All right, welcome to Hands On, Hands Off,
where we explore the minds
shaping the future of
manual therapy and rehab.
I'm your host today, Moyo Tillery,
and we're thrilled to
welcome Dr. Myra Meekins,
a physical therapist, educator,
and thought leader in
orthopedic manual physical therapy.
Dr. Meekins has been at the
forefront of integrating
motor learning and behavior
change principles into clinical education,
challenging the old adage
that practice makes perfect.
So today we'll dive into how
clinicians can move beyond
repetition and into purposeful,
transformative learning.
So let's get started.
Dr. Meekins, welcome.
To kick things off,
can you share a bit about
your journey into physical
therapy and orthopedic
manual physical therapy?
Sure.
Thank you so much for having me.
So I began my physical
therapy career in Nashville, Tennessee.
I graduated with a
bachelor's in physical
therapy from Tennessee State University.
From there, I went back home to Memphis,
Tennessee, where I
worked hospital-based.
So that was my first job,
a geriatric hospital where
I had the opportunity to
rotate through acute care,
skilled nursing, rehab,
and outpatient to get a
variety of settings.
But I always knew that
outpatient was where I wanted to
end up being my primary home.
So after a couple of years,
I transitioned to a
different hospital where I
was primarily hospital based outpatient.
So if you've worked in that setting,
you know,
you can get you can get a ACL injury,
you can get a stroke,
you can get an amputee,
you can get a COPD pulmonary rehab.
So you get really good at
seeing function and what's
the main thing that needs
to get this person to meet
their goals versus getting
too caught in the weeds.
So did that for about four or five years.
From there,
I eventually started working in
occupational rehabilitation.
for about seven years.
And so during that time is
when I had the opportunity
to complete a manual
therapy certification and
fellowship through Manual
Therapy Institute.
I did their Detroit program
and did my fellowship hours in Austin,
Texas with Peter Kroon.
Also during that time,
I had the opportunity to
become board certified in
orthopedic physical therapy.
I caught that learning buzz
and went back and got my
transitional doctorate of
physical therapy from Regis University.
And then eventually I
learned a lot about
movement diagnosis and
movement system impairments
during my manual therapy
fellowship and a little bit
about Washington University
and Shirley Sarman.
And so I took some
coursework through the APTA
and learned they had a fellowship there.
I applied and was able to do
a one-year fellowship at
Washington University
School of Medicine in St.
Louis learning movement
system impairments.
From there, I transitioned to teaching,
first at Arkansas State
University for almost five years.
The past ten years,
I was at University of
Tennessee Health Science
Center in Memphis, Tennessee.
And I have recently,
as early as January of twenty twenty five,
started at the University of Memphis,
which is developing a
doctoral physical therapy
program where I'm having
the opportunity to help
with developing the curriculum.
Oh, and I forgot my Ph.D.
was from Rocky Mountain
University of Health Professions.
So I've completed that in
twenty twenty and at
did a little certification
in health and wellness coaching,
which is kind of
contributed to some of that
behavior change and using
some of those techniques in
teaching and helping to
drive deeper learning.
Yeah, no, that's great.
Thank you, Dr. Meekins.
And, you know,
I love hearing about your
story and your path.
It's rich, it's inspiring.
And I, you know,
we talked about this a little bit,
which is how much we have in common,
thinking about our work in
occupational health and at Concentra,
where I spent, you know,
a couple years as well in
training through MTI.
It's been
something that we have in common.
And obviously, too,
now moving from clinical
practice to academia.
But back to you,
from clinical practice to
curriculum development and
some of your background training,
like your PhD,
driving some of your
interest in this work,
you've worn and continue to
wear many hats.
When we first started this discussion,
you mentioned that you have
an interest and a passion
for building or for
bridging the gap between
research and real-world
clinical application of OMPT principles.
And more importantly,
the clinical impact of all
of these things put together.
So can you share a little
bit about what has inspired
your path to doing this
work a little bit more?
You touched on it in your PhD work,
but can you tell us in detail,
maybe in more details about
what has continued to
inspire you into doing this work?
Yes.
Well,
my first inspiration was in PT school,
you know, it's knowledge, you know,
given to you by fire hose.
And so then when I got out
and started practicing, I was like, oh,
I needed to retain that information.
And so, you know, I was really inspired.
passionate about helping my
patients get better.
And so, you know, at that time I was,
you know, a little insecure, you know,
how sometimes we have a
little imposter syndrome
about my foundation.
And so even though now in
twenty twenty five,
I have this big alphabet behind my name.
It wasn't because I wanted
to be super smart and, you know,
stand out from the crowd.
It was I was on a journey and a path to
really find out what I need
to know to get my patients better.
That if my patient didn't get better,
it wasn't if they went
across the street to the next clinic,
you know, they would get better.
So I wanted to do everything
I could to really learn.
And so that's really what
started my journey.
And so as I was going through that journey,
I learned all of the
greatest things about
evidence-based practice and
what does that look like
actually in the clinic.
