Saturday, 29 April 2023

where is science in Physiotherapy curriculum

 
It's ironic that while physics and chemistry are evidence-based sciences, we have to promote evidence-based medicine as a separate movement. This highlights the fact that medicine has traditionally been taught through eminence-based approaches. You know, at my age, I can spout any nonsense and people might still believe me because I have gained some level of authority over time. This is due to the lack of education and training in scientific methods, leading to the phrase "science does not know everything," as if science were an all-knowing deity. In my college days, reading a non-prescribed book was frowned upon, and now we rely heavily on PowerPoint presentations, making us even more anti-science. 

 
It's concerning that we had to create a movement to remind ourselves to embrace science as students. However, this movement produced only buzzwords rather than genuine methods that should be taught in our educational curriculum. We now have entrance exams like NEET that assess memory rather than critical thinking, which is supported by political sycophants or people who have an unusual fascination with merit. Merit via a single test which can be trained by joining a course for 1 lakh per year starting from 9 th std or write the useless exam thrice to get first mark. They are going to be “brilliant doctors” the idiocy in our country is a shining star.  The real issue is the lack of science education. We produce medical professionals who don't even understand the criteria for an effective treatment or the methods to determine it. Sadly, many poorly educated professionals from biological carpenters to physical therapists believe that SWD, IFT, traction passive movements are effective treatments. Furthermore, there are millions of unnecessary CT scans, antibiotics prescribed for everything from COVID to chikungunya, and numerous unnecessary surgeries. So why can't we move away from this? Because we lack science education, people who understand science, and individuals with courage. 

It is essential to have physiotherapy science education to understand the concepts of posture, correction, and whether it is possible to correct them. We don't need individuals with fancy degrees or certifications that are useless in practice. For example, the NDT or visceral manipulation certification is a waste of time and resources. We should ask ourselves how they determined whether a muscle can be stretched, or posture can be changed and why it is necessary. For instance, does changing posture align the knee? Really. You think it is important?  
 

we need EBM- where I know what the terminology means. I need science education where I understand what an experiment is. I need education where I know we are all the same as we all have the same body and brain, still variations are there within the sameness. I need education where, I know 6 out 10 people will get better with “x” treatment. I am not afraid to say it does not work at all. I need an education where uncertainty is nothing to be feared . We need an education where we are not afraid to say- this needs no treatment, or we don’t have a treatment - from radiculopathy to adhesive capsulitis. We need an education where we don’t need to say explicitly this is “evidence-based”. What a joke isnt it? What else are we teaching in a science course? Well medicine based on dreams  



dont forget to share your love
Hariohm


Monday, 10 April 2023

#Me Too- not me

The #MeToo movement had a significant impact in many countries, including India. In my city, there is currently a controversy involving a prestigious dance school, and while I don't know the details of the incident or who is at fault, I believe it's essential that there is a fair and impartial investigation when allegations of misconduct arise. 

No, no, this is not about mansplaining me too movement. 

One of the accused- a Mr. Hari, and he had given an explanation from his side. His contention was Bharatanatyam cannot be taught like physics or chemistry and that it becomes inevitable to make physical contact while teaching the art. (Hence, they have either misinterpreted it or they are quoting that as a mistake.) Well, this is where I think he is either an idiot or a useless teacher – that is you need to physically touch to give feedback (what we call as knowledge of performance KP) or even make them focus the attention on the body parts is just poor teaching.  

So this is a chance for me ranting about learning and creeps 

Our brains perceive things as a whole, rather than as a collection of parts. For example, when we see a table, we don't consciously think about its color, its shape, or the number of legs it has; we simply recognize it as a table. Our brains are not designed to work like Sherlock Holmes in movies, where we pick up on small details to solve a mystery. Instead, our brains automatically focus our attention on what it deems important. 

Unfortunately, we don't have complete control over where our brains focus our attention. To change this, we need to train our brains to focus on specific things in specific contexts. For example, when a professional cricket player is batting, their brain automatically focuses on where the fielders are and how to hit the ball away from them, while ignoring other distractions. This ability doesn't come from simply sitting in one place and trying to focus on a ball. Similarly, if a cricket player were to switch to playing football, they would understand how difficult it is to focus on the ball and their teammates at the same time. 

So, when Mr. Hari says small movements must be corrected and I need to touch them- no boss that’s not Learning a new movement or skill involves training the brain to perceive the whole action, not just isolated parts. Practicing hand gestures without the accompanying movements of the rest of the body may not be effective for learning, as the brain needs to learn how to coordinate all the parts together to perform the full action. Therefore, it's important to practice the entire movement as a whole to effectively train the brain and develop muscle memory. By doing so, the brain can better recognize the movement as a single unit and perform it more efficiently. 

This also holds true for the many uneducated followers, who merely parrot what they were taught, rather than thinking critically about the approach. For example, some proponents of the Bobath or NDT techniques may simply put a child on a circus ball without fully understanding the rationale or considering the child's specific needs. Similarly, sports therapists may focus on training specific body parts without taking into account the athlete's overall physical development, and cardio therapists may view breathing as an isolated exercise rather than an integral part of everyday life. To effectively learn and develop new skills, it's important to focus on the whole movement or action, rather than just isolated parts, and to approach training with a holistic understanding of the individual's needs and abilities. 

