Dry Needling…Not a Type of Craft that Your Grandmother Does

Name: Katherine Koch

Undergrad: The Ohio State University

Hometown: Cleveland, OH

Fun Fact: Last summer, I climbed six 14ers

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Dry needlingnot a type of craft that your grandmother does. This type of treatment uses thin filiform needles inserted by a physical therapist into myofascial trigger points, or a tight band of muscle that might be causing pain (1). Dry needling is based on physiological evidence supported by research that is usually part of a broader treatment plan (2). If this needling sounds familiar to you, you’re not alone. Acupuncturists use the same type of needle to adjust the flow of energy, or chi, throughout meridians in the body. Acupuncture is an ancient Chinese medicine and operates based on the belief that these thin needles can relieve tension, stress, and pain when inserted by an acupuncturist (3). While you won’t be getting an itchy sweater from this treatment, it can lead to pain relief for many people. 

However, there is still confusion and debate among physical therapists and acupuncturists concerning the rights and responsibilities of physical therapists in performing dry needling on their patients. This debate of dry needling by physical therapists was recently taken to a Denver district court when the Acupuncture Association of Colorado (AAC) challenged the Colorado State Physical Therapy Board (Board). The AAC claimed that physical therapists had not undergone enough training to perform dry needling and requested the Board reverse the rule that allows physical therapists to practice this method of treatment. The AAC argued that physical therapists only perform 46 hours of training to be certified to practice dry needling, while acupuncturists train for almost 2,000 hours. The association claimed this made dry needling by physical therapists an “unsafe practice of acupuncture” (4). However, this statement is strongly misleading due to the additional 3,400 hours of doctorate level schooling that physical therapists already have behind them before they complete those 46 hours specific to dry needling training. Physical therapists spend three years in graduate school learning how the human body works, what can go wrong with it, and how to fix it within the realm of physical therapy. Additionally, doctors of physical therapy are required to take continuing education courses throughout their careers.

Additionally, the AAC made the claim that dry needling is just a misnomer for acupuncture, while the two are fundamentally different practices. They may look similar to the untrained recipient, but physical therapists and acupuncturists perform their respective treatments with fundamental ideological differences between the two. This is not to say that one is better than the other, and patients may make the informed autonomous decision to receive either or both treatments. However, as the Denver District Court decided, there is no need to prevent members of one profession from performing treatments all together. In December 2017, the court recognized that physical therapists are acting within the Colorado Physical Therapy Practice Act when they perform dry needling.

As the Colorado Chapter of the APTA President Cameron MacDonald put so eloquently,

“this legal debate was brought forth by those who wished to restrict the practice of another profession from their own. This debate could have been about any intervention utilized by physical therapists, and not just dry needling. It is imperative to consider this legal challenge and the lawsuits brought against the Colorado PT Board through the lens of the Colorado consumer of healthcare. Consumers in Colorado are provided access to health care providers which have a defined scope of practice under which to deliver patient care. Health care professionals are expected to provide the best care they can, and to practice under a scope flexible enough to both protect the consumer and not limit the development of practice by health care providers.”

When physical therapists perform dry needling, they are practicing within their professional scope. When acupuncturists perform acupuncture, they are practicing within their professional scope. Both professions can live harmoniously alongside each other while helping patients within their respective realms.

Why does any of this matter? First, any judicial ruling or legislative rule concerning a profession as a whole likely has implications that affect many of its members. In this case, physical therapists that perform dry needling in Colorado were in danger of losing their legal right to treat patients in this way. Further, patients were in danger of losing out on a treatment that can benefit them. To be effective health care providers, it is imperative that physical therapists are informed practitioners in order to best advocate for their profession and best treat their patients. Denying to inform themselves and take positive action does a disservice to future physical therapists and patients who will benefit from the work done to advance the profession today. In order to practice as autonomous providers, physical therapists must continue to advocate for their profession and understand the issues surrounding it. It also stands to reason that since the American Physical Therapy Association participated in this case as an amicus party and presented information that no doubt helped sway the case, physical therapists should support and be members of the organization that advocates for them on this broad level.

This debate is not in Colorado alone; lawsuits in three states have gone the opposite way and the state boards have been forced to remove dry needling provisions from their practice acts.4 Since each state has their own physical therapy act, it is important that the Colorado practice act, which will be revised next year, continues to maintain its inclusive language that provides “for new developments in physical therapy practice, which includes dry needling” (Caplan and Earnest, LLC, personal communication, January 9, 2018). For the good of physical therapists, patients, and the future of physical therapy as a profession, this particular case is closed.


If you are a student physical therapist, like myself, who hopes to perform dry needling as a professional one day or if you simply would like to learn more about its practice, please refer to the references below.

