My professional and ethical development in 2016

A quote by Bryant McGill: “Whatever makes you uncomfortable is your biggest opportunity for growth”.

According to Snyder (2005), many individual persons, groups, and institutions play a role in and are affected by medical decision-making. In an environment characterized by increasing demand, increasing regulation and decreasing professional autonomy, mounting health care inflation, and significantly constrained resources, tension and conflict are inevitable among patients, clinicians, insurers, purchasers, government, health care institutions, and health care industries. However, all these parties have an obligation to interact honestly, openly, and fairly. It is essential to note that all of these parties bear responsibility for recognizing and supporting the intimacy and importance of relationships with patients and the ethical obligations of clinicians to patients.

I have been faced with many challenges throughout my student career as a physiotherapist. However, these three challenges have really questioned me to how one can overcome them.

According to A.K. Agnihotri (2006),  Domestic violence is one of the most common forms of torture in women and is a major international social and public health problem in both developed and developing countries. Therefore I ask myself; why was I so affected by what my one patient told me one day? Why did it make me so uncomfortable? Why was this one of my biggest moral and ethical challenges this year?

The answer to those questions is simply based on me being fully against abuse especially towards females even more so if I become aware of abuse happening to somebody I know. It was definitely one of the most uncomfortable challenges I have been faced with this year. It was treating a female patient of mine that was being physically abused by her husband. The challenge I had with this was how to respond as professional as possible. As a human being I would have responded in a much aggressive manner to how I would respond as a physiotherapy student in a health care environment. This challenge was therefore based on how to respond to a patient by being professional yet still humane. As mentioned in my previous blog, with obtaining information about the reality of what really goes on behind the curtains of a marriage involved in abuse, I was more understanding and knew more or less how to respond to a situation like this. One would respond as humanely as possible however, with the experience and knowledge obtained from being in the health industry as a professional, one would provide the patient with as much professional information as possible that will direct them in the correct path and hope that the patient takes the initiative to use that information. This is link of a speaker who motivated me with regards to this challenge.   https://wDomestic Violence 

According to Sackett et al., 2000, Evidence-based practice has been defined as ‘the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients’ (Davidson et al., 2006). Another challenge that I was faced with this year was to adapt to each supervisors way of doing things. I found myself learning about a physiotherapy technique in one block and then another block to be completely different. My question to myself was always “which one is actually correct?” “Do I just do what’s clinically proven or what the specific supervisor wants?” This is what made this challenge difficult for me to overcome. With regards to this challenge, my class and I have raised this issue in class time and we were not truly given a proper solution. It was said that this is just one of the challenges that cannot be addressed or changed. One will need to learn what their specific supervisor likes and prefers at that given time and do what they have taught you within that block for exam purposes. This is exactly what we have been doing however in final year we have external supervisors also examining us. With this we have two different opinions and ways of doing things. Therefore I do suggest that all supervisors need to be told that when it comes to exam purposes, supervisors mark according to evidence based practice.

Decision

This year has been very challenging yet rewarding. I was faced with many struggles this year, even the previous year. It was extremely frustrating when I was trying my best to deal with them but now that I am at the end of my final year I do feel that it was a positive thing to have been faced with those kinds of diverse challenges because it did not only make me more confident with regards to practicing physiotherapy but also made me a stronger person within myself. It has aided in my growth as a physiotherapy student and I know that this is not the end of my challenges which is okay. The important thing is to always remember that it is not about what challenges you are faced with, but what you do to overcome them. From this point on wards with each and every treatment given to any patient will be evidence based and not what someone else prefers is better. Yes we all find our own ways of doing certain treatments that are effective but I do firmly believe we do need to remember to try not to steer away from evidence based practice.

According to Grace et al., 2013, a study found that both formal education in the classroom and in clinical placements and observed professional behaviour’s play equally important roles in developing a sense of professionalism. The concept of professionalism appeared to evolve with participants’ experiences in different professional contexts.

Throughout my student career in physiotherapy, my overall professionalism has definitely accelerated to the top.  With looking at an article called “A study of critical reflection in health professional education: ‘learning where others are coming from’”, the three understanding theories have most definitely aided my learning with regards to my professionalism (Delany et al., 2008). With being put in many situations, having many different clinicians and supervisors look after me during my block rotations, I have absorbed so much advice on how to be professional, have etiquette, be punctual, put the interest of the patients health first and to create a relationship with all patients because they are human beings and have other people who care about them. With being given this opportunity I have grown as a person but most definitely as a student physiotherapist. Not only has my knowledge expanded but more of how to deal with people on a day-to-day base medically and personally.

With regards to the decisions that I have made about all my challenges, I only felt uncomfortable with treating a victim of abuse. The moral decision that I made was being as humane as possible and not expressing my anger in an unprofessional manner. The ethical decision I made was to provide her with as much information as I could.  That was as far as I could go. What my patient decided to do with that information was all up to her. According to Snyder (2005), the patient–physician relationship entails special obligations for the physician to serve the patient’s interest because of the specialized knowledge that physicians possess and the imbalance of power caused by the medical relationship. The physician’s primary commitment must always be to the patient’s welfare and best interests, whether the physician is preventing or treating illness or helping patients to cope with illness, disability, and death. The physician must respect the dignity of all persons and respect their uniqueness. The interests of the patient should always be promoted regardless of financial arrangements; the health care setting; or patient characteristics such as decision-making capacity or social status. This has definitely been a challenge where I benefited most from.

I do know that the challenges will not stop here as a student and will still be existent in the future as a qualified health professional. The challenges might be different but there will always be something that we are faced with that challenges us in many ways. It is important to face them and solve them rather than turn a blind eye and pretend it will be solved within time. Challenges that especially involve patients are the most important to address because we do not want it to affect the quality of care the patient deserves to receive.

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Continuing to grow

I have found this module very challenging yet exciting and informative. It has given me the opportunity to identify certain challenges that I never thought could exist. The most beneficial aspect of this module was learning how to address these challenges with the exciting long conversations about topics within class time. I have grown within physiotherapy however; still have plenty more room left to grow in. Yes I could have made different choices as a physiotherapy student, but I am not the same person today as I was yesterday, I am improving with each challenge I am faced with.

Reference List

Snyder, L. (2005). Ethics Manual. Annals of Internal Medicine142(7), 560. doi:10.7326/0003-4819-142-7-200504050-00014

Jette, D. U., Bacon, K., & Batty, C. (2003). Evidence-Based Practice: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists83(9), 786-805.

Iles, R., & Davidson, M. (2006). Evidence based practice: a survey of physiotherapists’ current practice. Physiotherapy Research International11(2), 93-103. doi:10.1002/pri.328

Delany, C., & Watkin, D. (2008). A study of critical reflection in health professional education: ‘learning where others are coming from’. Advances in Health Sciences Education14(3), 411-429. doi:10.1007/s10459-008-9128-0

Grace, S., & Trede, F. (2013). Developing professionalism in physiotherapy and dietetics students in professional entry courses. Studies in Higher Education38(6), 793-806. doi:10.1080/03075079.2011.603410

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