Its up to you to ask the correct questions and listen to the answers and apply the information to help your clinical reasoning
I always start with something like “tell me what the issue is” or “how can I help you”.
This will allow the patient to talk freely about what effects them the most. It may be pain, it may be that they can’t do sport or can’t work.
Let them LEAD the conversation and you can listen and guide it to help you get the information you need.
Simply asking where does it hurt gets them talking about the pain but it may not be the pain that is their biggest concern.
It is important to look back at a couple of patient interactions or even interactions with fellow students/ qualified staff.
What went well, what didn’t work. You can learn a lot by reviewing a couple of incidences from they day.
Do it on the day and don’t try reflect on something from a few days ago because you may not remember everything correctly.
EXAMPLE OF REFLECTING:
The patient said they were sore after the exercise you gave them. Is it that they aren’t used to exercise? Did you select the right level of exercise? Did you not educate them about the discomfort they might fell and is it nothing to be concerned about?
Don’t feel you need to reflect in everything as there will be too much going on and you won’t have the time to do so. It’s key just to reflect on a couple of standout moments.
I get it, you see experienced clinicians interacting confidently and effectively with their patients.
They made it look easy and you are nervous and finding it hard to diagnose and treat patients.
But don’t forget they are experienced, you are gaining some experience.
There is a saying that “every master was once a disaster”.
Use the experienced clinicians to get inspiration from them and try to include some of their skills that you think are effective.
These might be communication or physical skills.
As part of your qualification, you need to learn the anatomy. Exact origins and insertions become a little less important as you develop as a physio.
However, it is important you understand the location and role of the anatomy regardless, whether its muscles, bones, joins or cartilage.
Understanding the structures and how the exert force on the body or absorb forces will help you understand human movement.
Understanding mechanised stress on the body allows you to make better clinical decisions when assessing and applying treatment regardless if it is exercises or manual therapy.
Actually putting your hands on a patient seems to be against the law for physios these days. But if your aren’t palpating, you could be missing a trick.
Physical touch is recognised to strengthen therapist-patient relationships.
You can detect stiffness in regions of the body and areas of increased muscle activity.
Using your hands and detecting muscle guarding/ spasms in treatment allows you to alter the treatment grade or position to get better quality of treatment to help your patient.
Does your treatment need to work more on musclular control or increasing mobility? Both may be needed to some extent but one may be more effective than the other.
When you check a patients active range of movement, consider the areal range, the quality through the movement and level of discomfort the patient experiences.
If the patient has overall good range and quality of movement during active range but has restricted range during passive assessment of the movement, it could be a good time to go hands off.
Very often it is the patient feeling nervous or unsure that causes muscle guarding and restricts the range.
Reassure them of how good they are when they do an active range and encourage them to keep doing it regularly.