I’m coming up on my 15th year as a physical therapist. It’s hard to believe, as I still feel so young and I still have so much to learn!
Over the years, I’ve spent many weekends in courses, trying to become a better physical therapist. Earlier in my career, I would walk in, wide-eyed and hopeful that I was going to learn the ‘one thing’ that I was missing from my skill set…another tool for my toolkit.
Over the years, I’d like to think I was more helpful than harmful , but I don’t have any data to support that. I can recall smooshing on ‘trigger points’, trying to release very specific muscles, and giving ridiculously long home programs. I followed protocols, and made a very organized binder of Muscle Energy Techniques.
I would often go home a bit tired, because I spent the day trying to figure out what I was doing wrong, trying to figure out why some people got better and some didn’t. I spent lots of time, energy, and money hoping my next class would be the one where I’d walk out with the skills that would let me help more people.
Then I started hanging out with Sandy Hilton. And reading more research. And talking about what we know vs. what we do vs. what we say we’re doing with researchers and clinicians from all over the world.
It was discussions like these that really made me reconsider how I was looking at continuing education.
How To Start Critically Thinking About Your Continuing Education.
Below is a list of four methods I like to use when picking my next CEC. While it can be tough making these choices at the start, it has been a really beneficial way to start changing my outlook and my practice for the better.
1. Look for courses that teach you principles, not protocols.
- Recipes are wonderful when you’re baking. However, people are not all the same. Trying to make everyone fit the same box results in lots of ‘non-responders’ or ‘non-compliance’
2. Look for instructors who don’t mind being questioned, and question them.
- It’s often said that if you’d really like to learn about something, teach about it. I believe this is true, and it’s not just the research to teach a topic! I learn so much from people asking me questions, or asking me to further clarify something I’ve said. None of us know everything, so instructors who rely on people just following instruction are actually just looking for followers. Which takes us to the next point…
3. Question what you’re doing and why!
- Sometimes it pays to act like a three year old: ask why, a lot. To yourself or out loud. Or a slightly more mature approach that I learned from Sandy Hilton is, “can you walk me through that?”. There should be answers as to why people do what they do. There can be discussions as to why what they are doing may work. You should be able to discuss, defend or explain what you’re doing.
4. Choose courses that challenge your beliefs.
- Having people agree with you can feel fantastic! But if you constantly surround yourself with people who agree with you, it’s not likely you’ll come to have a deeper or broader understanding of much. Move out of that comfort zone, and at least consider alternatives to your usual way of doing things.
A New Perspective
Any class or lecture I was attending was no longer a quest for an answer, but rather gathering more information to review and question my current practice.
I embraced that I could walk out of a class and think ‘Nope, I’m not going to do that’. The most wonderful part about realizing I was allowed to critically think about why I was choosing to do (or not do) things in the clinic. I realized I was allowed to respectfully disagree and question ideas. I finally realized that there were no magic answers, and the best we can do is strive to be less wrong.
It was so freeing to say ‘I don’t know’! To embrace the unknown, to acknowledge that I would have to actively work to know more, and even then I would get it wrong.
One thing these realizations did was make me start to question the people I was learning from.
What’s interesting, is that some people embraced my questions and my challenges! And that’s when it hit me: I didn’t need to learn any specific technique! I needed to be a better critical thinker!
A large majority of the continuing education for Physical Therapists (at least in the United States) seems to focus on specific techniques, some involving expensive trademarked tools. Some ‘techniques’ require several levels of training to become ‘competent’. Other courses seem to promise the impossible (or at lease biologically implausible).
The purpose of this post is not to discourage any technique or school of thought. It is to encourage questioning! And thinking! And discussion! And to challenge your biases. (Because we all have them!)
Now when I go to courses, I don’t plan on learning anything to actually do. I plan on listening with an open mind, gathering information, and looking at my entire practice. I’m much more vocal asking questions when points don’t seem to be supported by science or seem to contradict what is commonly accepted. As healthcare providers, we feel a need to do things, to help our patients or clients feel better and be healthier. So on the quest to be better (and we can all be better), acknowledge that the next technique you learn won’t be any more magical than the last one you learned. However, if you reflect and think critically, you may just be able to use what you already know to be better.