Maxi-mum understanding of EDI, therapeutic relationships in physical therapy

Maxi Miciak. Photo supplied.

Maxi Miciak is an assistant teaching professor in the Faculty of Rehabilitation Medicine at the University of Alberta. She obtained her doctorate here in 2015, then returned to the university in 2021 as a research associate after a sojourn completing a post-doctoral fellowship in impact assessment at Alberta Innovates and running her own consulting practice. Her research areas and interests include EDI in education and therapeutic relationships in physical therapy.

We contacted Miciak to learn more about her and her current research.

Please explain the focus of your research and why it's important.

My work is focused in two areas — equity, diversity and inclusivity (EDI) in teaching and learning and therapeutic relationships in physical therapy. Related to EDI, I study what is important for generating, understanding and assessing the impact of EDI strategies on teaching and learning. This work is important because schools shouldn’t just claim they are making a difference; they must demonstrate it while continuing to learn and adapt. Isolating EDI impact has its challenges, so getting a better understanding of what and who gets impacted, as well as when and how, will help us make a difference.

A second area (and original passion) is studying the therapeutic relationship in health-care interactions — or how physical therapists and patients get along and work together (or don’t) in trusting relationships to achieve the patient’s rehabilitation goals. It is important because the therapeutic relationship is a common factor in all clinical interactions and a pillar of person-focused care and professional practice standards. We’ve known for years that positive therapeutic relationships in psychotherapy are correlated with better clinical outcomes. We are just beginning to learn the same thing in physical therapy.

What part of your work do you find the most rewarding? The most challenging? 

The most rewarding part is having the work I do be useful and used. It’s satisfying when folks say that the frameworks I’ve developed help them understand important topics and be more effective at what they do.

The most challenging part of my work has been making sense of very complex social phenomena — such as EDI, impact and relationships — from scratch. It can sometimes feel like walking through a dense forest, blindfolded. But the flip side is that coming out of the woods is very satisfying.

What impact is your research making?

Working with the faculty's EDI Action Committee, I recently developed a conceptual framework — the EDI Teaching & Learning Impact Framework — that clearly lays out key impact categories along pathways to impact. This framework gives the faculty a tool for breaking down a complex area into something understandable and less overwhelming. I want the framework to inform strategic and operational decisions related to EDI within the faculty and ideally, in other parts of the university, as well as help us assess the impact of our initiatives. Down the road, I hope it helps shape a culture where “thinking” and “doing” EDI is just what we do, while giving us a frame to be critical of our efforts and their implications. I’d love for this work to bridge a gap between what students learn about EDI in the classroom and how they practise in the real world.

My conceptual framework of the physical therapy therapeutic relationship has influenced research, practice and policy. It’s been used to develop a physiotherapy-specific measurement tool to assess the therapeutic relationship and has informed entry-to-practice and post-graduate education as well as practice guides and briefings. Uptake has also been reported in clinical practice. In the future I’d like the work to have a greater influence in teaching and learning.

What first drew you to rehabilitation medicine and this area of research?

I am a physical therapist that came to realize the impact that relationships and spaces of belonging and respect have on people, but there was no evidence-based guidance in physical therapy like in psychotherapy. So I returned to academia after practising for 12 years for that very reason — to bring therapeutic relationship to the forefront of clinical practice and contribute practical knowledge that could make a difference in the profession.

What's the No. 1 piece of advice you give your students?

When trying to understand complex topics, slow down and allow your ideas to breathe and percolate. Trust the process, move between the details and the big picture. Use different ways of stimulating your thinking, such as talking or doodling out your ideas, and give yourself the time and space for your ideas to form and connect.

What is something your colleagues would be surprised to learn about you?

I think I was a rock star in a past life (or parallel universe). I once won a karaoke competition singing songs by Guns N’ Roses, Bon Jovi and Melissa Etheridge.