23 March 2015

In preparation for our teaching activity, we spent the whole Monday making an instructional design for our patients. This involves creating a matrix containing the objectives, content, general strategy, resources, and evaluation, to help create a meaningful treatment plan for the patient we will treat.

I initially had difficulty creating the objectives, specifically one for the affective domain. Ma’am Dana pointed out that the objectives must be something the client has yet to do; otherwise it will be useless since it will be accomplished at the start of the session. For example, giving an already compliant patient an objective to teach compliance would be redundant. She also emphasized that a good objective must be specific and measurable. I learned that creating objectives plays a big part in treatment as it is the foundation of the treatment. Having good and relevant objectives makes the proceeding processes easier since everything else follows.

With regards to the content, we had to recall our previous treatment courses to be able to create an intervention which fits the client’s needs. I realized how far we’ve gone already. We were clueless about these interventions two years ago.

The strategy the PT will use will depend largely depend on the characteristics of the patient. It would’ve been nice to have met my patient before thinking of the strategy to teach. In practice, we could observe the patient to come up with the best strategy to teach them.

Evaluation is closely linked to objectives. The evaluation must be in congruence with the objectives set for it to be relevant to the treatment. Setting the correct evaluative measure is essential in keeping track of the patient’s improvements.

Making an instructional design for a patient is an important step in the treatment. Having a good one will probably help with the patient encounter itself.

3.20.2015

“You can’t make someone want an education,” says Margaret Campbell, the prejudiced English department head of Woodrow Wilson High School in The Freedom Writers. Ms. Campbell speaks from years of handling reckless integration program students, and throughout those years, somewhere in her heart she sees the students of Room 203 as lost causes. By refusing to commit herself as a teacher to these students, she perpetuates a system of hopelessness and hatred in an already vulnerable population.

Ms. Campbell is the type of teacher who is clouded by discrimination and bases a student’s worth by the number of As in his or her report card. She is rooted in tradition and wary of change. She is a nitpicky teacher.

In the field of physical therapy, we cannot be nitpicky with our patients. As members of a distinguished profession, we must recognize and uphold the differences of each individual under our care. Several patients may have cognitive, physical, or psychological difficulties and are more difficult to manage than others; nonetheless, we must endeavor to give all patients fair and beneficial treatment.  Still, others may be uncooperative in therapy simply because they lack the motivation. Thus, we must alter our approach to accommodate their primary needs and let them realize their own desire for change.

Change, be it in behavior or physical function, doesn’t happen overnight. In reality, it takes more than one session to foster a therapeutic relationship or get our clients to accomplish a particular task. In such cases, they may become frustrated with the lack of progress and be even less motivated. Therefore, the challenge lies in the physical therapist’s ability to empathize with their situation and identify strategies that best facilitate their learning.

Empowering clients is the first step. We’ll be surprised to know the rest will follow. 

20 March 2015

Last Friday, we watched the movie, Freedom Writers (2007).

Freedom Writers is based on a book co-written by Erin Gruwell, a teacher, and her students from the class harboring the racial integration plan. It speaks of the real life occurrences that happened in their classroom, as well as her student’s experiences in the streets, and how they developed a unique teacher-student relationship despite the apparent difference in culture and beliefs.

What I liked about this movie is how it showed that we’re not that different from each other. Everyone is unique and to some, the difference is more apparent, but we all have a common ground where we can understand each other. As a teacher, this common ground should be exploited to facilitate learning better. Meet the students half-way by looking into their interests and motivations while still employing what you need to teach. For our clients, knowing them and building rapport will play a big role in the compliance of the client during treatment.

The teacher in the movie used a lot of strategies to facilitate not only learning, but behavioral change in the students. I think behavior is the hardest to correct as a therapist because it usually stems from something beyond us. There are a lot of reasons why people behave the way they do and a lot of patience and compassion is needed for us to help our patients. We can also try to employ strategies to motivate them to participate by making the activities relevant to their daily living or their long-term goals.

Being a teacher looks hard and tiring but seeing this movie made me realize that all those hardships are probably worth it when you see that you’ve changed someone’s life. I think the same goes for our profession and that makes me happy that I'll one day be a physical therapist.

Teacher vs. Humanity vs. Self

We had our movie day activity last March 20, wherein we watched the film  "Freedom Writers" starring Hilary Swank. It was about a new teacher, Ms. Gruwell, whose assignment to room 203 led her to a painstaking journey of working out the differences between her students and slowly bringing them together towards a brighter future. 

