Who is fit to teach…?


Not so long ago there was a debate on Twitter about what makes someone suitable to teach post graduate physiotherapy courses. Needless to say there were some different points of view, strong opinions, and a few heated exchanges. However, I thought I would let the dust settle a bit then expand on some of the points raised and add some of my own thoughts to the age old question of… ‘who is fit to teach.’
First things first, a declaration of my conflict of interest. I teach a course on simplifying the shoulder that tries to cut through the clutter, confusion, and crap that is out there, and of course I earn some income from it, so obviously my views and opinions are going to be biased here, so please take this into consideration!

Greed and Ego’s!

So this debate started due to some comments made about how there seem to be more and more post graduate courses recently, and how it appears that many of these are more for the tutors benefit to earn money and see the world. And I agree. I have noticed a huge surge in the number of courses recently, and having been on many myself I can say they vary massively in quality and content.
There are now courses on everything from manual therapy to exercise therapy, from taping to needling, from psychology to physiology. There are courses for paediatrics and geriatrics and everything in between. There are courses for tendons joints, fascia, skin, nerves, backs, hips, knees, and of course shoulders. This choice is endless.
This vast amount and choice clearly reflects a need and a market for post graduate courses, with hungry, keen, eager minds wanting more information and knowledge. However, with no official regulation or even minimum standard for these courses, there can be a high degree of variability in content and quality.
Personally I am still amazed that there is no formal accreditation procedures or regulatory bodies in the UK for post graduate physiotherapy courses. The idea that any Tom, Dick, or Adam can just ‘do’ a post graduate course without the content being checked, reviewed, or assessed by peers both concerns and worries me. In my opinion all courses, including mine, should be scrutinised regularly to ensure the content is up to date, the interpretation is on track, and the tutors biases are kept in check.
I have been on many post graduate courses over the years, spending thousands of pounds in the process, eager to learn and keen develop my skills to help my patients. However, I have often been hugely disappointed with some of these courses. In fact I wrote about this as one of my first blogs nearly four years ago here.
Now some of my views and opinions, as well as my writing style, have changed a little since that blog, but I do still think the world of post graduate training is rife with greed, marketing, and personal egos. In fact, I actually think this even more having had the experience of hosting and organising my own courses, witnessing the business wars, personal back stabbing and bitching from the training company’s and teaching guru’s within the ‘industry’.
If anyone is too be accused of profiteering and greed in the world of post graduate training then it is many of these middle men ‘training companies’ who often charge delegates extortionate fees, have very little costs or outgoings, and who pay lecturers and tutors small percentages of the income generated, keeping the majority of the profits for themselves.
It must be recognised that to design, write, and teach a course is no walk in the park, or something you do flippantly just one weekend. A good course is a long laborious process of learning, researching, assimilating, interepting, planning and rehearsing that takes a lot of hard work. And once done it has to be constantly updated, tweaked and adjusted as the evieence and practice changes.

Clinician or Academic?

However, this debate on post graduate courses soon moved onto the topic of who is most suitable to teach and what are the necessary or minimum qualifications and experiences needed.  This seemed too split into two camps, those who believed a course tutor should have the minimum qualifications of a PhD or at least a MSc, and have published peer reviewed papers on the subject they are teaching. Then there where those who thought these were NOT essential and that there is more to teaching courses than just having publications and qualifications. Try to have a guess which camp I was in!
Those who argued for minimum qualifications and publications went on to justify their reasons by explaining that this will guarantee that the tutor will have greater knowledge and in-depth understanding of the evidence as well as research methods and scientific processes. This, they state means a well qualified tutor will be more aware of the complexities and flaws of the research, and so will be able to present and teach a more complete and unbiased course.

What a complete load of utter bull shit!

To think that having post graduate qualifications and published papers makes someone more capable to teach a better unbiased course is at best naive, and at worst snobbish reductionist fallacious reasoning. Teaching isn’t just about knowledge, qualifications, and research. Of course having an in depth knowledge of a topic is essential, a teacher can not teach what they do not know, but knowledge alone simply is not sufficient to make a good educator.
To be a good teacher is to be able to enthuse, excite and explain to others effectively. To quote Albert Einstein below…

I have been on way too many courses with some of our professions most highly qualified and educated individuals who have publications falling out of their ear and arseholes, only to be bored shitless and confused witless due to their crappy presentation style, terrible explanations and jumbled delivery. Yet conversely some of the best courses I have ever been on are with a clinician who simply has a clear passion and deep knowledge for the subject they are teaching and often very little if any publications etc!

