Welcome to Digication
Scholars Conversations.

I'm your host, Kelly Driscoll.

In this episode, you'll hear part two of
my conversation with Kyle Hewson, Vice

Chair and Clinical Associate Professor
in the Doctorate in Physical Therapy

program at Stony Brook University.

More links and information about today's
conversation can be found on Digication's

Twitter, Facebook, and Instagram.

Full episodes of Digication Scholars
Conversations can be found on

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You know, I feel like the role of physical
therapist and healthcare is so different

than the kind of relationship that one
has with a doctor, for instance, where

you have a really kind of Define period
of time that you're with them and, and

sometimes physical therapist you may
work with for months or years and really

become your partner in rehabilitation.

And you spend a lot of time together
often, um, depending on the extent

of, um, rehabilitation needed.

And it really does become a more
personal relationship, I think, because

you have that amount of time together.

And you're often having a lot
of time together when you as the

patient are in pain and already
vulnerable because of that.

And they become, you know, your
cheerleader and your support person.

And as you mentioned, also your teacher,
um, because they're trying to give you

the tools to be able to kind of take
care of yourself when you're not well.

Right there with them and educate you
on why certain movements or exercises

or, um, even breathing techniques, you
know, are so important in your healing.

Um, and I was curious as the students are
kind of going through the program, there

is Is this kind of storytelling something
that's encouraged with their patients?

Um, because I think it's something that we
don't often hear about with doctors, for

instance, you know, because of the limited
time that you're with them, really.

Yes.

Yes.

Yeah.

Yeah.

I think there's two parts to it.

I think that we want to get I think
all the things you said are spot on.

I mean, the sense of we, we want to
encourage, we want to know them more.

So we want to hear about their, we
always, we'd say that every patient,

a diagnosis can be very similar, but
their role in life, they could be a

mother, they could have a job in the
city that they have to take, you know,

two subways and then go up three,
four, five or four flights of stairs.

They could, um, they could have, uh,
you know, they could be an athlete that

they're trying to get a scholarship.

And, you know, this is
like, are you kidding me?

This happened to me.

So we, the injuries are all the same, but
the stories behind it and all the roles

are complex and how they handle their
injury and where they are in this, you

know, so you have the Cycles of grief.

I say, Oh, you, we tend to get them
at like the anger and depression time,

you know, so, and then how do you,
cause it's a huge change in their life.

Um, so how they cope and
what we, so definitely.

So a lot of times we can, Connect.

So this, as I mentioned, so it's kind of
where they're at, but then also what can

we do in our experience of what we've
seen, how other patients have coped?

Can we bring someone in that
might've, Oh, you know what?

You know, this person, this
person over there on the other

side of the gym, she was just in
the same spot as you a month ago.

I'm going to bring you two together
and just talk a little bit.

So that's really important.

Um, and then, you know, you, you
never say as a therapist, I know.

You, you can say, I've had
a lot of patients that have

struggled with what you have.

Um, sometimes there's a cycle, like
a person gets better really fast

and then they kind of hang out and
takes a while to get, and this is

the boring and the tedious part.

And then like, do I ever get sex?

And then, and it's also hard for
a therapist to say, you know, I'm

not sure if you're ever getting
back to the baseline that you want.

Right, right.

You know, to that athlete or to that, you
know, the person that has a neurological

disorder or whatever, so, right.

I mean, yeah.

Yeah.

So they do learn, I think it's a little
difficult for them that all, they're

not gonna help everyone and they're
helping them, but not what they think.

That everyone's not getting back to a
hundred percent that they're, they're at.

This is what I explained to them,
they're shifting a phase, they're now

at a different phase in their life
and what, how you influence and they

never, they never forget you as a
therapist at that time, that's for sure.

Yeah.

Yeah.

So true.

And I also think, I'm sure for your
students, there's also conversations

about how the patient has to be a
big, you know, they have to make

decisions about how they're going
to take care of themselves too.

Absolutely.

Yeah, yeah.

I agree, yeah.

So, how do we motivate and how can we help
them adhere and, you know, be successful.

Give all kinds of suggestions and
human nature, of course, is a biggie.

Yeah.

Absolutely.

Yeah.

Are they introduced to, um, some kind of,
kind of psychology around that process?

So you mentioned that very often they're
meeting people at this kind of grieving

stage and may be depressed because, you
know, it's a big transition probably from

where they were to where they are now.

So what, what kind of, how is
that introduced in the curriculum?

