Professional Development

Participants who travelled overseas to study or to seek new experiences through work, gave a clear identification that they were striving to fulfil their personal professional development needs. The 'Developing Self' section of the 'Going Away' subcategory captures the key elements that participants articulated as important; gaining new and different knowledge, and developing thinking and reasoning. It also documents the focus on professional development as an internal personalised activity that may have subsequently led to extrinsic career development opportunities.

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"So to learn skill techniques and I want to gain more knowledge. That’s why I am here."

Suhani, FG1 (just arrived in UK for masters study)

The participants identified that physiotherapy practice in the overseas destination countries was different from the way it was practised in India, and most wished to "experience the work styles to see what is different" (Rani). The narrative demonstrated how many Indian physiotherapists were frustrated with the Indian hierarchical prescribed practice and sought to engage with autonomous practice. The development of knowledge and skills to enable them to engage effectively and to understand the different ways of practising, were identified as an important elements of their overseas professional development.

"And the thing about the practice here is really good. The research from UK is really good. And then autonomous, again."

Bipasha, FG3 (studied UK, about to return to India)

"The aspiration was mainly was to learn as much as I could in terms of what physiotherapy was there [overseas]; the concept of physiotherapy as

a whole, learn new techniques (...)and basically just getting as much as knowledge as I could so that I could come back here and practise better."

Minda (overseas returnee)

Professional development and professional knowledge are attributes that align with the characteristics associated with an individual's professionalisation (Richardson 1999). The participants wanted to increase the breadth and depth of their physiotherapy knowledge base; masters study would facilitate the development of reflective, critical evaluation and research skills, that would enable them to evaluate critically established modes of treatment and to develop new knowledge. FG1, FG3, Minda, Lalit and Adeeb had all aspired to

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gain overseas practice experience in order to understand the contextual origin of the knowledge in different social and cultural environments; the more experienced, especially Ashna, were also cognisant of the different ethical ramifications that overseas practice brought. The participants journeyed overseas to meet professional development objectives, this illustrates their subservience to the central concepts of professionalisation, lifelong learning and the development of personal practice. All overseas participants aspired to return to influence practice in India, which supports their adherence to the last identified tenet of professionalisation, to work to professionalise the profession. Professionalisation of individuals is considered to be an essential element in establishing an autonomous profession that can command the rewards (pay and respect) that are associated with professional status (Bithell 1999).

The narrative was very much about Indian physiotherapists equipping themselves as practitioners, to be better physiotherapists and to treat patients more effectively, but in order to do that they needed a wider professional knowledge base, as identified by Minda, but she also identified the importance of the higher levels of learning.

"...things that I may have probably not studied here, wasn’t as confident in doing over here and also applying all that - you know getting into that mode of lateral thinking, thinking broadly, into clinical reasoning and all of

that."

Minda (overseas returnee)

The development of confidence referred to by Minda was highlighted several times by the interviewees and appeared to be particularly important for the female physiotherapists. The confidence was around improved knowledge of the research evidence underpinning their ideas and an ability to justify and reason through their practice; but also improved communication skills. There

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was an expectation that the UK masters degree coupled with an increased confidence would help gain the 'respect' of doctors.

"But I think a masters from UK would help, because it will help in the doctors would sit up and take a bit of notice, because it is not just some bachelors young girl who is coming and trying to talk to me. And the thing is when you know how to talk to them, initially when we had done our

bachelors, I was quite shy. And I didn’t know how to approach and tell them that listen to me. I know about this and I have better knowledge. But now I know how to do that because I have those clinical reasoning

skills and I have that, you know I can search for articles. I know how to do that and I can show them articles and I can show them evidence so

I know now how to communicate and tell them and make them take some notice. And that way they will respect you, if you show them written work about it. And if you show that I know what I am talking

about."

Sushmita, FG3 (studied UK, about to return to India)

The increased confidence, the increased knowledge and an ability to articulate their ideas and to challenge the medical hierarchy to allow them to practise physiotherapy as the research evidence indicates, all support the notion of professional empowerment. The words in bold used by the Sushmita were all strong, positive and demonstrate a clear sense of someone confident in their profession.