One of the most exciting but nerve-wracking parts of becoming a physical therapist is beginning to treat real patients, whether during student rotations or as a new graduate with your first role as a clinician. 

As a Clinical Instructor for 6 years, and having mentored over 20 young clinicians during my time as staff PT, Clinic Director, and now Group Director, I have seen many people tackle the learning curve of practicing in an outpatient clinic. Everyone’s experience is different, but no one is perfect, especially at the beginning of their career. 

I try to handle mistakes from both new graduates and experienced clinicians with empathy and a growth mindset, trusting that today’s errors will become tomorrow’s well-learned lessons. 

That’s why I wanted to share what happens in our clinic when various types of mistakes come up: so you see how these things get resolved and hopefully feel less nervousness throughout your career. 

What happens when a student or new PT makes a mistake? 

When a student or new therapist makes a mistake during patient care, and the patient is unaware, I will talk out loud with the student/therapist and ask questions on hand placement for manual techniques or talk through their thought process to gain a better understanding and help them along with tips/tricks or other ideas to help them course correct. This way it’s more of a learning moment without anyone feeling uncomfortable.  

If it’s a larger mistake and a patient is questioning or concerned about a treatment/application, I will immediately step in and offer all reassurance as everyone makes mistakes but it’s how we learn from them in the future. If a patient is uncomfortable seeing that student/therapist in the future, I will have the student/therapist sit in with me on treatments and talk through rationales, hand placements, and highlight the things the student is good at with the patient to help with rebuilding that trust/rapport.  

For mistakes on non-patient tasks like billing, copay collection, etc., I will reiterate that everyone makes mistakes and review the process of righting any wrongs. Again with the goal being confidence in the correct way of doing the task.  

Feedback during and after evaluations 

In most scenarios, feedback for minor mistakes that might occur during an evaluation or a return visit can wait until after the patient has left and I have a normal debrief with the student or new grad. But it depends on the “severity” of the situation. If a student/therapist is performing manual therapy incorrectly and a patient could potentially be injured/hurt – immediately I will step in and talk through hand placement and technique to decipher if the therapist is ready to perform this. If it’s a goniometry or manual muscle testing error, we can review in the debrief afterwards. 

In both scenarios (a minor to major “offense”) I typically will ask the student or new grad: what are 3 things that you think went well and what are 3 things that you need to improve on? I also share my top and bottom 3 moments of the visit from my perspective. Most times people are aware of their mistakes and then we have a conversation to avoid the same mistake in the future. 

The main goal is to appreciate and accept the fact that you will make mistakes, and now is really a great time to do it and learn from it while you have a clinical instructor or mentor with you to help course correct immediately! Even seasoned PTs will make a mistake! It’s how you respond to it and learn from it in the future that matters. 

Real-life lessons from past students 

As you can imagine, every clinic has so many stories about mistakes that turn into valuable learning points for students and clinicians alike. A few great examples in my experience: 

• A student was doing a new patient evaluation and was asking about past medical history – she did a quick glance at the checklist on the documentation system and immediately asked the patient if she had any STDs. The student and patient were mortified. Afterwards I asked the student why that was her first red flag/past medical history question and she said that was the only one that she could see/remember on the list—whoops! Needless to say, she never asked that one again! 

• A patient came in complaining their ankle was hurting after a student performed long axis hip distraction the previous session and felt the student didn’t know what they were doing. Student and CI reviewed alternative hand placement and discussed a new plan with the patient who was agreeable to another attempt by the student and had great results! 

• A new therapist (not a new grad!) had been having difficulty retaining low back pain patients after their evaluation as they were always too sore. We reviewed hands-on manual therapy skills that this therapist felt less confident in and immediately saw instant results in patient returns. 

How I make our clinic a healthy place to learn 

Speaking for myself, I try to create a safe space for students, therapists, and even patients to mess up—we ALL do! No one should be ashamed of making a mistake. It happens and will continue to happen, but it doesn’t define you. How you recover from it is more of what I look at vs. the actual mistake. And usually most times, in a few hours/days that silly mistake is now our running joke!