Physical Therapists as Administrators and Educators

DESCRIPTION OF THE ROLES AND RESPONSIBILITIES OF PHYSICAL THERAPISTS IN DIFFERENT WORK SETTINGS

     One might perceive physical therapists as medical personnel in hospitals or clinics who treat physical disabilities of an individual. However, through this activity, this limited perspective of the role of physical therapists changed and moved into a wider scope of responsibilities.

University of the Philippines Manila- College of Allied Medical Professions

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Physical Therapist as Administrator
 

     One major role a physical therapist performs is being in administration. Being an administrator, one is expected to manage the different functional units within the department, extending to other fields of different sectors. Also, one is expected to develop good decisions in rendering actions involving students, faculty members, and patients. Decision making is the prominent and the hardest task an administrator performs. It is where proper considerations and careful analysis of the outcome of a certain action falls. One is expected to recognize the needs of their occupants through communication and consultation.

     As with physical therapy administration, the administrator's responsibilities revolve around maintenance of clinical equipment, appointment of academic personnel, assignment of student curriculum, and most importantly patient care.

Office of the CAMP College Secretary

     The scope of an administrator's responsibility extensively involves the academe. Because of this, one of the administrator's roles is to establish good relationship among faculty staffs and resolve conflicts regarding student's misconduct. They must be able to satisfy the needs of the students with regards to academic schemes and student relations. They must also serve as negotiator with investors and stakeholders, and mediator between faculty staffs and students. In order to be effective in administration, there are certain attributes that they must possess. They must be vigilant and considerate in making decisions, knowledgeable with their strength and limitations, and must be capable of establishing good relations among their personnel.

     Physical therapists in administration usually spend most of their time in offices and other similar work structure. Physical therapists in the field of administration can be seen in different hospitals, private clinics, sports clinics, schools and wellness centers as well, depending on their area of specialization.

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Physical Therapist as Educator

PT educator demonstrating his knowledge and skills to students

     Just like other educators, physical therapy instructors serve to impart knowledge to their students, enabling them to understand the concepts and ideas regarding the subjects. However, as physical therapy educators, their main aim is to be able to instill in their students to appreciate physical therapy as a profession.

     So as to expose the students to what the course is about, the PT curriculum offers subjects related to physical therapy early on. National Service Training Program (NSTP) I and II aim to increase the social awareness of the students, and their appreciation of the profession from a social perspective. During the second years, the course PT 100: Perspectives of Physical Therapy is offered to initiate the students with the underlying principles and concepts in the scope of PT practice. It will involve dealing with physical therapists and real patients with disabilities, so as to give a hint of what PT is all about. In the latter years, the educators would develop the clinical and social skills of PT students by teaching them with basic knowledge involving the use of therapeutic modalities and exercising the student’s professional judgment skills. In the fifth year, also called the internship period, would involve the application of the learning through exposure to the real work place of physical therapists.

Physical Therapy students

     The task of physical therapy educators is to familiarize PT students with the principles governing physical therapy. They are the ones responsible in improving the student’s critical thinking and professional judgment. Also, they enhance the student’s clinical skills by teaching them the proper way of dealing with patients. They are responsible for enhancing the strategies used in physical therapy education and practice, and are also responsible for maintaining the excellence of the education that their students are receiving. In effect, the quality of service that their students will be providing in the future is greatly affected by what they teach. PT educators are also available for consultation with students having problems with grades, financial assistance, or even family matters.

      PT educators hold their classes in rooms equipped with materials used in clinical procedures to demonstrate the proper usage of different equipments. They conduct their lessons involving the handling of patients in clinics in which students interact with patients. In ordinary classes, PT instructors make use of visual aids such as PowerPoint presentations for lecturing purposes. They handle their discussions so that it suits the age group of their students.

      Having presented the different work settings and the roles and responsibilities of physical therapists as educators and administrators, one can imply the extensiveness of physical therapy as a profession. However, in whatever roles a physical therapist could perform, it is the satisfaction that they get from the career that provides them with the determination to finish their goals effectively.

--Reflections--

 From left: Twinkle Arteche, Jelyne Alcantara, Prof. Mia Rotor, Dan Ronsley Dizon, John Rex Butial and Viviene Vicedo

      Being a physical therapist does not only revolve around treating and helping patients with disabilities. A physical therapist can also manifest different roles like being an educator and administrator.

