Reflective Report on Clinical Experience

The number of first year students is usually limited to 2 (it can go up to 3 depending on the day) together with a third year student. It means that there will be 3 or 4 people interviewing the patient at the same time and treatment in this arrangement.The third year students can benefit from the support of the supervisor but hardly any suggestion from the first year students as our role in the clinic is mainly observing.

Treatment are conducted in a team setting (two to three 1st year students lead by a 3rd year student) , this will obviously compromise the confidentiality by its very own nature and that carries the disadvantage of a reduced level of privacy.Feelings / ReactionAt first, most first year students found it overwhelming by the whole experience as we don't know what to expect. Fortunately, most third year students are friendlySince the kitchen area is quite small, if there are more than 6 or 7 people on the day and you are the last to arrive, you will have to stand up there and pretty much do not know what to do as you are not involve in anything. You do feel quite alone in that set up.

It does get better and feel more at ease as times goes by.EvaluationAs the first year students are only observing and not engaging in any treatment plan. We do feel left out of the whole process and therefore we do engage in the learning process as much as we want.AnalysisI have managed to bring a small notebook to drop down the points so to make my own learning process more involve even if I do not engage in the conservation regarding the treatment principles.ConclusionIf the kitchen area is larger and be able to fit all the students at once, then I am sure most students will feel more comfortable.

Indeed, if the room is not a kitchen so that people will not come in and out for drink, then this will increase the level of privacy.Action PlanI could arrive the clinic earlier so that I could occupy a seat but then again, if there is not enough seat for everyone, the same situation would occur to someone else.Operation Procedure of the ClinicDescriptionThe patient will wait while seating in the waiting area. We will be notified by the receptionist that the patient has arrived. Normally, the third year student will discuss the case with the clinic supervisor (for returning patient). Since the third year student may not be familiar with the case as he/she could be the first time seeing the patient, he/she may only finish the last patient and therefore in a bit of rush.

We then invite the patient into the treatment room and the following list of questions will then be asked for a new patient. It is quite a long list but it is necessary if we are to provide a through diagnosis.There could be 3 to 4 of the students together with the patient, normally the reduced level of privacy has very little or no impact on the ability to carry out treatments in the clinic. Most patient feel comfortable as they know this is a student clinic but I felt that a number of them found it overwhelming sometimes.

Obviously, this form of style will suit some more than others.After the initial interview, we will then looked at the patient's tongue and pulse taking. This could take up to 20 to 30 minutes, we would go back to the kitchen to discuss treatment with the supervisor of that day. The patient is then left alone in the treatment room for about 10 to 15 minutes depending the length of the discussing of the treatment plan.

The whole team is then back in the treatment room. The patient is then being asked to take their cloths off if necessary. The patients are normally comfortable to expose themselves but we do get out of the treatment room and let the patients get themselves ready. Once we are back in the treatment room, the first year student will then get the needles ready and try to write the points on the board. It all depends the experience of the third year student as to whether they have the points written down on a separate piece of paper.

If not, then we will then have to look at the file and sometimes this will get in the way of the third year students.Once the needles have been inserted, we then leave the patient in the treatment room (normally for 20 minutes). When the time is due to remove the needles, the first year students sometimes would be asked to take the needles out especially when the third year student is busy.Feelings and ThoughtsMost of the third year students is under a lot of pressure at the point of putting the needles in, we the first year students try to smooth the whole operation by helping them as much as we could.

But there is only so much we can do / help.The time pressures for the third year students to discuss the treatment plan sometimes is quite big as the patient is waiting in the room alone.EvaluationIn most cases, the amount of time that we spends with the patient is therefore reduced in this mode of student clinic. Another reason is that the patient did not realise that the whole session would take so long and therefore did not allow time for it. Because of these, the types of treatment given are therefore mostly limit to needling. We hardly ever have time for massage, moxa or cupping.

AnalysisOne thing that stand out is that if the patient allow more time for the session so that we can give a variety of treatments if the situation arises.Another thing is that the gap between the appointments could be extended so that the third year students are not under so much pressure for getting ready for the net patient.Some extra treatment rooms will help to ease the situation as we are under pressure to get the patient out and get ready for the next patient.ConclusionThis operation procedure itself is not perfect but there is not much we can improve upon due to the fact that this is the student clinic. As mentioned above, most of the problems are time related.Action PlanDue to the nature of the set up of the student clinic, there is a limitation of any action as a first year student can take.

But hopefully, the time issue will be addressed in the future.MYMOPDescriptionFor a New Patient, the 1st year student will do the MYMOP I. Again, this is another area where I think we need to be trained beforehand. Although there is a lesson on MYMOP, but we did not have any practical on MYMOP. I think it will be great if we can have some practise (on fellow students) in the lesson like we did on Pulse and Points.First, the patient is given three forms / leaflet (1.

Data Collection Consent Form, 2. One leaflet – Information for New Patients, 3. Confidential Pre-treatment Questionnaire and MYMOP 1).In the MYMOP 1, the first page explained this is the first questionnaire, then there will be another one in 6 weeks time and another one in 3 months time. But they will not have this page giving back to them so they will not know this is the case and may not remember that this will be anonymised by using a code number.

The following sentences is in the second paragraph. “This information, along with information about your condition and planned treatment, will be anonymised by using a code number instead of your name and stored on computer.” when I first looked, I was not sure whether this means all information will not be stored on computer. I think it will be much better if it simple state “ALL information in this form WILL not be stored on computer.” at the end of the paragraph.Feelings and ThoughtsThis lead to us 1st year student do not know how to explain this patient ID to the patient and in fact we do not know how to construct this patient ID even though we have been taught in class.

Evaluation and AnalysisSince most patient will not be aware of whether or not their record will be stored electronically (for the above reasons). I wonder whether we may consider storing all our patient records electronically as most patients understand that their records help to provide information leading to further clinical research (at stated in the Consent Form). As I am now home and would like to access the patients' records and I am sure most students will like to be able to access the information other than in the kitchen at the college. This will help us to understand their treatment by the 3rd year students and understand their thinking and approach. The first year student will learn much more quickly through this.

Action PlanMy reflect on this is if I am going to do it again, I may invite the patient into a room if it is available or somewhere quiet so that they feel more comfortable answering questions about themselves. I will feel much more confident and comfortable as well by asking them personal questions. Time constraints exist in certain situation especially when the patient is in a rush or when the group is in the treatment room.