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Hello Colleagues and friends

Once again I want to pick some brains.

I am involved with first year teaching of some of the basic techniques of corn cutting, callous cutting and nail cutting and drilling.


I am looking for some new ideas on ways of teaching these techniques.
Because of large student numbers it is not possible to teach this using live real patients. This happens in second year.

Any ideas or any stories of how you were taught ?

Thanks

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Our students do not even get to touch a foot in first year. I think they get to look at some though...

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Craig Payne
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

If you can´t use live patients

are they allowed to use each other ?

If so demonstrattion or 2 then cut each others nails etc

Video demonstrations of all the different skills required, from instrument holding all the way through, then practice as much as they can in a clinicial setting on each other.

It going to very boring without hands on stuff

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Mike Weber.



Crazy Mary

Pork scratchings are great for practicing drill work on gryphotic nails, even down to the layering of crunchy and soft!

Plus you get to eat the leftovers! (pork scratching obviously. Eating the leftover nails would be gross)

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Robert Isaacs
Specialist in Biomechanical Therapies
www.Footprintspodiatrysolutions.co.uk

small, yellow, leech-like, and probably the oddest thing in the universe

Semper in excretum sum sed alta variat

We started off with oranges for removing callous, and potatoes - the 'eyes' are good substitiute seed corns. We then moved on to strips of wax which had poppy seeds in them attached to each others feet with double sided tape. Then we practiced on each others feet before we moved on to real people.

They were lucky...we used t` dream of lookin` at a foot in first year.

Tell kids today.

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Just a rock `n roll refugee.

If...

We went straight in at the deep end with real patients. As first year students we had a 3rd year role model who mentored us and let us get hands on under supervision. The problem with oranges and potatoes is that you do not get any feel for skin tension which is a big part of technique.


Cornmerchant.

We used candle wax dripped onto fleecy web to form a callus.

These days I'm more aligned with Craig, teach them how to assess the patient before they start treating them.

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"My mission drive is to open up my eyes, 'cause the wicked lies and all the sh!te you say..." http://www.youtube.com/watch?v=V4NW5S1UTPQ

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Thanks guys and girls.

We do practice these techniques on each other and not on patients. It is only in second year that patients are seen.

We also use oranges and various wax corns and callouses to get them used to the techniques. It seems to work. I know some schools use soap bars to cut on.

Any other great ideas ?

In surgical training we used pigs feet. I don't see why the idea could not be used for C & C, always provided religious or other sensibilities were catered for. The poor teachers could take them home for tea afterwards!

Bill Liggins

Mr Webber noted the video demonstration. YES Video some 'gun' podiatrists hands on and add commentary. this was sorely lacking when i trained. there are so many facets that need emphasising.
i was 'bottom of my class' debriding, until i started taking home a blade and practising debriding the skin on the hypothenar eminence which gave me SO much confidence.

(It didn't help having a fellow student, from the very first day, who could debride and enucleate with her knees crossed and turning her head whilst talking, oh Angela D-N!!!!!)

we were given a special wax mixture to practise debridement and then special fake nails for cutting.
However after 7 weeks we were straight into treating real patients. Initially just nail cutting and callous, then corns were included as our experience grew.
We were fortunate in having a full podiatry clinic on campus for members of the public who were willing for students to practise
.... well fortunate until my final exam when 2nd patient told me one medical history, changed it when examiner came to check and then when he left said she hoped to see me again when I returned to repeat the year as she really liked my treatment!!! but i was passed , so haha
Taught you quickly how deal with the public LOL

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Duct tape is like The Force. It has a light side, a dark side, and it holds the universe together.

Probably just best to say his a scalpel and a blade - get on with it. Best way to learn is to be thrown in the deep end!!

they should all partner up and hold the mandrill/burr in one spot for too long!!

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Tristan Fairbairn
Brimbank Foot & Ankle Clinic
www.brimbankfootandankleclinic.com.au

Nasty yet nice.