  1. Dry Needling by a Physical Therapist: What You Should Know. American Physical Therapy Association. http://www.moveforwardpt.com/Resources/Detail/dry-needling-by-physical-therapist-what-you-should. Published December 25, 2017. Accessed January 28, 2018.
  2. Gattie E, Cleland JA, Snodgrass S. The Effectiveness of Trigger Point Dry Needling for Musculoskeletal Conditions by Physical Therapists: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017;:1-41.
  3. Miller J. Physio Works – Physiotherapy Brisbane. Acupuncture and Dry Needling. https://physioworks.com.au/treatments-1/acupuncture-and-dry-needling. Accessed January 28, 2018.
  4. Migoya D. Acupuncturists sue Colorado’s physical therapy board over the very definition of their craft. The Denver Post. https://www.denverpost.com/2017/04/05/acupuncturists-sue-board/. Published April 7, 2017. Accessed January 28, 2018.

So You’re Interviewing for PT School (and more specifically for REGIS!)…

Name: Erin Lemberger

Undergrad: University of Northern Colorado

Hometown: Littleton, CO

Fun Fact: I sing the national anthem at sporting events!

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It’s almost that time…interviews! I can’t wait to meet this year’s prospective students, and I know everyone else in our Regis DPT community is excited as well.

Those in the midst of or about to interview, I know this is a stressful and exciting time. Just a year ago, I remember the butterflies I was feeling, along with anxiety and anticipation. To start, take a deep breath, trust yourself, and know that this is the fun part. This is the time to find the program that is the right fit for you. You’ve worked hard preparing for this, so remember to take the time to enjoy it too. The more relaxed you are, the more you will be the best version of yourself on interview day.

Kelsie, the Class of 2019 admissions representative, received some questions about the interview process from prospective students last year. Carol, the Class of 2018 admissions representative, and her have shared some answers to these questions that you may be wondering about as well. I hope this helps assuage any concerns you may have!

Q: Should I bring anything to the interview (pen, portfolio, resume, notepad, etc.)?

A: No need to bring anything. You will receive a folder and pen, information about Regis, and a water bottle. Of course, you’re welcome to bring your own paper and pen, but there’s no need. Some people like having a notepad to jot down questions for the faculty or interesting things they learned throughout the day, but it is completely your own preference. Also, keep in mind, you will be carrying whatever you bring around campus during the campus tour.

Q: Are there any questions that stumped you or caught you off guard? What types of interview questions should I expect?

A: Interviews are now done in a group format, so not only will you have the opportunity to answer questions, you’ll be hearing and responding to what others have said. It really feels like the interviewers are sparking a conversation with each question. They want this discussion to be natural and give you the opportunity to be yourself. I really mean it when I say to be yourself as much as you can be. Regis is unique in the fact that they really look for people’s character during the interview, rather than solely admitting students for grades and GRE scores. When the faculty asks you questions, they are not seeking a right or wrong answer. They are seeking to learn who YOU are and how you communicate. With the group interview format, there is opportunity to listen and engage with the faculty as well as the other prospective students, so take advantage of these moments.

Q: How can I prepare for the interview?

A: Some advice is to look at the Regis website and see where the values of Regis fit into your life and how you can express that during interviews. Faculty biographies are good information to look at prior to interviews, and reviewing this information can give you an idea of questions you might want to ask faculty members. If you do feel stumped at any point, don’t be afraid to take a minute to gather your thoughts because they appreciate that more than a made-up answer. It also helped me to look up some common physical therapy school/traditional interview questions and brainstorm answers. Think about what you have experienced already and have those stories ready. If you have some solid examples of your experiences, you’ll be able to adapt to wherever the conversation goes. Finally, make sure you research the topics you’ve been given ahead of time so you can prepare and get your thoughts together. Another piece of advice is to perform a practice interview with friends or family members in a group setting. Practice speaking out loud and ensuring you are speaking clearly and loud enough as they ask you different interview questions.

Q: Is there a chance to meet current students?

A: YES! You will have multiple opportunities to interact with various students throughout your day. Also, from 4:30-6:30pm on both interview days, we will have a meet-and-greet off campus for prospective students to meet with current students. I hope to see you all there! That being said, this is by no means mandatory and your attendance will not affect your admission to the program.

Q: What should I expect from the group interview format?

A: The group interview will consist of two faculty members and three candidates. It is not designed to be all three of you taking turns answering one question at a time nor each of you competing to have the best answer; instead, it is designed to be more of a fluid, facilitated discussion of specific topics among everyone.

Q: What will the whole day be like?

A: Everyone will go through 5 different “stations,” so to speak. They include the interview, campus tour, student Q&A panel, a skills lab observation in one of our classes, and an anatomy lab presentation. They won’t necessarily be in that order, but the whole interview day will include all stations and conclude with lunch. You’ll also stick with the same student-led tour group between each part of your day, so you’ll have plenty of time to get to know them and ask them questions as they come to mind.

Q: What should I wear?

