Teaching is like ‘creating ripples in a pond’

After working as a physiotherapist with specialist expertise in pain and pain management in South Africa, the United Kingdom and United States for several years, the University of Cape Town’s (UCT) Associate Professor Romy Parker decided to return to South Africa. She became a teacher because she wanted to make a difference and extend her range of impact. As a recipient of one of four 2019 Distinguished Teacher Awards, Parker has met her objectives – and then some.

Penny Haw (PH): What motivated you to extend your work as a physiotherapist into teaching?

Romy Parker (RP): I think of this as creating ripples in a pond. I’m passionate about physiotherapy and healthcare. Whereas doctors mainly focus on mortality (things related to risk of death), physiotherapists focus on morbidity (levels of health and well-being). As such, physiotherapists can have a huge impact on enhancing the quality of lives. While, as a clinician, I could make a difference to one patient at a time, as a teacher, I contribute to helping graduate 60 other physiotherapists a year. I felt my impact would be greater. Like creating ripples in a pond, my reach would expand and I could help make a bigger difference. That was my motivation for moving into teaching.

PH: You also offered something unique in terms of having specialised in pain and pain management. How did that fit into your teaching?

RP: Yes. I completed my MSc (Pain) at Queen Margaret University in Edinburgh and, because it was a unique qualification in a critical subject, I felt that it would bring something different to a South African university. When, in 2005, I was offered a teaching job at UCT, which was where I had done my undergraduate degree and my sports science degree, I immediately began integrating the principles of pain management and an understanding of pain into all my teaching in the physiotherapy department. Since then, pain and pain management have moved to the Department of Anaesthesia and Perioperative Medicine, and the subject is taught to medical students too. We have also introduced Africa’s first patient-centred postgraduate one-year diploma in interdisciplinary pain management for all healthcare professionals.

PH: How did you adapt from being a clinician to becoming a teacher?

RP: I think most people come into teaching thinking that they will teach the way they were taught. However, things have changed and, in the Division of Physiotherapy, I was lucky to have amazing colleagues to help me see this. We held valuable discussions about the curriculum and whether it was still relevant and appropriate for the South African context. We also looked at how to best prepare students for what they would see in the clinical space and their responsibilities after they graduated.

“I realised that my job would be to teach students the skills to access the information, and evaluate, process and integrate it into their work.”

It quickly became obvious to me how things had changed since I was an undergraduate. Then, the curriculum was relatively small. Now though, with the massive explosion in knowledge and access to it through online resources and evidence-based medicine, I saw that it was impossible to teach it all to students. I realised that my job would be to teach students the skills to access the information, and evaluate, process and integrate it into their work. That not only shifted my thinking from believing that teaching was about telling people stuff, but also helped me understand that teaching is similar to what I do as a clinician with my patients: I facilitate growth. My work in teaching and as a clinician is about helping individuals grow by advancing their ability to access and process information and apply it to improve their knowledge, skills and lives. When I realised how alike my philosophy of clinical practice was to teaching, being an educator came naturally.

PH: How would you describe this approach?

RP: There are some core principles to pain management in terms of clinical reasoning, the way we think about the mechanisms of pain and how we access and treat them. These make the fundamental, philosophical approach of pain management a patient-centred approach rather than a tissue-centred approach. This not only applies in physiotherapy, but across all areas of healthcare. As such, my clinical approach is patient centred.

Similarly, my teaching approach is learner centred. It’s all about the person – not about the information – and focuses on engaging with people by accessing a range of tools. This frees me from simply instructing students to learn texts off by heart to introducing them to a much richer and diverse set of educational options. For example, instead of giving them a text to study, they could read a book, make a movie or do other things that encourage interrogation, open discussion and engage – and educate – them.

PH: Your role at UCT extends beyond education. What else do you do and what is the relevance of these roles to your work as an educator?

RP: I am also responsible for the UCT pain management team in the Department of Anaesthesia and Perioperative Medicine, where I lead the pain research cluster. I work as a clinician one day a week at the Chronic Pain Management Clinic at Groote Schuur [Hospital]. I have always believed that it is important to my role as a teacher to continue to practise, particularly in my niche in pain management. Working as a clinician means I am always in touch with the clinical context and am able to bring current experiences into the classroom to contextualise learning for students and to build veracity.

PH: Students tease you about how strongly you feel about your subject, going as far as presenting you with a certificate for being “The most sickeningly passionate lecturer” at a graduation celebration. What is it about pain management that enthuses?

RP: I am particularly passionate about teaching people about pain because it is typically poorly taught and also because the principles of pain and pain management apply in so many different areas. I get quite emotional about it because, as healthcare professionals, we are invited into people’s lives in their most vulnerable moments – when you are in pain you are particularly vulnerable. That is a privilege and I believe we have to approach people who have come for help with humility and respect.

“I get quite emotional about it because, as healthcare professionals, we are invited into people’s lives in their most vulnerable moments.”

If we do our job well, we have enormous potential to make a difference – not just for that patient, but also for their families and communities. That’s why I am passionate. Being a healthcare professional is a huge responsibility. That belief flows into my teaching and means it’s important to me that my students understand that what I teach is not an academic exercise with no meaning. What they are learning can make a difference [in] people’s lives.

PH: What are your proudest moments as a teacher?

RP: Some of my proudest moments have been associated with working with students who have struggled for multiple reasons early on in their undergraduate degrees. Where I have been able to develop relationships with them, walk beside them as they grow and see those who battled initially come back to do postgraduate qualifications makes me very happy. It is wonderful to see people who doubted their abilities to get their undergraduate degrees come back and do postgraduate degrees and diplomas, publish papers and/or go on to help people as clinicians. When I get messages from students who I mentored during difficult times and I see the impact they are having on society now, it makes me proud.

“When I get messages from students who I mentored during difficult times and I see the impact they are having on society now, it makes me proud.”

PH: What does winning this award mean to you?

RP: It means everything. I mean, the reason I came to university was to make an impact on South African society by educating, training and empowering physiotherapists to go out and make a difference. My personal goal is that every South African should have access to a healthcare professional who understands pain. Education is the route to achieve this goal. For me, this award is acknowledgement that I may actually be working towards achieving this; I’m helping others make a difference.

It’s important for me to note too that one of the things that has contributed to my development as a teacher is the UCT environment. I have had the privilege of interacting and learning from people – not only in physiotherapy, but also in occupational therapy, speech therapy, nursing and anaesthetics. I’ve been supported by health professional educators and educationalists, people from upper campus and all sectors of the university. Across UCT I have experienced a remarkable willingness to help. If I … asked a question, there [was] always … an offer to assist and share ideas. My experience of UCT has been of a very open, interactive and supportive environment and that has really contributed to my development as a teacher.