Professional and Clinical Skills Prior to Qualification - Assignment Example

Personal Assessment, Reflection, and Future Goals In my radiography training so far, I feel that I have not spent enough time in the clinical environment, and that the time I have spent has not always been structured in such a way as to create an effective learning experience. As a result, I do not feel that I have developed sufficient familiarity with the various pieces of equipment, procedures, and environments in which I have worked; instead of having the opportunity to become comfortable and competent in one setting, I have been rotated so frequently from one setting to another (each with its own slightly different way of working) that much of my experience has consisted of feeling bewildered and somewhat useless. By the time I begin to feel confident and capable in one setting, it is time to rotate to a different unit; and by the time I return to the first unit, so much time has passed that it is again unfamiliar to me. Further, much of the time I spent assigned to operating theatres, mobile units, and the major-trauma area consisted of waiting around while very little was happening; and when a case came in requiring radiography, senior radiographers almost always took over and seemed very reluctant to allow students to do anything on their own. What little they did allow me to do was generally very basic, and there was little opportunity for me to perform challenging tasks. Of course, this reluctance to let students handle serious cases makes sense from the standpoint of the patient and the hospital; but it leaves me feeling inadequately trained for the responsibilities of a qualified radiographer. Because of this lack of meaningful experience, I feel that I am insufficiently familiar with theoretical and practical aspects of some of the more complicated equipment with which I will need to be familiar – particularly the equipment used in operating theatres. Once qualified, I will be expected to handle this equipment and to cope with the pressures of a theatre environment without anyone to watch over me and assist me when I am uncertain of how to proceed. I also feel that my level of confidence is not yet sufficient to function efficiently in an environment that can be complicated and hectic. Surgeons, for obvious reasons, expect immediate and accurate results, and have little patience for an inexperienced radiographer who takes longer to get things done than an experienced veteran. I find that in high-pressure situations, I am frightened of making mistakes and lack confidence in my abilities – both to carry out procedures and to make decisions independently. I also lack confidence in my ability to assess the images I create and diagnose accordingly; I need to build my confidence so that I will be prepared to undertake this level of responsibility. Reflections on my experiences I have had a number of experiences in the course of my clinical training that were significant in highlighting my strengths and weaknesses. I have chosen to analyze them using Gibbs’ Model of Reflection. 1) My first trauma case Description I was working a five-to-midnight evening shift as part of my clinical placement in Accident and Emergency X-ray, when a call came in advising us of an incoming trauma case – a road accident. I had never had the chance to perform a series of x-rays for a trauma case before, as on every previous occasion when a trauma case arrived, we students had always been pushed aside. But this time the radiographer told me, “You can do this.” I was frightened, nervous, and a little confused as to what, why, how, and when I was supposed to carry out the procedure – having never experienced this situation before. I started slowly, and the radiographer constantly told me that I was working too slowly; but I wanted to make sure that I performed my tasks correctly. In fact I did manage to get everything right – or nearly so, and the only problem was caused by the patient. The patient came in on a trolley with his neck in a collar. I had to take two views of his neck, to views of his spine, and one view of his pelvis in order to access his injuries. When I mentioned to the radiographer that I was working slowly because I had never performed this type of examination before, he said that as a third-year student I should already know how to do it. After I completed the examination, however, he commented on how well I had done. I now suspect that many of his earlier comments may have been a deliberate attempt to rattle me, to give me a little more stress to see how I reacted to the situation. Feelings The radiographer’s comments made my feelings of insecurity and pressure even more severe than they were already. Evaluation This was certainly a stressful experience; but I did manage to do my job despite the stress, and do it well. The fact that I succeeded despite the stress taught me that I am capable of performing under pressure. Analysis If the radiographer was really making a deliberate attempt to increase my level of stress in an already stressful situation, I cannot say that I am particularly happy with that training strategy; although it may be effective in preparing students for their future careers, it would be nice if the same thing could be accomplished more gently. Conclusion I think I handled this situation fairly well. I did not let the radiographer pressure me into hurrying and perhaps making mistakes. At the same time, it is obvious that I need to learn to work faster, particularly under pressure. Action Plan I believe that my biggest problem is that I need more practice, particularly in handling high-pressure situations. 2) Community hospital assignment Description As part of my training, I worked for three weeks (instead of the usual one-week rotation) at a local community hospital. When I arrived, I was told that they were short-staffed; and very soon I was left largely to my own devices. I was responsible for booking patients in, examining them, and checking the images before sending the patients on their way, all with minimal supervision. At the end of this assignment, I felt that I had been a proper radiographer. I felt more confident than I had in any of my previous assignments, and was carrying out examinations that I had never performed before. The superintendent of the department commented on how good a job I had done; he said that because of the hospital’s staff shortage, I had been invaluable to them, and they could not have coped without my help Feelings This was a very rewarding experience, as for the first time I felt a sense of mastery of my new profession. Evaluation In this assignment, I learned that I could function successfully as a radiographer, handling all aspects of the job with minimal supervision. Analysis I think this assignment shows that I can function very well in a real-world environment, given some time to become acclimated to my working environment, equipment, procedures, and so on. Conclusion I see this assignment as the best model so far for my post-qualification career: I settled into a new environment, and within a short time I felt able to do my job effectively and accurately. Action Plan I want to use this experience as a model for future, and even greater, successes. 