|C.U.R.E. Giving Professional Phase PT Students High-Level Experience
Lebanon Valley College students enjoy the prominence of the physical therapy program – a six-year track that culminates in a doctor of physical therapy (D.P.T.) degree. One way by which students in the professional phase of the program can gain real-world experience is participation in Compassionate Undenied Rehabilitation Clinic (C.U.R.E.).
C.U.R.E. is a student-run clinic in the basement of Lynch Memorial Hall that opens two nights per week. Patients are referred to C.U.R.E. from either the Lebanon Free Clinic or the Volunteers in Medicine (VIM) Free Health Clinic. The only requirements for treatment are that the patient is uninsured and comes with a referral.
Initially, the C.U.R.E. clinic only accepted referrals from the Lebanon Free Clinic. Thanks to its successes and resources, C.U.R.E. was able to expand and take referrals from the VIM.
“What we’re seeing a lot in the uninsured population are some very complex medical diagnoses,” said Charlie Johnson, C.U.R.E.’s student director. “That’s if they’ve even been diagnosed yet. Many of the cases that come into the free clinic suffer from more than just tendonitis or what may be written on their script. A lot of these people don’t go through the regular preventative care or get regular screenings, and therefore, they come to us with a lot of comorbidities.”
Common problems seen are musculoskeletal or neuromuscular diagnoses. Many have chronic lower back pain and other orthopedic issues. The biggest challenge to C.U.R.E.’s student clinicians is that many of these problems have festered for years and gone untreated due to a lack of insurance.
“One of things I like to do is to take on the educator role,” Johnson said. “You educate and engage patients to stimulate the right questions on their behalf. Getting them involved brings about a positive experience for them.”
All students involved serve on a volunteer basis, and each is in their fourth, fifth, or sixth year. They work in teams of three with a supervising, licensed physical therapist overseeing all evaluations and treatments. It is a setup that has been successful at other college pro bono clinics.
Fourth-year students are responsible for documentation, including checking vitals and taking patient history. Fifth-year students complete examinations, run special tests and measures, and conduct interventions and patient education sessions. Sixth-year students hold a clinical instructor role and serve as team leaders.
The oversight of a licensed PT gives students a chance to ask questions while making their own assessments, so the entire experience gives students more than just “hands-on” experience. It also renews interest in the profession for a group that takes part in a very rigorous academic course load.
“We don’t do this for the résumé-building aspect,” said Marisa Maxwell, the clinic liaison responsible for accepting referrals. “It’s more that this is something powerful that we can do as students to help the community. It gives us a chance to use what we learn in the classroom and develop those skills. It’s also a way to remind us why we’re spending so much time sitting through rigorous classes.”
C.U.R.E. is advised by Drs. Stan Dacko and Kathryn Oriel. Dacko and Oriel meet with students, supervising PTs, and directors from the two referring free clinics to monitor the types of patients coming in and to give the program long-term direction. Both advisors are quick to emphasize that this is a student-run clinic and that the students have a great level of autonomy.
“Our biggest job is to help guide our students through,” Dacko said. “Because they move on through the program and eventually graduate, it’s difficult for those involved to have a long-term vision for the program. We try to bring all the different ideas together and ask, ‘Where should this clinic go?’”
This January, Dacko will lead a group to the Society of Student-Run Free Clinics in San Antonio. Students will present on student outcomes based on their experience in the clinic.
“This is also about building the brand of the LVC PT department and getting our name out into the community,” said Kyle Baiocchi, C.U.R.E.’s director of purchasing. “Dr. Dacko has indicated his desire to keep the clinic growing and potentially flourish that into something bigger in a separate building and in a more expansive role.”
Developed in 2010 by the class of ’11, the C.U.R.E. clinic opened in 2011 with the financial backing of college benefactor Dr. Jeanne Donlevy Arnold H’08. Arnold’s pledged donation is set for $12,000 per year for three years – totals that Baiocchi says will sustain the clinic for years to come. All of the foundational equipment is in place and the necessary renovations to C.U.R.E.’s space in Lynch have been made.
One form of short-term expansion being discussed is group exercise classes that will be able to help multiple patients at a time. Teaching different techniques – including diet, posture, and stretching – can help patients become more proactive in their daily lives.
“You hear about common ailments all the time, all over the place: diabetes, hypertension,” Johnson said. “A lot of people don’t even know what these things are, especially in an uninsured population. They haven’t been keeping up with health checks or speaking with a physician. We can in some of that education.”