Imposter Phenomenon

 As we had our class on Impostor Syndrome, I knew I had it from the start. I have always felt inadequate when it comes to test or projects throughout my life. As we draw near the end of OT school, I get the feeling more and more as we start our clinical rotations. I have received great feedback from my clinical instructors from previous fieldwork opportunities, but I still feel like I am an "impostor" in our field. When I took the Impostor Syndrome test and scored an 82 which states that I have intense impostor phenomenon experiences and I believe that to be true. The article that we had to read is going to help me as we start our first level II fieldwork placement I want to implement the five steps into my daily routine. I feel like if I do this, I will stop having the impostor syndrome as much. I think it is really important to self reflect in times that we are about to face because we should know that we have worked hard to be at the point we are currently. I think creating a list of accomplishments is a great way to show yourself that you can do it because you've done so much before. Accepting compliments is hard for me and that is something I hope I can work on soon. I plan to try to seek more mentorship opportunities so I can have a person to talk to when I start feeling like an impostor in our field.  I have such a great passion for OT and I need to remember that when the impostor syndrome sets in. I know I have done all the work I can to prepare to start my journey and I know that there will still be a lot for me to learn once I get out into the field. I am glad that we had this class topic because it made me realize how hard I am on myself and that I need to do better. We have made it to the end of our didactic school portion and I should be very proud of my accomplishments!!

Diversity

 I watched a TedTalk called "My road trip to the whitest towns in America" by Rich Benjamin. He went on a 27,000 mile trip for two years to the fastest growing and whites counties in America. He starts by mentioning a word called "whitopia" and he has three different definitions for it. #1: more than 6% population growth since 2000. #2: 90% of that growth comes from white migrants. #3: ineffable social charm, a pleasant look and feel. He went to three major counties that embodied whitopia. They were Coeur D'Alene, Idaho, St. George, Utah, and Forsyth County, Georgia. He stated that Whitopia operates at the level of conscious and unconscious bias. Some things have changed since 50 years ago. People are more acceptable to mingle and mix cultures in an appropriate way. But there are still individuals who act as if they're living in the past still. America is residentially and educationally segregated today as it was in 1970. It is important that we move forward as a country and get rid of the conscious and unconscious bias or we will never grow. The more we move forward, the diversity will grow. By 2042, it is predicted that white Americans will not be the majority race. I really enjoyed listening to this TedTalk because it reminded me how important it is to listen to each culture and race without judgement. As a future occupational therapist, it will be vital for me to remember this when treating someone who had a different culture or belief than myself. We should want to strive as a society to get rid of the bias and grow as a community. As a future OT, I pledge to always keep that mindset when treating every patient. I want each and every individual to grow and succeed! 

Link to TedTalk

https://www.ted.com/talks/rich_benjamin_my_road_trip_through_the_whitest_towns_in_america?referrer=playlist-bridging_cultural_differences

Documentation

 I had the opportunity to practice my documentation skills on my last Level I Fieldwork rotation. Dr. Woods was actually my clinical instructor on my placement. Each night we had to write a SOAP note of what we observed that day. I am attaching a screenshot of my SOAP note that I wrote and her feedback on it. 

I mainly got corrections/comments in my objective and assessment sections. Dr. Woods pointed out that some of the things I would say in the objective should be assessment. She said to think of how I can state what I observed directly that led me to the conclusion regarding level of activity. For future SOAP notes, I kept that in mind when writing the objective section. I know that I just need to write about what I saw and what happened during the session. For my assessment section, she stated that I was on the right tract, but again I confused one statement where I should have stated it in the objective section. I know now that assessment provides evidence and explanation of what you saw during the treatment session and what can improve during future sessions. I really enjoyed her providing positive feedback for my Plan section. It is encouraging to know that I am doing something right. By the end of my rotation, I had improved a lot from my first SOAP note. I feel more confident in what to write in each section and I appreciate the feedback Dr. Woods gave me throughout my two weeks of SOAP notes. 

