1. Invests in the acquisition of evidence through participation in workshops, continued education and pursuit of additional degrees. As a healthcare professional, it is important to continue to be a life-long learner so you are able to provide effective, evidenced-based care for your clients. During my clinical rotations, I have not had the opportunity to participate in continuing education courses, but have been able to read journal articles to stay up to date on evidence based practice. At Southern Hands, the lead therapist would provide journal articles for staff to read to help ensure the clinic was up to date on treatment approaches. Each staff member was required to read the article and initial once it was read. I have provided APA citation and the article for one of the articles that I read while at Southern Hands. I have developed a passion for hand therapy, and hope to purse my CHT one day. In order to fulfill this goal, I plan to try to obtain a job where I can work with hands, and will take many continuing education courses on hand therapy and orthotic fabrication to improve my knowledge in this area.
Colditz, J. C. (2018, March). Resolving the fat finger. Retrieved from: https://www.handlab.com/resources. resolvingthefatfinger.pdf
2. Is a knowledgeable consumer of global research related to occupational therapy and utilizes an evidence based approach to practice. During all of my fieldwork rotations, I did my best to incorporate research and strived to be evidence-based during my treatment sessions. While on my psychosocial rotation at ELMHS, I quickly realized how little I knew about different mental health diagnoses. In order to better serve my clients, I would research articles discussing common mental health diagnoses that were on my caseload. Throughout my research, I found the importance of engaging the sensory system with the mental health population. When the sensory system is engaged, clients are less likely to respond to internal stimuli. I frequently read journal articles providing evidence of engaging the sensory system during treatment interventions with the mental health population. After reading articles supporting the efficacy of engaging the sensory system, all my group activities had a sensory component. When the sensory system was engaged, my clients tended to be more attentive, provided relevant feedback to group discussion, and seemed to retain the education I provided them better. I attached a PDF of a emotions uno game that I created. This activity addressed many of my clients goals by helping them better understand coping skills and their emotions, but also provided a sensory component because the cards were bright and the game was interactive. Stacey Dupre, OTR/L stated, "addressing goals EVERYDAY with fun, sensory aspects that engage :)" Because I was able to see first-hand, how well evidence based interventions work I will continue to be a consumer of global research in order to continue to be an effective, evidence-based practitioner.
3. Integrates individual clinical expertise and patient values with the best available external clinical evidence. Integrating my clinical expertise and patient's valued occupations are a vital aspect of the therapeutic process. However, sometimes client's occupations are not feasible to incorporate into a treatment session due to equipment needs, space, etc. I found it especially challenging on my hand rotation to use occupation as a means, and not as an end. Many of the interventions were purposeful activities. I frequently found myself explaining over and over again how the activities I chose simulated work tasks. I had one client in particular, who had fractured her olecranon, and believed that the activities I was choosing for her would not be helpful when she returns to work as waitress. I used her concerns as an opportunity to collaborate about what work tasks she was most concerned about. She reported that she did not believe she was going to be able to carry plates to serve the tables which he elbow flexed, forearm supinated, and wrist extended. I remember that I read an article showing the effectiveness of engaging in occupation based activities vs. purposeful activities (cited below). Because of this knowledge, I had to create an activity to simulate the tasks using the equipment that was in the facility. Most hand clinics do not just have a bunch of trays and glass plates laying around! I had the client walk around the clinic with me to try to find an item that most simulated the trays she used at work. Once we found a tray, I placed a 5# ankle weight in the tray, and had the client simulate serving tables by holding the tray with her elbow flexed, forearm supinated, and wrist extended. She worked on strength and endurance and was able to carry the weighted tray with ten pounds for five minutes at discharge. After I incorporated this activity, the client became instantly more motivated to participate in therapy, and was more confident about returning to work because she felt like she was practicing being a server during her therapy sessions! This was a great experience for me because I was so proud that I used information from an journal article that I read to motivate my client and was able to successfully collaborate with the client to create an activity that simulate work tasks with the supplies in the clinic.
Krpalex,D; Hyun, A; Kim, J; Lee, A; Lee, J; et al; Exploring the effectiveness of an occupation-based intervention: an experimental study with calligraphy. American Journal of Occupational Therapy 2017;(71). do: 10.5014/ajot.2017.71S1-PO3151
4. Applies the domain of occupational therapy in gathering, evaluating, setting goals, planning and implementing occupational therapy. I was able to apply the domain of occupational therapy daily throughout the past nine months. Because occupational therapy is holistic, I always ensured that I obtained relevant information during the evaluation to gather an occupational profile in order to better understand my client's values and occupations. By understanding their limitations and values, I was able to implement treatment plans that were client-centered and motivating. My understanding of the domains of occupational therapy greatly developed during my rotation at ELMHS. As previously stated, the facility used paper documentation. The evaluation form that I filled out was the OTPF domains with lines for comments. In order to successfully complete the evaluation I had to ensure that I asked questions and had comments regarding client's occupations, factors, performance skills, performance patterns, and context/environment. The evaluations that I completed at ELMHS, greatly improved my abilities to complete a holistic evaluation during my hand rotation. Because hand therapy is very anatomically and biomechanically based, it would be easy to only look at the affected bone, tendon, ligament, etc. instead of using a holistic approach to treatment. However, I was able to successfully gather a holistic occupational profile that gave me insight into my client's values and occupations. Specifically during my hand rotation, I made a conscious effort to include occupation based activities and ensured that all treatment sessions did not consist of only purposeful activities. Megan Brack OTR/L stated, "excellent at grading interventions up and down, as well as selecting appropriate occupation based and client centered interventions." Being able to view a person holistically and not just by their diagnosis is one of the many reasons why I love occupational therapy.
5. Contributes to the knowledge base of OT practice by mentoring students, performing research, publishing, presenting and/or teaching. I have had several opportunities to contribute to the knowledge base of OT practice throughout my level II fieldwork rotations. During my rotations at ELMHS and Southern Hands, I had an opportunities to mentor level I students on a two week rotation. I was responsible for orienting them to the facility, answering questions they had, and was able to describe the purpose of the treatment interventions that I was implementing. During my pediatric rotation at North Mississippi Medical Center (NMMC), I was given the opportunity to provide an inservice to OTs, PTs, and SLP on a community resource available for young adults with special needs in Tupelo. Carrie Hoing, OTR/L stated, "Maggie completed an inservice on Brandi's Hope Community Services on 9/20/17, which included a powerpoint presentation. She presented her inservice to a group of OTs, PTs, SLPs within the pediatric department very professionally. The information she relayed was relevant to our patient population." I have attached a copy of the inservice below. When I become an OTR/L, I plan to continuously contribute to the knowledge base of OT practice by becoming a fieldwork educator for students and presenting in-services on continuing education classes that I attend because it is important to give back to the professional community to continue to make occupational therapy an excellent field to work in.
6. Incorporates continued education as a lifelong practice with the commitment to remain up-to-date and well-informed. As a student, I did not have any opportunities to attend continuing education courses as previously stated. However, I did have opportunities to attend "lunch and learns" during my pediatric rotation at NMMC once a month. Topics included hypotonia, sensory processing, and cerebral palsy. All of the lunch and learns presentations provided the latest evidence based practice on the presented topics. Having monthly lunch and learns at a facility about relevant populations is an excellent way to ensure staff remains up to date and informed. In the future, I plan to attend many continuing education courses to ensure that I am able to provide innovative, evidence-based interventions. As stated previously, in the upcoming future, I would like to take a course on orthotic fabrication to enhance my skills in this area.