Protocols

On Friday, I implemented my protocol for my mental health class. A protocol is roughly a lesson plan for a group session. My partner and I had to implement a session about time management for a group of OT grad students. Some of the grad students were given dysfunctions, such as being hung-over, fatigued, or having a song stuck in their head that we had to deal with. Our session went pretty well. We have had the most complicated activity compared to any of the other groups, but I think it was good because it actually challenged the clients. We had a few issues. One was I forgot to restate the goal of the activity right before I gave the directions. It was stated at the intro and the conclusion, but it should also be stated right before the activity. We could have also used other clients to help the clients that were having issues instead of just using ourselves. Our discussion at the end was very stilted because we just went around in a circle, which means people knew when it was their turn and tuned out otherwise. Many things went well though. We successfully integrated the previous sessions into our session, and our opening activity was a big hit. We had a blow-up chicken with get to know you questions on it that was passed around. I would say overall it was a success.

Problem Based Learning

This week I read "Why Good Classes Fail" on mediatedcultures.com. It made the point that classes can use all the proper techniques and still fail due to a lack of enthusiasm and genuineness from the professor. We have a couple of professors who are really big into problem based learning. They love to tell us that it is the best way to learn. They are even passionate about the subject material, but no one in the class is connecting. Other teachers use project based learning (but don’t shove it in our face that they are doing it), and it works. I personally believe the problem is in relevance and connecting with the students. Both of the classes that these teachers have taught are in areas that very few, if any, of the students think they will work in. I still think both of the classes are valuable to the curriculum; however, I think the focus needs to shift. Sorry, I know that is very vague and confusing, but I don't want to call out the class more than I have. Basically, I think the focus needs to shift to more current day practicability.  The other issue appears to be that the professors have failed to connect with the students, and the professors almost always step back so that we can solve our own problems. It is definitely valuable and necessary for students to facilitate their own learning. If we were given all the answers that would an issue too. However, when we get stuck and are unable to preserve they are still unable to help us. Occasionally, they will finally explain a few classes later, but at that point we  have stopped caring because we can no longer deal with the frustration.

This was left in the comments of the article:

When a Teach for America researcher “called up teachers who were making remarkable gains and asked to visit their classrooms, he noticed he’d get a similar response from all of them: ‘They’d say, “You’re welcome to come, but I have to warn you—I am in the middle of just blowing up my classroom structure and changing my reading workshop because I think it’s not working as well as it could.” When you hear that over and over, and you don’t hear that from other teachers, you start to form a hypothesis.’ Great teachers, he concluded, constantly reevaluate what they are doing.” (A. Ripley, 2010, The Atlantic)

 I think this summarizes the biggest problem I am having with my class. According to previous students, they have been teaching like this for a while, and it never works. Reflective teaching is always important. Just because theoretically it should work does not mean realistically it will. I also think this is an important thought to keep in mind as an OT, especially as a new one or veteran. Sometimes, we get so caught up in the idea that theoretically something should work or it has always worked in the past that we forget things can be changed and they probably should be. Reflection and constant experimentation are some of the best ways to create a successful practice in my opinion.  (Sidenote: one of my undergraduate professors also left a comment. It's a small world.)

Pintrest Roundup

Another Pintrest round-up. As the site gets more popular, it is getting easier and easier to find items that apply to more than pediatrics.

The first one is a simple modification for glasses. Just stick rubber bands around a cup to enhance grip. This could be used for small hands or hands that lack of sensory input. As I am typing it up, I see it is from Real Simple magazine, which provided an idea in one of my last roundup. Mainstream OT!

http://www.realsimple.com/home-organizing/new-uses-for-old-things/favorite-new-uses-00000000019718/page34.html

This is a homemade felt board. Take a picture frame and insert felt. So simple. This could be good for car trips or waiting at doctor's offices. It is quiet and relatively small and entertaining.

http://izziemacandme.blogspot.com/2009_10_01_archive.html

Here is a low-vision idea. Place a brightly colored picture frame around the light switches. This draws the eye to it, and creates texture to denote light switches. Low vision really intrigues me. We have not talked about it much in school, but at the Active Duty Rehabilitation at the Veteran's Affairs they have a low vision lab, so many of the guys I talk to tell us about their experiences. I have to be honest though, I don't know if OTs are apart of it. This is from a home decorating blog, so again yay mainstream OT!

 http://salttree.blogspot.com/2011/09/sometimes-its-simplest-things.html

One final idea, that even I could use from time to time, a homemade ice pack. This suggest putting in dishwashing liquid to create a gel like ice pack, instead of just plain ice. Now if you are going to ice everyday, I would still suggest buying an ice pack, but if you are on vacation or in a pinch this could be a wonderful solution.

