Review - Contagious precarity: a collective biographical analysis of early-career physiotherapist academics’ experiences of the COVID-19 pandemic

Article: Contagious precarity: a collective biographical analysis of early-career physiotherapist academics’ experiences of the COVID-19 pandemic
Article status: accepted
Author: Wenche Bjorbækmo
Review date: 29th September 2020
DOI: to be allocated

Review (Wenche Bjorbækmo) – Contagious precarity: a collective biographical analysis of early-career physiotherapist academics’ experiences of the COVID-19 pandemic

Thank you for the opportunity to review this paper, which I find both interesting and highly relevant for academia as such, not only to academic physiotherapists.

Title and topic

The title of the paper stimulates readers’ curiosity and expectation of the outlined phenomenon that are investigated, which is a very good starting point. However, the exploration of the phenomenon and, or metaphor “Contagious expectations” during the outbreak of covid-19, could have been more explicitly unpacked throughout the paper. I do not know if “contagious expectations” are entirely adequate for what comes out of your study/ your findings – is it not rather how restrictions and uncertainties concerning work in the time of the pandemic reinforce the experiences of living already uncertain, overloaded and vulnerable work situations as early career physiotherapist academics?

Aim and methodology

When it comes to the purpose and aim of the study, I specifically want to challenge you to focus more specific on what it is that are being investigated in this study/ paper. In the abstract the aim of the study is said to be “To explore the professional contexts in which we operate as physiotherapist academics through an analysis of our covid-19 pandemic-related experiences”.  In the introduction you state that your aim is to describe “our shared and individual positionalities in order to explicitly identify and communicate the standpoints from which we perceive our experiences of pandemic-related policies”. And, when you describe the impacts of your study you say that your analysis of the practice contexts of early career physiotherapist academics “provides a novel example of research about the lived experience of physiotherapy faculty members”. These descriptions differ and it is somewhat confusing to understand what the focus of the study is.

One suggestion is to limit your examination to be about the “lived experiences” of working as an early career physiotherapist academics in the time of the covid-19 pandemic outbreak. I have put lived experiences in quotation marks as I do think you have to elaborate on what “lived experience” mean to you. Since you focus both on the concept of lived experiences and the context within which these experiences are unfolding, my expectation is to get close to those lived experiences of physiotherapists academics in the time and place of the outbreak of covid-19 pandemic. I expect these situated experiences are being analysed and discussed in the light of an explicit theoretical framework. You do not explicit mention any theoretical framework, and I wonder why and if it may be “emancipatory physiotherapy practice” with reference to Trede (2012) you see to be such a perspective. Whether this is the case, “emancipatory physiotherapy practice” needs an explanation and interpretation of what it means and entails – what is the idea, what is the perspective in business. This ought to be explained as it is not self-explanatory.

Presented data, analysis and findings

The data of this study/ this paper is presented through three; examples, narratives, autoethnographic descriptions or as you name them “our individual situations”. As it is not clear which theoretical perspective being the basis of your study, and initially your research approach is just briefly explained the methodological procedure is unclear.  The readers need to know something more about the underlying applied perspectives before being presented for the empirical examples. Later in the paper you describe briefly how these examples have been developed. I would suggest you offer some details about this before presenting them.  As I read you, it has been through dialogue exchanging experiences that you have created the examples. What you mean by stating that you have seen “ value in moving beyond dialogue, drawing inspiration from other early career academics (Hartung et al., 2017) and early career clinical physiotherapists (Hammond, Cross, & Moore, 2016) to engage in a more systematic analysis of our situations” (see under the heading “Exploring our experiences through our professional practice context(s)” I suggest you clarify and elaborate more on this. How have the dialogues been, how did you agree on writing the examples related to their content and form, and how have you been working with the examples etc?

Far out in the paper you describe to have applied an analytical framework offered by Freeman & Jauvin 2019. A framework which “comprises three baseline questions, each of which ask from the perspective of three lenses, producing a total of nine questions. The baseline questions relate to practice realities, the difficulties experienced by professionals, and the responses of professionals. The lenses are those of accountability and ethics, and the lens of the professional-as-worker”. I wonder how lived experience relates to this analytical approach and I do think you already from the beginning of the paper have to make a clear description of the applied methodology of your study. I suggest you present the readers for this before presenting examples, narratives, autoethnographic notes. I think you must explain more detailed both the analytical framework and how it has the potential for revealing and interpreting “lived experiences”. There is also a need for an explanation of what “modifications of some questions” have been about.

