Round up

So, have I achieved my goals for the LPA unit? 

Revisiting my contract, I anticipated focusing on technique this year and whilst I am happy to say I do think my confidence has improved and my HVT success rate has gone up, I still feel far from the practitioner I hope to become. I do feel that spending the time arranging information visually and trying to bring together in a clinically relevant way anatomy; surface anatomy; examination & special tests; treatment & theory of treatment; differentials (musculoskeletal & systemic) and pathophysiology has been incredibly useful for me, even though it was very time consuming. With hindsight, I see that I was trying to write my own osteopathy (BSO version) "manual" which could really go on forever! In terms of the many modifications we have seen this year (which I have not managed to keep track of well) and the hours I have spent annotating charts and diagrams, it is mildly amusing to me that many students are just learning techniques straight from Laurie Hartmans' manual now! I could have saved myself the effort! I do realise that I have taken the course very literally and approached technique as if there is a "right way", adopting the first year approach for the whole four years in essence. I can see how this has probably held me back now and increased my levels of frustration, but I do need a framework in which to learn and a foundation to spring from! However, this exercise has forced me to organise my information in a better way for me and create links between subjects I seem to have learned quite separately and I have undoubtedly benefited from this. I also know that learning by testing myself (Q&A cards) is the method which suits me best. I only wish I had taken this approach earlier and had also tried to make all my learning clinically relevant from the start (and stuck to one or two books). 

The external courses, whilst draining my bank account, have really helped me fill in the gaps that I was so worried about. I hadn't attended any external courses in previous years, as I thought we would learn everything we should know within the degree course and that we were not meant to stray outside the syllabus. I really feel my soft tissue technique has now improved drastically along with my palpation as a result of these courses. Likewise, I found the IMS and ASM electives considerably helped my palpation. Somewhat unexpectedly, it is the obstetrics elective which I credit with improving my HVT success rate this year, particularly C spine, along with the fact that I did twelve weeks of extra hours in Chapman on Fridays and the tutor included technique in his excellent tutorials. There is nothing like one to one tuition and being told everyone has to try it and then getting individual feedback! Along with encouraging the belief that it is EASY! The power of persuasion. 

Including examinations again in my technique practice and increasing my knowledge of orthopaedic tests has made a big difference this year. Especially thinking about them from a differentials point of view and ruling conditions in or out. Likewise, practicing dcp more and moving from the somewhat rote fashion of last year to thinking more about justification and the actual meaning of any findings, has proved useful.

I have enjoyed going through case histories in study groups more this year as I have had more to say with regard to differentials as the weeks have gone by! I also think my new approach to pathophysiology is helping - ie: less is more - 3 sentences maximum about as many disorders as possible, rather than lots of detail about certain conditions and none about others! I have brushed up my pharmacology thanks to Darwin Court tutorials (the same tutor as Chapman clinic, forcing me to learn again!) and I am hoping I know enough to get through the CCA. Out in the real world I am happy I will be able to look things up, as the subject is vast and forever developing!

The surprise of the year was how much I learned about HIV patients. Friday tutorials were a wealth of new information and I enjoyed the clinic so much I am doing another eight weeks of extra hours this term! I was not expecting how much the external clinic tutorials would help me in general. EMC on Tuesdays, Darwin Court (Wednesdays) and Chapman (Fridays) really gave me a lot to think about. There were always tutorials in the external clinics and lots of information to be gleaned from them!

I did not spend the time I would have liked going over visceral and head and neck anatomy before the elective classes and I think I was lucky to get through the other revision I managed. The dissertation did take over towards the end of Autumn term and much of the Spring term and If I'm honest, I deeply resented its' intrusion into my precious time! Especially as my CCA results have been awful. My time could have been used much more wisely.

I have not managed to scan in anonymised case histories to back up my written descriptions of the  integration of new techniques into clinic and I have to admit that this is because of how difficult it is to get anything photocopied in clinic - eventually I just chose to avoid any hostility by giving up! I felt as if I had used up all my credit asking for photocopies of new patient histories for study groups, the returning CCA patients and the case report patient. I have volunteered to photocopy items myself, but apparently this is not allowed. Ultimately, trying to get things photocopied is an ordeal I never want to go through unless absolutely necessary!

Logs of techniques and dcp routines

Record of attendance of electives