It's quite common these days to see advocates of a more 'holistic' healthcare practice championing the Biopsychosocial (BPS) Model. In areas where healthcare has become increasingly complex - where people's individual values and beliefs can't be avoided, and where people's social context affects their lives so palpably that a biomechanical approach to assessment and treatment is simply inadequate - the BPS model is promoted as a way forward. But is it as sound as people seem to think? The BPS model was initially proposed by George Engel as a ‘unified concept of health and disability’ (Engel 1960) and was based on a very particular form of positivist psychology called General Systems … [Read more...] about Is the Biopsychosocial Model all it’s cracked up to be?
A very interesting thing has been happening with the CPN blog in recent weeks. After publishing two relatively controversial blogposts - one on Six useless treatments and the other titled There are no new treatments in physiotherapy, we saw a big spike in members and enquiries through our email service. The post There are no new treatments in physiotherapy has been accessed more than 15,000 times on Facebook, and Six useless treatments nearly 13,000 times. These might not be particularly big numbers for Justin Bieber, but they are for most groups in physiotherapy. What is it about these posts that made them so popular? Based on some of the emails we received after they went … [Read more...] about Desperately seeking evidence
In a recent article by titled Listening-touch, Affect and the Crafting of Medical Bodies through Percussion, Anna Harris discusses the effect that technology has had on the loss of doctors' physical assessment and treatment skills. The article focuses on the technique of percussion - the 'listening touch' as she calls it, that comes from percussing the chest to perceive the density of underlying tissues. Here's the abstract for the paper, and here's a link to the paper itself: Abstract The growing abundance of medical technologies has led to laments over doctors’ sensory de-skilling, technologies viewed as replacing diagnosis based on sensory acumen. The technique of percussion has … [Read more...] about What skills are you losing?
Physiotherapists, like all orthodox western health professionals, love endings. Think about it. Every time we begin a new patient assessment, we have got one eye on the patient's discharge. We love goals and outcome measures so that we can measure when milestones have been reached and end-points achieved. It seems every opening to a new episode of care comes with an implicit expiration date. Naturally, funders are eager that packages of care are limited and treatments don't extend on into days, weeks and months, and we seem to have accepted the inherent logic that care must have term limits. Time-limited care suits acute illnesses and injuries that are, by definition, … [Read more...] about New: Openings
For this post, we're linking up with Michael Rowe in South Africa and his excellent site /usr/space. Michael is a physiotherapist and educator in South Africa, with a passion for teaching and learning. He is an active member of the Critical Physiotherapy Network and a regular blogger on health care education, pedagogy and technology-informed learning. Earlier this week, Michael posted a blog exploring the possibilities of assessing teams, not individuals. Assessing teams instead of individuals Patient outcomes are almost always influenced by how well the team works together, yet all of the disciplines conduct assessments of individual students. Yes, we might ask students who … [Read more...] about New: Assessment
Some people reading this blog may be old enough to remember a time when physiotherapists, occupational therapists and other professions allied to medicine were trained in colleges and schools attached to large teaching hospitals. Others will have only known the university system. For most of us though, the university holds a special significance. It is where knowledge is acquired and one discovers the rudiments of one's future practice. (Of course, we all know the real learning takes place in the clinical environment, but this only serves to enhance the ivory tower image of the university and the people working within it). You used to go to university to acquire an education and a … [Read more...] about New: Open badges
"It seems easier to far too many teachers to imagine that students do work the way machines do — that they can be scored according to objective metrics and neatly compared to one another. Schools, and the systems we’ve invented to support them, condition us to believe that there are always others (objective experts or even algorithms) who can know better than us the value of our own work. I’m struck by the number of institutions that for all intents and purposes equate teaching with grading — that assume our job as teachers is to merely separate the wheat from the chaff. And I find myself truly confused when anyone suggests to me that there is a way for us to do this kind of work … [Read more...] about Teaching and learning has always been subjective