Simon Smith, Lower Quadrant MSK Extended Scope Practitione. Co-Chair, Professional Development Committee (PDC), MACP.
Having read Jenny’s great blog post from a few weeks ago I felt inspired to write one of my own. So here goes!
Like most people I come across these days that work in the NHS, my job as an Extended Scope Practitioner with an MCATT service is incredibly busy. My work with the PDC is supported by my employer, but realistically most of the work is done in the evenings and at weekends. In my mind the tasks I have on the PDC appear to be split between three different domains, managing the 9 strong committee, arranging and developing existing courses and looking to try to develop new ideas and development opportunities for our members with my Co-Chair Helen Welch. Most of this is done by email and on the telephone. A typical week sees 50+ emails go through my account.
Although it was a busy one, it is weeks like this that remind me why I chose to take on the role I have with the MACP. It was excellent.
Monday 23rd September.
Monday is always a wrench, I’ll not lie. I have two young kids and my eldest has just started school, so weekends are great family times. I’m brought back to the real world by my 8am patient. My evening clinic on a Monday finishes at 7:30pm so I always feel like I’ve earned a rest after the day. Today was different however. I had an exciting evening meeting booked over a burger and a pint. I shall explain my disproportionate excitement about an after work burger!
When I look back at the people who have influenced my career, I site my engagement with the MACP firmly at the door of a chap called Gary Rogerson. I worked with him as a junior while in Leeds. His ability to clinically reason through a patient was always impressive, but above all his ability to communicate his thought processes and further the practice of those around him was striking. He was and still is an MACP member and the person that introduced me to really structuring my thoughts and sparked a real interest in MSK. Although he does support the wrong football team, as a young impressionable physio I thought it was a good thing to be like Gary!!.
As a member of the PDC I feel that we should be providing opportunities for learning in extended roles as we do currently, but I feel very passionate about the fact that we should also be providing opportunity to spark interest in people at the beginning of their career. At our last executive committee meeting I received some clarity on how the MACP wished to proceed with bringing back courses aimed at advancing clinical reasoning skills for AfC band 5 and 6 physiotherapists. It was with great glee therefore that I arranged a meet with a friend and colleague James Midgley about the development of a clinical reasoning course for the knee. Both James and I spend our working days assessing knees, but also take great enjoyment in clinical discussion and mentorship with our wider physiotherapy team. Although the thought of burger and a pint was appealing, it was the act of getting moving on a task we have been talking about for months that really excited me.
I left the Dormouse pub in Clifton with a spring in my step, a burger in my belly and a really quite exciting outline for a one day clinical reasoning course in my hand. Watch this space!
Tuesday 24th September 2013
The pay off for working two evenings a week is that I get to have a Tuesday off work and look after my children. I delivered my boy to school and my daughter Isla and I returned home to read books and put nappies on dollies. Anyone with a two year old will know that this can literally go on and on and on and on…!
Tuesday is also a time where I try to get a lot of email contact sorted. On my radar at present is the running of the Introduction to MSK radiology course and the organisation of our Cervical Artery Dysfunction course. The ladies that have developed the CAD course for the MACP have put a terrific amount of work into it and the PDC is trying to arrange some dates for this to run.
Generally speaking by the end of a Tuesday, although I love my children dearly and I really quite enjoy the MACP work, I am glad to go out for a ride with my cycling club chaingang. My wife comes home from work to take over the mayhem. This Tuesday was no different
Wednesday 25th September 2013
I learnt a few months ago that I was not quite the athlete I thought I was. I enrolled on the Leeds Xpress Triathlon, trained diligently on the bike and even went for a few runs. However I found out that throughout my adult years what I thought was swimming is actually flapping about in the water while holding my breath. This is fine for short distances, but for completing a triathlon it is a tad embarrassing. After taking 24 minutes to swim 16 lengths I vowed to come back stronger, but with the ability to swim. Wednesdays now see me working through the day, home to bath the kids while my wife runs, then out to adult beginners swimming lessons. I’m not proud!
