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Dahl-Michelsen T.1, Groven K.S.2
1Oslo and Akershus University of Applied Sciences, Oslo, Norway, 2Oslo and Akershus University College of Applied Sciences, Oslo, Norway
Background: Over the last few decades, evidence-based practice has become increasingly predominant in physiotherapy programmes. This competence is crucial to ensure that a new generation of physiotherapists choose treatments that are proven to be effective. The focus on evidence-based practice highlights the need for campus-based students to develop the skills necessary to find and critically evaluate relevant research literature. It also draws attention to the need for student practice placements to train students in evidence-based practice. However, the focus should also be centred on how physiotherapy education can enable students both to develop the required clinical skills and to take their starting point from the patient's values and needs. From an educational point of view, it is essential to acknowledge the significance of these aspects of competence to evidence-based practice in physiotherapy. However, we have limited information on how the physiotherapy student's view of the competent physiotherapist intersects with thinking on evidence-based practice.
Purpose: The purpose of this paper is twofold. First, we seek to explore how physiotherapy students view the way that the competent physiotherapist relates to their understanding of evidence-based practice. Secondly, starting with Karen Barad's theory of agential realism and intra-action, we aim to add a more critically informed dimension to the discussion of evidence-based physiotherapy within physiotherapy programmes.
Methods: The empirical data derive from interviews with eight physiotherapy students who had themselves encountered physiotherapy prior to their enrolment in physiotherapy education. The analysis pays attention to the way that physiotherapy students view the relationship between the competent physiotherapist and different components of knowledge within a hierarchal and a circular model of evidence-based practice. Enhancing the discussion on evidence-based practice, we take a closer look at the limitations of these different models in physiotherapy treatment.
Results: The findings reveal that physiotherapy students view the competent physiotherapist as one who has knowledge based on external evidence. Their primary emphasis, however, is on the relational competence of the physiotherapist. This latter implies the ability to involve the patient in the physiotherapy treatment process. Based on the concept of intra-acting, we emphasise how knowledge as evidence on an aggregated level, knowledge as clinical experience and knowledge as patient values and preferences are co-constructed phenomena that become evidence-based practice within an embodied physiotherapy encounter.
Conclusion(s): Evidence-based practice within physiotherapy educational programmes appears to be a more nuanced phenomenon than the debate has so far acknowledged. The main point of this paper, however, is that evidence-based practice is not a fixed entity but rather the practice of becoming.
Implications: More knowledge is needed about how evidence-based practice is taught and perceived by students within the context of physiotherapy education.
Funding acknowledgements: This work is unfunded
Topic: Education
Ethics approval: Ethical approval was not required. The Norwegian Social Sciences Data Services (NSD) authorised the study. Participants signed informed consent letters.
All authors, affiliations and abstracts have been published as submitted.