      Well, being an administrator seems to be “bossy” for the title but yes, one has to in order to accomplish tasks required for a particular day. One may look at it differently, that being an administrator is easy, that he/she just sits on his/her desk, signs out papers provided that his/her assistant has done the studying and just recommends what the administrator would do. Well, this misconception seems to be naive, but somehow can be true. However, one forgets to look to the deep sense of responsibilities an administrator performs. This includes managing, decision-making, planning, and implementing agreed treaties. A good administrator must possess the leader attitude, in which one is considerate towards decision-making and is prepared for the outcomes of his/her action.

      As physical therapy educators, one would aim to improve their students’ knowledge by educating them about matters regarding physical therapy, like improving the student’s clinical and social skills. However, as an educator, Professor Mia Rotor says,” It’s not all about the knowledge that we want to impart to our students; it’s also about making them appreciate physical therapy as a profession”. Also, being an educator is a difficult yet satisfying task to fulfill. It’s difficult because they are the ones that would mold us into becoming who we are in the future, and satisfying as well because they can share experiences that may inspire students.

      In whatever roles a physical therapist would perform, there is only one thing that is for guarantee- that is, the idea of helping patients.

- Dan Ronsley P. Dizon

    The interview has given me a wider view of the scope of knowledge regarding administrative work of a college secretary. Based from what ma’am Rotor said, the administrative work accompanying her position is mainly concerned with student affairs. It is her task to ensure the proper distribution of the materials needed by the college community, and to determine the workload that is to be given to students, among others. However, she explains that that the final decision on these matters is from the college dean.

     The interview has also given me an insight regarding the kind of work environment present in CAMP, and it opened my eyes to the concerns that the college is facing at present, such as lack of stable in-between faculty, and low teacher-student ratio. She was also able to erase our notion that our college is lacking in necessary equipments, since according to her, the equipments we have are sufficient enough. It was a good thing that our college secretary does both administrative work and work as an educator, wherein she exposes her students to clinical settings. In this way, she was able to compare the differences and the similarities of clinical, educational and administrative work of a physical therapist based on her experience.

     She shared with us the upsides and downsides of her work, and I was touched by her reasons for staying. She also mentioned the skills needed in her line of work, which I found very helpful, since they can also apply to other PT’s and to students.

     After she enumerated the scope of her work, I was amazed. There were so many things to do, and she has to keep switching between an administrator and an educator. She admits that it is hard, and that she is still getting used to it, and apparently, she is handling the situation well.

- Mary Joy Twinkle P. Arteche

      Physical therapy in such a way is a very complex job. We treat functions, movement disorders and maintain capabilities. It may all seem physical, but we also exhibit these socially, emotionally, and psychologically.

      Having able to do these, a physical therapist must be equipped with certain qualities to survive the test of the profession. These qualities must always be intact in any setting or location given or chosen to/by them.

      For me, a physical therapist, (or any professional) given that they already have the knowledge, should love their job first. More than any reason, love for profession should be exemplified, to perform/carry out the tasks well. Second, PT’s should be collaborative, sociable and approachable. It is a profession wherein reaching out and communicating with others you may/may not know is crucial. Having these traits will surely be an advantage to the person. Third, is the willingness to sacrifice. Physical Therapy is a laboratory-intensive job. It will take a lot of time, energy & effort, and PT’s should love the fact that they should sacrifice to love the job.

      As a physical therapist in an administration or education, for an instance, besides the trait mentioned above, one trait that I have observed is that they should be consultative. Whether big or small decisions, having the ability to consult and discuss matters to your colleagues or to the patients or other people related to the transaction will break the wall that may result to misunderstanding and misconceptions. It will help construct a foundation to an institution, or even a relationship.

     Trustworthiness and being able to listen also is a must on PT’s because these traits will surely capture a person’s heart, and in that way, progression will follow.

- Vicedo, Viviene Neriz V.

     I say, being a physical therapist is indeed not as simple as being a masseur or whatever. Being a physical therapist does not limit you to being a physical therapist practicing the profession in a clinic or being an educator imparting your knowledge to others. In fact, with the observation we have conducted, I have learned that being a physical therapist is not dull after all. You can be an educator, and smile as you watch your students learn from you and develop within themselves a better individual. You can be an administrator, and be cheered and smirk for a while as you watch how all your efforts contribute to the betterment of the whole group of people you’re working for. You can be a researcher, and be filled with bliss as you discover and come up with great things that will be helpful for the whole community. You can be a clinician, and be everlastingly contented and happy knowing that what you do and give to your patients will be of great help to them throughout their lifetime.

