“Inappropriate sexual behaviour can involve many different types of incidents ranging from sexual remarks, and inquiries of a sexual nature, requests for sexual favours, leering looks, sexual exposure, vulgarity and crude remarks, to non-consenting touch and forced physical advances (Weerakoon & Sullivan,1998). These leering looks and remarks were what I encountered during my second clinical block.

I attended a school as part of my pediatrics clinical block. This particular school provides education to pupils with intellectual impairments, cerebral palsy and physical disabilities. As a result, pupils who required physiotherapy intervention were thus assigned to the physiotherapy students at the placement and were thus expected to be seen on a daily basis. Physiotherapy students were expected to collect pupils assigned to them from their classrooms each day. On my first day, at this particular placement, I had made my way to the classroom in order to collect one of my pupils I was expected to see that day. Along the way I had encountered a group of the older male pupils in the passageway. They made remarks in hopes to capture my attention but I merely ignored their attempt to do so as I was under the impression that they were merely seeking for attention given the fact that I was a new face wandering around in the passageway. As time went by, the remarks and stares received from the larger group of the older male pupils had stopped except for one. This one particular male pupil continued to make remarks whenever I passed by. He went as far as following me whenever I would pass by and would peep through the window of the physiotherapy gym in hopes of capturing my attention. I tried my utmost best to avoid the looks and remarks made as I made my way to the classrooms each day however, became increasingly frustrated as the weeks passed by. I had finally confronted this pupil when he tried standing in my way as I tried to get one of my pupils to the physiotherapy gym. In spite of my efforts to confront this pupil the remarks and looks continued for the remainder of my clinical block. This has made me realize that one is never prepared for these encounters. It thus caused me to pay much attention to various strategies which could potentially prepare students for inappropriate behaviour and assist them with approaching these forms of behaviour within the clinical setting.

According to Cambier (2013), inappropriate behaviour of patients is quite prevalent in clinical practice and as many as 85% of physiotherapists tend to encounter inappropriate sexual behaviour during their career. Furthermore, it was indicated that students should be prepared for inappropriate behavior by having the curricula place emphasis on inappropriate behaviour encountered within the clinical setting and informing students about their legal rights, their ethical obligations, assertive techniques and be taught instructions to effective documentation should professional boundaries be overstepped by patients (Cambier, 2013). Additionally, the inclusion of role play and case studies should be incorporated in hopes to encourage students to consider their own values and practice the formulation of responses. According to a study conducted by the American Physical Therapy Association (2018), participants identified certain strategies they found to be helpful when dealing with inappropriate sexual behaviour by patients. These strategies included distraction, direct confrontation and making use of a chaperone. Furthermore, the study placed great emphasis on the fact that clinicians as well as students should be taught assertive communication and redirection strategies. It is evident that both studies consulted place great emphasis on assertive techniques and curricula changes however it is imperative that changes are made within the workplace itself. The American Physical Therapy Association (2018)  thus indicated that policies should be set in place and supervisors as well as clinicians should undergo training that will enable them to resolve any cases of inappropriate behaviour should they arise.

Aziz and Marshall (2017), proposed strategies students and healthcare professionals may utilize when confronted with inappropriate sexual behaviour. According to Aziz and Marshall (2017), it is imperative that students and healthcare professionals see to their personal safety and that should they find themselves in a situation in which they encounter inappropriate sexual behaviour the patient should be referred to a colleague. Furthermore, boundaries should be implemented by communicating boundaries with the perpetrator. It is imperative that students turn to their colleagues and superiors for guidance when dealing with patients who display sexually inappropriate behaviour (Aziz & Marshall, 2017).

This encounter and the strategies reviewed has made me come to the realization that in spite of the fact that I implemented boundaries and avoided the pupil’s attempts to capture my attention I should have brought it up to my superiors. I also realized that the aspect that prevented me from reporting the pupil’s behaviour was also the fact that I was afraid the staff members may potentially deem this encounter as inconsequential and may regard the pupil’s behaviour as ‘typical teenage behaviour’. Reflecting back on this encounter I have also realized that should I have reported the pupil’s behaviour the pupil would then acknowledge the seriousness of the situation and ultimately conclude his inappropriate behaviour. In addition, this encounter has also made me realize that although others may have potentially deem it insignificant the fact that it made me feel uncomfortable is enough reason to report it to my superiors as it eventually caused each setting outside of the physiotherapy gym to be an unpleasant one.

 References:

American Physical Therapy Association. (2018). Study: Ignoring Inappropriate Behavior Doesn’t Work, but Other Strategies Might. Retrieved on 22 May 2019 from https://www.apta.org/PTinMotion/News/2018/07/02/IPSBResponsesPTJ/

Aziz, R., Marshall, J.(2017). Subjected to sexually inappropriate behavior? Set LIMITS. Current Psychiatry 16(5):53

Cambier, Z. (2013). Preparing New Clinicians to Identify, Understand and Address Inappropriate Patient Sexual Behaviour in the Clinical Environment. Journal of Physical Therapy Education 27(2):7-14

Weerakoon, P., O’Sullivan, V. (1998). Inappropriate Patient Sexual Behaviour in Physiotherapy Practice.Physiotherapy 86(19)