DPT Portfolios

Professional Goals:

My initial goal upon graduation is to be offered a position within an outpatient general orthopedic/sports medicine practice or be selected for an orthopedic residency to further increase my knowledge and skill-sets within the orthopedic setting in becoming a unique, diverse and multi-faceted Doctor of Physical therapy.

As an expert in functional movement, diagnosis, treatment & prevention of orthopedic injuries, I plan to use my extensive and diverse experience in high-intensity labor vocations, (Wilderness Tree Removal, Fuels –Reduction, carpentry, welding, Industrial Construction, Masonry) athletics and the rapidly growing niche of bouldering/rock climbing to provide task/patient-specific rehabilitation to optimize return to work/return to sport/completion. In order to most effectively treat this patient population throughout my progression through the DPT program I have chosen to take advantage of assignments and/or projects in courses such as Managing Contemporary Practice and Evidence Based Practice II to allow for more in depth research and understanding on topics of personal interest. Through these efforts I was able to develop a pre-emptive business plan, model and pitch for a realistic format in developing my future private practice. I was also able to develop a Critically Apprased Topic focused on the efficacy of implementing task-specific interventions which combining CKC UE positioning and postural stability training for rock-climbers presenting with GHJ pathology. Furthermore, my literature review showed that within the rock climbing population, following traumatic GHJ dislocation and confirmed lesion to the labrum, primary surgical repair followed by extensive rehabilitation is strongly indicated over solely conservative means of rehabilitation protocols and more effective in preventing further injury to the joint, recurrent GHJ dislocations and improvement of long-term functional outcomes in return to sport and overall health-related quality of life.

http://prezi.com/nzgbz7cqerx7/?utm_campaign=share&utm_medium=copy&rc=ex0shareCareer Path:

July 2014:

• Subscribe to the orthopedic journal of sports medicine through APTA and another magazine geared towards ergonomic assessment (Resources for my capstone)

 

May-July 2015:

• Complete final orthopedic rotation at Proaxis Therapy
• Participate in small study group sessions with CI and fellow PT at Proaxis as they prepare for OCS and CSCS coming up

 

August 2015: Graduate UNC DPT Program

 

September 2015:

• Study for boards, sending in resumes, begin studying for CSCS specialty certification.
• CLIMBING TRIP/ADVENTURE

 

October 2015:

• Take and pass boards
• Offered PT position in a general orthopedics/sport medicine clinic in the Raleigh/Durham/CH area

 

Spring/Fall 2016:

• Continue with same clinic gaining experience and confidence in clinical rationale and overall practice and differential diagnosis
  • Start working on continuing education for orthotic fabrication
  • Start working towards CEAS I
  • Continue to prepare and sit for CSCS certification exam

 

 

Fall/Spring 2016-2018:

• Increased exposure and continuing education regarding Upper and Lower Quarter, LBP/NSLBP manual therapy, ergonomic assessment and custom orthotic prescription and fabrication.
• Begin looking into process of obtaining contractors license and forming personal LLC
• Remain in close proximity to networking sources for labor-based vocations as well as involved within established climbing community to acquire current referral base
  • Goal of building a reputation with clinical experience to gradually begin taking on private self-pay contracts regarding pre/overall conditioning, injury prevention and skilled treatment on the weekends
• Begin CE and preparation for specialization in manual therapy
• Take OCS specialty examination
• Take CEAS I

 

Fall/Spring 2018-2020:

• Continue building my referral base/ contracty gradually within manual labor vocations and the climbing community
  • Goal: To be financially capable to lease warehouse space and hire a PTA or administrative assistant for LLC.
• Acquire enough CE to gain specialization in custom orthotic fabrication and certified manual therapist
• Continue with gaining knowledge and experience with general orthopedic and sports medicine practice as to feel confident to branch off within the rural and underserved environment more independently without as much guidance and mentorship needed.

 

By September 2025:

• After 10 years of practice I will have gained the knowledge base, experience and networks to transition to opening private outpatient clinic dedicated to the diagnosis and treatment of orthopedic based impairment/injury within the general community as well as onsite-assessment, performance enhancement, pre-conditioning, injury prevention, return to sport or vocational activities.

