Talisha Dawes

Clinical Experience Reflection #3

November 19, 2022

My final clinical rotation took place at the VA outpatient clinic in Salt Lake City. I was very

nervous, yet excited going into this clinical because outpatient orthopedics is what I have always been

interested in going into. I was excited to finally see and practice manual therapy techniques, work with

orthopedic diagnoses, and get to finally test my knowledge and ability of progressing treatment for

higher level patients. My clinical instructor graduated from SLCC’s PTA program almost 13 years ago –

and she had been a certified yoga instructor for longer before that. My CI specializes in yoga therapy and

deep breathing/relaxation techniques for treatment with chronic pain patients. I was able to learn a lot

about how to correctly utilize pain neuroscience education and different breathing techniques to calm

the sympathetic nervous system with patients expressing high levels of pain and/or stress and anxiety.

This clinic was definitely an adjust to me – especially compared to my first two rotations. I

wasn’t used to having so few patients to see in a day, nor used to patients being able to ‘cancel’ their

therapy for the day/week. I wasn’t used to only seeing a patient once a week or once every two weeks,

when at my first two rotations I was seeing the same patients’ multiple times a day, every day, for

several weeks. I also didn’t expect to see so many chronic pain patients at this clinic, when I had been

expecting more joint replacements, ligament injuries, tendinopathies, etc. (like a regular outpatient

setting). I am not going to lie – I was a little disappointed in that aspect of this rotation. I was excited

that this was finally the setting I wanted to go into, and I was hoping to become more comfortable

working with those kinds of diagnoses for my future job, and in reality, I didn’t really see any of that. I

didn’t get the opportunity to perform any special tests, take ROM measurements, manual muscle

testing, or any joint mobilizations/STM/DTM. I was told that the PTAs at that clinic aren’t allowed to do

much manual therapy, and it was basically left at that. I was also told to not think of the patient as “my
patient” but as the physical therapist’s patient who we as PTAs are only assisting with. I didn’t really care

for that state of mind either. I didn’t really feel like the PTAs were utilized there as they could be. Linda,

my CI, basically only saw chronic pain patients and Pablo, the other PTA, did a lot of modalities. I also

didn’t like how the PTAs were referred to as physical therapy assistants. Overall, I was just kind of

disappointed in this aspect of my outpatient clinical rotation.

Going back to my experiences with Linda, I was able to learn more about PNE and how pain

really affects the brain. I got to practice more gait and balance training with patients who demonstrated

gait abnormalities and/or were at high risk for falls. I learned new ‘corner balance’ exercises to keep in

my toolbox for future patients and more ways to challenge my patient’s dynamic balance and balance

reactions. I again worked with mostly chronic pain patients, so I did a lot of patient education,

breathing, relaxations techniques, mild strengthening, balance, and endurance training. I was also able

to learn more about mechanical lumbar traction and low-level light therapy from Pablo and was able to

utilize that with several patients. I also feel my documentation improved significantly during this clinical.

Overall, I thought that this clinical rotation was useful and that I did learn a lot to take into my

practice; however, I did not learn or become more comfortable in things that I was hoping I would. I am

grateful for my CI, and the other therapists there, for taking the time to have me as a student and for

always being willing to answer questions.