How You Got Your Start: Involvement in YOUR Professional Association
Estimated Reading Time: 7 minutes
When talking to current students about getting involved and engaged, common questions arise: Where do I start? How much of my time will this take? And maybe even, but what's in it for me?
So in an effort to help other students get their feet wet when it comes to getting involved in APTA, we asked members how they first got involved or engaged. Below they tell us about the first activity, event, or project that got them involved and how they took that first step.
Honestly, my first taste of involvement was with my current position as a state core ambassador. Between seeking information to help the students from my state and my first conference at NSC, I was hooked! My school has always been big on involvement and engagement with APTA, so prior to holding a position, we ran some local events promoting the profession. –Josie K.
My physical therapy program was looking to send several students to attend NSC. A few of us decided to go for the fun of the trip, if nothing else. We came away from that weekend with lifelong friends from all over the country. One student I chatted with at conference said something appealing to me about APTA leadership. Get students and PTs/PTAs to conferences, and I believe the benefits of membership and leadership will sell themselves. Fifteen years later, 3 of the 4 of us sent to NSC by our school that year are still involved in chapter and section leadership. –James S.
One of my involved classmates was honestly the reason I learned half of what I did about APTA. So I think building those connections to create more comfortable conversations is always important. Twitter was also a key player. I was outreach challenge director (Community Service Challenge) for our state chapter student special interest group my second year! –Bryn H.
I was asked to join the newly formed New York Chapter SSIG as a regional director. My role was to act as a point of contact to disseminate communication to physical therapy schools in my area. –Allen E.
My first involvement activity was when I attended the MPTA spring meeting. Meeting and speaking with like-minded students and professionals was such a thrill. I met Micah Secor and he encouraged me to get involved with the chapter SSIG. I haven't looked back since, and am always excited for the next opportunity to advocate for our profession! –Matt N.
I am fortunate enough to have great leadership role models at my school with a former and current chapter president in the faculty. We also have the current vice president of the APTA Board of Directors on staff here at MUSC. After watching them lead, seeing their network, and watching them utilize their positions to reach us as students, I was determined to get involved somehow. It just so happens that I met the Student Assembly Board of Directors at NEXT 2017 in Boston. They modeled everything my professors did, but at the student level, and that's when I became determined to be part of that group! –James N.
One of my actively involved classmates got me involved. I was lucky enough to share a room with her at CSM 2017, which then led me to get more engaged, attending conferences (AZ student conclave, NSC 2017, and CSM 2018). Because of that I have now volunteered at multiple events and booths at conferences! –Samantha S.
I wasn't really sure where I fell into place initially, but I happened to sit in on an informational session about leadership and involvement with some former APTA Student Assembly Board of Directors members in my chapter. I decided to ask questions and be engaged because I wanted to learn and do more for my profession. They saw my desire for engagement and urged me on to further opportunities, and that led to getting more involved. I showed up, asked questions, and sought out mentorship from the right people. –Dan D.
I showed up as a student to something where leaders were, but students weren't—NEXT 2016 PT-PAC night. I asked questions, I was present, and I pursued and fostered relationships at the local and state level, and they introduced me to people at the national level. I attended conferences. I never “networked”; I made friendships. Something I'll never regret: getting engaged on social media. –Timothy R.
I initially got involved in my state. First, just at the school level as a student liaison to the chapter SSIG. After 2 years of that, I got up the courage to run for president of the SSIG! I think one of the most important things about involvement is trying to discover what fuels you. Joining a chapter or section SSIG is a great way to start and listen to those in leadership. –Sam C.
I attended CSM and APTA's Federal Advocacy Forum during my first year and I was hooked, but I didn't really discover how to become more actively involved in leadership roles until I attended NSC during my second year. Take it from me, go to NSC! –Alyssa B.
I applied for an APTA Student Assembly Board of Directors position on a whim as a second-year student with no concept of what that actually entailed. I didn't get an interview, but I made lots of connections with other involved students and ended up attending NSC 2017, which led to lots of opportunities I never knew about. –Aly B.
Being involved was something that carried over from undergrad. I sought out one of the students who was on the chapter SSIG, and then I ran for his position my first year. Before that, I volunteered as an usher for the FPTA annual conference; there I met other students who worked on the SSIG with me later. I attended all of the state conferences my first year and APTA NSC, since it was in my state. This year, I've made it a goal to attend all of the national conferences. I was also blessed to be the APTA Student Assembly global outreach chair this year, which has expanded my #PTfam exponentially. –Kristie S.
My involvement ranged from APTA representative for my class, Move Forward PT brand champion, and the APTA Student Assembly professional advocacy project committee. –James M.
