Brad Grohovsky: Top 5 Lessons from the Residency Trenches

I am a big proponent of doing a Residency program upon graduation from Physical Therapy school. Not only does it contextualize what you learned in PT School, but it also gives you valuable mentorship that fast-tracks you on your journey to become a better clinician (and more!).

Dr. Bradley Grohovsky, DPT serves on the APTA Private Practice Section Government Affairs Committee and is currently a Resident studying with the Institute of Physical Art at Encompass Physical Therapy in Annapolis, MD – specializing in Functional Manual Therapy™. Brad received his Bachelor’s degree from Western Kentucky in his home state prior to moving to Boston, MA for physical therapy school. While attending Simmons College he also served on the APTA Student Assembly Board of Directors prior to graduating with his Doctorate of Physical Therapy in 2011.”

You can read more of his thoughts here. I recently asked him about the top five lessons he learned from his Residency so far. He responded with this generous guest post. Enjoy!


“Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannized by external evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. The practice of evidence-based medicine is a process of life-long, self-directed learning…” (Sackett)

​Physical Therapy is a rapidly evolving profession that is experiencing some revolutionary transitions both in our position in the healthcare system, but more importantly in our clinical skills and approach to patient care. Our profession currently stands at a great pinnacle with an opportunity to integrate into a vital (and missing) medical role in our society as both movement and lifestyle experts. Residency education is a catapult towards clinical expertise – if our profession is truly going to step into this role then we must step up to the plate as clinicians. If you are a student who is about to graduate (or just passed the NPTE..congrats!), a new professional, or a burnt-out experienced veteran I encourage you to check out a Residency in a specialty that interests you!

Here are the top five most valuable lessons of my Residency:

1. There is nothing more valuable than a mentor you respect and who challenges you to be your best.

-Because if you are not being challenged to be a better clinician everyday, then really what’s the point? Having an experienced mentor that challenges you to be your best improves both your skills as a clinician and your patient’s outcomes.

2. Attempt to prove yourself wrong with EVERY patient.

-Develop a hypothesis and use objective pre/post tests to validate your treatment and direct your plan of care. This allows you to develop and test your hypothesis every visit – if your theory isn’t correct, then change your treatment next visit (don’t wait until the next re-eval)! Every treatment becomes evidence-based and the objective information can provide immediate positive feedback for the patient!

3. Use your eyes, but trust your hands.

-More often than not, we are the first clinician to actually touch a patient’s pain. Learn to trust what your hands are telling you – they are your most valuable tool. In the book Outliers, author Malcolm Gladwell claims that 10,000 hours is the amount of time it takes to master a craft and achieve “greatness”. You can’t be Yoda – a Jedi Grand Master PT without mastering the force – and you can’t understand the force without putting in your time in the Jedi Academy.

4. Make every patient understand that this is a team effort.

-This reinforces compliance and accountability, which will encourage long term success. We are the mechanic who can repair broken parts, provide a tune up and clarify sections in the owner’s manual, but it is up to the patient to maintain the condition of their vehicle to the best of his/her ability.

5. Be an intelligent teacher, but an excellent pupil.

-Evidence continues to mount in support of the neuromatrix components of chronic pain involving neural, psychological and social components in addition to the physical presentation (Butler, Moseley, Wardlaw). Patients often teach us how to best treat them, whether intentionally or unintentionally. During treatments, be an active listener – both treat and educate each patient based on his/her individual learning style!

For further Residency reading please check out my recent post on PTHaven.com – To a Residency and Beyond!

Follow me on twitter @DrG_PT

Resources:

1. Sackett: Evidence Based Medicine: What it is and what it isn’t, BMJ 1996;312:71

2. Butler, D: Explain Pain

3. Wardlaw C: Taming Pain

4. Moseley: A Pain Neuromatrix Approach to Patients with Chronic Pain, Manual Therapy 2003


I am @Cinema_Air

 

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