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curriculum physiotherapy

Exposing the culture of professional practice

I often forget that learning is not only mediated by social relationships, but by cultural relationships as well. To a large degree we are the products of influence that emerge from interactions between thousands of variables within our families, groups of friends, communities, religions and countries. The process of becoming a physiotherapist is also embedded within a culture of the profession, and we forget that our system of values, social norms, belief systems and language is largely hidden to the student when they first arrive on campus. Not only is the world of academia a new culture for most of them, but then within that system is the sub-culture of physiotherapy education.

We spend a long time developing ways and means of teaching students the technical components of physiotherapy, but have very little in place to explicitly and intentionally induct them into the culture of the profession. We expect them to “pick it up” over time by a process of osmosis. Technical skills are relatively easy to teach: “Put your hands here, press this hard, so many times”. Knowing when to do that particular mobilisation, and why, is a lot harder to teach. Without knowing the when and the why, we’re little more than trained monkeys.

I believe that part of coming to know when and why to do certain techniques is partly related to the culture of the profession. Students must feel a sense of belonging to something that is more than the sum of a set of knowledge and techniques – a sense of becoming someone who is more than a trained monkey. I think that we can achieve this in some part by making explicit our social norms, values and belief systems, thereby exposing students to the culture of the profession.

The problem is that there isn’t much room in the curriculum for these aspects of professional practice, so we need a space for informal conversation in a way that the ideas and culture of the professional community can be shared in a normative way. We often make assumptions about what students (don’t) know and understand. As practitioners, we have developed a professional literacy over many years, but since our current state of knowing is tacit (it’s just part of who we are), we forget how we came to this point. We often forget that our students have not had the many years of experience that leads to the development of patterns of thinking and ways of being that we just know, and so we have expectations around performance that they cannot match.

I think that we can use online social spaces (i.e. social networks) to externalise and  make explicit the culture of the profession, exposing the hidden, tacit knowledge that students can use to orientate themselves to professional practice in a process of becoming a physiotherapist.

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