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Research,Physical Therapy

Physical Therapists, if You Hate Research, Read This

If you asked PT students to name their least favorite class in school, I imagine the following classes would be the most common responses: ethics; practicum or seminar course; and then research. That’s a shame. It’s not hard to understand why students and clinicians avoid research. It’s not easy to read and isn’t a lot of fun. You wouldn’t take a stack of research articles to the beach. It requires concentration and effort. Sometimes you have to read an article several times before it makes sense. There are a lot of numbers, a lot of statistics, and a lot of terminology that even experienced clinicians don’t understand. For this reason, many physical therapists decide that research is for researchers and academia only, and is irrelevant to practicing clinicians…it’s not!

“It certainly requires extra effort and time to become familiar with the nuances of interpreting research, and that is probably the biggest barrier,” states Eric Chaconas, assistant program director at the University of Saint Augustine, FL, and also a Fellow of the American Academy of Orthopedic Manual Physical Therapists (FAAOMPT). “I believe it’s rare for someone not to see the value in research but it is very common for some of us to lack the skill or interest in conducting and reading research in detail.”[i]
In the 1st installment of this series, I’m going to list 4 reasons why you should and must read research consistently.

1) Personal and professional growth through research

Research (Pubmed) is how we progress as individual clinicians and as a profession. Unfortunately, there are many physical therapists who haven’t read any research since they graduated from PT school. You know who I’m talking about: the clinic director in a nursing facility who has worked there for 30 years. It’s hard to believe that they can deliver high-quality care to their patients when they’re still doing knee-to-chest exercises and diathermy to treat back pain. Imagine going to a cardiologist who hadn’t read a single article about the heart in 20 years and still thinks eating cholesterol raises your cholesterol! No, thank you.

“Integrating current best evidence into ones practice improves outcomes and reduces mistakes,” says Chaconas. “You want your healthcare provider to be utilizing the most up to date and effective information, and that is why research is important”.

2) Competency

Janet Bezner, the former deputy executive director of the APTA, says we need to stop talking about continuing education and start talking about continuing competence.[ii] There is little evidence that weekend courses produce better results.[iii] If you want to be a competent physical therapist, you need to be constantly learning new ideas and new techniques. More importantly, though you need to focus on removing bad ideas and bad techniques. You can’t rely on a couple expensive weekend courses to make you a better PT. You must become a better PT every day.

3) Ignorance

Warren Buffett, the great investor and president of Berkshire Hathaway, once said you should discard at least 1 of your most cherished ideas every year. Start with 1 idea, but if you want to be a great physical therapist, you should discard at least 3 or 4 every year. There are a lot of fads in this profession and you need to be able to identify them as soon as you can so you don’t waste time and money. If you’re treating the patients the same way you treated them 5 years ago, you’re doing something wrong. Rehab science is constantly evolving, and it’s evolving fast. Charlie Munger, Buffett’s vice-president at Berkshire Hathaway says, “spend each day becoming a little bit wiser than you were when you woke up. Discharge your duties faithfully and well. Step by step, you get ahead, but not necessarily in fast spurts. You build discipline by preparing for fast spurts. Slug it out 1 inch at a time, day by day. If you live long enough, most people get what they deserve.”[iv] Reading research will make you less ignorant, but you must be consistent.

4) Fulfillment

Staying current on research will make your career as a PT more fulfilling and more rewarding.

Complacency and stagnation will kill you as a physical therapist.
You will get bored and you won’t care about your patients. You will be going through the motions. If you constantly modify the way you practice and treat patients, you are less likely to burn out, you will be more motivated, and most importantly, you will be a happier human being.  “It actually makes for a more enjoyable career,” says Chaconas. “You get out of the monotony of doing the same old thing and integrate a more contemporary approach to patient care.”

Conclusion

Research is not dull, it’s exciting. Reading a systematic review might not be as fun as reading Fifty Shades of Grey, but it’s necessary. With the right attitude, you will no longer need motivation to do it, but will find it intriguing. If you say you don’t like research, you’re saying you’re satisfied with the status quo and are not interested in changes or new advances. Instead, you should wake up every day and ask yourself these questions:

1. What am I going to learn today?

2. Who am I going to meet?

3. How am I going to be a better clinician today?

4. What am I going to know today that I didn’t yesterday?

5. How is the world going to change today?

We live in a time of rapid change, and you should have a desire to know what’s next. In my next installment, I will show you actual steps that a busy clinician or student can take to stay up-to-date on current research.

We want to hear from you! What are your favorite sources for research? Do you have a “go-to” journal that you read religiously or an online resource? Let us know in the forums section or comment below.

References

References

[i] Personal correspondence, 11/10/2015.

[ii] PT Podcast. http://ptpodcast.com/episode-4-janet-bezner/. Accessed on November 8th, 2015.

[iii] Brennan GP, Fritz JM, Hunter SJ. Impact of continuing education interventions on clinical outcomes of patients with neck pain who received physical therapy. Phys Ther. 2006; 86:1251–1262.

[iv] Kaufman P, Wexler E, Munger C. Poor Charlie’s Almanack. 3rd ed. Walsworth. 2005.

Cleland JA, Fritz JM, Brennan GP, Magel J. Does continuing education improve physical therapists’ effectiveness in treating neck pain? A randomized clinical trial. Phys Ther. 2009; 89:38–47.

Rodeghero R, Wang YC, Flynn T, Cleland J, Wainner R, Whitman J. The Impact of Physical Therapy Residency or Fellowship Education on Clinical Outcomes for Patients With Musculoskeletal Conditions. J Orthop Sports Phys Ther 2015;45(2):86-96. Epub 10 Jan 2015.

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