Related to the presented examples you explain that each of the authors have provide a text that is “beyond our commonalities – of profession, task orientation, career stage, and substantive focus” and emphasising that each of you is an individual, and your experiences are developed within your individual situations”. I do agree with you, but in the paper it might be an idea that you in order to capture the lived experience of the pandemic outbreak as early career physiotherapist academics make a distinction between the descriptions of the situation before the outbreak (which makes up an important background, and as you show through the three examples have some commonalities and of course individuality ) and the experiences of  the outbreak and of the changing life and work situations during this time.

When it comes to these descriptions, narratives, related to the pandemic outbreak, I will urge you to be braver and get closer to the lived experiences. Meaning that I challenge you to provide more evocative texts from the first-person perspective instead of only from a third person perspective. In these examples when describing the lived experiences during the early time of the pandemic outbreak – more compelling experience emerges as for instance; relief that some work tasks had to be put aside and the following experience of increased opportunity to complete other tasks etc.

The discussion

In the discussion you argue that your findings  illuminate how the Covid-19 pandemic “has exploited weaknesses in pre-pandemic societies, exposing these weaknesses for examination” you are here referring to Bezuidenhout, 2020 and Teixeira da Silva, 2020, but as I read your study,  this is your findings too. You also argue how the Covid-19 pandemic helped you to see and realise how unstable work organisations you are involved in. I really enjoyed reading the discussion and conclusion. Here you present your reflections, interpretations and analysis of the presented examples – your findings. Interesting is also your findings concerning what you describe as the biggest difference between you authors/ research participants namely the gendered experiences of responsibility burden and the feeling of anxiety connected to the care for children and elderly family members. But I see this as analysis and findings that should have been revealed linked to the presented empirical examples.

I also find your conclusion important when you state that you; rather  than continue to try to work your way out of a deficit of organisational conditions,  are inclined to seek ways to align with other parties who have seen the societal cracks exposed by the Covid-19 pandemic and respond with a demand for a system change rather than a “return to normal”.

Summing up

As already said, this is an interesting paper. I think it could be even better firstly by clarifying the purpose of the study in more detail. It is also necessary to clarify both theoretical and methodological choices, which is important for how the empirical examples are written and presented. In the material presented, I believe you have the potential to make deeper analyses related to the outbreak of covid-19 and the lock down of society with the consequences and experiences it entailed. I also believe that the analytical steps according to the strategy you have chosen should be seen as a tool for you in the analytical process and not necessarily be presented in its full breadth. Describe the analysis process and strategy and make visible how you have arrived at the results through analysis of the examples with emphasis on the experiences from the outbreak of the pandemic. This can help to make the text a little shorter – which will be an advantage as it now is very long and partly heavy to follow.



One Reply to “Review (Wenche Bjorbækmo) – Contagious precarity: a collective biographical analysis of early-career physiotherapist academics’ experiences of the COVID-19 pandemic”

  1. Dear Dr. Michael Rowe (Editor) and Dr. Wenche Bjorbækmo

    Thank you for your thoughtful attention to our article. Although the two reviewers raised different and complementary issues, there was one forceful common comment in both reviews: the submitted version was lengthy and difficult to read. We took this comment very seriously and have revised the article primarily to address this critique.

    As per the instructions that we have received, the changes to the article have been made directly online. Through this letter we draw attention to those changes and explain our rationale for making the decisions that we did.

    In addition to the reading and responding to these reviews as we would “a typical review,” we found that the entire experience of submitting to OpenPhysio has been unique. We feel that this unique arrangement has created new opportunities that we would like to pursue to the maximum extent possible. We describe these new opportunities in the final three paragraphs of this letter, within which we invite you to engage in supportive processes that we believe will further extend the value of this project. We understand that all are busy and recognise that we are pushing limits by even suggesting these possibilities. Accordingly, although we would appreciate greatly your acceptance of these invitations we also understand that you might not be available.

