Life long learning

Lifelong learning requires individuals to take personal responsibility for identifying their learning needs and evaluating if those needs have been met. This includes an awareness of learning needs and self-directed learning based on experience and perceived responsibility, and has been embraced internationally by numerous physiotherapy professional bodies. There has been much debate about whether lifelong learning in physiotherapy should be mandatory or voluntary. There are wide variations in lifelong learning across different countries, and most rely on professional self-regulation. It is often linked with statutory registration and therefore becomes an inherent requirement for health professionals to practice. Most lifelong learning systems are modeled on hourrelated input systems, where 1 hour equals one credit. Generally, accreditation cycles are of 3–5 years duration with a set number of credits required per year/ cycle (see Table 1). What do future physiotherapist think of the prospect of lifelong learning after they finish their bachelor’s degree? To answer this question, six first-year physiotherapy students of THIM-NL and eight of THIMCH were interviewed by peers about this.

How do you feel about mandatory lifelong learning in physiotherapy, is this a good or a bad thing?

Most students think that mandatory lifelong learning is a good thing. All six THIM-NL students and six out of eight THIM-CH students think lifelong learning should be mandatory. The other two Swiss students agree that lifelong learning is important, but they don’t ‘like the mandatory part’. They would rather choose for themselves. Some of the responses of the students can be found below:

- ‘It guarantees that all physiotherapists are up to date and can help their patients adequately’.

- ‘I don’t think that 4 years of physiotherapy study is sufficient to become a good physiotherapist. Further learning is needed, maybe not every year but at least every 2 or 3 years for one to be up to date with new information’.

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‘It is a good thing, but I can understand that not everyone wants to learn new things every few months’

One student posted a follow up question to a Swiss student: Do you view the fact that Switzerland doesn't compel life-long learning for physiotherapist an advantage or disadvantage?

On which the Swiss student answered the following: ‘I think it has both its advantages and disadvantages. On the positive side, Swiss physiotherapists are not kept under financial pressure or suffer the fear of losing their jobs when not pursuing lifelong learning. On the negative side, it not being an official rule may disincentivize Swiss physiotherapists from pursuing lifelong learning which would overall be detrimental to the quality of their work with potential clients’

What kind of topics should be addressed in the courses physios follow to keep learning?

Students agree that anatomy shouldn’t be a topic: ‘stuff like anatomy is unnecessary, because in school you learn every bone and muscle and that does not really change over time’. Actually, most students think that technology in physiotherapy would be an important topic to address in follow-up courses: ‘every year technology becomes more important. For example with the new devices like the apple watch. I think we should include that in our therapy’.

Several students mention communication is such an important element of physiotherapy that it would be good to follow extra communication courses after attaining the bachelor degree: ‘communication is also important for me. So that we don’t lose the relationship when we are online with the patient. Because online with the new technology it’s like more distance with each other’

Several other possible topics that were mentioned by students were:

- ’current diseases, for example arthrosis’

- ‘alternative therapy methods’

- ‘lifestyle related topics’

- ‘the lates scientific topics’

How do you integrate lifelong learning in a busy life?

Students have different thoughts on how to integrate lifelong learning in a busy life. Some students mention social media as an effective way, because you can learn about updates in physiotherapy on your own preferred time: ‘Personally, I integrate lifelong learning by reading new facts and information on physiotherapy topics like fitness and nutrition on social media. You can integrate lifelong learning by daily tasks like swiping through Instagram or reading in a book while riding to work or school’. Another student adds: ‘Since everyone has a smartphone, he develops the habit, that he spends a lot of time on social media and other smartphone-based applications such as games and other. So, everyone needs to think about how they spend their time. And out of this point of view you will always find a bit of time, to integrate the lifelong learning in your daily life’. Other students mention a subscription on physiotherapy journals as an effective way of life long learning.

Several students think that physiotherapists should be encouraged by their employers for continuous learning: ‘They should make time and money available for this’. However, they acknowledge that it is also the therapist's responsibility to learn: ‘every therapist should develop a certain routine so that they don't forget to learn. This should be developed during studies and become a habit. If it is a habit, everyone will always learn something new’. One student believes that it is important in life long learning to pick your friends wisely: ‘friends who have the same profession, you can learn from them. For example, you have a friend who is a doctor, and works in a hospital. However, if you do not have such a friend group, you could also connect with people who you might be around a lot, for example, when you practice your sport or when you are in the gym’.

In addition to all the former, one student adds: ‘the most important part to life long learning is keeping it interesting and functional for yourself as a physiotherapist. Life long learning must not feel as a ‘must’, but as a fun and interesting experience. Physiotherapist in the Netherlands must have around 24 credits annual, so you better make it interesting and functional, so choose things that have something of value for your clients. If your work is something with elderly people, than you shouldn’t waste time with sport classes (to get the annual credits). So if you keep it fun for you, then you are probably motivated, and that’s a way you possibly can get more educated, there is always time in your agenda. It is just a problem of wanting to learn new things’

Do people with a lot of experience still need to keep up with long life learning?

Students agree that this is definitely the case: ‘because new techniques are always being researched in this field’. Another student adds: ‘You must keep learning, because you will otherwise fall back in knowledge and finally loose knowledge’. Also students acknowledge that technology is evolving rapidly and ‘although you have 30+ years of experience, maybe you are not upto-date enough with technology. That would be a big loss’.

Not all students agree however that life long learning is just as important for the older more experienced physiotherapist as for the younger, more inexperienced one.

One student states the following: ‘I think with a certain amount of work experience you have enough knowledge’. Another student disagrees: ‘there are no upper limits to knowledge. Even hearing different aspects of something you already know could help to do something different or think different about it’. One student adds: ‘the older we get, the more our interests change. This can be an opportunity to learn new methods on new topics’.

One student sums it up as: ‘I believe that you should be able to acknowledge that you will never stop learning, and that you are never perfect’.

What will happen if you do not participate in lifelong learning?

Students agree that this wouldn’t bring them as a physiotherapist further. They think that this would be negative for the treatment of the patient, for the motivation of the physiotherapist, and the future of physiotherapy.

- ‘We would miss out on opportunities to help the patients with their well-being and diseases’.

- ‘Your clients will go to another physiotherapist because the other physio knows new and better techniques’.

- ‘For me personally, I would get bored if I never learn something new’.

One student summarizes nicely: 'You will stay on the start-line, just after you ended your physiotherapy study, and you will not be able to develop yourself. It may also cause, that you get bored in your profession. So, if that happens, you automatically loose the motivation to carry out your profession’.

First year, international students of THIM-NL