MSTH210: On Campus Internship 1

CLINIC LOG FOR DAIANA BRANCO

Date of Submission: October 2, 2014
Date
11/09/14

18/09/14

Time
12:00 p.m
to
3:00 p.m

12:00 p.m
to
1:00 p.m

Patient
ID

Type/ Focus of
Treatment Plan
Clinic Clerk

Wellness
Focused on treating
the lower back and
hamstrings

Clinic Instructor: Andrew Clapperton

Procedures Completed (Assessment/ Treatment/
Modalities/ Home Care)
I greed the patients as they walked in. I asked
them to fill in the health history forms, sign the
student wafer form, and told them that they
would get there receipt at the end of the
treatment. I also answered and made phone calls
to see if patients were coming or not. As the
patients were inside I had printed out there
receipt and attached it to invoice where it said
who had treated them, how much they paid, and
the RMTs number. Once treatment was done I
asked them how it was and if they wanted to
schedule again for next week.
I walked to the front of the clinic and introduced
myself to my patient. As we were walking, I had
asking him how his day was. From that point on
after seating and putting his things down I went
through his health history form with him to make
sure everything was okay and that he didnt forget
to mention anything that I needed to know. I then
performed vital assessment on my patient and saw
that blood pressure, heart rate and beat per
minute were all normal. I then went through the
pain assessment with him to see in what position
and how much discomfort he feels on his lower
back, since that as his main complain. Prior to all

Comments
I was very nervous at the
beginning because I didnt know
how to answer certain
questions patients had asked.
Also how there computer
system works. I know how to
work the front desk because I
work as a receptionist, just that
the system is a little different.

I wish I wasnt so nerves that I

could have performed postural
assessment, AROM, PROM,
RROM, SOT and MMT

MSTH210: On Campus Internship 1

18/09/14

1:30 p.m.
to
2:30 p.m.

25/09/14

12:00 p.m
to
1:00 p.m

Rehabilitation
Worked on patient
upper trapezius, QL,
rhomboids, ad lower
back

of this I got consent from my patient for

everything I performed. Once vitals were done I
started to treat my patient instead of doing
postural from hoe nervous I was that I just forgot.
As well as I forgot to do AROM, PROM, RROM, SOT
and MMT until I started writing my soap note.
During the second treatment time, I was finishing
up my soap notes from my first patient. I then
helped my classmates with holding there curtains
as they went to go and wash their hands. I also
helped with bringing them the hydrocollator and
putting it away for them as they were treating. I
referred back to the orthopedic visual assessment
to look for some SOT that I could perform on my
patient the next time he came in.
On the third week of internship I had seen the
same patient as previous. I had asked him if there
were any changes to his health history from last
time. I started to explain to him that I was going
to perform postural assessment and then go
through some ranges of motions, and then after
perform some tests such as SOTs and MMTs. As I
was performing postural assessment I notice that
his left shoulder was slightly elevated and that he
was protracted on his shoulders. I then ruled out
from above and below, which were his cervical
and hip. The patient had some tightness on his
anterior scalene and hamstrings when performing
flexion. During the PROM movements my patient
had a little bit of pain on his left side while doing
side flexion and also minimal pain while rotating to
the right. His RROM was a grade 5. We then did
some SOTs such as quadrant and slump they were
negative, but when performing posterior anterior
unilateral vertebral pressure, my patient was

Try and finish soap notes faster.

Still nervous but not as much as

the day went through. I slowly
started to build in more
confidence in what I was
performing. Learn how to
manage my time.

MSTH210: On Campus Internship 1

25/09/14

1:30 p.m.
to
2:30 p.m.

experiencing some pain on his L5. When

performing transverse vertebral on his right side
he had pain on L3-L2 and on the left side he had
pain from L5- L3. Lastly for his MMT we tested the
dynamic horizontal side support and the patient
was negative he was able to hold the position for
longer than 20 seconds. After performing all of the
assessment and finding my findings, I had asked
my patient to get on the table as I stepped out to
wash my hands. When he was ready I had used a
hydrocollator on his lower back to warm up the
muscles as I treated his upper back.
I was finishing up with my first patients soap
notes. After that I held some curtains for my
classmates. I reviewed with classmates the step
that we as SMT have to say before getting consent
for blood pressure. We also reviewed postural
assessment making sure we didnt miss anything
starting from a persons feet and making our way
up to their head.

Try and hit all point for postural

assessment.