I got involved with APTA ever since I attended NSC 2016. Initially, I wasn't sure what to expect since this was the first time attending NSC for me and my classmates from the University of Puerto Rico. –Jose C.
NSC, big time! But before that, my interest was sparked by a fellow classmate who was our state's APTA Student Assembly core ambassador –Brian D.
Mine was an NYPTA fall meeting. I met the leadership committee chair who encouraged me to plan a student conclave, and connected with our core ambassador at the time, who encouraged me to start a chapter SSIG! –Bronte M.
I applied to be an APTA liaison for my class with ZERO idea what I would be doing. From there, I joined my chapter SSIG, after wanting to learn more about how the machine that is physical therapy actually moves. Many people along the way have helped me learn, and I recommend it to anybody who's remotely curious –Jake R.
Listening to my fellow classmate talk about her experience at APTA's Federal Advocacy Forum (FAF) 2017 and the importance of it is what got me excited; so this year I sought out faculty, so I could do the same! Stoked to be a part of FAF this year. –Anya V.
I agreed to be the APTA liaison for my school. At the time, all I thought I was doing was forwarding an email once a month from our core ambassador. Later, I found out that part of my position was to organize the PT Day of Service events for my university. Then I went to NSC! –Rachel B.
I served as my school's Foundation for Physical Therapy Marquette Challenge coordinator, then the Federal key contact for MN, then I became an APTA Student Assembly Project Committee member, then chaired a committee, and finally I ran for the APTA Student Assembly Board of Directors. Not to mention, I attended chapter and national conferences in between. Take it from me, get on social media! –Domenic F.
I had almost zero leadership or involvement experience prior to getting involved. My chapter sent out a scholarship application for a student to attend APTA's Federal Advocacy Forum, and my thought was "Well, I don't know anything about advocacy, but hell, why not?" At the conference is where I met the APTA Student Assembly Board of Directors, who stayed in close contact with me and made me feel connected to something bigger than myself. The rest is history! –Keaton R.
My first activity was attending the Arizona student conclave at the end of my first year. I told the SSIG leaders at the time that I was interested in getting more involved. –Ariana J.
I started by becoming more involved in my program. After that I attended SSIG meetings, and I applied for a leadership role within the SSIG my second year, which led to me going to national conferences like NSC and CSM, and the rest is history! Start small and go from there! –Mindy T.
Want to get involved or engaged in APTA at the national or local level? Email your APTA Student Assembly Board of Directors and they will help you find an opportunity that fits your interests, your schedule, and more.
Want to share how you got your start getting involved or engaged with APTA? Leave a comment below.
The False Pursuit of Landing the Dream Job
Estimated Reading Time: 7 minutes
The pursuit of the dream job seems to be the ultimate quest in today's society. Many people have a vivid mental picture of the hypothetical job that would check all of their boxes.
Throughout your upbringing, you were almost certainly prompted to "follow your passion" by family, friends, teachers, and mentors. While this idea is appealing, only a small percentage of individuals ever find that perfect career path.
So what can you do to ensure that you find satisfaction in your work life?
I propose a shift in mindset: Rather than seeking out and pursuing the fabled dream job, aim to create such a job through thoughtful consideration. I'll elaborate on 3 important elements of this strategy, as well as practical means for implementation.
Don't Follow Your Passion
While it may seem cynical, this advice from Cal Newport has changed the way I view career development and the pursuit of meaningful work. In his bestseller So Good They Can't Ignore You, Newport purports that career passions are rare and are actually a side effect of mastery. In other words, most people don't actually have a preexisting work-related passion, but, rather, they develop one as they get better at their jobs.
While you likely pursued physical therapy because you find it rewarding to help people, a more specific career mission will present itself as you develop expertise and gain responsibility. This specific mission will drive your future work and blend the criteria for a meaningful career. The dream job arises not by chasing a preexisting passion but as a result of dedicated work and subsequent mastery that mold a unique passion over time.
When mastery is coupled with increased autonomy and a newly chosen mission, it creates a recipe for an enjoyable career. Pursuing and attaining this trifecta allows you to create a dream job. By shifting your focus to how you work, you will increase your value and create opportunities to pursue fulfilling work.
So how can you put this into action?
First, drop the pursuit of the uber-specific dream job that will be incredibly difficult to obtain. While the small odds of achieving this job exist, the reality is that this quest will likely only lead to frustration and anxiety. Understand that this single job is not the pinnacle of a successful career—there are multiple paths, all equally fulfilling in the end. Instead, shift your focus to getting really, really good at the basics. Mastery requires years of disciplined, consistent work. This means that every time you step in the classroom or the clinic, you have to approach your work with an open mind, soak up knowledge, and practice deliberately to improve your skills as a physical therapist. Rather than pursuing a niche population or area of practice, such as children with a rare developmental disorder or a particular professional sports team, focus on a general practice area, such as pediatrics or sports, and work to develop your skill set.
