Exploring the Ethos of the Physical Therapy Profession in the United States: Social, Cultural, and Historical Influences and Their Relationship to Education

Abstract

ABSTRACT. The purposes of this study were (1) to describe evolution of culture and ethos of physical therapy in United States, (2)to develop a conceptual framework for understanding how a ethos evolves, and (3) to explore impact of evolution of a ethos on education of physical therapists. Three sources of data (ie, individual interviews with three Fellows of American Physical Therapy Association; a focus group interview with 11 members of Prime Timers; and historical documents, including Mary McMillan Lectures and Presidential Addresses) were used to triangulate findings of this qualitative study. A qualitative data analysis was carried out using constant-comparative and grounded theory methods. Results indicated that ethos of physical therapy is composed of a set of core values, norms, and beliefs that are basis for enduring traits that do not change over time, as well as a dynamic portion that responds to changes from both within and outside of profession. These changes, as well as entrance of newcomers into field, contribute to evolution of ethos of physical therapy. A conceptual framework for understanding evolution of a ethos is described, and implications for educators in physical therapy programs are discussed. Key Words: Physical therapy education, Professional ethos, Professional socialization. INTRODUCTION One of goals of education is to assist students in becoming part of a community. Tammivaara and Yarborough1 have referred to this process of enculturation into a profession as attaining a Ethos is defined as the distinguishing character, sentiment, moral nature, or guiding beliefs of a person, group, or institution.2(p247) The ethos of a profession, then, is composed of distinguishing characteristics, sentiments, and beliefs of that profession that guide behavior of practitioners. This ethos is most often reflected in Codes of Ethics and Standards of Practice founded in norms and mores of profession, which, in turn, can be viewed as a reflection of values, attitudes, and beliefs of profession.3 As part of educational process, students in education programs must make a transition from world of college life to a world. The cultural values of must be transformed into professional ethos. The individual must stop being merely a competent student and must become a competent professional. This occurs as student begins process of values, traditions, and obligations of profession... [it] occurs when student develops a clear and accurate perception of role of profession and of self as part of that profession.4(p27) Learning about world thus involves not only mastering skills needed to perform work of competently, but also internalizing values and beliefs shared by others in profession so that collectively held values and ideals come to characterize very identity of novice practitioner. Like educators in other programs, academic and clinical faculty in physical therapy programs want their students to emerge from academia as competent professionals. They want students who have internalized ethos of profession and have developed a true sense of what it means to be a physical therapist. According to Tammivaara and Yarborough: To do this, educational programs must develop a cultural orientation toward behavior, a This is not something to be offered as a course, or even a series of courses; this is an attitude, a set of values, which must be conveyed and practiced by clinical and academic faculty. It must be manifest for students in expectations of their behavior, in conduct and content of all courses, in procedures of faculty/student interaction, in evaluation of students in use of space, in clinical education, in designation of heroes and valuing of field's history, and most of all in faculty's and clinical faculty's commitments to patient care, primary task of physical therapy. …