Looking back, Ms. Gruwell was faced with probably one of the toughest challenges a teacher could face -- teaching someone who does not want to be taught. Then again, I realized that if I were also in the same situation as the students, it would also be hard for me to be interested in school when I am constantly concerned of my own safety. In our practice, I believe we will also encounter clients who, for some reason, will also be too stubborn to comply with treatment. This would definitely test our patience, determination, and genuine compassion towards our patients as well as our dedication towards our profession. 

Now with these in mind, one important question comes into play: What are you willing to sacrifice as a physical therapist/teacher?  Some of what my group mates answered were time, comfort, or sleep as things they're willing to give up.  As for me, I would sacrifice mediocrity. I agree with all the things my group mates mentioned but I think all those should lead to something greater, such as excellence or better patient care. It is not only important to sacrifice something, but also to know the reason behind our sufferings. I believe that if we don't see a greater end, then we will only get tired and give up halfway through. 

Therefore, we should constantly remind ourselves why we are fighting and for whom are we fighting. This way we can live each day with a sense of purpose and fulfillment. 

Never Knew How Difficult It Could Be

You never truly appreciate the value of something until you fully understand the workings behind what is presented at face value. Teaching may appear easy until you step into the teacher’s shoes and realize the amount of preparation that the teacher had to go through just to be ready for a single teaching session.

This was perhaps the most exhausting activity of this course. I have never felt so drained before in all the other courses and I have never worked so long on a paper than I have on this activity. I did not realize that a simple “instructional design” needed so much effort in order to be truly polished.

Working in groups while at the same time working on individual instructional designs did help a little, but I do think that working in groups could have been more helpful at first because generating ideas was actually a bit difficult on your own and especially since this was our first time creating an instructional design. Studying the module beforehand and having advisers available for consulting aided in the process but having a more comprehensive and clear module and more advisers available would have been of more help.

All in all, this activity was tiring but effective in teaching us how to work on an instructional design. I know that this will be of use to me in my future career as a PT no matter which field I choose to work in. It always helps to be prepared and organized and this should be one of the most effective ways of doing just that.

A Good Reminder

Throughout my education, I do not know how many times I have been asked to watch a movie about a teacher who handles a seemingly hopeless class full of hooligans and effects a change of heart in each of the students. This is why this movie is not that big of a deal for me. I also did not care much for the way the movie ended nor for the actual plot which as I have implied, has become somewhat trite. However, this is not a movie review.

Film viewing may seem like a favorite activity of students and I do admit that I enjoyed the short period of relaxation, but for me, I never seem to get much out of it. It can be noted that we did process the movie while answering guide questions in a group after but still, I do not think I gathered insights that were not already embedded in me.

Yes, it taught us that teachers should be patient. Teachers should believe in the potentials of every student. Teachers should sincerely want for students to learn. Teachers can help change lives. These are only a few examples of lessons that can be gathered from the movie, but again, it is not as if these are not part of my own common sense.

What I can say is that the activity was helpful in reminding me of the values I must embrace in order to become the best teacher I can be, but that’s about it. It was enjoyable. It was relaxing. It was interesting. But, it was not the most productive.

The Wick of Change

How can you bend a stubborn iron? You can do it by force but the edges will be jagged and the shape, deformed. Conversely, you can warm it up until it softens slowly, until the iron itself is ready to be moulded and re-shaped. The same applies to a person; you cannot force someone to change drastically. It takes time and a ton of effort to change behaviour. This is what The Freedom Writers instilled in me last Friday.

Change takes time; however, this is not always applicable to clinical setting. As a therapist, knowing a patient can be difficult if there is limited time. A patient may come to you for the first time and you will be tasked to teach her/him a novel exercise for a limited 45 minutes. The real challenge as a Physical Therapist is not the physical effort of demonstration and contact guidance but the mental planning of how to facilitate the activity without an idea of how the patient learns best and how to use that “best strategy” to facilitate change in behaviour that is crucial for a treatment program to be effective. Teaching is a matter of trial and error; but 45 minutes is too short to conduct many trials to select the best option. From the initial assessment to the intervention itself, the therapist must closely and keenly search for clues to the patient’s personality as this will help determine the latter’s “soft side” that will eventually be the loophole to her/his persona and be the wick of her/his change in behaviour.

Values can be radiated; and are sometimes contagious. To instil determination and patience to a client, the therapist must first be determined and patient. To help another person change, we must be flexible enough to change in the first place.