Putting embodied knowledge into practice: a follow up study of graduates from complementary medicine training courses

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The use of complementary and alternative medicine (CAM) is an interesting social phenomenon for at least one, very simple, reason: one in ten people every year and one in three in their lifetimes use, and usually pay out of pocket, for CAM in the UK, when they have access to 'modern scientific' healthcare free at the point of use. Sociological studies of health and illness have traditionally focused on the practice of medical doctors to the neglect of understanding individuals' own ways of dealing with health problems within their family or community. In fact, most cases of illness (especially milder symptoms) are never seen by doctors. CAM therapists constitute a 'mid-way' between formal medical care and informal care by family or friends. Research into CAM is growing, especially studies that look at why patients use CAM therapies and the effectiveness of individual treatments. However, we still know surprisingly little about the practitioners of these types of therapy. CAM is a rapidly growing way for people to seek health advice and care, so it is important to understand more about the knowledge and skills that underpin this kind of healthcare, and how practitioners attempt to ensure the safety and quality of their practice.This study seeks to understand more about issues such as patient safety, regulation of practitioners and questions about the knowledge on which the practices are based. This will benefit the public who will have access to better information about these CAM therapies; mainstream health care practitioners who currently find it difficult to advise their patients about CAM because there is so little research in the field; and CAM professions because it will provide an independent insight into many of the key challenges that they are facing at the moment, including preparing students for practice.The Principal investigator (PI) is well placed to do this study. For her PhD, she undertook a study of students of two complementary therapies: osteopathy and homeopathy. She observed and participated in their classes over an academic year to understand their learning process. This kind of study had not been done before and the results brought new insights into the kind of knowledge about health, illness and the body that these two professions claim, in particular, the extent to which their knowledge is 'embodied'. This means that their knowledge and skills can not be represented by words in text books but are the result of an accumulation of bodily and sensory experiences, relating for example to touch or communication about emotions. This has important implications for the way that these practitioners are trained and regulated. Since then, the PI has worked closely with these professions on issues such as accrediting educational courses and patient safety in practice. She has also successfully applied for funding to run an academic conference on the regulation of these professions.For this study, the PI proposes to contact individuals who participated in the original study and have now gone into practice to find out about their careers and the ways in which their knowledge and skills have developed since graduating. Most complementary therapists work independently rather than having established career structures like doctors, nurses or midwives, so it will be interesting to find out how they ensure they have enough support and continue to develop their skills. This is also a unique opportunity because the research will be able to directly compare the values and practices articulated in training with how they are put into practice after graduation. The study will involve not only talking to practitioners about their experience, but also actually watching them in their daily working lives to see if what their say is the same as what they do, and to enable real events to spark off detailed discussions about how they deal with the realities of daily practice.