LEARNING CONTRACT

A) Student curriculum: Studies Personal interest in physical therapy/ area of practice Activities/ sports/ hobbies Rumours regarding the establishment Personal interest in the current placement Languages spoken and written Learning styles Preferred working method B) Clinical Instructor curriculum: Degrees Interests Area of specialization Clinical education experience

SELF-REFLECTION A) Previous clinical experience: Strengths Areas of improvement Supervisor’s attitudes (what was helpful/ less helpful)

SELF-REFLECTION (Cont’) B) Current clinical rotation: Expectations regarding this rotation Fears regarding this rotation Personal objectives: 1) Knowledge 2) Practical skills 3) Attitudes/ behaviours

EXPECTATIONS/ REQUIREMENTS OF THE CLINICAL SETTING Safety at all times Punctuality/ respect of the schedule Professional attire Professional attitude at all times Attendance Responsibilities Prepare the required equipment in advance & tidy it systematically Emergency codes

Major incident or situation Attitude (language or gesture) &/or omission of an intervention that may lead to prejudice, an injury or a serious problem on behalf of a client, a family member, a member of the staff or a student.

Examples Safety issues (wheel chair brakes, impulsiveness, client behaviour, specific physical condition) Leaving an impulsive client alone Does not respect the ordered weight bearing status Does not respect the contraindications Does not take a client’s vital signs when the medical condition requires it

Minor incident or situation Attitude (language or gesture) &/or omission of an intervention that may lead a client, a family member, a member of the staff or a student to be uncomfortable or inconvenienced.

Examples Arriving late Inappropriate comments Rigidity/inflexible in regards to overall feedback Not meeting the time delays for charting Not meeting the time delays for completing an initial assessment

Daily Journal Guidelines Our health care system and profession require reflective practitioners to deal with ill-defined problems. Self-awareness and self-reflection are crucial requirements in professional practice (Mezirow, 1990; Schön, 1982)

Daily Journal Guidelines What I’ve done What I’ve learnt Difficulties I’ve encountered Focus on future learning Reflection/ Questions

Daily Journal Guidelines Example 1 WHAT I’VE DONE (Important Learning Activities) Ms. L. was so discouraged with her lack of progress today that she started to cry. She cried for a good part of the session. Nothing I said made her feel better, I did not know what to do.

Daily Journal Guidelines (Cont’) WHAT I’VE LEARNT (Knowledge, Attitudes & Abilities) I never realized how important trust is in a helping relationship. Ms L. really opened up to me. I never thought that a client would talk this way to a PT.

Daily Journal Guidelines (Cont’) DIFFICULTIES I’VE ENCOUNTERED It was difficult for me to know what to do to reassure Ms L. But I also felt that I had to continue with the treatment session (I had to finish her assessment).

Daily Journal Guidelines (Cont’) FOCUS OF FUTURE LEARNING Discuss when to stop the treatment session to comfort the client and when the treatment should continue. What to say to reassure a client like Ms L.

Daily Journal Guidelines (Cont’) REFLECTION/QUESTIONS I was not sure how to show support to Ms L. I felt very uncomfortable. What could I have done differently? When a client is crying, when can you stop her and continue your treatment plan?

Daily Journal Guidelines Example 2 WHAT I’VE DONE (Important Learning Activities) I was able to complete Mr S’s initial evaluation in the recommended amount of time & use the different assessment tools practiced last week (goniometry, MMT and balance tests)

Daily Journal Guidelines (Cont’) WHAT I’VE LEARNT (Knowledge, Attitudes & Abilities) I have learned the importance of properly managing & organizing my time. I have also learned that it is important to listen to the client’s concerns so that I can focus on the problem area.

Daily Journal Guidelines (Cont’) DIFFICULTIES I’VE ENCOUNTERED I still feel somewhat nervous and awkward when I meet with new clients. It takes me a few minutes to get organized.

Daily Journal Guidelines (Cont’) FOCUS OF FUTURE LEARNING Practice of course! I really feel that I did a good job today, so this really motivates me. Now that I know that I can do it, next time I get a new client I will stay calm and confident.

Daily Journal Guidelines (Cont’) REFLECTION/QUESTIONS I am really happy with my performance today! I feel positive and confident in my assessment abilities. It feels great!!!

Daily Journal Guidelines Example 3 WHAT I’VE DONE (Important Learning Activities) When I was transferring Mr C. (with the orderly) from the wheelchair to his bed, his knees buckled. We were supporting him well and were close enough to the bed so that we could place him gently on it without injury.

Daily Journal Guidelines (Cont’) WHAT I’VE LEARNT (Knowledge, Attitudes & Abilities) It is really important to take safety precautions at all times. Mr C. transfers well usually with just a little assistance. Had I been alone or further away, I never would have been able to support him.

Daily Journal Guidelines (Cont’) DIFFICULTIES I’VE ENCOUNTERED I got really nervous when Mr C.’s knees buckled. It was hard to stay in control and reassure the client at the same time.

Daily Journal Guidelines (Cont’) FOCUS OF FUTURE LEARNING Be very vigilant about safety issues. Be aware that even “good” clients can have bad days.

Daily Journal Guidelines (Cont’) REFLECTION/QUESTIONS I was really happy to have the orderly with me. But I was also really happy that I was using proper transfer techniques and because of this (even though I wasn’t expecting it), I was able to support Mr C. well.