The second issue concerns Mr. Hari's teaching approach, which involves physically pointing out and correcting his students' mistakes. However, he lacks a fundamental understanding of the neurobiology of learning and teaching, despite being a dance teacher. It's unfortunate that the curriculum doesn't emphasize this crucial knowledge, but it's not just limited to dance teachers. Even neurologists and neurotherapists, such as speech or physical therapists, often lack a comprehensive understanding of how the brain learns. 

Moreover, this teaching approach is flawed because the brain learns through movements, not individual movements. By focusing on specific parts of the movement, the overall quality of the movement can suffer. Additionally, this approach hinders the student's ability to learn on their own, as it places too much emphasis on the teacher's feedback. When a teacher asks a student to focus solely on themselves, it can result in poor feedback that impedes the learning process. 

In summary, Mr. Hari's teaching approach is either that of a poor teacher or, in some cases, could be perceived as inappropriate (that’s being polite). It's essential to understand the neurobiology of learning and teaching to ensure effective learning outcomes, regardless of the subject matter. With access to a wealth of knowledge in the 21st century, it's important to utilize it to enhance teaching practices. 

 

The third point is about the power dynamics that exist between a teacher and their students. As a teacher, you hold a position of authority and power over your students, which means you have a responsibility to be protective of them. It's crucial to avoid being defensive when confronted with feedback from your students and instead listen to their concerns. 

Furthermore, it's important to respect your students' physical boundaries by asking for permission before approaching them closely or touching them. Even if a student consents, the power dynamics between the teacher and student can still create an uncomfortable or unsafe environment, so it's essential to be mindful of this dynamic. 

In summary, teachers must recognize the power dynamics that exist between them and their students and act accordingly. They should prioritize protecting their students and be receptive to feedback without becoming defensive. Additionally, teachers must respect their students' physical boundaries by asking for permission before approaching them closely or touching them. By being mindful of these factors, teachers can create a safe and comfortable learning environment for their students. 

You may be wondering why all these mansplaining:  

The whole thing seems like what PT teachers may also have to be warry of. I do hear lots of stories of teachers being inappropriate with female students. Sadly, I am not inside the system to know for sure or act. Well, that may be my defense for being a coward. But I do think we need robust systems PT colleges to monitor and receive complaints. Even though there are systems in place- the creepy teachers seem to able to either silence the students or the systems are very weak. As I have little understanding of these, I am not getting into solutions for these. But it's high time we change,. 
 

Well, sorry for ruining your “mood”. 

PS- as i have no idea about any of the issue about Hari but it is my rebuttal for what he said in the interview


Thursday, 6 April 2023

Is LeBron James a genius?

One of the boring cricket commentators is L. Shivaraman. He is worse than listening to ppt reading "experts". Shivaraman is a great fan of the GOAT Shane Warne. He once muttered "Warne is a genius" in his usual unenthusiastic monotonous way and the fellow commentator (can't remember the Englishman's name) replied- "really, i don't agree, in my mind only Einstein, or Hawking's are Geniuses. implying using the brain in a unique and beautiful way is a genius not people who use the body in a unique and beautiful wayIf i say Magnus Carlsen (or V. Anand) is a genius (probably a GOAT in chess) no one will disagree. As we think Chess is a mind game. 

   RenĂ© Descartes, who is well-known for his theory of pain and his dualistic argument, claimed that the mind was responsible for our thoughts, feelings, and consciousness, while the body was responsible for our physical movements and sensations. He identified the pineal gland as the point of interaction between the mind and body, leading some pseudo- spiritualist to consider it as a spiritual third eye. 

However, Eastern philosophies, beginning with Buddhism, have always held that the mind and body are interconnected and not separate entities. Today, biologists agree with this view and recognize that the brain and body are deeply intertwined, with environmental factors shaping our movements and thoughts. Although the mind and body cannot be completely separated, this does not mean that one can think or move without the brain. Instead, all these factors are essential and interact in complex ways to shape our experiences. 

A theory of mind is essential in all types of games. Successful gameplay requires the ability to anticipate an opponent's moves, manipulate their thinking, and maintain a holistic view of the playing field. This is not limited to traditional games like chess but can also be seen in sports such as basketball, where players like LeBron James use "no look" passes to outmaneuver their opponents. 

In cricket, we can see the importance of a theory of mind in players like Shane Warne and VVS Laxman. Warne's ability to deceive English batsmen with his spin bowling, and Laxman's skill in outmaneuvering Warne himself, were both products of their ability to read the game and their opponents, as well as the conditions in which they were playing. 

Overall, successful gameplay is the result of the complex interplay between the mind, body, and environment, including the actions of other players, the audience, and even the weather conditions. 

Dont be daft- Shane warne, Shewag, Magic Johnson, Curry, Messi, Cryuff are all geniuses- even though many of them could not do calculus are write poetry or list out all the cranial nerves


So, todays rant is read Buddha -the first neuro-behavior genius and respect the world of “dumb players” even if you think they have not finished high school.  

 

Love Hariohm PS: Lebron James in the title and not Laxman as I and my son are big fans of Lebron - not a dis on the great Laxman