How to Make the Most of Your Clinical…in ITALY!

 

Name: Lydia Hamstra, Class of 2018
Undergrad: Gonzaga University, WA
Hometown: Tucson, AZ
Fun Fact: I am a huge Harry Potter nerd and to help prep for Italy I read Harry Potter in Italian (since I’ve read it so many times in English, I was able to figure out the gist—it gave me ideas for how to say certain phrases that I liked and thought I could use. I also believe reading in any language is the best way to learn new vocab!).

Lydia Hamstra is currently in Umbertide, Italy for her second clinical rotation. She advocated for and helped set up Regis’ first entire clinical rotation in another country.

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Ciao, mi chiamo Lydia Hamstra e sono una studentessa di fisioterepia di secondo anno a Regis University. I have a passion for neurological rehab and travel and my goal is to combine those in my future career. One of the reasons I applied to the DPT program at Regis is because of the global immersion and service they do. Traveling off the beaten path has been a value instilled in me by my parents from a young age. Immersing myself in different cultures helps me grow as a person and as a clinician; it also enables a different kind of learning. By being present, helping others, exploring, and embracing what and who you find, you can create durable bridges that connect you to the world. It also illuminates parts of yourself you may not have known about and fosters reflection. We all want to have a positive impact in some way–I find that I grow the most when I’m out of my comfort zone and helping others.

Over the years, I have come to the conclusion that the best way to travel is by combining it with education. Why Italy? Honestly, it is difficult to say where I got the idea. I thought the country was romantic and charming, and more approachable than other countries. I actually picked my undergraduate school because they offered an Italian degree and had a second campus in Italy. In 2012, I was fortunate to study and live in Italy with a family from Florence (I’m actually meeting up with them during clinical!). My experience in undergrad made me realize that despite it being a first-world country, there is still a lot of need and hardship. I experienced it from the student perspective and I wanted to give back from the clinician perspective. I also wanted to learn about a different healthcare system and the pros and cons of socialized medicine. The clinical education team at Regis is one of the best in the country, if not the best. They worked diligently to create this opportunity–not just for me ,but for all future DPT students. The DPT program at Regis now has a partnership with Eduglobal and I am doing in-patient neurological rehab at the Instituto Prosperius in rural Italia.


If you’re heading abroad for a clinical experience, here are 5 tips to help you make the most of your time!

1)    Find Ways Around the Language Barrier

First off, you don’t need to get OVER the language barrier—you don’t have to speak the language fluently (or even well) in order to communicate with your patients.  It is, however, helpful to learn simple commands in Italian; these are great to take back home and use in English if you’re someone like me who tends to be wordy (beware the rest of my post!).  Beyond that, focus on teaching by example and using non-verbal cues to get on the same page with your patient.

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Stander at the Institute Prosperius: she does not have voluntary control of her lower extremities.

2)    Learn to Go With the Flow

Yes, a global immersion or clinical is going to be different, and like any clinical out there, there will be things that you like and things that you don’t like about the system. Remember that Italian physical therapists, too, will be frustrated by certain parts of practice–be it communication, lack of resources, or decisions by doctors, to name a few.  Remind yourself that professional frustrations and problems are universal. And remember that you are there to learn about physical therapy and to embrace the culture as much as you can. Learn to breathe and be patient—both with yourself and with your colleagues.

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Home sweet home! @vignedipace

3)    Go Above and Beyond

Just like any class or clinical, the time and effort you put in will transfer to what you get out of it. I believe this is true with regards to patient management, the language, and your rapport with your CI, the other students, and the other Italian physical therapists. One of the biggest differences in Italy is that they do not document every session…or even every day. This has to do with healthcare being a constitutional right for Italians, whereas we practice defensive medicine #CYA. Even though that is the case here, I am documenting certain things because I want to know how my patients are progressing. In general, Italians have an expectation that you hold yourself accountable. They expect you to push yourself; don’t fall into the trap of doing only the minimum.

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Positano on a sailboat on the Almalfi Coast

4)    Exchange Ideas with Colleagues

Going to Italy is unique, also, because you are placed with other students from a variety of schools. They are all at different points in their schooling, which provides quite the mix of ideas and understanding. Take advantage of this to exchange ideas and techniques with other students. For example, one SPT from Shenandoah taught us how to do a CT manipulation in prone.

Side bar: It is awesome to have a group to explore Italy with.

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In Venice for the weekend!

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Venezia-social commentary on global warming and human efforts to maintain our structures. Venice is not actually “sinking”, rather the water is rising because of the human impact of warming the earth and melting the ice caps.

5)    Take Advantage of the Slow Internet

You may find you have extra time here, especially because the internet is not as fast or reliable as in the US and certain websites *ahem Xfinity ahem* are unavailable. (You can get Netflix and Spotify, though, so I can promise you will survive.)

