Post Interview Reflection

 I feel like my interview went well overall. I was confident going into it but a little bit nervous because I wasn't sure what they were going to ask about.  I dressed like I was going into an actual interview but I mostly winged the interview honestly. I didn't do much preparation for it.  The only thing that went different than I expected was the somewhat casual conversation that the interviewer and I had. The conversation just kind of flowed the entire time.  One thing I would have changed would be to have more follow up questions to ask during the interview. I did ask 2 follow up questions, but in a real situation, I would have liked more information on the company. One thing I learned from this to take into my future workforce is that it is easier to have just a conversation than just trying to answer questions with a striaght forward answer.

A Glyph on Leadership

Glyph Key for Drawing A Self-Portrait of a Leader

 

Face Shape: If you believe that leadership is an inborn trait, draw a triangle-shaped head.  If you think that leadership stems from nurture over nature, draw a square-shaped head.

 

Eyes: If you think the vast majority of OTs are leaders, make big circles for the eyes.  If you think there is a fairly equal mixture of leaders and non-leaders in the field of OT, draw small circles for the eyes.  Fill in the pupils.  Add glasses if you feel that you have had more experience in leadership roles than most other people your age at this point in life.

 

Eyelashes: Draw one eyelash on each of the eyes for each of the five themes you can name based on your personal Clifton StrengthsFinder assessment from earlier in the curriculum.

 

Eyebrows: If you like to take the role of the leader in an out-in-front way, make curved eyebrows.  If your leadership style is more behind the scenes, make pointy eyebrows.

 

Nose: Draw a triangle nose if you think that seeing yourself as a leader is necessary to being a leader.  Draw a rounded nose if you believe that a person can be a leader without seeing himself or herself as a leader.

 

Skin:  Add a freckle anywhere on the skin of the face if you believe that self-awareness is vital to effective leadership.  Leave the skin clear if you don’t think it’s an essential trait.

 

Mouth: Draw a smiling mouth if you can think of at least one leader who has had a positive impact on you.  Draw a frown if you can’t think of a good example of a leader.

 

Ears: Draw round ears if you think technology is an important part of effective leadership in many situations. Draw pointy ears if don’t think so.

 

Hair: Draw the hair based on a continuum, based on your personal viewpoint in two areas:

 

What’s more important in leadership:             Curly hair  <------------------------->  Straight hair 

          creativity or organization?                   Creativity  <-------------------------->  Organization

                        AND

Can an introvert be an effective leader?         Short hair <-------------------------> Long hair

                                                                           No way  <------ I’m unsure -----> Definitely yes

 

Accessories: Add at least one accessory (example: a piece of jewelry) if you see yourself as a leader.  Add a hat if the way you think about or approach leadership has changed as a result of what you have learned since beginning in OT school.

 

Finishing Touch: Label your paper with your name, writing in cursive if you have a written plan or goal about to serving in leadership roles in the future; write in print if you do not yet have a written plan.

 

Below is my image I've drawn during my second year as an OT student. Comparing it to my first one, it is almost identical. I believe that I've had a lot of leadership experience and I've seen many different types of leaders, so I've had this in my mind for a long time. I do believe that OT school has given me a lot more perspective to view leaderships styles, but I believe this image will always be fairly consistent for me. 

 

Locus of Control

After completing the worksheet, I was not very surprised by my results. I scored a total of 10 for my locus of control which is almost right in the center of internal and external. I believe that I do fall more towards the side of internal locus of control because I do feel like I have control over most things that I do. I believe in working hard to achieve the goals that one sets for themselves and don't think things are just set in stone and never can change. I believe that the human mind is a very powerful thing and we can make changes if we try hard enough!

I can also see where I fall into the external locus of control at times.  Sometimes I feel like I'm on a "bad luck spree" and I just can't seem to catch a break and that is when I get in that external locus of control mindset. I usually stay in this for a while but as soon as I refuse to settle for "just bad luck", I switch back to internal and I do everything I can to make those changes because I don't feel like everything is already defined. 

