Reflective placement essay:
As part of my clinical placement I obtained a place at Essential Chiropractic, a private clinic in Torquay, home to Chiropractors, Sports Therapists and Physiotherapists who all work closely together. The clinics aim is to offer clients the opportunity to be treated by any or all three of these health care professionals. Patients visit the clinic for an initial assessment before being advised which treatment path is most suitable to their injury or needs, which may lead to them being treated by solely one health care professional or referred between the three. The majority of clients who visit the clinic, do so as they have not achieved the care they desired through the NHS (Mallett, Bakker, & Burton, 2014). The NHS offer a free service, which requires self or GP referral (Mallett et al., 2014)and often entitles each patient to a fifteen-minute appointment, where they are often given a sheet of home exercises. In contrast, in private clinics, patients receive thirty to forty-minute appointments which allows many of them time to talk about their injury and personal life and receive personalised treatment and exercise prescription to help them through this. This is particularly useful for any individuals who are lonely and want someone to talk to about their problems or for those individuals who suffer with their mental health. Essential Chiropractic serves clients of all ages and backgrounds with a range of injuries or just general muscle tightness. They also work closely with Torquay United to treat many of their players or provide them with maintenance treatment in between games. I was drawn to Essential Chiropractic as I was aware of their large involvement with the local community; every year they aim to raise 800 Easter eggs for Torbay’s Young Carer charity. I believe it is important that business’ have a good relationship with the local community and to make a positive impact by helping charities where possible.
I hoped that placement would give me the opportunity to develop my knowledge and skills in a practical setting and provide me the opportunity to learn from experienced Sports Therapists. I would describe myself as a visual learner, so I believed that applying the knowledge I have gained from lectures, to clinical settings would enable me to visualize concepts better in order to progress as a therapist. Despite being an outgoing individual, I have always lacked confidence initially when working with new people, especially in such a personal environment; I aimed to improve this during placement by working with a variety of patients of all ages. One of the main aims when deciding to pursue a career in Sports Therapy, was to one day own my own private clinic in my local area, therefore I believed working in a small private clinic would give me an insight into some of the daily tasks and issues involved, aside from the hands-on practice. As part of my placement, my role was initially to shadow the chiropractor, sports therapist and physiotherapist each of which gave me a different view on ways of interacting with clients (such as explaining the treatment, toweling techniques, putting the client at ease and keeping to a tight time frame). A few weeks into my placement I began to treat clients alongside the sports therapist (doing a section of the treatment each) and finally I built up to treating clients with the supervision of the sports therapist. This gradual progression allowed me to feel more confident and prepared as I gradually gained more responsibility. Throughout my time at placement my role was to treat clients, keep my room tidy and clean at all times, replenish any low stock (such as couch roll, oils, hand sanitizer, towels) and fill in consultation forms, always making sure clients notes were kept up to date and confidential.
I am aware that one of the first steps in the journey to become self-employed, was to build a website or social media page for advertisement and communication in order to build up a client base. The skills to allow me to do so and advice on appropriate content was also something I was eager to learn more about during my placement. Throughout my degree so far, I have spent a lot of time developing my Edublog, however I was unsure how to progress and set up a business page to advertise to future clients. This is something I spent a lot of time contemplating, talking to my colleagues at placement and researching about whilst on placement. My placement supervisor gave me some useful tips such as starting with a Facebook or Instagram business page first and posting regularly to gradually become well known and to interact with potential clients. One piece of advice which has helped me a lot is the importance of planning to ensure consistency; it is important that each post includes academic content such as a link to an interesting journal of a medical post which is accessible to all individuals (not too complex or technical) and is engaging. Since beginning my placement, I have used this advice to create a professional Facebook page on which I post weekly tips, such as how to maintain a good posture while working from home; this has been a big learning curve and has forced me out of my comfort zone. Furthermore, I have engaged more with my social media footprint and have become very aware of what I post on social media and the potential repercussions. I will continue progressing my Facebook page in the future and over the summer I aim to become more aware of how to develop a professional website, business cards and a logo for when I graduate. I feel like these skills that I have learnt will help me with my degree by giving me more inspiration when developing my EduBlog, as well as also giving me the basic knowledge on how to engage with clients professionally online. It has encouraged me to read more online Sports Therapy blogs and journal articles to inspire the content for my page, which has also broadened my knowledge around my subject area. I am now aware of how much I can learn about Sports Therapy on top of my degree, therefore I will set aside more time to read academic blog posts to expand my knowledge. I understand that each client is different, and one treatment is not effective for everyone; I have found that reading blog posts, comparing case studies and shadowing other therapists has shown me the importance of trying a few techniques until one which is effective for that client is determined.