Expertise is valuable. As your skills improve, opportunities aligned with your goals and interests will present themselves. Whether they are clinical management roles, work with niche patient populations, or other opportunities outside of a traditional practice model, these opportunities offer increased autonomy and responsibility, which are crucial to meaningful work.
Consider What You Can't Control
While you can control the actions you take to realize your dream job, it is also important to consider the factors you cannot control.
Let's face it, some people are lucky, while others are not. If you don't think this is fair, I would tend to agree with you. The good news is that you can probably increase your likelihood of being lucky by critically analyzing relevant external factors.
The first thing to consider is timing.
In his book titled Outliers, Malcolm Gladwell seeks to understand why some people are successful. But rather than focusing on individual character traits, he analyzes the world that surrounds these people. In several well-supported cases, he elaborates on the crucial role that timing plays in determining who is successful and who is not.
The world evolves, fluctuations occur, and things constantly change. This thinking can be applied to physical therapy as well.
Our profession is much different from what it was a couple of decades ago—the economy, technology, our education, and even our practice models have changed. With this in mind, consider what our profession looks like now. All states have some form of direct access to physical therapist services. More clinicians are moving to cash-based practice models. Physical therapists are becoming more specialized and working with increasingly niche patient populations. These are just a few of the notable developments.
By identifying these changes, you can start to predict how the profession will continue to develop going forward. This is crucial, as valued opportunities will generally go to those well-positioned to seize them. This leads into my next point—opportunities.
To capitalize on an opportunity, you have to be in the right place at the right time. Once you point your arrow in the direction you wish to pursue, consider where you need to position yourself.
Geography plays a huge role. Some areas have a high demand for particular services, while others do not. Some opportunities are available only in specific cities or regions.
Consider your connections, too. Do the networks of your faculty members align with the networks you want to join? If not, you may need to look elsewhere to develop these relationships. Are your classmates or coworkers active in professional organizations? Do they have similar interests to yours? If not, you'll have to use other means to connect with like-minded individuals. Fair or not, "who you know" is definitely important. By having solid connections in the area you're trying to break into, you'll increase the chances of being presented with desirable opportunities.
Accumulate Relevant Experience
By considering the external factors discussed above, you can increase the likelihood of being in the right place at the right time.
The next step is to make sure that you are ready to seize the desired opportunity when it's presented. If you don't have the necessary expertise or experience, someone more qualified will likely be granted the position. To be prepared, you need to have what Newport refers to as "career capital"—rare and valuable traits and experiences that uniquely qualify you for a given opportunity.
When you have skills, knowledge, and experience that make you valuable to an employer, you can "cash in" this capital for a position.
So how do you acquire career capital? Obviously you have developed a base of knowledge and experience during school and clinical rotations, but this is really the bare minimum. To stand out from others pursuing the same opportunities, you need to provide unique value.
Residencies are a fantastic opportunity that could very well push you ahead of the pack. They will allow you to gain experience and learn how clinicians in a given area work with other associated professionals. All areas of practice have unique environments, so understanding the climate and relationships definitely will give you a head start.
Even completing internships with associated professions outside of physical therapy can be valuable in many cases. If you are interested in pursuing academic positions, working as a teaching assistant or helping out in a research lab can be an excellent start.
If you are looking for leadership opportunities, there are plenty of ways to get involved within APTA nationally and locally, in your state chapter. Remember, these experiences don't have to be specific to the opportunity you are after—they just have to be relevant. You are limited only by your creativity! Having a diverse background of experience in extracurricular activities will absolutely differentiate you from others and make you a more attractive candidate.
It is truly an exciting time to be entering our profession, as increasing autonomy and ambition are resulting in new practice opportunities for therapists willing to go after them. If you want to move past the traditional model of practice and pursue a unique, fulfilling career path, these considerations will certainly help. If you are willing to work your tail off and put yourself in the right positions, the sky is the limit for what you can achieve.
Thornton Johnson, SPT, is a second-year student at Southwest Baptist University and is the APTA core ambassador for the state of Missouri, as well as chair of the MPTA Student SIG. You can connect with Thornton via email at: firstname.lastname@example.org and on Twitter at @ThorntonSPT.
My Whole Body Is a Nervous System: The Anxiety Diaries of an SPT
Estimated Reading Time: 10 minutes
Welcome to year 2, day 1, of my doctor of physical therapy program. I leave my musculoskeletal dysfunction class early so I can make my first appointment with a therapist at my school's Counseling and Psychological Services (CAPS) office.
