As a third year student I dreaded going to blocks every day and wished the days would go by as quickly as possible. I felt useless and uncertain about which treatments were most suited for my patients. Reading and learning about patients with specific conditions in class and actually treating them was completely different.
In a clinical setting the only person you can look to for immediate help is your clinician. However this was never the case, instead of receiving feedback and guidance from clinicians they often simply gave me a list of patients and said go and treat them. It was very rare for a clinician to accompany me to see a patient even when I asked for help.
Students have a basic need to know how well they are doing, as the expectation of success is fundamental to motivation and effort. Effective feedback occurs when the students are given insight into their actions and the consequences thereof. Such insight is valuable because it highlights the difference between the intended and the actual result, and provides motivation for change. Feedback, therefore, encourages learning and progress and is essential in allowing a student to remain on course in reaching a goal. On the clinician’s part, it also conveys an attitude of concern for the progress and development of the student in a real sense and not just as a function of awarding marks. Giving feedback, whether corrective or reinforcing, is an essential part of medical education, which helps to promote learning and ensures that standards are met. Given correctly, constructive feedback can improve learning outcomes and enable students to develop an analytical approach to learning. It can also improve a student’s competence (Chowdhury & Kalu, 2004).
The feeling of worthlessness I experienced everyday as a result of not receiving guidance or feedback left me second guessing myself to whether or not physiotherapy was the correct career choice for me. I also started to develop an “I don’t care attitude” towards everything I did and my self-efficacy was almost non-existent. Belief in one’s efficacy is a key personal resource in personal development. Efficacy beliefs affect whether an individual thinks optimistically or pessimistically, in self-enhancing or self-debilitating ways. Such beliefs affect people’s goals and aspirations, how well they motivate themselves, and their perseverance (Bandura, 2006). The negative attitude and lack of efficacy I developed was not normal for me, as I have always strived to be an overachiever in everything I did and anything below that standard was unacceptable.
Thankfully things changed for the best this year. My first fourth year block was at Groote Schuur Orthopaedic department. For the first time I actually enjoyed going to blocks and looked forward to learning something new every day. This was my first orthopaedic block so I had limited knowledge in this aspect of physiotherapy.
Clinicians are regarded as role models to students. Positive role models can be described as being excellent, experienced clinicians who have empathy for patients and positive interactions with patients, patients’ families, and other health care workers. Positive role models also display teaching qualities, including commitment to the growth of students and a humanistic style of teaching, as well as personal qualities such as enthusiasm. Thus, the literature describes the clinician who is a positive role model as someone who is admired for being, or acting as, a professional, or as someone who inspires and teaches while carrying out other tasks (Jochemsen-van der Leeuw, van Dijk, van Etten-Jamaludin, & Wieringa-de Waard, 2013).
The Clinicians who assisted me at Groote Schuur Hospital were true role models were helpful and supportive. I never felt embarrassed or scared to ask them anything if I was unsure. The clinicians always took the time to accompany me to patients when needed, gave advice and recommendations with regards to treatments and when the wards were not busy they even gave us tutorials on how to read X – rays, issuing appropriate assistive devices and how to decide when a patient can weight bear or not.
I ended off this block feeling motivated to learn and wanting to be the best physiotherapist possible. This experience has taught me that sometimes you will get “good clinicians” that are willing to assist you and sometimes you won’t, it’s up to me as an individual to take responsibility for my own learning. You are only as good as the amount of effort you put in…
Bandura, A. (2006). Toward a Psychology of Human Agency. Association for Psychological Science, 1(2), 170.
Chowdhury, R. R., & Kalu, G. (2004). Learning to give feedback in medical education. Royal College of Obsttrician & Gynaecologist, 243-247.
Jochemsen-van der Leeuw, R., van Dijk, N., van Etten-Jamaludin, F. S., & Wieringa-de Waard, M. (2013, January ). The Attributes of the Clinical Trainer as a Role Model: A Systematic Review. Academic Medicine, 88(1), 1-9.