I know science me!

To think that those without post graduate qualifications or publications can not be fully aware of the evidence base, or can not understand the scientific processes is just more qualification snobbery. Of course there are many clinicians hopelessly out of date and totally clueless of the current evidence, but conversely there are many clinicians out there with a remarkable in-depth awareness and understanding of the evidence base and the scientific method that puts most academics too shame.
Qualifications and publications are no guarantee of knowledge and many clinicians like myself choose not to gain further qualifications not because we don’t know stuff or can’t understand science, but rather due to personal choices or other life events taking priority.
Finally to think that having more qualifications makes a teacher less biased is simply deluded wishful thinking. If anything I often see it the other way round. Many academics often have greater bias due to their personal involvement in it. Most researchers often have invested and sacrificed a hell of a lot of time, energy, and expense into their research and qualifications, and this is to be commended. But this effort does tend to skew their views and perspective due to the hardship this process took to achieve.
It is known that those who work hard to acheive something do tend to place a greater emphasis on its importance than those who haven’t (ref). It is this phenomenon in my opinion that tends to makes some academics exaggerate the importance of a particular area of interest of theirs and all to often I see academics promoting their own research without recognition of other work that challenges their own.

So what makes a good teacher?

This is an age old question and one that has been asked time and again right from the days of Aristotle and Plato. There have been many disagreements on what are the essential characteristics for a good teacher, and many have tried to determine what separates those that are perceived as good educators from those that are not (ref).

When you read around what makes a good teacher there are many factors and qualities discused, however, the number of qualifications and publications a teacher has is never one of them. As mentioned an in-depth knowledge of the subject is essential, but good teaching tends to be more about other factors and qualities other than knowledge alone. I have broken down what I think makes a good teacher/educator into four key areas.

No 1: Passion

Having a strong passion for a subject and conveying that passion to others is what I truly think separates a good teacher from a bad one. It is hard not to pay attention to and learn from someone who is talking passionately about a topic that they know a lot about, yet the exact opposite is true when someone is speaking with lethagy and disinterest. Simply put with no passion, there will be no learning.

No 2: Personality

A good teacher needs to have the right personality. In my opinion this is a mix of part nerd, part comedian, part shakespearian actor. Teaching is just like acting, having a theatrical ability helps impart knowledge greatly. Being able to deliver a creative, imaginative and engaging learning experience is a skill and trait not all educators have. Being able to take a subject and shape a learning experience that is unique and dynamic, that grabs attention and makes them wanting to come back for more is what makes a great teacher.

No 3: Respect

A great teacher does NOT see themselves on a higher pedestal than their students. Although good teachers tend to be good leaders and naturally command respect, they do NOT achieve this through hierarchy, qualification snobbery, or appeals to authority. A great teacher earns respect from others not just by demonstrating knowledge but also by leading by example that they are able to learn from others and can listen to other ideas and opinions, make balanced and rationale arguments and discussions. A good teacher ensure others feel safe to ask questions and explore ideas. A good teacher creates a relaxed and welcoming learning environment without imposing their own rhetoric and agenda

No 4: Fun

But at the end of the day good teaching is about fun, both having it and making sure others are having it too. Good teachers do it not for the money nor because they have to, but because they truly enjoy it, and they want others to enjoy it too. I bloody love teaching, I love the interaction, the opportunities, and the fun it gives me. I love meeting new people and learning from them, in fact I often see my courses are just as much for me to learn from those attending as they are learning from me.
In summary, good teaching is as much about passion as it is about qualifications. Sure qualifications are important but they are not sufficient to be a good teacher. To be a good teacher you have to be part stand-up comic, part salesman, part expert, part nerd, part counsellor.
Teaching is about motivating others to learn, but also guiding others how to learn for themselves in a manner that is relevant, meaningful and memorable. Good teaching is as much about personality and performance, as publications and powerpoint.
As always thanks for reading

  1. Here here….great piece Adam. As always written from the heart with a huge splash of common sense.

  2. I totally agree. Just because someone has the letter DR before their name we assume they know stuff!! I have been in all the Mckenzie courses A to E, thinking that these people teaching me are the real deal. Unfortunately, not true, these guys are suckers fwho have been indoctrinated into the Mckenzie philosophy and trying to spread the word like disciples. Hence, I do not use Mckenzie for any of my patients. Is it all a money making gimmick, I would say 90% of all of these post grad course are of the same ilk, to satisfy the egos of the so called personalities who run the courses. Yes NOI I’m talking about you too.