 

Self-Assessment:

Strengths

• General knowledge of orthopedics and good grasp on the Lower Quarter as well as shoulder
• Gait analysis
• Functional/Task analysis
• Intervention development
• Take a look at some of the intervention programs I have tailored and developed over the course of the DPT program (Link)
• Extensive previous work history/experience and skill with rock-climbing, The National Forest Service, National Park Service, Industrial construction, Mason
  • Ability to be uniquely task-specific & patient-centered
  • Set network in all niches mentioned above that are aware of my upcoming graduation from the UNC DPT program

 

• Special Interest in the Lower-Quarter Screen, LLD, static/functional malalignment and production of custom foot orthotics

 

• Recent orthopedic sx and rehab since beginning program
  • Gained good amount of tools as well as hands-on ME experience to get a true feel for force, pressure exerted and progression of treatment

 

• Interest and motivation for continual EB research

Areas of Professional Improvement:

• Continued exposure to acute and chronic LBP
• Continued experience with administering detailed LQS
• Get ducks in a row for SCS examination
• Increased observation and experience with work-site assessment
  • Talk with Pat-Pande
• Increased Observation, experience and knowledge with diagnosis of Lower quarter malalignment and fabrication of custom foot orthotics.

 

• More experience with functional mobility training and interventions with Amputation and CVA
  • Majority of workers in construction field (obese, DM, HTN, chronic smokers)

 

• Start looking more into different residencies as well UNC
• Increased organization
• Increased compliance with checking Emails
• Become more consistent with electronic and phone communication with colleagues and superiors and improve my willingness to embrace conflict or having difficult conversations with superiors or those I am in-charge of.

Objectives:

1. Become and continue to practice and develop extensive library of EB research, and communication during online portion of DPT curriculum as to optimize efficiency in performance as well as maintain networking avenues for future jobs, clinical sites, residency etc.
2. Begin studying for Board exams over Christmas break and develop system to cover all material in a gradual manner.
3. Continue to fine-tune and increase my knowledge base with skilled rehabilitation in regard to the topics below by completing capstone project on evidence based methods for diagnosis treatment and prevention of repetitive, high-intensity, work-related MSK injuries and chronic LBP
   1. Biomechanics
   2. Functional gait/task analysis
   3. Ergonomic assessment
   4. LQS
   5. Custom orthotic prescription and production
   6. Physiology, kinesiology and treatment of the avid/competitive rock climbing, industrial construction, Wilderness construction.

 

 

 

Strategies:

• Continue to stay in contact and work within NACS on specific weekends or portions of holiday shut-downs
  • Keep up skills ability within this very specific construction entity
  • Networking for future clients
  • Continual task analysis to determine functional requirements and ideas to center on for capstone

 

• Contact the NC Trail Conservancy and inquire about what if any means the organization takes to educate volunteers/completion of ergonomic seminar/afternoon class about proper body-mechanics to prevent injury when building and maintaining hiking trails.

 

• Contact Tim Warner (former boss/ director of the SW-region of the Montana Conservation Corps) Currently the Trails Director at Great Smokey Mountain National Park.
  • Inquire about avenues utilized for PT/rehabilitation with acute or chronic overuse injuries with crewmembers.
  • Set in stone due to government agencies or wiggle-room or non-existent?

 

• Begin to look-up, contact and observe more on-site assessment and increase awareness of available clinics/firms that deal mostly with workers-compensation FCV
  • Contact Pat Pande

 

• Talk to Mike Gross about increasing observation opportunities as well as possible placement with him as CI during ICE elective during the second semester to obtain one on one tutelage and practice completing LQS along the functioning of the entire kinematic chain of the lower quarter.
• Make business cards
• Start membership at new climbing gym in CH with massage therapy
• Continue to research and analyze functional requirements with rock-climbing and manual labor vocations regarding injury prevention, treatment and performance enhancement.
  • Segment length/trunk/proximal stabilization APR, APA
  • Quasi-static equilibrium
  • Weight shifting
  • Inter/intra-joint coordination
  • Motor learning
  • Grip/gross/fine motor control

 

• Start getting materials together with regard to timing, sequence and due dates for orthopedic residencies at UNC as well as other locations.

