A Baradian approach to evidence-based practice in physiotherapy education

Abstract

During the past decade, there has been an increased focus on evidence-based practice in physiotherapy programmes. Evidence-based practice involves combining best research evidence (external evidence), clinical expertise and patients’ values and preferences. Competence to search and evaluate research evidence is considered crucial in ensuring that a new generation of physiotherapists are able to choose treatments proven to have the best effect. Physiotherapy programmes also focus on equipping students with clinical skills and taking patients’ values and needs as their starting point for evidence-based practice. How these different forms of knowledge relate to one another, however, is unclear. Inspired by Karen Barad’s theory of agential realism, this paper explores evidence-based practice as processes of becoming within the physiotherapy encounter. Drawing on the experiences of physiotherapy students, who prior to their study in the physiotherapy programme had encountered different physiotherapists, we put Barad’s concept of “intra-acting" into play as a critical and alternative way to conceptualise evidence-based practice. Our findings show how knowledge as best research evidence (external evidence), knowledge as clinical expertise, and knowledge as patients’ values and preferences, is co-constructed into the phenomena of evidence-based practice within the physiotherapy-patient encounter. When discussing how students should develop their skills in order to learn how to perform evidence-based practice, we argue that physiotherapy programmes need to take into account that evidence-based physiotherapy comprises a number of intra-active processes of becoming rather than being a fixed phenomenon.