For the last 2 years, in all honesty, I have absolutely hated studying neuro. Learning all the various nuclei of the thalamus etc and practicing tasks that seemed pointless on healthy individuals. In my opinion, the workload expected was always unrealistic. Before attending this prac I could have guaranteed you 99.9% that I would never work in neuro - EVER! Since attending 4 weeks at Shents, I have leant countless relevant information - heaps more than my entire time at uni - and to my astonishment I absolutely enjoyed myself. This got me thinking.
What could the uni have done better? I found that uni gave me an idea of how normal movement was supposed to occur, but most of my time on prac was spent having to identify deviations from normal movement and having to come up with ingenious ways to undo them. I remember learning about the upper limb and how normal reaching works but not all about excessive proximal fixation and the trunk ataxia that goes with the inability to fractionate movement. Likewise, retraining lateral weight shift does not work by getting pts to simply move their pelvis towards a plinth!!! I think we spent like 1 lab on the upper limb, just practicing one task of reaching. I now have quite a few ideas of now the neuro steam could be changed to benefit me as a student, but it is ironic that we no longer have to do "Cue" or have the opportunity for formal feedback now that we really could have some valuable feedback to provide.
In my opinion, you can show videos and practice on healthy young class mates until you're blue in the face - you're not going to learn what you really need to. There is a huge waiting list for people to attend PT in the public system. It would be extremely helpful if we could somehow have observed close up (not from a video where you can't see much or from the back of a lecture theatre) these people in out lab sessions and provide free Ax and Rx sessions for them whilst they are awaiting a place in neuro outpatients. Good for patients, good for students!
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Thanks for the feedback Leah. To be honest we take more notice of feedback from students at the end of the course as it is often only with the perspective of clinical placements that it all gets put into perspective. I agree with what you have suggested 100% in terms of the best method of teaching would be to have patient's come into labs, however having tried to explore ways that this might happen unfortunately it is not practical to have 20 patients come in for each double lab session to allow sufficient patients for students to practice in pairs. We have toyed with the idea of an onsite neuro clinic, but space and funding are the biggest barriers at present.
The other option that we have been trying is to lobby the Federal Govt for some time now in getting more funding for clinical education to allow for more clinical placements throughout the course. Each of the Physio Schools has had students sign petitions to lobby through the APA for a more appropriate funding model. Any assistance that you guys can give through the APA is greatly appreciated!!!
LIZARD,
I too enjoyed my neruo prac!! The uni work for neuro was an overwhelming amount of information…but after finishing my prac at CHARLIES, I can now see why we were given so much info. Yes, some is more important and relevant then other bits, but the stuff that was harped on most did surface somewhere in the past four weeks (wink). I found it soooooo helpful when we would have tutorials from our clinical supervisors on things such as upper limb and pelvis facilitation as well as gait retraining etc. We did touch base on some of these topics at uni, but in real life you learn to alter things a bit. It was priceless!! A majority of the time, my patient would just so happen to be a prime candidate for our previous lesson. I found this 30 minutes (the tut) to almost be more valuable than … well, other things and it sticks! It was good to see what happens in the real world with real patients! I think this should be common practice with pracs. That is why we are on rotations…to LEARN and see the REAL thing. Ya, it’s too bad we don’t get more of the real thing during semester because working on ‘normals’ doesn’t allow us to really get a good feel of what’s out there when we are in labs and actually doing practice! Hopefully, more and more areas for clinics will take that into consideration and share the wealth and standardise between placements instead of just some getting thrown into the deep end. I guess it's personal preference!
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