I enrolled on the Health Studies PhD programme at Oxford Brookes in February 2018. This is both incredibly exciting and pretty daunting, as I will be studying part-time trying to juggle the PhD alongside my lecturing position and the manifold other commitments that come with being a dad and partner in your mid 30s.
A key part of my learning is going to be developing the discipline to read methodological and subject specific literature; critique, assimilate and synthesise this with my existing knowledge and ideas in order to articulate my evolving conceptions of the existing literature and my own research project. To that end I plan to use this blog as a way to record my research journey.
In the first instance I will be summarising and reflecting on my reading. The posts will be often short and probably messy. They are not intended to be a collection of polished, authoritative and comprehensive posts, but an attempt to capture some essence of my thoughts as they occur. My views will likely evolve as I read more and progress along the PhD path. The chances are they will be of no interest to anyone but me, but I would welcome with open arms any views, corrections, arguments or agreements on any of the posts.
Cheers
Ben
(The picture is of my son in beautiful Hope Cove, South Devon)
It is just over a week until we have our first stab at an In Beta session on 19th July 2017 at 2pm (British Summer Time). The session is based around my ideas for the initial sessions of a new module on the physiotherapy management of long term conditions. So I thought I would just run through how you can get involved for anyone who would be interested in discussing the teaching of physiotherapy management of long term conditions.
The first step is to join the In Beta Google+ community if you haven’t already done so by clicking this link (Google account required)
I’ve introduced my current thinking on this in a Google Doc, which all In Beta community members are able to access and edit (you can see a non-editable version here to get an idea). This is open to edits and comments already, and Michael has added a few to kick things off.
On 19th July In Beta community members will be able to join a Google hangouts online discussion, consisting of me giving a bit more of the background to my thinking on my teaching idea and responding to some of the questions raised in the document. If anyone else feels they have something particular to contribute from their own practice they are invited to informally present this too. We round things off with a discussion.
The Google doc then stays open for further edits and comments that come to people after the hangout, or from people who weren’t able to make it on the day. Once I’ve actually run the sessions, I will add further information to the document and feedback the key learning at a subsequent In Beta hangout.
In Beta is a little project that I am working on with Michael Rowe from University of the Western Cape to create a space for physiotherapy educators to develop their pedagogic practice through discussion and sharing of ideas and good practice within a digital collaborative community.
In Beta has developed from discussions that Michael and I had at ER-WCPT last year about the limitations of traditional conference formats for actually stimulating discussion and collaboration between delegates. We have since kicked around a couple of ideas around models of unconferences which place control over content in the hands of delegates and are structured to facilitate open discussion between attendees who are assumed to have knowledge to bring to the topic at hand rather than the traditional conference expert/audience set up. We have been particularly influenced by the unconference structure used in Teachmeets in primary and secondary education in the UK, and the approach to sharing of educational resources and ideas in the hundrED project in Finland.
So what is In Beta?
It is a space where physiotherapy educators can develop their pedagogic practice through open discussion and collaboration with a community of peers sharing their knowledge and experience.
In order to overcome the geographical barrier to collaboration of having relatively few physiotherapy programmes in any one country, it made sense for In Beta to be a digital space and community. To keep involvement as accessible as possible we will be using Google+ to host the community and Google apps to support collaboration and sharing of ideas between community members.
Why In Beta?
Software and website development goes through several stages of testing prior to release. The first stage is Alpha testing, in which the software is tested by a small group of people within the company developing it, this is followed by Beta testing, which is a limited release of the product to people outside of the developer company to find bugs and problems prior to the final release.
The idea of In Beta is for physiotherapy educators to bring a teaching and learning idea that they have been working on themselves or with colleagues within their institution to a group of peers in order to spark discussion, feedback and collaboration to improve and develop the original idea prior to releasing it into the classroom or clinic.
How does it work?
In Beta has a monthly topic covering an aspect of physiotherapy teaching/learning/assessment etc, brought by a member of the community (the “Developer”). Each month there is a synchronous In Beta session lasting 1-2 hours using video conferencing via Google Hangout and an opportunity for asynchronous discussion and collaboration over the following 2 weeks using Google Docs.
Members of the community put forward an aspect of their teaching/learning/assessment practice for discussion by sharing a brief proforma on Google Docs giving a little detail of their educational context and their thoughts so far on their idea (The “Alpha testing”) with the other community members on Google+
Once a month the community chooses a topic from those put forwards two weeks prior to the In Beta session. Community members who have experience, knowledge and practice to share relating to this topic have time to consider how to share this with the developer
At the In Beta session, The Developer introduces their work so far on their teaching/learning assessment idea in an informal 10 minute Google Slides presentation via Google Hangout.
After the initial presentation there is opportunity for discussion around the idea with community members taking part in the session. Community members with experience, knowledge and practice to share relating to this topic can also offer to share this via an informal 5 minute presentation
The Developer’s Google Docs proforma is open to community members to comment, add suggestions and share links and resources throughout the In Beta session and remains open for two weeks
The Developer uses the Google Doc to feedback how the In Beta process influenced their teaching/learning/assessment (The “Release Candidate”)
Developers are invited to share resources from their teaching/learning/assessment back with the community in order to build a library of resources for physiotherapy educators
How can I get involved?
Anyone with an interest in any aspect of physiotherapy education (clinical or practice based educators as well as academics) can join the Google+ community for In Beta here (Google account required).
