- Email: [email protected]
The Use of Hypothesis
The Use of Hypothesis MADAM - May I comment on the problems with regard to the use of hypothesis in some articles in Physiotherapy. I refer specifically to the three papers published in the December 1990 issue by MacLean p 738, Finlay et a1 p 793, and Nussbaum et a1 p 803. While MacLean attempted to disprove the null hypothesis, the primary aim of Finlay et a1 was to prove or disprove the hypothesis. These are fallacies in the use of the concept of hypothesis. The null hypothesis states that the relationship predicted between t w o or more variables does not exist; which means that any effect observed from the research is attributable to chance. It is pertinent to point out that the words ’prove’ and ‘disprove’ in relation to the hypothesis are never used (Hicks, 1988). Instead, what one sets out t o do is to find some evidence that supports or fails to support the hypothesis which is just a prediction of a relationship. Predictions do not have to be proved or disproved. The paper by Nussbaum e t a l p 803 could have been an excellent illustration of the use of an hypothesis. The authors set out at the outset to test a specific hypothesis. After what was a sufficient review of literature
on the relationship between cutaneous temperature and the application of interferential (IF) current to specific areas of the body, a statement of the hypothesis would have been in order, serving the purpose of implanting their study to the exploration of the issues in the identified problematic literature. But instead, readers were left in suspense t o seek for the connection between the review and the methodology. If the authors had simply wanted to explore fully the effects of IF therapy on peripheral blood flow without formulating any hypothesis, they still owed it to their readers to clarify their aims. The statement of the aims of the study or the hypothesis should have immediately followed their review of literature. Journal reviewers should have picked up these minor errors in the writing up of the research submitted for publication. The presence of these errors detracts from the professional standards of the journal as a whole. ALPHONSO R A ONUOHA PhD MCSP DipTP London SE5 Hicks, C M (1988). Practical Research Methods for Physiotherapists, ChurchiII Livingstone, Edinburgh.
Salaries and Conditions in the USA MADAM - I was a senior lecturer in physiotherapy in England until I left to work in the USA in October 1988. Now I am the chief physical therapist at a hospital in Williamson, Kentucky, USA. I was extremely glad to read Ms P Shaver’s outspoken statement regarding her concern over physiotherapists from the UK desiring work experience in the USA (November, page 679). I agree with her whole-heartedly and feel that the MCSPs in the USA should form a support group and be willing to offer information, assistance and/or advice to the CSP professional adviser, international affairs and/or any individual Chartered physiotherapist. M y comments on salaries and conditions are as follows: 1. There is no set national scale as in the UK. This puts us in the bargaining arena and if one is ignorant of the going rate, one is likely to accept the figure offered without an idea of the maximum and minimum figures of the scale, the present exchange rate, and the standard of living in the USA, etc. Initially I was a victim of this but got it altered at the earliest possible opportunity. 2. There is no set paid vacation, national holidays, sickness and insurance benefits. They vary from hospital to hospital. The mbximum one can get is three weeks vacation, nine paid national holidays and three weeks sick time. Many hospitals offer only three or four weeks inclusive package of all three put together. One has to check this prior to signing any contract, and go through the contract very thoroughly, and get advice/opinion before signing it. 3. Every foreign trained physical therapist coming to work in the USA will be scrutinised by the particular State Board of Physical Therapy where one is seeking employment and if proven satisfactory, will be granted a temporary permit to practise as a physical therapist. But then one is also required to sit a licensure examination and
physiotherapy, February 1991, vol77, no 2
expected to pass the first time. This may vary slightly from State to State. Then one is also expected t o go through a supervised clinical practice for a year (this may vary too) and pass a clinical evaluation performed by the supervising licensed physical therapist, on a quarterly basis. If successful the first time, then there is no need for further assessments. These are the procedures I had to go through. But looking back, it was well worth it. The challenges and opportunities are abundant. For example, I have been offered $60,000 to take up a director’s position. PRADEEP D PILAKEL MCSP DipTP RPT Kentucky, USA
Sick Notes MADAM - My brother is a qualified registered osteopath, and, as such, has the ability to sign patients off work with the same ‘sick note‘ as a general practitioner. I feel strongly that we as physiotherapists should also have this facility at our disposal. Not only are we highly qualified at determining whether a patient is fit enough to resume work, but it would also relieve the GP‘s workload in having constantly to review the patient’s condition. Any comments? JANICE C MEYERS BSc MCSP Newquay Cornwall Mr T Simon, Secretary o f the CSP. comments: In fact, adjudication officers o f the Department of Social Security have discretion to accept sick certificates signed by Chartered physiotherapists in appropriate cases.
