'Observation is essential to expertise in medicine, and yet clinical training lacks a standard model for teaching and learning how to look. Interacting with visual art is exactly the kind of practice-based experience that is required to learn to look effectively. Learning to see brings many unexpected benefits: quite literally, opening eyes opens minds. Arts Practica proposes a model for learning observation in the context of art museums to improve quality in the clinic.' This quote comes from 'a medical education consultancy [called Arts Practica, which is] committed to improving healthcare quality, reducing misdiagnosis, and increasing arts engagement (link). Physiotherapy is so much … [Read more...] about New: Looking
New: Histories
I’m speaking purely for myself here, but I feel that physiotherapy doesn’t really need any more quantitative research on hamstring stretching. I think we’ve seen enough evidence that pain is aversive, and that putting scores on complex conditions critically misrepresents the condition, the person’s lived experience, and the benefits of physiotherapy. Where I feel we could definitely do with more research - particularly these days, where we are increasingly looking for ideas about how physiotherapy might need to change in the future - is research about our past. Not just accounts of past events, although even some of this would be nice, but historical works that connect to messages … [Read more...] about New: Histories
New: Truths
One of the inescapable realities of modern life, or should that be post-modern life, is that we have all become skeptical of authority figures that want to tell us that they know the answers, and that we should follow them compliantly, passively and unquestioningly. There once was a time when people genuinely believed that the church, judges, the police, school teachers, parents, doctors and other authority figures genuinely knew best, but our trust in these authorities has been eroded by scandals, self interest and injurious practices. And while some of us yearn for a simpler time when the world was black and white, we can’t erase the image of child abuse by Catholic priests, medical … [Read more...] about New: Truths
New: Money
A lot of really interesting attempts to change the way health care is being delivered are foundering because people can't work out how to fund them. There are certain pockets of money available: seed grants and step-change funds that get projects started, but often these are term-limited and there is rarely any chance of ongoing funding. One of the unspoken principles underpinning a lot of new models of health care (including primary care, health promotion, inter professional practice, patient-centred care), is that they will cost less, (or at least they will shift the responsibility for payment onto the individual and away from the state.) But few people have yet worked out ways to … [Read more...] about New: Money
New: Normals
Think about how much time you spent learning about the 'normal' body in physiotherapy school. Think about how much time you spend in clinical practice assessing people to see what's 'abnormal.' And all of those clinical trials that develop sensitive, reliable and valid measures of activity, bodily function, movement and pain; all based on some universal notion of normality. Tests and measures have to assume that there is one universal normal for them to be universal. So, in principal, a score of 13 on the Modified Borg Scale means the same thing in Afghanistan as it does in Alaska, and a BMI of 28 is obese no matter where you live. Physiotherapists learn the principal of … [Read more...] about New: Normals
New: Stories
For reasons I've never really understood, physiotherapists seem really reluctant to tell their work stories. I'm not talking about the conversations we've all had with our partners, families and friends about interesting clinical problems we've faced or patients we've treated, but rather the kinds of things that give us pause to reflect on what we're doing, or make us think that there's a lesson here that others could share in. A long time ago, doctors, midwives, nurses and psychologists recognised the value of stories, giving birth to the whole idea of narrative-based medicine and the medical humanities. But physiotherapists have been slow on the uptake. The latest edition of the … [Read more...] about New: Stories
New: Activism
Many years ago, I was one of the first of the new student reps to attend the CSP’s annual Congress. Back then Billy Bragg was railing against the Miner’s Strike and the IR department of the CSP reigned supreme. It became obvious pretty quickly that people took Congress really seriously. The first motion I remember being discussed was a levy on member’s fees to raise funds for Nicaraguan Freedom Fighters. Sadly the motion went no further after being referred to Council, where it ended up disappearing like gold in the San Juan rivershed. Not long after the Congress I attended an Association for Chartered Physiotherapists in Respiratory Care meeting and was dismayed to hear the keynote … [Read more...] about New: Activism