The first In Beta session will be at 2pm (UK) on Wednesday 19th July 2017. The topic is teaching long term condition management and the background and outline of the teaching idea is available via the In Beta Google+ community.
Those of you who follow me on twitter may have noticed that I’ve been banging on somewhat about the Department for Education’s consultation on proposals to develop apprenticeship standards in physiotherapy (among several health professions) and the Chartered Society of Physiotherapists’ lack of engagement with its members over what this might mean for the profession.
First time I’ve written a letter to Frontline. Re: physiotherapy apprenticeship proposals and the importance of CSP member engagement pic.twitter.com/dQmBkpjxu4
The proposals form part of the government’s strategy to double the number of apprenticeships and increase the range of higher apprenticeships by 2020, funded by the new apprenticeship levy which will apply to all NHS Trusts from May 2017. It is suggested that an apprenticeship route to becoming a HCPC registered physio may increase the diversity of people entering the profession and improve the ability of hard-to-recruit-to trusts to find, develop and keep their own staff. These are good aims to work towards. What is clear is that this would represent the biggest change in entry requirement to the profession in the UK since we went all-graduate entry in 1992. There appears to me to be an inherent risk in the development of an alternative entry route to the profession that the two routes may not be equivalent. A two-tier system would be to the detriment of (some) patients, (some) health services and all existing and future physiotherapists. I therefore wanted to try and expand a bit on some of the questions that I have regarding whether an apprenticeship route will be able to offer a comparable experience to the current degree route in a key, but hard to define, component of a physiotherapy programme; namely, the development of critical thinking.
I guess this is where I need to declare my biases. I’m a university lecturer. Somewhat unsurprisingly, I think that the university bit of a physio degree is as important as the clinical placement bit. I think its important for different reasons and those reasons are only partly because that is where students learn “the theory”. I believe becoming all graduate-entry has allowed physiotherapy to grow as a profession over the past two decades. I think this is because going to university is about changing how you think, not just increasing what you know. It is about developing critical thinking skills through exposure to different perspectives, different ideas and different people. Its then about having time, space and encouragement to reflect on those experiences in order to raise your awareness of your own biases and preconceptions in order to challenge them. The current system isn’t perfect but the mix of academic and clinical practice in a qualifying physiotherapy programme ensures that graduating physio students have encountered and learnt from a variety of lecturers and clinicians, with different backgrounds and different ideas about practice, who work in different ways in different trusts and different teams. I believe this is essential in developing the kind of critical thinking physiotherapists able to meet and adapt to the healthcare needs of our changing society.
Apprenticeships are by definition different. Historically being an apprentice meant working for a master tradesman from whom you learnt the skills of their trade. It didn’t traditionally involve questioning that tradesman, spending time with other tradesmen to broaden your perspectives or reflecting on what you might do differently to your teacher-tradesman based on the latest peer-reviewed scientific evidence.
Clearly modern higher apprenticeships are more complex than this. Physiotherapy apprenticeships would involve a higher education institution (HEI) in elements of the training. What does remain the same however is that apprentices are employees of a trust, which would commission a HEI provider to deliver the training, whilst retaining “…full ownership of apprenticeships, designing and owning the content of all apprenticeship standards and assessments”. In the proposal being developed by United Lincolnshire Hospitals NHS Trust and Sheffield Hallam University, an apprenticeship would last 27 months with the “theory” component (their words) taking up 20% of the apprentice’s time (equivalent to 1 day a week) and 80% spent in practice working for their employer. There’s very little detail at this point in terms of how this proposal would be delivered; from whether the 1 day a week is in University with other physiotherapy students, to whether apprentices are supernumerary or included in staffing calculations.
To my mind there are a number of questions that arise from the proposals which need answering to provide reassurance that the proposed apprenticeship route won’t disadvantage apprentices compared to student physios.
Will an apprenticeship that is split 80:20 Clinical practice to “theoretical teaching” have sufficient space in the curriculum to develop critical thinking skills?
How will the development of apprentices’ critical thinking skills be monitored and assessed?
What opportunities will apprentices have to encounter alternative perspectives on practice from outside of their employer trust?
What impact will being an employee instead of a student have on the practice educator/apprentice relationship?
What impact will being an employee instead of a student have on the trust’s expectations of apprentices?
Will apprentices be supernumerary?
(Assuming the answer is no) How will apprentice’s time for learning, reflecting and thinking be protected from workload pressures, especially in the current NHS context?
What is to stop a trust removing elements of the physiotherapy curriculum that they do not consider relevant to their services from their apprenticeship standards?
Will an apprenticeship that is split 80:20 Clinical practice to “theoretical teaching” have sufficient space in the curriculum to develop research literacy equivalent to a BSc(Hons) student?
Will apprentice-route physios be eligible to go on to study for an MSc? a PhD?
Will apprentice-route physios have a qualification that is internationally recognised to enable them to work abroad?
I would love to hear your thoughts on these questions, or any of the many alternative questions that you think I should have been asking instead. This is a big, complex issue and it deserves a conversation that includes as many views as possible. Luckily, the fab folks at #physiotalk are running a tweetchat on physiotherapy apprenticeships between 8 and 9pm on Monday 9th January 2017 so if you read this in time and have opinions on the apprenticeship proposals please contribute to that as well as letting me know what you think.
Getting Better 