I am on prac at the moment and we have three supervisors each week, and things are becoming a bit confusing. I realise that every physio is different and they treat patients based on personal experience. But the problem comes when you learn something really great from one supervisor and think you are on the right track, only for the next supervisor to come along and ask you why you are doing something a certain way. This has happened a number of times. I was treating a patient with another student, and we were practicing sit to stand with the patient resting one arm on a large bolster to encourage him to make more use of his lower limbs during the task. Things were going really well, and the patient was happy with how he was going. One of the supervisors then came along, and right in front of the patients asked us to explain the rationale of using the bolster. When the other physio had explained it and had been using the bolster, it made perfect sense to us students and the performance of the task looked pretty good. The second supervisor then went on to explain all the reasons why we should not use the bolster. We did not want to say that the first physio had suggested we use it, because we did not want to sound rude. So we carried on the treatment session without the bolster, and the patient really struggled for the rest of the session. In my personal judgement, it gave him a sense of security knowing the bolster was right there in case he lost his balance, and once it was removed he really struggled to complete the task well. Due to this fact, extra load was placed on me and the other student trying to facilitate sit to stand and I needed the rests more than the patient.
This happened two or three other times last week, and I am feeling a bit confused. Who do you listen to? I have not spoken with any of the supervisors about this because I know they will just say that its all a matter of personal choice. But then isn’t it also our choice based on our capabilities as students. Is it not fair that we choose the option that we feel most comfortable with. I have spoken to another student who had this same prac and she said she experienced the same problem all the way through her prac. I think it probably wouldn’t hurt speaking to one of the supervisors at some stage and just voicing my concerns, just so that they are aware that I am willing to try different treatment options from all of them, but that we just may vary which ones we use. The other student and I have also decided that we will choose techniques based on which supervisor is there, and be able to rationalise why we are changing if we decide to do so.
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4 comments:
I think your management strategy is what most people would do in the same situation. It highlights the differences professionals will have in reasoning their approach with aiming to achieve a common outcome. It is unfortunate as students, and even as graduates, we do not always feel comfortable in questioning that reasoning for fear of being seen confrontational. The good thing is you are prepared to back your own treatment choices based on sound reasoning.
This is a really awkward situation and one that I am in at the moment. Not only is it challenging enough to perfect the facilitation of movement with my patients, but to be confronted whilst treating them about the way its being done I feel is a little unprofessional. I have been dealing with the situation in the same manner by suiting my treatment options to the supervisor there at the time. I feel that as long as the patient is benefiting from the treatment and that I can provide a rationale for it, its all good!
Wow, its interesting that 3 of us have blogged on having multiple supervisors this month... I believe we should be able to take in all treatment methods and adjust them to which supervisor we have, but i agree it is more important to use your own clinical judgement. Supervisors need to allow us to choose what treatment style we will use so long as we can justify it correctly.
I think multiple supervisors is something that might work as long as they are supervising in quite different areas. When I was on my rural placement I had two supervisors, one for inpatients and one for outpatients. From the beginning they were quite clear that I would be assessed at the end of the placement with an new outpatient person and all the written feedback was given my one physio. This seemed to work quite well and I really enjoyed the placement and supervision I received.
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