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In July 2014 I travelled to India to undertake a 20 day work placement with the volunteer
network Interburns, at Choithram Hospital and Research Centre, in the city of Indore in Madhya
Pradesh. Prior to my departure, I was aware I would be living on hospital campus grounds and
my work would primarily involve shadowing a Dietician on the Burns Unit, conducting clinical
assessments and analysing patients’ nutritional requirements. In my learning contract I set out
aims that I hoped to achieve;
 Enhance my organisational skills
 Collect data formy research project
 Enhance my independence
 Gain a cultural competence
 Providedirection on my future career
 Observe a high standard of clinical care
 Improve the quality of my contribution during my stay
It has become apparent to me thorough reflecting on my time in India that certain themes
present themselves in my behaviour and actions that have either hindered or enabled me to
develop. I now understand that my lack of structured preparation often acted as a barrier to me
gaining the most from the placement experience. Before travel to India, when I would read a
burn nutrition journal in preparation, I would worry about everything I didn’t know “will I be
expected to know all these requirements and formulas?” These kinds of thoughts made me feel
anxious and resultantly I resigned to let the experience unfold. On placement I would often
shadow trainee Dieticians at the hospital. The trainees were first enthusiastic in attempting to
offer explanations in English, though understandably they often found it too much effort and
would switch to talking in Hindi. I would try to remain engaged but resultantly in these
situations, I felt both isolated and useless. Had I gone to the effort to memorise a few Hindi
phrases, I know I would have been treated with more respect and involved more often. Looking
back, I see why I became anxious and failed to prepare in these instances. I also see that the
thought process that led to inaction is counterproductive as any lack of preparation will only led
to further anxiety at a later date. Looking forward, I feel that gaining this understanding will
benefit me as I lookto prepare for presentations and interviews.
Although my lack of preparation was at times an issue in communicating, I do feel that in a
broader sense I was placed in many situations which led me to develop my communication
skills. I was immersed in a clinical environment and surrounded by health professionals; as a
result I soon learned to adopt a professional communicative style when interacting with
colleagues. I was also aware that I was the only Western Caucasian male working at the hospital
and was resultantly the subject of much attention. I felt flattered at the time but understood that
I needed to remain professional, enthusiastic and disciplined in order to warrant attention.
My communicative and organisational skills were tested daily when I would work on gathering
data for my research project. Over the 20 day placement period I approached a range of health
professionals and handed out my questionnaires at locations spread across the hospital grounds.
It was my responsibility to follow up on the study participants to ensure they had completed all
forms. At the time I used my logbook to record when and where I would need to go the
following day to collect my data. I was able to achieve the aims detailed in my learning contract
and collected over 50 completed questionnaires. At the time I felt empowered, Cattaneo &
Chapman (2010) would attribute this to the result of personal goal achievement. I believe the

