Experiences of physical therapists not-knowing during international service-learning work.

Abstract

Not-knowing implies that one does not have knowledge of something, to not be sure of something, or to not be able to recognize or identify something. When one finds oneself in a moment of not-knowing, he or she is in a state of being unaware or not informed. As members of a profession, physical therapists act as clinicians, educators, administrators, consultants, and researchers. Opportunities are now available for physical therapists to move onto the global scene as they become involved in international service-learning (ISL) work. Professional core values and a code of ethics set the stakes on knowing quite high. The familiar experience of performing one`s professional duties is altered by the context of the international setting. Not-knowing, consequently, holds serious implications professionally and personally for those who are supposed to know while engaging in ISL physical therapy work. This research project examined the phenomenon of not-knowing for physical therapists engaging in ISL work. Descriptive phenomenological methods were used to analyze interviews of 20 physical therapists on the topic of not-knowing during ISL work. Data were collected from two interviews with each participant in order to create the general structure of the experience of not-knowing. The interview transcripts were analyzed using the descriptive approach described by Giorgi (1975, 1997) and Dahlberg, Drew, and Nyström (2002). This process involved a whole--parts--whole type of holistic examination of the interview texts until the constituents of the experience were revealed. Descriptive phenomenology was used to describe the experience of not knowing what to do for physical therapists engaged in international service learning work. The structure of not-knowing was described as periods of surprise, shock, anger, guilt, and self-doubt, before being transformed by the experience and being able to move forward into action. The essence of not knowing for physical therapists engaged in international service learning work was signified by four constituents which included (a) Facing limitations -- Surprise or shock: Oh, my God!; (b) Strategizing and improvising: On the fly by the seat of my pants; (c) Professional identity and self doubt: I feel like an imposter; and (d) Illumination and clarity: When the light bulb turned on! The constituents revealed in this study have implications for physical therapists and health care workers who engage in international service learning work and for the programs which sponsor this work. By better understanding the physical therapists` experience we can better anticipate the kinds of support needed for those who engage in international service- learning work. Seeing moments of not-knowing as opportunities to learn may provide us with a cornerstone for building better relationships with people involved in health care across cultures and nations. The capacity to teach and practice life more sensitively is brought to light after an experience of not-knowing in an ISL setting for the physical therapist participants in this study.