3) Following procedure: an unnecessary dispute Description I was working an evening shift when a request for an x-ray came in. I followed correct procedure by consulting with the shift radiographer. She proceeded to berate me for not acting more independently: “You’re a third-year now; you should know what is justified and what isn’t. Before long you’ll be qualified.” I responded that I knew all this, and I knew that the request was justified, but I had an obligation to both the university and the hospital to consult with her rather than act on my own. I reported this incident to the superintendent of that department, and he confirmed that I had acted correctly: “You are exactly right in your comment and did the right thing; I will reconfirm with the radiographers their duties as far as students are concerned.” don’t know if that’s any good, just kind of shows the attitude of some of the qualified staff towards students, were treated like no bodies, have to do all the work and talked to like animals some of the time which affects your confidence and ultimately your skills Feelings I felt belittled and insulted by the radiographer, who was abusive despite the fact that I had done exactly what I was supposed to do in these circumstances. Evaluation I did ultimately get validation from the superintendent, who confirmed that I had acted properly. However, the whole incident was really unnecessary and unpleasant. Analysis While the radiographer was clearly at fault in criticizing me for following correct procedure, it is possible that I could have avoided the whole incident – or at least lowered its intensity – by making it clear to her from the outset that I was consulting her because it was the correct procedure, and not because I was unsure of how to proceed. Conclusion I may be able to avoid incidents like this in future by projecting a more confident image to my colleagues. Action Plan In addition to developing my technical skills and self-confidence, I need to improve my communications skills; in particular, I need to learn to project confidence and competence to my colleagues – without, of course, overcompensating and appearing arrogant. This will be easier once I genuinely feel more confident in my abilities. My first-year action plan According to the Health Professions Council Standard for Radiographers, a qualified radiographer needs appropriate communications skills regarding colleagues as well as patients (HPC-SPR 1b.4); s/he also needs to be fully competent in working with radiographic equipment, including all the tasks involved in safe and accurate imaging (HPC-SPR 2b.4). These are both areas in which I would like to improve over the course of my first year as a qualified radiologist. I feel that the primary way in which I will improve is by having the opportunity to work in a single, stable environment; this will enable me to focus on mastering the equipment and procedures I will use, and will thus allow me to build my confidence along with my competence. I will focus on my communications skills as well; and of course my increasing self-confidence will make it much easier to communicate confidently with my colleagues. SMART Objectives Are these goals “SMART”? They appear to be only moderately specific, but that may be unavoidable until I have been working as a qualified radiologist long enough to formulate more specific and concrete objectives. As my goals are both somewhat subjective, measurability represents something of a challenge. By the end of my first year of qualification, I should feel comfortable in my working environment. I should feel that I know everything I need to know about the equipment I am using and the procedures I am meant to follow. I should feel confident that I can correctly and efficiently perform the diagnostic procedures required of me. These feelings should be confirmed by my supervisors’ assessment of my skills. In addition, my improved communications abilities should be measurable by my own feeling that I am a trusted and appreciated team member, as well as by feedback from my supervisors. I believe that my goals are eminently achievable and realistic – particularly as I have already experienced some degree of success and progress in my student assignments. As these goals are identified from the outset as applying to my first year after qualification, they are more or less by definition time-bound. References Health Professions Council Standards of Proficiency for Radiographers (“HPC-SPR”) is available for download at http://tinyurl.com/2eb2cv or http://www.hpc-uk.org/assets/documents/10000DBDStandards_of_Proficiency_Radiographers.pdf . Models of reflection: Gibbs’ original work (Learning by Doing: A guide to teaching and learning methods, Oxford: Further Education Unit, Oxford Brookes University) appears to be out of print. However, a number of on-line sources discuss Gibb’s method alongside several other models of reflection. See the following: Clinical Placement Support Unit, UCE Birmingham, “Using a Model of Reflection”, 2005. Available on-line at http://www.health.uce.ac.uk/cpsu/Placement%20Support/Model%20of%20Reflection.htm or http://tinyurl.com/2egpfx . University of Brighton, “Reflection”, undated. Available on-line (as Word document) at http://staffcentral.brighton.ac.uk/clt/events/documents/Ramage%20Example%201.doc or http://tinyurl.com/28e5lm . Lydia Arnold, “Reflection: Introductory thoughts”, Anglia Ruskin University Ultralab, 2005. Available on-line at http://intra.ultralab.net/~lydia.arnold/RM/reflectionintro.html . Personal development and “SMART” objectives: Andrew Bell, “Ten Steps to SMART objectives”, National Primary and Care Trust Development Programme, August 2004. Available on-line at http://www.natpact.nhs.uk/uploads/Ten%20Steps%20to%20SMART%20objectives.pdf or http://tinyurl.com/37xky9 . University of Stirling Human Resources Services, “A guide to personal development planning”, undated. Available on-line at http://tinyurl.com/yu9uu4 or http://www.hr-services.stir.ac.uk/traininganddevelopment/pdf_files/masters/personaldevplan.pdf . Read More