MSTH210: On Campus Internship 1

LEARNING LOG FOR DAIANA BRANCO

Date of Submission: October 2, 2014
Date
11/ 09/ 2014

18/09/14

Clinic Instructor: Andrew Clapperton

Description of Experience
As a clinic clerk I learned quite a few things. For instance the first
thing I learned was that patients are warned that they might not get
treated on their first time because there are quick a few assessments
that will be done. I learned how to properly greet patients when they
come in, and also how the computer system works. At first it was a
little hard because Ive never used the system before so I wasnt sure
where to go for certain thing, and would also refer back to the
booklet that Felicia had provided me with. After seeing how Felicia
and Brianna where using the program, I started to get the hang of it
and knew where to go to show that the patients had arrive or even
then they were dont. I also knew where to go to make different
types of payment when the patient were either paying with credit or
debit. I learned how to printing receipt out, scheduling a returning
patient or new patient and even how to check/ change their
information. Lastly I learned that when you schedule in a new
person you have to provide their first and last name, e-mail address
so you can remind them of their appointment, phone number, and
reason to why there coming in for. After performing the same things
over and over I started to feel really comfortable with it and had way
more confidence in myself then I did in the beginning.
On my first time treating I learned what the difference between
wellness and rehabilitation. When I first was treating my patient I
thought I was treating them in a rehabilitation setting until found out
it was a wellness treatment. During my first treatment I
accomplished letting my patient know that everything that is said is
all confidentiality, and that no one will know unless I have his
authorization or by law. I then went through his health history form
and explained to him the important of me knowing his health history
form. This is because allows me to create a safe and effected

Performance Indicator Achieved

1.1.c Utilize effective electronic communication.
1. Demonstrate working knowledge of current
technologies.
2. Maintain security of electronic
communication.
1.2.s Perform basic information functions
electronically.
1. Manage electronic data.
2. Create documents electronically.
3. Access information electronically.
1.2.u Perform billing procedures.
1. Demonstrate billing procedure.

1.3.d Comply with confidentiality and information

privacy requirements.
2. Maintain the confidentiality of patient information.
2.1.a Obtain comprehensive case history from patient
1. Explain the importance of obtaining case history.
3. Interview patient to obtain case history and their
desired treatment outcomes.
1.1.f.Utilize active listening skills

MSTH210: On Campus Internship 1

treatment plan for him without causing any harm to him and also on
any areas where he may have something happened. We then moved
on to pain assessment where I actively listened to everything my
patient was explaining about his pain, and also rephrased what was
said back to him just to make sure I was understand everything that
was being said. Once I was done with pain assessment we had then
moved on to vital signs, where I explained to the patient the whole
procedure that was going to be done such as what I was doing, the
risk, benefits, that he has the right to stop me at any time, if he had
any questions and if I had his consent. I also had communicated with
the patient letting him know what hes blood pressure was. Lastly I
then started to treat my patient and made sure everything around
him was safe and that he was comfortable by checking in on his
comfort level.

2. Demonstrate active listening

3. Affirm key points
4. Clarify contradictions
2.1.p Perform vital signs assessment
1. Identify the indications, contraindications and
precautions for performing vital signs assessment.
2. Communicate the assessment procedure to patient
3. Describe the process for performing vital signs
assessment.
4. Demonstrate vital signs assessment base upon
patient history and presentation.
5. Differentiate between normal and abnormal
findings.
1.3.e Maintain informed patient consent regarding
assessment and treatment.
1. Explain the importance of initial and ongoing
informed consent as a principles of patient-centred
care.
2. Obtain informed consent prior to performing
assessment, treatment and reassessment.
3.1.b Maintain a safe and comfortable treatment
environment
2. Establish and maintain a safe and comfortable
environment
3. Ensure setting and equipment meet patient needs.
4. Maintain equipment in proper working order.