Gripe about it for a day…and then let it go and be in the moment. Journal, walk around town, engage with the locals, practice Italian, talk to your peers, learn how to make pasta, or study for the comp exam. You’ll feel less dependent on technology and it’s actually been amazing to unplug. It has given me more time to reflect on what I’m learning about myself, our practice, the meaning of life, etc, and always with a glass of wine in hand.

Ciao bella,

Lydia

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Lovely day at Agriturismo Tenuta I Colli del Trasimeno!

My Immersion Trip in Ethiopia: A Reminder About the Importance of Communication

Name: Matt Gervais, Class of 2017
Hometown: Medford, OR
Undergrad: University of Portland
Fun Fact: I actually enjoy wearing ties.
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Matt Gervais, disguised as a bottle of Sriracha sauce, ran the Move Forward 5K/10K with his classmates in the fall

Every year, the Regis University School of Physical Therapy puts on a series of immersion trips around the world as part of students’ 3rd or 4th clinical rotation. Through an application process, around 25 students in each class get selected to participate in 1 of 4 immersion experiences. This year, the options were Ethiopia (available in Fall and Spring), Peru (Fall), and Nicaragua (Spring). I applied for and was fortunately selected to go on the Fall Ethiopia trip. The experience did not disappoint!
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Regis DPT students on the Ethiopia immersion trip (from left to right): Brent Ingelman, Alexander William, Matt Gervais, Elizabeth Heckmuller, Morgan Pearson, and Amanda Morrow

Six of us students and three faculty members took part in the trip.  We students worked in several different hospitals around Addis Ababa, the capital city of Ethiopia.  One other classmate and I worked in an outpatient clinic at Yekatit Twelve Hospital, a government-run hospital near the center of the city.  In Ethiopia, inpatient physical therapy and initial mobility work is far less common than it is in the US, so most PT is outpatient PT.  The Yekatit 12 clinic sees a huge variety of patients: post-stroke, spinal cord injury, low back pain, post-fracture contracture, post-burn contracture, Guillaine-Barré syndrome, and many others.  Several things jumped out to me about the clinic: the small space available (coupled with a ton of patients), the lack of clinic resources, and the positive mindsets of the patients.

img_3531The small clinic was very crowded from the time we arrived at work in the morning until the time we left the clinic at noon. Because physical therapy is not the most lucrative career in Ethiopia, many PTs only work 3-4 hours per day in the morning and work other jobs in the evening. As such, every patient with a prescription for physical therapy would come to the clinic early in the morning and wait—sometimes up to 2-3 hours—to be seen. Naturally, this meant we had very limited space to use for treatment in the clinic.

Also, the clinic lacked many resources that we take for granted in outpatient clinics in the US; we learn to expect high-low tables/mat tables, exercise equipment, private rooms, a large selection of weights, and space to do a variety of PT interventions. I believe every student on the trip learned to be significantly more creative through the process.  For example, several times we used a makeshift combination of theraband, a dumbbell, and an ankle cable attachment cuff to create a forefoot weight, along with many other techniques that can only be described as “winging it.”

In any event, we made the small space and relative lack of resources work. And, despite the shortage of space and equipment, patients managed to maintain a very positive attitude and constantly work towards their goals. These attributes, coupled with an unwavering respect for healthcare practitioners, undoubtedly contributed to improving their outcomes.

Because of our short clinic hours during the mornings, we worked with many Non-Government Organizations in the afternoons. Our work included teaching basic nutrition, basic first aid, and performing PT at several different aid organizations. We also collaborated with students from the Regis-sponsored DPT program at Addis Ababa University—the first program of its kind in the country. Between our work and simply exploring the city, it was an incredibly busy and transformative trip.

Ultimately, my greatest takeaway from our trip to Ethiopia was the importance of communication. I started the trip assuming that many of our patients would understand English, at least to some extent. My first day in the clinic disproved that assumption, though, and I had to rapidly scramble to learn basic Amharic words so I could create some form of communication with my patients. In the end, I was not very successful during my short trip, but I learned to lean more on teaching through demonstration. I was reminded that, even in patients that do speak English, you can never underestimate the value of demonstrating a task to help a patient learn.

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Beyond all else, my immersion trip to Ethiopia reminded me that communication is paramount. As PT students and future healthcare professionals, we often are focused entirely on providing the most optimal care as efficiently as possible. However, without effective communication and rapport, that optimal care will likely never be delivered effectively. This program was a tangible reminder that sometimes strong communication can trump every piece of optimal practice that research can provide. I believe I can speak for every student and faculty member on my trip in saying that the Ethiopia immersion trip was a fantastic and informative experience. I highly recommend it to anyone in the program—even if you don’t necessarily have an interest in travel. Each trip is an invaluable experience to work with populations you rarely get to work with and is a unique opportunity to hone your clinical skills, communication skills, and intercultural awareness.