Apparently no practicing on each other any more. Which I think is dumb. How can you have empathy if you've never been on the dangerous end?

I know I'm much more aware of patient comfort with digital blocks having been practiced on by someone so nervous I could FEEL the needle shaking.

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Robert Isaacs
Specialist in Biomechanical Therapies
www.Footprintspodiatrysolutions.co.uk

small, yellow, leech-like, and probably the oddest thing in the universe

Semper in excretum sum sed alta variat

When we did local I was the only person our teacher new the name of so I was the patient demo. When I heard Tim say if you see the needle do this then you have hit bone - I made sure not to do that on a patient - pain I tell you. Bloody stupid not to practice on each other.

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Mike Weber.



Crazy Mary

Hey Dennis

If I remember right, we used wax on all manner of plaster and it worked. It was the tension and feel of the foot that was key in learning rather than 'managing' the handel. Of course all the great suggestions above give invaluable 'handel-management' beforehand.

Hope you well.

Brandon

....doesn't surprise

..or on onself, i tried it and again it helped me (confidence-building)


Jag förbliver Eder ödmjukaste tjänare, mark

not allowed to practice on each other??????????????

who's idea was that?

we used dental alginate to practice sharp debridement-we put it on the plantar surface of our feet.

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Julius Ceasar and the Roman Empire
Couldn’t conquer the blue sky

When I was trained our 1st scalpel exercise was on candle wax melted onto fleecy web.

Probably breeches their human rights. You know, life liberty and not being repeatedly and unnecessarily stabbed with a trembling hypodermic.

I have to say, supervising someones first time is more stressful than either doing it or having it done to you!

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Robert Isaacs
Specialist in Biomechanical Therapies
www.Footprintspodiatrysolutions.co.uk

small, yellow, leech-like, and probably the oddest thing in the universe

Semper in excretum sum sed alta variat

Hey Prof ... candle wax on stretch strapping...brings back memories. Hope there is a new "blikkie". Thumbs up for alwyas trying to find new ideas to teach the new students. The ideas given above are rather interesting. Have you considered asking the anatomy department if the first year students can practice on the cadavars that the 2nd years are using? I suppose that callous may be a bit hard to debride though...

If you can cut the peel in layers off an orange and/or apple with a blade you know how to hold the instrument. Then you are qualified to practice on another student only if he has good blood supply and normal sensation. You will cut too deeply, but he will heal.

Hi Guys,
I am a second year student, during our first year we used wax on tape stuck to each others feet and had a go. We also cut each others nails. Once the tutors considered it safe ( tm varied between students dependent upon manual dexterity), we got to practice on each other for real :-) Then later in the year we where allowed to practice on patients selected by our tutors. Worked well for us, no problems for students or patients.

Dennis,

Not sure if you would consider it part of 'technique' or not but I think it is something that should be included right from the start.

When cutting toe nails, where some of the toe nails are fungally infected, ensure that the uninfected nails are cut before the infected nails and if part of a nail is infected ensure that the uninfected part is cut before the infected part.

Good luck.

Bill

Before we did any clinics we were taught learn how to clean down and set up a trolley and prepare (swab) a foot, take a medical history and we also learned all the abbreviations we would need for record-keeping

In the first year we didn't see a "real" patient until the third term. In the second term we cut each others' toenails, and then went on to wax cutting - a blob of wax put onto ZO tape and stuck to the foot. Finally in the third term we saw "real" patients but these were all screened, so we just did nail-cuts and maybe a bit of callus or an HD.
Running concurrently with this was Padding & Strapping and detachable/ chairside appliances so we could relate these to the type of problem we might encounter

The real "heavy" cases came in the 2nd year because by this time we were learning something about biomechanics and orthotics and could devise off-loading strategies for our patients.

I can't see how any of this could be taught without hands-on training?

Catfoot

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"Thousands of years ago, cats were worshipped as gods. Cats have never forgotten this."