Week 1 STARES Prac 3 (Freo MSK OPD)

Situation:
This entry relates to an incident that occurred on my first day of prac, when my supervisor asked my a routine theory question relating to a patient who i had just assessed.
Task:
My supervisor asked me which nerve root was responsible for a certain muscle action.
Action:
After a quick period of thinking I answered the question with what i thought was the correct answer.
Result:
My supervisor informed me that my answer was incorrect and told me the correct answer.
I was fairly confident the answer I had given was correct and later when I checked it in a textbook I realised my answer was correct. After i had confirmed the answer in the textbook I was then in a dilemma whether I should approach my supervisor to discuss the answer. As it was still my first day I decided not to bring the subject up again, however two days later an almost identical incident occurred. With a little more confidence, I approached my supervisor to clarify the answer and clear my confusion, my supervisor was really good about it and apologised for any confusion she had caused and confirmed that my answer was correct.
Evaluation:
After the first incident I was frustrated and embarassed because I presumed my supervisor would build an inaccurate initial impression of me based on this simple question, which in fact i had answered correctly. On reflection, I feel I handelled the situation appropriately however I think I should have discussed it with my supervisor to clear my confusion and concern. The main reason for not discussing it was my lack of confidence on my first day and also I wasn't sure how to approach the situation without coming across as arrogant or confrontational. However, my reflection from this incident meant that when the identical incident occurred later in the week I felt more confident to discuss it with my supervisor and did so without causing appearing arrogant or confrontational.
Strategies:
When I approached my supervisor in regards to the second incident I did so in a very open manner and just told her i was a little confused and could she help me clear up this confusion. This eased any tension and just created a free flowing discussion on the topic without any sense of confrontation. Had I approached my supervisor, for example saying " I think you may have got that wrong..." it would have immediately created confrontation which is not what I wanted in my first week. A second strategy which I will continue to adopt in the future is to not let my emotions get involved in a discussion and the best way I found to achieve this is be going away thinking about the situation, confirming the correct answer, and then discussing later when emotions are not involved. Reflecting on this incident, although I am disappointed I did not discuss the initial incident with my supervisor, I am pleased that I learnt something from it which allowed me to approach the second incident with a lot more confidence and professionalism.

Initial Entry (third rotation)

My third rotation is at Fremantle Hospital, musculoskeletal outpatients. After reading through the clinical mixes I expect to be predominatly working with patients 65 years and older. I expect to see a wide variety of presenting complaints including ankle sprains, shoulder dislocations, lower back pain and post joint replacements. I believe conducting a concise and structured subjective and objective assessment will be critical in this placement as this will form a diagnosis and subsequent treatment plan. Specifically, I expect assessment items such as goniometry, muscle length and joint testing to be used repeatedly throughout the placement. I expect to see 6-8 patients per day, with initial consultations lasting 40-60 minutes, and follow-ups lasting 30 minutes.
I expect to be given more independence at an earlier stage in this placement, so that I have an independent caseload from my third or fourth day. Although I expect to be working independently from a very early stage, I am confident I will be in a very supportive environment and will be able to seek assistance where necessary. Unlike my last placement at Joondalup hospital, I do not expect a strong multidisciplinary emphasis at this placement, mainly because it is an outpatient setting.
I am very nervous and anxious prior to beginning at Fremantle because apart from practical classes and exams at university I have no experience in musculoskeletal physiotherapy. Further, although I have done more study and preparation for this placement then any of my previous placements, I still feel under-prepared and constantly remind myself of areas that I have not revised. I am also a little intimidated of the prospect of patients presenting specifically to see me for a diagnosis and treatment, rather then in an inpatient setting where the priority is on medical managment and physiotherapy augments the medical management. In this inpatient setting patients have already received a diagnosis, whereas in the outpatient setting the patients will be presenting in order to receive a diagnosis and this makes me extremely nervous. My final concern relates to time management as on this placement patients will have scheduled appointments and I will have to ensure I keep a tight schedule so that patients are not left waiting for long periods, as this is something that annoys me when I have doctor/physiotherapy appointment.