Flat Stanley Goes to Clinical

Name: Nicole Darragh, Class of 2017

Hometown: Columbus, OH

Undergrad: Regis University

Fun Fact: I think kale is totally overrated.

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The Class of 2017 recently returned from their second clinical rotations with a plethora of new knowledge and stories to share.  Some students even had a visitor along the way: Flat Stanley.  Flat Stanley is a small paper figurine that keeps students connected outside of the classroom.  Students take a photo of Flat Stanley completing an activity, learning a new technique, or going to a cool new location, and share those photos with their classmates through social media.  This helped us learn a little bit about each rotation, and keep in touch with our classmates.

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Pictured: Sarah Campbell ’17 with Flat Stanley on her first day of clinical (PC: Sarah Campbell)

Flat Stanley traveled to a wide variety of locations across the country including California, Wyoming, Kentucky, and even Alaska!  Along the way, Flat Stanley learned new documentation systems, new techniques in the clinics, and went on a lot of hikes.  Really, what Flat Stanley is trying to tell you is that while you’re on your clinical rotation, don’t forget to take the time to explore your new surroundings!

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Flat Stanley reviews Functional Electrical Stimulation (FES) while at clinic in Chico, CA (PC: Adam Engelsgjerd)

 

Clinical rotations work in a variety of ways.  The first is the lottery option; students choose ten clinical sites from a large list compiled by the clinical education faculty, and rank them in order from 1-10.  Once the lottery is generated, students are placed at a site.  The second is the first come, first serve option; students can choose a site before the lottery begins that they are particularly interested in, and request to be placed at that site before it is taken.  The third is the set-up option: students are allowed to contact a clinical site that is not affiliated with Regis and set up a clinical rotation with them if they are interested.  When rotations get closer, you’ll learn more specifics about how they work, requirements, etc.

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Flat Stanley’s meet up at Devil’s Tower outside of Gillette, WY (PC: Amanda Morrow)

 

Throughout the clinical process, it is important to know that you might not always end up in Denver, and you’ll have to try something new!  Wherever you do end up, make sure to enjoy your free time.  Clinical can sometimes be very overwhelming, and it is crucial to take time for yourself, whether that be exploring your new surroundings, trying a local restaurant, or binging on Netflix.  And if the thought of being gone for six, eight, or twelve weeks scares you a little, all of us will tell you that the time flies by so quickly.  There isn’t much time to be bored!

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Flat Stanley goes sandboarding in the Great Sand Dunes National Park in southern Colorado (PC: Lauren Hill)

 

If you have any further questions about clinical rotations–or other places Flat Stanley and/or students traveled–please feel free to contact me at darra608@regis.edu!  Also, I would recommend reading the post below called “Class of 2017 DPT Student Lindsay Mayors Reflects on Her Clinical Rotation.” (https://regisdpt.org/2016/05/27/class-of-2017-dpt-student-lindsay-mayors-reflects-on-her-clinical-rotation/)

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Flat Stanley helps out with some end-of-the-day documentation (PC: Amy Medlock)

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Flat Stanley enjoying a nice Moscow Mule after a long week at clinical (PC: Amy Medlock)

 

 

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Flat Stanley joins Lauren Hill and Jenna Carlson to run the Bolder Boulder race (PC: Lauren Hill)

Cover PC: David Cummins, Class of 2019

 

Global Health Immersion: Students in Peru

In preparing my capstone presentation and reflecting on the last three years in physical therapy school at Regis, I began to see a theme linking all of my most rich experiences from which I learned the most: discomfort. From patient labs and practical exams to clinicals to presentations to service learning, we are constantly thrown into situations where we do not know exactly what to expect, are not sure of our abilities, and have to be willing to be flexible and a little bit vulnerable. These are the times we grow and learn the most. The global health immersion to Peru this spring was no different, and it even amplified those familiar feelings of unease. But I have found that those times of the unknown, unexpected, and unsure are the times when the most growth occurs. I feel fortunate to have had the opportunity to participate in the global health program at Regis, to learn from the people of Peru, to challenge myself to practice with cultural sensitivity, and to gain a better understanding of a culture different from my own.

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Third year students Allie Smith, Elena Absalon, and I traveled with Dr. Heidi Eigsti to Peru where we spent three weeks working with therapists and patients in the city of Huancayo. We spent much of our time with the Catholic Medical Mission Board (CMMB), which is a Non-Governmental Organization that serves primarily women and children.

