Carolyn Mistele

Professional Goal Statement

I plan to use all of the knowledge and experience I gained throughout my Doctor of Physical Therapy program at the University of North Carolina at Chapel Hill to become a successful entry-level clinician upon graduation. I believe that physical therapists are in a unique position to positively impact others through movement, and I aspire to use my expertise to help patients develop, maintain, and restore function so they can best participate in their own lives. I aim to provide high-quality, patient-centered, comprehensive care and to work on an interdisciplinary team in whatever practice setting I choose. I plan to use the first years of my career to explore the various realms and practice settings of physical therapy before determining my area of specialization. At this time, my focus is on neurological conditions and rehabilitation across the lifespan; and in the future, I may concentrate my efforts to either Pediatric or Neurologic Physical Therapy. My goal is also to maintain my enthusiasm and passion for this profession and continually seek out new knowledge so I can practice at the full level of my expertise.

Career Plan

• December 2017: Received a B.A. in Exercise and Sports Science, minor is Neuroscience from the University of North Carolina at Chapel Hill
• August 2018: Entrance into UNC DPT program Class of 2021
  • Clinical Affiliation I (8 weeks) 2019: Johnston Health Hospital, Acute Care; Smithfield, NC
  • Clinical Affiliation II (2.5 weeks) 2020: Select Physical Therapy, Outpatient Orthopedics; Concord, NC
  • Clinical Affiliation III (8 weeks) 2021: UNC Inpatient Rehabilitation, Neuro; Chapel Hill, NC
  • Clinical Affiliation IV (12 weeks) 2021: Child & Family Development, Pediatrics; Charlotte, NC
• July 2021: Graduate with a Doctorate in Physical Therapy, UNC-Chapel Hill
• July 2021: Pass the National Physical Therapy Examination
• September 2021: Begin my career as a Physical Therapist in the Charlotte area
• First 5 years of employment:
  • Pursue mentorship from an experienced Physical Therapist in my area
  • Become a Clinical Instructor for PT students
  • Sit for specialty exam

Self-Assessment

Areas of Strength

Strong interpersonal skills to build rapport with patients of various ages, backgrounds, and conditions. Great informal education skills to teach patients, families, and SPTs with a wide range of health knowledge about their bodies, conditions, and treatments. Excellent professionalism and communication with peers. Compassionate, enthusiastic, and respectful. Strong ability to recall and apply didactic coursework. Clinical experiences in a variety of practice settings including rural acute care, outpatient orthopedics, inpatient rehabilitation, and outpatient pediatrics

Areas for Professional Development

Leadership and advocacy efforts in the profession. Time management and efficiency with documentation and billing. Navigating requirements for various payers (Medicaid, Medicare, etc.). Ability to think critically during complex patient encounters. Expanding knowledge of and integrating evidence-based interventions into my practice. Coordinating resources for patients/families with complex needs (ex: financially, psychologically, environmentally)

Objectives

Possible special areas of interest: Pediatric PT, Neuro PT, Inpatient rehabilitation, Acute Care

• Graduate from UNC-Chapel Hill with a Doctorate in Physical Therapy in August 2021
• Pass the NPTE in July 2021 to become a licensed Physical Therapist in North Carolina
• Obtain employment as a full-time or rotating PRN Physical Therapist in a large healthcare system in Charlotte, NC by September 2021
• Become an APTA-certified Clinical Instructor and begin working with SPTs within 3 years of employment. Work with at least 1 student/year throughout career.
• Become a specialty clinician (NCS or PCS) within 5 years of employment
• Maintain enthusiasm for the Physical Therapy profession throughout my career

Specific Strategies-

• Complete, pass, and gain as much knowledge as possible from my remaining graduate courses
• Participate in neurologic physical therapy research for my Capstone project
• Complete ICE elective in orthopedics to develop more comprehensive clinical skills
• Complete 8-week clinical rotation in neuro-based inpatient rehabilitation
• Complete 12-week clinical rotation in outpatient pediatrics
• Create and adhere to a study schedule for the NPTE starting in January 2021 to be continued during 2 clinical rotations
• Attend relevant networking events (ie: Atrium Health networking dinner in 2020) and reach out to potential employers independently during my final clinical rotation.
• Attend state and national APTA conferences (ie: CSM in Washington, DC in 2019, APTANC Student Conclave in 2020) and virtual conferences in light of COVID-19 safety precautions
• Update my resume and LinkedIn to reflect my recent experiences and accomplishments in preparation to apply for jobs
• Research and prepare specific questions for potential employers about mentorship, productivity expectations, and support for continuing competency to ensure that my work environment fosters professional development

Product Examples

Below are the links to several projects and products I created during my final year of the program.

