Katie Woosley

My program has four full-time clinicals worked into our curriculum and the first one is for six weeks at the end of the first year. As my classmates and I worked our way through our first year, the cohort above us consistently reminded us that it gets better once you get to your first clinical. In the spring, our professors told us that we would come back completely different students after clinical. Everyone kept talking about how amazing clinical was, and I was excited, but I was also very nervous. How could I possibly be ready for a clinical after just one year of school? As I talked about in my very first post, this is when I really had to trust the process, and it turns out, the then second-year students and my professors were right. It really does finally get better, and you definitely come back as a different person with a different perspective. There is so much to talk about when it comes to clinical, so today I wanted to share a little bit about my experience and talk about why clinical is amazing. Then, in my next clinical post, I’ll share some tips/things to keep in mind.

A Quick Overview of Clinicals

Clinicals provide us the opportunity to apply information and skills we learn in the classroom in the clinic under the direct supervision of a licensed physical therapist. My program requires at least one outpatient, one acute, and one neurological clinical throughout the curriculum. When it is time to select clinicals, we are given a large list of clinical sites and we rank our top 10 choices. Then, we are assigned using a random generator. The therapist who supervises you is called your clinical instructor (CI) and, typically, you work the same hours they do.

My clinical was at an outpatient clinic in my hometown. There are two full-time PTs and two PTAs who work there, so it stays pretty busy! My CI typically saw between 12-14 patients each day. I saw a variety of musculoskeletal conditions as well as a few patients for gait and balance deficits. I learned SO much during the 6 weeks I was there, and could not have asked for a better first clinical! Everyone was so welcoming and always willing to help me! I have truly missed clinical since being back in the classroom!

Starting Clinical

As I mentioned, I was excited but also very nervous as I prepared for my first clinical. I had no clue what to expect, and so many thoughts were running through my head. For the past year, I had been in such a bubble studying, practicing skills, and taking exams. Now, it was time to apply all of this in the real world with real patients. What if I wasn’t ready? What if I messed up? Looking at these questions today, I now know I was more ready than I thought I was. I did mess up (a lot) and that’s okay because I am still learning, and nobody expects me to be perfect.

The first week of my clinical, I was pretty overwhelmed. Everything was so new, and I was trying to take it all in. I was learning how the clinic ran, the documentation system, meeting so many new patients, and learning how to treat them. For the first few days, I primarily observed, and helped treat a few patients. As I became more comfortable, my CI started having me take the lead with treatments and evaluations and gradually added in patients. By the end of clinical, I was treating an average of 6-8 patients a day.

Applying What I Learned in Class

One of my favorite things about clinical is you get to apply the information you have learned in class and in doing so, everything starts to come together and make more sense. We practice skills on one another, but it’s hard to be fake patients. For example, manual muscle testing is something that seems so simple in class. You just have the patient go into a position, apply resistance, have them hold, and grade it from 0-5. Sounds easy enough. The problem is I had only ever completed it on my classmates who did not have strength deficits. During my first evaluation, my CI was documenting the strength testing as I performed it, and I remember being so unsure of what number to tell her. I had memorized the grading scale, but until then, I had never actually had to grade strength because it was always a 5/5 on my classmates. However, my patient does have strength deficits and I needed to be able to accurately measure it. This made me realize how different things are in the classroom versus in the real world.

Learning New Things

Not only do you get to apply what you have learned in the classroom, but you also learn SO much more! Prior to clinical I had taken my foundational anatomy classes, neuroscience, biomechanics, motor control, acute patient care, musculoskeletal evaluation, and a few other courses. I had learned a lot, but there was so much still to come. The first or second day of clinical, my CI was treating a patient and she said “Okay Katie, are you ready to practice your soft tissue skills?” After freaking out internally for a second, and thinking to myself “What soft tissue skills?”, I explained how we hadn’t learned soft tissue techniques (or any treatment) yet. So instead, she had me observe her treat that patient, and then I performed the soft tissue mobilization on the next patient. I was stressed about going into clinical not having learned any treatment, but it ended up working out just fine. My CI met me where I was and taught me what I needed to know. I learned soft tissue and joint mobilizations. I learned different therapeutic exercises and how to progress them. I am in my musculoskeletal treatment class right now, and my clinical has helped me dramatically with it. Treatment is something really hard to learn in the classroom because every single patient is different. Sadly, the “it depends” answer you get all the time in class, doesn’t go away on clinical either…my CI said it all the time 🙂 . Two patients can have the same diagnosis or surgery, but different impairments and goals, which means their treatments may be very different. I came into clinical not really knowing where to start with treatment, and by the end, I was able to progress treatments more independently and talk through ideas with my CI. In addition to treatment, I learned about different surgical protocols, documentation, how to complete progress notes, and create home exercise programs. I could go on and on, but I’m sure you get the point!

Gaining Confidence

My CI’s number one piece of feedback to me by far was to work on my confidence. I needed more confidence when communicating with patients, with her, and when performing manual techniques. Confidence is something I have always struggled with, and this was no different. Much of what I was learning was so new, and this made it hard to maintain confidence. However, if I am not confident in myself, my patients will not be confident in me either. I had one patient who was very high energy, loved to talk, and had a lot of questions. Her evaluation was one of the first ones I completed, and I remember being so overwhelmed. I did not feel great after finishing the eval, and honestly, I was hoping my CI would take the lead on her treatments because I wasn’t sure if I could handle it. She did not take the lead, but what she did do was help me come up with a plan before the patient’s next visit, so that I would be more comfortable once she arrived. She talked with me about how important it was for me to portray confidence when working with her, even if I was unsure. This case really pushed me out of my comfort zone, but it helped me with my confidence so much. Confidence is still something I am working on, but it definitely improved throughout my 6 weeks on clinical, and I know it will continue to improve as I practice and gain more experience.

A Breath of Fresh Air

My most favorite part about clinical was how it puts things back into perspective. During the first year of PT school, it is easy to get lost in the flood of information coming at you and lose sight of the purpose. For me, clinical was a breath of fresh air. It helped me reset and reminded me of why I’m doing what I’m doing. I was able to show up each day and help patients get stronger, feel better, and reach their goals. How cool is that?! Knowing that in a couple years I will be able to do this every day makes the countless hours of studying and all of the stress worth it!