A: I would err on the side of business formal. Most men typically wear matching pants and jacket, a button-up collared shirt, and a tie. Most women wear slacks or a dress skirt, a blazer, and a blouse. Cropped dress pants would work too, and if dresses are your thing, then go for it. It is really important that you feel comfortable in whatever you end up wearing! That being said, when it comes to shoes, heels are great, but as long as you’re really comfortable in them. Flats are perfectly fine; in fact, if you opt to wear heels, I would bring a pair of flats along with you so you can change into them while you go on your campus tour. Also, be sure to bring a jacket in case it’s cold. There will be a coat rack available to store your belongings while you are inside. Simply remember this is a professional interview, so dressing professionally is highly recommended.

Best of luck, interviewees! Feel free to reach out if you have any more questions. I can be reached via e-mail at elemberger@regis.edu. We are all looking forward to meeting you!

– Erin, Kelsie, and Carol

Finals Week: A Beautiful Struggle

It’s that time of the year again…

No, we’re not talking about the holidays.

It’s Finals Week, the crescendo of each physical therapy (PT) school semester.

If you haven’t experienced a finals week in PT school, then here are a few ideas of what Regis students encounter during this time each semester.

  1. …but first, Practicals Week

Gone are the days of “dead weeks” leading up to final exams. Practical Exam Week is usually the week prior to all of the written final exams. This is where the skills you have acquired over the entire semester are put to the test to see how you are able to apply them in a real-life situation. During the days leading up to these exams, you will often see students crowding into room PCH 409 to practice their skills and drill each other on the specific times to use them. Study sessions can extend late into the night for some students (Pssst…PT school secret: often these practicals require knowing information that will also be on the written final, so it’s like studying for two exams at once…now that’s a deal!)

  1. Review Sessions

It is not uncommon for faculty members to hold review sessions discussing what to expect on the final written exam. These are often a great help in refining study strategies (PT school pearl of wisdom: take advantage of these sessions!)

  1. Finals Week Schedules

Each class takes 4-5 exams the entire week, with one exam per day and each one for 2 hours. You can find last minute study sessions dispersed across Claver Hall in the hours leading up to the exams to review any lingering questions or fill any remaining knowledge gaps. And hey, after one exam is over, students have 22 hours to study for the next test…what an ample amount of time!

  1. Work-Life Balance

In the words of The Great Tom McPoil, “take a day for yourself every week.” This may be hard to remember during these challenging weeks, but still very relevant. Students usually make modifications to Tom’s “day” suggestion during finals week, and instead take a few hours to relax and meditate with various types of exercise (or naps) – whatever takes the mind off studying for a few moments.

  1. The Triumph of Completing a Semester of PT School

At the end of each finals week, you will find students celebrating another semester down and another job well done! It’s a time to look back at the terrific accomplishments with pride and relish in the fact that your hard work got you here

– Courtney Backward

Check out this video of first and second year students studying (and relaxing) for their finals!

 

Video Credit: Janki Patel

 

Charting Your Clinical Education Course

Name: Josh Hubert, Class of 2019

Undergrad: Bellarmine University

Hometown: St. Louis, MO

Fun-fact: I was told by a Greek reiki-master that I am a crystal baby

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Like any great exploration recorded in history, your clinical education at Regis will be a trip fueled by careful planning, curiosity, intrepid spirit, chance, and financial backing from a powerful monarch. Just kidding on the last fuel source, but the others may be necessary. I am the Clinical Education Representative for my cohort,  and I’d like to share how and why I chose my first few clinical experiences. Through my process, I hope you can draw parallels to your own clinical education journey and chart a course that is ultimately fulfilling to you and your future practice. In an effort to wring my exploration analogy dry, you may be seeking cities of gold, but much like Francisco Vasquez de Coronado, the late Spanish explorer, you may find that golden cities do not exist. There will be greater treasures on the journey itself (the Grand Canyon). Coronado was deemed a failure for his “fruitless” mission, but he and the Spanish people failed to recognize the beauty that had been found. Enjoy the journey and respect those you meet along the way. So, to continue with less figurative advice, here are the steps that led me to my decisions:

1. Assess your resources

a. Requirements/Desires

Forget ships and gold! Sit down and take inventory of available resources to direct your search, just as you would use MeSh terms when searching for relevant articles in databases. Firstly, consider your curriculum requirements to determine how and when to use your resources. You must complete an outpatient (OP) and an inpatient (IP) rotation. One of your rotations must be rural, and one must be out-of-state. However, one rotation may satisfy both the rural and out-of-state requirements. Lastly, rotations II, III and IV or III/IV combined cannot be in the same concentration area. Prioritize these requirements in such a way that aligns with your vision for future practice, which is bound to change and develop. Try to set aside time for deliberate development of your vision and allow growth to happen. Enjoy the journey. The chart below that depicts these requirements.