During my time at placement, I learnt the importance of time management ensure appointments did not run over. This is something I lacked confidence in initially as I had limited experience on treating a patient in such a tight time frame. A big learning curve for me was when one patient continuously tried to extend her treatment time by asking me to treat other injuries (which were not mentioned in the initial consultation), this was a big challenge for me as I had no experience in how to be polite yet firm with patients. My placement supervisor explained the importance of taking control of the situation and not letting difficult situations knock my confidence and professionalism. Since then I have focused a lot on the way I communicate with patients and have ensured that at the beginning of every session I outline their injuries and if there is more than one, I ask them to place them in priority order and discuss how we will manage the treatment time. I have found this method to be very effective and have since had no issues, this is something I will continue to work on as I progress through my degree and career. This knowledge will help me in other areas of my degree, such as pitch-side management where other team mates, family members or coaches may try to interfere with my treatment, but I must be firm and polite when asking for space to offer the best possible treatment to the injured athlete. I am now aware of the importance of remaining professional, calm and confident and I can see why Herzog and Hays, (2012)say that good communication is an essential skill of a Sports Therapist.
Furthermore, I also learnt the importance of good bed side manner; listening to clients and allowing them to offload their personal problems to you in a non-judgmental, safe environment can help them just as much as the treatment. Some patients see a Sports Therapist because they are struggling with their mental health as well as their physical health and listening to them and keeping information confidential can help them to make progress with their mental well-being as well as recovering from a physical injury. I have learnt that it is not always about having the answers to their problems but providing a safe environment for them to offload and relax. Additionally, some patients may be unaware that they are suffering mentally or may be in denial due to fear of acceptance (Philips & Jahanshahi, 1986). As a Sports Therapist it is my job to identify this and help the individual by educating them on coping strategies such as positive self-talk (Scherzer et al., 2001), setting them goals (Locke & Latham, 1985)and providing them with social support (Smith, Smoll, & Ptacek, 1990)so they do not feel alone. This is an area where I feel I could benefit from more experience and to achieve this I aim to look into continuing professional development courses available in psychology for Sports Therapists.
As previously mentioned, initially I hoped to become self-employed straight after graduating and work towards owning my own clinic, however, throughout my placement I have learnt how difficult this may be and how many other tasks come with this responsibility. At Essential Chiropractic there is a practice manager who is in charge of ordering supplies, ensuring all stock is up to date, checking patients in, booking their appointments and taking payments. I never realised the importance of this and how smoothly it makes the running of the clinic. This became even more apparent with COVID-19, as supplies of hand sanitiser were becoming increasingly expensive and hard to get; insufficient stock would have meant that the clinic could not open due to the safety of the patients and staff. In hindsight I now believe I will require more experience after graduating to have the knowledge and skills required to be self-employed. Having worked in a clinic, I have noticed the benefit of working along-side other therapists for support and to discuss complex cases to ensure the most effective treatment is offered. I have also enjoyed being a part of a multi-disciplinary clinic as I am aware that the treatments Sports Therapists offer are not always suitable for every case and sometimes patients may need to be referred on to a Physiotherapist; working alongside Physiotherapists makes the referral process a lot quicker. In addition, the pandemic has also made me realise how unpredictable work and life can be and the challenges business’ face. I have never handled stress very well, which is something I am always trying to improve day by day; however, I now question whether I could cope with the uncertainty of being self-employed. I will continue to explore career directions for when I graduate as I build my knowledge, but currently I still hope to one day reach my goal of being self-employed.