On the fifth floor, I tell the psychologist that I had trouble sleeping during first year more often than not. I tell her my mind was racing every night during my first clinical in the summer, even without any tests looming. I tell her that I stress about being stressed. I tell her that I might have "like, a little anxiety or something."
Spoiler alert: Six months later, I can tell you that I definitely have anxiety. I should add that I am not a mental health professional or a wellness guru. And I couldn't even begin to capture the intricacies of living with mental illness beyond my recent attempts to understand what it means to deal with anxiety. Everything stated in this article is from my own experience navigating the mental health system as a physical therapist graduate student.
What is anxiety? Mine is mind-racing, heart-pounding, muscle-aching stress. It's constant fatigue and the necessity to eat snacks all. the. time due to energy depletion from lack of sleep and incessant worrying. Irritability. Restlessness. Feeling like I'm not in control of any aspect of my life. Drowning in uncertainty 24/7. Not having the motivation to pay attention in the classes required for me to complete the degree that's setting me up for my future life. I'm tired just writing that.
In isolation, these typical signs of anxiety might strike you as "normal" for a student physical therapist, especially if they occur before or during an exam. And while it is normal (and can even be good!) to have stress in life, especially in a rigorous graduate school program, it is not normal to feel as though your whole body is a nervous system. .
If I look back on my life, I had probably been dealing with anxiety since adolescence, but I didn't know what to call the nebulous cluster of seemingly-unrelated symptoms until recently. Before now, I hadn't experienced them simultaneously and so intensely. I chalked them up to me being stressed because of my perfectionist tendencies, and I convinced myself I'd be able to handle it. I never felt like I had everything under control, but I repeatedly told myself, "everything's fine." .
My grades were high enough for me to be accepted into an excellent DPT program. I hadn't come close to failing any classes. I had a part-time job, volunteered regularly, and became the class representative for our curriculum committee. All this is to show that I looked like someone who knew how to excel on paper. To the outside world, I looked "fine." .
Inside though, I felt like that pit in my stomach, filled only with dread and apathy. My waking thoughts were of my overwhelmingly full to-do list, which allowed no time for myself or my personal interests. For weeks on end I wondered, "Who the heck has time to eat, sleep, AND exercise? I need to be studying!" But I didn't even want to do that. Every time I thought I might reach a mental breakdown, I was granted a reprieve by virtue of the break between trimesters. .
At this point, you might be thinking, "I know those feelings. I'm screwed." Thankfully, I'm here to offer some good news: You can do something about it. .
If you're not struggling with something in life, you're in the minority. Maybe it's a DSM-5 recognizable mental illness. Maybe it's grief from the loss of a loved one. Maybe your partner broke up with you, and it's hitting you harder than you anticipated. Maybe it's finances, or purpose, or burnout. Maybe you can't even identify a single trigger or event that may be causing your distress, but you know that you don't feel like yourself. Whatever the case, you can (and should) ask for help from a professional, because we all deserve to be well. .
Why did I finally go to talk therapy? Frankly, I got tired of feeling tired all the time. I had a LOT of knowledge on how to be well, but I wasn't putting it into practice. I didn't like that I was constantly seeking reassurance from my peers and professors to tell me that I was competent and valued. (If that rings a bell, read Cruz Romero's article on imposter syndrome.) And I went to CAPS because I have big ambitions! My anxiety was firmly standing in the way of my potential as a student and future clinician. I didn't want to be the accomplice. .
So, here's what you can do to help yourself. Find out whether your school has a counseling office; many do. They should have a website and a phone number. They may even have an online screening tool to see whether professional counseling is right for you. If not, you can check out this site. If you can't find any services, ask 1 of your program's administrators to direct you to them. Your faculty members are literally paid to help you succeed. Talk with someone. Make an appointment. Go! .
If you're still not convinced, here are my top 8 reasons why you should talk with someone ASAP about your mental health (+ 1 reason why I'll accept that counseling might not be for you right now):
* Disclaimer: The information presented in this article is not intended as a substitute for care from a mental health care professional. The author's opinions are her own."
Everyone else is doing it—they're just not talking about it. After I started going to therapy and sharing my experience, I was shocked at how many classmates told me they were going to or had been to counseling. We tend to keep it hush-hush because mental illness is still so stigmatized. Mental health problems can leave you feeling isolated and lonely, but by no means are you the only one with issues. I've even talked with faculty members about their feelings of anxiety.
