Part Three: A New World – Broadening the MSK Physiotherapy Offer

Exploring the role of Practice Education in broadening our approach

In this week’s Clinical Insight, the final installment of our three-part series, we explore a broader approach to MSK practice. This exploration of how MSK physiotherapists can influence the wider elements of health when developing a clinical plan has been central to this series, and we now want to close this off with some thoughts regarding the development of the next generation.

Focus on Practice Education 

Student education is built around numerous models; one of those being practice education. It is here that as clinicians we can influence the next generation. As clinicians it is vital that we positively affect change through how we support the students of today to become fantastic clinicians.

These students are prime for considering the wider elements of an MSK presentation as they are continually working across boundaries. Respiratory, neurological community, ward etc based practice is second nature. It is only when they move into roles that the narrowing towards specialism begins.

So, how in our MSK worlds how do we ensure we can draw that learning out in a seamless fashion whilst also offering that next steps of knowledge and experience?

Challenging our Practice

Firstly, we need to challenge our own practice and instil the broader reasoning, intervention planning and explanations to our patients. Integrating and weaving in the medical and drug history with supportive solutions that cross MSK and beyond requires (as per our last two publications) that change in how we approach the broader needs of the population.

Secondly, students must be encouraged to think across boundaries with focus not just on the MSK side of the presentation but far wider across a population need. And that requires the educator to ask the right questions, not just focusing on MSK issues, but health and wellness as well.

Thirdly, to de-mystify an MSK diagnosis aiming to wipe away unnecessary time spent on physical tests and lists of questions that do not change the diagnosis or inform the outcome. This leaves time for the broader exploration and supporting change in health and wellness behaviours that will help in that cross boundary, broader assessment.

Developing Reasoning Skills

Lastly, to offer permission to students to reason in a different way. That complexity is the person not the condition and whilst learning is a challenge in this space, practice educators need to ensure they use the reflection on practice with students to develop those reasoning skills. Development of reasoning in MSK should perhaps not be through the numbers of patients seen but in the depth of assessment and broadening each one as far as possible.

This inevitably is a challenge, but with population health needs widening, physiotherapy has to think about now, and the future in term of impact, and that must include the education of the clinicians of tomorrow.

You can also read Part One and Part Two of our ‘A New World’ series.