Summer learning: Class helps aspiring physical therapists learn to connect with patients for better outcomes

In a classroom of physical therapy doctoral students who have deeply studied the body and techniques for helping people recover, the focus for one special class is on the mind and how everything from a person's coping mechanisms to family interactions play a role in rehabilitation.

The psychology class, "Health Profession Disability Psychology," is a spring/summer course that for nearly 20 years has provided interdisciplinary insight for aspiring physical therapists. The class is taught by Mary Bower Russa, a professor of psychology who specializes in health psychology.

Russa's goal is to impart to students the importance of psychological knowledge in a clinical physical therapy practice, helping to boost patients' motivation and adherence as well as setting the stage for more positive outcomes.

It's natural for students in such an intensive program to focus on the mechanics they are learning, Russa said. She wants students to understand the benefits of approaching patients with a holistic view.

"The idea is that we want to make sure when you go in to treat a patient that you see them not as an arm or a leg or a spinal cord or an amputation or a heart attack, but that you see them as a whole person," Russa said. "We want to emphasize to students that they're treating this disability or illness in the context of a person who has their own coping strategies, their own life challenges, their own family dynamics, and their own set of circumstances.

"Being able to form a strong relationship with the patient you are working with allows you to create a connection that gets you better treatment outcomes. People are more likely to listen to you and take your advice if you build that relationship."

In a recent class, Russa and the students also discussed the story of a police officer who was so badly burned in a car crash that his son didn't recognize him, he was no longer able to hold a gun, upending his career in law enforcement, and he wasn't able to throw a ball with his son. That kind of impact on a person's self-concept can be profound, Russa said.

A beautiful day, feeling fortunate, and in an instant, a life-changing moment

Charles Pazdernik has also experienced that sudden shift in self-concept. The professor of Classics has for several years spoken to this class and answered students' questions about the aftermath of the serious bicycling crash he experienced in 2014.

He told the class this summer that he had become a passionate urban cyclist who was in peak physical fitness, adding, candidly, that he was "feeling very self satisfied." One day in July he was bicycling along Fulton Street NE to the Pew Grand Rapids Campus when a driver pulled into his path near Prospect Avenue and everything changed.

Pazdernik's spinal cord was severely injured in the resulting collision, leading to initial paralysis. He was able to regain some mobility and still uses mobility aids. With a mix of candor, humor and perspective, Pazdernik recounted his journey, sometimes turning to his daughter, Thea, for more insight on how the family was affected.

He also expressed his gratitude to physical therapists, who were so crucial in his rehabilitation.

"There is a need for people in your position to meet people when they are in the worst circumstances in their lives," Pazdernik said. "I've been impressed by the incredible complexity, judgment and acumen that comes into this role."

That need to understand patients' vulnerability and other psychosocial considerations is a central reason why this course has been part of the physical therapy curriculum, said Barbara Hoogenboom, professor of physical therapy and the curriculum chair for the department. 

"What happens is they are very focused on being a PT and what they've seen of being a PT is the doing – the manipulation of the arm or the leg, the stretching, the exercises – and they haven't always taken into account all of the psychological preparation and the ability to interact well with the patient, to become someone who guides and directs," Hoogenboom said. 

This preparation also helps set the stage for what is expected of students in clinical training, Hoogenboom noted. She added that practicing physical therapists must also be attentive to needs that could benefit from a referral to a different specialist, such as in mental health.

The psychological aspect of physical therapy training is of particular interest to student Erick Hernandez-Morales, who had considered pursuing psychology as an undergraduate. He said he has seen the benefits of motivational interviewing, reflective listening and other communication skills when he has worked in a clinical setting.

"Not only is your relationship better, but patients are more willing to be open to your advice and to the recommendations you make and actually adhere to their programs," Hernandez-Morales said. "This program really helps give you the whole picture of when you treat people you treat them as a person not just their diagnosis."

Student Katelyn Bonhaus said one of the reasons she is pursuing a career in physical therapy is because of her own experiences with treatment when an injury forced her to miss a soccer season. She sees the benefit of drawing both on the skills learned in this class and on that tough period in her life, which affected her identity, when interacting with patients.

"After an injury a lot of times patients are fearful and one thing that is important that I've experienced in working with patients is we've all gone through hard things in life," Bonhaus said. "It's important to be able to meet people where they're at so they understand that we might be meeting at the worst part of your life but we're going to try to get you back to being functional and to doing what you want to do."