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b. Location

Next, consider a location with requirements and resources in mind. Is there a clinical site that happens to be in your hometown? Or a town in which you have a friend or relative? How will you get there? This can help to lower the cost of lodging and travel, which calls to mind your living situation in Denver. Based on the dates, could you create a situation that avoids the need to pay double rent while at clinical? Do you see yourself practicing in a rural setting or an IP setting? Or maybe not? Do you have a burning desire to work with a particular population? These answers help to filter out less practical locations off-the-bat.

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Bardstown, KY – the bourbon capital of the world

c. Connections

Did you develop any relationships with physical therapists before coming to Regis? Have you developed any relationships with faculty since being at Regis? Do these professionals practice in a place that you would like to practice? Talk to them and seek their counsel. If they work in an area that interests you, ask about potential or existing clinical education opportunities that they may know about. And don’t stop there. Research their suggestions for yourself. Just because you have developed a relationship does not mean they know exactly what’s best for you. Decide on your own when you feel enough information has been gathered.

d. Time

Do you have a good idea of what you want to do? If so, go with it. It may change after your first clinical, but we are fortunate to have time for reassessment. Consider a FCFS (first come first serve) or Corporate site if you have a strong sense of where you want to end up or where you don’t want to spend the majority of your clinical time. If you choose one of these sites or set one up, you are locked in. You may save yourself time required by deliberation and also open up spots in the lottery for your classmates. However, if  you are not completely sure, then consider the lottery. If a site you desire is not in contract with Regis, then explore building that bridge, under the direction of your Clinical Education advisor, and after accounting for all the sites available to you. In addition to Acadaware, there is a list of corporate companies which typically include a handful of sites in different cities both regionally and nationally. Setting up a rotation with one of these sites is much more manageable than starting from scratch, which will be more time-intensive, but worth it if you’re vision is clear.

2. Mobilize your resources

a. Plan

I save your Clinical Education Team for this step because I believe it’s helpful to come to them with an idea of your requirements in order to direct the conversation. I think we can agree that sitting down for a 30-minute meeting regarding 3-5 prioritized sites will likely be more productive than a 30-minute meeting covering the possibility of 134 potential sites. Your advisor is your second most valuable resource, after your own brain of course, and it’s a good idea to develop a relationship with your advisor that fosters open dialogue.

b. Pursue Your Choice

Time is a resource. Consider a FCFS or corporate site if it aligns with your vision. With the blessing of your advisor, commit to that site on the list or create a site of your choosing, and do it with gumption. If you go the prior route, there is not much else required of you than a commitment, but if you go the latter route, put in work. Understand that if the site agrees to host you, you will be required to go. Take initiative and offer to establish initial contact with the new site. If your advisor approves, compose a professional and compelling email to get the ball rolling. See your choice through to the end. If a site is unavailable, refresh and continue with your next choice in the same manner.

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I completed my first clinical at KORT-Bardstown, a corporate site in KY. The site was not previously an option as a first clinical site.

c. Logistics

Piggybacking off the suggestion to narrow your site options before attempting heroic feats of decision amid many options, it is easier to cross-compare the logistics of a few sites rather than 100 sites. If you have 5 sites that all meet the same criteria you’ve established for the unfolding of your vision for practice, then maybe something simple like the cost or availability of housing distinguishes one site as the preferable option. What will weather be like during your clinical? Will there be unearthly traffic on your commute in one city? Is there good food and good beer there? These things, while seemingly superficial, may help with that final step of narrowing it down, since our quality of life is important too. #happyPThappypt

d. Enjoy the ride

Map it out as carefully as you like, but uncharted territory is only chartable once you get there. In other words, there is only so much calculation you can rely on in life before you need to simply rely on curiosity and spirit. There may not be golden cities on your course, but be sure to recognize a giant canyon for what it is…graaand. The reality is that you can take all these steps along with others and still end up with a site you did not chose. In this case, gear up for an adventure and come back with a map of your own for those that follow. Embrace each moment on your adventure as a learning opportunity whether it’s what you wanted to learn or not, and respect the people who teach you. Experience is a willing teacher and learning makes the vision clear.

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My CI and I enjoying homemade mint juleps, in accordance with KY tradition.

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Sentimental cookie-cake. I’ll miss them, too.

Feel free to stop me in the hall or email me if you have any more questions about my experience: Jhubert001@regis.edu

Bonus Fun-Fact: I did a project in 7th grade on Francisco Vasquez de Coronado.