So that's right up my alley too.

So of course, one of the requirements
of coming to the program and Stacia

wide is they have to take a psychology
class of some kind in undergrad.

So that could be normal development
or it could be abnormal or,

you know with child, whatever.

So that's Many of them actually can
be in any kind of bachelor's degree

when they come, they can be musicians,
they can, so psychology is a great one

if they are doing that because they
know they're going to work eventually

with people that are in crisis.

Um, so this, In the first, uh, summer that
I mentioned that class, we do one course

on, um, one class on communication and
a little bit on culture and why culture,

you know, you may come across this way.

I'm a, I'm a loud person.

I'm a, I talk fast, high energy.

That could totally not work with someone
who is just Just, you know, from a

different culture or not understanding,
I'm giving too many directions.

Right?

Yeah.

So we just talk generally about that.

And again, they're still new.

Um, we share different experiences.

In the second year, we have a class
and it's just started, um, it's called

psychosocial aspects of disability.

Mm-Hmm.

. So we look at all the parts, what.

You know, what are all the different
avenues and areas, I should say,

that are affecting why a patient
is having difficulty or they're

bringing this to the table.

So again, culture is mentioned again.

We look at spirituality.

We look at avenues that might not be good.

Substance abuse.

Um, we look at pain.

How pain, you know, like, so
people that are chronic pain, their

families seems kind of like, Hey,
you know, come on, you can handle it.

One day they can another day they can't.

So all the different aspects of how we
would be challenged, um, as a therapist

and that we have to understand.

And, you know, that's a lifelong process.

Um, I always say, I, I only am as as the
experiences that I've had, you know, I

tell them if I had my choice go work in
a large city, in a clinic or a hospital

and be involved with as many types of
patients and types of diagnosis and ages

just explode and be like, you know, Wow.

There's 16 languages being spoken
in this room, you know, so that

would be that really, it can be
difficult, but what, what a great

challenge and you'd learn so much.

So that is really, and so they
learn about that from each other.

Um, I get it's not, there's no recipe
book for this, but we also give them the

two things are as a therapist, how does
this area about substance abuse or even

suicide, what do you do in your role?

How do you say something to the patient?

You know, I've noticed recently,
Kyle, that you seem extremely down.

You're usually able to just handle
our session together, but som...

is something is going on?

And then they say something like, Yeah,
I really, you know, I'm done with this.

And you're like, Okay, so then what
do you say and then, so what are the

supports and then how do you refer and
to our other mental health professionals

and what's available in the community?

I say your job also when you end up
wherever you may be, you need to know

in that community all the resources.

So if you're a small clinic, you know you
can call 9 1 1, but who else is around?

Yeah, like the relationship
with your physician.

Do they have a counselor?

Do they have, you know, all these things.

What's, what are your
resources in your library?

What are your resources in associations
that maybe someone has multiple sclerosis?

Well, guess what?

They have this fantastic chat
room meets every Mondays.

And everyone just vents about, this is
an awful diagnosis, you know, so that

is really your job to be an advocate
and know where you kind of can't be

a counselor, but who can help you.

So, I think that's again, that is again,
I'm going to say the problem solving part.

of being a physical therapist and
your brain is always thinking about,

Oh, I got to make sure, make sure.

Oh, you know what?

You, you'll be really great
with some new orthopedic shoes

because you have diabetes.

You need this and you know, all you
are the reference and referral source,

which is really, really an honor.

to be able to kind of help them in these
other areas of life, even finances, right?

Finances are huge.

We can't fix that boat.

Oh, do you know that there is this
association that maybe could get your

child a power wheelchair, you know,
like there's, there's things out there.

Yeah.

Yeah.

And as you were speaking, I was also
reminded of a slightly different topic,

but another thing that's really core to
you and your background and your teaching

is around ethics in working with patients.

Could you speak to that a little bit also?

So I always joke around that, you
know, how did I get involved in this?

This is usually one of those very dry
topics, but, um, it's so important.

Yeah.

It doesn't necessarily always
mean I'm going to say doing

the right thing all the time.

It's actually just knowing, and this is
how, again, how I present it, that in

any situation, You have many options.

So my goal in the third year
is I'll give them a case.

I'll be like, okay, think of every single
option that you could do in this case,

including the big one is do nothing.

Just not going to do anything.

I'm going to pretend I never heard
this and then you go through them.

So maybe you have ten, five of them.

There's no win win.

It doesn't make a change.

