Lately, I've been thinking a lot about professionalism in physical therapy, more precisely, about professionalism in physical therapy education. So, too, have many others, judging from the numerous presentations and conversations about this topic at the 2004 Combined Sections Meeting of the American Physical Therapy Association (APTA) this past February. Driven by APTA's Vision 2020 statement and the vision of a doctoring profession, the recently developed and adopted document, Professionalism in Physical Therapy: Core Values,1,2 provides a valuable blueprint for physical therapy educators as they consider how to promote student learning and development as future health care professionals who will embrace and enact these core values in their everyday practice. The result of an APTA sponsored consensus conference, the document identifies and defines seven core values that are essential to professionalism in physical therapy: accountability, altruism, compassion and caring, excellence, integrity, professional duty, and social responsibility.1
As I read through the definitions and indicators put forth in this document, I couldn't help but think that teaching and learning about these values and dimensions of professionalism is not so much about what is being taught and learned as it is about how we are teaching, and, perhaps most importantly, who we are as teachers in relation to our students. Furthermore, I believe these values urge us to attend to and critically examine how we teach and who we are as faculty both individually and collectively in physical therapy education. Professing and owning these values is obviously not the stuff of rote memorization and recitation of some oath or pledge—it is living them; it is about “ways of being” with our students as they make the journey toward professionalism. Sam Feitelberg, in his recent Pauline Cerasoli address to physical therapy educators, “The Influence of Leaders,”3 echoed my thoughts, and I hope those of many others, on this matter:
We should never forget that a student is a learner and should be respected…and is not a lower form of person on the road to becoming a professional. If we go forward to adopt a pledge or oath, then we have committed ourselves to behaving in a way that will bring meaning and life to the words as students recite them.
Many authors have written about the importance of who we are in relation to our students (ie, our relational stance or ways of being with students in educational endeavors) and the influence of such presence on learning.4-10 This presence can have both positive and negative influences on learning.
Social constructivist theories of learning remind us that teaching and learning are extraordinarily relational, contextual, and reciprocal endeavors. As such, they also remind us that learning does not just occur in one's head but through active and authentic engagement with academic content through and with other individuals. Thus, our presence as faculty (both academic and clinical) is critical. Students, educational researchers, and educational philosophers have all helped us to identify and understand characteristics, attributes, and behaviors that contribute to positive presence and that enable and enhance learning. In one recent study of physical therapist students and their approaches to learning, Sellheim9 reported positive presence factors as faculty enthusiasm, respectful and positive attitudes toward students, and accessibility. Alternatively, negative presence factors were reported as intimidation, egotistical attitudes, and mistrust.
Other influential authors have urged teachers to explore and develop positive presence as a means for facilitating learning through “thoughtful teaching,”6 “mindful practice,”11,12 and, last but not least, “pedagogical sensitivity and tact.”7 The latter of these concepts, described in van Manen's7 treatise on the moral dimensions of teaching, The Tact of Teaching: The Meaning of Pedagogical Thoughtfulness, should be required reading for physical therapy educators, in my opinion. Max van Manen's reflections on our ways of being teachers and our relationship with learners can inform and potentially transform our philosophy and practice as educators. In fact, he suggests that if we cultivate tact in our teaching, then the hope of many teachers that we will “…not leave the student untouched in his or her fundamental being” is more likely to be realized.7(p187) Such an aim seems to be of crucial importance as we ponder teaching and learning about professionalism in physical therapy.
It should be obvious that our presence (as individual and collective faculty) and student learning can be shaped by a variety of external and internal factors. Among these factors are the physical environment, the sociocultural climate of the educational program and university, student beliefs and perceptions about teaching and learning, and curricular design and content. I believe that the latter of these factors takes precedence when traditional views of teaching and learning, in which knowledge and course content is viewed as a thing to be delivered and transmitted to the student, reign supreme. In such conceptions, course content and knowledge is something the faculty member has (in addition to status and power) and that the student does not have, at least at the outset of a course or a curriculum. An unfortunate corollary to this view, in addition to creating haves and have-nots, can be faculty wedded to their content areas within a curriculum versus attentive to (1) the broader aims of a curriculum and (2) the people and professionals we are seeking to develop and transform through the professional educational experience. In physical therapy education, I suggest that one sign of this myopia can be our all-too-often content-driven and over-laden curricula; related symptoms can be divisiveness among and self-orientation of faculty and overburdened, frustrated, and tired students. The study by Sellheim9 found that when students feel overwhelmed by content overload and strapped for time to accomplish required tasks in physical therapist curricula, they revert to “surface” approaches to learning in spite of their desire to attain “deep” learning and understanding of the material and experiences that constitute their professional education. It is difficult for me to discern how an “education-as-commodity,” “student-as-consumer,” and “delivery-of-goods” approach to teaching and learning will help us transform our students (and ourselves, for that matter) into individuals who embody the values described in the Professionalism document. On the other hand, I find it tremendously exciting and challenging to think deliberately, critically, and, I hope, creatively, about how physical therapy educators and our students can become better models of professionalism and good stewards of the profession.
Returning to my original assertion that teaching and learning about professionalism is more about how we engage with our learners and who we are in that relationship rather than about what we teach (or delivering content), I'll conclude this reflection with a quotation from a recent book titled Credo, by William Sloan Coffin.13 Although this excerpt has to do with social justice and equality/inequality, I believe it is pertinent to some of the ruminations I have put to the page here:
When we are intent on being, rather than on having, we are happier. And when we are intent on being, we don't take away from other people's being— in fact, we enhance it. But when we are intent on having, we create have-nots….13(p51)
In the pages of this volume you will find many articles articulating what I believe are creative and thoughtful ways of addressing some of the issues raised in this editorial, and introducing ways of facilitating learning and growth regarding the core values that have been identified as the essence of professionalism in physical therapy. You will also find a new feature—some educational software reviews that replace book reviews in this particular issue. As always, the editorial board and I welcome your comments and suggestions in response to the content of the Journal of Physical Therapy Education.
Elizabeth Mostrom PT, PhD
1. Professionalism in Physical Therapy: Core Values.
Alexandria, Va: American Physical Therapy Association; 2003. Available at: www.apta.org/About/core_documents
. Accessed March 10, 2003.
2. Bezner J. Getting to the core of professionalism. PT Magazine.
3. Feitelberg SB. The influence of leaders. Presented at: Combined Sections Meeting of the American Physical Therapy Association; February 6, 2004; Nashville, Tenn.
4. Eble KE. The Aims of College Teaching.
San Francisco, Calif: Jossey-Bass Inc Publishers; 1983.
5. Ramsden P. Improving teaching and learning in higher education: the case for a relational perspective. Stud Higher Educ.
6. Clark CM. Thoughtful Teaching.
New York: Teachers College Press; 1995.
7. van Manen M. The Tact of Teaching: The Meaning of Pedagogical Thoughtfulness.
Albany, NY: State University of New York Press; 1991.
8. Jackson PW. Untaught Lessons.
New York: Teachers College Press; 1992.
9. Sellheim DO. Educational factors influencing physical therapist students' approaches to learning. J Phys Ther Educ.
10. Weimer M. Learner-Centered Teaching: Five Key Changes to Practice
. San Francisco, Calif: Jossey Bass Inc Publishers; 2002.
11. Epstein R. Mindful practice. JAMA
12. Langer EJ. The Power of Mindful Learning.
Reading, Mass: Addison-Wesley; 1997.
13. Coffin WS. Credo
. Louisville, Ky: Westminster John Knox Press; 2004.