Physiotherapy Helpers A NEW GUIDELINE A new guideline, no 12: ‘The Delegation of Tasks to Physiotherapy Helpers and Other Support Workers‘ is now available from Mrs Jill Evans, Professional Affairs Department, The Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED, on receipt of a stamped addressed envelope. The guideline provides information on:
* Criteria for the delegation of tasks f Record keeping * Insurance Hydrotherapy Recommendation
Hand Signing MADAM - We are currently planning a multidisciplinary course which will address the problems of accurate hand use in sign language, with people who are deaf and/or have mental and physical handicaps.* We would be most interested to hear from physiotherapists who have been running ‘hand classes’ associated with signing, or have used any other approaches to develop functional hand skills in this context. Please send any information about your experiences to us at 86 Bedford Road, London N2 9DA. NICOLA GROVE Speechnanguage therapist Barnet Health Authority BENCIE WOLL Centre for Deaf Studies Bristol University School of Education ‘Grove, N (1990). ‘Developing intelligible signs with learning-disabled students: A review of the literature, and an assessment procedure’, British Journal of Disorders of Communication, 25, 3.
MADAM - I have recently returned from attending a hydrotherapy course in Melbourne which was mentioned in Physiotherapy last year (January 1990) by Jane Barefoot MCSP and I would strongly recommend this to anyone interested in hydrotherapy. It was a five-week intensive course covering anything and everything related to hydrotherapy, from pool design and pool chemistry through to circuit training. It was predominantly a practical course with time devoted to placements at hydrotherapy departments in Melbourne. The standard of lectures was very high and subject matter extremely varied. The course will take place again this year in late summer and is advertised in this issue of Physiotherapy - see ‘Courses and Conferences’. I thoroughly enjoyed my stay - last year was the first occasion the course was open to overseas students and despite exams and a project to do on completion of the course I gained my certificate in hydrotherapy! RACHEL MACKENZIE SMITH MCSP King Edward Vll’s Hospital for Officers London W1
103
on the relationship between cutaneous temperature and the application of interferential (IF) current to specific areas of the body, a statement of the hypothesis would have been in order, serving the purpose of implanting their study to the exploration of the issues in the identified problematic literature. But instead, readers were left in suspense t o seek for the connection between the review and the methodology. If the authors had simply wanted to explore fully the effects of IF therapy on peripheral blood flow without formulating any hypothesis, they still owed it to their readers to clarify their aims. The statement of the aims of the study or the hypothesis should have immediately followed their review of literature. Journal reviewers should have picked up these minor errors in the writing up of the research submitted for publication. The presence of these errors detracts from the professional standards of the journal as a whole. ALPHONSO R A ONUOHA PhD MCSP DipTP London SE5 Hicks, C M (1988). Practical Research Methods for Physiotherapists, ChurchiII Livingstone, Edinburgh.
