Due thanks, moving forward, and valuing the journey

Article Outline

• Copyright

I am delighted to become the new UK Editor for the journal. Having reviewed past editorials in preparation for writing this piece, much of the content focuses on the role research should play in developing practice and the profession in general. The 10th anniversary editorial by Nic Lucas and Rob Moran looked back and reviewed the progress of the journal, looked forward to new initiatives and thanked many people involved in IJOM's development. The authors made an understandable, but serious omission. There was no mention of their own role in developing the journal over the last 10 years. Nic and Rob have tenaciously pushed the journal forward. Their foresight and resolve have been the main drivers in developing an international journal that is steadily growing and providing an important resource for osteopathic healthcare worldwide. Much of the energy expended in publishing a journal involves behind the scenes coaxing, cajoling and helping authors in the submission and publication of work. As well as the authors, each manuscript submitted to IJOM is peer reviewed by referees who need supporting and nudging towards their deadlines. This work takes an enormous amount of time, dedication and patience. Without drawing away from the debate and concerns about research clearly articulated in the other anniversary editorial by Jan Leach, I hope that readers will pause to acknowledge Nic and Rob's contribution to osteopathy. I intend to follow in their footsteps with my own deeper involvement in the journal.

The recent Advancing Osteopathy 2008 conference in London, was hosted by the National Council for Osteopathic Research, The General Osteopathic Council and the British School of Osteopathy in partnership with the Osteopathic International Alliance. It was a stepping-stone for the future. The three-day event brought together researchers, practitioners, and educators from the international world of osteopathic practice. The quality of original material presented and general debate was excellent and reflected upon a profession that has matured in areas of education, research and practice over recent years. Excitingly, for those with a passion for osteopathy, new knowledge derived by osteopaths and researchers was presented in relation to the every day practice and education of osteopaths. Indeed as many as 20 different countries were represented by delegates and it was pleasing to see valuable contributions from all over the world.

The third day of the conference titled “Osteopathy Learning and Practice” focused on osteopathic education. Given the limited capacity of the profession to develop primary clinical research, studies exploring and evaluating osteopathic education may be fruitful ground to develop research capacity within osteopathic education institutions and offer insights into the practice and delivery of osteopathic care. Furthermore, if positive attitudes to research, critical thinking and evidence-informed practice are to grow within the osteopathic profession, the most fertile ground for change is likely to be in undergraduate education settings.

One of the recurring themes that emerged at Advancing Osteopathy 2008 was the tension between new knowledge and our osteopathic heritage. Much discussion was focussed on the “roots of osteopathy”. In order to move forward effectively the implications of becoming “pot bound” and stifled must be considered. The professions' roots should nourish and provide support as practice develops and grows. In one sense, this growth is reflected in osteopathic curricula throughout the world and is evidenced by the development of recognised academic qualifications. It is hoped that the journal will receive an increase in submissions focussed on learning and practice in the future. As part of this initiative we will be publishing a series of commentaries derived from symposia at “Osteopathy Learning and Practice”. Invited speakers were asked to prepare a manuscript in advance, which was circulated to delegates. Three of these contributions from one of the sessions entitled “Criticality, research, scholarship and teaching” appear in this issue. They reflect some of the tension that comes with a well-developed set of roots!

These contributions identify issues in implementing evidence-based practice, but clearly describe practical ways of integrating theory with new evidence. The context in this instance is education, but the issues are transferable to practice. One question that arises is whether osteopaths will be led by evidence and guidance from an increasingly regulated healthcare sector, or will have the skills available to critically appraise evidence and theory in order to use it effectively in practice. In order to consume and make informed decisions about research, professionals need to be able to interpret research papers. Undeniably, this involves some awareness of research methods and basic statistics. However, research papers are often written by researchers for researchers and reviewed by other researchers; sadly the primary audience is rarely the average practitioner. Having been involved in teaching research related skills to students for many years, making plain the transferable skills into practice is often difficult, but has become less difficult in recent years as compared with the past. There are no easy solutions as to how to improve the accessibility of material whilst maintaining sufficient detail to ensure an appropriate level of quality in the papers that get published in IJOM. The collection of commentaries in this issue explores some of these problems and we would welcome correspondence from readers in this area.

The conference highlighted the variable levels of development and maturity associated with osteopathic learning and regulation in different countries. The praisewrothy endeavours to bring together different flavours of osteopathy across the world should be recognised, but importantly should be further enhanced by information derived from original research activities. Clearly much of osteopathic treatment, like other medical treatment is not currently evidence-based. However, treatments delivered by osteopaths should be informed by evidence, where it is available. This evidence should be developed using a range of research methods from different parts of the “evidence hierarchy”. Fearing exposure to rigorous examination may be indicative of the profession being more concerned with preserving its identity and roots than with trying to improve patients' experiences and their outcomes. If we are to demonstrate that our profession is indeed patient centred and holistic we must grapple with these issues and face the implications head on. If that means changing aspects of our practice then that is what we must do. Surely it is the dogmatic adherence to practice based on conviction and belief in the face of compelling evidence that holds the strongest threat to maintaining a strong and laudable professional identity.