 

DPT School Nutrition: 4 Ways to Eat Healthy

Name: Janki Patel, Class of 2020
Hometown: Fremont, CA
Undergrad: University of California, Davis
Fun Fact: I hiked a 14er (Mount Democrat) for the first time…three days after moving from the Bay Area’s sea level.
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If you are currently enrolled in physical therapy (PT) school, or attended in your past, you can probably identify with the struggle of eating healthy, stress eating, and forgetting exercise. With one exam after another, I’ve found myself eating one snack after another. And by snack, I mean chocolate-covered espresso beans, chocolate-covered almonds, and chocolate-covered pretzels. Anytime anyone mentions “free food,” my ears perk up, eyes widen, and I suddenly feel as if I’ve been starving for centuries, instantly questioning “Where?! When?!” And, when I do finally find the time and energy to go grocery shopping, I think to myself, “I’m going to get a ton of vegetables, fruits, and healthy foods only.” Yet, I end up walking out with a handful of unhealthy items, which I justify by all the vegetables and fruits I just filled my cart with (it’s all about balance, right?!). Days later, I find myself eating all those unhealthy items first though, while the vegetables and fruits start going bad. And with more stress, I seek out the fatty, carbohydrate-heavy, sugar-loaded foods for comfort and relief. When I talk to classmates, I find many are in the same boat. It’s almost as if we could use a class about how to consistently eat healthy while in PT school…or maybe just a blog post!

We already learned that nutritious foods are better fuel sources for our brains and bodies, leading to improved energy, clearer minds, and overall better productivity. Ensuring proper nutrition takes self-discipline and motivation. Once you make it part of your everyday though, you won’t even have to think twice about it. Just like driving a car or riding a bike or remembering the direction of roll and glide for the convex-on-concave rule of arthrokinematics. It’s simply a matter of training the brain, or neuroplasticity, if you will.

1. Mindfulness

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Photo Credit: Mindfulness Words

 

Take the time to really listen to your body and thoughts in the present moment. When you find yourself reaching for a snack, ask yourself if you’re truly hungry. Is your stomach really rumbling? When was the last time you ate? If the answer is “no” and “just a half hour ago,” then try opting for a drink of water or a piece of gum to chew instead. If you start deeply craving food, ask yourself where that craving is stemming from. What’s really causing it? Hunger? Or, stress and anxiety? If it’s stress or anxiety, then first acknowledge that the true cause of your feeling is stress or anxiety. But, don’t let that acknowledgement stress you out more. Take a minute to close your eyes and take a few deep breaths, rather than running to the cafeteria or kitchen. Try to then relieve the craving by simply changing your position (sitting up straighter, getting up and taking a quick walk, or stretching) or environment. I find that every time I study on the dining room table, I end up grabbing a snack shortly after I start, or I sit with one to begin with so I don’t have to get up later. With the kitchen so close by, there’s little time between my thought and action. Choose a study spot away from food sources so that you’re given more time to think twice about any craving that occurs and prevent yourself from fulfilling it.

Find more activities to relieve cravings in the moment as well, whether it’s having quick play time with your pet, reading a short article (PT in Motion has great ones!), or talking to a family member or friend for a few minutes. Essentially, we want to train the brain to think “this is my cue to grab water, take a walk, or talk to someone” instead of “this is my cue to eat” whenever it receives the signal of a craving or desire to eat that really stems from stress or anxiety rather than hunger.

2. Commit to a List

Photo Credit: Grocery List

 

This is one of my biggest challenges. I always have a few items in mind that I need to get from the grocery store, but the rest of the items in my cart end up being in-the-moment purchases. Make a solid grocery list beforehand and commit to sticking with it by grabbing only the items you need. One way to do this is to first find healthy recipes and then creating a grocery list from the ingredients. For example, I’m subscribed to New York Times Cooking, which sends me daily emails of recipes. I choose and bookmark a few healthy ones every day so that by the end of the week, I have a list of ingredients for my weekend grocery shopping trip (as well as recipes to cook for next week then!). You can go paper-and-pen style or use an app on your phone to keep track of your list.

Another way is to commit to a 5-5-5 rule. Include 5 vegetables, 5 fruits, and 5 protein items on your list every time you make a trip to the grocery store (or any other area, such as fiber or a specific vitamin, that you may not get enough of). Depending on when your next trip will be though, you may have to increase these numbers. Think of your grocery list as being a grading rubric for a class assignment or a list of topics on an exam. Just as you would ensure to cover all required items for your clinical skills check or anatomy exam, and not a single more item than you have to, commit to ensuring you cover all the items on your list, and not more, for groceries as well.

3. Avoid Justifying Unhealthy Items for Costing Less

Photo Credit: Money Fork

I know we’re all “balling on a budget,” but try to not let that be a reason you start compromising healthy foods for less nutritious ones. Order that avocado for the extra 50 cents. Don’t order that whipped cream on the frappachino simply because it comes at the same price without it. If you’re like me and are easily lured by sale items at the grocery store (who doesn’t like buy one, get one free items?!), try to take more time to practice the previous points of being mindful and committing to a list. It’s easy to fall into marketing schemes since sales make “sense” that we would be saving money. However, it does not make “sense” to feed our brains and bodies with foods that have little to no nutritious value.

