3.4.1 The role of identity kits in physical therapy (synthesis)

February 2021

This essay pertains to what I am majoring in and that is the profession of Physical Therapy. Specifically, I will discuss the different discourses and identity kits that are involved in the world of Physical Therapy. This career requires a lot of communication and cooperation whether that is between the Physical Therapist and the patients, or between the Physical Therapists themselves. Building relationships and trust within the health field in general as a Physical Therapist plays a huge role in how practices operate.

The philosophies that James Gee discusses in his academic journal “What is Literacy?” reflect the ideas that will be presented in this essay about Physical Therapy and the way that discourses are used every day in this field. The main idea that Gee discusses and defines in his reading is the idea of discourse. He explains that discourse is something that defines a person through the way they talk and act (Gee 18). I think of a discourse as a community of people that share the same interests. There is a certain way they act around each other. Gee also talks about how the discourses give each person in that specific discourse an identity kit which dictates their behavior (Gee 18). Gee also defines more specific discourses that are involved with literacy. He specifies two different types of discourses: primary discourses and secondary discourses (Gee 21-22). He describes primary discourse as something that we gain through acquisition (Gee 22). This is usually something that we would gain while being in our home environment as we grow up like eating with utensils or communicating with our family. In contrast, Gee explains that a secondary discourse is something that we gain from beyond our home life and build on it throughout our life consciously (Gee 22). These ideas that he presents can be applied to the field of Physical Therapy and put into context how these aspects of Literacy are relevant to everyday practice of this specific field of medicine.

When we reflect on the philosophy of identity kits and having certain roles in discourses, we can see that this is very important to Physical Therapy itself. The academic journal, “Impact of interprofessional peer teaching on physical and occupational therapy student’s professional role identity” by Kim Dunleavy et al., touches on this idea of identity kits and how that can have a huge impact on the field and how the health field as a whole discourse communicates between each profession. The premise of the study was to look at how specifically peer-teaching affected communication between different professions in the medical field (Dunleavy et al. 1). Teamwork is the backbone of medical professions as a whole and this study wanted to demonstrate that significant aspect with individuals studying different health professions. A main objective was to demonstrate how important it is for Physical Therapists and Occupational Therapists to communicate with other individuals in the health field (Dunleavy et al. 2).

The method of the study took 300 medical students and would rotate them through different rooms where Physical Therapists students and Occupational Therapy students would give presentations about their profession (Dunleavy et al. 2). The presentations consisted of information about different practices that Physical Therapists and Occupational Therapists do. Specifically, they would discuss different balance assessments and ambulation techniques (Dunleavy et al. 2). After the activity was done, the Physical Therapy students and the Occupational Therapy students wrote a reflection of the activity and their feeling toward it ( Dunleavy et al. 2). The study wanted to see specifically how the Physical Therapy students and Occupational Therapy students felt interacting with other people from different health professions and presenting their information. The overall results and theme were that Physical Therapy students and Occupational Therapy students were more confident in their identity kits. They did see a that when they were presenting their information to the medical students, that the medical students did not have much knowledge about the Physical Therapy and Occupational Therapy health professions (Dunleavy et al.2). PT (Physical Therapy) and OT (Occupational Therapy) students also saw the significance in working as a team and how communication plays such a huge role in how you operate as a health professional (Dunleavy et al. 3). Another significant finding was that PT and OT students were able to develop their own self-identity. Presenting their information to the medical students and finding that they did not have much knowledge gave the PT and OT students the clarity on how significant their roles are in the medical field (Dunleavy et al. 3).

The next study that will be presented is the academic journal “Changes in perceived self-efficacy of physical therapist students following a pediatric experiential learning opportunity” by Mitch Wolden et al. It is especially important for PT’s to gain confidence when working with patients. The premise of this study was look at how experiential learning can increase a PT student’s self-efficacy and confidence to work with different demographics (Wolden et al. 115). This study took 37 second year DPT (Doctor Physical Therapy) students at the University of Jamestown to take an Online survey that used the PCHSES (Pediatric Communication and Handling Self-Efficacy Scale) (Wolden et al. 116). They would be participating in 16 hours of experiential learning in the pediatric demographic (Wolden et al. 116-117). When the study is finished, The DPT students would have to complete a second part to the online survey to give their overall experience and how they felt (Wolden et al.117). The results illustrate a considerable increase in the numbers on the PCHSES (Wolden et al.117). This study shows that there is an increase in confidence when DPT students are involved in more experiential learning. DPT students in the study were no longer afraid of working with pediatric patients (Wolden et al. 118). The Conclusion that the study found was that incorporating more experiential learning within DPT programs can show an increase in self-efficacy for the student (Wolden et al.118-119).

