Physiotherapists participation in the McKenzie Institute Musculoskeletal Mechanical Diagnosis and Therapy diploma programme: A qualitative descriptive inquiry

Increasingly healthcare providers including physiotherapists have been expected by their professional and regulatory bodies to undertake continual learning to develop both clinically and professionally. Additionally, in response to changing health provision landscapes, within the allied health sector, there has been greater emphasis on promotion of autonomous practice with the opportunity for expansion of physiotherapists' scope of practice. Musculoskeletal physiotherapists, through extended, advanced and specialist roles, have worked toward achieving recognition as musculoskeletal primary care providers of choice. Participation in postgraduate study has been indicated by physiotherapy governing bodies as an essential requirement for progression into these extended physiotherapy roles. An area of emerging research in musculoskeletal physiotherapy is exploration into existing models of postgraduate education. The McKenzie Institute is one group that provides postgraduate education and continued professional development for musculoskeletal practice. The McKenzie Institute’s education framework involves completion of sequential competency programmes in Mechanical Diagnosis and Therapy (MDT). The highest competency level is attainment of the Diploma in MDT. Although Mechanical Diagnosis and Therapy has been extensively researched in terms of reliability, efficacy and patient outcomes, to date there are no known studies that have focused on the McKenzie Institute’s education programmes. This inquiry aimed to explore physiotherapists’ perspectives on the experience of undertaking and successfully completing the McKenzie Institute diploma programme. An exploratory qualitative descriptive approach was utilised. Semi-structured interviews were conducted with nineteen MDT Diploma graduates. These were audiotaped and then transcribed. A foundational thematic analysis approach was used to analyse the data. Three overarching themes emerged from the data. (1) “Trust and hope in the system” – Trust was articulated in the belief of MDT. Participants viewed the MDT system as an assured learning continuum and anticipated that participating further in the continuum would progress them. Hope in the system signified the desired consequences or outcomes that participation in the MDT diploma programme might bring. Being a better clinician, credibility and the possibility of becoming an educator were highlighted as the central aspirations to be gained by placing trust and hope in the system. (2) “Learning to fully trust the system” – Described the participants learning journey. This encompassed their challenges, development and evolution through the systems learning continuum which brought about the expansion of practice insight and facilitated ongoing practice transformation. (3) “Beyond the system” – represents what “learning to trust the system” has brought to participants following completion of the MDT diploma programme. Participation became a driver for change and development both beyond the mechanical and beyond being a clinician. Additionally, it made participants feel more legitimised in the MDT community of practice, while also exposing them to new and broader communities of practice beyond MDT. Findings may enhance the experience of future MDT learners considering undertaking the diploma programme. Additionally, it may help inform the McKenzie Institute how to sustain trust and hope in the system, as well as consider strategies for enhancing the Institute’s ongoing education and organisational endeavours. More broadly the findings may also prove meaningful or useful to other groups involved in developing and delivering similar postgraduate education programmes