The Quality Enhancement Plan: Getting a resident
I believe this was one of the first meetings I attended
about the QEP and how it would affect me. I am part of the second cohort to be
on the QEP track. When I found out that as a new intern I would be provided
with a resident I felt a huge weight lifted off me. I was ready for
clinic but of course I was also very nervous and to some degree felt like first time
interns get thrown to the wolves. Knowing that there would be someone
in the room with me from beginning to end was so comforting. I had a positive experiences
with all my residents and I learned a great deal about the ins and outs of
working in the clinic.
I am excited
and proud to be a part of a school that continues to strive to improve
themselves. I know they were required to do this, but I feel they did a thorough
and thoughtful job and I’m looking forward to seeing how they continue to improve themselves
in the future.
2) Intern Meeting Winter 2014
Conflict Resolution: Thomas Kilmann Model
In the Thomas Kilmann Conflict Model there are five possible outcomes to conflict: competing, accommodating, avoiding, collaborating, and compromising. In the clinic environment there are many differing types of relationships ranging from your treatment partner to your supervisor to your patient. We discussed the ways in which we might use this model to best resolve conflict.
I find that personally I do not shy away from conflict and tend to appreciate the ways a peaceful conflict resolution can improve a relationship. Soon after this meeting I found myself in conflict with my treatment partner. They would ask my patient questions while I was in the middle of my intake. This not only annoyed me, but I felt it undermined my relationship with my patient. To be fair, we had never talked about a protocol for our partnership and therefore I suspected they didn’t know what they were doing was causing a conflict. My partner and I have a history of working together in various roles and based on our previous encounters I was worried they would not take any type of confrontation well. My instinct was to avoid. Just pretend it wasn’t happening and wait for the term to end, but I could feel my annoyance with them building to the point it was spilling into other parts of our relationship. I decided to pursue a “collaborating” model and confronted him the next time we were in clinic. The results were fine, I could tell they were somewhat miffed but they immediately complied and said they understood. Our relationship was a rocky one to begin with so after the confrontation when it went back to being rocky I figured that was the best result I could have hoped for.
3) Intern Meeting Summer 2015
Coaching Psychology: Improving connection to and compliance
of patients.
During this intern meeting we were shown techniques for
discussing issues with patients and learning how to develop a plane with
patients, not just for them. Asking questions such as: "what are your goals for
this?" Or "what strengths you’ve used before to help you in other challenging situations?"
Since attending this meeting, and taking Clinic
Communication Skills 3 with Lorena Monda, I have been able to apply these
skills in my work with patients. I have found it especially effective when
discussing the use of herbs and dietary modifications. The latter especially can
be extremely difficult for patients to comply with, even if they truly want to.
Commitment to act: I would like to try and utilize some of
these questions even more in my treatments. I believe that including you
patients in the treatment process will produce better, more long lasting
results for them.
4)
Intern Meeting Fall 2015
Charting: If you didn’t chart it, it didn’t happen.
I have noticed this happens in two different areas. One,
when recording e.stem, interns will leave off the Hz and the length of
stimulation. These are both vitally important for replication of the same
treatment by the next intern. Two, when recording Tuina clinics over and over I
have seen merely the word “Tuina” with nothing else.
Commitment to act: I have always made sure to chart as many
specifics about the e.stem as possible and will continue to do this, even in my
own future practice. I started in Tuina clinic this term and since this intern
meeting I have made sure to always include what specific techniques, routines or manipulations I have used as well as length
of time for each.
5) Intern Meeting Fall 2015
Physical Exams: Organization and break down
In this training session we went over all the appropriate
exams and as Lesley was writing them up on the board she put them in categories:
musculoskeletal, neurological, vitals, auscultation, etc. Physical exams have
been an area I always feel
unsure of myself in. I think part of it has to do with the number of PE we
learn and have to sort thru in clinic at the drop of a hat. When Lesley started
categorizing them it made me realize that so much of what I already do (vitals)
are PE and also that by putting them into categories it helps simplify choosing
the correct ones.
Commitment to act: I would like to work on my confidence in
asking for patients to do PE for me. I would also like to encourage myself to
simply do one PE per patient no matter what. In that way, allow myself to
practice some of the PE that are less common.
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