FINAL ENTRY

Looking back at my five week placement at PMH I am disappointed. With such large expectations for this placement I have not achieved all that I would have liked too. I feel this is for two reasons;

Firstly, the placement structure was hard to familiarise myself with as I had different supervisors each day, as well as attending many clinics throughout each week. Often my schedule was not planned until the Monday of each week. This left a lot up in the air and I found it hard to prepare for the upcoming days. To a degree this made me feel slightly unnerved as I prefer to be organised and prepared for the upcoming week.

Secondly, I was rarely given the opportunity to demonstrate my skills. I understand that it is a matter of the family’s wishes and our involvement is largely dependent on the family’s acceptance of student participation, though certain supervisors allowed for minimal hands on experience and as a result I was marked low in this area. Given consistent opportunities I feel I would have been able to learn and develop skills in this area though as my main supervisor only treated complex presentations, it was rare for such an opportunity to arise. Also having no consistency in patients was difficult as I was unable to gain familiarity with the family or the child.

In hind sight I should have taken a more proactive role and asked to have my schedule done in advance. Also getting hands on by coming forwards and requesting to try everything that the supervisor demonstrates.

This is a very difficult placement. The most difficult element would have been the instability and variability of the placement structure. In terms of the paediatric physiotherapy I feel I could have done well given the opportunity.

I was able to come out of this placement with a few new experiences such as, suctioning, facilitation, working with children and exposure to a very broad range of patients. Particular areas I enjoyed were Hip Surveillance clinic on CP children of all ages and plastics clinic. I also enjoyed working with the older children and teenagers as they were able to take on board my feedback and respond appropriately. You can also gain a clearer subjective from the child directly rather than through the parents.

Recapping on my initial concerns;
- The emotional attachment issue did crop up on occasion and at times it was a challenge to stay composed. PMH has the worst paediatric presentations from the whole of WA in the one location and this can be overwhelming but I managed control this majority of the time.
- Communicating with families wasn’t a strong point for me as I often found it hard to try and gain handling opportunities as well as relating to the families.
- The barrier to students treating children was a prominent issue. This was evident in most treatment sessions and it was obvious when the parents changed their tone and general posture when I went to try a treatment. When asked a question by myself, they would often answer by addressing my supervisor which I found frustrating at times.
- And as previously mentioned, getting hands on experience was difficult.

From my initial expectations and desire to do paediatric physiotherapy my plans have changed somewhat. I enjoyed the musculoskeletal side of paediatrics and found these patients were more willing to have student input, though when medical complications were added to a substantial history of complaints, this is when student input is less welcomed. Community based paediatrics would be an area I would consider.