This goes for restaurants as well, especially if you don’t cook at home or buy groceries often. Think back to the 5-5-5 rule when ordering still: did you have vegetables, fruits, or protein today? Create and commit to a list and find items on the menu that incorporate this “grocery list.” We’re actually lucky that our bodies already give us a grocery list of items they need for optimal functioning: proteins, carbohydrates, fats, vitamins, minerals, water, etc. Seek the specifics your body truly needs on the menu, just as you would seek keywords in multiple choice options on an exam question to know it’s the correct answer.

4. And Of Course, Don’t Forget to Exercise!

Photo Credit: Time for Fitness

 

This last point is more of a reminder to exercise regularly. The benefits of exercise are endless. Schedule it into your calendar as if it were a mandatory class. Additionally, any time you start to feel your energy levels plunge, try exercising rather than reaching for energy bars or sugary foods for a boost, even if it’s simply 10 minutes. If you’re in class and a craving or energy lull hits, try seated calf raises under your desk, flexing and extending your toes in your shoes, or flexing and extending your fingers and hands (set a frequency too!). Again, it’s about creating a healthy response when your brain gets these signals.

We know exercise can cause physiological changes in more than just our muscles, specifically in our metabolic pathways. Keep moving regularly and solidifying healthy eating habits and it’ll soon feel like you never had a struggle with healthy eating, stress eating, or forgetting exercise. You won’t even have to think twice about it. Just like driving a car or riding a bike or remembering the direction of roll and glide for the convex-on-concave rule of arthrokinematics. It’s simply a matter of training the brain, or neuroplasticity, if you will…these are my foods for thought. Happy nutritious eating!

Lessons Learned During the First Clinical Experience

Name: Kelsie Jordan, Class of 2019
Hometown: Portland, OR
Undergrad: Oregon State University
Fun Fact: I spent the summer of 2014 studying in Salamanca, Spain.
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When I tell people I was in California for my first clinical rotation, everyone’s minds seem to jump to the flashy big cities like Los Angeles, San Diego, or San Francisco. Sorry guys, I wasn’t lying on the beach or treating the movie stars; I was working more in the realm of Middle of Nowhere, CA in a small town called Orland. If you’ve ever driven to or from Oregon along I-5, you’ve probably driven right past it without ever even knowing it existed, as I actually have multiple times. I have lived in or near major cities all my life, so I had no idea what to expect from working in a rural setting. I was worried I was going to be bored, and that being away from everyone I know would make me lonely. But Orland, with its farmers, high school football, and Dollar General stores, turned out to be the best place I could have been for my first clinical.
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Welcome to Orland!

Here are just a few things I learned along the way:

Work schedules > school schedules

I’m not going to lie, clinicals are exhausting. Being on my feet all day, both literally and figuratively, drained the life out of me, especially in that first week. The good news is, I immediately discovered how great it is to come home at the end of a long, demanding day and have nothing–and I mean nothing–to worry about. After a year straight of exams, projects, and endless studying, I forgot how nice it was to have a mellow evening without feeling guilty about procrastinating. My clinical instructor (CI) once asked me what I generally do after work and I had to laugh; my nightly routine was pretty much eat dinner, drink an occasional glass of wine, and re-watch early episodes of Game of Thrones. Call me lazy, but I look at it as taking advantage of the free time I never get to have during school.

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Wine tasting in Sonoma!

It’s never easy, but it gets better

As barely a second year student going into this rotation, I was pretty much inexperienced in every sense of being a physical therapist. Even the skills I was most familiar with had a different feel to them when working with real patients instead of practicing on healthy classmates. Luckily, my CI was an amazing teacher. He did a great job of layering on responsibilities for me so I always felt challenged but never felt thrown into the deep end. After an observation-heavy first week, I was tasked with doing the subjective interview portion of every evaluation and taking over the exercises for a couple patients. At the time, that honestly made me nervous and it felt like a lot of independence. But fast forward to my final week: I had somewhere around 10 patients all to myself, I was flying solo on pretty much every lower extremity and back evaluation, I was completing all documentation, and I had discharged three of my patients. We had a packed 8-5 schedule and it was never easy because my CI always gave me more to do before I got fully comfortable. It was demanding, I made a lot of mistakes, and being challenged every day sometimes made me feel like I wasn’t improving or I shouldn’t still be struggling. But looking back at what was difficult for me in that very first week compared to what I was able to do by the end, it’s easy to see how much I learned and improved!

Confidence takes practice

I have always struggled with my outward displays of confidence in patient interactions because I get nervous and tend to doubt myself. I’ve always been told, “Fake it ‘til you make it,” but that’s a lot easier said than done; I guess I just don’t know how to fake confidence. Instead, my confidence builds gradually as I experience success and overcome challenges. And that’s exactly what happened during my clinical. From prescribing and teaching exercises on my own to completing several full evaluations in Spanish, I was definitely challenged, but I was also successful. Sure, I felt like I didn’t quite know what I was doing half the time, but I learned to not dwell on mistakes and to push myself out of my comfort zone. Most importantly, I gained confidence in my own knowledge and abilities, and I now feel more prepared to take on the rest of PT school. If there’s anything I learned from my clinical, it’s that I am capable of doing far more than I ever thought I was.