It's really kind of doesn't follow
the legal, uh, you know, the

legality of your practice act.

So you cross those out.

Okay, now you're down to your five.

Okay, so which one would
be the most powerful?

Which one for you would
be the most powerful?

Difficult.

A lot of times it's
confrontation of any kind.

Who, how could, who could you trust
that you could talk to about the

situation and could really keep
confidence and be able to guide you?

And I've had students send me an email
way after they're graduated, you know, Hi

Kyle, I'm not going to give you the name
of this person, but I have this scenario.

What do you think?

And I'd be like, you know what?

You are spot on.

Great idea.

This is a three step thing.

You're going to go first
with your supervisor.

Then you're going to go together and
talk to the patient and then you're,

you know, so it's that kind of thing.

So it's, again, it's really communication,
but in a larger scope and a little

bit more of pressure on them that
you may be like, I don't want to

deal with this, but guess what?

You have to, because this is a big thing.

So we talk about fraud.

We talk about people not practicing, uh,
you know, the practice act, which is a

little different in each state, kind of
how, how, um, Physical therapy assistants

can work and aides and different, you
know, um, boundaries that they have.

So you have to be, and it's tough, um,
some of these are easy to fix and some

are more that you say, you know what,
this is not going to be fixed and I've

tried and I'm going to leave this job.

So that, you know, that
is kind of a big thing.

But, um, so I've kind of broken it down.

I mean, there's so many
beautiful books on ethics and

healthcare and working together.

So it's a good blend.

Um, some of my students are,
they're like, Oh, they're able

to figure it out right away.

And they're kind of probably in
the back of the room like, Kyle,

really, we have to go over this.

And then all the students are like,
I have no idea how to fix this.

So, you know, that's kind of
how we, we do group discussions

and cases and things like that.

Yeah.

Yeah.

Well, and I'm sure sometimes, you know,
hearing about it and thinking that you

know how you might respond, um, you know,
can be different in theory than when,

you know, you're out in the field and
you have, you know, various hierarchical

relationships and, um, yeah.

And your income is dependent on things,
you know, it really changes, changes

things and how wonderful that they.

You know, have the opportunity to
kind of break it down with you while

there's still students and then coming
back to you as a resource afterward

and knowing that, um, you can give
them some continued mentorship.

I'm, I'm sure that that makes.

You're heartful to knowing that,
yeah, that they can come to you

and do, um, that's very powerful.

Um, so I also wanted to talk a little
bit about, uh, some of the project-based

learning that happens as the students
are moving through your program.

Um, could you talk about
some of the projects?

It seems like they have some that are at
each of the different, um, kind of years.

there.

Well, how is that kind of
designed and presented?

So I'll talk a little bit about
the template and just explain that.

So they, you know, as I said, they
do kind of that first year, uh,

welcome and all about themselves.

And then they have first, second
and third year and they get to

choose, um, the first year and
the second year, uh, two or three.

I think it's three classes that
they really enjoyed and did some

kind of project like you mentioned.

So, um, you know, I, I always say to
them, by the time you graduate, after

three years, you'll have every type
of learning, uh, methodology, teaching

methodology to you, you know, there's
group work and there's presentations

and there's, um, going out to a clinic.

Uh, so we use our, um,
veterans home right on campus.

And so you learn something
in neurology, neurological.

Physical Therapy, but now you
actually go and try it and connect

with one of our residents and
Chris, they have a great time.

And then you debrief and be like, Oh my
gosh, I was, my hand was shaking as I was

trying to touch his arm or something, you
know, and you don't realize, you know,

all those things, how nervous you are.

So I, we also have a patient simulation,
um, So you have to go in, and you don't

know what's going to happen, and you're
in a, you're being watched by your

classmates in another room, and it's
really, you know, you have your, you have

your laptop, and everyone's listening,
and you know, so, and, and it's usually,

so there's There's just so many great
things now in education to, to look

at it from different ways, you know.

So the projects, we have a kinesiology
project, they have to, they're given

an area of the body, the hip joint, or
something that's interesting to them.

And they have to create a project
actually out of wood or plastic or

something to actually demonstrate.

And then we have a fair and they
stand in front of their object.

And then they have to explain to us
how they use pipe cleaners Or they use

pulleys or whatever it may be, a Play
Doh, or to make a point of how this

joint works and, you know, the mechanism.

So, so they've taken pictures
of that and sometimes they've

written a little bit about that.

Um, I actually have my curriculum
map here, so let me take a quick

look if there's anything else.

