Feedback to Patients

My musculoskeletal outpatients placement was my first prac for this year and during that placement I discovered a skill that I was not very good at. My tutor brought to my attention that during objective assessment of an ongoing patient I would simply do the assessment and write my findings into the notes without saying anything about the objective findings to the patient.

A situation occurred where a patient was limited with their range of motion into dorsiflexion and when I saw them a week after treatment, on reassessment they had gained somewhere between 5-10 degrees (I can’t recall the exact amount) of dorsiflexion. I simply just noted this in the notes and carried on with the session. My tutor was watching over me and mentioned afterwards that this was a great improvement in range and I was not giving the patient any feedback during objective assessment.

I think I am reasonably good at giving feedback whilst instructing a patient how to do an exercise or assessment correctly, however, I realised that I wasn’t really giving enough feedback regarding the results of objective assessments. And ultimately, a patient is often likely to be more concerned with whether or not what they are doing each week is having a positive effect, rather than if they are doing it the right way. This is also beneficial in compliance with HEP, as a patient is more likely to do their exercises if they are told that they are making a difference. I think I give feedback during subjective reassessment fairly well, as it is often unconsciously brought up when asking patients questions such as “is your pain the same, better, or worse?”, however I hadn’t realised that I wasn’t doing it enough for objective measures. My tutor mentioned that I give good feedback during objective re-assessment after a treatment session, but that it is also important to give feedback to the patient at the beginning of the session to reassure them that your treatment and their HEP is beneficial.

I made a point of telling a patient if they had any objective improvements at the beginning of each session for the rest of my placement. My tutor mentioned I had improved well in this matter and I also noticed that by mentioning if a patient had for example improved their ROM, that they were more compliant throughout the rest of the session and also with their HEP until I saw them next. I now approach similar situations with more effective communication regarding this feedback. My current placement is orthopaedic inpatients, and I have noticed that I am now communicating this feedback automatically with my patients. Through this experience I will now approach this situation in the future with greater care for the patient and for appropriate feedback to them, and hopefully this may also apply to other students reading.