This past week in the clinic, I had the opportunity to work with a student PT. He was completing one of his last clinical rotations in his 3rd year as a PT student. Naturally, we had a lot in common, and we both wished we had learned a few things in PT school before starting a PT clinical rotation.
To say you’ll learn a lot in PT school is an understatement; it’s a doctoral-level degree for a reason. But PT school won’t teach you everything, and what it doesn’t you’ll learn the hard way.
So after discussing this with the student PT, I felt I needed to share four things I wish every PT student knew—and one thing in particular I wish I had known when I was going through my clinicals.
Soft Skills Matter…A Lot
As a clinical instructor, I can teach you how to write a textbook physical therapy evaluation, and I can lead you through the steps of assessing a patient with a total knee replacement. But what I can’t easily teach you are the soft skills in our job—skills that will take you further in your career than any advanced certification could.
Soft skills are aspects of your character and personality which enhance your work performance. For instance, good soft skills for PTs might include a strong work ethic—a willingness to show up early, stay late, and be engaged throughout the day. Clinics rely on PTs with a strong work ethic to not only carry out their own schedule but also assist other aspects of running the clinic.
The ability to communicate appropriately with patients and coworkers is also a type of soft skill, called “interpersonal communication.” The student I had this week demonstrated good communication, but some of my past students showed a dire lack of communication skills: speaking before thinking and making unprofessional, immature comments to patients and coworkers.
If you think your interpersonal communication could use some work, do yourself (and your future coworkers) a favor and pick up the book Emotional Intelligence 2.0 by Travis Bradberry. I recommend reading it fully before your next PT clinical rotation.
Ask questions—at the right time.
There’s no doubt that asking good questions is essential for a vibrant learning experience. But once you start your clinical rotations, it’s not just about asking the right questions; it’s about asking them at the right time.
In a classroom setting, questions are almost always welcome, but a clinical setting is different primarily because the patient is present. Now, some questions are okay to ask in front of a patient, but other types of questions should wait. (And if you have a good sense of emotional intelligence, you’ll know what those are.)
Further, you may have a patient-appropriate question to ask, but asking it at the wrong time could interrupt the flow of the evaluation or treatment and take time away from the patient. Instead of asking your questions outright, try writing them down so that you can ask your clinical instructor (CI) afterwards.
In most cases, as you become more comfortable with your CI you’ll figure out when it’s appropriate to interject a question. But early on, start with writing them down. The timing of your question is just as important as the question itself.
Bring along a small notebook for taking notes
In order to jot down your questions, you need something to keep notes. As ubiquitous as smartphones are, taking notes on your phone could leave a poor impression on your patient and instructor.
Instead, one of the best things you can bring to your clinical rotation is a small notebook (my favorite is this moleskin notebook). Besides jotting your withheld questions, you can use this little book to write down anything that comes to mind during the day—such as things you need to look up after work or other details that can help you be a better clinician.
Early in my clinical rotations, I struggled to come up with good questions to ask a patient during their initial evaluation. So I used my notebook to write down the questions I heard my instructor ask patients in their evaluations. This helped me figure out a pattern to replicate with my subjective questions and allowed me to simplify my approach. As a result, my evaluations greatly improved.
Finally, keeping a notebook shows your CI and others that you are engaged and interested in what you’re doing. Whether or not you need a notebook to remember details, it’s always better to take notes and demonstrate active learning.
A PT clinical rotation can be draining—I know, because I’ve been there. You may feel overworked, frustrated, or impatient to be done with them. But no matter how you feel, it’s important to take a step back and express gratitude for where you are in life and for those who helped you get there.
Although clinical rotations are a lot of work, it’s a privilege to perform them. There are so many people in the world who wish they were in your position—about to graduate and become a Physical Therapist. Think back to when you were applying for DPT school, anxious to be accepted and eager to begin your new career. Think how far you’ve come!
With that perspective in mind, be sure to give credit where it is due and thank the clinical instructors and staff who are volunteering their time to help you become a better clinician. Maybe you think it’s cliche, but simply writing them a thank-you note is one of the best-received, most effective ways to express gratitude.
Even if your rotations are in a clinic you don’t want to join later, practice gratitude for your own sake. Get into a habit of acknowledging the positive aspects of your work and environment, and you’ll reap the benefits later if you’re ever at a job that’s less than dreamy.
Don’t Over-complicate things
When I was doing my PT clinical rotation, sometimes it was difficult for me to come up with a sequence of exercises appropriate for each patient. I would get hung up figuring out which exercise to do next and how to write things down in a way that reflected our skilled treatment.
But a switch flipped in my head when I decided to list every treatment we had done for a patient with a rotator cuff repair. I went through the exercise flowsheet line by line, thinking through every movement and considering the reason for each exercise.
Once I understood the rationale behind the exercise plan, I realized I had simply been over-complicating things. Instead of working from a blank slate for every patient in my clinic, I learned to come prepared with at least 3–4 exercises in mind. It became even easier to write my notes when I could relate those particular exercises to functional activities the patient had difficulty doing.
If you struggle with choosing the right treatments, check out the therapy treatment flowsheets I have on the blog. Or, if you need help writing notes that reflect the skilled treatment you do each day, consider downloading my documentation templates.
Using a “cheat sheet” like mine will more than boost your clinical confidence. My flowsheets and templates have helped dozens of PT students and newly-graduated PTs establish efficient work flow. Besides making sense of your clinicals, these templates will also help you save time on documentation and avoid writer’s block.