Received: 4 January 2022

DOI: 10.1002/pri.1977

RESEARCH ARTICLE
- -
Revised: 20 July 2022 Accepted: 9 October 2022

From passenger to citizen—portraits of learning to be a

physiotherapist

Sarah Barradell1,2

1
Department of Nursing and Allied Health,
Swinburne University, Hawthorn, Victoria, Abstract
Australia
Background and Purpose: Understanding the experiences of learners—and future
2
Sydney School of Education and Social Work,
graduates—is integral to their professional development and to the development of
University of Sydney, Sydney, New South
Wales, Australia the profession. This paper adds to understanding of physiotherapy student expe-
riences by exploring the ways students and recent graduates approach, learn about,
Correspondence
Sarah Barradell, Department of Nursing and connect with and form a relationship with their chosen profession of physiotherapy.
Allied Health, Swinburne University, Methods: Heuristic inquiry, a form of phenomenology, was used. Thirteen partici-
Hawthorn, VIC 3122, Australia.
Email: sbarradell@swin.edu.au pants (11 students and 2 new graduates) were interviewed.
Results: The findings are presented as four portraits: passenger, tourist, resident and
Funding information
citizen. These represent four particular and prominent ways that the participants
Open access publishing facilitated by
Swinburne University of Technology, as part of connected with specific situations and/or to the profession as a whole, the sense
the Wiley ‐ Swinburne University of
they made of those situations (or the broader profession) and the identity formed.
Technology agreement via the Council of
Australian University Librarians. 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' motiva-
tions and struggles are better prepared to help students to see themselves and the
profession in sophisticated ways.

KEYWORDS
becoming, experiences, professional development, student

1 | INTRODUCTION
While physiotherapy education has evolved in terms of adopting
new educational strategies, different degree structures and addi-
tional learning environments, the purpose of physiotherapy educa-
tion has been slower to change. The World Confederation for
Physical Therapy (WCPT) (2019) states that the goal of physio-
therapy education is to ‘facilitate the continuing intellectual, pro-
fessional 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 (Atkin-
son & 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, profes-
sionally capable practitioners ready for their first day of clinical
work.

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© 2022 The Authors. Physiotherapy Research International published by John Wiley & Sons Ltd.

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https://doi.org/10.1002/pri.1977

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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 social-
isation. 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 ed-
ucators 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 contrib-
uting members of society and the best versions of themselves they
can be (e.g. Barnett, 2004; Barradell, 2017; Biesta & Braak, ; Dal-
l’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 prac-
tices) 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 pro-
fessional 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. Contem-
porary 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
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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 com-
mon, 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 physio-
therapist (Richardson et al., 2002), the focus of physiotherapy stu-
dents' 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 un-
derstandings 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 inten-
ded to support physiotherapy bodies and educators rethink the
shape of the curriculum, and to shift the intersection between stu-
dents, 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 physiother-
apy 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

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TABLE 1 Heuristic inquiry's forms of data representation and their analytical intention (Moustakas, 1990)
1. Individual depiction 2. Composite depiction
� focuses on an individual's story/ � represents the totality of partic- � focuses on select individuals as � an original and integrative re‐
experience without extrapolation ipants' experiences as themes
(i.e. participant focus) (i.e. phenomenon focus)
T A B L E 2 Summary characteristics of Males: Females
participant sample
Year of study
International students
Previous tertiary study
Previous allied health assistant work
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.
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 de-
gree 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 oppor-
tunity 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).
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
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3. Exemplary portraits 4. Creative synthesis
exemplars (examples) of experi- presentation that includes the
ence considered characteristic of most explicit interpretations of
the whole group (i.e person and the researcher's own knowledge
phenomenon focus) and personal experience
3:8
Year 1 = 2 participants
Year 2 = 3
Year 3 = 3
Year 4 = 3
Graduates = 2
None
Yes = 4 (whole degree completed)
Yes = 2 (1 year of study only)
No = 5
Yes = 4
No = 7
researcher field notes. Face‐to‐face semi‐structured interviews last-
ing 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 physio-
therapist. 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

