AN EXPLORATION OF EPISTEMOLOGY IN PHYSIOTHERAPY PRIVATE PRACTICE IN IRELAND

M. Dowling¹, D. McCormack¹

¹Maynooth University, Adult Education, Maynooth, Ireland

Background: Epistemology is concerned with theory of knowledge and for physiotherapy contexts, it considers where knowledge comes from and how physiotherapists know what, why and how to do what we do in practice. There are many epistemologies in physiotherapy and this research explores different types of knowledge used by physiotherapists working in private practice in Ireland. While practitioners may not be familiar with the term epistemology or have had formal chances to explore theirs, this research seeks to examine the types of knowledge that are privileged and emulated, and in active use by practitioners.

Purpose: This research formed part of a professional doctorate in education for the primary author. It developed from a personal disconnection between epistemologies of some disciplinary research to generate evidence for practice and epistemologies used in practice.
It aims to illuminate practice knowledge in use by physiotherapists that may not be visible in research outputs.

Methods: A qualitative approach was taken to explore epistemologies in practice. Twelve physiotherapists in private practice in Ireland participated in semi-structured interviews. Data was analysed using a 3-step thematic analysis approach.

Results: The findings of this research suggest that the processes of professionalisation and an identity aligned with medico-scientific knowledge leads practitioners to position themselves alongside epistemologies of evidence-based practice. This research also finds that despite not seeing it in research outputs, tacit craft knowledge is strongly utilised by practitioners and is acknowledged and valued by them in their work. The physiotherapist practitioner respects and sees value in evidence-based practice but navigates through their practice drawing from multiple epistemologies, many of which are from the craft knowledge domain, like personal knowledge and knowing from experience that allows them to participate with their patients in a profoundly relational way.

Conclusions: This research provides an illumination of physiotherapy private practice in an Irish context. It examines knowledge sources in use by clinical practitioners and finds that craft aspects of practice are fully appreciated, though not easily articulated, and are felt to be beyond research in the format these physiotherapists are most familiar with.

Implications: Craft aspects of knowledge that are felt to be beyond research may tend to be silenced by aspects of knowledge more easily researched. Room for exploration of epistemology in physiotherapy curricula would be useful to help physiotherapists identify knowledge sources that are crucial for physiotherapy practice.

Funding acknowledgements: This study was not funded by any agency

Keywords:
Epistemology
Craft Knowledge
Knowledge Sources

Topics:
Research methodology, knowledge translation & implementation science
Education
Professional issues

Did this work require ethics approval? Yes

Institution: Maynooth University

Committee: Social Research Ethics Sub Committee

Ethics number: SRESC-2018-076