The Skype Diagnosis
This weekend I had to stretch my already-struggling assessment skills to the virtual world during a Skype session with my uncle. He's been having shoulder pain for the past few weeks and sought out my opinion via e-mail. We chatted back and forth about his symptoms, onset and pain, and he eventually tricked me into the session by suggesting that we Skype so I could see my 1-year-old cousin. Turns out he had a hidden agenda.
First of all, my confidence with all things outpatient musculoskeletal is at an all-time low. I haven't been in that sort of setting for a year now, and even when I was there I felt my assessment skills were lacking most of all. This was and is particularly highlighted with shoulder pathology. Maybe it's because we covered the shoulder in such a short time period and I didn't have the chance to assess many patients after the didactic portion was complete. Either way, when faced with the "video" eval, I was caught off guard. Luckily I had my notes within reach and my uncle, understanding that I'm still a student, was as patient as ever. (Hey -- he got a free assessment so he can't complain).
What I really took away from the experience was how valuable it is to be physically present during a patient assessment. It was so much more difficult to figure out even the most basic ROM restrictions without being able to place my hands on my "patient." The Skype session was, however, a great lesson in communication and trying to explain special tests and exercises with only the use of words. It's definitely something I need to work on, but for now I'll appreciate my face-to-face patient time, at least while I'm still in the learning phase.