MSTH210: On Campus Internship 1

18/09/14

25/09/14

During the second half of treatment I learned how to be a leader. For

instance I helped my classmates with anything they needed help on.
Such as holding their curtain as they washed their hand. Also getting
them an ice pack or hydrocollator for their patients and putting it
back for them. Once treatment was done and soap notes were
finished, I took five minutes to think back to what I did, compared to
what I should have done. I learned that I could have ruled out the
cervical and hip since his main complaint was lower back pain. I
could have done AROM, PROM, RROM, and even some SOT to see
exactly where the pain was located.
On my third week I got to massage the previous patient from last
week, which made me feel less nerve, because a therapeutic
relationship had slowly started. I learned that the SOT that I choose
for the areas where my patient had pain didnt mean the test was
going to be positive. For example my patient has pain on his right
quadrauts lumborum, I thought that he would have been positive for
quadrant kemps test but, he wasnt he was actually negative. Some
specific assessments that I performed on my patient was I asked my
patient to go all of the ranges of motion for active, passive and
resisted, I selected the SOT that I believe were best for lower back
pain such as quadrants kemp, slumps, posterior anterior unilateral
vertebral pressure (patient had pain on L5), and transverse
vertebral. As for MMT I got my patient to perform dynamic
horizontal side support. I also got my patient to perform postural
assessment so I could compare the right side from the left side and
vice versa. I had explained to my patient before performing postural
assessment that I would look at him in all four different sides and
then touch to confirm my findings, and that I would communicate
everything I saw. During treatment I had my patient in prone
position in order for me to treat his lower back. I had placed a
hydrocollator on my patients lower back and explained to him the
purpose and the outcome from having a heat pack. While the heat

2.1.d Select and perform assessment

incorporating knowledge of patient history,
contraindications and precautions.
1. Identify assessment needs
2. Select appropriate assessment procedures
3. Explain approach to assessment
4. Perform assessment
2.1.g Perform postural
1. Identify the indications, contraindications and
precautions for performing postural assessment.
2. Communicate the assessment procedure to
patient.
3. Describe the process for performing postural
assessment.
4. Demonstrate postural assessment base upon
patient history and presentation.
5. Differentiate between normal and abnormal
findings.
3.1.f Apply draping as relevant.
2. Drape patient appropriately for treatment.

MSTH210: On Campus Internship 1

pack was on I had massaged his rhomboids, upper trap, and erector
spinae as I was trying to maintain good body mechanics and making
sure I wasnt over stressing my back, shoulder, and thumbs. The
techniques that I had performed were effleurage to get the tissue
and blood blow moving, then did some c-kneading, wringing,
palmar/ fingertip kneading to the lower back as well as some muscle
striping. I would always let my patient know that Im about to drape
them and make sure I have it done professionally.

3.1.g Position patient for selected therapeutic

techniques
1. Select appropriate positioning.
2. Direct and position patient.
3. Modify position according to patient
response.
3.2.e.8 Perform techniques utilizing therapeutic
heating.
1. Explain the purposes, effects, and outcome of
therapeutic heating.
2. Demonstrate therapeutic heating.
3. Incorporate therapeutic heating into a
comprehensive treatment process.
4. Modify therapeutic healing based on patient
history, presentation, and response.
3.1.l Apply biomechanical and postural skills for
therapist self- protection.
1. Demonstrate biomechanical and postural
skills that support therapist safety.
2. Adapt biomechanics and posture as required
during treatment.

25/09/14

What I learned from the second half of internship was going through
consent with a classmates is easier to say to them then it is to your
patient because you not as nerves as you would be saying it to your
patient. Also it helped me refresh my mind since were always
learning new thing every year. Going through postural assessment
was also a good mind refresher, especially since I had missed three
things that I was supposed to look at during the postural assessment
and didnt. I honestly forgot all about them, which were quadriceps
muscle bulk, head and jaw, and gastrocnemius muscle bulk.

Three (3) Performance Indicators I have not achieved are

Three indicators that I havent achieved but would like to achieve are:

MSTH210: On Campus Internship 1

1.1.b Utilize effective oral communication

2.1.h Perform palpatory assessment
3.2.b.1 Perform trigger point release techniques
My plan for achieving these three performance indicators is
The steps that I would take to achieve oral communication would be talking to my patient calmly, and taking everything one at a time. Usually
when Im nerves I mumble everything very quickly and my patient just looks at me and is like sorry what. I plan on preventing this by talking
slowly and very clear so my patients understand everything Im saying. I plan on achieve palpatory assessment by first starting to palpate the
patients muscle and see where I find tender muscles compared to squishy muscle, and also palpating deep muscle to release any tension thats
being built. Lastly I would perform trigger point release by muscle stripping on the muscle fibers very slowly.
I am SATISFIED with my progress in this Internship so far
So far during internship Im satisfied with everything I have performed. Even though treating my first patient didnt go so well, since I missed a
lot of assessment, but I made up for those assessments during my second treatment with him. I made sure that I accomplished everything that I
didnt do on the first treatment. The more practice Im getting the more comfortable it starting to feel and Im not as nerves.
I am NOT SATISFIED with my progress in this Internship so far

Additional Comments: