From passenger to citizen—portraits of learning to be a physiotherapist

Abstract

Background and Purpose

Understanding the experiences of learners—and future graduates—is integral to their professional development and to the development of the profession. This paper adds to understanding of physiotherapy student experiences by exploring the ways students and recent graduates approach, learn about, connect with and form a relationship with their chosen profession of physiotherapy.

Methods

Heuristic inquiry, a form of phenomenology, was used. Thirteen participants (11 students and 2 new graduates) were interviewed.

Results

The findings are presented as four portraits: passenger, tourist, resident and citizen. These represent four particular and prominent ways that the participants connected with specific situations and/or to the profession as a whole, the sense they made of those situations (or the broader profession) and the identity formed.

Discussion

The portraits help educators to think about how students are navigating the process of becoming a physiotherapist and might act as a tool to help foster students' professional development. Educators who understand students' motivations and struggles are better prepared to help students to see themselves and the profession in sophisticated ways.

1. INTRODUCTION

While physiotherapy education has evolved in terms of adopting new educational strategies, different degree structures and additional learning environments, the purpose of physiotherapy education has been slower to change. The World Confederation for Physical Therapy (WCPT) (2019) states that the goal of physiotherapy education is to ‘facilitate the continuing intellectual, professional and personal development of students….’, yet the curriculum the WCPT describes is very much centred around traditional knowledge and skills. Physiotherapy education, and indeed health professional education generally, has often advanced that its main purpose is learner preparation and competency, despite a range of researchers highlighting the limitations (i.e. lacking clear meaning and shared understanding, narrow focus) of both (Atkinson & McIlroy, 2016; Barradell, 2017; Burford & Vance, 2014; Chesterton et al., 2021; Ottrey et al., 2021; Reeves et al., 2009; Zou et al., 2021). While the COVID‐19 pandemic was a catalyst to teach and work differently, especially with more use of technology through necessity, very few physiotherapy initiatives strayed from traditional profession‐bound experiences (Maric & Nicholls, 2020). A key aim of physiotherapy education remains the graduation of safe, professionally capable practitioners ready for their first day of clinical work.

Physiotherapy education involves supporting students to learn the implicit and explicit practices of their chosen profession. These practices reflect the ways of knowing and doing that the profession holds in esteem (Barradell et al., 2018, 2021). Professional identity is formed along the way but there are different theories as to how that might happen (Leedham‐Green et al., 2020). One is through socialisation. As students interact with others and learn about their place within the profession, they become enculturated to the norms and values of the social surroundings. Through this lens, learning to become a physiotherapist is a social practice, and physiotherapy educators and researchers are increasingly embracing sociocultural theories of learning, such as communities of practice, to engage students in experiences that enable them to join the professional community (O'Brien & Battista, 2020) but also to advocate and lead it (Barradell, 2021; Trede & McEwen, 2016; Tshoepe & Goulet, 2017). However, another school of thought is that learning fundamentally changes people and who they are. More and more, engaging students in educational experiences that form and transform are necessary to develop the capabilities that graduates require in an increasingly complex, ambiguous world. In this view, graduates become contributing members of society and the best versions of themselves they can be (e.g. Barnett, 2004; Barradell, 2017; Biesta & Braak, ; Dall’Alba, 2009; Halman et al., 2017; Higgs, 2013; Horton, 2010; Trede & McEwen, 2016; Tshoepe & Goulet, 2017). The emphasis has shifted towards learning to be a physiotherapist in society, rather than learning to be ‘like one’.

For accrediting bodies, institutions and educators (academics and clinically based supervisors), substantial effort goes into the ‘why’—questions of the purpose (i.e. meeting the healthcare demands of individuals and communities, addressing practice standards); the ‘what’—matters of content (i.e. theoretical knowledge, practical skills, clinical reasoning) and 'the how’ (i.e. teaching and pedagogical practices) of physiotherapy education. There has arguably been less consistent attention on ‘the who’ (i.e. learners), yet learners—who they become—are the real outcome of physiotherapy education. Understanding the experiences of learners—and future graduates—is therefore critical to helping students develop both professionally and personally and also to shaping the future of the profession. To work in a complex, ambiguous world requires that graduates learn how to be emotionally intelligent, socially responsible, agentic, imaginative, courageous, empowered and reflective. These skills and dispositions require graduates to know themselves as much as they know professional theory and skills and to develop a feel for their contribution to practice and the profession. Physiotherapy educators who have a rich and nuanced understanding of the development and growth of their learners are better prepared to support learners to achieve these educational goals and transition to professional life. Contemporary higher education approaches (i.e. Blackie et al., 2010; Healey et al., 2014) position students and educators alongside each other but this can only begin to happen when staff take steps to understand learners, their concerns, struggles, hopes and beliefs.

Physiotherapy students are increasingly approached to offer feedback and act as data sources, especially to gauge their satisfaction with new educational activities or their perspectives of areas of practice such as resilience, ethical dilemmas and clinical reasoning. Research directed at understanding students' overall educational experience of becoming a physiotherapist is less common, yet this work is critical for physiotherapy education because it is better able to gauge its outcomes and impact, and to most effectively meet contemporary demands. It is a complex space of inquiry; there is no single definition about physiotherapy formation and it includes concepts such as professionalism, professional values, identity, roles and development pathways (Rappazzo et al., 2022) yet these are not homogenous constructs (Trede, 2012; Trede et al., 2012). The body of work that focuses on students' overall educational experiences within physiotherapy is small and diverse. Previous studies have provided insights on how physiotherapy students' university learning experiences impact their engagement with their study (Hamshire & Wibberley, 2014), new students' expectations of being a physiotherapist (Richardson et al., 2002), the focus of physiotherapy students' learning experiences (Lindquist et al., 2006a; Lindquist et al., 2010), professional identity (Lindquist et al., 2006b) and development pathways (Korpi et al., 2014; Kurunsaari et al., 2018, 2021).

This study adds to the understanding of physiotherapy student experiences by exploring the ways a selection of students and recent graduates approach, learn about and connect with learning to become a physiotherapist. The study reflects contemporary understandings of the intersubjectivities of practice (Dall’Alba & Sandberg, 2006) as it focuses on the students themselves, but at the same time the curriculum and practice (i.e. context) comes in and out of the foreground. It also highlights the kinds of relationships students are forming with their chosen profession of physiotherapy, through physiotherapy education. The insights from this research are intended to support physiotherapy bodies and educators rethink the shape of the curriculum, and to shift the intersection between students, universities and clinical experiences for future generations of practitioners.

2. METHODS

2.1. Design

This study is part of a larger heuristic phenomenologically oriented inquiry (Moustakas, 1990, 1995) that explored how physiotherapy practice was experienced through physiotherapy education (Barradell, 2020). Heuristic inquiry focuses on: experiences of a phenomenon; the meaning and significance attributed to those experiences by those experiencing it; and prolonged periods of reflection and analysis from the researcher (Finlay, 2012). Heuristic inquiry presents experiences of the phenomenon and/or participants in four sequential but different ways (Table 1) to develop a layered understanding of the phenomenon. Each way of presenting these experiences is a move away from the original raw data and has a particular analytical intention. Individual depictions are ‘closest’ to the original data, with each subsequent stage involving more researcher interpretation while remaining grounded in the data. Describing these four forms of data representation as ‘stages’ belies the complexity of both the analysis and findings, but it is useful practically. This paper reports on the third ‘stage’, the exemplary portraits, and aims to illustrate experiences of learning to become a physiotherapist via typical characteristics of the whole sample.

TABLE 1.

