One of the key challenges we can foresee results from the fact that, much like other healthcare professions’ curricula, physiotherapy programmes around the world are already extremely crowded with content (Walpole, Barna, Richardson & Rother, 2019; Hackett et al., 2020). Ongoing innovation across diverse areas of education, physiotherapy, healthcare, digital technologies, and artificial intelligence, means that physiotherapy educators and education institutions are under immense pressure to reconsider what and how they are providing to their students. This comes mainly with the sense that there is ever more material that needs to be added into curricula, yet coincides and collides with hesitation to discard already existing content with valid justification. Evidence of this can also be found in the current debate about extending entry-level physiotherapy courses to five years as a means to create more space for already identified new content. Finally, we also wish to acknowledge that these are not just pressures perceived and borne at a somewhat impersonal, institutional level, but also at a very personal one, by the physiotherapy educators in charge of making decisions about content and ultimately delivering it.
It is not the intention of this Agenda to add to these pressures, though we realise and acknowledge that we are moving within this space. We are not seeking to leverage power but to collaborate and engage conversation. We hope that these pressures are additionally lightened by our highlighting that physiotherapy has an inherent, historical affinity to the environment that readily lends itself to making it more explicit. The challenge presented by already crowded curricula is also one of the reasons for which the EPT Agenda 2023 is not calling for the production, addition and delivery of comprehensive and ideally assembled content. Rather, the aim of the EPT Agenda 2023 is for physiotherapy education institutions to make a start; to begin thinking and talking about the relationship between human health, environment, and physiotherapy, to make this process explicit (where it is happening already), and importantly, to involve physiotherapy students in the conversation.
To make an interesting proposition by example, one way in which this conversation could take place is via a physiotherapy education institution deciding against formally integrating environmental physiotherapy due to a lack of space in its curriculum, or similar. From our position, making this decision and its reasons explicit, and communicating this with students or involving them into the decision-making process would, in itself, be a viable way to achieve the aim of the EPT Agenda 2023. That is, by discussing that and why broader environmental concerns should be included or excluded, we would already be engaging with questions concerning the relationship (or lack thereof) between human health and functioning, the environment, and physiotherapy and so a beginning to this conversation would have been made. This, in turn, would undoubtedly open for a range of new and fertile questions that could help all of our further development of this field.
Notwithstanding this challenge and the different approaches that could be taken to addressing it, we also strongly believe in the passion and ingenuity of all of our colleagues in physiotherapy education, as much as the passion and enthusiasm of physiotherapy students around the world. To quote a recently published article on leadership in physiotherapy, ‘physiotherapists are problem solvers...give me a problem and I will explore and find a solution’ (McGowan & Stokes, 2019). With that in mind, we are confident that we can find exciting, rewarding and novel ways of integrating environmental and sustainability perspectives into entry-level physiotherapy education that can be meaningful for our clients, our entire profession, and our colleagues across the world of healthcare and beyond.