    Responding to Dr. Bjorbækmo’s review:

    While Dr. Bjorbækmo has identified multiple points of interest, our impression is that these stem primarily from the fundamental presentation of “what this project is.” Instead of reviewing these points in the order that they are identified by Dr. Bjorbækmo, we begin our response with the fundamental elements. We suspect that by clarifying these points, the understandings of the other points will change. To ensure a follow up on all points, we respond to these after having addressed the fundamental elements.

    Dr. Bjorbækmo challenged us “to focus more specifically on what it is that is being investigated in this study/ paper.” This challenge was presented under the heading “Aim and methodology,” a heading that contained multiple fundamental points, each of which is discussed below.

    In response to the concern that we express multiple aims, and that these aims are not consistent, we have modified the Introduction section to remove our statement about describing our positionalities in order to identify and communicate our standpoints. In the implications, we have preserved the statement about this study being a novel example of an analytic phenomenon but have changed the wording of the implication to better harmonise this with the project aim.

    To address the concern that our references to “emancipatory physiotherapy practice” might be evidence of a theoretical framework – that was inadequately developed and applied in this project – we have removed all references to Trede (2006) and Trede (2012). We had never intended that “emancipatory physiotherapy practice” be a theoretical framework to guide this work. In fact, our intention was limited to an attempt to use a more elegant name for the substantive focus of our professional interests. Dr. Bjorbækmo’s review has helped us see that this attempt might have created an inadvertent distraction. Rather than “aspiring to emancipatory physiotherapy practice (Trede 2012),” we have revised the text to a more descriptive form, such that we “focus on promoting equity and human rights.”

    Dr. Bjorbækmo proposed that it was necessary for us to “to clarify both theoretical and methodological choices.” To address this concern, we have emphasised the analytic nature of the article, moving the description of our approach to an earlier point in the article. To stay closer to Hartrung et al. (2017), the project that was our primary methodological inspiration for this work, we describe our project as a “collective biographical analysis.” We have modified the text to be consistent to this language.

    Describing our theoretical choices are more challenging. This project was initiated as a practical endeavour, as a response to unstable circumstances. Although we all incorporate theory into our own qualitative research, our collaborations thus far have not been driven by commonalities of specific theoretical approaches. In light of these circumstances, we chose to make the practical decision of analysing our experiences through the Freeman and Jauvin (2019) framework. We are pleased with that choice as we feel that it was successful at helping us systematise our lived experiences. In making these choices, we recognise that these are not atheoretical – as expressed by Sandelowski 2010[1] there exists no cognitive space that is void of theory – yet these choices are not theoretically-focused. To explicitly acknowledge our stance towards theory, we have added a final paragraph to the Discussion section.

    Finally, in light of the issue of this article being too lengthy, we have opted to condense the description of our positionalities into tight summaries. We believe that these summaries offer the minimum information necessary for readers to make sense of the key element of this collective biographical analysis: our use of the Freeman and Jauvin (2019) framework. In our submitted version, it seems that the lengthier descriptions of our positionalities could lead readers to believe that these were the analyses.

    With respect to the lengthier descriptions of our situations/positionalities, we would like to acknowledge Dr. Bjorbækmo’s encouragement “to be braver and get closer to the lived experiences. Meaning that I challenge you to provide more evocative texts from the first-person perspective.” As early career physiotherapist academics, all of us focused on socio-political concerns, we can see the value and promise of Dr. Bjorbækmo’s suggestion. This value and promise has led us to make the proposal that we present in the final few paragraphs of this response to reviewers.

    Dr. Bjorbækmo expressed uncertainty as to whether “‘contagious expectations’ are entirely adequate for what comes out of [the] study/ [the] findings.”

    We thank Dr. Bjorbækmo for helping us to see this point. In hindsight, we might have selected the term ‘contagious expectations’ more for its allure than its descriptive accuracy.

    We have modified the title to address this critique and to improve the consistency of the title with the project, now described more succinctly. We hope that a change in title is indeed acceptable in the review process.

    Dr. Bjorbækmo has requested that we, “elaborate on what ‘lived experience’ means to us.”

    We have added a description of our understanding to the Introduction.

