Episode 400 - The MDT Diploma Programme: Final Exam Prep

In episode 400 of the Mechanical Care Forum, we’re continuing with Season 13 highlighting the McKenzie Institute International Diploma Program. Today we’re connecting with three other candidates, Micah Sales, Daniel Paggan, and Ray Peralta, who like me are scheduled to take the final exam of the program soon after this recording. We’ll hear how they’re feeling about it, how they’ve approached study, what they’re learning and plenty more. This week on MCF!

SHOW NOTES

(by Jayla Hall)

(3:30)

Diploma Candidates of the 2023 Cohort

Micah Sales is located in Athens, GA. He works as a clinical director in the outpatient clinic of FYZICAL Therapy and Balance Centers, seeing primarily orthopedic and neuro patient populations. Gary Dykes, a senior instructor for the McKenzie Institute USA, was strongly influential in Micah’s pursuit of the MDT Diploma Programme.

Ray Peralta is located in New York City, NY and serves in an outpatient orthopedic clinic attached to NYU Langone Health Hospital. Ray also owns an online business (Running Pain-Free) which is concerned with injury prevention and sports performance with runners, integrating MDT principles in this endeavor. Noticing the patient care outcomes of his colleagues, Ray decided to pursue the MDT Diploma Programme.

Daniel Paggen is located in Durham, NC and works within an outpatient clinic. He primarily sees the orthopedic patient population. Daniel began his MDT journey in 2011.

(5:55)

Perceptions of the MDT Diploma Programme and Take-Aways

Daniel discusses the issue of balancing family and home life, work, and time away from the clinic to undertake the program. Micah reflects upon the organization and time management required of the programme with his full-time position as a clinical director. 

(12:52)

Clinical Residency and Patient Cases

Ray alludes to a patient case in which he oscillated with his differential diagnosis between a lumbar derangement or an SI joint. Micah pinpoints the thought process of the McKenzie Method, underlining the clarity that he gained of it for the sake of efficient patient care. Daniel recalls a patient who, without the prior experience and guidance of his clinical instructor, Daniel could have worsened.

(16:45)

Approaching the Final Exam

Ray continues educating himself on the recent literature and applying studies for the purposes of the oral portion of the exam. Ray also utilizes the MDT Diploma Manual and Robin McKenzie’s “Treat Your Own…” series for preparation. 

Micah and Daniel confer within study sessions, reviewing McKenzie’s older texts, the Diploma Clinical Concepts, and research articles (all from which they generate their personal notes).

(20:12)

The Literature and its Impact on Patient Education

Daniel refers to the concept of centralization as a prognostic indication for a patient’s chronic pain that had successfully centralized throughout her care. Educating this patient on centralization, Daniel also provided illustrations of peripheralization relative to centralization.

Referring to chronic pain patients, Micah regards Mark Werneke’s studies pertaining to centralization and directional preference. Micah also mentions Richard Rosedale's Extremity Pain of Spinal Source (EXPOSS) publications. Jason highlights the shared decision-making cultivated within the therapeutic alliance. 

(23:55)

Psychosocial Aspect of the Biopsychosocial (BPS) Model

Regarding the contextual and cognitive-emotional drivers of pain and disability, Ray incorporates the Yellow Flag Risk Form (YFRF) into his patient intake, as well as the Modified Oswestry Low Back Pain Disability Questionnaire (MOLBPDQ) and STarT Back Tool.  

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