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On-Site Clinician: Alec's Story

Hey readers! It's Kam here and I've brought along a new story for you all. We're switching it up a little here and bringing you all the experiences of one of our on-site clinicians, Alec Chisholm.

Alec and his family

The Tele-Rehab team and I are extremely thankful to Alec for allowing us to interview him and learn about his experiences as a clinician with the Tele-Rehab team and off-site as well.

Before we get into the details about Alec's experience with the team, let's learn a little bit about him. Alec grew up on a ranch in Alberta about an hour and a half away from Pincher Creek. He then went on to study at the University of Alberta, where he graduated from the physiotherapy program in 2012. After graduation, Alec worked at the Lethbridge hospital and private clinics. However, the position in Lethbridge was temporary so he decided to make the move to Pincher Creek. When Alec moved to Pincher Creek, he began working at the hospital and also ran his own private clinic. Alec is one of only two physiotherapists in Pincher Creek, and the only one with a private clinic. Just imagine how busy Alec's life must be with being one of the two physios in town!

You all may remember from last week’s blog, Sheelah (our vestibular expert) has a love for the mountains and made a move to be closer to them. Well, we’ve got another mountain lover who made a similar choice! Alec and his family are always outdoors. They love to hike, fish or anything to do with the mountains. Alec also volunteers for the High Angle Rescue Team in the mountains where they help those who are stuck in the mountains. Basically, anything that involves the mountains, Alec will be there!

Alec first heard about the Tele-Rehab project from Dr. Scrimshaw, a physician in town. Dr. Scrimshaw called and informed him about the project and the technology that would be coming to the clinic. Alec was intrigued and decided to join the team because of the potential to better serve isolated patients. He knew that not everyone had the means to travel to complex treatment centers. Again, just like Sheelah, Alec thought that having the technology on site would be beneficial. November 2020 was the beginning of the project in Pincher Creek, making it the beginning of Alec's journey with the project.

Just like Sheelah, Alec did not have much experience with tele-health before joining the team. The only experience he had was from when the pandemic first began and everything went online. Alec provided some outpatient treatments over the phone or Zoom during that time. Just like Alec (and a lot of other people), I can say my first experience with tele-health was also at the beginning of the pandemic.

Alec's role as the on-site clinician includes assisting with vestibular, hip and knee, and shoulder assessments. Alec prefers the vestibular assessments as they help in expanding his own knowledge of the vestibular system, and help him gain new skills with the mentorship from our remote vestibular expert Sheelah. Having Sheelah guide Alec helps his learning, as this is not something he would be getting with taking a class. I 100% agree with Alec on this! Applying the skills you gain in a classroom to real-life situations helps an individual expand on the knowledge from textbooks. Last week, Amber had mentioned that in our undergrad we don’t learn much about the vestibular system and I have to agree with her on that. Before joining the Tele-Rehab team, I also had no experience with the vestibular system and honestly only remembered part of the diagram of the inner ear. Even with just watching the assessments, I have definitely been able to expand my knowledge about the vestibular system and the different conditions that can occur.

Diagram of the Vestibular System

The introduction of the Tele-Rehab project in Pincher Creek brought in equipment that was never available at the clinic. This was particularly important for vestibular patients, as none of the clinicians had the specialized training or the equipment to provide treatment. The majority of the time, vestibular patients in Pincher Creek would be provided with referrals to Lethbridge. This meant a long drive just to see a vestibular therapist, and most of the time those referrals would be to private clinics, so patients would be paying out of their own pockets. This pattern, seen in many rural communities, leads to most patients not receiving the care they require. But ever since the introduction of the Tele-Rehab system, Pincher Creek patients have found it beneficial. Alec noted that the team fills in the knowledge gap best for him when it comes to conditions related to the vestibular system.

With life, there comes challenges. But challenges are meant to be overcome, right? Alec lives an extremely busy life. On a daily basis he has to balance time between the clinic, hospital and home life. Alec also prefers in-person over remote assessments, but because he is inclined to expanding his knowledge about the vestibular system, he has found a way to overcome that challenge by making himself available for all vestibular assessments. As a clinician, Alec finds being part of the team beneficial for himself. As mentioned earlier, Alec does not have the training to assess vestibular patients on his own. But with Sheelah present on the double robot, Alec now has the opportunity to be exposed to vestibular training without having to leave Pincher Creek. With the Tele-Rehab team, Alec is able to apply skills he hasn't used in years. Alec has found that having him as the middle person makes virtual assessments easier. Having that remote expert present for conditions such as vestibular makes things flow easily. It gets rid of the unnecessary travel and wait time for the patients who would have been referred to somewhere further away from town.

Alec teaching his kids, along with the cat!

Overall, the technology brought into the clinic was all new to the clinicians on-site, but it has been extremely useful. During all assessments the Double Robot is used, through which our remote clinicians are able to drive around and complete their assessments. Alec believes that the Double Robot is very useful. He says that patients are able to engage with it easier than with Zoom on the computer. The zooming-in mode on the Double is also a great feature as it makes it easier for the remote clinician to see what Alec is seeing in person. His thoughts on the infrared goggles are also similar; they are extremely useful, as you can see the eye movement zoomed in and in real-time. Last week, Sheelah had mentioned that without the goggles it makes it close to impossible to complete virtual assessments. So, having the goggles on-site makes it easier to see the eye movement rather than having to go close up into the patient's face without them. Alec finds viewing the eye movement through the goggles very interesting as this isn’t something he was able to see before the introduction of the technology.

After the pandemic has made an exit (hopefully soon!), Alec believes that there is potential for Tele-Rehab to continue, as there is a demand for both in-person and online care. The Tele-Rehab team brings in technology that some clinicians have never been exposed to along with the help of experts. The inclusion of the technology and extra help makes it easier to complete virtual assessments. Having Tele-Rehab present will help facilitate outreach to larger teams, while still seeing local clinicians.

Once again, I’d like to thank Alec for giving me the opportunity to interview him and share his story and experiences with us! It’s been amazing to get to hear perspectives from our patients and clinicians and learn how Tele-Rehab 2.0 is making a difference for them.

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