      I guess this is what the observation has caused on me. It made me appreciate not only just the profession itself but also being a professional or just a worker in general, way even more than before. It made me realize that you can do and pursue your own stuff, your own aspirations and dreams; as long as you are able to give to the community, to your family, and even to yourself, what you can give as a professional or whatever occupation you are in, fulfillment would then be such a vague term to describe for you are so into what you are doing that you barely have the time and opportunity to think what is causing the fulfillment.

– John Rex C. Butial

     Physical therapy in health care is tough but Physical therapy in Administration is indeed tougher. Physical therapists in the field of administration perform not only health related jobs but more importantly, roles in the faculty such as faculty issues like employment of faculty members, promotion and management of matter concerning academic freedom.

     It is reasonable to say that physical therapists in the field of rehabilitation possess more skills than other physical therapists who work in clinical rehabilitation. It may be true that the two had equally succeeded in the physically taxing PT education; however the capacity of responsibility of a physical therapist in the area of administration is more extensive thus giving way to more abilities that are not within the capacity of physical therapists in a simple clinical setup.

     Physical therapy in administration employs more inter and intra personal skills since they have to actively communicate not only to patients and other professionals but to other people who are in the field of administration as well.

     Perhaps the best reflection of the contribution of PT in administration is clearly manifested in the positive approach of the students in their respective PT curriculum. Every carefully planned proposal is a step towards increasing the integrity and motivation of every individual dreaming becoming a physical therapist some day.

     So why do many physical therapists enter the field of administration? Some say it’s the money, some say it’s the experience and other even say it’s the reputation. But there is a far better reason for choosing administration – satisfaction.

-Jelyne A. Alcantara

Alternative Learning Resource School, Philippines, Inc.

26^th of August 2009...........

        Germi, BJ, My, Jana and Elia

 

     We are the members of the group who went to the Alternative Learning Resource School (ALRES) in Quezon City. Our task is to observe a PT at work in a special education class. Mr. Marius Bautista, PTRP, is the one to whom we are assigned to go. Like any other profession, being a physical therapist entails different responsibilities. It will allow you to play a role based on what setting you are in. Mr. Marius Bautista, a registered physical therapist, works in ALRES, Inc. He conducts physical education classes to children with different cases of disability. He handles two sessions during Wednesdays. 
 

ALRES is a special school for children with disabilities. Its facilities can be seen like in other preschools. The entire building is not really that big. Its hallway and rooms are colorful and attracting to the eyes of the children. The classroom has enough space to conduct different activities.Equipments were properly organized at the side of the classroom.

Equipments provided and used by ALRES varies regarding the activity that they will do in their physical education classes. There are activities in balancing in which they use foot mats and blocks with textures used as balance beams. They also have balls for throwing and catching, blocks used for stairclimbing exercise and rackets, bats and many other tools for teaching motor skills.

Children handled in ALRES ranges from 4- 9 years of age. Most of the conditions of the children in the school are Autism, Global Development Delay (GDD) and Down syndrome. Though, their conditions are only mild. From 2pm to 4pm, Sir Marius handles a total of 18 students.

Before the class started, Sir Marius prepared the equipments that will be used for the exercises. Then, the class set in motion. They did warm-up exercise through stretching and dancing. During the class proper, he provided activities that will improve the children’s balance and response to tactile sensation. The kids perform the activities one by one. Two to three teacher aides were taking care of the other students sitting on a mat while one was doing the task. He made sure that every student was doing the proper way to do every activity by assisting them and making them repeat the exercise until they got it right. The class lasted for one hour. After the activities, he asked the kids to help him putting the equipments back to their proper places. He gave every kid a prize for behaving well that day.

PE room and equipments

Being in this kind of setting, requires a lot of patience because dealing with children requires patience. As physical therapist

someday, we do not only interact with our patients but we also work with other professionals and other therapists. As professionals we need to excel or perform well in our work but we also need to work with our colleagues to produce better results.