SIM Lab 11-13-19

Overall, I believe my simulation encounter went really well.  I was very confident going into this SIM.  Even when I stumble over obstacles, I was able to think on my feet very quickly and respond to the situation.  I believe my confidence in this SIM came from how much knowledge I've gained through school so far and the experience of past simulations.  One thing I would do different if I had a do over with this SIM is try to get less hand sanitizer when I first enter the room and try to get more feedback about the child from the parent during the explanation of things to implement during his routine.  I did ask about his interest in different foods and things that he does at school, but I would have liked to know more on her perspective of the child's interests. One example of of how attitude of caring can be communicated to the client is by using active listening techniques and letting them express their concerns and letting them know that they are not alone in the situation.  Another example would be by following through with the things that you speak about with them and then following up at a later date.  An example of this could be attending a school meeting with the parent to advocate for the child if needed.  Taking the feelings of the parent into consideration is something very big that I will incorporate into practice in the future.  You could tell just from the actors that this was a very big deal to them because it was a situation that pertained to someone very important to them and it will be the same way in clinical practice.  Taking their feelings into consideration and being very empathetic is what I will incorporate into my clinical practice as well as future SIM labs.

Neuro note - TBI 2

For my fourth neuro note, I chose to return to a neurological condition that intrigues me more than any other, traumatic brain injury.  The video I chose to watch is a speech by Kim Gorgens called, "Protecting the brain against concussion."  I chose to watch this video because I feel like prevention is key to many health problems in our society.

In the video, Kim uses her over protection of her son to lead into the reasoning of the prevention for concussions. Many people would disagree with her thoughts behind whether kids should play football or the law requiring all bicycle riders to wear a helmet, but she is promoting the safety and prevention of concussions.  She goes on to say that the three keys to preventing concussions are to study up, speak up and suit up.  Studying up on the signs of a concussion could play a big role, especially in coaches.  Speaking up about the topic can help promote the safety laws and implementations put into place by legislation.  Finally, suiting up by wearing a helmet to protect the most vital organ in your body, your brain.

The video is very short (~9 minutes) and provides a good insight of prevention methods from concussions.  There is not much scientific evidence in the video to back up her thought process besides the concussions statistics, however, this is a big topic around football players today and I believe that it should be strongly taken into consideration the prevention methods that she provides.  If you would like to hear her thoughts, I have provided the link below to the Tedtalk. Hope you enjoy!



Link: https://www.ted.com/talks/kim_gorgens_protecting_the_brain_against_concussion#t-536488



Gorgens, K. (n.d.). Protecting the brain against concussion. Retrieved from 
         https://www.ted.com/talks/kim_gorgens_protecting_the_brain_against_concussion#t-536488

Media Project - Chopsticks

The "Ah-ha" moment for me with the project came when I decided what I was going to put in the middle of the chopsticks to keep them pulled together on one end.  I already had it in my mind that I was going to create something similar to a pair of "pliers" for this project. I started off with rubber bands and several different objects as a spacer between the chopsticks but I knew it needed some sort of spring in the middle for the tension that would be required for the tasks. The clothes pin also provides enough tension that would help with pincer strength if any deficits were to occur due to his broken arm. 

                                                 

This project taught me that some of the most unexpected things, such as chopsticks, can be such a useful tool for someone in their everyday life. A combination of simple household objects can give a person just the right amount of assistance they need to be independent performing an ADL. Completion of this assignment has helped me use my OT think skills to use an intervention to help a client engage in their daily lives. This can carry over into future practice by making use of what is available in the moment to come up with an intervention for a client that can be temporary or maybe even for long-term use.

Neuro Note - Alzheimer's

Due to my love of Tedtalks, I chose to watch another for this neuro note!! I chose to watch the video, "What you can do to prevent Alzheimer's" with Lisa Genova.  I already had an understanding of Alzheimer's disease and it's effects on an individual, but I was very curious to learn ways in which you can prevent the disease. 

Lisa Genova spoke about the affects of the disease and how it makes people forget things such as where they have put their keys or maybe even what their keys are used for.  She then gave the reason as to why people develop this disease which is the build up in between synpases. This build up occurs over time and gradually gets worse and the body is unable to clean it out.  There is currently no medication to help with this or to cure the disease at all.  So many people think that you have to keep using your brain as you get older or you will develop Alzheimer's which is not necessarily true, but it can be beneficial. 

Lisa talks about a group of women who had developed Alzheimer's disease but did not show any symptoms before they passed away.  How could this be?  It is believed that the women had a high cognitive reserve which means that they had more synapses in their brains than normal.  So the more synapses you have, the less likely you are to see the effects of this disease.  She explains it in further detail by explaining that if you know her as an author, a Tedtalk spokeswoman and a neuroscientist and then develop Alzheimer's, you have a greater chance of remembering who she is because you have more than one synapse connecting your memory to who she is. So if the synapse of her being an author and a neuroscientist is destroyed, you still remember her from the Tedtalk.

I recommend anyone who studies or is interested in neurodegenerative diseases to watch this because this links back to neuroplasticity in the brain. This is a quick ~13 minute video with some really good information to think about with Alzhiemer's disease.  The link is below and I hope you enjoy it as much as I did!

