My core knowledge of the anatomy and function of the human body is something that began during the completion of BSc in Athletic therapy and training which involved modules in anatomy, physiology, psychology and ethics to name a few. However, it has been the experience I have gained on practice placements that has allowed me to practice and apply this knowledge within predictable and complex contexts and demonstrate professional autonomy. I have presented on this page a demonstration of my placement hours completed as 'Placement Sites and Hours'.  By getting this valuable patient time, I have been able to increase my patient mileage which has allowed for me to gain more experience. From placement to placement this has seen a growth in my scope of practice.

I have demonstrated my Knowledge of anatomy and the function of the human body by my completion of online anatomy modules for different parts of the body which I received certificates for completing. These are presented here as ' Anatomy Certificates 1-3'. I have also completed a module in respiratory anatomy - an area less familiar to me to ensure I can act within my scope of practice and understand the key concepts of the knowledge base relevant to my profession. In addition to this I completed VIVA exams in each of Musculoskeletal (MSK), Cardiorespiratory and Neurology, with anatomy and physiology being a key component of these exams. While I already had  MSK knowledge from my BSc studies, this was not the case for Cardiorespiratory and Neurology (neuro). Here I needed to consolidate knowledge, by creating revision notes, which a sample are presented here as " VIVA Revision Notes".   An area of weakness within this for me is the anatomy and function of the different parts of the brain. It is an area I struggle to remember unless I regularly revise my VIVA notes. These notes are all saved for future revision with the aim of being committed to quality care - even when on different rotations. These notes are quite basic, and as this knowledge becomes more second nature to me, I aim to increase the complexity of my neuro notes. This will ensure I keep developing. Having these notes, along with attending stroke and various neurological condition seminars will be important for maintaining my scope of practice while being on a different rotation and will ensure I can draw on this knowledge to inform practice.

My knowledge and appreciation for the role of other professions in health and social care is growing continuously. My first exposure to this was during my inter-professional learning module, where we were placed into groups containing physiotherapists, occupational therapists and speech and language therapists. Each of our sessions and dialogues together were reflected on, including the role of each profession. These reflections are presented here as 'Interprofessional reflections'. This was just the beginning of my exposure to a Multi-Disciplinary Team. While on placements I got the opportunity to work effectively with others. I have worked on teams containing medics, nurses, dieticians, Occupational therapists and speech and language therapists to name a few. While initially I had only minimal knowledge of some of these roles, this has grown massively through exposure. In a number of instances, I have spent days shadowing pain team nurses, Occupational therapists and medics to further understand their job roles and scope of practice.  By improving my knowledge on different roles, I have also increased my own scope of practice. Having spent time on ITU, it was often the case that patients would need a swallow and speech assessment from speech and language. As I am now more aware of the scope of different professions, I have now a better ability and confidence to seek out members of the wider MDT to work together for the patient. While there is still much that I do not know about different professions within the MDT, I hope to attend many multidisciplinary meetings, make notes on all the relevant disciplines and ask questions of my colleagues as often as possible when qualified. I believe, the more I am aware of what other professions can offer the patient, the more I am putting the need of the service user at the centre of decision making.

During my undergraduate study I was exposed to research methods. However, it has been during my research activity as part of my MSc physiotherapy that I have started to appreciate the principles and applications of scientific enquiry. This began with a first-year module 'Evidence based practice', which in itself was striving to achieve excellence. The task encompassed defining 'evidence based practice' and then synthesising the evidence of a chosen intervention on a specific population. As this was one of the first assignments we were required to complete since starting the course, I really struggled to find the evidence I needed and at deciding which evidence was 'robust'. I have presented this here as ' Evidence Based Practice - Task 1'. It was not until I completed some reading from a text-book prior to beginning the literature review part of my research activity in second year, that searching through data bases for evidence started to become easier. I have evidenced this through the inclusion of my search terms and results section of my literature review, presented as 'Scientific Enquiry'. This demonstrates I had the ability to refine terms in order to discover relevant research articles I could discuss based on the topic of my literature review. I am certainly still a novice when it comes to research methods, but this journey during the course has allowed my scope of practice to improve to the extent that I can  perform basic searches to inform on appropriate treatments for given populations. I intend to maintain these skills by setting personal time aside to practice searching through the literature on various topics of interests and using tools such as PEDro or CASP to help me to evaluate the strength of the findings.