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experience taught me that at my best I can be organised and intrinsically driven. Looking
forward, this gives me confidence that I will be able to approach self-managed tasks with the
right attitude.
On the Burns Unit I worked with critically ill patients who had often suffered tremendous
physical and psychological pain. I was always aware of how I conducted myself and at the time I
felt the natural response was to adopt a caring, empathetic attitude. I grew conscious of my
posture, facial expressions and eye contact. Mast (2007) highlights that such forms of nonverbal
communication are essential in developing a patient-clinician relationship. The daily work
required on the Burns Unit also afforded me insight to the responsibilities of a clinical Dietician.
Using the required literature (Gopalan et al, 2007) I would conduct the morning rounds and
calculate requirements based on the standardised formula (Curreri et al, 1974). Undertaking
these tasks, I felt a great sense of pride and started to gain first-hand experience of life as real
health professional. However, I understand that in a broader context the responsibilities of my
mentor, a clinical Dietician, far exceeded my work. I was often amazed at the workload involved.
This made me feel concerned that I would never be able to meet the rigorous demands of the job
while maintaining such impeccable time management. Looking forward, I feel a strong desire to
gain experience working with a UK-based Dietician, I suspect the workload would not be as
overwhelming and the experience would go further to informing my career choice.
There were instances on placement where I had to improvise and I believe this lead me to
further develop my communicative skills and self-belief. On one occasion I was sent to one of
Indore’s low-income communities, tasked with delivering a talk on ensuring adequate nutrition.
Having one day to prepare, I felt my seniors had rushed the planning of this trip in eagerness for
me to experience life outside the hospital campus. When I arrived, I was faced with a room of
young children. It was clear the talk I had prepared was totally inappropriate and would not
engage my audience. Instead, I used initiative and began talking about myself, life in the UK and
why I came to India. I interacted with all the children and distributed bananas which I had
thought stop and buy en route. On leaving the slum I believed I had salvaged what could easily
have been a waste of hospital staff time and resources. The trip showed me that when placed in
situations where I am required to improvise, I can remain calm, structure my thoughts and
engage while thinking on my feet.
I feel one of my biggest achievements occurred when I was tasked with hosting a clinical
meeting. I had observed surgeons presenting on new advancements in practices in a previous
clinical meeting. The idea that I had to present to a room of academic minds was incredibly
daunting. Initially I was incredibly nervous and struggled to find a topic which I could present
with confidence. Finally, I decided to present on my experience at Choithram and the aims of my
research. During the presentation my nerves settled and I was able to speak with clarity and
convey my message. Following the presentation I was relieved to find that everyone in the room
seemed satisfied. My mentor congratulated me on a great presentation. Looking back, I realise
this was a massive personal achievement. Beforehand, the thought of presenting at a clinical
meeting would have induced fear. Looking forward, I feel empowered by the experience and
confident that in future I will not succumb to nerves when having to speak in public. I feel this
will undoubtedly be of benefit to me throughout life.
My confidence continued to grow. Towards the end of my time at Choithram hospital, I was
tasked with writing an account of my Interburns experience. Initially I felt very apprehensive. I

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knew that my mentor, the Director of Interburns, and Interburns staff members would all be
interested in reading it. I felt determined to write a good account and affirm that the right
decision was made when I was awarded the placement opportunity. At the time I had no
internet access at my accommodation and was worried that without reflective examples and
models I wouldn’t be able to convey my experience in a professional, concise form. To my
surprise, once the Interburns director read my work it was published on the official website
(Interburns, 2014). At first, viewing my own published writing felt surreal. Reading it now gives
me strength that I can achieve more than I often give myself credit for.
Overall I have learned a lot about myself over the process of this reflection. I now have a greater
understanding of my negative tendencies in preparation and how at times my mind set can
create many problems for me. I also believe I achieved my aims set out in my learning contract.
However, I’m also aware there still so much within the nutrition field I still don’t know. I do feel
that my placement experience has really equipped me to tackle the coming year and I am
looking forward to gaining the knowledge needed to apply myself in life after university. Overall,
the experience working in India has led me not just to reflect on my strengths and weaknesses
in areas of my personality but on my whole outlook. Experiencing life on the Burns Unit opened
my eyes in many ways. I have found it very difficult to put in to words how exactly the tragedies
I have witnessed have actually improved my outlook. I think it’s because I realise how incredibly
fortunate I am to be able to live the kind of life that I do. I feel I owe it to those I briefly met and
befriended to seize opportunities that will never be afforded to them. I am optimistic that I will
be able to draw on the lessons I have learned and carry the experience with me in to the coming
years.

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References
Cattaneo, L, B., Chapman, A, R., 2010. The Process of Empowerment A Model for Use in Research
and Practice.AmericanPsychologist[online]. 65(7).646-659.
Curreri, P, W., Marvin, J, A., 1974. Advances in the Clinical Care of Burned Patients. Medical
Progress [online]. 123, 275-281.
Emanuel, E, J., 2000. What makes clinical research ethical? The Journal of the American Medical
Association.283, 20.
Gopalan, C., Rama Sastri, B, V., Balasubramanian, S, C., 2007. Nutritive Value of Indian Foods.
National Institute of Nutrition, Hyderabad.
Interburns, 2014. Burns Nutrition Fellowship at Interburns Training Centre [online]. Available
from: http://interburns.org/burns-nutrition-fellowship-interburns-training-centre-india/
[Accessed 22 September 2014]
Mast, 2007. On the importance of nonverbal communication in the physician-patient interaction.
Patient EducationandCounselling [online]. 67(3),315-318.