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Profession on the move: Changing conditions and gendered development in physiotherapy
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.ORCID iD: 0000-0003-3083-106X
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Physiotherapy in Sweden has developed from a practical, hands-on, assistant job predominantly taught at college level to a university-based academic discipline emphasising evidence-based practice and research. Women are in majority although an increasing number of men have entered the profession. Women and men physiotherapists tend to undertake different career paths. The overall aim of the present thesis was to use a gender perspective to describe and analyse attitudes to the professional role, health care work and the development of the profession among actors engaged in physiotherapy education.

A questionnaire was distributed in 1997 to all Swedish physiotherapy students in the second semester of the education (n=273). The same cohort was investigated in 1999 at the completion of the education. The response rate was 93 percent at both occasions. For an international comparison, the same questionnaire was distributed in 1997 and in 1999 to a group of Canadian physiotherapy students in their first and last semesters (n=60). Qualitative research interviews were conducted with 8 novices in physiotherapy and with 14 women educators in academia. Five focus group discussions with clinical supervisors were conducted (10 women and 5 men). Methods used were Grounded theory, factor analysis, logistic regression and path analysis. Feminist theories and Bourdieu's theory of culture constituted a theoretical framework

Four ideal types were identified among the novices representing attitudes to the professional role. The Treater and The Supervisor were attitudes found among the women, whereas The Coach and The Entrepreneur were attitudes among the men. Type of health care facility was important for their positioning in the organisational hierarchy. Swedish students favour future employment in private practice. Sports medicine clinics and fitness centres are health care facilities highly endorsed, as is health promotion. Neither care of elderly nor hospital work are preferable fields of practice. Research is not favoured. Men students are more likely to have chosen the profession because of their interest in physical activity and sports. They are also more likely to prefer owning a private clinic and working with alternative approaches such as fitness training in sports medicine clinics. Women students are more likely to prefer an employment in private practice. The Canadian men students favour private practice whereas the women prefer the public sector of health care. The academic educators experience a gap between theory and practice which causes conflicting messages to students. Competing professions, emergent societal change and a conservative clinical practice constitute threats to the profession. The uniqueness of professional competency, theoretical development and new arenas such as home rehabilitation, consulting and research constitute a vision for future development of the profession. Masculinity is highly valued for status and power whereas femininity symbolises empathy and caring. The clinical supervisors update their theoretical knowledge base through supervision of students, but claim that students lack hands-on skills. Stress at work, unequal power relations in the hierarchy and restructuring of health care are factors that influence work satisfaction negatively. To conclude, gendered habitus, different symbolic capital and different attitudes towards health care work and development of the profession were found in the sub-fields of physiotherapy.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet , 2001. , 132 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 730
Keyword [en]
career, gender, division of labour, physiotherapy, health care, professional socialisation, professional development, gendered habitus, field, symbolic capital
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-7519ISBN: 91-7305-017-2 (print)OAI: oai:DiVA.org:umu-7519DiVA: diva2:147190
Public defence
2001-05-11, Tandläkarhögskolan, Sal B, 9tr., Umeå universitet, Umeå, 10:00
Projects
digitalisering@umu
Available from: 2008-01-10 Created: 2008-01-10 Last updated: 2015-04-29Bibliographically approved
List of papers
1. Attitudes of novice physiotherapists to their professional role: A gender perspective
Open this publication in new window or tab >>Attitudes of novice physiotherapists to their professional role: A gender perspective
1998 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 14, no 1, 23-32 p.Article in journal (Refereed) Published
Abstract [en]

Most Swedish physiotherapists are women, but an increasing number of men are entering the profession. The aim of this qualitative study was to examine the experience of eight novice physiotherapists. In-depth interviews with four female and four male novice physiotherapists were conducted. The analyses used Grounded Theory and ideal model. Gender, context and time were identified as important analytical categories. Four ideal types, which reflect the attitudes of the novices to the profession, were constructed. The attitudes of the female physiotherapists were used to construct the ideal types called the 'Supervisor' and the 'Treater'. They were patient-oriented and experienced great job satisfaction in their close relationship with patients. They had an open mind as to their future professional activities. The attitudes of the male physiotherapists were used to construct the ideal types called the 'Coach' and the 'Entrepreneur'. They were team-oriented and unsatisfied with team leaders, salaries and organisation. They were choice-decided as to their future professional activities. In the primary health care setting, the physiotherapists wished to cooperate upwards with others in the organisational hierarchy as well as outside the health care organisation. In hospitals, the physiotherapists wished to cooperate horizontally or downwards with others in the hierarchy.

