Clinical Case Studies in Physiotherapy

A Guide for Students and Graduates

Lauren Jean Guthrie

• Publisher: Churchill Livingstone
• Year: 2008
• ISBN:
  9780702036200
• Topic: Medicine
• Subtopic: Physiotherapy, Physical Medicine & Rehabilitation

Starting a placement or rotation in an unfamiliar clinical area is exciting but can be daunting. CLINICAL CASE STUDIES IN PHYSIOTHERAPY provides invaluable advice and practical guidance on cases and problems encountered on a daily basis allowing you to work with ease and confidence. By adopting a problem solving approach to the cases through the use of questions and answers, the authors will help you to think constructively about each case within all the key specialities of physiotherapy.Starting a placement or rotation in an unfamiliar clinical area is exciting but can be daunting. CLINICAL CASE STUDIES IN PHYSIOTHERAPY provides invaluable advice and practical guidance on cases and problems encountered on a daily basis allowing you to work with ease and confidence. By adopting a problem solving approach to the cases through the use of questions and answers, the authors will help you to think constructively about each case within all the key specialities of physiotherapy.

• Hints and tips to get you ready for clinical placement
• How to secure your first physiotherapy post
• Case studies in the following clinical areas: respiratory, orthopaedics, neurology, musculoskeletal out-patients, care of the elderly, mental health and womens health
• Cases covering paediatrics also included

CHAPTER ONE Introduction

Lauren Guthrie

Every person who trains as a physiotherapist has to go through it. You might be a first year physiotherapy student about to begin your first placement or you could be a final year student about to do your last placement. You might be a newly qualified junior physiotherapist looking for your first post or you might have been working for some time, in a rotational post. It’s nerve racking but at the same time exciting and most defiantly full of unknowns. Don’t know what I’m talking about yet? It’s entering a clinical specialty of physiotherapy that you don’t have much, or any experience in. Do not fear, help is at hand and this book aims to help and support you, and take away the unknowns in some of the many specialties within the physiotherapy profession.

Chapters two and three are aimed primarily at students preparing for a clinical placement as part of a training programme, but provide lots of references recommended by specialists in their field and may, therefore, be of use to any physiotherapist looking to find out more about other areas of physiotherapy. These chapters will tell you everything you need to know, from what your first day could be like to recommended texts and revision topics for the main physiotherapy specialties.

Chapter four is an excellent resource for students nearing the end of their study or recently qualified graduates who are trying to secure their first physiotherapy post. This chapter gives lots of hints and tips on where to look for jobs, how to fill an application form, how to compile your CV and how to survive that all-important interview when it comes along!

The remaining chapters of the book are case study chapters covering the main areas of physiotherapy along with two less common areas. Various clinical settings have been covered within each chapter, for example, community, acute hospital, rehabilitation hospital and out-patients. Each chapter also incorporates a range of patient age groups from paediatrics to the older adult. You may find that case studies from several chapters will be of benefit to you prior to and during placement, as, in reality, the various areas of physiotherapy can cross over. For example, on an orthopaedic ward you may have a patient with some respiratory complications post surgery. Or you may be working in the community dealing with a range of conditions from neurology to musculoskeletal.

The case studies are structured to help you develop problem solving and clinical reasoning skills as these are important once you are in the clinical setting. Each case will give details of a subjective and objective history of a patient. Take note of how the assessments have been structured in the case histories. They have been written out in more detail than would be expected when writing SOAP notes (the standard format of physiotherapy notes) in a clinical environment but include all the information that you should be looking out for, for example the patient’s body language and behaviour. Getting used to the content of an assessment will be of great help once you start placement. Following the case history you will be presented with several questions relating to it, which will get you thinking about what the patient’s diagnosis and main problems are as well as what types of treatment would benefit the patient. Questions relating to other health professionals are also included in some cases.

It is important to realise that the answers to the questions posed and suggested treatments are not a recipe for all patients with similar conditions. Every patient is individual and will cope with their condition differently and respond differently to treatments. What treatment is suitable for one patient may not be suitable for another patient with the same injury or condition. Therefore, use the case studies to give you a general idea and consider the patient’s individual circumstances when assessing and treating them.

Working through the case studies can be useful prior to placement to get an idea of the clinical application of knowledge, in addition to during your placement as it may help you to see how everything fits together in the clinical setting. You may choose to revise your theory knowledge in a certain area then test that knowledge by working through a case study. Or, you could use case studies to identify your learning needs in a particular area, then form an action plan to address these needs and record it in your CPD (continuing professional development) portfolio.

When working through the case studies don’t be alarmed or worried if you feel like you don’t know or understand anything, it’s normal. Use the suggested reading to help you or discuss it and think it through with some like-minded friends. Some of the techniques or approaches discussed within some of the case studies may be completely unfamiliar. Don’t worry if after reading up on some of the techniques or approaches you are still unsure or are struggling with the questions, sometimes these things require practical experience to fully understand them but the case studies within this book will get your brain working in the right way and help you get started.

Unfortunately, it has been impossible to include everything that I would have liked to in this book. However, the recommended reading and sources of further information are really useful. Having a physiotherapy dictionary close to hand to look up any terms you are unfamiliar with will help, as it is outwith the scope of this book to provide definitions of physiotherapy terms.

CHAPTER TWO How to prepare for placement

Lauren Guthrie

Clinical placements are one of the most exciting and enjoyable parts of your training as a physiotherapist. Placements provide the opportunity to develop and enhance your patient handling, problem solving, communication and team working skills, and to apply all of your theoretical knowledge as well as gain lots of new knowledge.

The Chartered Society of Physiotherapy (CSP) states that to qualify as a physiotherapist you need a minimum of 1000 hours of practise- based learning to prepare you for professional practise (Chartered Society of Physiotherapy 2005). To some this may be adequate in order to build enough confidence in your own ability, get out there on your own and go for it. For the majority of others it just doesn’t seem like enough time. Therefore, it is really important to make the most of every one of those 1000 hours and one way to achieve this is to do some placement preparation. Investing some time into getting ready for your placement will prevent you playing catch up on theoretical knowledge when you’re working full time as a student physiotherapist, trying to process all the new clinical knowledge that you will be gathering daily.

Where to get information on your placement

Placement profiles

Some universities have a profile for each placement. This should give details of type of placement you are going on, the address of where the placement is and how to get there, the name and contact details of who your clinical educator(s) will be, hours of work, accommodation if applicable, educational facilities, local information (Chartered Society of Physiotherapy 2003), ...