Heuristic inquiry's forms of data representation and their analytical intention (Moustakas, 1990)

1. Individual depiction	2. Composite depiction	3. Exemplary portraits	4. Creative synthesis
focuses on an individual's story/experience without extrapolation (i.e. participant focus)	represents the totality of participants' experiences as themes (i.e. phenomenon focus)	focuses on select individuals as exemplars (examples) of experience considered characteristic of the whole group (i.e person and phenomenon focus)	an original and integrative re‐presentation that includes the most explicit interpretations of the researcher's own knowledge and personal experience

Ethics approval was obtained from the Human Research Ethics Committees of the University of Sydney (2014/138) and La Trobe University (FHEC14/083).

2.2. Participants

Participants were recruited from an entry‐level physiotherapy degree of a large metropolitan Australian university using purposeful sampling. Students enrolled at the time of the research, or who had graduated within the previous 18–24 months (recent graduates) were invited to participate. Students across all year levels were eligible. It was anticipated that this sampling strategy would assist in achieving both a breadth of experiences and saturation. A staff member independent to the study informed students of the opportunity to participate; those who expressed an interest were sent further information. Eleven students (spanning all levels of the course) and two recent graduates consented to participate (Table 2).

TABLE 2.

Summary characteristics of participant sample

Males: Females	3:8
Year of study	Year 1 = 2 participants Year 2 = 3 Year 3 = 3 Year 4 = 3 Graduates = 2
International students	None
Previous tertiary study	Yes = 4 (whole degree completed) Yes = 2 (1 year of study only) No = 5
Previous allied health assistant work	Yes = 4 No = 7

2.3. Procedure (data collection and analysis)

The data to develop the exemplary portraits came from multiple sources. There was raw data in the form of interview transcripts and researcher field notes. Face‐to‐face semi‐structured interviews lasting between 50 and 90 min were conducted individually with each participant. Interviews were audio‐recorded and transcribed verbatim. Field notes served as supplementary data. Further detail about the raw data is described elsewhere (Barradell et al., 2018). The researcher's interpretive insights from the previous stages of data representation (i.e. through developing the individual and composite depictions respectively) also informed the development of the exemplary portraits. These interpretive insights helped to guide the specific analytical process needed to develop the exemplary portraits.

The aim of exemplary portraits is to bring the person and the experience to life. In the context of this research, exemplary portraits are thus portraits of two connected things: the individual students and their experience of physiotherapy. It was clear from earlier analysis stages (i.e. interpretive insights when developing the individual and composite depictions) that participants had described experiences relating to their learning journey from student to graduate practitioner; that is the development of knowledge, skills and values when learning to become a physiotherapist. The relationship between the student and what they were learning about their profession (including the capacity to exercise agency along the way) seemed to be different among the participants. The various forms of data—most particularly the raw data—were returned to afresh to analyse them in terms of the way participants made sense of or approached learning to be a physiotherapist. This analysis aimed to connect the individuals and their experience of learning physiotherapy as described above. The analysis was inductive and emergent (i.e. coding occurred without any pre‐conceptions about the experiences), and as it progressed, it also became deductive (i.e. coding was informed by the reading and analysis of other transcripts) (Patton, 2002). The analysis included coding words and statements that seemed meaningful to the participants. This involved exploring statements used by participants and how their responses shed light on what might have informed and shaped their perspectives of professional life. The learning of knowledge, skills and values (or the knowing, doing and being associated with learning to become a physiotherapist) was also an analytical lens, drawn from higher education curriculum, teaching and learning literature generally and health professional formation literature more specifically. Table 3 shows an example of moving from transcript to coding to portrait. For example, some students talked about valuable sources of knowledge (i.e. journal articles but not books) based on what they had been told by others but at no point had those students questioned this. Such statements were interpreted as ‘rule following’ with students acting with little agency.

TABLE 3.