  3. Interesting piece Adam. I’m more a lurker than contributor on here but thought this might be relevant.
    As a Pod I’m involved in running training courses for pods to gain extended scope practice to use manual therapy skills. To gain extended scope status the courses had to be approved by the professional body and, to retain, the extended scope status the courses have to be reviewed and reapproved every 3 years.
    In the past I’ve purposely requested an observer come along and observe me, which they did. (Must admit to bricking it then). They Brought some helpful critique to bear as a result.
    Not saying all courses need to be run like this but it keeps me on my toes.

    • Hi Ian, thanks for your comments and I think that sounds like a great way to ensure a course is up to date and on track! I would welcome this across the board for all therapy post grad teaching!

  4. I’m also a long time lurker here but I really enjoyed this one and felt inspired to comment…
    I know in the US and Australia they have accreditation type processes for their courses, not so in the UK and Canada. I’m not convinced this is the best way. I think it might mean jumping through so many hoops the red tape puts the courses way behind the evidence (look how long it takes the undergraduate programs to catch up). I also don’t see top down getting rid of the crap, plenty of courses that look pretty dodgy to me are accredited in the US.
    I think with the popularity of blogs like this one, some of the awesome podcasts out now and all the healthy debates on twitter physios are becoming more skeptical. It’s easier than ever for people to call out bullshit and I think it’s a really good thing.
    We’re not children who need to be protected from bad educational courses. We’re professionals who should be able to critically evaluate what we are being told.
    Anyway, that’s my thoughts 🙂
    Thanks for another great blog,

    • Hi Matt
      Thanks for you comments and thats a very good point you make… We are all adults and we can all make our own choices and mistakes, and who is to say the policing will work and accredit the right courses anyway!

  5. Great post, Adam !
    I guess a great teacher teaches a course differently every time based on new inputs, knowledge and audience. It is a livin’ thing !
    Cheers from Brasil !

    • Totally agree, my course now is COMPLETELY different from when I started it two years ago, its even different from last month, constantly evolving and changing as the evidence does, and from feedback from those who attend!

  6. Great post Adam, Thanks.
    As a under- and post-graduate lecturer/teacher I totally agree on your opinions 🙂
    Good work, Regards

  7. Really interesting read. I would love to get into teaching at some point and a lot of the points you make are the points that put me off. I’m not studying for a masters or PhD but read regularly and love my profession. I love asking questions but often find that i’m rubbish at asking questions of the answers I get back (crap at arguing/discussing points). I do usually formulate another question but about 4 days later. Rambling now.
    Keep up the great work, as inspiring and thought provoking as ever.

  8. I absolutely agree with you, Adam. I’m on the cusp of rolling out training in addressing chronic and complex pain issues. It’s my clinical perspective and skills I wish to share. Writing papers for research is a career in and of itself. Being a skilled clinician is another different career’s worth of training. Great if someone has both, but not a requirement to put out great information that is organized for clinicians to apply. Rachel

  9. I very much agree! But what is even more interesting, is what you mention at the beginning of your blog – what Can be done to ensure a bit of quality/evidence based at every course? And should we?
    Very interesting debate, and I’m not sure what is best. Would it be a good idea to classify courses like the evidence hierachy?

  10. Hi Adam – love your post, educating is something dear to my heart also. I feel education needs to be fun, content challenging and inspiring. My experience is having an accreditation process does add layers of paperwork and doesn’t add anything to quality. In today’s age of social media, FB, testimonials and a bit of online research are probably better regulators for short weekend type courses.
    The other characteristic that I would like to suggest is humility. You kind of had it under Respect, but i think that a great teacher firstly understands they stand on the shoulders of those that came before, and secondly they need to be willing to listen and learn from those they are teaching. Thanks for your posts.

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