Link: https://www.youtube.com/watch?v=twG4mr6Jov0

TED. (2017, May 19). What you can do to prevent Alzheimer's | Lisa Genova. Retrieved August 19, 2019, from https://www.youtube.com/watch?v=twG4mr6Jov0

Neuro Note - Parkinson's Disease

I chose to watch a Tedtalk for the topic of Parkinson's Disease. The title is called, "Simple hacks for life with Parkinson's." Being an OT student, the title immediately drew my interest as I thought I was going to see some homemade adaptive equipment using everyday objects around the house. I did see some modified equipment, but I gained insight of using basic "technology" to help people live an independent life with Parkinson's.

The spokeswoman began talking about how she developed a cup that would not spill with someone who had tremors and she demonstrated how the rounding of the top of the cup would just splash the liquid back down into it.  This was only a solution for one symptom of Parkinson's.  It led her to begin thinking of other adaptive equipment she could make and she starting with walking. Her father had Parkinson's and he took small steps and turned very slowly, but the walker helped with most of his problems.  She started thinking about how he could possibly climb stairs with as much trouble as he has walking on flat ground, so she had him attempt to climb up and down stairs. To her amazement, he went up and down the stairs very well.  He moved quickly and smooth without the use of any assistance. He was able to due this because going up and down stairs is one continuous motion.  She had the idea to have a 3-D picture of stairs laid out on the floor and have him stare at it while he walked across the flat ground.  When she had her father do this, he walked across the flat ground just as quick and smooth as he did when he was going up and down the actual stairs. This brought her back to thinking of basic ideas to help individuals with Parkinson's in their daily lives.

I chose this assignment because as a future OT, I could implement this thought process she uses and even the idea of using the image of the stairs to promote independence in individuals with neurological conditions. You can manipulate the mind into doing something while using low-tech, low-cost things such as this, which is exactly how OT's operate. I highly recommend watching this video because it gives you another perspective to see things from and it really focuses in on the client-centered thought process that we use as OT's.

Link: https://www.ted.com/talks/mileha_soneji_simple_hacks_for_life_with_parkinson_s#t-401266


Soneji, M. (n.d.). Simple hacks for life with Parkinson's. Retrieved August 13, 2019, from https://www.ted.com/talks/mileha_soneji_simple_hacks_for_life_with_parkinson_s#t-401266

Neuro Note - TBI

I watched a Tedtalk called, "Can the brain repair itself" under the list for TBI.  I chose this topic because I personally know people who have suffered from a traumatic brain injury and I was interested in learning if the brain could in fact repair itself.  I know there is no cure for a TBI and the title of the video caught my attention as to wonder if there were new discoveries that could benefit a person with a TBI.  I am always interested in learning about advances in medicine and this video was perfect for me to watch!

The gentleman in the video began by talking about new hope for the future for individuals with neurological disorders and shared a story and video clip of a man named John who also has motor neuron damage.  Images of the brain were shown to distinguish the differences in a normal brain and one that has been damaged. As we learned in class, a ABI can be traumatic or non-traumatic.  The neurological conditions that were shown were a result from other disorders which lead to the brain injury.  This would be classified as a non-traumatic brain injury.  After seeing all of this damage and learning that the annual cost for neurological conditions is 700 billion dollars, the doctor finally reveals to us the hope for the future, stem cells!

We have known about stem cells for a long time and we have the understanding that they can regenerate new healthy cells while killing off the bad cells.  We have stem cells already in our brain, but the thing that we have not figured out is how to activate them to work when we have an issue.  This doctor performed a study where they injected stem cells into an individual who had multiple sclerosis and that results where an increase in the optic nerve size, whereas the person was suffering from a decline in the size of the nerve due to MS.  He stated in the video that he did not believe that the new stem cells actually took over but that they activate the stem cells that were already in the person which is ground breaking advances in this medicine.  He believes that a drug needs to be produced to make these stem cells become activated because of the timely process that it takes to produce these stem cells in a lab. Making these discoveries could lead to finding a cure for many individual neurological conditions in the future and I am looking forward to seeing more news about stem cells in the near future!


I encourage you to watch this video, which I have provided the link for below. This is really an eye opening discovery that could lead to many improvements in the field of medicine and could mean finding cures that have been studied for so long!

