CTS- Pedia, UPM CAMP

One of the major requirements in PT100: Perspectives in Physical Therapy is the deployment of students into various possible work settings of a physical therapist. As students honed to be colleagues of present physical therapists, there is a need for BSPT students to have firsthand observations on what specific roles and responsibilities a physical therapist plays and the relationships that a physical therapist has within the working environment. This exposure will help students appreciate further the practice of Physical Therapy. Our group was assigned to our very own, Clinic for Therapy Services- Pediatric section of University of the Philippines-Manila, College of Allied Medical Professions.

CTS Pedia: Therapists in Action

Description of the place

The Pediatric section of the Clinic for Therapy Services is like a small playground. A slide, a seesaw and a swing can be seen upon entrance. It has a shelf which contains storybooks and cabinets containing toys used by therapists to treat their patients. There are small tables and chairs, but therapists usually sit on the matted floor. A small stairs could also be seen in the center of the clinic. There are also rooms equipped with microphones and the like which help speech pathologists conduct their treatments. There is also a special room called the sensory room. It contains the swing, a rope ladder, a trampoline and a ball pool which is filled with small plastic balls just like the ones seen in establishments like McDonalds. This is the room used by therapists for children with sensory impairments. The clinic, though at first impression appears to be a daycare center, plays an important role in the cure of children with disabilities. Those things are being used by the therapist in treating patients as for what the physical therapist we have observed Ms. Deanna Katrina Maranion said, there is no other way to treat kids but to play with them.

Materials used for movement development and books

Patients are referred from the Philippine General Hospital. Sessions of the patients are scheduled, the frequency depending on the need and capability of the patient's parents to bring the patient to the CTS-Pedia and pay 50php per session. The fee goes to the fund of UP-PGH. Most of the patients are children with chromosomal disorders, like cerebral palsy. Treated in the clinic are children of various ages, but if the therapists see that the patient is better suited to be treated in the CTS Adult and Adolescent Section, then the child may be referred to it. Patients are treated by either occupational therapist, physical therapist, or speech pathologist, depending on their need. Interns from the College of Allied Medical Professions practice here under the supervision of a registered therapist. During the first hour of our observation, many of the patients treated are children with cerebral palsy while on the second hour most of them were children with speech difficulties. Since the therapists deal with children, electrotherapy is not advised to be used to treat the patients. The use of water in treatment is hard to facilitate in the location of CTS-Pedia. Exercise and massage are the modalities most used in the clinic.

Roles and Responsibilities of a Physical Therapist

Ma'am Dk and an intern treating a patient with cerebral palsy

The group observed Ms. Deanna Katrina Maranion, PTRP in the Clinic for Therapy Services - Pediatrics. Ma'am DK, as everyone calls her, personally chose pediatrics for her practice. She graduated from UP Manila under the Physical Therapy department, and has finished Bobath Pediatric Basic Course in South Korea.

There are many responsibilities of a physical therapist in pediatrics and clinical teaching. To name few, the physical therapist has to teach and supervise the interns, train them on how to deal with their patients as well as guide them throughout their therapeutic plan. Also, the physical therapist has the responsibility to explain what is done to the patient. This does not only show respect to the patient and the patient’s parents. It also helps the physical therapist gain the cooperation for more efficient and effective treatment. A physical therapist explains the child's condition and needs to the parents. She/he also acts as a teacher to the parents and patients. Exercise that should be regularly done are taught to them so that the exercises can be done at home. The use of prosthetics are also taught by the physical therapist. As we have observed in the CTS-Pedia, the physical therapy interns do not only perform what is expected of a physical therapist. He or she has to extend her abilities to compensate for the lack of speech therapist or occupational therapist in the area. Since the therapists in the CTS Pedia are still students, the interdisciplinary relationship among the therapists caters to an atmosphere conducive to learning and practice. 

Ma'am DK doing joint mobilization on a patient with cerebral palsy

Aside from clinical treatment, a physical therapist also has duties within her work settings. Ma'am DK is the clinic supervisor of CTS during Thursdays. She acts as the facilitator in any activity that her patient does. She acts as the observer who monitors bits of improvement of the patient, and looks for signs that may lead to problems in the treatment of the patient. She also acts as an instructor who observes the interns and guides them through the therapy sessions. She gives advice and comments on their performance for the day.

