How to Mentor New Physical Therapists

0:00 Don't screw it up. You're listening to the PT Pinecast, where smart people in healthcare come to make noise. Here's your host, Jimmy McKay. She spent over four decades helping kids move better, think sharper, and live fuller lives. With a heart for mentorship and a clinic full of purpose, now she's pouring her energy into helping the next generation of PTs recognize the huge functional impact we can have on conditions like dyspraxia, EDS, and executive functioning challenges. She also once ran a backyard empire of seventy-eight guinea birds. I'm not a hundred percent sure if I know what that is. I'll have to Google it. But these days, it's all about growing clinicians.

0:41 And not just birds. Sherry Woodson joins us on the show right now. Sherry, welcome to the program. Thank you. Are there any guinea birds within arm's length that we could see? I mean, I'll Google it later, but what is a guinea bird? Can you describe? That is, it looks like a chicken. Got it. Out of Africa, but they eat a huge number of ticks. And we have... a huge number of ticks. So you were, these were operational. These, this was a purpose. They were not just, not just look cute, but all right. So I mentioned in your intro and before we hit record, you said your, your real passion. is treating, but really it's mentoring and creating more leaders.

1:27 What sort of prompted that? Where's that come from, from you? And what does that give you? And what do you think it gives the future of our profession? I think what prompted that is through the years, often work next to individuals that kind of poured into me and I could pour back into them and realize how that made me more well-rounded clinician. It allowed me to look outside the box. I got questioned, which makes you not step, I guess it makes you step back, but it makes you delve into information more. And then also saw how the population that we could serve was either changing or maybe I just didn't didn't see it initially.

2:16 And so wanted to share that so that the next generation could also kind of learn from both my mistakes and those successes out there. Sure. And kind of speed that critical thinking part up. I know I'd read a research article that talked about it took five years for the average PT to become a really critical thinker in their practice. And I was like, how can we speed that up? And we've really operationalized it, not so much me, but my executive team. What are all the steps that need to be taken to do that?

2:59 Um, so what are they or big picture? What are a couple of the big levers that you see from the mentor side, knowing that there's going to be some people out there going, yeah, I want to do this, but also the people on the side going, how can I improve? So what are those things that people listening now, both mentors and mentees or potential mentors and potential mentees can focus on? Where's, where's the, where's the biggest lever? I think one is, you know, there's so much that has to be taught in PT school and then translating that to practice. So they may have gotten a clinical experience in pediatrics.

3:40 It may have included a vast population. It may have included a variety of diagnostic groups, but the chances are also that the clinician they were with only, I think the requirement is one year of experience. before you can become a clinical instructor, or they may have really specialized in an area. So then going through and looking at what are those core proficiencies that they need and operationalizing that, listing those, looking at all the other elements that go into I think serving children a little different than serving adults of working with caregivers and listening to what the problems are at home.

4:34 And then, you know, being able to provide clinical education or caregiver education, caregiver coaching, I think is a better word. Coaching and collaboration is what we do is we have to know what we're doing and why we're doing it and what our hands are doing. And, you know, what are the things that, that make being a parent more successful or make them feel more successful, which is different than being a therapist. You know, like what, what part of that, I don't want to make them many therapists or many parents, the parents, many therapists. And so, you know, you ask a therapist and they're just trying to, a new therapist is trying to kind of share what they just did.

5:17 So you're setting you up. This was my next question on the list. How do you help families understand the need for therapy when a child might not have a formal diagnosis? How do you approach that? What's the conversation like? How do you even start a conversation with someone who's like, well, we don't have a diagnosis. So where does this start? This is a communication issue. It's a communication issue. What I love to do is help Like if I get a four year old, I can almost kind of share with the parent what they look like at one, two, and three. That was different than what most other parents' kids look like.

6:00 So you can kind of go, so then they're going, oh yeah. And so you can share what probably the future might look like and where the little building blocks or how their child may process information differently or, And so we kind of go through that. I think that's one that's a real buy-in for parents. I also sometimes do the same if I'm treating torticollis, which is a, you know, I call it the gateway diagnosis. It's a gateway into, yes, it might be sternocleidomastoid tightness, but that's very, I would say that's not that many of them. That's where all the literature is going to be on because that's a homogeneous diagnosis.

