Motivation Behind the Madness: How Research Chose Me

The number of allied health professionals returning to school to explore research at the Master’s and PhD levels in Canada is on the rise. Over the past couple of years, newly established professional and thesis-based PhD programs are now offered in Rehabilitation Science departments along with a demand for more faculty with PhDs. Over the next few years, more clinical research will lead to the evolution of evidence-based practices and clinical practice guidelines to strengthen our professions (excellent!). It also means, that the future cohort of new graduates in allied health professions may have significantly more research training than previous years.

So, does this mean current practitioners should consider being involved in research? And how do you know if it’s the right choice for you? I confronted this decision after a couple of years of clinical practice, and I decided to take the plunge back into academia to begin a PhD in 2016. It didn’t matter if I ran into a colleague, family member, or a friend, I was faced with the same questions,

“Why the heck are you going back to school after spending so many years in university to become a Athletic Therapist/Physiotherapist?”

“Weren’t you done school?”

“What are you going to do with a PhD??”

Which were typically followed by these statements,

“I don’t know how you have the time!”

“Good for you, I definitely wouldn’t be able to go back to school at this point!”

And sometimes, I would get the intrigued colleague who would ask me about my experience because they were also considering the same career decision.

I must admit, when I graduated from my Master’s program at 25 years old, I was not at all interested in pursuing academia any further. I wanted to kick-start my career and dive right into full-time clinical practice. This was the best decision I made at this point in life, I had to learn and develop clinical skills, and discover my niche in sports medicine. Clinicians are all Type A, over-achievers, who are always seeking more knowledge. Even though we finish our formal education, we take continued courses in various skill sets to build our clinical “tool box”.  We’re lifelong learners whether we like it or not. There came a point where I realized that I needed more than the 40-hour private practice grind, I needed something more dynamic.

I’ve always had interests in sports medicine and neuroscience stemming from several years working on the rugby pitch and at the rink witnessing the management of countless concussion injuries. Throughout this time, I would send players to the emergency room after screening them with a SCAT form on the sideline. Typically they would be sent home and told not to fall asleep, while isolating themselves in a dark room (sounds great, right?). I was always questioning the rigour of assessment measures that were used, particularly to determine return to sport. A little over a year into practice, I started to investigate opportunities for research, considering a handful of universities within my area. This led me to meeting with my current advisor (and previous professor) about his research program that involved objective balance assessment of asymptomatic athletes who had sustained recent concussions. Ultimately, the meeting sparked my interests into applying for the doctoral program.

At the time, there were only a handful of therapists that I knew who had PhDs, and I asked them everything I could possibly think of about their programs, their research, lifestyle, clinical work, sanity…the list went on. What I want to emphasize, is that this was not an easy decision, I didn’t just decide to do a PhD just so I could have a PhD. My interests were derived from my own clinical questions in an area I was passionate about. I found myself reading and identifying gaps in the literature long before I decided to pursue another degree. It was a major life change that affected not just my full-time job but would affect my entire lifestyle for the next few years.

The process isn’t easy, it’s different for everyone in each program. You will face challenges and barriers along with a much higher level of expectations that far exceeds anything you did in the several years of school prior. That being said, it’s been the best decision I’ve made for my career so far. My research has provided me with opportunities to present at national and international conferences, build a much larger professional network, develop leadership and teaching skills. Most importantly, I am a far better clinician based on the knowledge I’ve gained in my area of neuromechanics of balance control, visuomotor function, and sport-related concussion. The best advice I can provide to any clinician considering taking the leap into research is to have a purpose, know why you want it, and be passionate about it! I highly recommend seeking out a supervisor with common interests and an interest in YOU as a student. This creates a very strong working relationship and support for the marathon that is a PhD.

Since my opinions are biased to my own experiences, I wouldn’t be a good academic to just provide my side of the story. I thought I’d include a few other clinician-researchers with their decision-making advice based on different types of programs and areas of research,

“I always thought I would one day go back to get my PhD – I just figured it would be later in life. I was always frustrated with the lack of answers I could provide to my athletes who had sustained a concussion. So, I decided to pursue my PhD in that. I love being able to inform clinicians of current evidence and playing a role in improving care for my athletes.”

Dr. Johanna Hurtubise, PhD, CAT(C), Lecturer, University of Winnipeg

 “I had been wondering about graduate studies since my days as an undergraduate student in Athletic Therapy. I went to University of Florida to earn a course-based Master’s degree because I wasn’t sold on doing research. My decision to pursue a doctoral degree stems from a conversation with a football coach during my time as an Athletic Trainer in Florida. He said we were overacting to the concussion issue because the media had publicized a few bad cases. He added that the medical community didn’t know much about the injury which resulted in us being over cautious. Although we were right to treat concussions as a serious injury, he had a point. There was much to be done to better understand concussions and I wanted to be part of the solution.  I applied to the University of Ottawa shortly after.”