Reflections, Insights, and Comments

L-R: Dana Laron, Dianne Duque, Lorie Pena, Paola Marcaida, Maan Erese, Celine Domingo, and Ma'am DK at CTS Pedia

The following statements are reflections of physical therapy students after the observation in the CTS-Pedia of UP CAMP. The statements include reactions on the attributes of the physical therapist in the work setting, including the quality of relationship with the patients, parents of patients, and other therapists, the physical therapist’s responsibilities, and personal insights on the PT profession. Dana Leron and Celine Domingo are 3rd year BSPT students, and Dianne-Josephine Duque, Paola Josefina Marcaida, Lorelie Anne Pena, and Anneliz Marie are 2nd year BSPT students. They are all under the Department of Physical Therapy, College of Allied Medical Professions of the University of the Philippines Manila.

ANNELIZ MARIE ERESE

At first, my groupmates and I decided that we want to have our clinical exposure at the Philippine General Hospital because of the diverse professionals and personalities that we might encounter there. We thought that it would really be a great experience to interview a physical therapist who is hospital-based. Also, we do not want to be assigned to the CTS-Pedia because it is just around the school college and there would be no thrill anymore since we see the clinic and the random patients outside regularly. But, with some luck (yes, now I know we were lucky), we got it. I was not that excited when our Clinical Exposure Day had come. We went inside the CTS-Pedia and I looked around the place and had an affirmation of what I have suspected before—it was small. But it was not really, really small that it cannot contain 15 students. Actually, it can. But since it is a clinic, five students would be more than enough. Contrary to what I thought before, I like the place. It makes me think of a playground. Not because the place is noisy and the children are running everywhere but because there are a lot of toys and toy-like structures that children can really enjoy. After we have observed the procedures in a normal day at CTS-Pedia, I have realized that it is not just the simple clinic that we pass by every time we go to CAMP. For the children and also for their parents or guardians, the clinic is a kind of refuge, or escape from the cruel reality of the world. In this place, children with disabilities feel that they are secured and safe, that they are well-loved and taken care of, and that they are just really ordinary children who happen to be more special than everyone else.

DIANNE-JOSEPHINE DUQUE

After having to observe at the CTS-Pedia, I have come to realize that there is really something more important than what I am currently focusing on. Other than making sure that I get good grades, graduate (on time), and pass the boards exams to be a legalized Physical Therapist, I also have to make sure that I will have a better heart and be a better person to be the best Physical Therapist that I can because being a PT entails more than just the skills. Patience, determination, sympathy, passion, enthusiasm, professionalism are just a few traits that I have realized that I need to work on so that I would be able to provide my future patients what they truly need and also have a good working atmosphere with my colleagues. I also realized that it is not only to that person who is seeking our aide that we have responsibilities to fulfill. We also have responsibilities to their family, especially to their parents to make them understand what we are doing. And also to educate them on what things they can do at home, it is like teaching a man to fish instead of giving him fish. Besides all these realizations, the one that really struck me the most was what Ma’am DK told us about fulfillment. She said that we’ve got to focus on the small things, the small ways in which these children improve, because in appreciating these small ways you get fulfilled. She also said that people search every where trying to find this one thing that they can do to make a change in the world. And here we all are, Physical Therapist (soon to be), going to work everyday and doing that change in the world, being that change.

