EXPLORATIONS OF STRATEGIES FOR INCLUSION FOR NEWLY QUALIFIED PHYSIOTHERAPISTS FROM RACIALIZED MINORITY GROUPS IN A LARGE, URBAN NHS TRUST, UK

C. Turner¹, T. Bhandari², G. Jones^1,3, J. Jones¹, J. Hammond⁴

¹Guy's and St. Thomas' NHS Foundation Trust, Physiotherapy, London, United Kingdom, ²Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, Paediatric Haemophilia Centre, London, United Kingdom, ³Centre for Human and Applied Physiological Sciences (CHAPS), King’s College London, London, United Kingdom, ⁴St. Georges University, Physiotherapy, London, United Kingdom

Background: Previous research demonstrates that student physiotherapists from racialized minority backgrounds experience behaviors by others that marginalize them, and expend energy deploying strategies in efforts to belong. It is uncertain whether newly qualified physiotherapists from racialized minority groups experience similar behaviors, deploy similar strategies, or modulate themselves in the transition from student to professional working.

Purpose: First, we aimed to understand the experiences of newly qualified physiotherapists from racialized minority backgrounds at a large, urban NHS Trust in London. Our second aim was to co-create and implement strategies hypothesized to affect current work culture based on our initial findings. These collective aims were intentionally formulated to contribute to meaningful and sustainable change.

Methods: The project used an action research design with co-creation principles and was in 2 phases. Phase 1 (January-July 2022) explored the experiences of inclusion for newly qualified racialized minority staff and the themes identified were used to co-create strategies for inclusion. Phase 2 (July-Dec 2022) implemented the strategies and developed an evaluation framework to monitor project outcomes including data collection tools, a survey, and further interviews. In phase 1 participants were invited to join focus group discussions either for newly qualified racialized minority staff, newly qualified white staff, or senior staff. Focus groups were digitally recorded, transcribed verbatim and analyzed thematically. Co-creation sessions were facilitated by two leads and generated solutions associated with the focus group findings. Phase 2 data analysis was undertaken by a researcher independent from the source data collection.

Results: Phase 1 findings - Seventeen newly qualified physiotherapists (8 racialized minority and 9 white colleagues) and 10 senior physiotherapists participated in 7 focus groups. Thematic analysis revealed four themes; 1) A fear spectrum where all colleagues struggled to find a common ground for discussing race, 2) An additional burden for racialized minority staff in belonging in the physiotherapy department, 3) The culture of the organization and the contradictory impact on racialized minority staff, and 4) The processes for consistent work practices giving an illusion of inclusion. Participation in co-creation events consisted of 17% of all physiotherapy staff. Six areas of focus for action emerged: Promoting allyship, Being authentic (work self vs personal self), Having inclusive conversations (during social interaction and about race at work), Diversifying social events, and Reforming recruitment.

Conclusions: The findings reflect previous studies that racialized minority individuals experience additional burdens not fully understood by their white peers. To our knowledge this is the first known study to develop co-created solutions to facilitate culture change necessary to affect the status quo in the physiotherapy workplace. We plan to continue to implement and evaluate the solutions in Phase 2 and beyond.

Implications: Our findings have implications for the department which are currently being enacted and evaluated. We also contend that these findings are relevant for the wider organization and other disciplines. While not intended to generalize, the model of co-creation may be used as an exemplar within physiotherapy departments and across other healthcare professions.

Funding acknowledgements: This work was funded by the Guys and St Thomas’ Charity.

Keywords:
Social inclusion
Racial minorities
Physiotherapists

Topics:
Professional issues: diversity and inclusion

Did this work require ethics approval? Yes

Institution: Guys and St. Thomas's NHS foundation Trust

Committee: Therapies and rehabilitation Directorate Goverance Committee

Ethics number: 13293