• Capstone Project: Age-Related Hearing Loss for the Physical Therapist: Effects on Postural Control and Strategies to Promote Comprehensive Care in the PT Clinic 
  • Hearing Loss for the Physical Therapist presentation slides PDF
  • Capstone-Evidence-Table appraisal of relevant literature
  • Communication Tips Flyer key points for practicing clinicians
• Comprehensive Annual PT Examination for Adults with Parkinson Disease
  • Annual PT Exam
• Community-Based Exercise Program Proposal:
  • Physical Education for Parkinson Disease (P.E. for PD)
  • Evidence Table

Electives

• Spring 2019:
  • Multidisciplinary Service-Learning Trip to Tyrrell County
• Fall 2020:
  • Child and Family Assessment and Intervention
  • Research Experience: Role of Auditory Input in Postural Steadiness during Quiet Standing in Older Adults With and Without Hearing Loss with Vicki Mercer, PT, PhD
• Spring 2021:
  • Integrated Clinical Experience: 60 direct patient care hours in outpatient orthopedics at faculty practice clinic

Justice, Equity, Diversity, and Inclusion

Experiences:

• • P Goddu A, O’Conor KJ, Lanzkron S, et al. Do words matter? Stigmatizing language and the transmission of bias in the medical record. J Gen Intern Med. 2018;33(5):685-691. doi:10.1007/s11606-017-4289-2
  • “Reflections on Race and Medicine in the Year of COVID-19 and Nationwide Protests” by Dr. Damon Tweedy, MD, author of the book Black Men in White Coats https://youtu.be/1xyadm9Mhqk

Reflection

It’s crucial that we all recognize and remember that health care is not objective; rather, it is part of and inherently influenced by our larger society and culture. We would like to think that the medical field is driven by evidence and objective findings; however, it has been shown time and time again that the health care system as a whole is rife with implicit biases and systemic policies that perpetuate healthcare disparities. The COVID-19 pandemic has shone a light on these problems and sparked a wide scale discussion about the inequity of medical care and medical outcomes that negatively impact marginalized groups. In his webinar in September 2020, Dr. Damon Tweedy noted the higher mortality rate of Black people from COVID-19 and lack of Black representation in vaccine trials. He also made a prediction that there would be an inequitable distribution of the vaccine based on race and socioeconomic status (four months before any vaccines were available to the public). Come January 2021 to the present (June 2021), his prediction unfortunately and unshockingly came to fruition.

“If I cannot do great things, but I can do small things in a great way”—Dr. Martin Luther King, Jr. It is overwhelming thinking about trying to fix such a historically broken system. However, as Goddu et al. underscore in their randomized study, we do have control over our specific actions; and we can make conscious decisions to reduce the chances of being a vessel that perpetuates bias. Medical records should be an objective means of transmitting pertinent health information about a patient from one provider to another. However, based on the language used while writing medical records, one clinician can influence the judgment of subsequent providers. I can take the specific examples put forth in the article with me as I enter my career and strive to record only relevant and objective data and exclude any personal value judgments, feelings, or opinions in my patient notes. In their study, language that stigmatized the hypothetical patient’s chart included: casting doubt on the patient’s pain, adding unnecessary information that may portray the patient negatively, implying patient responsibility or uncooperativeness, and using disease-centered language. As I read patient’s charts and write my own PT notes in my career, I will try to always remember how much words matter and how they can affect my patients’ health outcomes.

Reflective Statement

One of the biggest decisions of my life so far was enrolling in UNC’s Doctor of Physical Therapy program. Chasing after the career I wanted took a significant financial and time commitment; but looking back over my last three years, it is clear to me that I have gained an amazing return on that investment. These years have been equally challenging and fulfilling. I am forever grateful for the personal and professional growth that I have experienced at UNC. I have gained invaluable knowledge, skill, and confidence in Physical Therapy that I will carry with me throughout my career. From my time at UNC, I will also take away crucial practice in accountability, professionalism, and continuous learning. I am immensely appreciative of the UNC DPT community that I have been a part of for the past 3 years and that I will remain in as an alumnus. I have felt supported by my faculty and classmates, and I have made beautiful, lasting friendships. When I was 17, I moved from my home state of New York to Chapel Hill, NC to attend UNC for undergrad. UNC and this program have made North Carolina my home indefinitely. I’m excited to now begin my clinical career in Charlotte, NC. While I don’t know what area of PT that will be in, I do know that I am ready and that I will continue to build upon what I’ve learned at UNC.

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