Nikki:

Many Universities in the USA are/will be offering the tDPT after evaluating
a portfolio. What additional credits are required after evaluating the
portfolio can mostly be taken through distance learning. Has the PT
educational community in the UK considered such an approach?

I understand that the University of Edinburgh is a leader in the distance
education and technology in teaching areas.

Douglas M. White, PT, OCS

I've been following this one with great interest ! As a clinician, and
ex-senior lecturer in Physiotherapy.

I have several points:

Here in the UK we already have professional autonomy from the point of
qualification. Anyone training before the early 1980s gained a diploma as
their professional qualification. Anyone training after this may have gained
a degree as courses gradually gained degree status. Now all Physiotherapy
training courses are at honours degree level.

 This has caused rather a hamster-in-a-wheel effect for those qualifying
several years ago. To keep up with the qualifications of new graduates,
there's been considerable pressure to do a top up degree of some sort. The
wise ones opt for a Masters degree, but this takes a leap of confidence if
you've not written an assignment for a while. Many have gone for an Honours
degree, only to discover that they then need to go on an get a Masters.  The
effort of combining a further degree with work and maybe family commitments
is substantial. Most of it inevitably gets done on the kitchen table and
home PC after a long day. Getting paid time off from work is not easy, the
culture is changing slowly but pressures are huge - even if some time off is
granted, it is rare to have your clinical hours covered in your absence. As
a profession there seems to be wide acknowledgement that academic
development is important - but we are such a caring lot that the immediate
pressures of the current case load and waiting list tend to take precidence
over the longer-term & wider benefits of researching. Anyone who succeeds in
jumping these hurdles to the point of Doctorate level has exceptional
stamina & determination -this simply is not an option for the majority of
Physiotherapists.

I feel very strongly that there is a great need for properly funded,
research therapists, who can do their very valuable stuff in work-time,
collaborating with, and thereby educating and inspiring, other clinicians.
This type of post is very rare, and usually connected with an educational
institutution rather than the Health Service. Some Extended Scope
Practitioner, or Consultant Therapy posts where active research is part of
the job description are cropping up with increased frequency, but again I
suspect the clincal workload will be what gets done in work time.

The other big problem in the UK is that the grading structure in the NHS
simply does not encourage development. It is quite possible to reach the top
increment of the top clinicial grade about 8 years after qualifying, without
doing any research at all. We need a "SuperClinical" grade so that people
can develop their clinical specialties to include research, and a culture to
match ! What happens at the moment is that good clinicians leave the shop
floor to teach or to go into management or private practice. Where is the
research option ????

Thanks for the soap box opportunity, I feel better for that!

Nikki Adams   [log in to unmask]


----- Original Message -----
From: "Frank Conijn" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, August 07, 2001 5:40 PM
Subject: Re: DPT


> That's indeed a good point, Jason, "should we put that in the hands of
> students who have never treated a patient by themselves?". It could indeed
> well be that students do not yet have the clinical insight to be able to
> determine what would be a useful research topic.
>
> But then: would that differ from the other medical educations? It seems to
> me that medical educations that are universitarian, and that require
and/or
> facilitate medical research, deal with the same problem. Still, I have
never
> seen a government or insurance company question classical surgical
treatment
> for chronic spinal problems, with respect to the cost-effectiveness ratio.
> At the same time however, PT is constantly criticised for being
non-evidence
> based, and/or being non-cost-effective.
>
> This discrepancy is starting to **** me off, when I look at the equally
poor
> scientific foundation of surgery.  I'm a (professional) literature
> researcher, and when I look at the number of RCTs that compare surgical to
> non-surgical treatments, the number in itself is devastatingly low, and
the
> number that prove surgery to be more cost-effective is even lower. In
fact,
> zero!
>
> That's why I would like to see much more research being done by PTs, and
> would love to do research myself, for that matter. The thing however is:
> means and coaching....
>
> R.,
> Frank
>
>
>
> ----- Original Message -----
> From: "Jason Steffe" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: dinsdag 7 augustus 2001 1:02
> Subject: DPT
>
>
> Frank,
>
> Many of the professional programs in the United States do grant the Master
> of Science in Physical Therapy degree which all have research components.
> The program that I graduated from awarded a MS in PT and had a
full-fledged
> thesis requirement from beginning to end (public and private defense).
Most
> if not all of the projects were hampered by lack of funds, lack of time
and
> lack of experience by the investigators.  I can only think of one or two
> students from my school that have gone on to a PhD.  I believe that my
time
> would have been better spent learning more about how to treat a patient
than
> learning about research.  It would've made me a better clinician coming
out
> of school.
>
> I don't see how a few more PhD's in peripheral fields is more important to
> our profession than clinical doctorate's in Physical Therapy.  I agree
that
> our profession needs more research, but should we put that in the hands of
> students who have never treated a patient by themselves?
> --------------------------------------------
> Jason Steffe, PT, MS, MTC
> Physiotherapy Associates
> 1901 Phoenix Blvd, Suite 205
> College Park, GA. 30349
> Ph: 770-907-1023
> Fax:770-907-5608
>