For the final part of this session, my supervisor and I made time to sit down and discuss our time together and to reflect on my placement with them at the clinic and we reviewed the goals that we set at the beginning of the term.

As I had the opportunity to discuss my time spent here at the clinic, I was able to record the written feedback provided by Katarina, before forwarded this document on to my personal development tutor.
I have inserted the link to a copy of this Declaration of Placement Attendance and Summative Assessment as well as my Pre-Clinical Experience Checklist here:

Declaration of Placement Attendance and Summative Assessment Artemis Grainger

Declaration of Placement Attendance and Summative Assessment p.2 Artemis Grainger

Exmoor Osteopathy – Pre Clinical Experience Induction Checklist Inc. Health and Safety Artemis Clark

I felt that it was important to allow Katarina the chance to complete the feedback form prior to our discussion so that we can provide our own opinions as to our assessment of the placement and use these as a basis for discussion.

At the beginning of the placement, I did not document what I felt were my strengths as I was unsure at this stage in my development as to where these lie.
I did, however make a note of what I hoped to achieve from the placement and periodically reflected on my progress with these.

1. Gain experience identifying joint movements, end feels and enhance my understanding of capsular patterns:
I have been tremendously lucky to have found a placement within which I had a one on one relationship with my supervisor, who allowed me to take a primary role in many of the assessments and treatments. By Katarina being with me throughout many of my treatments, I was able to attain continual feedback, which provided me with huge reassurance as to my own ability and for me, joint end feels and stiffness is something that I felt I needed more guidance with.
I would manually assess joints and soft tissue and look to have my thoughts confirmed; which by the end of my placement, were more often than not similar to Katarina’s and as accurate as I had hoped.
I feel as though I have developed a better understanding of common restriction patterns and through experiencing recurring issues and by getting hands on, I feel more confident in being more specific about where exactly the restrictions are.
I have learnt that Osteopaths especially, need to be specific with which joints are restricted, for example in vertebrae, as they need this knowledge in order to specifically manipulate the restrictions. As manipulations are beyond my scope of treatment, I had to step aside for Katarina to fulfil this element of the treatment, however I was able to play a huge role in identifying the area of restrictions, often requesting that manipulations may be a feasible option and also manipulating the soft tissue surrounding the joint, in preparation for the joint mobilisations.
I found it difficult to see the differences in manipulation technique from where I was standing and I do feel as though I would like to further my understanding as to the mechanisms behind the specific nature of joint manipulations, but for my current level of understanding, I am able to use before and after manual assessments as a guidance as to the effectiveness of this treatment. In each case of a manipulation, I was able to feel the immediate difference from before the soft tissue and joint mobilisations and manipulations.
Patient feedback has also been a key component in ensuring that treatment has been effective and in discovering any reasons for limitations in this. Because of the relaxed atmosphere and rapport with the patients, I have always been able to trust and rely on their feedback, which has proved incredibly useful.

2. Improve Technique: this has happened naturally throughout my time at the clinic; the more patients I was able to treat, the more chances I got to practice and gain more confidence.

3. Develop a relationship with Exmoor Osteopathy: I feel that this is one of the most positive aspects of this placement. Because I conducted my placement so close to my home, where I will hope to build my future career, I feel confident that I will be able to maintain the relationship that we have developed over the past 50hours of placement. I have ensured that I showed commitment, time management, reliability, willingness to learn, enthusiasm and a good professional attitude, all of which I feel I was able to demonstrate for the duration of my placement.
I feel that having this relationship with the clinic will form a fantastic foundation for me to build upon a new client base in the area and with their help and support, instead of a potential rivalry that may have been present.

The keys points from the placement were as follows:
Strengths: clearly explaining exercise rehab to patients, demonstrating and assessing them as they tried to do it.
Very good hands on treatment.
I was really pleased to have received this feedback. I felt as though the exercise and conditioning aspects of my knowledge and understand as well as the practical elements of this were in need of much improvement and unknowingly, over the course of the last term, I have done just this. In fact, from doing these very reflections, I have gained a much better repertoire of exercises for a wide range of injuries, with evidence based rationale.
I was also reassured to know that Katarina has felt as though the practical element of my treatment was good, as this was something I was really hoping to improve and felt as though I had.
This gives me confidence knowing that I am on the right track to developing good technique suited to my own ability, strength and style. Knowing that I can adapt certain positions and treatment techniques, providing it is still effective, has allowed me to feel confidence in my application of my artistic licence.
Being able to “clearly” explain anything to patients requires a good relationship with them, so these elements to practice all intertwine together.