You don't need to be at a breaking point to get counseling. You can still benefit from talking to someone or seeing a mental health professional! Physical therapy is beginning to address prevention and health promotion. Think about this within the context of your brain health. Instead of training new movement patterns, you'll focus on training new thought patterns. Just like physical therapists see patients across the spectrum of physical functioning, mental health therapists can provide suggestions for you at any stage to keep your emotions and your stress at manageable levels. Be proactive.
You have to advocate for yourself; other people don't always see your struggle. Case in point: During an oral exam, one of my favorite professors told me, "You need to be more confident!" I, in sheepish frustration, blurted out, "Well, I have a lot of anxiety." My professor responded, "Really? You don't seem like it! It's not, like, debilitating, is it?" Was that the right venue to disclose my anxiety? Probably not. The point is that faculty with whom I regularly interact had no idea I was having problems. And even if your peers notice that something is wrong, they might not know how to intervene. Streamline the process and be your own best mental health champion. I believe in your power to use your voice. I believe in you.
Your friends, family, and support network are not substitutes for a trained therapist. Compassion fatigue is real. And it happens when a person such as friend, family member, teacher, or physical therapy practitioner accumulates feelings of stress from other peoples' experiences. I'm not saying you can't vent to any of these people—ask my roommate, she'll confirm I do this all the time—but talking about personal issues can be draining on relationships, especially if it's not reciprocal. All healthy relationships need boundaries. Do friend things with your friends! Enjoy your family time. Manage personal stresses by seeing an objective third party who can talk with you about your personal stresses at a designated time and space. Mental health professionals have the expertise to provide you with research-based, clinical tools to help you meet your needs.
You can lead by example. Cultivate an academic culture that's focused on student learning and well-being instead of grades. Teach others that everyone deserves the right to thrive, not just survive. Part of being a professional is learning to take responsibility for yourself—and that includes your health. Asking for help doesn't mean you're broken or doomed or incompetent. If you're still questioning whether you should do this for yourself, at least do it for your patients. One of the best analogies I heard at CSM 2018 was if you're on an airplane, you need to put on your own oxygen mask before anyone else's. You can't treat patients effectively if you're not taking care of yourself. This brings me to my next point….
You might become a better clinician. Going through counseling helped me better understand what life is like for my patients living with mental illness. Making time for appointments, putting in the work of being vulnerable, practicing skills throughout the week, calling insurance to see whether visits are covered, figuring out if you like your counselor, etc. It's a lot to handle when you're already down. What better way to understand the system than to immerse yourself within it?
You have time for regular appointments with a therapist. You don't have time to NOT go see a therapist. I can't tell you how much time I wasted during undergrad and my first year of PT school because I didn't have my mental health under control. I wasn't optimizing my study time in order to make personal time. (FYI, staring at notes while not absorbing material and scrolling through Instagram for half an hour is not efficient or beneficial.) Maybe you think things will just get better after PT school. News flash: "Real" life can be just as demanding as school; don't you want to have some tools in your toolbox to deal with it? There will always be 24 hours in a day, and you will never have more time than you do now. It's much easier for me to justify missing part of a class for an appointment than it would be to cancel patient appointments or leave work early once I'm a practicing PT. Set yourself up for success by investing in yourself now.
You can afford regular appointments with a therapist. At my school, all CAPS visits are free for enrolled students. A few visits may be enough to get you through your tough time or give you skills to prevent a real breakdown from happening in the future. If you need to be referred out for further counseling, it can be expensive. But, you can still shop around for someone who fits your insurance plan. Some places offer free services or reduced rates for those in need. Again, think about this as an investment in your health—current and future.
But, you just really, really don't want to/can't go to therapy right now, even if it's logical. Sometimes there are extenuating circumstances which make any type of therapy (physical therapy, counseling, etc) out of the question for right now. Maybe you've seen this in your time working with patients. Sometimes we're stubborn or in denial about the extent of our distress. Sometimes we have external family commitments. Sometimes we just really, really can't find the time or money. If this is you, here are some very basic strategies I've found helpful to increase resiliency and boost your mood for the time being.
- Use a meditation app to take 5+ minutes for a mental reset.
- Write a gratitude letter or copy down 3 things you're grateful for every day.
- Take a walk and focus on objectively noticing your surroundings.
- Keep a journal.
Don't use these as the magic pills which preclude you from seeking counseling to discuss your issues with a trained professional, though.
IF YOU ARE IN A CRISIS OR CONSIDERING SUICIDE, GET HELP NOW and/or CALL 911.
The following resource directories are free and available 24/7:
With these tips in hand, I'll remind you that I am not a mental health professional or a wellness guru. And I couldn't even begin to capture the intricacies of living with mental illness beyond my recent attempts to understand what it means to deal with anxiety. Everything stated in this article is from my own experience navigating the mental health system as a physical therapy graduate student.
