Urban ideals and rural realities: Physiotherapists navigating paradox in overlapping roles

Andrea Gingerich, Kevala Van Volkenburg, Sean Maurice, Christy Simpson, Robin Roots

Résultat de recherche: Articleexamen par les pairs

10 Citations (Scopus)

Résumé

Objectives: Rural practitioners who develop a sense of belonging in their community tend to stay; however, belonging means neighbours become patients and non-clinical encounters with patients become unavoidable. Rural clinical experiences expose students to overlapping personal and professional relationships, but students cannot be duly prepared to navigate them because ethical practice standards primarily reflect urban, and not rural, contexts. To inform such educational activities, this study examines rural physiotherapists' strategies for navigating overlapping relationships. Methods: Constructivist grounded theory guided iterative recruitment of 22 physiotherapists (PTs) living and practising in rural, northern or remote (RNR) communities in British Columbia, Canada, and analysis of their experiences navigating overlapping relationships. Results: PTs routinely navigate overlapping relationships while mindful of practice standards, neighbourly and community expectations, personal well-being and patient welfare. While off-duty, they balance opposing expectations and manage various responsibilities to achieve contradictory goals such as being a professional who protects patient confidentiality while being an active and cordial community member. While on-duty, they face ethical dilemmas where deciding not to treat acquaintances potentially denies access to care but allows for clearer personal-professional boundaries and deciding to treat contravenes (urban) practice standards but could allow for customised patient care based on knowledge gained through both clinical and social interactions. Conclusion: Overlapping relationships are a rural norm. Urban ethical practice standards imposed on rural contexts put RNR practitioners in a paradoxical situation where clinical and social interactions must be but cannot be partitioned. Examining the identified strategies through the lens of paradox theory shows sophisticated cognitive framing of the conflicting and interrelated aims inherent to living and practising in RNR communities. Consequently, introducing a paradox mindset in educational activities could be explored as a way to prepare students for the ethically complex overlapping relationships that they will need to navigate during RNR clinical experiences.

Langue d'origineEnglish
Pages (de-à)1183-1193
Nombre de pages11
JournalMedical Education
Volume55
Numéro de publication10
DOI
Statut de publicationPublished - oct. 2021

Note bibliographique

Funding Information:
This study was fully funded by a University of British Columbia Distributed Medical Education grant awarded through the Centre for Health Education Scholarship in 2019. This study benefitted from contributions made by University of British Columbia students. We are grateful for the interview facilitation and preliminary analysis provided by Christina Daoust, Anh Duong, Carli Kerr, Karissa Polsom and Rebecca Sidow, master of physical therapy students, and for the interview facilitation provided by Talise Lindenbach, medical student.

Publisher Copyright:
© 2021 John Wiley & Sons Ltd and The Association for the Study of Medical Education

ASJC Scopus Subject Areas

  • Education

PubMed: MeSH publication types

  • Journal Article

Empreinte numérique

Plonger dans les sujets de recherche 'Urban ideals and rural realities: Physiotherapists navigating paradox in overlapping roles'. Ensemble, ils forment une empreinte numérique unique.

Citer