Solo adventures are good for the soul

I’m usually go go go from one thing to the next for fear of missing out on any fun, so being alone in a rural area was definitely a change of pace.  Although I was lucky enough to reunite with some college friends during trips to San Francisco and Lake Tahoe, I actually probably spent more time alone over the six weeks of clinicals than I did throughout the entire first year of PT school. It allowed a lot of time for self-reflection I didn’t even realize I needed. I was itching to get out and explore, and my weekend adventures were definitely worth all the miles I put on my car: I took my first solo camping trip, discovered a National Park I had never even heard of, and hiked upwards of 35 miles by myself. Of course I missed my friends and my normal crew of camping/hiking buddies, but I learned how to embrace time alone without being lonely.

I enjoyed the opportunity to appreciate silence and just be.

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Support systems are necessary

As a class, we spend so much of our lives together throughout the year that, I have to admit, it was oddly nice to be away from everyone. No, I’m not saying I was sick of my classmates, but those 6+ weeks apart allowed me to actually miss my friends. And, although I already said I enjoyed my time alone, man did I miss them. When you go from sharing all of your time together to none of it, all while you’re being thrown into a new situation, there’s a lot to catch up on after just one day! I did my best to reach out to my friends here and there to see how their clinicals were going, and sometimes those check-ins turned into 2-hour phone conversations. Shout out to the two friends who kept up a group text with me every single day–we practically shared a play-by-play of our clinical experiences, from funny patient stories to weekend plans. Knowing everyone else was having similar challenges was reassuring, and receiving daily encouragement and sharing my accomplishments kept me excited to keep learning.


In a rural setting, a physical therapist needs to be a jack-of-all-trades and a master of none, as my CI once told me. As a result, I got to see a little bit of everything. Sure, there were quite a few back, shoulder, and knee injuries, but I also did some detective work with more neural issues, and I got to observe several vertigo treatments as well. I absolutely loved being in Orland, not only for the varied learning experiences, but also for the people and the small town charm. I found out the correct way to pronounce almond is “am-end” (according to Northern California farmers), and I even joined in on the tradition of wearing blue on Fridays in support of the high school football team.

“You are enough!”

That’s what we were told in our final pre-clinical prep session over the summer, and it turns out it’s true! At first it was easy to think,“I’m just a student” and feel as though I had to run every thought and decision by my CI. However, as he let me become more independent, I realized even as a student, I really did have enough knowledge and skill to make a difference in patients’ lives all on my own. Now, when people ask me how my clinical went, I have nothing but good things to say. I was pushed into recognizing how much I was capable of, and humbled into realizing how much more I still have to learn. Although it was a short period of time, those six weeks were like a refresh button to help me overcome the burnout I had experienced after a year in the classroom, and allowed me to come back to Regis ready to keep expanding my knowledge base before I head back into the real world again.

 

Chris Lew Reflects on Working With 2017 Opus Prize Winner

What is the Opus Prize? 

The Opus Prize is an annual faith-based humanitarian award that is designed to recognize and celebrate those people bringing creative solutions to the world’s most difficult problems. The award partners with Catholic universities, although recipients can be of any faith (Excerpt from Crux.).

Mercy Sister Marilyn Lacey received the Opus Prize from Regis, the host for 2017. Chris Lew, 3rd year Regis DPT student, assisted in her work in Haiti for displaced women and children as an Opus Student Scholar. Here is his reflection about his experience in Haiti, initially published in the Jesuit Journal of Higher Education.

Name: Chris Lew, Class of 2018
Undergrad: University of Portland
Hometown: Eugene, OR
Fun Fact: I have a whistle reminiscent of various fairy tale soundtracks…or so I’m told.

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Throughout my life I’ve had many opportunities for international travel – from travel abroad to Granada and London, a Fulbright scholarship to Madrid, and a service-learning immersion trip to Nicaragua, I have always considered myself blessed to be able to travel the world, experience different cultures, and see the world from a different perspective. Nevertheless, my time performing a site assessment in Haiti at Mercy Beyond Borders (MBB) for the Opus Prize was a unique and eye-opening experience.

MBB was founded more than 30 years ago by Sister Marilyn with the vision that education, especially of women, is the key to overcoming the widespread corruption and poverty that has consumed Haiti and South Sudan. Through my research of the Opus Prize, I understood this site assessment was different from the typical trip to an underserved community. From the initial interview to the final trip preparations, it was made very clear that the purpose of these trips was not to do; rather, the intention was to be, to see, and to experience. It was this aspect of the Opus Prize that interested me most in the organization and its mission. There is a plethora of groups in developing and underserved areas that perform charity work such as building houses and providing medical goods and services. While this service work provides a certain degree of benefit to the community, I have always been somewhat hesitant of this type of altruism because it generally fails to provide long-term, sustainable change to an underlying societal problem. What happens when the volunteers leave and no one is left to provide the necessary medical services? What happens when a fire destroys a new house and there are no resources to build a new one? This traditional type of charity work seems to be a superficial bandage over a much deeper, wider wound.