Heather Beaudoin, SPT, is a second-year DPT student at Northwestern University. You can connect with Heather via email at: email@example.com.
Take a Moment to See the Forest
Estimated Reading Time: 3 minutes
Recently, I attended a lecture and the speaker said that as students we are constantly hitting trees. This quiz, that test, and on and on.
But his advice is that as students we need to take a moment now and then to look up and see the forest. And while it seems like a challenge in the midst of life as a student, I couldn’t agree more.
Most students can relate firsthand to feeling burned-out or overwhelmed at a point or two during their time in school, and when that happens, it’s easy to forget how exciting learning can be. We get so bogged down by trying to demonstrate knowledge and perform well, that we lose sight of our motivation. It’s defeating to even thinking about how uninspiring it is, but I’m here to tell you about a recent experience that allowed me to see that breathtaking forest. That experience was the American Physical Therapy Association’s (APTA’s) 2018 Combined Sections Meeting (CSM) in New Orleans, Louisiana.
Looking at the CSM schedule prior to arriving was overwhelming and electrifying at the same time. There were sessions for every specialty and subspecialty that you can think of. Admittedly, the bright-eyed, slightly nerdy girl in me, found that trying to choose 1 session to attend was the most difficult part of my day.
In the sessions I was able to lift my head out of the textbook, sit, and absorb the knowledge of the innovative thinkers around me. After every session I left invigorated. When walking between sessions everyone was buzzing and discussing the interesting information they learned. Overall, I was inspired knowing that there are endless opportunities within our profession, and wherever your passion lies, there is a way to integrate it into physical therapy.
The sheer size of the exhibit hall was astonishing. While some people went in with a system, I roamed around like a child in a candy store. I bounced from one booth to another, as they caught my eye. I quickly realized that exhibitors were jumping at the bit to chat with all the fresh-faced students. Just seeing the number of clinics represented gave me reassurance about the job security that our profession offers, and confidence that I’ll be able to pay back those student loans one day!
Pediatrics is where my heart lies, so I went into the exhibit hall feeling slightly closed off to any opportunities that a typical outpatient orthopedic clinic had to offer. But while hunting for a fun t-shirt, I stopped to speak with representatives of one of the orthopedic clinics. I was surprised to find out that not only did they have pediatric clinics, but I spoke with a clinician who had established her own pediatric clientele at her clinic. As a second-year student, I still have some time before making any job decisions, but I learned that there are endless possibilities awaiting me if I just approach things with an open mind.
However, the biggest impact of my whole CSM experience was getting to meet and really getting to know so many amazing people. I learned so much from speaking to students and clinicians throughout the week. Everyone I met was incredibly welcoming and willing to share their experiences and knowledge. I felt like they genuinely wanted to hear what I had to say. The APTA Student Assembly Project Committee chairs, Student Assembly Board of Directors, and others involved in APTA were extremely supportive and encouraging of the projects that I’m working on, and they helped guide me down the right path.
I truly felt that I had become part of the #PTFam.
It reminded me that I’m a part of something much bigger than just a classroom or clinic, and that I can be a future part of the physical therapy profession…. And that’s a really cool feeling.
"The real voyage of discovery consist not in seeking new landscapes, but in having new eyes."
I am a firm believer that travel will open your eyes in more ways than you can even imagine. Not only do you get to travel to a fun city for professional conferences, but there is so much growth that happens that you can’t learn from a textbook. All this goes to say that I highly encourage you to take a moment to look up from the trees and truly see the forest. It’s really a magnificent site!
Rachel Burch, SPT, attends the University of Alabama at Birmingham.
Top 5 Questions Physical Therapists Can’t Answer
Estimated Reading Time: 3 minutes
One aspect of evidence-based practice, from a clinician’s perspective, is knowing what questions to ask about a condition, a population, or an intervention—and how to find research-based answers. From a bird’s-eye view of the physical therapy profession, evidence-based practice also means understanding how physical therapists (PTs) practice, determining whether they are following clinical practice guidelines, and explaining variations in care.
This was 1 of the reasons APTA created the Physical Therapy Outcomes Registry. In addition to providing practices and facilities with actionable data about their own organizations for benchmarking against other practices (see this PT in Motion article "Strength in Numbers" for more), an increasing volume of clinical data will help transform how we treat patients.
Ready for your quiz? Here we go…
What are the top 10 diagnoses in physical therapist practice today?
This seems like a pretty simple one, right? Wrong. The government collects data on top medical diagnoses in ambulatory care facilities, for example. But there hasn’t been a single comprehensive repository to collect this data.