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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 par-
ticipants 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.
2.4 | Researcher‐researched relationship and
reflexivity
The researcher‐researched relationship is essential to heuristic in-
quiry (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 dis-
tance. Strategies to enhance methodological and interpretive rigour
included: prolonged immersion; critical friends to prod at assump-
tions 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 par-
ticipants were willing to share their experiences due to their famil-
iarity 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 ac-
cess 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 expecta-
tions, awareness of structural influences (i.e. power, organisations),
personal values, emotional capital and the ability to see both the
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bigger picture and alternative perspectives. Each participant's expe-
rience 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 differ-
ences 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 situ-
ations ahead (Kilminster et al., 2011). Reading the Supplemen-
tary Material S1 along with Table 4 provides a full sense of the
meaning of the experience.
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 se-
lections 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 (Scan-
lon, 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.
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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 Knowledge sources Knowledge ‐ being told by others, Passenger
put Wikipedia in my references or Google or anything like What's credible knowledge? accepting this on face value, conventions,
that by scholarly articles from experts in that field but Who decides that? right and wrong
even then some of them are a bit dodgy….. Skills ‐ not questioning
Basically at uni we've been told to not use those. Anyone can ‘Proper’
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 pub-
lishing 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.

TABLE 4 Summary of the four portraits

Development of and learning approach to

Portrait Knowledge Skills Values

Passenger Be told Choices, job, tasks, like doing Time concerns

Exact knowledge Safety Self‐serving
Being ‘trained’ Fun and satisfying Getting further along (in life)
Studies required topics, skills, subjects Follow rules (without question or Very underdeveloped
Being correct, right, know nuance) Responsibility lies outside of self
Based on what is visible and of prominence Sheltered
(‘knowledge about’)
Preconceptions, assumptions

Tourist Things to cover, see and move onto need to be Work orientated Learning intentions centred on self
exposed to it to learn it Structured parts Follows
Developing but limited (due to learner and The good parts Struggles and insecurities abound as assumptions,
learning expectations) Opening up in the right now pre‐conceptions and identity are challenged
Experiences start to be important but focus on Developing some awareness but not the capacity
what without why to deal with what arises
Outsider looking in, expanding but in specific
separate contexts

Resident Mix of professional and personal shows through Occupation Independence

integration of the multiple layered parts Expanding but situated within Focus shifts beyond self
particular confines
Degree of authenticity and
ownership
Aware to a point but not
challenging

Citizen Seeks Profession, career
Asking questions in limited scopes Layered, nuanced, complex
Boundaries expanding but still in similar area Aware of alternative perspectives
and experiences
Greatest sense of the inherent
tensions but still in
development
Flexible, mature, self aware in a range of situa-
tions both familiar and not
Degree of humility
Starting to think can have a limited influence as
change agent

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 demon-
strate a sense of belonging; the resident ‘belongs’ by having reached
a certain level of know‐how and ability to actively make their own

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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 in-
frastructures 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 edu-
cation such as resourcing and infrastructure challenge tailored indi-
vidual 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 phys-
iotherapy 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
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development (at least in terms of skill acquisition) is earlier than
graduation. The research described in this study lends further sup-
port 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 Lind-
quist 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 & Wib-
berley, 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 en-
culturation 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

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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 methodolog-
ical 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 (Bram-
ming, 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. Sociocul-
tural characteristics were not a determining factor for inclusion or a
lens for analysis. This does not detract from heuristic inquiry's rigour,
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- 7 of 9
as the main determinant, with respect to sampling, is that partici-
pants have experience of the phenomenon (i.e. studying physio-
therapy). 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 physio-
therapy 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 pro-
fessions 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 cur-
riculum, 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 curricu-
lum 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 por-
traits 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 phys-
iotherapy 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

8 of 9
- BARRADELL
involve students in how we make sense of the profession, its prac-
tices and educational programs.
A CK N O WL ED GE M EN T S
I thank Tai Peseta and Simon Barrie for the many conversations that
greatly helped the development of this paper. And thank you also to
#thesisthinkers for their encouragement.
Open access publishing facilitated by Swinburne University of
Technology, as part of the Wiley ‐ Swinburne University of Tech-
nology agreement via the Council of Australian University Librarians.
C O N F LI C T O F I N T E R ES T
The author declares no conflict of interest.
D A TA AV A I LA BI LI T Y S T A T E M EN T
Research data are not shared.
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S U P P O R T I N G I N F O RM A T I O N
Additional supporting information can be found online in the Sup-
porting Information section at the end of this article.
How to cite this article: Barradell, S. (2023). From passenger
to citizen—portraits of learning to be a physiotherapist.
Physiotherapy Research International, 28(1), e1977. https://doi.
org/10.1002/pri.1977