Link: https://www.ted.com/talks/siddharthan_chandran_can_the_damaged_brain_repair_itself#t-774658



Chandran, S. (2013). Can the damaged brain repair itself? Retrieved July 22, 2019, from 
         https://www.ted.com/talks/siddharthan_chandran_can_the_damaged_brain_repair_itself#t-
         774658

Restoring confidence in mobility

The hierarchy of mobility skills begins with bed mobility then goes to mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and finally community mobility and driving.  This is very close to what I expected the "stages" of mobility skills to be like because each one builds on the other. I have seen this used when working with clients and I agree that it is the correct way to work with individuals on mobility.
From class and labs, I have learned that you start working with clients on tasks that are not as complex and then grade the individual up or down based on their performance.  This is why the hierarchy of mobility skills is in the correct order in my eyes because each one builds up to being able to perform the next. 

Fitting Assistive Devices

Fitting assistive devices to clients is very important and specialized to each person.  It is crucial to fit the device to the person so that they are able to use it for a long period of time.  As discussed in class, insurance companies expect a device to be used for a certain length of time before they will pay for another.  This is especially for children who may outgrow the device.  Another reason it is important to appropriately fit assistive devices is so that the client can use it safely. If a walker is too low when a person is using it, it could cause them to be flexed at their back and cause additional injuries to that person.  Another example would be a cane being too short cause the person to lean further to one side and could also cause them to fall when supporting themselves on it.

To fit an individual for a cane, they should be wearing shoes and the cane should be adjusted to the height of their greater trochanter.  They should use the cane on their uninvolved side as well.  To fit a person for axillary crutches, the axilla rest should be approximately 5 cm below the person's axilla. The handgrips also need to be adjusted to the height of the greater trochanter of the person with their shoes on.  The lofstrand crutches should attach the arm band approximately 2/3 up the forearm with the handgrips at the height of the greater trochanter and facing forward. 
A platform walker should have the handgrips adjusted to the height of the greater trochanter of the individual with shoes on. The platform should be set with the individual's elbow flexed at 90 degrees to allow weight bearing through their forearms.  The proximal forearm should be 1-2 inches off the platform to avoid compressing nerves.  The handgrip of the platform should be slightly medial for comfort of the individual.  Finally, a rolling walker should have the height adjusted to the person's greater trochanter while wearing shoes.  The front and back legs should be at the same height allowing the handgrips to be level as well.

Body Mechanics

Having good posture and body mechanics is very important for every individual.  If someone has bad posture, their spine could become more kyphotic which puts more pressure on the disks in between the vertebrae.  Having good posture also helps keep back muscles strengthened by keeping them engaged.  Back injuries are very common in the work place which is why teaching proper body mechanics when lifting stuff is crucial.  Keeping the back straight when lifting from the floor keeps from having bulging or herniated disks or even straining back muscles.  The large thigh and glut muscles should be used when lifting objects.  Teaching proper body mechanics would also allow a person to have more power and strength when trying to lift or move objects. 

One way you might teach body mechanics is as a prevention method to a company for their employees.  Teaching them proper lifting, pushing or pulling techniques would be an effective intervention for this population.  This could be from an ergonomic standpoint in a factory.  Another way you may teach proper posture or body mechanics is for transfers in patients in a hospital.  You would want to inform them on positioning of their feet when going from a wheelchair to a bed or vice versa.  Moving around in the bed would also require good body mechanics in order for the patient to become independent. 

Man from the south

Like the soldier in the story and many others think, the pinky finger does not play a crucial role in ever day activities, but this is incorrect.  If the soldier would have lost the bet and had his pinky finger cut off, he would have lost a lot of his grip strength.  The pinky finger is a huge contributor to the power grip and his ability to open a door with a flat handle would be greatly affected.  Many military doors have this style of handle, so it would be important for him to be able to perform this activity.  One strategy that would be beneficial in the soldier regaining the ability to do this would be simply teaching him to grab the door handle towards the end, where not as much pressure needs to be applied in order to open it. If he grabs the handle closer to the point where it rotates, more force will need to be applied as well as more grip strength will be needed. This simple modification could get him back to being able to perform this activity.

Health Promotion

One big take away I got from listening to professor Flick was the vision change for healthy people from 2020 to 2030.  The focus for the new 2030 vision puts an emphasis on health and well being across the lifespan instead of where people are at a certain point in their life. By putting the focus on health starting at birth, preventative measures can be put in place to improve the quality of life for people.  Screening for things before they happen is another way this can be implemented in this vision statement.

A big key in health promotion is prevention.  Prevention is the absolute best way to improve health among any population.  There are three types of interventions that aim to reduce health risks.  The first is primary which prevents injury or disease before it occurs.  The second is secondary when the injury/disease has already occurred, but it is detected early to keep it from getting worse. The final one is called tertiary which is where you work to improve the quality of life for someone who has a chronic illness or injury.