I have evidenced my understanding of the scientific bases of physiotherapy through the inclusion of an example of a clinical reasoning form that I completed and a document I created on conditions I had encountered on a placement. This can be seen here as 'Neurology Clinical reasoning' and 'Conditions Encountered on Placement'. In order to demonstrate the appropriate clinical reasoning biological, physical, clinical and behavioural sciences must all be considered, as echoed by Caneiro et al (2). However, this clinical reasoning form was completed on my third clinical placement in year two. Behavioural science only became a concept for me in the preparation to MSK VIVA exams when a number of papers were cited by our lecturer. As it was a new concept to me, I read a number of articles including those by Caneiro et al (2) Gifford (3) and O'Sullivan et al (4). The more I understood about the Biopsychosocial model of pain the more I was able to incorporate this into practice. I felt by being able to translate this work into practice would be helping to support the development of physiotherapy. However, I feel my knowledge in this area still has some gaps, particularly when it comes to pain. To further my future practice, I hope to attend some seminars on the topic of pain, and read as much relevant research as I can find.

Ethical Principals and legal framework are at the forefront of all physiotherapy treatments and assessments. We must work in an ethical manner but also within the regulations of the HCPC , CSP and  government policy. Ethical dilemmas from my research proposal have been included as 'ethical and political considerations', evidence of my ability to consider scenarios that may arise and how to manage them ethically. With to regards to legal framework, presented here as 'Placement sites and hours', is the HCPC requirement to have a minimum of 1000 hours clinical experience before graduating (5).  Also, the HCPC standards and CSP code of conduct that are seen colour coded throughout this portfolio to ensure I demonstrate my abilities and commitment to reach these standards. I feel that this value is not independent to physiotherapy. Much of having the correct ethical and legal knowledge is from my education and being able to differentiate right from wrong.

There are elements of this domain which I still need to improve greatly at. One of those being leadership. While I am aware of the role of leadership within physiotherapy - I am yet to fully engage with being a leader. One example of being a leader would be the implementation of a service improvement which I have completed and is presented on domain 13. I have experienced small amounts of leadership, from leading with group work to managing my own caseloads on placement. However more of this type of work is needed in the future to enhance my knowledge and experience of leadership. Once settled into a team, I hope my confidence and knowledge will grow (6) and therefore allow me to lead activities such as in- service trainings on various topics. While demonstrating knowledge and understanding was initially difficult for me as I was only at the beginning of my journey as a physiotherapist, I have now got to a stage where I have reached a reasonable scope of practice and know information about a variety of areas without being an expert on any. I believe this in the normal progression of a student, as they learn more theory, get more hands-on experience, start to reflect more and gain feedback. I aim to keep increasing my patient mileage, reflecting, seeking feedback and continuing to keep up to date on the latest guidelines to ensure I meet this domains criteria moving forward.

COVID-19 has certainly made an impact on how my scope of practice has developed over the duration of this course, while also generally having a big effect on knowledge and understanding within the profession. Personally, for me, COVID has caused me to miss out on placement hours through isolation and sites closing, while also limiting over half of my University taught sessions to remote learning. It is hard to say how significant missing placement hours is to my scope of practice, but it certainly has not impacted positively from a knowledge gained perspective. Similar could be said for online teaching which replaced face to face from April 2020 onwards. Consolidating knowledge becomes harder to achieve when one is faced with trying to learn off a laptop screen in a living room as opposed a classroom (7). Personally, I feel like a more interactive learner and benefit from interaction face to face. I have used methods such as re-watching recordings and taking notes to ensure I maximised learning. However, it is my opinion that students may benefit from more support on developing their remote learning styles, as it is a novel concept. Speaking of the impact of the pandemic as a whole on physiotherapy. One particular area for concern, was Universities having to abandon face to face teaching, based on public health advice. As I mentioned previously, this type of teaching is not ideal for everyone and some individuals may struggle. Similarly, to this many in-service trainings and seminars were also cancelled. This meant that many physiotherapists would have to adapt new ways consolidate knowledge gained from an educational programme.