The Registry can help by… characterizing the most common physical therapy diagnoses. This would help us to better understand physical therapy in a broader sense and determine what types of patients are most commonly seeking physical therapist services.
Do we know if physical therapists are following published clinical practice guidelines (CPGs)? Are those CPGs effective at improving patient care?
There has been no way to measure whether PTs are even aware of CPGs, let alone following them. While there are valuable studies on the effectiveness of interventions for low back pain, for example, to compare apples to apples researchers often exclude patients with certain comorbidities. This means the results don’t necessarily reflect the clinical population you see.
The Registry can help by… tracking physical therapist interventions in combination with patient data on a broad scale. This would help to not only see what PTs are doing, but influence future CPGs based on recorded patient outcomes.
Can we explain variations in care by different physical therapists?
To use the low back pain example, we have had no way to know, aside from anecdotal evidence, why this PT uses X intervention and that PT uses Y intervention for treating similar patients who present with the same symptoms.
The Registry can help by… identifying patterns in the data. Are there comorbidities present? Do PTs with more advanced training tend to use different treatment strategies? Understanding these and many other questions could really guide the profession, individual practices, and individuals PTs.
What proportion of patients are covered by private payers, Medicare, and/or Medicaid?
We don’t know this yet. Your future employer might not even know it, depending on their IT set-up. This information has legislative and policy implications related to payment. In addition, patient outcomes may vary depending on payer.
The Registry can help by… recording all of this data and putting it in 1 place. The profession as a whole would benefit, because APTA and the various sections and chapters would be able to align advocacy efforts appropriately.
Is there an easy way to identify the number of physical therapists practicing in medically underserved areas of the country?
Aside from surveying each facility that employs PTs in these areas, no. But it would be helpful information to know, in order to identify shortages and how better access to physical therapy could improve community health.
The Registry can help by… recording not just patient data, but physical therapist data by National Provider Identifier (NPI). So you won’t just know that Anytown PT Associates treated 80 patients last month; you’ll know that 3 individual NPIs were associated with that facility.
Answering these important questions is not something individual practices can do alone. There is strength in numbers, and together we can take the physical therapy profession to a whole new level.
To learn more about the Physical Therapy Outcomes Registry, visit www.ptoutcomes.com.
To PTA or Not to PTA, That IS the Question
Estimated Reading Time: 3 minutes
I have been a physical therapist (PT) since 1999 and an educator since 2003.
For the past 7 years I have been a full-time physical therapist assistant (PTA) educator, while still working in the clinic on breaks.
I became a board-certified clinical specialist in orthopaedic physical therapy in 2014 and LOVE this job!
My hope for you is that you truly love this profession that you are entering.
Throughout my career I have been blessed to meet and work with the most amazing people and work in some fabulous clinics. I have also been very fortunate to work in a facility that values and has mastered the utilization of the PT–PTA intraprofessional team.
My current clinic runs like a well-oiled machine and the dynamic is exemplary. PTs get to progress and treat their patients, but have more flexibility in their schedule and have a collaborative partner in the treatment of their patients. Two brains are always better than 1.
A few questions for you as a student: How much do you really know about your counterpart? Who are they really, and what are they learning?
PT students, a few questions for you:
- What do you know about the PTAs in your region?
- Do you know what they are learning in school?
- Do you know if they are using the same books as you?
- What do their practical exams look like?
- Do you know why they went to physical therapy school?
- Do you know if it might have been their first choice, and not a backup?
- Do you know if this is a career change for them?
- Do they already have a bachelor’s degree or even a master’s degree?
- Do you know if they have a family they are supporting while in school?
- Are they working full time while raising a family and going to school?
PTA students, a few questions for you:
- What do you know about the PTs in your region?
- Do you know that they might be taking 8+ classes each semester?
- Do you know why they decided to become a PT?
- Did they know this from age 17 or 18?
- Do you know how much they love this profession, that they might go hundreds of thousands of dollars in debt in school loans?
- Do you know if they have a family? Do you know if their family might be hundreds of miles away?
- Do you know if in addition to those 8 classes, they still have to work? And find time to study? And find time to sleep?
We had an interactive social event with our PTA program and the physical therapy school in the area. It was very loosely structured and was set up as an opportunity to just learn more about each other. By the end of the event, we had answered all of these questions. Both groups felt more comfortable working as a part of the team.
Both groups felt a mutual respect for the other members of the team. Each group felt that they really learned valuable new information about their professional counterpart. We published an article about the event.1 It is very easy to replicate and requires minimal time to plan or prepare.
This is our profession, together.