        No man is an island, so we need the presence of other people especially when we need help. We have observed that a physical therapist in a special education class should be professional in his work and have established a good relationship with other healthcare professionals that would help him teach the students. The physical therapist that we interviewed mentioned that he aside from having other physical therapists in the clinic, he also works with other professionals such as SpEd teachers, teacher aides, occupational therapists, speech pathologists and child psychologists that help him in facilitating the class. To have a good working relationship with them, a physical therapist respects his colleagues especially their opinions, suggestions, how they work with the students, and how they perform their own tasks. A physical therapist should also observe and encourage ethics in his working environment. 
 

In school, the teachers are the second parents. They guide the students while they are away from home. This guidance may take form in instilling good values in the kids and by making sure that that the children are safe all the time.

Mission and Vision

Sir Marius is a perfect example. He has this authoritative attitude which makes the children listen to and obey him. The good thing is, he does this in a very kind and amiable manner—just like how a father should be to his son.  

During the games and activities, it is unavoidable that the kids be naughty. Also, I noticed that there are some children who find it hard to follow the instructions. There was this “hop only with one foot”, and the child can’t get it at first. However, Sir Marius is patient, he never gave up, and after a few tries, the kid finally got it. Patience is indeed something to be possessed by somebody who works in a SPED setting.

While watching them play, I know they are happy. The children are enjoying the activities and it can be seen from the bright smiles in their faces. Actually, one will not be able to think that these children have some incapabilities in them. And I think it also helps that there is a good teacher guiding these children.

All the while, I was thinking about how Sir Marius was able to do this all—to smile despite of a very tiring work. 
 

So after the class, I grabbed the chance to ask him, 
“Why did you choose to work here with the special children?”

He said with a smile, “Eh eto talaga yung gusto ko.”

“Kahit “po mahirap?”, I followed up.

And his answer to that was enough to seal it all.

He said that it is not about the physical efforts. Even though that the work is a bit hard, it pays off to see the children at their best.  

“Basta gusto mo ung ginagawa mo, ok lang kahit mahirap.”
 

I think what he is trying to say is that the reward is more of a feeling of satisfaction, knowing that you gave your all in doing what you do best—in doing what you love.

                                                             My, Sir Marius, Germi, BJ, Elia and Jana

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Germilyn D. Ramboyong

The Red chair. Phrase feared by Sir Marius' students in Alternative Learning Resource School (ALRES). Sir Marius Bautista, PTRP works as a P.E teacher in ALRES. During Wednesdays, he's conducting two classes from 2- 4 pm. They separated the 18 youngsters in two different classes depending on their ages. The first class are like 7- 9 years old and the other sre most likely 4- 6 years old. Sir Marius strats the class with a warm- up which is very important in P.E classes to ready the students for their activity of the day. When we went there, the activity prepared by Sir Marius is about balancing. The room is conducive for that class and since they're only a few, Sir Marius and his co- teachers and assistants can handle them very well.

Sir Marius didn't allow us to take pictures with the kids. This is fine with us. We know that they're only protecting the kids and their parents may not allow us as well.

Kids are so fun.

The first time I saw the children were in the lobby. At that moment, I'm thinking what conditions do these kids have because looking at them is not considered as a criterion for them to think that they have diseases/ disabilities/ illness. Upon entering their room, they greet their teachers and their classmates. Almost all of them speaks in English which made me proud about the children because though they have conditions, they can be better than others kids. As the class go on, you can now observe the behaviors of the children. Some are really hyperactive. Running. Shouting. Moreover, there is this kid who is a “door- addict.” You can see him running around the room trying to open the doors and cabinets during the class. Though, there are also other kids that do not speak and are “emo” (nasa gilid lang, nakaupo) in the class.

Teaching these kids needs a lot of patience and determination. Three to five teachers are needed to handle the kids. And I can see how patient and determined Sir Marius is to improve the physical fitness of the kids. I then realized that there are thousand of kids, including my cousin, who needs to undergo therapy classes. To sum it up, I WANT TO BE A PT!

Brianne Jane J. Castillo

We observed how physical therapy is practiced in a SPED setting. Even though the observation lasted for only 2 hours, we were able to have a good outlook on how we, as future physical therapist, will be possibly doing after graduating. I can say that it has become a very fruitful and inspiring experience.

Even before this observation was made, I am already drawn in the idea of working in a pediatric section when I become a professional physical therapist. When we observed them, it is the day allotted for their PE class. They do warm up exercise by singing and dancing, then do the activity for that day. As observers, we also participated somehow by singing and dancing with the kids. I think working in a pediatric setting is really fun. Helping children with disabilities have better physical and mental capacity is really nice so I realized that it is really the work that I would love to be in the future.