6:44 group that they can pick, but it could also be, um, hemiparesis. It can also be, um, that they just got some tightness from, um, sitting in those like container, you know, the container babies that we have now. Um, and so we kind of go through that and I usually go over and show a parent on them like, okay, if I, if I put you in this position, what, what does it change for you? Um, And so it's been fun recently, probably in the last couple of years, to also look at how something so simple as a little tightness of the capital extensors impacts a mom who's trying to nurse a baby at usually about four months and how they sometimes have to give up at that point because of all the changes that go on, like moms don't hold baby's heads as much.

7:40 And they, so they, we expect as the breast empties, you know, the baby to make all these tiny little adjustments, but if they have tightness, they can't do that. So they start pulling off and pulling off and you're going, Oh, well that, that was a, that was maybe to visit, you know, change this week. And then they have it. So the other one would be looking at dyspraxia and what that, and that's, that's probably a word that PT's, may use or may not use but we look at a group of kids and it's not they're not moving and why aren't they moving they don't have cerebral palsy they're not moving and we start looking at it going okay we can see this at four more what is that and that's that kid that i call it like the deer in the headlights sometimes they you see them wanting to do something but they can't do it and i've I've gone, you know, so we break that down and start looking at that with new clinicians.

8:40 I often say, what if we could go to a playground, a recess and go, okay, all these children that are circling the playground, I think they would like to participate. I can't imagine that they don't want to, but what's keeping them from being able to do that? You know, is it a coordination issue? Yeah, because they feel clumsy compared to the other kids. Or is it they cannot, they don't have the praxis to do it. You mentioned PT schools a second ago. What do you think PT schools miss? They have to teach so much so we can go an inch deep, a mile wide, but an inch deep.

9:22 Specifically about peds, right? A lot of programs might not have a very robust class just simply because of not having maybe a pediatric PT on staff. So what are the things that you think PT schools could do better? That's, you know, this is a person who graduated with a bachelor's, remember, as a PT. Okay. Forty-eight years ago. I went and did go back and get a master's at the University of Kentucky just because I wanted to know more when I was there and kind of combined it with a, took some med school neuro class, you know, they let me in those classes and put some other things together and there's, a personal prep grant that was out there looking at how do we serve children?

10:11 And so I went through that. And so I sometimes am like, I get it that there's so much content that they need to share. I wish there were more internships for people when they got out of school. I wonder if I don't know, man, you go to school forever as a doctor. I have a daughter who's also a PT, pediatric PT, very strong in ortho. And I'm like, what would I change for them? Yeah, sure. I wish there was a great answer to that because then do you take away from the ortho?

10:52 Do you take away from that? I think it's the clinicians in the field. we we have to think more robustly about those individuals who come to us as and want um take a clinical you know an eight-week clinical ten-week clinical or twelve-week clinical which uh whatever the schools get um have and that because we have like we've put that together at ours and i know a couple other um clinics that have done that as well where there's We try to mix them up with other therapists so that they have the opportunity to see a group of, a larger group of types of patients.

11:35 And I don't even, I haven't looked at what the APTA is requiring within the curriculum now. I mean, I know it's a really robust group of objectives. that I even did for the PTA program. So I'm like, I can't even imagine what they're doing there. But I think it's trying to, I know they go across, they do those lifespan things. I mean, I think I would have fun going in and talking to an ortho group about all the orthopedic changes that go on during the first two years of life and the development isn't occurring consistently.

12:19 quite right, you know, why you would have a different, why you might have tibial torsion issues or why, which tells me, you know, likelihood, if it's not hereditary, of what muscular pulls weren't on the tibia. Same thing with the hip, you know, our hips starts out with very small amount of angle. What are the developmental things that occurred during that time with adductors pulling it down so that the angle, Is it increased or decreased, you know? And the, the femoral anteversion kind of changes that go on. I think that's the part that I would love to see kind of woven in.

13:04 And it's exciting because if you're an adult PT, you go, Oh, I bet this has been a, this has been a long time issue, you know, and they have a different, biomechanics, could I put it that way? So those are the kinds of things that I think could be interwoven more successfully for both ends, for the PEDS therapist, as well as the ortho at the other end. So Sherry, you've seen decades of change, but what's one myth about pediatric therapy that's still around that we've outgrown that if you could just bring on the eraser, you'd remove?