The two academic journals recently discussed, “Impact of interprofessional peer teaching on physical and occupational therapy student’s professional role identity” and “Changes in perceived self-efficacy of physical therapist students following a pediatric experiential learning opportunity”, are both related in many ways. Both studies looked at and tested how Physical Therapists interact with either patients or other health professionals. They both highlight the importance of communication in the field and how it affects day to day operation. They both also touch on the importance of confidence within the Physical Therapists to treat patients and be confident in their knowledge.

The last article that will be presented is the academic journal, “The role of the therapeutic alliance on pain relief in musculoskeletal rehabilitation: A systematic review” by Ana Carolina Taccolini Manzoni et al.  Communication between the Physical Therapist and the patient is what separates a valuable experience for the patient versus an unpleasant experience for the patient. Creating a bond with your patient is incredibly significant and it can influence how the patient feels. Although this academic journal researches a specific topic within the profession of Physical Therapy, it still highlights a significant component within the world of literacy. The premise of the study was to see if therapeutic alliance between the patient and the Physical therapist would influence the patient’s pain outcome (Manzoni et al. 901). The study was gone about by doing research on different data bases to find studies that measured Therapeutic alliance and pain outcome (Manzoni et al. 902). Since there has not been many studies done about this topic, only a few studies were able to illustrate an impact that therapeutic alliance influenced pain outcome (Manzoni et al. 908-909). They concluded that because of the few studies, there is not enough evidence to relate therapeutic alliance and pain outcome (Manzoni et al. 910).

The articles “The role of the therapeutic alliance on pain relief in musculoskeletal rehabilitation: A systematic review” and “Changes in perceived self-efficacy of physical therapist students following a pediatric experiential learning opportunity” both have similar premises behind each study. They are similar because they both touch on the fact the relationship between the Physical Therapist and the patient is an especially important part of the career. Being able to communicate with the patient no matter what demographic they are in or other factors that are involved is something crucial to being a Physical Therapist.

All the studies presented are related to Gee’s philosophies in “What is Literacy?” in many ways. The first academic journal ““Impact of interprofessional peer teaching on physical and occupational therapy student’s professional role identity” covers many of Gee’s topics. The biggest topic shown is the idea of identity kits and using it as a secondary discourse in the Physical Therapy Profession. The students involved with the study consciously felt they became more confident into their professional role identity (Dunleavy et al. 3). In other words, the students became more connected with their identity kits as Physical Therapists by teaching other health professionals about their career choice. Another aspect of Gee’s philosophies that the article covers is the use of communication in the secondary discourse. The secondary discourse in this case would be the field of medicine. The health profession students had a certain way of communicating with each other and the students found that communication within the health field was especially important (Dunleavy et al. 3). The second article “Changes in perceived self-efficacy of physical therapist students following a pediatric experiential learning opportunity”, covers Gee’s philosophy of Primary and Secondary discourses. By allowing students to gain knowledge through experience and working with different demographics, it can make them more prepared for when they are in the work field (Wolden et al. 119-120). This shows that an important part of gaining knowledge is through acquisition. The last article “The role of the therapeutic alliance on pain relief in musculoskeletal rehabilitation: A systematic review”, covers Gee’s idea of communication by showing the significance of the Physical Therapist communicating with the patient.

The career of Physical Therapy requires a lot of communication skills and gaining confidence throughout your whole career. Gee’s ideas that are expressed in the article “What is Literacy?”, play into how the world of Physical Therapy operates every day. Communication between patients and other health professionals is important and should not be overlooked. Physical Therapists also need to have the confidence and feel a sense of identity when working with patients. The health field needs everyone to work as a team to provide the best care possible.

Works Cited

Dunleavy, K. (. 1. )., et al. “Impact of Interprofessional Peer Teaching on Physical and Occupational Therapy Student’s Professional Role Identity.” Journal of Interprofessional Education and Practice, vol. 6, pp. 1–5. EBSCOhost, doi:10.1016/j.xjep.2016.10.006. Accessed 25 Feb. 2021.

Manzoni, A. C. T., et al. “The Role of the Therapeutic Alliance on Pain Relief in Musculoskeletal Rehabilitation: A Systematic Review.” Physiotherapy Theory and Practice, vol. 34, no. 12, pp. 901–915. EBSCOhost, doi:10.1080/09593985.2018.1431343. Accessed 25 Feb. 2021.

Wolden, M., et al. “Changes in Perceived Self-Efficacy of Physical Therapist Students Following a Pediatric Experiential Learning Opportunity.” Pediatric Physical Therapy, vol. 31, no. 1, pp. 115–120. EBSCOhost, doi:10.1097/PEP.0000000000000550. Accessed 25 Feb. 2021.