Example of moving from transcript to coding to portrait

Transcript	Coding	Knowledge, skills and values	Portrait
‘Credible sources of information. Obviously I'm not going to put Wikipedia in my references or Google or anything like that by scholarly articles from experts in that field but even then some of them are a bit dodgy….. Basically at uni we've been told to not use those. Anyone can go on Wikipedia and write anything but for a journal to get published in a magazine, especially if it's peer reviewed, it's got to be accepted by other experts in the field. So you know that it’s written by people who are doing proper research not some person who's just publishing on some public blog about why the sky's blue or something. It's from people who have spent their whole careers in that field so surely they've got to know what they're talking about.	Knowledge sources What's credible knowledge? Who decides that?	Knowledge ‐ being told by others, accepting this on face value, conventions, right and wrong Skills ‐ not questioning ‘Proper’	Passenger

2.4. Researcher‐researched relationship and reflexivity

The researcher‐researched relationship is essential to heuristic inquiry (Moustakas, 1986, 1995). Being an ‘insider’ is a strength of this research but it is also not without its challenges, as is true of research conducted with similar researcher positioning (Toy‐Cronin, 2019). Some of those challenges relate to the conduct of the research itself and included managing potential conflicts of interest (i.e. recruiting and interviewing current students) and ensuring interpretive distance. Strategies to enhance methodological and interpretive rigour included: prolonged immersion; critical friends to prod at assumptions and push for clarity and explanation; the complementary use of reflexive field notes as a data source; and member checking. Then there were challenges of a more ethical nature. It is likely that participants were willing to share their experiences due to their familiarity with me. Some students told me more about their experiences than anticipated: for example, sharing personal likes and dislikes about subjects in the course. It was as though they appreciated access to someone who would listen to their concerns, perhaps seeing me as someone who could make change happen. It was a privilege to have heard their stories and it was a deliberate decision to focus on perspectives typically under‐represented in physiotherapy education literature.

3. RESULTS

Four exemplary portraits were developed: passenger, tourist, resident and citizen. The portraits differ in terms of an individual's disposition and capacity for independence around knowledge, skills and values, and thus their development towards physiotherapy graduate. Each portrait demonstrates variation in, for example,: learner expectations, awareness of structural influences (i.e. power, organisations), personal values, emotional capital and the ability to see both the bigger picture and alternative perspectives. Each participant's experience of learning to become a physiotherapist is reflected in one of the portraits.

A brief general description of each portrait follows; a supporting description of participants who exemplified each portrait can be found in the Supplementary Material S1. The features of each portrait, with respect to knowledge, skills and values, are summarised in Table 4. The table's function is to illustrate the prominent differences across and between portraits rather than to suggest distinct boundaries. Transitioning from one portrait to another (i.e. a shift in experiences and approach to learning) appears to be unsettling and problematic. It is at these ‘crossings’ that learners engaged with needing to know, do and behave differently to cope with new situations ahead (Kilminster et al., 2011). Reading the Supplementary Material S1 along with Table 4 provides a full sense of the meaning of the experience.

TABLE 4.

Summary of the four portraits

	Development of and learning approach to
Portrait	Knowledge	Skills	Values
Passenger	Be told Exact knowledge Being ‘trained’ Studies required topics, skills, subjects Being correct, right, know Based on what is visible and of prominence (‘knowledge about’) Preconceptions, assumptions	Choices, job, tasks, like doing Safety Fun and satisfying Follow rules (without question or nuance)	Time concerns Self‐serving Getting further along (in life) Very underdeveloped Responsibility lies outside of self Sheltered
Tourist	Things to cover, see and move onto need to be exposed to it to learn it Developing but limited (due to learner and learning expectations) Experiences start to be important but focus on what without why	Work orientated Structured parts The good parts Opening up in the right now	Learning intentions centred on self Follows Struggles and insecurities abound as assumptions, pre‐conceptions and identity are challenged Developing some awareness but not the capacity to deal with what arises Outsider looking in, expanding but in specific separate contexts
Resident	Mix of professional and personal shows through integration of the multiple layered parts	Occupation Expanding but situated within particular confines Degree of authenticity and ownership Aware to a point but not challenging	Independence Focus shifts beyond self
Citizen	Seeks Asking questions in limited scopes Boundaries expanding but still in similar area	Profession, career Layered, nuanced, complex Aware of alternative perspectives and experiences Greatest sense of the inherent tensions but still in development	Flexible, mature, self aware in a range of situations both familiar and not Degree of humility Starting to think can have a limited influence as change agent

3.1. The passenger

The passenger is embarking on a pre‐determined path to professional entry, with choices based on certain likes and interests. These selections and perspectives are strongly influenced by prominently displayed ideas, such as those portrayed in the media, from hearing stories or from limited prior experiences. As a result, passengers have ‘knowledge about’ based on a subjective form of reality (Scanlon, 2011). Passengers are sheltered from the real world, bound by rules, and are not in control, nor authentically contributing to the passage. Their chosen degree is seen as similar to an itinerary comprising an overall course structure, enrolment, subject codes, topics and skills. Passengers focus on getting to the chosen ‘place’ and what they see themselves doing in the future, and so may be oriented towards tasks and stages.

3.2. The tourist

The tourist is very much outside of his/her customary environment but is experiencing aspects of the culture and community and therefore starting to create ‘knowledge of’ (Scanlon, 2011). In this sense, a tourist is an outsider‐in, being located within an environment but not fully a part of it. His/her horizons are broadening and a sense of purpose is beginning to develop, as well as an understanding of the culture and surrounds. However, this understanding is more as a series of isolated parts rather than the whole. The tourist is exposed to new discourses and experiences, and the contrast between the familiar and the different is never more obvious, which can be both disconcerting and exhilarating. There are similarities with the passenger—certain things are of prominence—but the tourist starts to see beyond what is on show, to make their own choices (albeit with limitations) and looks for meaning behind what might be considered traditional. Plans and routines help the tourist to join in and navigate the unaccustomed.

3.3. The resident

The resident has a greater level of professional competency, and with it, more confidence than the tourist. Another key difference is the resident has an awareness of the bigger picture having developed an understanding of how things are connected—one that includes both self and others (who are like minded), and one that is quite different to his/her initial naïve views. The non‐ordinary has begun to become the familiar, even taken for granted, and residents possess a sense of security. Residents are comfortable and for the first time demonstrate a sense of belonging; the resident ‘belongs’ by having reached a certain level of know‐how and ability to actively make their own choices. This allows residents to have established their own place within a community but also act somewhat independently within the ‘neighbourhood’. They have an understanding of the local infrastructures and are comfortable with their own role within the scope of these infrastructures which act more as boundaries (at least until residents have belonged for a while). Becoming a resident marks the point at which most students achieve entry‐level competency.

3.4. The citizen

The citizen shares some similarities with the resident but is more curious and more capable. The citizen is beginning to show signs that they are not afraid of uncertainty and is comfortable with venturing into situations they have not previously encountered. This signals greater agency. In some ways, citizens set their own course through a greater willingness to adapt and while the scope of their capabilities are expanding, they are still confined within the distinct boundaries of their chosen field. Nonetheless citizens enjoy the challenge and stimulation that comes with forging ahead.

4. DISCUSSION AND IMPLICATIONS

The portraits resulted from a novel interpretative methodology that sought an original and integrative representation of physiotherapy student participant experiences. These empirically derived portraits remind us that a critical objective of higher education is to pay attention to learners as they navigate becoming health professionals, as educators are in a better position to facilitate student learning when they understand where students are coming from and what they are wrestling with. The portraits also remind us that student cohorts are not homogenous. While systemic issues in higher education such as resourcing and infrastructure challenge tailored individual approaches, key learner‐centred strategies with high impact are a good investment. Paying attention to the development paths of students should be an imperative in health professional courses because if students remain as passengers, or even tourists, it hinders their professional development resulting in a form of ‘mimicry’ of the ways of thinking and practising of the practitioner (Meyer & Land, 2005); they graduate ‘like a physiotherapist’, rather than being a physiotherapist.

