Connection

I like to try to find connections among various aspects of my life that may not seem well connected.  This may occur by connecting people from different realms (someone from church and someone from the lab who have a shared interest), connecting my interests with those who are outside of my discipline (a current education project with a PharmD student), or in connecting common themes across different experiences (content related to my therapeutic practice and a course entitled Self Efficacy).  Finding connections between differences feels satisfying.

I was struck when reading through various blog postings and comments that there has literally never been a time that I have engaged in dialogue with classmates over the content of a class that was as lively as that which has occurred over the past week.  In most of my training, there are very precise pieces of information that is presented in courses, integrated into the knowledge bank of the human body and movement as a whole, then applied to whichever patient fits that scenario.  This type of information rarely leads to debates over theories or word choice or anything for that matter.  The origin and insertion of a muscle or the range of motion of a joint or the innervation of a motor unit or the cranial nerve affecting such and such…  In professional training, I memorize, integrate, and apply.  Move on.  To participate in discussion that evokes emotion, debate, controversy…  A world previously unknown to me in an educational context.  (Aside: One might infer from previous mentions of my family life that our household is not devoid of such things.  Just health sciences education perhaps.)

So, weekly, I am trying to connect my frame of reference to this new learning environment and style.  When I read, I subconsciously must be looking for connections, trying to make it all fit.  So, when I was reading an article called “Shared decision-making in physical therapy: A cross-sectional study on physiotherapists’ knowledge, attitudes and self-reported use”, it was clear that self efficacy fit right in.¹ Joy of joys!  I would not have known to consider self efficacy in reading this article before this class, so I am thankful for being introduced to a new perspective.  The article was reporting the findings of a study that measured the knowledge, attitudes and self-reported use of shared decision making (SDM) between physical therapists and their patients.  In summary, level of knowledge of the practice of SDM varied, but overall attitudes among therapists about including patients in care decisions and treatment planning were positive.  Interestingly, the authors report that “[k]nowledge on SDM was associated neither with attitudes nor with use…”¹  There was an apparent disconnect between knowing about the practice, thinking it was good and using it.

I have also been learning about signature pedagogies in professional training programs.² There is a recent interest in defining what the signature pedagogy is for physical therapy training programs.  After attending a discussion about this very topic in DC, I could not help but to conclude that physical therapists may not feel confident in their ability to implement a practice strategy outside of their training paradigm, such as SDM.  Limited self efficacy in the practice may stop PTs from trying to include patients more either because they don’t know how to start or they tried a few times and didn’t have much success.  To confirm my suspicions and to build my efficacy in connecting PT to self efficacy, Topp et al. threw me a bone in their conclusion by stating that including shared decision making in curricula of PT education may help to resolve the discrepancy between knowledge, attitudes and implementation.¹ I would add that the curricular elements must stretch beyond just knowledge sharing to implementation strategies to promote the practice.

I’ll spare you further comment, but my PT brain is inclined toward goal-setting, so I was in connection heaven in reading “Cultivating competence, self-efficacy, and intrinsic interest through proximal self-motivation”.³ What a delight!

1.         Topp J, Westenhöfer J, Scholl I, Hahlweg P. Shared decision-making in physical therapy: A cross-sectional study on physiotherapists’ knowledge, attitudes and self-reported use. Patient Educ Couns. 2018;101(2):346-351. doi:10.1016/j.pec.2017.07.031

2.         Shulman LS. Signature pedagogies in the professions. Daedalus. 2005;Summer.

3.         Bandura A. Cultivating competence, self-efficacy, and intrinsic interest through proximal self-motivation. Journal of Personality and Social Psychology. 1981;41:586-598.