Um, Yeah, I love that
that's actually shown also.

So people have the opportunity to really
go in and see the entire curriculum.

Yeah, and then they learn a lot
about physical therapy by just

looking at the different topics.

Wow.

You know, the each clinic, uh,
clinical experience, they do

have to do a presentation so
they can put that in service up.

And I always say that, listen,
you know, you already did

something in one of these classes.

You can, Take that wonderful
presentation and use it as in services.

You kind of get a twofer out of that.

So, um, we also have, um, patients come
in to our, um, you know, to our university

as an example, uh, share their stories.

Um, also in neurological physical therapy,
someone that might be, uh, have a spinal

cord injury might share how, again, their
kind of grieving cycle and kind of how

they found their place and, if it was
hard to find work they wanted to do and

then they did and or whatever it may
be that, again, that share their road.

I mean, pediatrics, same thing.

Our teacher brings, um, some of, she's
had some of these, uh, children since

they were babies all the way now.

She knows them in their teenage years and
they're growing up so she'll have that.

Come in and share.

So we have baby day in the summer, uh,
where all the babies come in because

we're learning normal development.

So anyone from zero to three,
these kids are, you know,

they try look at the reflexes.

So the more you can kind of integrate, uh,
You know, like lectures and PowerPoints

that you have to memorize and understand
and make it become, you know, come alive.

And again, that's used.

But that is a typical thing in
many physical therapy programs,

all different ways of interacting.

And then now, you know, the buzzword
is interprofessional practice.

So we've been doing that with.

Occupational Therapy and
Physician's Assistant.

Our school has a large
event now every spring.

Uh, last year was on ethics and we've
done one, I think, on communication.

So, I don't know what the topic is this
year, but, uh, you know, how can we all

add our piece to it if we're a respiratory
therapist or we're, you know, uh, Applied

Health Informatics, whatever we may face.

Yeah.

Uh, let me see, I'll look at one more
thing and give you another example.

Um, yeah, um, in health and wellness,
which is in their third year, they

actually do a project on, I think
it's over an eight week period.

They have someone in their life that might
have want to do something to get well.

It could be anything, smoking.

It could be trying to get
their cholesterol down.

So actually, um, The professor,
uh, gave me, uh, sent me an

email about that recently.

It was one of the students sister is a
skier and wanted to get fit to go back

on the slopes, you know, and every year,
you know, it's kind of like, Oh my gosh,

I didn't do, I didn't get in shape and
this is tough and I might injure myself.

So they put her on a eight week
exercise program and she sent

an email, she went to Colorado.

She sent an email to her sister.

You have no idea.

I am doing fantastic..

I feel limber and I feel strong.

So, so things like that.

So that's a health and wellness course.

And it's trying to just show
that it doesn't necessarily

always have to be an injury.

It could be a preventive
type of look at that.

You can have a PT practice that is
all about prevention and, you know,

trying to avoid some of those things.

Things that, you know, you might have
in your family or in your workplace.

Yeah.

Yeah, absolutely.

Yes.

Absolutely.

That's good.

You know, there's a lot,
as I said, it's packed.

Definitely packed.

And you can see, yeah, you can see
it as you kind of go through it.

And I kind of think about it as kind of
unfolding the layers of, of their story

really, and, um, You know, right from that
welcome page, you know, you often get to

get a little, you know, a little picture.

There's actual pictures, but you
also just get a little picture

of who the individual student is.

So, as you go through the various
pages, you have in mind that kind

of history and background and.

Passion for what they're doing and you
can, you can literally see that growth

just being kind of manifest as you're
going through and viewing their work.

And you mentioned that there's, um,
certain points, uh, in some of the

courses where the students do have
the opportunity to actually utilize

the technology in the classroom and
sharing things with other peers.

Um, do they give feedback on each other's
work in those spaces or is it more of a

informal kind of sharing and storytelling
and connection kind of building?

I'm curious how.

You know, what levels of kind of
assessment or review of the student

experiences may be happening
throughout the program, too?

Yeah, so that's a great idea.

And it's kind of changed
through the years.

It's usually has been more informal.

Um, sometimes we've had, uh, you know,
we can, it's the first and the last

years, uh, kind of their beginning
and, you know, pre and post of how

they gather everything together.

Those are part of my courses and it's
just a percentage and they, it's.

This is what you need to do and this
is what you want to put into it.

And then we definitely have, you
know, take a look at each other's

and, and check, um, you know, see,
see, again, learn about someone new.

