Physiotherapy beyond Our Borders: Investigating Ideal Competencies for Canadian Physiotherapists Working in Resource-Poor Countries

Abstract

Purpose: To explore the perspectives of Canadian physiotherapists with global health experience on the ideal competencies for Canadian physiotherapists working in resource-poor countries. Method: A qualitative interpretive methodology was used, and the Essential Competency Profile for Physiotherapists in Canada, 2009 (ECP), was employed as a starting point for investigation and analysis. Semi-structured one-on-one interviews (60-90 minutes) were conducted with 17 Canadian physiotherapists who have worked in resource-poor countries. Descriptive and thematic analyses were conducted collaboratively. Results: The seven ECP roles-Expert, Communicator, Collaborator, Manager, Advocate, Scholarly Practitioner, and Professional-were all viewed as important for Canadian physiotherapists working in resource-poor countries. Two roles, Communicator and Manager, have additional competencies that participants felt were important. Three novel roles-Global Health Learner, Critical Thinker, and Respectful Guest-were created to describe other competencies related to global health deemed crucial by participants. Conclusions: This is the first study to examine competencies required by Canadian physiotherapists working in resource-poor countries. In addition to the ECP roles, supplementary competencies are recommended for engagement in resource-poor countries. These findings align with ideas in current global health and international development literature. Future research should examine the relevance of these findings to resource-poor settings within Canada.Key Words: world health; developing countries; competency-based education; qualitative research. RÉ SUMÉObjectif : Analyser ce que les physiothé rapeutes du Canada qui ont de l'expé rience en santé dans le monde pensent des compé tences idé ales des physiothé rapeutes canadiens oeuvrant dans des pays pauvres en ressources. Mé thode : À partir d'une mé thodologie d'interpré tation qualitative et en nous fondant sur le Profil des compé tences essentielles des physiothé rapeutes au Canada, 2009 (CEP) comme point de dé part de l'é tude et de l'analyse, nous avons procé dé à des entrevues personnelles et structuré es (60 à 90 minutes) auprè s de 17 physiothé rapeutes du Canada qui ont travaillé dans des pays pauvres en ressources. Des analyses descriptives et thé matiques ont é té ré alisé es en collaboration. Ré sultats : Les sept rô les relié s aux CEP-expert, communicateur, collaborateur, gestionnaire, promoteur, é rudit et professionnel-ont tous é té considé ré s comme importants pour les physiothé rapeutes canadiens qui travaillent dans des pays pauvres en ressources. Deux rô les, soit ceux de communicateur et de gestionnaire, comportent des compé tences supplé mentaires que les participants ont jugé es importantes. Trois rô les nouveaux-apprenant en santé dans le monde, penseur critique et invité respectueux-ont é té cré é s de fac¸on à dé crire d'autres compé tences lié es à la santé dans le monde jugé es cruciales par les participants. Conclusions : Il s'agit de la pre...

How are Canadian universities training and supporting undergraduate medical, physiotherapy and occupational therapy students for global health experiences in international low-resource settings?

“…2 Furthermore, students may be unaware of the various power differentials existing in GH settings and of their impact: a combination of north-south relations, of the very nature of the professional-patient relationship and of the students' privileged background. 5,[28][29][30] Finally, local culture, history and language were hardly addressed at all in PT and OT, yet a basic understanding of these is essential in developing cultural competency. 3,8,17,28 To align themselves with current recommendations, universities might consider standardizing their PDT content to include general GH and placement-specific knowledge, ethics and critical thinking, cultural humility and cross-cultural communication, as students may not automatically have the knowledge, attitudes or skills necessary to be effective and appropriate in multicultural and low-resource health care settings.…”

“…14 Given Canada's cultural diversity and its many low-resource settings, concepts related to critical thinking and humility that emerged in GHE training could be relevant for all students. 28 Moreover, cultural competency and cross-cultural communication training are considered critical core components of professional practice. [25][26][27]32,33 As certain programs offer their PDT to mixed groups of students (i.e., ILR, IHR and IH), it seems important to highlight specificities that practicing in IH settings warrant, especially considering the recent publication by the Truth and Reconciliation Commission (TRC) in 2015.…”

Clinician's Commentary on Clarke et al.

“…Physiotherapists must also further cultivate essential competencies as strong collaborators and advocates to forge connections among organizations, government, and people with disabilities to facilitate sustainable outcomes. 4 Of the expanded essential competencies for physiotherapists in global health, 5 the competency of critical thinker , which involves reflective analysis of one's own motivations, position, and actions as well as those of the various CBR stakeholders, is especially relevant for effective CBR practice.…”

Discrepancies Between the Motivational and the Skill Factor in Choosing the Physical Therapist Profession

“…These are joined by the ability to make clinical decisions, or character traits, such as: politeness, amiableness, gentleness, * E-mail: gabigmares@yahoo.com correctness, seriousness, etc. (Cassady et al, 2012;Sander et al, 2016;Kurunsaari et al, 2015;Tilson et al, 2016).…”