This is where Opus is different.

The Opus Prize Foundation emphasizes six values that it seeks in the recipient of the Prize. The one that stands out to me most is Sustainable Change. Rather than focusing on a top-down, government-focused approach to solve global issues, Opus intentionally sponsors and supports organizations directed towards community development and cooperation. Opus understands that the resolution of profound societal problems and corruption is ultimately driven internally, not externally. As such, the Prize acknowledges individuals who are addressing the root of social issues and are striving for change that is pioneered locally.

With this in mind, I embarked on my site assessment trip to Haiti with a very different perspective and intention than my previous international travels. The first stop on our trip was in Ft. Lauderdale, FL , where we met Sr. Marilyn, who lives in California and operates MBB in both Haiti and South Sudan. She introduced us to her story and illuminated details of the work she does with MBB. Her work in Haiti revolves around empowerment and opportunity for girls and women. Extreme poverty and corruption of the educational system prevent most children from obtaining a basic education. Most primary schools are private and, as such, require tuition as well as uniforms and books. Many families cannot afford to send their children to school or can only afford to send one child. In the latter case, most families opt to send boys rather than girls because males typically have greater opportunity for success than females in Haiti. As a result, most girls in Haiti only receive up to a 1st or 2nd grade level education. Sr. Marilyn and MBB attempt to ameliorate this disparity by providing secondary school scholarships, leadership development opportunities, and a safe and supportive living environment for girls who demonstrate academic potential. Additionally, MBB provides vocational and literacy training for young adult mothers and older women to develop skills such as reading, writing, computer skills, and baking. These skills provide women with greater independence and self-sufficiency and can even allow them to earn money through both formal and informal work.

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The following morning we took a short early morning flight from Ft. Lauderdale and landed in Port-au-Prince, Haiti. The contrast between our departure and arrival city–only a quick two-hour flight apart–was profound. Destitution was apparent on our short drive from the airport out of the city. Litter filled the streets and empty plots of land and stray animals ran largely unmonitored throughout the city. Sr. Marilyn explained that, due to political and financial reasons, much of the rubble from the 2010 earthquake was never adequately disposed of in many of the poorer areas of the capital. As a result, many parts of the city appear recently destroyed even though the earthquake was seven years ago.

Our initial stay in Port-au-Prince was short as our first destination was Gros Morne, about a five-hour drive north of the city. Gros Morne, a town of about 35,000 people, is the community that MBB primarily serves in Haiti. Following the earthquake in 2010, Sr. Marilyn noticed that many relief efforts developed in Port-au-Prince but much fewer resources made their way out of the city and into the more rural parts of the country. She understood that her vision for MBB in Haiti had its limitations and saw the most potential for change in a smaller community.

Our time spent in Gros Morne and the surrounding area was quick but powerful. To gain insight into the MBB’s operations and its community impact, we met with several partners and individuals associated with the organization. We were able to meet several of the girls who are a part of the educational program as well as their families and see the personal impact that MBB has on their lives and their future. We interviewed the principal of a primary school that hosts several of the MBB students; he had high praise for the organization, stating that many, if not all, of the students would be unable to afford their school dues if it wasn’t for the support of MBB. On our final day in Gros Morne we also met with Sr. Jackie, a missionary sister who has worked in Haiti for almost two decades. She provided insight into the corruption in the Haitian political and educational systems. She explained that the private school system is largely unregulated, meaning almost anyone can start a school. This inhibits children from receiving a high-quality education and prevents those students who have the potential to succeed academically from actually achieving success. Overall, these interviews and personal interactions further highlighted the need for an organization like MBB in Haiti.

Sr. Marilyn embodies the spirit of the Opus Prize and models many of the Opus values, including Sustainable Change, Faith, and a Life of Service. She understands that long-term transformation is driven from within, not purely from her work, and this is what directs her vision for MBB. Through empowerment and leadership training of the girls she sponsors, employment opportunities for the local people, and a conscious effort to have Haitian and South Sudanese representation on her Board of Directors, she demonstrates a continued commitment to sustainable change in these countries. A woman humble in both stature and personality, she demonstrates her love and passion for her work in Haiti and South Sudan through her relentless work. I was most impressed by her ability to understand the needs of the communities she works with, while also maintaining a realistic expectation of how many people one person and one organization such as MBB can effectively impact. Although her work may be relatively small in the scope of the vast corruption and poverty in Haiti and South Sudan, her heart is big, and it shines through in both her actions and words.

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