Learn it, teach it, know it.
Thoughts from a newly appointed “Professor of Clinical Inquiry”
It’s been a month or so since my last post (starting to sound like a confession for those of you raised in the Roman Catholic Church - - but don’t worry, that’s not where I’m headed). A bit less than a week after thanksgiving I got sick (not COVID, but still not great for a week or so). Then I got behind in my work so priorities replaced fun activities such as writing on Substack.
This post is really for me. It’s my first post on substack in a month. I’ve been writing a lot - but in a notebook every morning as I work through several interrelated thoughts - none of which are ready to be posted here. This post is an inertia breaker. It’s breaking the inertia of “not writing on substack”. As Pressfield says: “Do the Work”.
One thing I’d like to write about - really for closure on my own part is my inability to obtain a basic, entry level, job as a physical therapist. Exactly one month ago today, on 11/22/2022, I found out that I was not even considered for a per diem (Latin for “per day”) position at a local acute care hospital as a physical therapist (a profession that I have been a member of since 1992, first as a student, and then as a licensed professional since 1994). I was not considered. Meaning, my resume was looked at and deemed unworthy of an interview. That’s an important part of the story because it means I was not given the opportunity to respond to questions about my experiences. The (non PT) professional that is the manager of inpatient rehabilitation services decided that my clinical experience was too long ago. To get to that part of my resume they (it’s a she, but I’m pretending I don’t know that) had to skip about 5 pages of publications about how to best practice physical therapy and 25 years of teaching people how to practice physical therapy in the acute care setting; and an award provided by the Academy of Cardiovascular and Pulmonary Physical Therapy of the American Physical Therapy Association for making “outstanding and enduring contributions to the practice of physical therapy…”
My simple message here is that teaching something - and teaching it well (I have 4 teaching awards and founded a DPT program) - requires you to really “know” a discipline. The pattern that many people recognize when they are learning is that they learn it (understand something, definitions, concepts, etc), then they take the time to teach it (explain it and analyze it, be subjected to questions about it) and then they know it. Simply put - after 25 plus years of teaching physical therapy - I really know it. If there were concerns about my physical capability to “do it” because I hadn’t done it (physically done it, not cognitively done it, I’m cognitively doing it all the time) - then the opportunity to demonstrate my physical capabilities would have been nice. I would have welcomed a physical interview to demonstrate my abilities.
Now - the only reason I applied was because I heard they had been looking for help. That hospitals were super busy and understaffed locally. I thought I could help - particularly during the holidays when I’m on winter break from teaching.
I was bitter - a facebook post reflects my bitterness. I’ve entertained many reasons and explanations - all of which are reasonable and I appreciated all the thoughts people shared with me.
I’m over it now.
Upon reflection I’ve come to two mental places since then this past month.
First, If being a professor of physical therapy doesn’t carry any weight for practicing physical therapy - perhaps I should make a change to a new title. So, with my chair and provost’s approval I’m now a “Professor of Clinical Inquiry.”
With my new title, I’ll make it a point to study and evaluate the claims of physical therapists by subjecting them to rigorous philosophical inquiry (and science is a particular segment of philosophical inquiry, one with particular empirical presuppositions). It’s been my focus for a while now, might as well embrace it with a named professorship. I’ll stay licensed as a PT, and will be a PT professional (card carrying member of the Professional Organization - the APTA), but I’ll lean further toward a broad (peripatetic) perspective of the profession in my professorial role. This goes along with my new adventure in the PSU Philosophy program teaching a course on Science vs. Pseudoscience this spring (2023). I’ll be educating undergraduates about how to evaluate the truth claims of “science” including those truth claims that may not be actually following a philosophical approach that meets what most accept as science (i.e. pseudoscience). The added nuance for my course (beyond the investigation of quackery and superstition), will be the investigation of conspiracy theories (i.e. the govt is trying to….. will in the blank with any bad intention you like …. Through the use of masks, vaccines, or fluoride in our water, etc.
Second, I think I’ve spent too much time trying to study clinical decision making. I think I’ve found what I was looking for in the way of knowledge based practice and the use of causal directed graphs (Bayesian networks) and rather than trying to continue to develop those methods (but I’ll continue to teach them), I need to switch to understanding the systems we are making decisions about - - that is ecological, physiological and anatomical systems. Again, this is not a completely new venture - it really goes back to my pursuit and completion of my dissertation topic on stress disequilibrium theory and most recently my work with Bog and Tom Sniezek on Unifying Systems Theory for a new perspective of clinical physiology. In other words, rather than focusing on “how we’re thinking” - accept what I currently understand about “how we’re thinking” and shift focus to “what we’re thinking about”. It’s a small jump- and throughout my career I’ve jumped back and forth (from how to what to how and then back to what). But for now, I’m back to what we’re thinking about, not how (well, again, I’ll teach how we’re thinking about what we’re thinking about but my research will be on what, not how). That - in my opinion - is just as important in the process of clinical inquiry as how.
For the philosophically minded or inclined - what I’m saying is that I’ve bounced between clinical epistemology and clinical ontology (note the “t” - not “c” - I’m not studying oncology). But I’m going to settle on my current “clinical epistemology” as reasonable enough to proceed to now focus my time on “clinical ontology” - which includes a better understanding of the systems we are trying to know, not how we know them.
One of the implications of this “closure” on my clinical epistemology is that I feel confident that I can start to write about it. I have a paper in draft form about probability logic; and I’m going to dust off a draft that needs editing about clinical epistemology. Ironically to some, by “not working on clinical epistemology” - I can actually now write about it. I was resistant to writing too much about it while I was working on it because I felt I had more to learn. While I may still have more to learn, I’m resigned to not learn it - to accept where I am and write about it so that others, should they feel up to it, can take it from where I’m leaving it.
There. I’ve broken the inertia - I did the work - I can start to post a meandering weekly writing weekly again. Lots going on - lots to say - so little time.
Merry Christmas! I’ll be back before the New Year!