Between protocol and judgment: physiotherapy education as a field of epistemic dispute
DOI:
https://doi.org/10.62059/LatArXiv.preprints.702Keywords:
Reasoning, Physiotherapy education, Disciplinary equity, Epistemic injustice, TerritoryAbstract
Background: Physiotherapy education in Chile takes place within disciplinary inequalities, institutional heterogeneity, and territorial gaps that affect the teaching of professional reasoning, a key competence for clinical autonomy. Biomedical dominance, protocol-driven cultures, and fragmented curricula have made reasoning an implicit rather than explicit learning objective, producing unequal training trajectories. Objective: To understand the barriers, challenges, and opportunities in learning professional reasoning in physiotherapy, considering inequalities in training quality, territorial context, and institutional type, through the voices of academic leaders. Methods: A qualitative interpretive study based on Grounded Theory. In-depth interviews were conducted with four leaders from three types of institutions in southern Chile: a regionally oriented private university (UPVR1), a public traditional university (UTE2), and a publicly oriented private university (UPVP3). Data were analyzed using constant comparison and open, axial, and selective coding until theoretical saturation. Results: The central phenomenon was professional reasoning as a “declared core but pedagogically fragile” element of training. Main barriers included biomedical dominance, protocol culture, the academia–clinical gap, and unequal student trajectories. Strengths were linked to role-modeling teachers, student diversity, and situated learning experiences. Discussion and conclusions: Inequities in learning professional reasoning reflect an unequal distribution of epistemic agency. Achieving equity requires explicitly embedding professional reasoning in curricula, strengthening teaching practices, and recognizing physiotherapy’s disciplinary object as the basis for autonomous and socially responsive practice.
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