PTE Journal Club: May

 I am really enjoying attending these journal club meetings. I have more confidence in my knowledge with understanding medical terminology and studying scholarly articles. For this Journal Club meeting, we reviewed the article "Home-Based Occupational Therapy for Adults with Dementia and their Informal Caregivers: A Systematic Review". This systematic review investigated whether home-based occupational therapy interventions for adults with dementia and their informal caregivers optimized care recipients' performance of daily occupations and reduced caregiving burden and improved caregivers' sense of competence. The participants included community dwelling adults with dementia and their informal caregivers. People such as family or friends who provide care without being paid for their services were included. This was a systematic review of 20 studies reported in 22 articles. They used a customized data extraction form. They had a primary reviewer who screened all titles and abstracts. There was a disagreement between reviewers resolved through discussion with a third reviewer. The independent variable was home based OT intervention. The dependent variable is performance in daily activities for adults with dementia and caregiving burden and sense of competence for informal caregivers. The main findings included moderate evidence supported interventions provided jointly for adults with dementia and their informal caregivers using a combination of intervention strategies. Evidence from this review underscores the importance of using multifaceted intervention approaches provided jointly to promote performance in daily occupations for adults with dementia and improve caregiving capabilities for their informal caregivers. I determined that the study was not valid and reliable because it is not replicable and not generalizable. A limitation was that the included studies used different terms for similar outcomes - for example, ADLs versus self-care. Also, some studies used author-developed outcome measures with unknown external validity and generalizability. There was variability in the reporting of types and stages of dementia. Most studies examined ADLs, IADLs, or both without describing specific activities, thereby limiting their generalization to clinical practice. A strength of the study was that it adds support for the use of home-based OT interventions and they provided high quality of evidence. Some future recommendations are that future empirical research is needed to investigate the efficacy of multifaceted intervention approaches for specific types of dementia (e.g., vascular dementia) and at particular stages of dementia (e.g., mild, moderate) to offer sound evidence supporting clinical decisions for occupational therapy practitioners. Also, it would be good to have a clearer definition for occupation therapy practitioners. The frames of references that went along with this article include PEO Model, Ecology of Human Performance, MOHO, and COPM. Occupational performance can be enhanced for adults with dementia when compensatory intervention strategies are embedded within their daily routines. I have enjoyed learning about these topics and plan to continue to attend journal meetings to enhance my skills more and have lively discussions with my peers. 

PTE Journal Club: February

 During our February Journal Club meeting, we reviewed the article "Effectiveness of Interventions to Address Cognitive Impairments and Improve Occupational Performance After Traumatic Brain Injury: A Systematic Review". I really enjoyed reviewing this article because I knew some information about occupational performance after a TBI from our EBP classes in the past. The study looked to determine the effectiveness of interventions addressing cognitive impairments to improve occupational performance for people with traumatic brain injuries. They looked at adults who had sustained a traumatic brain injury only. It was a systematic review that consisted of a total of 37 studies that met all the inclusion criteria. There were 9 Level I systematic reviews, 14 Level I studies, 5 Level II studies, and 9 Level II studies. They searched all the databases and related studies that were similar to group them into themes. The independent variable observed in this study was the type of cognitive intervention (specifically interventions to address problem with memory). The dependent variable in the study was occupational performance of the people with TBIs. There was strong evidence that supports use of direct attention training, dual-task training, and strategy training to optimize executive functioning, encoding, and use of memory compensations, including assistive technology. However, in most studies, occupational performance was a secondary outcome, if it was evaluated at all. We concluded that the study was valid and reliable because it is a Level I review with a good amount of RCT. It also used multiple researchers. One major limitation of the study was that all forms of bias could not be eliminated. More studies are needed where occupational performance is the outcomes. Expansions of options for measuring occupational performance beyond self-reports. Development of a wider range of reliable and valid performance-based cognitive outcome measures. The frames of references that applied to this study would include Cognitive Behavioral Frame of Reference, Rehabilitative Frame of Reference, Allen's Cognitive Levels, and Toglia's Dynamic Interactional Approach. The implications for our practice would be the cognitive intervention combined with client-centered, occupational-oriented approach have the potential to minimize limitations experience by individuals with TBI. I am enjoying having in-depth discussion with my classmates to further my clinical vocabulary and knowledge. 