Place, publisher, year, edition, pages
Informa Healthcare, 1998
National Category
Pedagogy
Identifiers
urn:nbn:se:umu:diva-66888 (URN)10.3109/09593989809070041 (DOI)
Projects
digitalisering@umu
Available from: 2013-03-06 Created: 2013-03-06 Last updated: 2017-12-06Bibliographically approved
2. Competent women and competing professions: Physiotherapy educators' perceptions of the field
Open this publication in new window or tab >>Competent women and competing professions: Physiotherapy educators' perceptions of the field
1999 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 1, no 2, 59-72 p.Article in journal (Refereed) Published
Abstract [en]

Career choices are still strongly gendered in health care professions. In Sweden, physiotherapy is a middle-class women's profession that nowadays also attracts men. Career strategies and professional development in physiotherapy are sparsely studied from a gender perspective. The purpose of this qualitative study was to describe and analyse perceptions of individual professional development, physiotherapy education and the profession in general, among a group of women educators in physiotherapy, using a gender theoretical framework and some of Bourdieu's theoretical concepts in the analysis. Thematized in-depth interviews with fourteen educators in physiotherapy were performed. The analysis used the Grounded Theory method of constant comparison. To increase credibility, the study design used triangulation in interviewers and investigators, member checking and reference group checking. Three core categories were identified. The Competent Woman category involves the professional development of the educators, including aspects of competence, success, efficiency and flexibility. Perceptions of femininity and masculinity reflect the symbolic dimension of gender. Femininity is regarded as symbolic capital for empathy and care, while masculinity represents status and power. The core category Theory-Practice Gap describes the isolated position of physiotherapy education in relation to the field of health care. The fragmented and disintegrated professional knowledge base does not facilitate the development of the profession. The core category Profession under Change reflects ideas about physiotherapy in society. Other female health care professions, ongoing societal change and conservative physiotherapy practices constitute a threat to the future development of the field. Visions for future development of the field emphasized the importance of professional competence and engagement in innovative activities in new arenas and new professional roles. The results shed light on the symbolic dimension of gender in a professional field where femininity is connected with academic success, empathy and care, while masculinity is related to business mentality, status and power. Notions of competition include both internal and external factors affecting the field of physiotherapy.

Place, publisher, year, edition, pages
Informa Healthcare, 1999
National Category
Educational Sciences
Identifiers
urn:nbn:se:umu:diva-66896 (URN)10.1080/140381999443447 (DOI)
Projects
digitalisering@umu
Available from: 2013-03-06 Created: 2013-03-06 Last updated: 2017-12-06Bibliographically approved
3. Career choice, professional preferences and gender ?:  the case of Swedish physiotherapy students
Open this publication in new window or tab >>Career choice, professional preferences and gender ?:  the case of Swedish physiotherapy students
2001 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 3, no 3, 94-107 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to identify reasons for the career choice and professional preferences among students enrolled in the Swedish physiotherapy education. The study design was longitudinal and used a questionnaire administered to a cohort of 273 students in the beginning of the university programme in 1997 as well as at the completion of the programme in 1999, yielding a response rate of 93%. Data were analysed with factor analysis and univariate and multivariate logistic regression analysis. To test the relationship between the factors and outcomes that showed significant effect in the logistic regression analysis, a path analysis was performed. The two most preferred healthcare facilities after graduation were sports medicine clinics and fitness centres. Future work in private practice was highly endorsed by a majority of students. Health promotion was highly valued. Care of elderly and hospital work were not preferred. Significant differences between men and women appeared. Men were more likely to have chosen the programme because of their interest in sports and physical activity. Men were also more choice decided about future professional activities, whereas women were more open for several areas of practice. Men preferred to become the owner of a private clinic and to work with alternative approaches to healthcare, such as fitness training in sports medicine clinics.