What are the student’s weaknesses?
Artemis initially lacked a bit of confidence when demonstrating her knowledge and hands on skills, however this rapidly grew as the placement went on. I absolutely agree with this comment; I felt as though my confidence was holding me back in the first weeks of the session, due to my lack of trust in my own knowledge and ability, however with the encouragement from Katarina, the patients and with my growing knowledge and experience, I am continuing to grow in confidence although I still have a very long way to go before I feel confidence (or maybe this will never come!).

What area(s) of professional development would you suggest that the student focuses on in the next 12 months?
Finding evidence based treatments for conditions.
I have thoroughly enjoyed this aspect of my degree. I am not always confident in my own knowledge and ability to explain my rationale behind treatment, but with evidence based treatment and plenty of supporting literature behind most of the treatments that I can offer, I am able to confidently apply these. By conducting this research, I have learnt a great deal of different treatment options of which I may not have considered and as such I have developed a greater range of options. I have also developed an interest in the background of musculoskeletal injuries and throughout this year, I have become more academic in my learning, which has surprised me; I always thought I was more hands on. I am now hoping to use my interest in surrounding literature to apply it in my practical application of sports therapy and hope that this will form a basis for a well-rounded sports therapist.

I feel as though I still need to develop my treatment technique further but as I have developed throughout my time in the clinic, I hope to continue to improve and learn the more experience I gain.
I understand that this vocation is a learning platform for continued development and a steep learning curve and will be throughout my career as a sports therapist, with ever changing research and developments and as such I will hope to remain in tune with the latest studies and maintain a professional level of CPD.

Other comments:
Artemis is a very knowledgeable student with a lot of empathy for patients. She connected very well with all of the patient he treated. She will be an asset for anyone she works for, I wish her all the best for the rest of her studies.

What I have learnt from my time at the clinic from a business perspective:
From my time at Exmoor Osteopathy, I have picked up a number of excellent tips on how I may be able to conduct myself as a clinician, including time management, note writing and note management and, arguably most importantly, developing good rapport with the patients.
I thoroughly enjoyed my time in the clinic and that was largely down to the positive and relaxed atmosphere that Katarina had created and the sheer trust and kind rapport that has been built within the clinic between the patients and the Osteopaths.
I would hope to manage a similar environment within my sessions as I feel that patient feedback in optimised when they feel relaxed and cared for and where the patient’s experience and outcome is top priority.
From this placement, I have developed a further interest in the sheer importance of evidence based exercise rehabilitation and, interesting although this is, in my opinion is my weakest area of knowledge and ability, this is what interested me the most. I have seen so many patients walk through the door and receive treatments that only allow for short term, transient effects and who showed an obvious lack of willingness to commit to any form of exercise plan. I feel as though this was an element that was hugely lacking for these individuals, who themselves felt as though age was a long term barrier, to which I quite disagree.
I want to explore the possibilities of creating a clinic whereby functional, every day movements are restored, maximised and pain reduced. I strongly believe, through reading research and from my experiences in the commercial clinic at Marjon University, that exercise treatment is the most effective in most musculoskeletal injuries, either as the only treatment, or in conjunction with other treatments such as STM, ultrasound, taping and stretching and should be formed into the foundation of any rehabilitation plan.
I feel as though I would be able to bring a more exercise based approach to the elderly population of patients in the area in which I live and nearby to the Osteopathy clinic and could potentially form a creative relationship with Exmoor Osteopathy and help to form a team, whereby we compliment each other’s treatment focus.

I am very grateful for my time at the Exmoor Osteopathy Clinic and will look back at this time fondly and will credit this time and Katarina with a huge element of my personal, academic and practical development as a sports therapist.