CVAHEC Student Project Reports

Cindy Dion
Freeman Scholar Program

The intent behind my summer AHEC project was to allow me to use my previous experiences in the treatment of patients with lymphedema as a physical therapist in combination with my newly acquired basic science knowledge as a first year medical student. My advisors, Dr. Rubin and Dr. O’Brien, have helped me to tailor my objectives into a realistic project design with goals to use the information in the future in educational ways.

My intent was to develop case based learning modules to allow clinicians who treat patients with lymphedema to be able to explore learning points illustrated in these challenging cases. I was able to obtain permission to use information from three patients who were actively being seen in Lymphedema clinic with the help from Dr. O’Brien. I reviewed their outpatient physician/clinic charts, inpatient hospital charts (when applicable), physical therapy charts, radiographic studies, and photographs.

On Power Point, I assimilated each of the cases, highlighting the various medical issues which needed to be considered in designing an individualized physical therapy regime to address their lymphedema. Additionally, I was able to comment on their treatment programs, why one intervention was used versus another, and the various outcomes from these clinical decisions.

Each of the individual cases required further exploration of their respective diagnoses to assure a comprehensive understanding of their history. One of the cases also highlighted the need for multiple team members to give their clinical opinions guiding physical therapy treatment given the patient’s tenuous medical status.

Although, the intent of my project was to be able to provide an educational tool for others, I found it to evolve into an effective teaching tool for me. The complexity of the patients certainly allowed me to review and revisit the basic science information I had gained last year, with emphasis on physiology and anatomy.

Additionally, some of the patients’ specific diagnoses and procedures that I was familiar with as a physical therapist became much more clear in terms of therapeutic purpose, effects and potential risks associated, given my interactions with attending physicians managing the care of these patients.

I am thankful that the information I was able to gather will be able to be used in a meaningful way. Each of the cases will be presented as a case based review of managing a patient with complex lymphedema at a day course offered in Burlington in October for clinicians who work with lymphedema patients. The physical therapists treating the patients will be presenting the cases with the assistance of Dr. O’Brien as an attending physician contributing to their medical management.

My eventual goal, however, is to pursue the idea of making a web based self learning module available for clinicians interested in learning more about lymphedema treatment. My plan is to be in contact with IS specialists at UVM, to help me begin designing the web based program using the three cases that have been developed.