Currently I am on my community physiotherapy placement of which I conduct classes for specialised populations. I’d like to share a difficult situation I encountered in the last week with regards to supervision and communication in a group setting.
I was asked to take parts of an aqua function and balance class at a new leisure centre which had opened just over a month ago. As I had already attended one of the classes and observed the class content of the supervising physiotherapist I felt confident that I would be able to take the warm up, strengthening and flexibility components of the class. So beforehand I had a set plan of exactly how I was going to take the class and the appropriate sequence of exercises I was going to do related to the specific conditions of my clients in the class.
This task proved to be a lot more of a challenge then I had expected. Firstly maintenance repairs were being done in the pool enclosure so I had to compete against noises of drills and workmen. Three clients who had been absent last week attended the class one of which was a non swimmer so they required more individual supervision. The clients were distracted by the noise and at how hot it was, as it was a twenty six degree day and the sun reflected into the hydrotherapy pool room which felt like a sauna. To make the situation even more trying, the leisure centre had put a restriction on the space allocated in the pool for the class roping off half the pool so everyone was quite crowded. I felt really frustrated and agitated and as I began to conduct the class I found it almost impossible to project my voice, maintain the attention of my clients, keep watchful eye on my non swimming clients and modify the exercises I had chosen to accommodate for the new clients. The supervising PT could see my frustration that she took over the class for awhile giving me a chance to reflect on my experiences.
Observing the PT I noticed how well she modified all of her teaching strategies to this challenging situation; she modified exercises so they required less space, she projected her voice well by speaking slowly and using less instruction, she involved the class by asking them questions about stretching to engage their interest, provided progressions for the advanced clients and both the new clients to still be challenged and allocated me to individually supervise the non swimmers. Once I overcome my frustration and by observing this PT I was more effectively able to conduct the rest of my class plan despite the fact that it was a completely different story to what I had planned on paper. After the class my supervising therapist discussed with me how important it is to be flexible with class plans and that in a group setting it is important to not stress and just modify teaching techniques as you would modify a treatment technique on an individual client.
I think it was a good learning experience for me to be faced with a challenging environment. Usually as physiotherapy students we become accustomed to adapting and changing treatment techniques due to a challenging patient and sometimes forget that environmental factors can effect how we conduct ourselves. As a result of this experience I have become more conscious of my treatment environment; do I have enough space, equipment, how best can I instruct a client; am I competing against noise and distraction? And as a result are more flexible with my class plans allowing for these considerations.
Was wondering if anyone has taken any group sessions in any of their pracs and if so were their any environmental barriers or considerations which they had to contend with……what was your strategy to overcome these?
Rach
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2 comments:
I have taken group classes for LBP and lower limb strengthening as well as hydrotherapy at two different facilities. Throughout my experiences with taking group classes I have rarely experienced any environmental barriers and have therefore found your thoughts helpful in identifying similar situations that I may find myself in the future.
For the most, my main difficulty I have found in supervising a group class is where one patient consumes your time to the point that it is unfair to the other patients. In some instances it may be because they need more attention than other patients and in other situations it has been because they simply keep talking to you and it is difficult to get away from them without offending them.
I did experience environmental barriers during one group class that required me to adapt to the changes. During my class, a patient at the other side of the gym with another physiotherapist lost consciousness. A medical team arrived and there was significant disturbance within the physiotherapy department. Meanwhile, my class was consumed by the incident and just stood and watched. In this situation I had to adapt my previous class plan to maintain the attention and involvement of the patients in the class. To do this I got the group doing an exercise together that required them to face the opposite side of the gym as to where the events with the unconscious patient were going on. I was also required to communicate clearly and effectively to make sure I maintained their attention to the task. This was effective in the situation I was in. As for your situation, I think I would have been challenged as well. It takes experience to run a group class well, and I think your experience will make you handle similar situations better in the future.
Hi Rachael,
I would have found this quite challenging as well I think! I agree that this will be a valuable experience for your future treatments - We are told to make sure we set up 'our environment' at Uni, but it isn't until we are faced with these challenges that we see the importance of it. I think that being able to effectively adapt and modify treatment plans comes down a lot to experience, and I believe this helped in allowing your supervising PT to deal with the situation so effectively.
I have not yet experienced such environmental barriers to group sessions, however, i conducted a few groups on my last gerentology placement. We had, as you can imagine, quite a few characters that would participate in the fitness class, with differing diagnoses, and complications. Your post made me think of how I could have improved the environment for these patients, as there was often too much equipment (their 4WW or ZF), in a small training room.
I did want to comment on one of my experiences - one of the patient's suffered from Parkinson's Disease, and was a real delight, however he would break out in poetry, or start singing to the other patients in the group! I adapted my exercise plan by making it fun for the other patients, and they either joined in the singing, or listened to the poetry in beat to their free weights! I guess the point is that you never know sometimes what you are going to get out of the group, and your post made me reflect on my group experiences, and how I could have improved so thanks!
Ange.
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