Continuing education (CE) outside of a professional qualification is always going to be a good thing. The more we can learn and expose ourselves to information the better. I am always reminded of a profound statement from a friend a few years ago in which he said:
“Have you got 10 years experience or 1 years experience, 10 times”
This can sometimes sum up some peoples evolution within their chosen profession.
As well as a lack of learning, problems can also arise when we don’t evaluate the information we are learning sufficiently. Learning is not just about sitting in a room and diligently making notes from a well respected or even revered ‘guru’ but critically evaluating the information, the evidence presented and its plausibility.
In fact being critical about the information all around us on websites, blogs, articles, journals; conferences etc is important. This blog just happens to be about the sometimes murky world of continuing education but myths continue to be perpetuated in the worlds of therapy and fitness in many forms and at an institutional level sometimes. That is why we have seen the emergence of many critical thinking websites and articles dedicated to myth busting. It does not matter if you are a personal trainer, physio, osteopath or massage therapist, some basic critical thinking skills will benefit you.
On a simple level with a basic understanding of science, does what you are learning make any sense? I have listened to many theories presented in vast technical detail but when you peel away the layers of the onion the basic idea underneath does not hold water or when subjected to rigorous scientific trial does not produce the desired or expected results.
To be able to evaluate the basic science we first must have a grasp of the basic sciences behind the body, its anatomy and function. Continuing education can prey on this area sometimes. In both the fitness and therapy worlds magical wonder courses offering instant miracle cures or earth shattering results are often more attractive than those offering quality science, evidence, hard work, limitations and a dose of reality.
Any idea or technique has to be underpinned by basic science. I think sometimes we take the view that if we don’t understand it is because we are less intelligent than those teaching it. In fact I have felt like this myself in the past, especially if the teacher has obtained a certain status in their chosen field.
It maybe however that it actually just does not make sense and to disguise this it is layered in ever more complex wrappings. Einstein said:
“If you can’t explain it simply, you do not understand it well enough”
Although we can delve in to the minutiae of any concept it is often the best teachers who can make you understand the complicated in a simple digestible manner at first.
Cult of CE
Here we get to the cult of CE. I have a basic rule, if it seems to be to good to be true, it is!
If it is a wonder ‘secret’ that no one else knows or offers to provide miracle cures to debilitating problems but cannot offer plausible science or evidence then we have to say, why is that? Often however people are hooked by the extraordinary efficacy and rapid gateway to the status of miracle worker instead of asking the hard questions.
Often they offer close to 100% success rates but anyone who has worked with the body knows we can easily make problems worse as well as better and often do. If the ‘method’ (Disclaimer: The reference to ‘method’ is not meant to reflect any particular ‘method’ or organization, just merely for want of a better term) does not work for the patient or client then it is their fault rather than the fact the ‘method’ may not be right for that person.
No one ‘method’ will be right for everybody all of the time. We may need many skills to help many people. The biggest skill of all is to know when to pass someone along to be helped by someone with a different set of skills.
We also must realize reams of testimonials are simply not evidence of a ‘method’ working. A facebook page or website piled high with testimonials and case studies is simply no substitute for evidence. It is often not the ‘method’ I object to but the claims that surround it. If you claim it, you prove it! The onus should be on the person making claims to prove it not to be disproved by others.
The same people who go for this kind of ‘method’ would laugh at the faith healer in a church who offers miracle cures but I fail to see the difference as they are often based on a belief and claims rather than evidence or science.
Obviously it would be great if we all lived in a world where we were honest and upfront about our limitations but, newsflash, we aren’t. We can also be blinded by our own conformation biases both when teaching and using ‘methods’ we are earning money from and have spent good money on. It has to come down to the individual to critically evaluate the information being taught. Often we see opinion served up as hard evidence and fact both from ‘guru’ types and their disciples, who if challenged appeal to the authority of their chosen ‘guru’.
It has to come back to the individual to be critical of what they are doing with their clients and patients. We should be critical of ourselves first and foremost before turning our critical eye on others. Often followers of a ‘guru’ or ‘method’ are quick to turn their critical thoughts onto other ‘methods’ but less willing to turn it on themselves.
