Learning professional touch: an exploration of pre-registration Physiotherapy students’ experiences

Abstract

Physical touch is considered a core competency in Physiotherapy, central to clinical reasoning and communication. Nevertheless, there is a dearth of research into how the skill is learned and the experiences of students in that process. The aim of this paper is to explore that learning experience among pre-registration physiotherapy students. An approach underpinned by phenomenology and ethnographic methods was undertaken over an 8-month period in one Higher Education Institution in the UK. Data came from a series of observations and focus groups, complemented by personal reflective learning diaries with first-and second-year undergraduate students. Focus group data were analyzed thematically and triangulated with other data sources. Three themes were developed: 1) 'Uncertainty, self-awareness and anxiety' explores the discomfort experienced in the early stages; 2) 'Emerging familiarity and awareness of inter-action' demonstrates developing confidence in bodily capability and communicative capacity; and 3) 'Realities of touch in a clinical environment' focuses on the shift from the pre-clinical to clinical context and highlights the cyclical processes of embodied learning. This study highlights the complexity and immediacy of the embodied learning of touch and its interactions with the development of professional identity. Negotiation of boundaries, both seen and unseen, creates jeopardy in that process through the first two years of the course.

Forming and shaping of professional identity within pre-registration physiotherapy curricular: A scoping review

“…The findings suggest that there are different factors which contribute to the forming and shaping of professional identity expressed in different ways dependent on an individual's 'self', skills, curricular, program and location (Adams et al 2006;Lindquist et al, 2006b;Kyte et al, 2018;Norris et al, 2020;). Self-encompassing values attributing to the person which is developed through skills that are encountered through pre-registration curricular.…”

“…Thematic analysis was the most frequently adopted data analysis method to analyse common occurring themes of the participants of the studies (Lindquist et al 2006b;Davies et al, 2011;Furze et al, 2011;Kyte et al, 2018;Grace and Trede, 2013;Roskell, 2013;Fernandes et al, 2015;Stephens and Ormandy, 2018;Wormley et al, 2018;Harman et al, 2019;Norris et al 2020). Exploratory factor analysis and ordinary least squares regression model for variables as outcome measures were used in the quantitative article (Adams et al, 2006).…”

“…Shaping of professional identity was influenced by the location that a pre-registration physiotherapy student was situated in. These included the physiotherapy workforce (Norris et al, 2020), community engagement experiences (Furze et al, 2011), role emerging placements (Kyte et al, 2018), observing clinical supervisors and lectures at university (Grace and Trede., 2013) and E-learning experiences (Nortvig, 2017). These findings were similarly replicated in the literature of shaping and forming of medical, nursing, occupational therapy, and psychology professional identities during pre-registration education (Goodolf, 2018;Volpe et al, 2019;Goodolf andGodfrey, 2021, Gray et al, 2020;Heeyoung and Boyung, 2021;McLean and Pecoraro, 2021).…”

The utility of physiotherapy assessments delivered by telehealth: A systematic review

“…For example, MSK special tests and neurodynamic testing were less reliable and valid when completed using telehealth systems than when performed face-to-face. This is not surprising, given the extensive training and experience that physiotherapists possess in manual handling and the value that the sense of ‘feel or touch’ can add to interpretation of assessments [ 87 ]. Those assessments that involved the use of questionnaires also appeared to be more valid and reliable than some other types of assessment, when conducted via telehealth.…”

How Do You Touch an Impossible Thing?

“…But physiotherapy has always historically taken a narrower view, confining itself to bio-physical understandings of touch or, more recently, Nordic phenomenologies inspired, most especially, by the works of Merleau-Ponty and van Manen (6,(43)(44)(45). Of course, other theoretical aspects of touch are periodically discussed in the physiotherapy literature (46)(47)(48)(49)(50)(51)(52)(53), but the emphasis always remains firmly grounded in the humanistic.…”