PMC, 2 years later

As we near the 2 year mark of the end of data collection for the ambitious Physio Moves Canada project (and as I consider the value in paying for another year of website subscription), it feels like it’s time for a quick update on what’s been happening since. Some day, hopefully not far into the future, I’ll sit and write a proper reflection on the experiences since the end of this paradigm-shifting experience for me. What I initially thought would be a relatively straightforward focused ethnography of practice innovations in Canada, and some thematic analyses of threats, opportunities, and concepts like mobility, has grown into far more. The growth and evolution in my own perspective over the past couple of years, driven largely by exposure to other terrific and alternative thinkers in the rehab space and beyond, has meant that progress has been slightly slow as I feel increasingly compelled to make sure I do as right as possible with the information I’ve been given.

As far as key deliverables I initially set out to achieve, they’ve all been hit. There have already been two related publications in the scientific journal Physiotherapy Canada (here and here) with 2 more currently in press (early versions are here and here). While the publishing timeline for these 4 pieces has been unexpectedly long, already they are beyond the 3 papers I originally had planned. There have been several other dissemination initiatives, including a number of conversations and interviews through both traditional and digital media (news magazines, local TV spots, podcasts, etc…) mostly in 2017 and ‘18, there have been invited keynotes and presentations at large conferences and professional gatherings both within and outside of Canada, and there have been countless other personal one-on-one or small group discussions with leading thinkers that have been both challenging and deeply inspirational. However, and this is the critical component to all of this, I will continue to be haunted by the question of ‘has anything changed?

I am now more than ever deeply committed to making sure I do right by those 100+ clinicians who participated in some part of this project, and the groups who provided funding to see it through. The threats papers, representing 3 of the first 4 publications, are interesting and will hopefully stimulate some discussion when they are out in the wild. But as I look at the broader corpus of information collected, I see far more that can come from it. I am now finding myself exploring critical social concepts, such as those of scholars like Foucault and Bourdieu, of critical behaviour theorists like Ryan and Deci, Higgins, and Maslow (with whom I’d had some familiarity prior to this project). And new critical disability and rehab scholars, like Nicholls, Gibson, Setchell, Teachman, Davis, and Rudman. I am challenging myself with questions to which the answers are from clear: What exactly is physiotherapy? What is a good physiotherapy outcome? What should count as physiotherapy knowledge and how should we be generating and appraising it? What is it that our community and society really needs from this discipline, and are we providing it? To borrow from prior scholars: What is the grand question to which physiotherapy is meant to be the answer? What are we doing when we are doing what we do?

I believe the information in front of me, if interpreted correctly, can provide a glimpse of what is hiding behind some of these questions. For example, if over 80 clinicians submitted invitations for the PMC team to come and see their practice innovations, that must mean that there is a ‘base of standard PT practice’ from which these clinicians consider their alternatives as ‘innovative’. If we can uncover the (conscious or unconscious) assumptions of biases that lead these to be considered ‘innovative’, does that mean we can start to define the boundaries of ‘traditional’?

Now I find myself however with another potential problem, which is not unique amongst scholars, and that is to know when to just stop thinking about things, reading other things and collecting additional knowledge, and when to simply start writing. Like those earlier questions, not as easy to answer as one might think. For example, when I write the reflection on this academic journey and my own thoughts on who we are and where we’re going, how can I be sure to do so in a way that opens space to allow conversation but does not come off as directive or prescriptive?

It is a good project that results in the researcher questioning the way he/she/they thinks and changes him/her/them as a person, and that is what has happened here. As I find myself attempting to integrate new ways of thinking and new approaches to inquiry I’ll admit I’ve been quite deliberate in how I handle the remaining data. The publication process so far, having been rather lengthy, has also forced me to rethink the best avenue for dissemination, and that remains at the back of my mind. There will be at minimum two additional papers and a reflective piece yet to come, though they may not come through traditional means of scholarly dissemination. Stay tuned.