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Service Learning Reflection

My service-learning experience at the Southside Clinic was one that increased my

confidence in patient interaction, allowed me to put into action skills that I learned in class, and

opened my eyes to the lack of sustainable support available for people who have experienced a

stroke. Seif defines “service learning” as “a structured learning experience that combines

community service with explicit learning objectives, preparation, and reflection.” My experience

at the Southside Clinic fits this definition. With the clinic being a health center that serves a low-

income community and primarily people on Medicaid, I would consider this community service.

I had the opportunity to complete all of the objectives stated in the course syllabus such as

completing evaluations, delivering client-centered therapy services and providing

recommendations to the patient and family. Each intervention that I implemented was prepared

for and discussed with peers and instructors.

Occupational therapy plays a crucial role in the community, many people with a low

socioeconomic status do not have access to health care within their neighborhood and their

means of transportation to get out of their neighborhood is limited. Therefore, people with a low

SES have many more barriers to accessing occupational therapy services, but when OT comes to

the community clinics, patients with low SES can have similar access to therapies as their middle

and high SES counterparts. Both of the patients I saw at the clinic had a stroke within the last

year. Both of their left upper extremities were flaccid. Their insurance paid for a certain number

of outpatient OT visits after their stroke but they are one year post-stroke, no longer receiving

OT services and have a very low level of independence. They cannot afford OT out of pocket,

therefore our services at the free community clinics are very valuable because more intervention

is certainly necessary for them to increase independence.

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One of the individuals that I treated experienced a heart attack, then while in the

hospital experienced a R CVA, about one year ago. When he was discharged from the hospital

he continued with outpatient OT visits, his OT visits primarily focused on adaptive ADL training

because his entire left side was flaccid. In the past year, he has gained some movement in his L

LE and can walk short distances with a cane. He primarily gets around by Hemi-propulsion of a

wheelchair. Up to the point of treatment at the free clinic, he had seen no motor improvement in

his L UE but he did have reflexes in his affected UE and displayed trace muscle movement in his

forearm while engaging in mirror therapy with us.

As I mentioned before, being of a low SES can majorly affect one’s access to

health care. It puts many barriers in place for people receiving necessary preventative care,

screenings, prescriptions, diagnoses, therapies, and surgeries. This lack of access can snowball

into larger health problems and poorer health outcomes for the low SES community.

Throughout my experience at the Southside Clinic, we primarily collaborated with

physical therapy. It was very helpful to have another team of professionals with another medical

perspective. Since I was in the first session of OT students at the clinic, we had many evaluations

with patients we did not have a chart for. The PT students had previously seen those patients, we

asked to read their chart so that we could get an idea of what the patient was like before entering

the evaluation. The patients also talked to us about the exercises they were doing for physical

therapy, we were able to reinforce the importance of those exercises, include our exercises and

educate the patient on how important it is to include a functional component to their home

program. For example, with the stroke patient with trace motor movement in his L UE, we

discussed the importance of engaging that arm in occupations by using his affected arm to

stabilize, or putting the arm on the table rather than in his lap.