http://www.funcheaporfree.com/2011/04/youre-welcome-wednesday-diy-ice-packs.html

Gait

This week we had a physical therapist come guest lecture on gait. It was intriguing and a worthwhile  lecture. We focused on gait patterns more common in geriatric populations, since that was where her expertise was. We focus on the gaits of a person with Parkinson's or a CVA (stroke). Then we learned to walk with a variety of canes, walkers, and crutches. They are much harder to coordinate than I would have imagined. I also always thought it was the people with walkers that were slow, but it is really the walker itself. The walker forces one to take smaller steps, and it prevents one from gaining momentum. Canes should be used for balance, and almost never for weight bearing because it is likely to cause hand issues because the hands are not meant to weight bear. I also learned that I am horrible with crutches, so let's hope I never need them.

Here is a video of the gait of a man with Parkinson's before and after medication. It is amazing.  

Sometimes it was hard for the class to pay attention to details because realistically we will not be teaching anyone walk properly. We just need to know to refer to a physical therapist. However, we do need to know how the assistive devices work because often we "trick" them out to make them more functional. It is important to learn about gait though because many of the activities we do with patients will require them to be slightly mobile, even if it is a short trip to the bathroom, and we need to know how they are likely to fall, so that we can prevent it.

Lab Practicals

Occupational therapy is a hands on profession; however, many of the skills one needs are hard to test on paper. My school has chosen to test these skills through lab practicals. Typically, students are paired up and told to perform different skills on each other. Ideally clients would be brought in, but that is rarely practical and sometimes unethical.

There are many benefits to lab practicals (especially compared to paper testing), but there are drawbacks. One is they are time consuming to perform. Often it leaves students hanging around the building, sometimes for hours. Another issue is the student being the client knows what the student practitioner is looking for and typically makes it easy. In one of my practicals my "client" always knew what position to get into, and sometimes naturally got into that position without me asking. That is not going to happen in real life. Finally, these situations are very controlled. Even when the "client" is instructed to act up they are still usually on the practitioner's side. Even if in the clinic, one is lucky enough to have the perfect client there are still the issue of distractions from other staff and clients as well as missing materials. Don't get me wrong I appreciate my school giving me the time and encouragement, but I wish there was a more realistic way to test. I guess we are slowly building our way to fieldwork. It would probably be too overwhelming otherwise. 

All Hands on Deck

This semester we have started to learn manual muscle testing (MMT) and how to take range of motion (ROM) with a tape measure and a goniometer. It is really exciting to start to get hands on. So far we have only done the neck for range of motion, but we have done the trunk and neck for MMT. It is amazing how important practice is. I was practicing with friends after class today, and it was amazing how many different times we had to rearrange our bodies to be able to take the measurements. An experienced practitioner would know exactly how to position themselves, and the right order to do all the testing, so that the impact on the client was minimal. Book learning is only going to get you so far on these skills.

Today in mental health we formed four different groups for different projects. Group work is a big part of occupational therapy school. Group selection is a little different in the second semester. People have friends that they like to work with, other people want to work with people they do not hang out with, and sometimes people who like to get work done early seek the others who like to get work done early. Let's hope all these projects run smoothly.

The other big happening this week is we got to meet the family that is building the house that we are help designing. I am assigned to work on the bedroom for a 15 year old boy with Duchene Muscular Dystrophy (DMD). I was a little disappointed because he spends most of his time in the common areas currently, but I know we are going to make his room so awesome that he is going to spend all his time there. I have a to-do list that is a mile long, so I should get a start on that. 

Darius Goes West

We watched this documentary in one of my classes. I thought it was amazing. You should definitely check it out. It is the story of a boy with muscular dystrophy that wants to get his wheelchair pimped by MTV's show "Pimp My Ride". With the help of some friends a three week cross country trip in a RV from Athens, GA to Los Angeles, CA and back was planned to try to convince MTV to trick out the wheelchair. They also filmed a documentary to bring awareness to muscular dystrophy and wheelchair accessibility. It is an eye-opening and heart touching film.

The story that struck me most from the film was Darius, the boy with muscular dystrophy, was dared by some of the crew (comprised of his friends) to eat a spoonful of wasabi. Darius was not one to back down from a bet. However, someone else in the restaurant yelled at the crew for picking on Darius. Darius in no way felt picked on and felt like he was just hanging out with his friends. It was just a strong reminder that people in wheelchairs do not want to be coddled or pitied, but be part of the gang.

The film brings up wonderful perspectives on wheelchair accessibility, living with muscular dystrophy, and living your life the fullest. If you want to check it out you can go to http://www.dariusgoeswest.org/the-film/ to purchase the film and learn more.   

Here is a preview: