Many facilities may assist us to learn about the world around us and the way in which it and we can work together. I have spent quite some time considering whether or not to provide video clips of the work which I complete.
The modern classroom can and possibly should include multi-media presentations because they offer perspectives that a lecture presentation or a book don't obviously (or immediately) proffer to the student who would wish to know more.
I don't think of the audience for which I pen this blog as students of mine nor do I think they are in need of tuition from me. I do feel that some of my work methods may assist other cast technicians to arrive at ways to complete their work; in a manner which they may find easier than their own current work approaches.
Maybe not for every cast or splint demonstrated but possibly the depicted techniques herein will provide just enough additional information for other cast technicians to make their own patient workflow easier. I would like develop a library of techniques so that cast technicians across the globe can draw on the collected experience of all cast technicians.
One of the the issues I have struggled with over the years is this; that the currently available helpful information appears to have been packaged in a 'cookie cutter' format and this has lead to the inevitably rather prescriptive form of suggested approach. I have no wish to be quite so prescriptive. The format of the video clips which I present is open to a charge of being rather loose and indefinite.
Working as a practising cast technician, I am aware that I will frequently modify a prescribed cast from my base premise... because every patient is different and multi-factorial considerations may be present which were not obvious from the clinician's prescribed treatment. A simple and common example would be where the patient is a type I diabetic.
I have a significant blind spot insofar as the working approach of other cast technicians. We all work in isolation from each other. I will usually modify my own cast application methods for a type I diabetic. The undercast padding and the cast edges will be markedly different to a cast which I have applied to a patient without significant contraindicative co-morbidities.
The practical aspects of creating video clips include finding the patient models, cast room premises and the time and equipment to record clips. Some editing for sound and video clip content will have to be completed. Elements of reality are missing from clips which are made with patients who are not really injured. Limb handling can look a little false. Wound care cannot be completed and muscle wasting cannot be simulated.
On the other hand, patient permission does not have to be sought and the Caldicott Principles are always upheld. There is no breach of patient confidentiality and live patient data is never passed to parties who are not entitled to see it thus ethical approvals are not required.
The arrangement of my library of video clips is going to be based upon whether the cast is circumferential or applied as a splint. Additionally it will be subdivided into upper or lower limb and then whether it is a complete or a partial limb cast. It may be helpful to denote whether the cast is a routine cast or whether it is considered to be functional or complex. Material selection may become relevant.
The clips will demonstrate the cast type in a simple manner... that is they will generally be applied in the most efficient manner possible; in order to give effect to the treating clinician's prescription. The soundtrack will explain each step and possibly highlight common errors of application.
Each video clip will be accessed from a page which explains the clinical rationale behind the cast type and the intended objectives for its application. Further links will dig into the clinical approach to non-operative treatment of the particular fracture pattern. Some links may lead the reader to a discussion of advanced techniques and it is hoped that these will assist cast technicians to realise improved methods of work.
All video library clip pages will provide the reader with a discussion link. It is hoped that cast technicians from around the world will discuss what is shown and add their own commentary. This will enrich the cast technician community who do read these pages.
There have been 1788 unique views of these pages since the blog was uploaded again. If every cast technician discussed one of their own methods, it should not take very long to build a considerable global library of casting techniques.
What cast technicians (as a working group) do not have at this time is a global body of knowledge to which we can all subscribe. It is my hope that the new video library will become the embryo for such a project.
watch this space...