Friday 27th September 2013
All week I had been fielding emails about the first running of the MACP’s Spinal Masqueraders: Expanded course, due to take place on Saturday. We developed the Spinal Masqueraders Study Day, the prequel to this new course with Chris Mercer, Laura Finucane, Sue Greenhalgh and James Self back in 2009. This has been incredibly well received. The remit of this course was always to give an advanced practice view on the recognition and management of serious pathology masquerading as spinal and radiating pain. When we developed this we figured that Cauda Equina Syndrome and Abdominal Aortic Aneurism are commonly discussed and that our study day should focus on some of the less commonly seen masqueraders. However the feedback we have received over the 2 years this course has been running is “why do you not cover CES or AAA”. The market clearly existed for a course covering these topics so a year ago Chris, Sue, Laura and myself arranged a teleconference and bashed out some ideas. What came out of this was Spinal Masqueraders: Expanded. You can imagine that after a year’s preparation I was quite anxious that all would go well.
When we run a course under the PDC commonly what happens is that we look to recruit someone locally to organise the day, book rooms, order refreshments and put up signage. As this course was to run at York, my home city, I took this role on. Not only did I have the anxiety surrounding our new course, I also had to make the right choice of biscuits for our delegates. I took to Twitter for help with this issue. Twitter did not disappoint. I was clear that if I bought Jammy Dodgers and Chocolate Hobnobs all would be well. Thank you @kedarkale16 and @littlephysio, it would have all been a disaster if it wasn’t for you. Friday, after my clinical work I bought biscuits and put up signs.
I went home expecting to go back to York to have a beer with Chris and Laura when they got to their hotel. At 9:30pm when they were still stuck in traffic in Luton I shelved any plans for beer and started to worry that I might not have lecturers for Saturday
Saturday 28th September 2013
The big day! I got to York Hospital early to make sure all was well. I texted Chris, he was in Yorkshire. All seemed well. 30 delegates arrived, nobody complained about the biscuits and everyone seemed happy.
After my short introduction to the course Laura Finucane kicked the day off with a presentation entitled ‘Not all leg pain is from the back’. Laura’s remit was to discuss pelvic masqueraders. I know from previous experience that when Laura presents you will get a very well researched complete appraisal of a topic, delivered in a way that is easy to digest and engaging. She did not disappoint. Following on from this Sue delivered a further presentation under the heading Cauda Equina Syndrome; Before or After the horse has bolted. Sue has been involved in recent research in this area and is able to talk on the subject with levels of assurance matched by very few others. She truly is an expert in her field and her presentation reflected this.
Although the day started with a few presentations, this is really aimed at getting everyone warmed up and thinking. The main thrust of the day was to enhance delegate’s clinical reasoning of cases of masquerading spinal pain. Hence the majority of the day was given over to case presentations and clinical reasoning workshops. There has been a slight change of emphasis from the Spinal Masqueraders Study day to Spinal Masuqeraders: Expanded, we aimed to engage delegates to a greater degree in the reasoning of cases. This sounds wonderful, but in practice if the people that attend on the course don’t engage, the day will not be as great an experience. Essentially if you’re a delegate, you get out what you put in. I worried before the day that this might be a stumbling block. I needn’t have done. The course was filled with bright inquisitive clinical reasoners; A real credit to our profession. From our first case study session onward I knew the day would be a success. Thank you to the York 30!
After lunch, just as our stomachs may have been telling us that we had gorged too much at Costa, Chris kindly kicked the afternoon off with a presentation on visceral pain. I’m not sure if this is a selling point or not, but Chris (unbeknown to me) had planned to get his abs out to make a point or two. I’d not book onto a course specifically to see this, but some might. I couldn’t bring myself to take pictures for Twitter. You’ll have to book onto the course yourself if you wish for more information on this subject. Chris works as a Consultant Physiotherapist down on the South Coast. His breadth of knowledge is frankly scary. If ever there was a man that never rests on his laurels, never thinks he knows all he needs, it is Chris. His scope of practice seems potentially endless. A true trailblazer in physio I feel. Abs aside, his presentation was great, everything I would expect from him really.
The day finished off with further case clinical reasoning and some time to discuss any issues arising from the day in our panel discussion. The biggest selling point for this course is, I feel, the easy access you have to some great clinicians whom in their roles as Consultant Physiotherapists can give advice on forging new and developing existing extended role pathways. I’m biased, but if you’ve not been on one of our Masqueraders courses you really must.
Above all I finished my day on Saturday pleased all had gone well. Pleased that I’d enjoyed a day of discussion and learning and pleased that I was part of the vibrant intelligent profession that is physiotherapy.