Consider this list:
- Participatory action research
- Ethnography
- Case study
- Narrative ethnography
- Discourse analysis
- Grounded theory
- Visual methods
- Feminist
- Critical humanism
- Photo-voice
- Queer theory
- Mixed method
- Performance ethnography
- Constructivist
- Critical arts-based inquiry
- Oral history
- Online ethnography
- Conversation analysis
- Memory work
- Interpretive phenomenology
- Autoethnography
- Q methodology
- Ethnomethodology
- Historiographic
- Institutional ethnography…
This list is just a sample of some of the different approaches to data collection, text generation and analysis that are part of the growth of qualitative, and theoretically and philosophically-informed research now taking place in health care. (If you’d like to get a sense of how comprehensive and wide-spread this world of research has now become, take a look at the catalogue of books now available through just one health research publisher here.)
There is nothing particularly exclusive about these methods; certainly nothing to say that they are beyond the understanding of physiotherapists. They are agnostic about the person or profession that might wish to make use of them. So their uptake is largely dependent on the knowledge of the user, and the suitability of the question being posed.
With one or two notable exceptions though, the items on the list will be almost entirely alien to most readers. And yet these approaches offer some really valuable ways to interrogate our practice, our ideas and theories, our past, present and future.
Why is it that physiotherapists have been so slow to join in with doctors, nurses, psychologists, occupational therapists and others in taking advantage of these new approaches?
I couldn’t agree with you more, David. I wonder how much of this mindset (“if it can’t be presented as a number then it can’t be of much value”) is linked to our professional past? Your “History” post (https://criticalphysio.net/2015/09/14/new-histories/) got me thinking about how much we can learn about our current position by understanding more about where we come from. I’m not familiar with our history, although I have bookmarked “Chipchase et al. (2006) – Looking back at 100 years of physiotherapy
education in Australia” in an attempt to make a start. I also came across the NZ 100 year archive (http://www.100yearsofphysio.co.nz/) and will have a look at that as well. Anyway, my point is that I think it’s a great idea to spend some time learning where we came from so that we can better prepare for our future.
And now for the point I started off wanting to make. I have no evidence for this other than my own intuition based on observations, but I think that our profession has a deep inferiority complex that goes back to our origins and that we make up for it in part by trying to always do “hard science”. Many of us have forgotten that we work with people, not with knees, and we need the profession to embrace the “soft sciences” and come back to the notion of working with people instead of parts of people. It’s time to take the RCT off it’s pedestal and acknowledge that it is a gold standard in one context only and that for all of it’s power in that one context, it still lacks the ability to explain why something happened. It has the power to predict (in that one context) but not to explain. As you said, we don’t need more research on hamstring strains (or lower back pain). We need to better understand how human beings work and for that we need to get inside their heads, not their joints.
Note: I have made some generalisations in this comment. I understand that there are many physiotherapists who treat patients holistically.