PTE Journal Club Meeting: January

 For the January PTE Journal Club meeting, we discussed the article "Occupational Therapy Group Interventions in Oncology: A Scoping Review". This study examined the association between occupational therapy-based oncology groups and improved functional activity of daily living outcomes for adults with cancer. By being functional, you will see an improvement and an increase engagement in ADLs. The population that they looked at involved adults in the inpatient and outpatient setting that had a diagnosis of cancer. They looked at ages 25-28 years old. Most of the individuals in this study were women even though there were a few men. There was various types of cancer and participants were at different stages with their cancer. This study was a scoping review. It was chosen to explore all existing and accessible peer-reviewed evidence on the topic. There were eight research studies chosen for this article. There were only eight articles that they found that met all the inclusion criteria. The articles reviewed were 2 randomized controlled trials, 1 case study, 1 descriptive exploratory research study, 1 mixed-methods study, 2 pretest-posttest studies, and 1 longitudinal prospective comparative study. The results indicated that occupational therapy groups led to a significant increase in occupational performance and satisfaction, an improvement in functioning, and a decrease in fatigue. There is benefits of shared experience. This study was found to valid and reliable because they use inclusion and exclusion criteria, with an aim to provide a clear and reproducible methodology. The search strategy could also be easily repeated. Some of the recommendations for future studies that we discussed included a larger sample size. They could also have a more consistent type of cancer that they are looking at and specify the stages each individual is at. If they had more inpatient results, it would help more. We also said that they could assess the impact of IADLs.  The frames of references that went along with this study included social participation, MOHO, PEO, and Canadian Model of Occupational Performance. This scoping review demonstrated that OT groups in oncology lead to positive patient outcomes. The findings from this review not only are applicable to OT practitioners working in oncology-related settings, but also are relevant for practitioners who work with patients with caner in other settings because patients with cancer are treated both in general hospitals and units as well as in cancer-specific centers. I really enjoyed reading this study and discussing it further with my fellow classmates. It was a good article since we don't dive deep into oncology and OT during our coursework. 

Locus of Control

 Locus of control has to do with the way people believe certain events have control of outcomes in their lives. An individual can either have an internal locus of control or an external locus of control. People who have an internal LoC tend to believe that they have control of what happens in their life. They believe that the effort and time that they put into something will produce a certain result. They tend to not believe in luck or happen chance. They believe in facts and their own effort. These individuals are usually more motivated to work harder to achieve their goals because they believe it is possible if they put forth the effort need. They also take responsibility for the events that happen in their life. 

Individuals who have an external locus of control believe that the events in their life that happen are the results of external factors. They believe that they have no control or cannot influence things that happen. They believe in luck, fate, and chance. These people have a more relaxed state of mind when thinking about things that happen their life and they don't tend to get anxious much. To me, they have more of a free spirit than individuals with an internal locus of control. Some may even say that they don't work hard for things. Wether a person has an internal or external locus of control can come from genetic factors or even the experiences a person faces at a young age. Parents can even have an influence on a child's locus of control. 

When I did the Rotter's Locus of Control Scale test, I found out that I had an internal locus of control. It made since to me because I have always thought that I was controlled the results that happened to me. I know that when I put a lot of time and effort into studying for a test, I have a better chance of doing it better than if I didn't study at all. I know that not studying for a test and hoping I will get lucky has always seemed odd to me. I believe that my parents had a little influence to my LoC. They always told me that if I worked hard for something, I would have a better chance of achieving it. I am grateful for that mindset because it has made me work hard to be where I am today and how I want to be as an OT. I believe that having an internal locus of control will help me I treat patients because I will want the best for the and will know how to motivate them and encourage them to have the same mindset. That they will get better if they work hard for it. I enjoyed learning about this topic and learning that I have an internal LoC.