by Michele Berhorst • March 11, 2019
Amy Nguyen, MSOT/S ’19 (right), completes an evaluation of basic ADLs in the OT Student Stroke Clinic.
In the spring of 2015, the Program in Occupational Therapy opened its first student experiential learning clinic (SELC) for un- and under-insured patients with stroke in the St. Louis community. Following the success of the OT Student Stroke Clinic, three more SELCs have been developed to provide services to individuals experiencing homelessness, in need of hand therapy services or living with a spinal cord injury. Licensed occupational therapists from our faculty and/or Community Practice program provide the mentorship and direct supervision for all evaluations and interventions delivered in an SELC.
Quinn Tyminski, OTD, OTR/L, instructor in occupational therapy and psychiatry, oversees the Community Independence OT Clinic. In November 2018, the clinic began seeing individuals experiencing severe and persistent mental illness and co-occurring homelessness through a partnership with St. Patrick Center in downtown St. Louis. Tyminski started providing OT services at the center as part of her doctoral project. Based on the program’s success, she decided to start up an SELC so students could have the opportunity to work with this often-marginalized population.
“I knew there was need for OT services to bridge the gap between homelessness and housing, but I quickly realized that those services were needed at every step of the process. Most of the clients that we work with have deep trauma histories and are dealing with at least one mental or physical diagnosis,” Tyminski says. “Working within this population is more than being someone’s occupational therapist. It’s about truly listening to their story, providing emotional support and often being the only person who consistently shows up for them.”
Ronnie Drummond, OTD/S ’20, joined Tyminski’s SELC because he also sees the difference OT can make in the lives of his clients. “One of my first experiences in the clinic was with a gentleman who had been receiving our OT services for a few weeks. He had just gotten an apartment and was so excited, he broke down,” Drummond shares. “It was that kind of heartfelt moment that got me interested in this population. Just seeing what OT can do for these individuals who oftentimes have no one else to turn to is truly inspiring.”
Lea Fang, OTD/S ’20, has had similar experiences in the Hand Therapy Student Learning Clinic, where students work with individuals with hand or upper extremity musculoskeletal conditions. Clients are referred to the clinic from the orthopedic and plastic surgery resident clinic at BJC’s Center for Outpatient Health and from therapists at Milliken Hand Rehabilitation Center. Vicki Kaskutas, OTD, OTR/L, FAOTA, associate professor of occupational therapy and medicine, oversees the clinic, which opened in January 2018.
“I had a client with an upper extremity injury who couldn’t tie his shoes. During our first session, he was so frustrated that he wanted to chuck his shoes out the window,” Fang shares. “At our next session, I went through one-handed shoe tying techniques with him. After practicing it a few times together, he became a master at it. You could see it on his face how happy he was to be able to tie his shoes.”
Before working in an SELC, students like Drummond and Fang participate in advanced training to prepare them to work directly with clients. Students identify the client’s individual needs through a standardized assessment battery, develop intervention plans and provide OT services to achieve the client’s goals. A secure database of evaluation and intervention data helps track each SELC’s outcomes and answer scholarly questions, and students’ competencies are measured throughout the experience to track their growth as therapists.
And the popularity of SELCs is growing. On the national level, the Society of Student-Run Free Clinics (SSRFC) provides an interprofessional platform for student-run clinics (SRCs) through an annual conference, website and newsletter. Their Journal of Student-Run Clinics is a student-run, peer-reviewed publication with a specific focus on SRCs to spread inspiration for and increase communication regarding SRCs and best practices in patient care, student education and practice management. Kaskutas encourages students to attend these types of regional, state and national professional conferences and submit research proposals and papers.
“One of our students is presenting our hand therapy clinic outcomes at the SSRFC conference this year, and students from our other clinics will attend this conference. Last fall, students presented outcomes of our stroke and hand clinics at the Missouri Occupational Therapy Association conference, and several students will be presenting a short course at the American Society of Hand Therapy conference. These events allow students to interface with other professionals, learn about cutting-edge research and further their clinical skills. It is important for students to recognize the value of becoming active members of their professional organizations and societies,” Kaskutas says.
In January 2019, the Collaborative Community Clinic began providing services to individuals with spinal cord injury or disease at Paraquad’s Center for Independent Living. Led by Carla Walker, OTD, OTR/L, ATP, advance practice clinician, the clinic holds group sessions that focus on improving health and participation, with individual sessions available to address outstanding rehabilitation and self-management needs. Students gain valuable experience in program development and facilitation of groups in the clinic. Walker, who has worked with this population for years, is excited to offer this experience to students.
“This SELC is an opportunity for students to apply what they've learned academically about spinal cord injury, secondary conditions and community participation to working directly with clients whose lives are impacted every day,” Walker says. “Students learn how to collaboratively set meaningful goals with clients and promote establishment of weekly action plans, allowing clients to move closer to achieving their individualized goals. Above all, they make that same one-on-one connection with real clients as they would in practice. ”
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