CELINE DOMINGO

During our clinical exposure, I realized that being a Physical Therapist is not just about graduating and passing the board examinations. It entails a lot of responsibilities, especially to the patient and their families. I learned from Ma’am Deanna that as a future Physical Therapist, I must keep in mind that it is my duty to let the parents know how their child improved through short notes and evaluations. I also realized that in the future, I must also make sure that the patients or their parents understand what we are doing to them or to their child. By observing Ma’am Deanna, I learned that being a Physical Therapist means having professionalism. I was also moved by her warmth not only to her patients but to the interns as well. I really admired how she smiles a lot and how she patiently deals with her patients and their parents. She also told us that as Physical Therapists, we must learn to appreciate small things like helping a patient extend his or her hand. In just a short span of time, I caught a glimpse of what I will be in the future and personally, I liked it. I love how PTs are an instrument of change in someone else’s life. These changes, small as they may seem to be, help people live their life fully. As Ma’am Deanna herself said, some people say that they want change but she as a Physical Therapist see and help make that change possible every day. I also want to be an instrument of change in someone’s life. By doing this activity, I realized that this is the true meaning of fulfillment for me. If I can make even just one life easier, then I think I would be fulfilled.

DANA LARON

From what I have observed, Ma'am DK doesn't just treat patients. She does a lot of things in the therapy clinic that, for me, is a bit overwhelming. She treats patients, guides interns, teaches parents/caregivers, interacts with other therapists, checks evaluation notes and more in an hour of therapy session. With that much work to do, a physical therapist should be focused. Being a pediatric phycal therapist requires a lot of patience. Treating children is not easy though it seems like simple play. One should be very caring when handling patients. He/she should be very open to the expectations of the parents and caregivers and should maintain professional relationship with other therapists and interns.

PAOLA JOSEFINA MARCAIDA

Upon knowing that we will be observing in CTS-Pedia, I was very disappointed. It seemed unfair to me that we will be observing in a place just below the classroom we were holding the lesson in. The CTS-Pedia, however, proved me wrong. I liked the place. Being a physical therapist require a lot of energy. They have to deal with tantrums of the patient. The therapist cannot always follow what the patient wants to do even if the patient is already crying. She/he has to be firm but also careful in handling the patient, since the parents of the patient usually participate in the treatment. It is also very noticeable that the therapist knows each of their patient’s name and case, his/her personality, and also the personality of their parents. This relationship not only helps in gaining the trust of patients but also in assessment of their condition. A physical therapist acts as a teacher and playmate in the CTS Pedia. She/he has sufficient knowledge to provide the necessary treatment for the child, and this knowledge must be shared to the patient and to the parents so that there will be an understanding among them. Therapy, therefore, will be more efficient. At first glance, the patient and the physical therapist appear to be just playmates, but there are still rules that need to be followed. In the case of the physical therapy and the patient, it is professionalism. Between physical therapists, or physical therapist and speech pathologists or occupational therapist, there is nobody who comes to be more superior than the other, instead they help each other to treat the patient. A physical therapist, occupational therapist, and speech pathologist maintain to be patient-centered. I am very happy that I was given the chance to observe in the CTS-Pedia, because it made me want to be a good physical therapist so that I can help children with disabilities. I never really liked children, but there is something about kids that can really make you feel happy, especially when you are able to help them.

LORELIE ANNE PENA

Our clinical exposure started at around 2:00 in the afternoon at CAMP CTS Pedia. The registered Physical therapist then was Ms. Deanna Katrina Maranion, PTRP. After introducing herself to us she then asked us to go around and observe the facilities while she looked for an intern’s patient so that she can show us how she works. Being a physical therapist is not an easy job. Aside from the fact that you have to be really good academically so as to pass the board exam you also have to have the qualities of a good physical therapist. During our clinical exposure, we saw the qualities of physical therapists when interacting with her patients and colleagues in the health care field. Some of these qualities have already been mentioned above. I guess the most important quality a physical therapist should have is patience, especially if the PT is handling children. Well, I think this is the most important one because for obvious reasons that these children aside from being young are with disabilities thereby making them harder to control. A physical therapist should also be open-minded. He/she should be open to other possibilities like other ways in treating patients. This is one quality that will not only improve the physical therapist in her work performance but it will also help the patient. And in this field the welfare of the patient comes first. This is one of the responsibilities of the physical therapist. During treatment, the life of the patient depends on the physical therapist and this is one big responsibility. We are talking about the improvements of lives here. So I guess being a physical therapist is hard and you have to really want to be a physical therapist to be one.

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Towards service, compassion, and excellence.