CMMB has two programs in Huancayo. The first is CHAMPS, which focuses on promoting health, hygiene, nutrition, prenatal care, and access to health care providers. The second, with which we worked, is Rehabilitación Basado en Comunidad (RBC), or Community Based Rehabilitation. The program focuses on serving children with disabilities and their families in the most impoverished neighborhoods in Huancayo, Chilca, and Azapampa. Two physical therapists, Carmen and Loreley, and one psychologist, Lucia, care for 40 children and their families with both home and clinic-based treatment. The goal of the program, in keeping with the World Health Organization’s initiative to improve accessibility for people with disabilities around the globe, is to provide community-based rehab that is relationship focused and incorporates functional activities into everyday routines to improve patients’ participation in their homes and communities.

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The impact that RBC was having on the community in Huancayo was evident. The families with whom we worked were well educated on goals of therapy, extremely involved in home exercise programs, and motivated to do whatever they could to help their child improve. The therapists focused on all aspects of the child’s well-being and had developed strong relationships with them and their families. The Jesuit value of cura personalis was definitely at work, incorporating mind, body and spirit into care. The therapists put together events to connect the families, and they were working to develop of community of support. It was a valuable learning experience to see such a team-based, holistic approach being implemented in an underserved community. CMMB is definitely working to create a sustainable solution to removing the barriers to health and participation faced by the women and children of Chilca and Azapampa. That sustainability is imperative in making a lasting difference in the area, and I am excited for future Regis students to have the opportunity to continue to develop this new relationship with CMMB.

I should mention the whole immersion wasn’t all work. We went on an artisan tour in the mountains surrounding Huancayo where we learned about gourd painting, silver jewelry crafting, and textile production. We hiked to the glacier on Huaytapallana mountain at around 16,000 feet and completed a three-day trek to Machu Picchu City. These experiences introduced us to more of the beautiful landscape and culture of the country, and we were welcomed everywhere we went by warm people of Peru.
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Blogger: Abby Burger, Class of 2016

 

 

Taking a gap year before Regis PT school: Meet Mason Hill

Name: Mason Hill

Hometown: Tacoma, WA

Undergrad: California Lutheran University

Fun Fact: I think I have a cold.

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Congratulations are in order! You’ve completed the long and arduous process of applying to and interviewing for a position in a top-ranked physical therapy school. You should feel a genuine sense of accomplishment for being considered to be a part of the Regis DPT program.

This post is for the candidates that will unfortunately not be receiving a letter of acceptance this year.

When I first applied to PT programs I felt relatively good about my chances of acceptance. I had a strong resume and GPA, would be published in multiple scientific journals before graduation, and had just received the American Kinesiology Association Undergraduate Scholar award.

That being said, I failed to even receive an invitation to interview at my top choice, Regis University.

I did, however, gain acceptance to a program that shall remain nameless, and one which I knew very little about.  I started doing my research on the university’s staff, mission, and facilities and was not pleased with what I saw. I had been working toward PT school since I was 16, and I felt a considerable amount of pressure to accept the position.

After a long conversation with a current student of that program, I came to the conclusion that I would reject the position and reapply to my top choices the following year; it was far and away the best decision that I have ever made.

The odds are good that if you, the reader, were invited to interview at Regis, you have been accepted to some other program. I do not write this to discourage you from attending said program, but to encourage you to follow your intuition and reassure you that waiting another year and once again dealing with the dreaded PTCAS is not the end of the world. You’ve got plenty of options.

Here’s what my gap year looked like at a glance:

After crunching the numbers I decided that going to the UK for a MSc  program would not be financially feasible; so, after graduating college, I packed my bags to head home to Tacoma, WA to plot my next move. During those first few months at home I turned my attention to PT in developing countries.  After doing a bit of research into disability rates and the prevalence of physiotherapists in the developing world, I was hooked. Within a few weeks I was headed to Tijuana, where I spent the next two months volunteering in various clinics and at a school for children with special needs. During those two months I reapplied to Regis, was granted an interview, and made plans for my next trip to work for 4 months in a physiotherapy clinic in the Kingdom of Swaziland.

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When it came time to answer that all important question “what have you done to improve your application?”, I had too much material to work with. The beautiful thing is that not only was that year spent out of the classroom the most enriching and transformative time of my life, but it also enabled me to gain access to what I believe is the program that is best-suited to serve me as a student of physical therapy.

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If you are faced with a year away from academia (by choice or not), it will undoubtedly look different than mine. Just know that you can do with it whatever you like. (Personally I would suggest a bit of solo travel to a foreign country. In my opinion there is no better form of education.) However you decide to spend the next year, be sure to take the opportunity to grow as a person and future clinician.

If you have any questions about how I was able to fund my year of travel/volunteering, how to make connections and find opportunities in other countries, or anything really, feel free to contact me at hillmasond@gmail.com.