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

补充和替代医学（CAM）的使用是一个有趣的社会现象，至少有一个非常简单的原因：每年有十分之一的人和三分之一的人在他们的一生中使用，并且通常自掏腰包，在英国，当他们在使用时可以免费获得“现代科学”医疗保健时。健康和疾病的社会学研究传统上集中在医生的实践，忽视了了解个人在家庭或社区内处理健康问题的方式。事实上，大多数病例（特别是症状较轻的病例）从未被医生发现。CAM治疗师构成了正式医疗护理和家庭或朋友的非正式护理之间的“中间道路”。对CAM的研究正在增长，特别是研究患者为什么使用CAM疗法和个体治疗的有效性。然而，我们仍然对这些类型的治疗从业者知之甚少。CAM是人们寻求健康咨询和护理的一种快速增长的方式，因此，了解更多关于支撑这种医疗保健的知识和技能以及从业人员如何确保其实践的安全和质量是非常重要的。本研究旨在了解更多关于患者安全，从业人员监管以及实践所基于的知识问题的问题。这将使公众受益，他们将获得有关这些CAM疗法的更好信息;主流医疗保健从业者目前发现很难向他们的患者提供关于CAM的建议，因为该领域的研究很少;和CAM专业，因为它将提供一个独立的见解，他们目前面临的许多关键挑战，包括为学生的实践做准备。首席研究员（PI）很适合做这项研究。在攻读博士学位时，她对两种互补疗法的学生进行了研究：整骨疗法和顺势疗法。她观察并参与了一学年的课程，以了解他们的学习过程。这种研究以前从未做过，结果为这两个专业所声称的关于健康，疾病和身体的知识带来了新的见解，特别是他们的知识被“隐藏”的程度。这意味着他们的知识和技能不能用教科书中的文字来表示，而是身体和感官经验积累的结果，例如与触摸或情感交流有关。这对这些从业人员的培训和监管方式具有重要影响。从那时起，PI就与这些专业人员密切合作，如认证教育课程和实践中的病人安全。在这项研究中，PI建议联系参与原始研究并现已投入实践的个人，以了解他们的职业以及他们毕业后知识和技能的发展方式。大多数辅助治疗师独立工作，而不是像医生，护士或助产士那样建立职业结构，所以了解他们如何确保他们有足够的支持并继续发展他们的技能将是很有趣的。这也是一个独特的机会，因为研究将能够直接比较培训中阐述的价值观和实践，以及毕业后如何将其付诸实践。这项研究将不仅涉及与从业人员谈论他们的经验，而且还实际观察他们在日常工作生活中的情况，看看他们所说的与他们所做的是否相同，并使真实的事件能够引发关于他们如何处理日常实践现实的详细讨论。

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.