It is my hope that you, the future PTs and PTAs, can continue to cultivate the relationship, learn about each other, and work with each other to fulfill the needs of our patients, and to make for a wonderful work environment.
1. Hawthorne K, Cohoon C, Chambers E. Fostering PT–PTA student relationships, pilot study. Internet Journal of Allied Health Sciences and Practice. 2017;16(1). Article 4.
Christie Cohoon, PT, DPT, is a board-certified orthopaedic clinical specialist, program coordinator, and academic coordinator of clinical education at St Louis Community College, Meramec. You can connect with Christie via email at firstname.lastname@example.org.
Advocating For A Mindset Shift
Estimated Reading Time: 5 minutes
As I am writing this, I am about halfway through my final clinical internship. If there is one thing that I have learned from all 3 of my rotations, it is that patients have a set of expectations before we even walk into their rooms.
Patients have a preconceived notion of what they want from us, of what is going on with them, of how they should be feeling and moving, and even what treatment should look like. And if one or all of those things don't meet or exceed their expectations, then disappointment is bound to be felt.
I think it is safe to say that there is a direct correlation between someone's happiness and how close reality is to their expectations. Honestly, sometimes it seems that happiness is more contingent on how much reality exceeds expectations, than just meets expectations. As health care providers, this mind-set can make things challenging. But it's not just the patients who experience this; as a student I have expectations, too—expectations for my performance, expectations for a patient's progress, and expectations of their impressions of me as a future clinician. This can lead to feelings of disappointment, frustration, and anxiousness.
I recently read Daniel Kahneman's Thinking, Fast and Slow in which he discusses the important fact that most events and outcomes in life are due to luck. Regardless of how well-thought-out our decision is, there are numerous other factors working behind the scenes that contribute to the conclusion. However, we tend to believe that we have a lot more control than we actually do. I'm not saying that a patient's success in therapy is contingent on luck. But I am saying that there are more factors at play than what they do in therapy. It is important for the patient and therapist to understand this.
Annie Duke explains in her book Thinking in Bets: Making Smarter Decisions When You Don't Have All the Facts that the way our life turns is influenced by 2 things: luck and skill.
For example, a patient may have performed below baseline for functional mobility in the hospital because of their lack of willingness to participate in therapy (skill), the staff having a demanding caseload with not a lot of time for mobility training (bad luck), or numerous other reasons. On a more positive note, a patient maintaining their functional mobility status could be due to regular therapy sessions and the patient performing their exercises in between sessions (skill), or a quick resolve of their current condition due to a healthy and effective immune system (luck). With both skill and luck working at the same time, outcomes can be hard to predict, making expectations hard to meet.
I'm not advocating that we explain to each of our patient's that most of what happens in life is based on either good or bad luck. What I am saying is that it can be a powerful tool and worthwhile if we take the time to explain that there are only certain things that are in our control, and one of the most important is what we choose to do in the present moment.
I am making 2 distinct points in this post that I believe directly tie to our patients' and our own emotional well-being.
The first is that we have expectations and beliefs about how something should be and when reality doesn't meet those expectations, we are usually disappointed.
The second is that we don't have as much control over events that happen in our lives that we would like to believe; most outcomes, regardless of our decision, are based from good and bad luck. This might come off as if the solution is to have low expectations and not bother trying because everything happens by chance anyway. However, that is not what I'm saying. Instead I am advocating for a mind-set shift.
To be aware and focus on what you are doing in the present, while also trying to ignore what has happened the day before or what might possibly happen in the future. This is the essence of mindfulness, and I believe that it can help to decrease frustrations and feelings of low self-efficacy in a therapy setting.
I recently read an article that said, "What screws us up most in life is the picture in our head of how it is supposed to be." Talk about letting expectations dictate our welfare.
Going back to my second point, with so much of life being out of our control, the picture we believe our life should be is bound to be different from reality. We are setting ourselves up for disappointment.
A number of my patients have expressed frustration during therapy because of the difference between how they think they should be moving and how they actually are moving. The picture in their minds of how they should be is based from memories of how they were prior to the situation that landed them in front of me.
Mindfulness and putting energy and attention on the present moment, help to steer the mind away from this picture of how we think something should be.
I think our patients will greatly benefit from gentle reminders that what matters is what they are doing in the moment and how that's contributing to the bigger picture—that life is fluid and our situations are not permanent. What we have control over is what we are doing in the present and that should be our focus. By living in the moment, we can reduce the power expectations have over us, and as their therapist, it can greatly impact our patient's outcomes.
Megan Mitchell, SPT, is a third-year student at the University of Maryland, Physical Therapy and Rehabilitation Science. You can connect with Megan on Twitter at @MegMitchellSPT.