The professional development literature, particularly within medicine and nursing, draws strongly on the seminal work of Dreyfus and Dreyfus (2004) and Benner (2004), despite more recent critique (e.g. Dall’Alba & Sandberg, 2006; Peña, 2010). That seminal research focuses on skill acquisition and knowledge utilization and describes development for qualified practitioners as a series of sequential stages from novice through to expert. Research within physiotherapy seems to support the existence of these stages within certain physiotherapy practice contexts, although one difference is that ‘novice’ was found to map to final year students and new graduates (Brooks, 2011), suggesting physiotherapy's view of professional development (at least in terms of skill acquisition) is earlier than graduation. The research described in this study lends further support to the idea of professional development starting during pre‐registration learning experiences. Each of the four portraits describe experiences around particular skills and how they were perceived and valued. However, the portraits do more than describe skills (or doing); they also reflect experiences relating to knowledge and values. For each portrait, the three elements (knowledge, skills and values) together come to represent a particular approach—an ontological and epistemological representation—towards becoming a physiotherapist.

Moreover, there are parallels between the four portraits and other research about students' overall educational experiences within physiotherapy (Korpi et al., 2014; Kurunsaari et al., 2021; Lindquist et al., 2006a; Lindquist et al., 2010). For example, there are similarities between the portraits and the three learning patterns (‘Learning to cure body structure’, ‘Learning to educate about movement problems’ and ‘Learning to manage peoples’ health) described by Lindquist et al. (2010). In that work, the learning patterns reflect different categorical views about knowledge and learning, and they vary in terms of what, how, and with whom, students learned. Some features about what students learn are represented across the portraits presented in this study: for example, Lindquist et al.’s ‘learning to cure body structure’ pattern and the passenger portrait both tend to focus on exact knowledge and facts, while the learning to educate about movement and problems pattern and resident portrait both represent a shift beyond one's self. Another similarity lies with the stages (e.g., previous studies, new ways, understanding physiotherapy and turning professional) described by Korpi et al. (2014) and the expansion of understanding that comes with embracing new ways of learning, seeing the profession differently and more holistically and adopting a professional mindset; similar transitions are reflected across the four portraits. There are also differences between the portraits and existing literature that explores the structural factors impacting achievement and sense of belonging (Hamshire & Wibberley, 2014), ways of thinking and practising in the form of skills or competencies (Kurunsaari et al., 2018; Lindquist et al., 2006b; Richardson et al., 2002). The differences across this body of work and the study presented here are perhaps indicative of the different understandings and inherent complexity of professional formation. While there is undoubtedly value and meaning in these studies collectively, the portraits presented here make their own unique contribution to the professional formation landscape and offer another layer to our understanding of becoming a physiotherapist. Their power lies in the accompanying descriptions of each exemplar participant. Stories or cases are valuable pedagogical tools in healthcare education because individuals are memorably brought to life as a way of making sense of complex human situations (Gray, 2009; Talley, 2016). Educators can use the portraits to think about their teaching and the conditions that usefully shape the enculturation and development of their students. It might likewise be beneficial to ask learners to self‐identify with a portrait, to critically reflect on related strengths and weaknesses and develop a learning contract towards becoming a citizen. In both these applications, the portraits act as a narrative that can develop reflective practitioners (Greenfield et al., 2015). It is also important to recognise that these portraits are exemplary for the sample of study and the methodological approach used. They are best used by both teachers and students in partnership; they prompt thinking rather than narrowly categorise. Indeed, students within the sample, such as Freya and Beth (see Supplementary Material S1) described experiences that showed they were straddling features of both tourist and resident. Teachers may be able to design learning activities around the portraits that shift and reward student behaviours and consider if their own teaching was conducive to students' developing a more educationally nuanced view. Students might also become more equipped to evaluate their professional development, seek out and ask for specific help, and take steps to more fully engage with the process of becoming.

