn't working right. For example, if a patient is having trouble lifting his arm up to the side, and you're looking only at the arm and the shoulder, you might miss that the patient is also compensating with another part of the body. He might be shifting his weight, moving the pelvis, to enable him to lift the arm a little more easily and you might not realize the extent of the problem.
"Our program stresses looking at each person in his own context and understanding what his goal is," Rhode continues. "In this way, you can come up with creative therapeutic exercises. If the patient is doing repetitive motions, but has poor body mechanics, you can perhaps teach him to turn his arm or hand in a slightly different direction that makes the whole task just a bit easier for him."
Student Julie Norris, from St. Paul, Minnesota, reports that her particular enthusiasm for Wisconsin's PT program stems from the fact that "we have a really fun group of people-- faculty and students, both, who make the whole process of learning in class and working with patients something that's always interesting."
She talks about a man who is, she says, perhaps her most rewarding patient. "He was in his mid-70s and had had multiple surgeries on his shoulder for injuries, such as rotator cuff repair. He'd fallen a number of times he had decreased postural tone, due to a long-standing battle with Parkinson's Disease. He was so motivated, though, and I worked with him on gait training, walking, and balance training. He responded very well to the therapy, particularly when we scheduled the therapy following close behind the time when he received medications for the Parkinson's. I was able to see the whole mix with him."
One of the things that Kohn says she values most in Wisconsin's PT program is the camaraderie among students and faculty. "Even though the program is very demanding and very competitive to get into, I never find that one person is trying to undercut another one. Everyone is very concerned about all the others. The faculty, too, is very approachable," she says, "and they make themselves available if we have problems. They challenge us, but if we need help, they're there. Our professors are very willing to come in and do an extra lab if that's what you need to understand something. They give you every opportunity to do well."
"Madison has a very strong reputation," Kuphal emphasizes, "geared at empowering the student to make decisions in the clinical setting." He says the pace at which the program progresses is ideal. "They don't lay out everything in front of you all at once, but they present you first with situations that are common examples, then they give you a patient scenario that's a little bit different to encourage you to think on your feet. You have to be able to think creatively in certain situations."
The example he gives is of a patient who has a shoulder problem that is most often treated with the patient lying down. "Because of, say...maybe an unrelated back problem, though, this patient cannot lie down," Kuphal says. "So what do you do? Well, you think, 'What's the next best thing?'... and it might be to put the patient in a semi-reclining position in a chair that gives some support and will allow the patient to relax the muscles around the shoulder."
Through all his clinicals, Kuphal says he is constantly putting to use the ten specific generic abilities that Wisconsin's program prizes so highly. "These are truly valuable tools," he says. "They are very behavioralistic in their approach to things, and you begin working with them in small steps. In the self assessment area, if a student identifies a problem with time management, he sets small goals for himself. Maybe he's late to class lot, so the goals he sets would be to get to class on time for the next five weeks. Then when that's accomplished, he will set a larger goal and carry that over into other parts of his life and a self inventory at various steps along the way keeps him focused on what he's trying to accomplish.
"Eventually, these things you practice become second nature," Kuphal says, "and you find that they can help you in all levels of your work in dealing with patients, in dealing with other professionals, and even in job interviews." Kohn agrees, saying, "You get to the point that you do the things that make you a good clinician, without even thinking about it."
Michael Samsot is a freelance writer in Ellicott City, MD. She is on the Editorial Staff of NEWSLine for Physical Therapists.
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