Plans for Clinical Courses, Electives & Doctoral Project:

• Fall coursework
  • PHYT 820: Advanced Patient Management I
  • PHYT 752: Evidence-Based Practice II
  • PHYT 824: Topics in Health and Wellness
  • Elective I (3 credits)à Advanced Orthopedic Assessment

 

• Spring Coursework
  • PHYT 822: Advanced Patient Management II
  • PHYT 839: Advanced Practice Issues
  • PHYT 854: Capstone Project
  • Elective II (3 credits) Integrated Clinical Experience
    • Gained further knowledge behind the concepts of manual therapy techniques, mobilizations and manipulations and hands on practice and experience in their timeline of use, technique and purpose behind implementation
    • Gained a large amount of experience with completion of detailed lower-quarter screen (LQS) regarding strength, tissue extensibility and presence of static and/or functional malalignment as well as possible leg-length discrepancy.
    • Gained experience with methodology and rationale in fabricating custom orthotic inserts as a means to treat and reverse musculoskeletal pathologies or conditions
    • Gained experience with the evaluation, differential diagnosis and treatment within the Upper quarter, cervical spine
    • Observed and worked with multiple faculty-clinicians in diverse orthopedic settings and patient population. This allowed for a wide breath of exposure to different styles of treatment, patient interaction and various means to practice in a evidence based manner within the orthopedic setting.

 

Doctoral Project:

 

• I chose to complete a 2-year follow-up assessment of a pilot protocol I helped to develop at SMH, located in Laurinburg, NC. In doing so I hope to identify and share what is necessary to research, advocate, develop, implement and sustain an early mobility program and more importantly a culture which embraces mobilization early and often when indicated within any and all inpatient facilities. Lastly I hope this will become a dual opportunity for other students and clinicians by introducing a new perspective regarding clinical practice in rural areas by highlighting the ability clinicians and student clinicians have to be creative, and possess a voice of great weight and value. I also plan to provide a Lecture presentation for PHYT 736(PT for the Older Adult) which will cover the large breadth of research advocating the use of ICU early mobility, the process of developing a early mobility protocol tailored to an individual inpatient facility and the importance of interdisciplinary collaboration of clinicians and student-clinicians alike to best serve those residing in rural and underserved regions of NC.

 

 

Reflection

My aunt who worked as a massage therapist in conjunction with an outpatient orthopedic practice exposed me to the profession of physical therapy at a young age. Ever since I have always found the profession especially attractive, active and exciting career and seemed an excellent opportunity to be a personable primary care entity and health care professional.. My observation in different settings solidified PT as my career path with my exposure to orthopedic differential diagnosis, clinical deductions, biomechanics, movement analysis, hands-on skilled treatments and task-specific strength & conditioning.

In going through the DPT curriculum the knowledge I have acquired and experiences during hands on patient care have facilitated significant personal growth, self-transformation and facilitated great personal fulfillment as well as accomplishment. This journey has been solid affirmation of an often questioned and somewhat convoluted “less traveled” path to become a doctor of physical therapy was in actuality, the perfect one to take to take.

My early expectations of the profession previously mentioned have been met and far surpassed in the great breadth of opportunity I now have to make a positive impact of longevity in another’s life across their entire lifespan and any point along the healthcare continuum.

Upon beginning orthopedic practice, while enhancing my clinical skills within the orthopedic setting, my many tangible experiences with healthcare legislation and opportunities such as being an actual lobbyist for the PT profession at the NC House of Representatives have been large motivating factors to become and remain an active advocate to assist in the molding and modification the publics current notion of the PT profession, it’s scope of practice and the type of individuals who become doctors of physical therapy.   With the significant amount of patient interaction we experience I am motivated to use my diverse background and life experiences along with sound clinical rationale to provide competent and optimally relevant incite and empathy to optimally promote trust, mutual accountability and respect. I have learned through my path less traveled that being flexible, having a realistic understanding with welcoming mindset regarding the variability of life in-general whilst focusing on it’s influence in the development, healing or attenuation of the injury or pathology at hand.

This personal view will serve as a foundation to facilitate a sense of opportunity and obligation as a DPT to consistently practice in creative, evidence-based manner that is truly individualized for patients orthopedic setting within both urban or rural, underserved and non-underserved alike. These ideals will serve as a spring board for development and implementation of holistic-based ideas for heath promotion & wellness programs/protocols within my future clinical practice such as elder adult hiking groups and Community Gardening  initiatives/programs which combat immobility, malnutrition, multimorbidity and frailty within the underserved, rural community which I developed during my DPT progression.

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