Impressive students

I am really impressed with the students I am currently teaching. They are really on task. Now I realize that it is still early in the semester but I really think these guys are going to go strong throughout the entire semester. They are working hard through every lab we have. Not only do they do what I ask them to do with their assigned partners but they consistently do the task with several other students. We have told them how important it is to practice a task many times with many different people and they have certainly taken this recommendation to heart and do so on a daily basis.
Hooray for students that listen! Hooray for students that practice time and time again! Hooray for all of us that will be associated with hard working, skilled practitioners in the not so distant future!

Practical Exams

Well, we had our first practical exams this past week. A practical exam is an exam where the students have to not only answer questions orally but they must also show manual skills they have learned in class. There is no doubt about it, these are very stressful tests and I have seen many a student fall to pieces because of the amount of stress. On the flip side, the practical exams are a great place for learning. We are often able to find out if students really understand a concept or if they are able to articulate their knowledge or show that they have mastered a skill...this is all, of course, depending on whether they can get passed the stress thing.
I really get a charge out of when a student can make sense out of signs and symptoms and make great choices and then show me they have been practicing by nailing a manual skill. While most students get pretty nervous the large majority of those that spend the time studying and practicing really do well. I often tell students that if they work hard, more than likely things will work out...a pretty good lesson for most things in life.

From certain surgery to happy camper

I had a great day in the clinic yesterday. My very first patient of the day is doing extremely well. He came in with neck and radiating arm pain and paresthesias of less than 30 days. Looking up did not aggravate his symptoms. He was still working and not afraid of working or doing other activities due to his neck and arm pain (although he wanted to make sure that what he was doing was not going to make anything worse). He had limited neck extension and his thoracic spine was stiff and flat. He told me that the neurologist he went to told him that he would have to have surgery to help him with his pain and especially the numbness and tingling he was having in his arm. He did not want to have surgery and asked the surgeon if there were any other options. The surgeon told him plainly that that surgery was his only option. Luckily, the patient decided that he would try physical therapy first and he called the surgeon and asked if he could do that and the surgeon reluctantly gave him a script for physical therapy but told him that physical therapy would not help him and that he would see him in a month when they could schedule his surgery.

Well, it has been less than a month and my patient is very close to being completely free of his symptoms. He occasionally gets some neck pain but his arm pain and paresthesias are gone. He told me yesterday that he was really scared when the doctor told him that surgery was the "only solution." When I saw him on first visit I knew that I could help him. Why did I know? Because I followed a clinical prediction rule that states if the patient has at least 4 of 6 matching criteria my success with thoracic manipulation and cervical exercises goes from flipping a coin (54%) to 93% success rate. He matched and I was certain I would help him. And I have. It is great to have a day like I did. It is really good for me when I can use evidence to guide me to be solid physical therapist and even better for my patient who avoided a costly and risky surgery that may or may not have even helped him. He is a happy camper and so am I.