Postgraduate specialisation in sports physiotherapy – Academic or clinical expertise?

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As we head towards the latter part of the 1st decade in the 21st century, Physical Therapy as a profession has continued to develop towards the promotion of specialisation as part of lifelong learning and to advance quality of patient care. Sport as a specialist field is no exception to this and the International Federation of Sports Physiotherapy (IFSP), as a sub-group of the World Congress of Physical Therapy (WCPT), has been at the forefront of promoting recognition of expertise in sport and exercise physiotherapy. Postgraduate education at M level has become an expected part of the steps towards specialisation and as a consequence, more and more M level programmes are becoming available globally.

Part of the WCPT declaration of principle is that lifelong learning and professional development is the cornerstone of a competent therapist and that all physical therapists should be encouraged to undertake postgraduate education in order to further the profession. Similarly, the IFSP has set its competencies and standards of a specialist sports physiotherapist at M level, whilst recognising that there will be variations in membership countries as to specific pathways towards this standard. These developments over the past 10–15 years have changed the profile of sports physiotherapists and it is inspiring to see practitioners approaching athlete management in a much more critical way, using evidence based principles to support their clinical reasoning.

The down side to this evolution is that the drive to complete M level education sometimes supersedes the important role of experiential learning and the value of reflection in expert practice. In this ever competitive area of physiotherapy, where there are limited opportunities to work in the higher levels of sport, the rush to be able to tick the MSc box on a professional development portfolio can dominate individual development plans to the exclusion of all else. Whilst being a strong advocate of achieving MSc qualifications and running such a programme myself, I remain convinced that specialist or expert practitioner level can only come with a combination of academic advancement alongside skills acquired through reflection of significant clinical experience. Indeed, both WCPT and IFSP contain caveats in their documentation that professional development can be achieved in a variety of ways and not just through attendance on formal courses. Access to formal courses is also variable internationally and therefore there has to be some flexibility in how individuals can demonstrate their expertise. This is where the role of evidence based scientific journals becomes an important component of professional development, providing sources of relevant evidence based practice and a means of disseminating best practice, whether through original research or case study presentation.

Different countries are using varying means of demonstrating specialist practice, either through formal examination, or through presentation of an appropriate professional portfolio, or a combination of both. This has to be flexible enough to accommodate accepted practice within professional organisations of those different countries and comply with their legislation. The IFSP has gone some way towards such acknowledgement of expertise, looking at the possibilities of individual portfolio submission in some countries where M level education is difficult to access, whilst recognising the existing developments within other countries. Hopefully, with the continued excellent work by IFSP over the next decade, we will see a globally recognised standard of specialisation in sports physiotherapy, accessible and flexible enough to encourage international accreditation within our clinical field.

As we get ready for Olympics in London 2012, the Association of Chartered Physiotherapists in Sports Medicine (ACPSM), as the host country sports physiotherapy professional group, are striving to work with the London Organising Committee towards facilitating such professional development in order to provide high standards of athlete care through the volunteer programme. Postgraduate education will form part of that, as will clinical skills based continuing education courses alongside mentored and supervised clinical practice. The challenge will be to support professional development towards a high level of expertise, using the competencies detailed by IFSP, to provide an excellent service through sufficient numbers of expert practitioners in 3 years time. Conversely, the impetus provided by hosting an Olympic Games in the UK has provided an increased profile for the role of sports physiotherapists nationally and ACPSM will strive to use this as a legacy to promote our specialism in both high performance and recreational sport, as well as in the exercise or healthy active lifestyle area.

I look forward to being a part of that challenge and to seeing how sports physiotherapy continues to develop, using both academic knowledge and clinical experience to support clinical reasoning in an evidence based profession.