    Dr. Bjorbækmo has suggested that we, “clarify and elaborate more on … [the way we actually did the] … systematic analysis of our situations.” She has also suggested that we, “explain in more detail both the analytical framework and how it has the potential for revealing and interpreting ‘lived experiences.’”

    We have added more details on our approach to the start of the manuscript, including the following new text:

    “…we present a collective biographical analysis, an approach that was inspired by academic colleagues who were also compelled to analyse their own experiences and the situations that contributed to these experiences (Hartung et al., 2017).”

    Later in the paragraph, we state that using the framework suggested by Freeman and Jauvin (2019), “[enables] us to use the lived experiences as an entry point to explore the professional contexts in which these experiences were produced.”

    In the section now retitled, “Exploring our professional practice context(s)experiences through our lived experiences,” we build upon this text, following the reasoning above to justify why professional contexts are of interest.

    Dr. Bjorbækmo stated “there is also a need for an explanation of what ‘modifications of some questions’ have been about.”

    This point is addressed in the text in the sub-section, “What difficulties are professionals experiencing?” (paragraph 1) and in the Discussion sub-section, “Innovative aspects of this exploration,” (paragraph 2).

    Dr. Bjorbækmo proposes that our Discussion sub-section, “The COVID-19 pandemic: a greater burden to carers” should be seen, “as analysis and findings that should have been revealed linked to the presented empirical examples.”

    In addition to the elements of gender and care that were already present in the core section, “Exploring our professional practice context(s)…” we have made the descriptions of our individual positionalities more explicit on this point.

    Given that we have made major changes to the article, and that we have reviewer suggestions pointing in opposite directions with respect to content (Professor van Wijchen has suggested that we move content into the Discussion), we have re-submitted this version of the article without moving content into our out from the Discussion section.

    Dr. Bjorbækmo supported our conclusion of attempting to step outside of existing structures and look for broader alliances.

    Nearly 10 months after first beginning this project and 7 months after submitting the article, we can report some promising signs and some failures to pursue this strategy. We might or might not be able to write about these, separate from our “early pandemic insight” at a separate point in the future.

    We think that this review process was in fact effective at improving the quality of this article – especially in response to the critique that the article was lengthy and difficult to understand. Whereas we feel that we have approached this critique constructively in a way that is consistent to our goals and our situations, we also recognise that our solution to the problem was the opposite of the one to which Dr. Bjorbækmo was nudging us (i.e., to add more depth, detail, and theoretically informed analysis to our accounts of lived experience).

    Our decision to focus on the Freeman and Jauvin (2019) framework does not come from a disinterest in theoretically rich, in-depth, first-person accounts; it instead comes from a concern that we will not be able to do this well, and that by attempting this strategy, the project might never be finalised. Nonetheless, we are open to the possibility of developing these accounts more deeply on the condition that we have additional support in the form of additional reviews. While we have removed the accounts from the article text, we have moved these to an online document that is hyperlinked from the article text (see “this satellite page”) in paragraph 3 of the Introduction. As of now, those who access the document are able to view but neither comment nor edit. We are willing to change the access permissions to allow comment and edits if we have the confirmation that reviewers wish to engage in this process.

    With the freedom enabled by separating these accounts from the article text, they are now expressed in the author’s voices. We can imagine scenarios in which we have reviewers who will provide critiques to help us develop these documents and also scenarios in which this support is not available. We are requesting that the journal consider hosting this document, either in its in-process version or in its final version. If the journal is not willing or able to engage, we will most likely change these accounts from being an online document and move them into some form of academic repository.

    Finally, our last message is directed primarily at the editor. We recognise that our revisions are somewhat radical: the creation of an additional document and a changed title (with respect to the changed title, we hope that there are ways for us to ensure that this article – whose pre-print we have been promoting for 7 months now – will remain easy to find). In addition to the radical actions, we would also like to propose an action that is very conventional: if this article is ultimately accepted into the journal, we ask that a pdf version of the article be posted along with the html version. We have noticed that some articles in the journal have a pdf version while many other accepted articles do not. As part of our mandate to disseminate our work more broadly, we think that a pdf version of the article will be a positive resource.

    [1] Sandelowski, M. (2010). What’s in a name? Qualitative description revisited. Research in nursing & health, 33(1), 77-84.

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