Monday 13th June 2022
Hours: 3
Patient presentations:
- Anterolateral knee p
Reflection Focus
- Anterolateral knee p
Reflection Model
- Gibbs Reflective Cycle 1988
What Happened?
- Patient presented with anterolateral knee p after walking 14 miles
- Has had a previous injury on this knee but cannot remember what it was or how it was resolved
- Subjected and objective did not reveal anything that would fit a specific pathology
What were you thinking and feeling?
- I had a another student in observing me so it was good to have someone to bounce some ideas off.
- Neither of us could ascertain what was the root of the problem and after discussing the assessment with the clinic supervisor I was confident that I hadn’t missed anything significant.
- It was frustrating not to have a clear clinical impression for the patient; however, we were able to identify certain areas to work on that could improve knee health and alleviate his p. He was starting to feel better at the end of the assessment so he was happy and confident with his treatment plan which in turn made me feel happy and confident.
Analysis and Evaluation
- Not all patients are going to fit nicely into a box when it comes to presentation of symptoms which could make ascertaining a clear clinical impression difficult.
- In this situation, rather than panicking like I have done in the past, I stayed calm, cleared red flags and treated how the patient presented. Isometrics were prescribed for knee p, glute strengthening was prescribed due to glute weakness on ipsilateral side and proper heel-to-toe walking was encouraged.
Conclusion
- I have found that I am becoming much more confident in my clinical practice and I am okay with not knowing the answer to something. Not knowing a clinical impression doesn’t necessarily mean you can’t help a patient; however, by being honest about not knowing what was going on and how I was going to proceed, I was able to gain the patients trust and buy-in.
Revisiting Reflection
References