The 4^th week of inpt neuro placement was spent on preparing for final assessment, progressing patient’s treatments, writing handover summary. Nothing significant, hence I thought: maybe I will list a summary of learning points from this placement:

a)Evidence-based practice in neuro

- not that I went to read up on all the current research. Reading up on the clinical practice guidelines for Stroke rehabilitation (sept 2005) gave me an overview of some of the current research points and level of evidence for some of the stroke rehab techniques. For instance, I was curious about the use of FES for stroke patients with subluxed shd as I had 2 stroke patients (acute, subacute) with 1 – 3 fingers shd subluxation. Research revealed that there is some short term improvement, however, nothing is conclusive or very little research is done about the long term effects/ improvement for subluxed shd. Hence, ?usefulness of FES?

- The clinical supervisors also shared that UL WB ex has been shown in research to help address UL ataxia problems.

- N finally from what I can recall about what Anne said before about ax, rx and re-ax.

b) Communication

I realized from all 3 placements, communication skills is an essential component of physio – if we can’t communicate properly or phrase the questions properly, we won’t be able to get a good subj ax fr patients for musculo for instance, and this is essential in directing our obj ax; We won’t be able to give an effective patient education with regards to explaining condition, or teaching exercises; Patients may not be compliant to our treatment plans, coz they are clueless about what they’ve to do or what’s going on or how our Rx can help them.

Communication skills were also important in terms of verbal/ written handover to fellow colleagues, and other allied health stuff, because very often in inpatient settings, the patients require multi-disciplinary team approach.

c) Teamwork

I learnt from my neuro placement it is not just about teamwork with other allied health professionals, but also teamwork within the physios. Throughout the whole placement, we’ve to “share” patient cases; or require assistance of another physio to treat a patient requiring 2person (A). We’ve to come together to plan the treatment for a specific patient, and to cooperate on who leads the treatment session. Sometimes we may even have differences regarding our thoughts about the patient, or even scoring the different outcome measures. Nonetheless, this has helped me learn from my peers and receive feedback on how I can improve my handling or clinical reason better.

I guess this sort of end my blog (for now) for this clinical education unit. It was good fun meeting new pals and going through placement together, learning about one another, and for me, experiencing a new culture.

All the best for tomorrow’s PCR!!