13:45 What's the thing that comes up the most that you wind up correcting pretty often? I think it's probably looking at a skill and not breaking down all the, it's just looking at Like you said, when we were talking earlier about making it fun and that it's play, but being really purposeful in that and thinking, I always think, so I don't always see it as purposeful. Like what am I doing that's gonna make a difference in this kid for tomorrow or in the family and their engagement?

14:31 That's a myth of thinking, okay, I can just take this child and I can, I can play with them and they're going to have a great day. And yes, we're going to work on a skill versus going through and going, all right, like what, why is this child not progressing? Or if they don't make the following changes that we're going to see, um, a group of problems, a different kind of group of problems. Um, I think it's getting down to the real etiology of issues. Like, why isn't that kid moving? Is he dyspraxic? Is he weak? Is he tight? And addressing that. And they should be treated very differently.

15:14 And I think, I don't know if that answered your question. I think we know a lot more now than we used to. And I think... Listeners love strategies and takeaways, specific things, right? What are two things they can do tomorrow maybe to better support kids with motor planning or executive functioning challenges? The kids you had the pleasure of working with, with your organization, two things real quick. And I probably do dyspraxia and I'd look at access and think about it's yes, they cannot ride a bike or yes, they cannot. um, go and look at a piece of playground equipment and just go get on it.

15:57 I wouldn't go put them on it. I'd really start thinking about like, what are the, what are the, um, what are the, what's the plan? What's this, what, where do they need to be helped as far as sequencing? Um, it's a processing issue versus a, a body structure issue. Right. And I think that's, um, looking at things that if I should have given you an example of a play, looking at a play structure and going, I can't just model how to do that. There's twenty kids going up and down and this child can't do it.

16:37 And so it's going, OK, how do we go through that and teach them each part of that? But then also giving them a chance to process that. and not let them get stuck in it. And so I always think dyspraxia children, I do not, I never, I always go and put my hands on them. And as soon as they look at something and they even indicate there's an interest, I help them see how they, their body can engage with that. Because they don't have imitation skills and we don't, and that's something we can't even imagine. So that body awareness part, And then breaking sequences down for them so that they're successful.

17:25 Does that make sense with that? Totally. Because you do have to put your hands on those kids and you have to do it quick. Because sometimes we see them twirling their hands and twirling their feet. And we think, oh, that's autism. And it's like, I would say majority of children with autism have dyspraxia. but not all children with dyspraxia are autistic. And so realizing that sometimes those are communicative behaviors that I just can't, I can't figure out what you're doing and what I have in my repertoire is these repetitive movements. Sherry, we have a tradition on the show called the parting shot.

18:07 Are you ready for the parting shot? Go for it. This is the parting shot. One last mic drop moment. No pressure. Just your legacy on the line. The bar's low. It's not high. Just your legacy. But what's one thing you'd want to leave with the audience as we wrap up? What's the thing you'd want them to take away, right? We remember the last thing we heard typically. What I would, I want them to take away. I would say to really utilize all the, everything in your repertoire of treatment strategies. And if you don't have a large one, get, keep working on that. And look at, you know, how people are using e-STEM and how they're using, oh, I don't like to, some reflexes and go, oh, is there something different than inhibiting that?

19:02 Were they there? They were there for a purpose. Let's figure out what that purpose was. And people have done that and use that to help children. And I'd say never get stuck in a box. I think that's something that has made probably why I'm still a practitioner after forty five years is that there wasn't a box. that I got stuck in, that there's always something new to learn. And whether that's from another clinician or from a child or from a new therapist, I always say, who's the kid that taught you the most this year? You know, with other clinicians.

19:46 So that's that's one of my most enjoyable things is who taught me the most. And they would look at it. Sherry, appreciate what you're doing. for the people that you get to do it with. And by people, I mean kids, parents, other PTs, the local community. So thanks for doing what you're doing in your little corner of Arkansas. Thank you. That's it for this one, but we're just getting warmed up. Smash follow, send it to a friend, or crank up the next episode. Want to go deeper? Hit us at pgpinecast.com or find us on YouTube and socials at pgpinecast. And legally, none of this was advice.

20:27 It's for entertainment purposes only. Bullshit! See, Keith? We read the script. Happy now?