Blog 3 Shoulder

The scapulohumeral rhythm is the movement of the scapula with the humerus. It is important for these two bones to move together in order for the human body to achieve full range of motion. These structures move in a 2:1 ratio meaning for every two degrees the humerus moves, the scapula moves one degree. The muscles producing this movement help to stabilize the head of the humerus in the glenoid fossa by not allowing it to come out of the "socket". If a person does not have scapulohumeral rhythm, then they will not be able to have full range of motion which would decrease you measurements in the shoulder.  The humerus could hit the acromion from being pulled up too far also not allowing full 180 degrees ROM. Movement of the scapula provides the sliding motion of the humerus to allow this much motion. 

Foundations Podcast

One thing I learned from the assignment was that universal design is an important aspect that we as a society need to seek out.  Universal design helps eliminate any issues that may arise from anyone with a disability. Something as simple as a modification of a door knob design can help millions of people.  When universal design begins to take place, it becomes a downhill affect and it continues to happen with everything being designed.  It is important to think of how every single person can use something when it is being designed.  Every single person has some sort of disability regardless of if it is temporary or permanent.
Another thing I learned from this assignment was about working with different people throughout OT services.  From listening to the podcasts, it seems like every individual client has something unique about them that either helps or hinders their participation in an activity.  As an OT, you have to come up ways to get your client to participate in an activity that they may be scared of or not want to do at all.  Similar to the Au-Some swimmers podcast, they had to sprinkle the water on this child's head to get them use to having water on their head because they did not want to put their head under the water when swimming.  Small steps such as this can lead to success when working with clients in OT.

Measuring ROM and MMT

Locating bone landmarks and positioning are very important when measuring range of motion.  Using the same location provides reliability and validity when repeating the measurement.  The bone landmarks provide a point to position the center of the goniometer and also where to position the stationary and moving arm of the goniometer.  Positioning the person is also important because it allows them to have full available range of motion without any unnecessary obstructions.  

The purpose of the test position for MMT is so that the muscles have optimal contraction. The position allows for the maximum amount of myosin and actin to be used in the muscle.  The MMT also allows the OT to position themselves in a position to apply force needed to test the person.  The gravity eliminated position is used when the person cannot produce much force against gravity itself.  Placing someone in the GE position allows them to move in a motion parallel to the ground which take gravity out of the equation.  This allows you to be able to rate the person based on their performance in this position.  

Daily Movement

When I cook breakfast in the morning, I turn the knob on the stove to turn it on.  When I reach for the stove, my elbow flexes at first at the same time my shoulder flexes. Then my elbow extends and as I grab the knob, my arm pronates from the neutral position to turn the knob. My arm is then returned to the starting position. Both flexion and extension occur in the sagittal plane and the frontal axis of rotation. Pronation of the arm happens in the transverse plane around a the vertical axis. Considering the osteokinematics of the elbow, it does from flexion to extension in an open kinematic chain. The arthrokinematics of the elbow in this movement would be the radius and ulna gliding on the humerous head while it rolls in the opposite direction.  Shoulder flexion would primarily use the deltoid muscle.  The prime movers for elbow flexion would be the biceps brachii, brachioradialis and brachialis.  When the elbow extends, the triceps would be the prime mover. The pronator teres and pronator quadratus would be the prime movers for pronation of the arm. All of these would be concentric actions.

Therapeutic Relationships

Having a good therapeutic relationship is important in the field of occupational therapy because it helps the client connect with us with a balance of someone who is there to help them but not superior to them.  I use the active listening technique many times in my own conversations so that not only I, but the person I am speaking with has a clear understanding of what is being discussed.  This is important to use because it is easy to use terminology that other people do not understand without even realizing it. Showing empathy to the client is also an important thing to use when building a therapeutic relationship because it helps builds trust and lets the client know that you care about them and helps them open up more to you.

Knowledge Check 3/14/19

My main take away from Dr. Keisling's presentation today was the progress we have made as a society to include people with disabilities in our daily lives.  From the pictures he shared with us today and the stories that were told, it is horrific to think about how we use to treat people with disabilities.  I have a clear understanding now as to why we need to know this history so that it never happens again.  "Those who cannot remember the past are condemned to repeat it" - George Santayana.

I believe that covering this material will have a big impact on not only myself, but all of us as we become OT practitioners.  We have a new generation of people who have grown up without ever knowing what it is like to be discriminated against, but we still have the ones that were.  Understanding this history will help us be better OT practitioners and helping us strive to continue making sure that no one is treated differently again.