Underresearched areas of Physiotherapy.

[Lauren_April]

Hey all,

I am currently a 2nd year physio and i have to decide upon a research question to study. As alot of you are out there working in the world of physio, i thought you may be the best place to start.

What areas do you think need more research carried out in???

Thanks,
Lauren x

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[physiobob]

HOw about looking at something non-clinical such as "How much time is devoted to the teaching of business related management, marketing, PR in UK (or wider universities) as it relates to the running of a private enterprise". This could be the running your own private practice, running a fund holding NHS type practice, running a Hospital.

To often we see nurses rise to Hospital Director positions, we compete in the public (private) market place against numerous complementary medical professionals. Would be nice to highlight the lack of training in this area. As more physio schools acknowledge this lack of basic training the more they will be able to offer it as an incentive to pick their course above other who do not offer it.

[gcoe]

Hi Lauren_April

As research is a generative process there is virtually always more research that is useful in just about any area of inquiry. There is no such thing as an over-researched area. Good research results always produces all sorts of new and interesting questions that we need to know more about. And then there is the scientific principle of replication. Studies should be replicated in different localities with different populations. so repeating answers to questions is an essential part of scientific inquiry.

At your level you will be contributing something that is meaningful but it is quite limited and you should be thinking about something that is quite contained. One thing to consider is the research interests of your superivsor(s) as they may have one piece of a larger research questions that they want answering. For example conducting a clinical trial would be way too ambitious. Projects that can be quite contained could be examining a single measurement property of an outcome measure in a different population. Or a small qualitative study examining the experiences of patients of an aspect of physiotherapy. A case study of a novel treatment could be another. A survey of physios, or patients about some aspect of physiotherapy can also be quite contained. Of course this all depends on the requirements of your school. Getting ethics approval can be quite a mission so for a student project you may want to consider something that doesn't involve patients - usually getting ethics approval from a university committee (not involving patients but say involving healthy students) is less difficult than getting approval from health and disability ethics committees.

This might sound contradictory to what I just said about aligning your project with that of your supervisors. However it is important that you can get passionate about your topic. Choose something that you can really get interested in. You will be putting a lot of time into it and if it is something you are really interested in this will sustain you during the difficult times.

So think about areas that really interest you so far. And try to engage your supervisor. What has really interested you about physiotherapy so far?

[estherderu]

Hi Lauren April

I would say, if one area has been under-researched, that area would be the skin.
I find that many of us know too little about what the reactions of our body are to being touched ( by massage, electricity, sonor etc). We, most of us are still hands-on professionals, work with the skin all day, and we know so little about it......

I agree with Gcoe that you definitely have to feel at least a bit "extremely" interested in whatever you choose.

Good luck with your choice

Esther

[namratasnv]

Yes, You are right, as one area which is has to be covered is skin and I think in the near future we will surely get some new ideas and treatments for this by the help of Physiotherapy.

Thanks
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[Christopher.pl]

I agree with Physiobob.

When I left university, I had alot of theoretical knowledge and practical experience from the various clinical blocks. But when I grabbed an opportunity to take open my own practice, I had no clue how.

At university we learnt alot. Physiotherapy isn't a Mickey Mouse course. We learnt anatomy, physiology, pharmacology, orthopedics, neurology, physiotherapy techniques and even proffessional development and leadership. But we learnt nothing about the ins-and-outs of practice set up, management, marketing and the likes. This is a huge gap in the physiotherapy curriculum. At the end of the day, we are just 'the physio' in hospitals and clinics with physiotherapy skills and not much more.

I don't know of any ambitious physiotherapist who is the director of a clinic or hospital (private or public) or who is even sitting-in on board meetings.

Good luck with your research Lauren.
PS: Have fun with it.

[gcoe]

Yes I agree Christopher.pl.

Entry level education is just that - an entry point to the profession. A starting point. There are always huge compromises to be made about what to include in an educational programme and what has to be ditched because there just isn't enough hours to pack everything in the limited time available. I know our faculty has frequent robust debates about what needs to be in and what has to be left out. We all have our pet favourites about what should be included to make a better course. I would like to see a better grounding in exercise science and its application to special populations, and biomechanics along with a better ability to work with the research evidence. I know one of my colleagues would like to see a much better coverage of manual therapy as that seems to have suffered in recent years, while someone else thinks we should be including more cultural competence and being more responsive to community needs.. But in the end no one gets exactly what they believe is optimal.

Recent years has seen students being better prepared theoretically but the clinical experiences are limited, particularly as opportunities in clinical practice has expanded. Things like how to manage a practice, manage a team, negotiate change in the workplace just doesn't get a look in

There is also the disconcerting fact of life these days: the half-life of the profession. That means the time it takes for half of what you learnt at university to become obsolete. The half life in medicine is about 3 years and for physio we don’t have any estimates but it probably isn't much longer. So we have to do a good job preparing graduates for world that changes.

Personally I think I learnt one heck of a lot in those first two years out in the real world. I used to blame the educational institution I trained in for not preparing me well enough. However while there is always room for improvement in physiotherapy education, I think we have to be realistic about what can be achieved in that very short time it takes to go from knowing nothing about physiotherapy to being able to competently stand your ground as a therapist.

[Fyzzio]

Well said, gcoe, I agree wholeheartedly.
However well you try to set up a programme, there will be gaps, as 4 years cannot possibly cover everything which we will encounter in the medical world.
And that also reflects the fact that we will always learn, wherever we go.
Physiotherapy is so versatile and our working environment varies so much from job to job and country to country. I am more than 20 years postgrad and have still not yet met 2 patients that presented exactly the same.

I think that it is vital to touch on certain aspects like professional development and management in undergraduate education, however I do not believe it is responsibility of a BSc Physiotherapy programme to bring up business managers, teachers, or similar. We will have to except that these areas are professional specialities in themselves and will require expert training.

As to the research topic: I agree, there is lots of areas which have not been loooked at (nice idea about skin/ touch), however since you are a year 2 student, and it is likely to be your first project, I would keep it simple and look at some of the questions you might have already asked yourself during patient encounters.

Have fun,
Fyzzio