Janie Courneyor, MSc, CAT(C), ATC, PhD Candidate, University of Ottawa

“I had been practicing clinically for 4 years and despite continuing to take post-graduate courses, I still felt like my learning and progress was slowing. I decided to jump back into academia in order to kickstart my personal growth. I found a supervisor who challenges and develops me, and a topic which I can see myself dedicating the next 4 years to. After working with older adults in the community, I wanted to investigate how older adults are being connected with exercise programs tailored to those with balance and mobility problems. 6 weeks in and no regrets!”

Kyla Alsbury, PT, MScPT, BASc, PhD Student, University of Toronto

“After working as an Athletic Therapist for a few years, I realized there were questions I didn’t have the answer to. I was questioning if the treatment strategy I was using (ex. complete rest after concussion) was the best approach. My clinical experience was showing me that it wasn’t an effective treatment. I decided to start a graduate degree to research the use of exercise in concussion management. What I’ve found is that my work as a clinician inspires research ideas, and my work as a researcher informs my clinical practice.”

Danielle Dobney, PhD, CAT(C), RKin, York University

“After 2 years of clinical practice, I really started to appreciate how much we still don’t know. We are encouraged to always practice in an evidence-based way, but in many areas (particularly modalities and pain management) evidence is lacking. I still practice part-time and am glad for my clinical background and continued presence in the clinical world, because it makes my line of thinking and research questions as clinically applicable as possible. For any clinicians considering a PhD, it’s never too late! I know many clinicians further along in their career who have gone back. My advice is to look around, talk to as many people as possible about your interests, and don’t be afraid to go into a program outside of rehabilitation science. I’m realizing every day how connected my program is to rehabilitation science despite having a focus on fundamental, rather than applied, healthcare research.”

Emma Plater, PT, MScPT, PhD Student, University of Guelph

“I went back and did a PhD simply because I had a clinical question: why did so many patients who’d had concussions experience symptom exacerbation in busy environments? This question formed the basis of my PhD research, and since I continued to practice clinically, my research informed my clinical practice too. My advice to other clinicians thinking of getting involved with research is to do it. You don’t have to do it full-time, you don’t even have to do a PhD (although I’d recommend it – I loved the experience). Taking the time to investigate questions that are of interest to your clinical practice makes you a better clinician, and having clinicians driving research ensures scientists are asking questions that practitioners actually care about.”

 Meaghan Adams, PT, PhD, York University

“Your team matters. Research is a creative process. You need to work with and—most importantly if you are going back to school for formal research training—be guided by individuals who respect and value your creativity, and your process, while helping you build the capacity to produce work of value. Research is hard. It can be consuming, frustrating, and full of rejection. You need people outside of research that can remind you of the person you are outside of research. Keep these people close. The fact that they see you better than you see yourself is invaluable. Especially when you’re eyeballs deep in data cleaning.

Words matter. Not just because research is incredibly pedantic, but because you, as a clinician-researcher, aren’t just expected to be fluent in two languages, you’re expected to communicate and translate both languages at an expert level. This means lots of writing, lots of testing out of similar messages on different groups and tweaking it to the feedback that is provided. Be humble. Speaking of feedback, you are going to get loads of it, and not all of it will be complimentary. If you can’t take constructive feedback, if you can’t be critical of your work, if you have a hard time detaching from things because your too close to it, this world is not for you. That doesn’t mean you have to be an emotionless robot. It’s ok if things sting. But you have to be able to step back, reflect, and respond in a way that serves the work, not just your comfort. Be intentional.

Understanding what you want to know has disconcertingly little to do with producing quality research. The fact is, what you want to know and what you end up learning often don’t bear even a passing resemblance to each other.

Understanding why you want to know, however? That’s the key. The why speaks to the heart of the matter. The why reflects your intention in this work. And for almost everyone who is crazy enough to hyphenate in healthcare, that core is service. You want to know what sideline test is best to evaluate concussions, but you want to know this because you want to ensure that the teams you work with are getting the right care at the right time by the right professional, for example. The why becomes the touchstone you can turn to whenever the research process makes its inevitable zig when you were expecting a zag. It’s where you return when outside forces beyond your control flip your plan on its head. It’s what allows you to adapt, pivot, slow down or stop altogether in order to ensure that the work is a true reflection of you, not the funhouse mirror version. Be clear about your intentions. Share them with those you work with and love with early, and often. Infuse the intention in every task you take on, large or small. And protect that  intention. Without it, the danger losing the plot of your research, and your unique perspective as a clinician-researcher, is far too real.

Lest Part 5 sends you into a pit of despair, lets end with this. Remember you aren’t alone. The community of clinician researchers in Canada and beyond, is growing. Learn from some, mentor some, collaborate with some, heck, just share a meal or a beverage or an email with some. Your own experience will be richer for it.”

Tracy Blake, PT, PhD (PhD Mentor Extraordinaire)