When observing the professionals, we also saw how hard it can also be to handle the patients or kids. I have realized how passion in the profession really matters. Patience is also one important quality a physical therapist must possess. Even though the number of kids in one class is only few, it can still be hard to disciple and make them follow orders. I observed that sometimes, the teachers can lose temper, but still they managed to keep their patience. It is also their responsibility to make sure that everyone participated in every activity they provide.

I say that being a physical therapist, whatever setting we may want to work, not only needs to be knowledgeable, but also has to know the right qualities that we need to possess to do good in our work.

Janelle Mia San Miguel

The PE class for the SPED children is like any other PE classes. Warm- up exercises were done before the activity proper. In the room are toys such as blocks of different colors, tiny balls and colorful hoops.

However, knowing that the clients are special children, the work of a physical therapist here is undeniably hard. Some kids are naughty and very hyperactive. Well, it is a good thing that there are other persons who help Sir Marius in handling the kids. I really admire them for being patient in dealing with the children. And what is more admirable is that Sir Marius always sees to it that the kids are happy and are learning from each activity.

Myzelle Anne Infantado
 

Indeed, a profession requires not only skills and education but also your passion, your love for what you’re doing. Having the opportunity to observe in ALRES makes me feel like I want to work there someday. I saw that Mr. Bautista is happy and satisfied working there, treating the children with fun activities. Kahit na nakakapagod kasi, mararamdaman mo na masaya ka sa ginagawa mo. Ang nakakapagod lang naman ay yung paulit-ulit na pagbubuhat niya sa mga bata kapag umaalis sa tayo nya at kapag hindi tama yung pineperform nyang activities pero masaya pa rin naman.

When you see the children, you will think that they’re just like other kids without impairment because that’s the way the physical therapist and the teacher aides treat them. At young age and with their condition, they show independence and obedience. The physical therapist and teacher aides teach them to be disciplined. There’s one kid who’s fond of opening every door and cabinet he saw and when he’s really getting out of control, the teachers made him get out of the room. Akala ko nung una, dapat you take care of them like a fragile thing yung tipong sasabihan mo lang na stop doing this and that tapos malumanay pa dapat, pero hindi pala, the kid was almost get kicked out of the classroom by the teacher. Pero ung bata, nagbehave naman din after he got out of the classroom.

I love kids although they’re not easy to handle but sometimes those who are older are harder to manage than kids. Perhaps, that’s what made me think that I want to work there when I become a physical therapist. Being in this kind of setting, really requires patience and love and energy, I guess. 
 

Ellia Dominique Baguio

ALRES is a clinic and school for children with special needs. They provide education for children who are not able to study in a regular school because of their special case. ALRES also have a clinic for their students or patients who have physical disability. It is nice to know that there are facilities and establishments that are available for sustaining the need for education and health or well-being of people especially the young ones and there are physical therapists and other professionals who work in these kinds of institutions. Persons with disabilities in our country need our help but we don’t seem to notice them because we lack awareness and understanding regarding their situation. The formation of these kinds of institution will not only help PWD’s need for education but it also raise awareness that there is a growing number of PWDs in our country and they continuously need not only help from healthcare professionals but also from ordinary people. I have observed that being a physical therapist in a special education class is also a tough work because you have to deal with behavioural fluctuations of special children. A physical therapist must take note that they are not just regular students but they are children with special needs who need a different kind of attention and interaction.

Observing how a physical therapist work helped me understand more about my future profession and being a PT is not an easy job. It also made me realize that there are a lot of people who need the help of a therapist to improve their mobility and way of living.

..to be a PT...

is a privilege.....

St. Luke's Medical Center

St. Luke's Medical Center provides facilities and services that respond to the demands of the 21^st century. Specifically, the Department of Rehabilitation Medicine may be considered one of the best in terms of facilities (i.e. a fully equipped therapeutic gym), equipment (i.e. low power laser machine, infrared lamp, therapeutic ultrasound, etc.) and services rendered. In terms of facilities, the venue was structured accordingly because it is appropriate to accommodate the specific needs of patients or clients. It is also structured this way in order to make the patients comfortable while doing their PT sessions. The clinic is divided into different sections according to what case they are under. Moreover, the mood of the place is very welcoming. It gives you a feeling of assurance that you’ll gain something fruitful at the end of your therapeutic session. In terms of equipment, they are equipped with advanced and up-to-date devices which can be used to carry out treatment plans of the physical therapists. Also, the clinic offers high quality services to its patients or clients with the help of efficient and adequate facilities, as well as equipment. These high-quality services will not be possible if not for the people who work hand-in-hand in maintaining excellence of services.