And at the end I mentioned like,
you know, someone that you, you, you

didn't know maybe about that person.

We've done it in the middle
on the second year course.

We have done it in the past kind
of like as, okay, you're adding

this to um, your second year.

Sometimes it's just been an email from me.

Hi guys, you're at the midpoint now
of, of our, um, you know, program.

Please update.

And then sometimes I've been
like, oh, you just hold on to it,

but then you lay it at the end.

So it's been different, but
I think that's a great point.

I think there is usually more of a
surprise of like, Oh, I didn't know.

So that kind of thing.

Um, but yeah, I mean, it's,
it's a very good suggestion.

Um, I usually, I do have, um, more
of a rubric of just kind of, you

know, uh, the, what did you include
and you were, you know, you were

meaningful or you went above and beyond.

And I do ask, um, usually about five or
six of students of the classes, look,

can I use your portfolio next year as
examples to show to the new students, you

know, what, uh, what, what you've done.

And, you know, some of them are just
because you can change the banner and

this and that and the colors and, you
know, so, Um, I was trying to, I was

trying to go back to see when did I
actually switch from paper to ePortfolios

because I only have, I only have a
certain amount of years on this computer.

Um, we started in, we, we always had a
large program, about 50 or 60 students

and in 2013 we split to two campuses, uh,
close by within an hour and we have, uh,

so I'm out here in Southampton and then
we have Stony Brook, our main campus.

So it's 50 and 35.

So I actually went back in and
I remember that first class was

out here, which would have been
2013 and they were 2016 graduates.

One of our students put a video of her
doing like aerial dancing with this

ribbon and I'm like, what is this?

So we've just laughed
and you know, she is.

Super strong and she's a
really just a great student.

So that was, I remember her.

So that was definitely 2013,
you know, just a decade already.

Yeah.

Yeah.

These incredible experiences that
your, your students have had.

And, um, it's wonderful that you're
kind of connecting with the students

before they graduate to kind of
see who's, Ready to become an

exemplar for the incoming cohort.

And I'm sure as the, the program has kind
of involved, and as you know, Digication

keeps evolving too, as we're working
with different schools and, and learning

how, you know, different educators
and students, and even alumni are kind

of putting it, putting it to work.

So it's been such a joy to have this
Kind of long term partnership and

collaboration with, with Stony Brook
so that we can all kind of celebrate

that, that evolution together.

It's, it's always so much fun to
see what the students are doing

and it's very inspiring to us to,
to see that and to also have the

opportunity to connect to educators.

Like you who are really providing
this incredible opportunity for your

students and giving them a space where
they can really celebrate who they are

and everything that they're learning.

And, um, I was curious
if you've heard from any.

Students after graduation, if they've
been able to share it with any

audiences outside of the institution.

I know that some have opted to make
them public, but we don't often

hear, you know, what that, you
know, next step is when they public.

Yeah.

I actually don't.

I can't recall anyone now.

I know that, um, you know, when
people are kind of the hot area

for posting information about
yourself is LinkedIn, of course.

So, um, sometimes, you know, the idea
of moving some material over, um, I

know that they, Can download the whole
portfolio and and take it with them.

We give them, I think it's an extra six
months after graduation to have access.

Um, you know, because then they, they
will not have their Stony Brook emails.

And most of them, as I said, if they,
Decide to make it public or not.

And usually it's within
the university initially.

Yeah.

No, it's okay.

Cause I, I had, sorry to say, I
don't have any specifics for that.

Yeah.

But I also, I wanted you to be
aware too, that, um, Digication does

provide unlimited alumni access.

So if they did want to update their
account to be with their personal

credentials, if they lose access
to this, you know, that's great.

I didn't know that.

No, that would be great.

Okay.

Wonderful.

Yeah.

It's definitely something that they
can continue using after graduation.

We do have those options to download and
of course they could get to individual.

files as well anytime.

Um, but yeah, we, we're very happy
to continue hosting it for them.

There's some other programs
that take advantage of that too.

Okay.

That's good to know.

Great.

Yeah, absolutely.

Well, I know we're getting close to the
end of our time today, Kyle, and I just,

I just really, again, wanted to thank you
so much for, for joining me to share your

experience, uh, again, over a decade now,
uh, using this kind of technology with

your students and, um, so excited to be
able to share what they have done and,

and their extraordinary stories as well.

Thank you so much.

My pleasure.

Absolutely.

Talk to you soon.

Okay.

Bye.