This post begins in Geneva. I'm sitting in the foyer of the Palexpo and quickly jotting down all my thoughts of the past three days of learning, networking, and laughing with international physios from all corners of the world. Everyone told me I was going to have a great time at the 2019 World Confederation for Physical Therapy (WCPT) World Congress but, if I’m being completely honest, I wasn’t sure what I was going to take away from it.
And now everyone can say “I told you so!” because it was nothing short of fantastic. I sat in sessions that I’ve never or rarely seen at sports medicine conferences. Sessions on behaviour change, leadership, diversity and inclusion, physical activity promotion, technology and informatics, and more. It’s lead me to reflect on myself as a clinician, as a researcher (well, PhD candidate anyway), and as an overall human being! So that’s why I wanted to write about some things that I learned in general and about myself over the last week. Time for #reflections.
1. BEHAVIOUR CHANGE. People say “nobody likes change” and I get that. It explains why I always order pad thai with tofu from my favourite restaurant (it is SO good, why would I get anything else). Change can be scary and unpredictable (hmm yellow curry, I dunno). Even when you can rationally see that taking on a change could or would likely lead to something positive (belly full of yummy thai food), it can still be a large leap of faith.
So if I’m hesitant to change, why am I forcing my patients to suddenly change and adopt healthy behaviours? Admittedly, I’ve tried to coerce a patient or two to start exercising, eat healthier, quit smoking, and all of that. My guess is that you have too. We do it because we want the best for our patients but what happens if that person in front of you isn’t ready for change? It can be frustrating to stand idly by when you know there’s something you can do or discuss that will help your patients but sometimes you have to be, well, patient (sing it for us, Alanis!).
My take home from this brilliant behaviour change discussion session was that we, as physios, must recognize that we cannot force people to change. Just as we need to prepare how to facilitate change, our patients need to prepare to accept change. We need to meet halfway – not 75/25 or 60/40. The patient ultimately is the one who decides if they are ready. And if someone isn’t ready, that’s okay. We continue to check in and leave that door ajar for when they are.
2. LEADERSHIP. We're now shifting lens from behaviour change to leadership and mentorship but some of the messages are quite similar. At the risk of sounding like a broken record, the success of a mentor-mentee relationship also relies on this 50/50 balance. It makes sense that if the mentor isn’t teaching or guiding, that the mentorship isn’t effective. The vice versa is true as well. If the mentee isn’t willing to learn, absorb, ask questions, be afraid to make mistakes, then the mentorship also falls apart. Let's engage, y'all! Let's go full in!
Who am I?
Where am I?
Where am I going?
How am I going to get there?
Even if you’re not seeking to be a leader, these are some excellent self-reflection questions. Since all my (three) friends have now left me (tear), I’ve had some time to ask these questions of myself. I know who I am (aka some crazy lady rambling on about quality of life) and where I am (into year three of my PhD). But I’m not sure where I’m going after it’s done (assuming it doesn’t kill me first) and, therefore, don’t know how to get there. The uncertainty is both exciting and stressful at the same time. It’s something that I will continue to reflect on and slowly piece the “how” together as I gradually figure out the “where.” And if anyone has any ideas, let me know :)
Gross, enough about me. Back to Phil (I'm pretending we're friends so I can call him by his first name hehe)! Phil also mentioned that people’s true colours will show when they’re under pressure. Can Declan still follow through on his ideas under pressure? (Yes) Can Karen still support her peers under pressure? (Yes) Can Tracy still voice her perspective under pressure? (Yes). How someone acts or reacts under pressure can tell you a lot about their ability to lead. In my case, I’m very fortunate to be surrounded by some badass leaders.
3. DIVERSITY & INCLUSION. I won’t lie, writing this is makes me squirm a bit. That’s because it’s a very important subject in physiotherapy and I don’t want to get it wrong.
Let’s start with the difference between these terms. Diversity represents all the differences among us – age, gender, ethnicity, socioeconomic status, educational background, personality traits, etc. Inclusion is being involved or engaged at whatever capacity or degree someone is comfortable with. The analogy goes: diversity is being at the party but inclusion is feeling comfortable to dance or not dance, play music that you enjoy, and be on the party planning committee. And as Tracy Blake would say, these go together like peanut butter and jelly.
And we all know physios can party! Wait, no, that’s not the point here.
Getting back on track... If we think about diversity and inclusion in the context of physiotherapy, we raise our awareness of how people of different ages, genders, ethnicities, etc might deal with an injury and experience pain. As Uchenna Ossai said, it's about recognizing that health goes beyond an individual’s choice. That there are systems of power in place that may positively or negatively affect a person’s ability to seek and receive care. Imagine you are treating a patient who has ruptured their ACL (sorry, these are the limits of my imagination these days). How would you change your treatment if this person came from a low socioeconomic bracket? Or if this person was Muslim and practiced fasting during Ramadan? Or if this person experienced anxiety and fear of public spaces like gyms? You surely would adjust your treatment plan accordingly!
This topic has really stuck with me. I've found myself thinking about it on a daily, almost hourly, basis which is likely a #reflection of its importance coupled with my lack of knowledge about it. Thankfully, my good friend, Tracy, put together a few calls of action to help you and me understand and navigate diversity and inclusion:
Be accountable. Use your power as a physio to create a space where your patients are empowered to use their voice when they can or where you can advocate for their needs and rights when they cannot.
Be reflective. Learn from your great moments and not-so-great moments. Think about how your training and previous experiences align with your core mission (re-read those four Phil Glasgow questions) and how they might allow you to help your patient in their recovery journey. Examine your professional development habits – what are you reading, watching, attending and why? When was the last time you engaged in something not centred on your technical skills? (My answer was this session and holy dyna, did it ever make me think.)
Be critical. Diversify your evidence based and read a few qualitative papers or non-healthcare books. Develop your critical appraisal skills (I second this!) and join a journal club (and this too!). Engage with researchers and other stakeholders. Put your money where your mission is.
For more info about diversity and inclusion in physiotherapy, I strongly recommend you check out the WCPT policy statement on this very matter.
I still have HEAPS to learn in this realm but I look forward to the journey. And I invite you to join me! The way I look at it is: there is NO way I would want to be trapped in a room with 50 other Christina Le’s. We would all make terrible jokes to fill the awkward silence, attempt to sing Disney songs despite only knowing 1/10 of the lyrics, and passive aggressively fight over the last bits of pad thai. Build relationships with people from different backgrounds, acknowledge your strengths and weaknesses, challenge your biases, and recognize and embrace the diversity of your patients and colleagues.
Now I sit at my coffee table in my home. And as much as I love my home, I still wish I was waiting for the no.10 bus to the Palexpo.
So thank you, WCPT. Thank you for making me realize how our amazing our global community of physios is. Thank you for the opportunity to listen to and share ideas with these amazing physios. Thank you for selecting me to present on a sports injury panel with people much smarter than me from Brazil, Taiwan, Rwanda, Chile, and Switzerland. Like – what? How cool is that?!
And finally, thank you for three incredible days of learning and growing. Three days of laughing and dancing with old friends and new friends. Three days that have inspired me to act a bit more thoughtfully, think a bit more critically, and search a bit more often for new things to learn!
- Chris [@yegphysio]
PS. Want more? Luckily for you, many sessions were live-streamed and recorded. Hit this link to watch a few - including that leadership symposium with Phil Glasgow!