  Therapeutic gym at St. Luke's

In terms of their patients or clients handled, it was said by the physical therapists who facilitated our exposure, namely Mr. Charles Alfonso and Mr. Chernenko Galeng , that there is a wide range of cases that they handle every day. Majority of the cases they handle are patients who had stroke, persons with low back pain, shoulder pain, frozen shoulder, and other sports-related injuries. In these cases, it is expected that there would be observable improvements in three sessions. When we asked what the rarest case was, Mr. Alfonso told us that it was persons with spinal injuries. He also added that based on his experience, it was the hardest to handle and also the longest. This case would take around nine months and still, very limited movements would be observed within this span of time. As with the age bracket, we have observed and we have been told that most of their patients are middle-aged to the geriatric age group.

  Physical therapists in action

Speech Pathologists are not included in the Department of Rehabilitation Medicine because they have a separate section in the hospital. Physical therapists have no specific area of work or specialization because the patients are divided equally among them. One patient is attended to by only one physical therapist throughout his/her rehab sessions until it reaches completion in order to monitor the patient’s/client’s progress. Moreover, if the patient did not pose any sign of progress, the physical therapist could improve or adjust the treatment plan under the supervision of a physician in accordance with the RA 5680 (According to RA 5680, the Philippine Physical Therapy and Occupational Therapy Law, Physical Therapists may only practice physiotherapeutic procedures only as directed by a licensed physician). This is done to see if the new treatment plan works better than the former. By way of this, the patients have a higher probability of getting improvements and progress.

Person with knee pain performing a strengthening exercise (leg press)

A physical therapist possesses several roles and responsibilities. First and foremost, a physical therapist is expected to apply his/her knowledge to improve a patient’s/client’s condition. A PT is responsible for the possible outcomes of his/her therapeutic plan because his/ her patient is solely dependent on his/ her knowledge and capabilities.

Mr. Charles Alfonso showing us the theraband

Another role of a physical therapist is to be a motivator. Moreover, he/she is responsible for gaining the trust of the patient/client. Gaining the trust of patients/clients is a huge factor in determining the outcome of the therapeutic sessions.  He/she must motivate the patient/client to effectively execute the tasks at hand. Motivating a patient must also be done with care because the PT must still focus on realistic goals and relay these to the patient. Another role of a PT which goes hand in hand with this is being a good communicator. Before any session can be started, the PT is responsible for the first impression that he/she may give out and so, being a good communicator can remove any doubts on the part of the patient in the PT’s abilities. Furthermore, good communication is also needed during the therapeutic sessions.

                Also, a PT is not just a healthcare professional with duties attached to his/her patient/client, he/she is also a colleague. He/she has the responsibility to maintain a harmonious relationship with other PTS, and other healthcare professionals. This harmonious relationship is crucial for the effective therapeutic sessions for the patient/client.

From left to right: Ansha Garcia, Faith Hussin, Mr. Chernenko Galeng, Jessica Morales, Victoria Agustin, Jan Crisostomo, Mr. Charles Alfonso

Individual Reflections

"Considering everything I had seen during our clinical exposure in the Rehabilitation Medicine section of St. Luke’s Medical Center, I would say that they are one of the best in the Philippines. By simply looking at their facilities and observing how the staffs work in there would prove my claim.

During the clinical exposure, I made sure that I would be able to observe everything a physical therapist does in the clinic and to know how they interact with their clients and I know through this, I would be guided with the things I need to learn to succeed. And this acquisition of knowledge was made possible with the help of Sir Fil Charles Alfonso and Sir Chernenko Galeng as we observed them do their work. I noticed that every time a therapist wanted their client to do something, he or she said it in an authoritative manner yet the caring feeling from the therapist was there, as if saying “you have to this because this will help you” and in this way too, he or she could pass the impression that he or she was equipped with enough knowledge to help his or her client. I also observed that the therapists there are able to make variations in their treatment plan because of the completeness of their facilities; modern and old, both of which are still very effective. We also had a very fruitful interview with Sir Chernenko and Sir Charles as we ask them questions with regard to Physical Therapy as a course and as a profession.

