learning by doing 2016

FYSIOTERAPI INN I FREMTIDEN

FREDRIKSTAD 11.10.2016

#fysiofuture

A game changer changes the way that something is done, thought about or made.

Todays game changers

Todays supporters

These are the rules Please respect the speakers and keep to time Talking to eachother at coffee break and lunch is

obilgatory Please feel at home, we are here for you Questions during sessions in any two ways

- email svein@mskklinikken.no- personal message facebook to svein kristiansen

Associate Professor Mr Roger Kerry, University of Nottingham UK

LEARNING BY DOINGHolder det ?Svein Kristiansen

Manuellterapeut, spes i manuellterapiFysioterapi inn i fremtiden, Fredrikstad 2016

#fysiofuture

INTEGRATION OF KNOWLEDGE IN PRACTICE

TYPES OF KNOWLEDGE

CLINICAL KNOWLEDGE

RESEARCHKNOWLEDGE

INTIUTIVEKNOWLEDGE

THEORETICAL KNOWLEDGE SITUATIONAL

KNOWLEDGE

EXPERIENCALKNOWLEDGE

EXECUTIONALKNOWLEDGE

ETHICAL, MORAL

KNOWLEDGE

MODERNPHYSIOTHERAPIS

T

CONSEPTUALISATION OF PRACTISE #1 Clinical practise is the execution of worthless skills, theory og

scientific knowledge to solve, in a simple mechanical way, preassumptive clinical entities.

Knowledge is unproblematic and objective.

Eraut 1994, Fish 1998, Fish & Coles 1998

CONSEPTUALISATION OF PRACTISE #2 Clinical practise is the execution of priniciples and context

dependent decisions through improvisation, inventions and tests, to construct and solve complex and linked uncertain and hypothetical clinical entities.

Knowledge is socially constructed, discussed and worthy

Eraut 1994, Fish 1998, Fish & Coles 1998

CONSEPTUALISATION OF PRACTISETechnical rationality=Hard and solid ground

Professional artistry= Swampy lowland

Can I really be bothered to think?

Could we drift through clinical practise for 40 years and do ok?

Comfortable in the grey?WISE CLINICAL DECISION MAKING ?

Wise clinical decision making(the original defintion of evidence based practise)

Clinicalexpertise

Scientific Evidence

Patient values and goals

Is it possible to be ‘a EBP physio’ i 2016?

About 64 scientific journal articles pr month About 30 articles in each journal About 15,360 pages with ‘evidence’ each month

How do you develop clinical expertise?

ALL Knowledge ClinicalReasoning

Understanding clinicl practise related to ALL

knowledgeExperience

Conseptualisation of practise

Developing clinical expertise? Physiotherapist must be able to engage in their own

practiseFind time, make time and have the ability to think

critically and objectively around their own practise. Be able to accept and challenge new ideas and change practise (behaviour)

Is this possible through the post grad education system we have today?

What do we do with all this (shit) knowledge?

Peter O’ Sullivan via SigMikk 26.05.2016

•"...we have to change what we value in a consultation. The advice we give and the strategies we empower people with are maybe way more important than the (manual) techniques we apply."

"...but I'm in there with my hands. Because TOUCH is a powerful communication tool that can guide people to safely move. The (manual) skills are very useful, but the thinking is different.“

https://www.facebook.com/groups/manuellterapi/

Physiotherapists, please read and understand published data, but realise that this data is only meaningful when positioned within the narratives and socio-cultural contexts of our patients and our own experiences. Allow data – if sufficient – to free yourself from traditions and habits. Don’t be swayed by preposterous gadgetry and pretty colours but always look towards the data to drive positive ways of developing your practice. Stop handing out leaflets.

www.rogerkerry.wordpress.com

The easiest thing is to stop being a disciple, and start to think for yourself. A bit like a professional would. Ignoring biological aspects of our patients’ complaints is evidence-based silliness. Calls to abandon a biomedical model is evidence-based moronicy. And downright dangerous. Psycho-social dimensions are of critical importance to our reasoning and management. So is differentiating non-specific back pain from aortic aneurysm.

www.rogerkerry.wordpress.com

HOW ABOUT IF WE JUST KEEP GOING?

Our perceptions, our appreciations and beliefs are rooted in the worlds of our own making that we come to accept as reality (Schon, 1987)

Spørsmål?Svein Kristiansen

Manuellterapeut MSK Klinikken ASwww.mskklinikken.no

www.facebook.com/mskklinkkenwww.twitter.com@sveinekr

#fysiofutureEpost: svein@mskklinikken.no

Telefon: 46973828

#fysiofuture