Place, publisher, year, edition, pages
informa plc, 2001
National Category
Educational Sciences
Identifiers
urn:nbn:se:umu:diva-66884 (URN)10.1080/140381901750475348 (DOI)
Projects
digitalisering@umu
Available from: 2013-03-06 Created: 2013-03-06 Last updated: 2017-12-06Bibliographically approved
4. Career choice and professional preferences in a group of Canadian physiotherapy students
Open this publication in new window or tab >>Career choice and professional preferences in a group of Canadian physiotherapy students
2002 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 4, no 1, 16-22 p.Article in journal (Refereed) Published
Abstract [en]

This article focuses on reasons for the career choice and the longitudinal development of attitudes to healthcare work and the physiotherapy profession. The study is part of a larger project on professional development in physiotherapy. A cohort of 60 Canadian physiotherapy students was surveyed on two occasions during their educational programme. The questionnaire was constructed using a theoretical framework about professional socialization. Forty students completed both versions of the questionnaire yielding a response rate of 67%. Seventy-two per cent were women and 28% were men. Job accessibility or economic (25.5%) were the most frequently indicated reasons for the career choice. The most frequently chosen role models were the preceptors in clinical placements (52%). None of the students indicated having a faculty member as a role model. The desire to work in private practice and with adults was ranked highly in both administrations of the questionnaire. Few students regarded home care and community health as preferable healthcare facilities after graduation. Research, managerial work or occupational health were not given as preferable areas of practice. There advantages were statistically significant differences between women and men in their preferences for private practice work and the public sector of healthcare. The results are discussed in relation to gendered division of labour in healthcare and to the development of the profession.

Place, publisher, year, edition, pages
Informa Healthcare, 2002
National Category
Educational Sciences
Identifiers
urn:nbn:se:umu:diva-66894 (URN)10.1080/140381902317303177 (DOI)
Projects
digitalisering@umu
Available from: 2013-03-06 Created: 2013-03-06 Last updated: 2017-12-06Bibliographically approved
5. A stimulating, practice-based job facing increased stress: Clinical supervisors’ perceptions of professional role, physiotherapy education and the status of the profession
Open this publication in new window or tab >>A stimulating, practice-based job facing increased stress: Clinical supervisors’ perceptions of professional role, physiotherapy education and the status of the profession
2005 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 7, no 3, 114-122 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to study perceptions of professional role, education and the status of the profession among clinical physiotherapy supervisors. Five focus group discussions were conducted with 15 supervisors attached to four universities in Sweden. Qualitative analyses were carried out using constant comparisons. Triangulation of researchers was used to increase trustworthiness. The supervisors experienced themselves as being in the centre of two competing and changing fields - the academic setting and the clinic in healthcare organization. The contact with students and their updated knowledge base were the most positive aspects of being clinical supervisors. To create a good learning environment for the students was considered important, but lack of time in all aspects of the work created stress and dissatisfaction. Students’ hands-on skills and treatment techniques were regarded to be rather poor and there is too much emphasis on theoretical knowledge and research methods in the curriculum. The physiotherapy profession has potentials to develop in innovative fields such as health promotion and disease prevention outside the hospitals, but healthcare with its hierarchical organization is a hindrance for this development. Collaborative efforts to bridge the gap between university and clinical setting are needed.

Place, publisher, year, edition, pages
Taylor & Francis, 2005
Keyword
Focus group discussion, hands-on skills, healthcare organization, physiotherapy education, stress, student supervision, theory-practice gap
National Category
Educational Sciences
Identifiers
urn:nbn:se:umu:diva-66897 (URN)10.1080/14038190510010359 (DOI)
Projects
digitalisering@umu
Available from: 2013-03-06 Created: 2013-03-06 Last updated: 2017-12-06Bibliographically approved

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