As I observed everything in the rehab, it feels like there is something in me that tells me that I am in the right track."

- Jessica Christine Morales

"As what I have observed during our group’s exposure in St. Luke’s Medical Center particularly in the Rehabilitation Medicine section, their facilities are utterly impressive in the sense that they have numerous equipment useful for almost all sorts of modalities. Such significant facilities present in the rehabilitation section, that I find them to have good qualities, and proven to be effective and safe are their electro-therapy equipment and therapeutic gym. During the observation, Sir Chernenko Galeng and Sir  Charles Alfonso, the PTRP assigned to assist us, gave us the chance to see, on actual setting, how Physical therapists work.

We were allowed to interrogate them while they were giving therapeutic exercises to their patients. Some of the questions asked are about their rehabilitation facilities, which are apparently not a problem. We also subsequently ask information regarding their handled patients/clients, like what are the common diagnoses and age. As with professional attributes, we feel very comfortable interacting with them, this might probably due to Sir Charles being receptive and also Sir Chernen being bubbly while we’re conversing with them. They answer each and every question that we have intelligently and transparently. But they were cautious with the words they use especially when comparing their services and facilities to the other rehabilitation centers. They share some tips on how to handle patients and how establish a good relationship with them. As what Sir Chernen and Sir Charles said: “You should not let your patient feel as if you’re the one who have the authority in rehabilitative session, but rather treat your patient with respect and be sensitive enough with what they feel—be it physically or emotionally.” Thus, professionalism is not merely measured on intelligence; morals still act as the main driving force of your feat."

- Marie Ansha Garcia

"The Rehabilitation Medicine Section in St. Lukes Medical Center was one of the best I have ever visited when it comes to facilities and services. That was a very good experience for a future physical therapist like me.

From the moment we stepped in, we already felt the warm atmosphere inside the clinic. From there, we met Sir Charles Alfonso, the PT in charge of us. He introduced Sir Chernenko Galeng, the PT to be observed. We toured around the clinic with Sir Charles to take a look at their facilities. We were introduced with different modalities. Some were new but some were a little old yet still effective for treatment. I can say that they have efficient and adequate facilities but these are nothing if not for the physical therapist that use them. Sir Charles told us that it is still the physical therapists that make a good clinic. Moreover, based on what I have observed, the physical therapists were very strict in applying modalities to patients. Instructions on how to use a modality and why it will be used were clearly stated so as to avoid misunderstandings. Through this, they made their patients trust them because they showed that they were equipped with enough knowledge to perform the treatment plan. Furthermore, they showed professionalism while working but still maintaining a harmonious physical therapist-patient communication. One act of professionalism that I observed was using appropriate words in communicating. We learned from Sir Chernenko that a PT should be a good communicator, for if not, the patient won’t believe you. A PT, too, should know how to deal with difficult patients. He also said that a PT should have continuous education to know the latest modalities and to be knowledgeable with what’s in."

- Victoria Agustin

“With the exposure we had at St. Luke’s Medical Center, I was given the chance to observe how physical therapists go about their work. The experience I had made me think that physical therapists may somehow be affected by their work environment. Just like what Mr. Alfonso and Mr. Galeng said, St. Luke’s is at par with hospitals offering the best rehabilitation services with their state-of-the-art facilities and equipment. It seems to me that they have no scarcity in terms of their resources. Due to these, I do think that they have little trouble fulfilling their responsibilities. It gives them the opportunity to focus more on giving the best quality services because they need not worry about what they do and don’t have to fulfil their tasks. In comparison to community-based rehabilitation, as was said by Mr. Galeng, physical therapists resort to alternatives to be able to execute their tasks due to lack of equipment and facilities. This would in turn, affect their performance. Though this might be true, Mr. Charles and Mr. Galeng emphasized that a good therapeutic session is still based on the PT's abilities and is outcome-based.

As with the qualities of physical therapists, I really do admire the level of attention they give to each patient. It made me think that if I were a patient there, I would really feel at ease that they would give me quality services. In addition to this, though we went there at a time when people are expected to be exhausted from a day’s work, I was surprised to see the physical therapists still at their best states. The feel of the whole place was very warm. They made everyone there feel that they would be attended to, and at the moment they are attended to, they wouldn’t be disappointed with the time they spent waiting.”

- Jan Christine Crisostomo

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.