Mershen Pillay speaking at the symposium

Criticising ourselves is the mark of a positive, confident profession

Thinking critically about physical therapy education, research and practice – asking questions about what we do, why we do it, and how it might be different – is the positive, creative act of a confident profession. So said David Nicholls from New Zealand, founder and Co-chair of the Critical Physiotherapy Network in a focused symposium on critical physiotherapy.

He said that critical thinking was a “positive force for an otherwise physiotherapy”. “It involves the kinds of insights that can be gleaned into the ways power operates in healthcare, to privilege some people and some ideas, and marginalise others,” said David Nicholls, who is an Associate Professor at AUT University, Auckland, New Zealand.

“The reality, though, is that we don’t really prepare our students or practitioners for this kind of big-picture, innovative and creative critical thinking. So we may lack the tools and the confidence necessary to bring about meaningful change.”

Some health professionals, however, are beginning to ask challenging questions about where their profession has been and where it is going. Presentations at the symposium reflected some of this questioning. Alma Viviana Silva explored the impact of neoliberal ideology on physiotherapy practice in Colombia. Jenny Setchell from Australia asked what conditions make stigma possible in physiotherapy. Barbara Gibson from Canada looked at how a critical approach could be used to confront traditional ways of thinking in research.

And Mershen Pillay, an audiologist and speech therapist from Durban, South Africa, examined how the history of colonialism was still exerting a pervasive world order – and how understanding its influence could change practice. He explained, for example, how the dominant Euro-American scientific knowledge, focused on a single technical and objective reality, had displaced and ridiculed knowledge from a Global South.

“Critically,” he said, “what we do in the clinical moment with our clients is not immune from these broader social, political processes.”

“Perhaps we can engage our potential creative freedom. We suggest celebrating African humanism as a basis for re-thinking rehabilitation – and we can do this using through critical dialogues, critical actions and providing new ways of doing.  For example, the educational process for innovation requires deconstruction of the dominant knowledge and texts that we use with students. We need to ask: how will this knowledge serve population needs and the inherent inequities?”

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