What They Didn’t Teach You in the Classroom

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By John Pope, MS, MSPO, CSCS
stack of books

You hit the ground running. School gave you the tools and the concepts needed to begin your residency-and now you are applying everything you learned.

However, I am encountering situations and identifying skillsets that aren't covered in textbooks or that can't be taught in school, such as how to deal with difficult patients, how to problem solve, or how to develop my own opinions and question others. I am learning these things through trial and error out of necessity. Leadership, work ethic, hustle, and professional and community development are central qualities to success in practice and they are skills that I am learning and improving upon daily. Here is an important piece of advice: You can't hide behind the fact that you are a resident, and you have to welcome the responsibility.

What follows are concepts about personal and professional growth that I have learned from others throughout the years. I hope they can help you in your residency experience, too.

Leverage Past Experiences

Before entering O&P, I worked in health and human performance as a coach and teacher. I worked with a wide variety of populations on opposite ends of the performance spectrum and learned the importance of trust, empathy, and accountability. I also gained firsthand experience dealing with noncompliance and developed strategies to build rapport with the athletes and students with whom I worked.

I was able to translate those experiences and approaches to my early O&P patient care. Identify your strengths and leverage those skills to guide your practice. Along your journey you will develop your own style, skills, philosophies, and approaches, which help you continue to grow and mature in your profession.

Live in a World of Understanding (Not of Knowing)

When you limit yourself or your patient to only what you know and don't question why or how it applies, you create constraints. You live in a world of knowing. Instead, we should continually seek understanding, look for the bigger picture, and constantly search for the why, sometimes challenging conventional wisdom.

For example, O&P professionals have to understand gait biomechanics and how changes in alignment affect the body. However, we may not know as much about how the body regulates movement and how to search for physiological capacity rather than perceived limitation. When you don't address the underlying problem you are, as Gray Cook, MSPT, OCS, CSCS, RKC, says, "putting movement on top of dysfunction." High muscular tone can be the body's way of masking deficiency, for instance. In some cases, tuning prosthetic alignment reinforces poor gait mechanics by compensating for dysfunction instead of addressing it. With a more thorough evaluation and better communication with physical therapists, we can provide the patient a device that demands function rather than accommodates for dysfunction.

Constantly seeking understanding forces us to reevaluate best practices. For example, Cook has an approach to movement concepts that has shaped the way I examine dynamic movement and identify poor movement strategies.

Continually Reinvent

"Continued reinvention forces you to constantly challenge your perception of what you want and need out of life." While I don't know the origin of this quote, it highlights the idea of stepping outside of our comfort zones. Trying new things and entertaining new ideas and concepts is how we stay creative and avoid stagnation.

Explore the concept of lateralization- the pursuit of learning and diversification. Especially as new O&P practitioners, we should seek to understand how our colleagues in related allied healthcare disciplines, such as physical, occupational, and exercise therapy and chiropractic medicine, identify, define, and address deficiencies and deficits. Understanding their philosophies and approaches will help us expand our own, will open lines of communication and create a common language between disciplines, and will support an integrated, multidisciplinary patient care model.

Desmond Masterton, CO, CPed, my orthotics instructor in school, echoed the idea of being a boundary spanner. He taught me that today's practitioner needs to be able to communicate with other healthcare professionals on their levels and that bridging the gap between health professions should be a focus. He also introduced me to Robert M. Pirsig's Zen and the Art of Motorcycle Maintenance. Reading this book started me on my journey for understanding.

Practice Positive Habits

Practicing positive habits sets us up to be successful. These don't have to just refer to your O&P practice, although knowing where your tools are because you put them away does help. These can be habits in any area of your life.

Identify Mentors

I can't take credit for the central concepts that I have shared. They are ideas that I adopted and applied from mentors and coaches and they are continually evolving. I invite you to use these concepts to develop and expand on your own approach. Search out coaches and mentors; share their philosophies with others, and examine how they impact your own. The philosophies and concepts you adopt and implement will grow and evolve with you as you develop your own approach to patient care. As stated by one of my inspirations, the late Chris Moore, author, podcaster, and fitness champion, "Your pyramid can only grow as tall as its base."

I would like to thank my numerous mentors and teachers. Your philosophies and teaching methods are helping me to develop my own approach to patient care and to develop as a professional.

John Pope, MS, MSPO, CSCS, is a resident at Orthopedic Appliance, headquartered in Asheville, North Carolina.