PhD Project - Understanding Engagement and Resistance to Evidence-Based Practice in Osteopathy

Overview

Across international osteopathic communities, a minority of practitioners actively reject or resist evidence-based practice (EBP). While global surveys show generally positive attitudes toward EBP (Sundberg et al. 2018; Leach et al. 2019; Cerritelli et al. 2021; Alvarez et al. 2021; Pelletier et al. 2024), they also reveal wide variation in knowledge, skills, uptake and philosophical alignment. Importantly, a distinct subgroup of osteopaths view EBP as incompatible with osteopathic identity, autonomy, holism, or traditional epistemologies (Figg-Latham and Rajendran 2017). Despite this, there is very limited in-depth qualitative work that has examined the beliefs, values, lived experiences or identity processes of osteopaths who reject or engage with EBP. Existing research has largely been descriptive and survey-based, leaving a lack of explanatory theory to account for why these orientations emerge and persist.

A theoretically informed, exploratory programme of research is therefore required to understand the underlying mechanisms shaping osteopaths’ orientations toward evidence before effective educational or professional interventions can be designed. This represents a significant gap in professional knowledge and limits the profession’s ability to address epistemic diversity, regulatory expectations, and the integration of osteopathy within wider healthcare systems.

This PhD project will examine the UK osteopathic profession as a case study to develop theory concerning how evidence-based practice is negotiated within osteopathy, with the primary emphasis on exploratory theory development and the secondary aim of informing the design and feasibility of future interventions, with implications for comparable international professional contexts.