Salaries and Conditions in the USA MADAM - I was a senior lecturer in physiotherapy in England until I left to work in the USA in October 1988. Now I am the chief physical therapist at a hospital in Williamson, Kentucky, USA. I was extremely glad to read Ms P Shaver’s outspoken statement regarding her concern over physiotherapists from the UK desiring work experience in the USA (November, page 679). I agree with her whole-heartedly and feel that the MCSPs in the USA should form a support group and be willing to offer information, assistance and/or advice to the CSP professional adviser, international affairs and/or any individual Chartered physiotherapist. M y comments on salaries and conditions are as follows: 1. There is no set national scale as in the UK. This puts us in the bargaining arena and if one is ignorant of the going rate, one is likely to accept the figure offered without an idea of the maximum and minimum figures of the scale, the present exchange rate, and the standard of living in the USA, etc. Initially I was a victim of this but got it altered at the earliest possible opportunity. 2. There is no set paid vacation, national holidays, sickness and insurance benefits. They vary from hospital to hospital. The mbximum one can get is three weeks vacation, nine paid national holidays and three weeks sick time. Many hospitals offer only three or four weeks inclusive package of all three put together. One has to check this prior to signing any contract, and go through the contract very thoroughly, and get advice/opinion before signing it. 3. Every foreign trained physical therapist coming to work in the USA will be scrutinised by the particular State Board of Physical Therapy where one is seeking employment and if proven satisfactory, will be granted a temporary permit to practise as a physical therapist. But then one is also required to sit a licensure examination and
physiotherapy, February 1991, vol77, no 2
expected to pass the first time. This may vary slightly from State to State. Then one is also expected t o go through a supervised clinical practice for a year (this may vary too) and pass a clinical evaluation performed by the supervising licensed physical therapist, on a quarterly basis. If successful the first time, then there is no need for further assessments. These are the procedures I had to go through. But looking back, it was well worth it. The challenges and opportunities are abundant. For example, I have been offered $60,000 to take up a director’s position. PRADEEP D PILAKEL MCSP DipTP RPT Kentucky, USA
Sick Notes MADAM - My brother is a qualified registered osteopath, and, as such, has the ability to sign patients off work with the same ‘sick note‘ as a general practitioner. I feel strongly that we as physiotherapists should also have this facility at our disposal. Not only are we highly qualified at determining whether a patient is fit enough to resume work, but it would also relieve the GP‘s workload in having constantly to review the patient’s condition. Any comments? JANICE C MEYERS BSc MCSP Newquay Cornwall Mr T Simon, Secretary o f the CSP. comments: In fact, adjudication officers o f the Department of Social Security have discretion to accept sick certificates signed by Chartered physiotherapists in appropriate cases.
Physiotherapy Helpers A NEW GUIDELINE A new guideline, no 12: ‘The Delegation of Tasks to Physiotherapy Helpers and Other Support Workers‘ is now available from Mrs Jill Evans, Professional Affairs Department, The Chartered Society of Physiotherapy, 14 Bedford Row, London WC1R 4ED, on receipt of a stamped addressed envelope. The guideline provides information on:
* Criteria for the delegation of tasks f Record keeping * Insurance Hydrotherapy Recommendation
Hand Signing MADAM - We are currently planning a multidisciplinary course which will address the problems of accurate hand use in sign language, with people who are deaf and/or have mental and physical handicaps.* We would be most interested to hear from physiotherapists who have been running ‘hand classes’ associated with signing, or have used any other approaches to develop functional hand skills in this context. Please send any information about your experiences to us at 86 Bedford Road, London N2 9DA. NICOLA GROVE Speechnanguage therapist Barnet Health Authority BENCIE WOLL Centre for Deaf Studies Bristol University School of Education ‘Grove, N (1990). ‘Developing intelligible signs with learning-disabled students: A review of the literature, and an assessment procedure’, British Journal of Disorders of Communication, 25, 3.
MADAM - I have recently returned from attending a hydrotherapy course in Melbourne which was mentioned in Physiotherapy last year (January 1990) by Jane Barefoot MCSP and I would strongly recommend this to anyone interested in hydrotherapy. It was a five-week intensive course covering anything and everything related to hydrotherapy, from pool design and pool chemistry through to circuit training. It was predominantly a practical course with time devoted to placements at hydrotherapy departments in Melbourne. The standard of lectures was very high and subject matter extremely varied. The course will take place again this year in late summer and is advertised in this issue of Physiotherapy - see ‘Courses and Conferences’. I thoroughly enjoyed my stay - last year was the first occasion the course was open to overseas students and despite exams and a project to do on completion of the course I gained my certificate in hydrotherapy! RACHEL MACKENZIE SMITH MCSP King Edward Vll’s Hospital for Officers London W1
103