Wednesday, September 29, 2004

Informed Consent

There's this form that patients sign when they begin treatment for physical therapy (one of the many forms you sign when you go in for any medical treatment). Basically, it says that the clinician will try to help you, and with your permission, that he can move you this way and that, and perform the necessary tests to do his job, as long as you are aware and consent.
At orientation before our PT program started, each of us signed one of these Informed Consent papers. Not only can our teachers ask us if we will demonstrate something for the benefit of the class to observe, but our classmates also have our permission to move us around in order to facilitate learning.
In order for the clinician to comply with the regulations involving informed consent, he must explain to the patient what he is doing and give detailed enough instructions so that the patient cannot mistake treatment for abuse or assault. We do a whole lot of discussion about informed consent, learning how to give specific instructions to someone so that we don't end up hurting them.
For the students, it's a lot less formal. We've been putting our hands all over each other from day one, and we're all excited about learning this stuff. Letting someone palpate my greater trochanter on my upper thigh during a lab is no problem. The whole class is very aware of patient dignity, and when I let someone else "practice" on me, he has to pretend that I'm really a patient. Usually I know what he's trying to do, and if he does it wrong, I tell him.
But it's funny how this freedom with each other has extended beyond lab. I didn't understand a concept today during our group study session. So one of the guys came over to me, moved my arm into a compromising position, applied some force to it, and told me to try to resist it with a specific muscle group.
Sure, this was in the context of studying. But as I think about it, everything I do with these people during the next 3 years is going to be in the context of studying. Even if we're not techinically "studying!"
I picture a Friday night at the bar. One of the girls stands up to go get another beer:

Janel: "Hey! Sarah! Dude, what's up with your knee? Phil, did you see how she just stood up?"
Phil: "No, I didn't. Do that again, lemme see. [Sarah stands]...ooh. Looks like you've got some seriously limited extension there."
Sarah: "Yeah, recently I don't like to fully extend. It's not painful, but it doesn't feel stable, you know?"
Phil: "Wait, can I just--"
Sarah: "Yeah, go for it. [she sits back down and Phil kneels beside her] See if you can figure it out."
Janel: "Yeah, Phil. Can you try and extend it passively, maybe?"
Phil: "It's kind of a spongy end-feel. Here, Janel, you try it. See what you think."

Completely realistic, I assure you.
I love it.

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