Another key reason for me wanting to undergo a placement in a multi-disciplinary clinic was to give me an insight into the role of a Physiotherapist and how their job differs from that of a Sports Therapist. Having originally been unsuccessful when applying for a degree in Physiotherapy, I was led to the alternative route of a Sports Therapy degree with a master’s degree in Physiotherapy. Having begun my degree, I still remained uncertain as to which career was most suitable for me; Sports Therapist or Physiotherapist. This was something I aimed to become clearer on throughout my time at placement. Due to the nature of the clinic and all therapists working very closely together I learnt a lot from each therapist. However, many of the patients came in for injuries that limited their athletic ability but did not affect their quality of life, therefore the two roles were not drastically different, and as a result I feel I still need more information before I make the decision on whether to pursue a master’s degree. Physiotherapists in a hospital environment work to re-gain an individual’s basic movements (such as following a stroke), whereas Sports Therapists work more towards getting that individual back to their athletic ability once they can complete daily tasks, to see this difference I hope to undergo work experience shadowing a Physiotherapist at a hospital next year.
I have identified a few key areas which I require more experience in, these include exercise prescription, spinal assessment, Maitland’s Mobilisations (Samir, Zak, & Soliman, 2016)and pitch-side management. Due to placement being cut short I did not have much time to practice these areas, therefore these are something I will focus on more next year and on future placements. I hope to undergo another clinic-based placement in my final year, whereby I can develop my exercise prescription knowledge by continuing to work with a variety of patients and injuries. I feel I have built my knowledge a lot on the benefit of exercise prescription and how it can help patients to progress in their rehabilitation in between sessions (American College of Sports Medicine, 2014). However, I require more practice and confidence in progressing and regressing exercises to make them appropriate for all clients and injuries. Over the summer, I am going to create a bank of exercises to expose myself to more potential exercises which I can use in third year and in my career in the future, this knowledge will allow me to quickly provide clients with the most appropriate at home exercises to help them between treatments. Furthermore, I feel I have benefited from and can continue to benefit from a hands-on placement, to allow me to perfect certain areas of my degree, such as spinal assessment and Mobilisations. I find placement a safe, useful environment to practice these skills one to one with my placement supervisor, allowing me to get feedback and constructive criticism which may have been missed in a seminar due to the larger group size. It also gave me the opportunity to practice on someone who can give me feedback whether the technique feels correct (opposed to just looking correct) before I treat a client.
In summary, I have learnt a lot on my time at placement which has opened my eyes to the responsibilities involved in running a clinic and being self-employed aside from day to day practice; and the importance of good organisation and forward planning. I feel confident that a clinic hands-on based placement is something I hope to do in third year, to continue to develop my skills in all aspects of practice. I have identified the areas in which I need further practice and I am confident that with the knowledge I have gained so far and what I hope to learn next year, I will have a clear idea of my aims post-graduation by the time I reach that time.
American College of Sports Medicine. (2014). ACSM’s Guidelines for Exercise Testing and Prescription(9th ed.). Lippincott, Williams & Wilkins.
Herzog, T., & Hays, K. F. (2012). Therapist or mental skills coach? How to decide? The Sport Psychologist, 26(4), 486–499. https://doi.org/10.1123/tsp.26.4.486
Locke, E. ., & Latham, G. . (1985). The application of goal setting to sports. Journal of Sport and Exercise Psychology, 7(3), 205–222.
Mallett, R., Bakker, E., & Burton, M. (2014). Is Physiotherapy Self‐Referral with Telephone Triage Viable, Cost‐effective and Beneficial to Musculoskeletal Outpatients in a Primary Care Setting? Musculoskeletal Care, 12(4), 251–260.
Philips, H. ., & Jahanshahi, M. (1986). The components of pain behaviour report. Behaviour Research and Therapy, 24(2), 117–125.
Samir, S. ., Zak, Y. L. ., & Soliman, M. . (2016). Mulligan versus Maitland mobilizations in patients with chronic low back dysfunction. International Journal of Pharmtech Research, 9, 92–99.
Scherzer, C. ., Brewer, B. ., Cornelius, A. ., Van Raalte, J. ., Petitpas, A. ., Sklar, J. ., & Ditmar, T. . (2001). Psychological skills and adherence to rehabilitation after reconstruction of the anterior cruciate ligament. Journal of Sport Rehabilitation, 10(3), 165–172.
Smith, R. E., Smoll, F. L., & Ptacek, J. . (1990). Conjunctive moderator variables in vulnerability and resiliency research: life stress, social support and coping skills, and adolescent sport injuries. Journal of Personality and Social Psychology, 58(2), 360.