If we accept that the purpose of higher education, and therefore physiotherapy education, is to transform not to train (Bramming, 2007; Wenger, 1998), then physiotherapy educators need to foster learning for becoming and being. As Shulman (2002) offers ‘an educator can teach with integrity only if an effort is made to examine the impact of his or her work on the students’ (p. vii)—the impact of educational work should be judged by whether ‘transformation is an ontological condition of learning’ (Bramming, 2007, p. 48). Learning for becoming and being therefore demands that educators know their students. And it demands that students know themselves, their capabilities and capacities, and to develop skills to shape their future and that of the profession. In an educational climate still focused on work‐readiness while simultaneously wrestling with how to manage the 21st century limitations of an historical focus on disciplinary specific clinical skills, agency can be an overlooked even though it is an important capability of education (Su, 2011). The development of agency contributes to a shift in thinking from knowing about or doing to towards knowing oneself (within the profession). The four portraits differ in terms of agentic capability; the passenger is more a passive recipient, the tourist a naïve learner, the resident an experiential learner and the citizen a more active learner. For physiotherapy to remain relevant and respond to the challenges facing society, the profession needs ‘citizens’ to come out of its physiotherapy programs. Learners who are self aware, ask questions, embrace different ways of seeing the world and are comfortable with not knowing are most capable of being the kinds of physiotherapists that the world needs right now (Barradell, 2021). The portraits can help program directors and educators to think about curriculum, teaching, learning and assessment—from cohort selection to graduation—in ways that maximise personal and professional transformation.

4.1. Limitations

None of the students identified as international students although there was some ethnic diversity amongst the participants. Sociocultural characteristics were not a determining factor for inclusion or a lens for analysis. This does not detract from heuristic inquiry's rigour, as the main determinant, with respect to sampling, is that participants have experience of the phenomenon (i.e. studying physiotherapy). Although the sample is small, the number of participants was sufficient for heuristic inquiry (Moustakas, 1990) where the aim is not generalisability but rather a process of ‘being informed, a way of knowing’ (p. 10). Furthermore, the exemplary portrait phase of heuristic inquiry is a way of vividly profiling unique stories that still have relevance to all individual participants. The portraits are informed by what each participant chose to talk about and it is acknowledged that they might not represent the totality of physiotherapy students' stories. Additionally, the physiotherapy profession and physiotherapy education have particular ways of thinking and practising that provide context to the student experiences. It is acknowledged that the experiences represented here may not translate to contexts in other institutions and/or countries. More broadly, physiotherapy shares commonalities with other health professions but also important differences. Features of the portraits may resonate with other contexts (including other health disciplines) and they offer a useful framework for shifting students beyond the learning of knowledge and skills.

In focusing on the student experience, this research focuses on one element of physiotherapy education. If it is accepted that curriculum, teaching and learning should be considered in broad, expansive ways, then understanding the student experience is just one means of thinking more deeply about professional formation. Professional identity is influenced by a myriad of things including the nature of the profession being studied, pedagogic experiences and participation, conceptions and expectations of teaching and learning and workplace or learning culture (Reid et al., 2008; Strand et al., 2015). This research did not aim to critique the nature of physiotherapy, its underpinning philosophies or how and where these might be represented within the formal curriculum the students were exposed to. The degree structure, pre‐requisites and descriptions of intended learning outcomes however indicate the intended curriculum is highly structured and biomedically oriented. Additionally, this research did not set out to explore the delivery of curriculum or teaching practices and it is acknowledged that intended and enacted curricula are determining factors in students' experiences.

5. CONCLUSION

This research offers a new understanding about physiotherapy learners and how they approach, learn about, connect with and form a relationship with their chosen profession. Presented as four portraits and a summary of associated characteristics, the findings offer educators additional insight about the development of students and provide an avenue for educators to think about the conditions of teaching and learning that might help move and transform learners from passengers to citizens. While derived from a particular physiotherapy sample, the summary descriptions may resonate with and/or provoke conversation in other health professional contexts. This research also offers an example of how valuable it is to listen to and involve students in how we make sense of the profession, its practices and educational programs.

CONFLICT OF INTEREST

The author declares no conflict of interest.

Supporting information

Supporting Information S1

Barradell, S. (2023). From passenger to citizen—portraits of learning to be a physiotherapist. Physiotherapy Research International, 28(1), e1977. 10.1002/pri.1977

DATA AVAILABILITY STATEMENT

Research data are not shared.