Adam Meakins of thesportsphysio.wordpress.com has a well written and honest blog on being critical here.
When undertaking any education we have to say to ourselves:
Are the techniques and opinions presented well supported by firstly scientific plausibility and then some evidence relating to the proposed efficacy?
Unfortunately ‘in my experience’ just does not cut it and neither do testimonials. A basic scientific rationale is good but we have to be aware of modern evolutions in thinking. An example might be ‘overpronation’ presented as a problem that needs to be addressed but we simply do not know what ‘normal’ pronation is to be able to say what is ‘over’ and if this is a problem anyway. This boils down to an assumption or theory rather than being based in science or evidence.
What is the quality of research presented?
Firstly is there any? Theories based on ideas key to a ‘method’ don’t really count in this respect. Without some form of research or evidence these amount to little more than nice stories.
Then we have to look at quality of evidence. Not all research is equal in method and the conclusions and evidence do not always nicely tally up. If you read around the subject is there also a weight of associated evidence or a dearth of available information? If it does boil down to experience or opinion then this should be made clear rather then presented as hard evidence. The people I respect most often do this.
P.S Case studies and testimonials don’t count!
Does the information presented evolve and change as new information and research comes to light?
If your chosen CE provider has stayed still for the last ten years pedaling exactly the same message whilst the rest of the fitness or medical community has forged boldly on then in my opinion they are lazy or arrogant. New studies and research come to light everyday offering new perspectives on a host of subjects. Can we just discount them? My personal opinions change regularly. This is not about being wrong but now having better information than before. That’s called evolution. The most important thing is the critical and introspective thought process than being right or wrong at any given moment. This is certainly not an easy thing to do or something I personally have always done. Maybe each of us has our own critical epiphany somewhere along the way.
Same old, same old!
The worst perpetrators are those that continue to peddle the same old information even though there maybe a weight of evidence contradicting some of the underpinning foundational ideas behind a particular approach.
This is where CE can become more of a business than education business. Many ‘methods’ excel at marketing, a necessary evil, but this can often hinder change and evolution that is vital for progress.
Sometimes CE is a little bit like having a brand loyalty such as shopping at the same supermarket. Loyalty can go a long way to stopping us running a critical eye over what we are being taught; especially if there is a social aspect or community feel from being amongst ‘like minded’ people. Multiple levels and arbitrary certifications can keep people coming back for more rather than exploring different approaches.
Often we can get individuals who are very good at knowing the intricacies of a system or ‘method’. We could confuse that with being knowledgeable about a broader understanding of the body and related research. If you take the individual outside of the ‘method’ are they quite as impressive? Good knowledge of a ‘method’ is different to having good knowledge!
I sincerely believe that there is merit in the teachings and experiences of many educators and ‘methods’. If you can critically evaluate the information it allows us to be able to take what is useful and based in science and evidence and maybe discard what is not. The problems start when we accept hook, line and sinker a ‘method’ without question. Any educator who does not like being questioned is simply not worth his salt. If they cannot offer you explanations or evidence from where they formed their opinions then that is a deal breaker in my opinion. I run CE courses myself and I encourage critique. In fact I sometimes tend to get the most critical thinkers it seems!
We can build our own personal opinions and technique toolbox based on our own education, scientific knowledge and an appreciation of the current evidence base rather than being a (fill in the blank) “……. practitioner”. Learning how to think critically and applying a critical mindset, is well, critical to this. Just paying your money and simply accepting the information is lazy learning and allows the perpetuation of information without a solid and plausible science and evidence base.
An awareness that everything that glitters is not gold is the first step to having a more critical mindset. Of course the opposite end of this is being so critical than you never move from your narrow bandwidth of beliefs. In fact we can use critical thinking to reject anything that does not fit with our current mindset. We also have to realize the limitations of our current evidence base and look to expand this rather than be limited by it.
If we were to never hypothesis or theorize we would never push things forward. These theories do have to based on science and look to be validated by evidence if we want to make claims about their efficacy.
The more critical we become then the better the information that is served up in our education will have to become.
‘I want to believe, I really do, you just have to help me’ would be a great slogan for a T-shirt for the next CE I attend, and I will be attending some I assure you.