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Hi, I've just graduated this summer and have managed to secure a short-term post in MSK Outpatients. My last outpatients placement was 2 years ago so I was just wondering if anyone had any good advice/tips for working in outpatients as a new start and any specific texts that could be helpful?
Thanks in advance for any help!
Not sure if this will be much help, but I found the physio pocket book a good quick reference guide to use on my feet.
Grants Anatomy Atlas is also a big help for me
Good Luck
Ollie
Dear Physio88
First of all let me congratulate you on your new post. I believe MSK physiotherapy to be on of the most challenging aspects of physiotherapy as it requires a sound knowledge of anatomy, a very sharp clinical reasoning ability and the ability to also think laterally. The problem is this requires speed as patients expect to have a quick solution to their problems since the majority of them are able to walk into the clinic.
I dont think knowing any specific tests will be helpful as opposed to clinically reasoning when to apply these tests, how accurately you can perform and decode the results of this tests. It is a good idea to have a pocket book, I feel this would be more appropriate to the intermediate practitioner who has had some experience but needs refreshing every once in a while.
To be able to work in outpatients MSK one needs a huge domain of conditions mentally, patterns that are easily recognisable and this only comes with experience( truly there is no other way). What I am saying is the ability to sieve out information from what a patient says to focus on what might be the problem and/or to be able to recognise a pattern to a problem simply because you have seen or heard it before. then you can apply a test to either confirm or rule out what you are thinking in your head...
Even if you knew all the tests possible in the field of MSK and you cannot recognise these patterns, then it is useless, you would peform the tests and not know what they mean.
I think the best way to go is not to be far fom your senior colleagues...i would suggest bothering them over and over and over again...everytime you see a condition, tap from how they address these conditions, ask the questions as to why? if you have good superior colleagues then thats a blessing because they would be happy to impart some knowledge.
I find that most people who start a new post are eager to show that they know...this would be the disadvantage for you because the reality is you are new, accept this an you will learn more, act like you know and you will not become skilled and knowledgeable...
Forget tests, stick to your superior colleagues and learn from them.
cheers
Congrats Physio88,
Thanks Drdamien for your comments - i endorse them...
My take is a little different...
1. Be teachable - your senior physio should help you if you are however...
2. Fake it until you make it - supreme confidence in what you know is essential until you know more. Patients don't get better if they sense you don't know what is going on...so make a decision and test it. If you don't know, be honest and ask for help but be confident in "not knowing"...does that make sense? If you say "yeah, ummm, i'm not really sure", that is not inspiring at all. However a confident "you know what, i am good at what i know but in this case, i am not sure what is going so i am going to get someone who does know". The patient will appreciate that you are big enough to know what your limitations are but will also trust you when you do appear to know what is going on in other areas...
3. Don't get side-tracked by their symptoms but rather use all the evidence you are gathering to tell the story. e.g. low back pain - standard treatment = mobilisation to L/S, H/P, IFC, etc etc, exercises, core staiblity retraining etc. But a better way is to ask "why is the back sore?". Look at their posture. Look at their hips and lower limb kinetic chain in functional motion. All these things help.
4. Go on courses - choose ones that are recommended - i recommend Manual Concepts and Discover Physio - Diane Lee and LJ Lee
5. Learn from everyone - even if it is how NOT to do something!
Cheers