So really developing that toolkit,
that teaching someone how
to fish was very impactful for me.
But also what I learned as I
was going through the journey is
A lot of academia enjoy
getting into the details of
the discussion,
rigorous debate of the
evidence that's there
versus the therapist
Thursday at two thirty
that's trying to help Miss
Jones be able to sit
through Sunday service or
help Mr. Smith be able to
stay on his job a little bit longer.
aren't necessarily arguing
in those details.
So some of my passion was,
how can I take this knowledge that I'm
and translate it in a way
that's helpful for my colleagues,
for students,
for patients that's very
real and very helpful.
And I can see it within
treatment sessions versus
it being so abstract,
which sometimes it can be
when you go to conferences
or you're in graduate
school and those types of things.
Yeah, no,
that's an excellent point because
that's the purpose.
That should be the driving factor.
Like you said,
the alphabet soup is at the
end of the day,
the letters are meaningless
if you can't impact
patients and outcomes.
And I love that.
And I think it's clear to me
that your work is centered
around both evidence
and empathy,
which brings us to another
area that I think is
central to both entry level practice,
but also advanced clinical practice.
And so I want to move us
toward the discussion that
we're here to kind of dive
into a little bit more,
which is that motor learning.
I think I'm really excited
about this conversation
with you because I think a
lot of clinicians
you know,
early clinicians or seasoned clinicians,
as evidence continues to change,
we kind of struggle to
bridge that gap as things
continue to evolve.
So, you know,
a lot of what we talk about
in OMPT practice is like
refining movement patterns
and it's psychomotor based, to your point,
and optimizing and
facilitating neuromuscular
control and things like that.
how do you see motor
learning principles kind of
shaping the way we approach
not just the hands-on care,
but how we approach OMPT education?
So whether we're educating
OMPT educators themselves,
or fellows in training, or DPT students,
um can you just share some
insights on what successful
motor learning looks like
for a student it can be you
know students or everyone
you and I are students uh
dpt students fellows
educators what does
successful motor learning
looks like look like for for us learners
So yes, so one,
most of us are familiar
with the traditional
theories of motor learning
and the repetition and the
time it takes to master a task.
So versus just getting the
initial components together.
And then of course the practice,
was it the thousand repetitions?
So it goes from
unconsciously incompetent
to consciously incompetent
to eventually that mastery
of unconsciously competent.
And so as a DPT student,
our main goal is for them to be competent,
learn the techniques, be safe,
and have a strong
foundation upon graduation
that they can build upon.
versus a resident.
Again, now I have that foundation.
I want to focus in a
specific area of practice
so I can refine and become
a little bit more purposeful,
intentional with my examination,
my evaluation.
and how do I use movement
diagnoses to direct my care
versus a fellow or fellow in training
With that motor control, at that point,
most of them should have
that psychomotor skill as a
focus of that refinement of
how I want to practice
really delving into the
complex and into the gray.
in order to develop that mastery.
So with motor control,
when I presented in twenty twenty three,
we talked a little bit about the optimal
motor learning theory,
which is not replacing
traditional motor learning theories,
but just contributing to that.
In addition to what we know,
we also need to look at
psychomotor psychosocial contributors.
So the influence of positive expectation.
So I can't speak for you, but for myself,
when I was going through my training,
it was, you know,
in the nineties and the thousands where,
you know, it was a little bit more strict,
a little bit more.
You need to do it.
You know, this is right.
This is not.
And I'm actually someone
that thrives with that
because I say I rise to, you know,
to that level of challenge
and know that I know.
However,
the twenty twenty five student
needs a little bit more of
an environment that feels safe.
And so in the optimal learning therapy,
having positive expectations,
having autonomy to be able
to make choices,
having external goals and
expectations for motor learning,
they have found that that
increases motor learning as
well as deeper learning retention.
So to bring this back to
learning psychomotor skills
and orthopedic manual physical therapy,
Those days of do it my way.
And that's the only way.
While, yes,
you can learn a technique in
order for you to optimize and master it.
We do need to address these
psychosocial skills.
These high level of
expectations aren't so high
that they aren't achievable,
but they're clear,
but they're also affirming.
So you do and you will be
able to master these things.
And so the combination of
using those things,
whether it's a DPT student,
whether it's a resident,
whether it's a fellow in training,
can be very impactful for
learning the skills or
competencies that we want
them to be able to graduate with.
Yeah, no, I love that.
There's so much there, right?
You talk about purposeful refinement.
I love that.
I think that's a wonderful
definition of OMPT practice
and understanding that we are,
educating diverse learners now.
We've got, you know, second,
third career individuals
maybe coming into our profession,
non-traditional students,
and then you still have
your traditional students.
So like, you know,
motor learning and teaching
motor learning has got to
be adaptable in that realm
because your learners are also diverse.
So I love that, preparing students for
you know,
the real world diversity of not
just who's in the room, but of practice,
I think is really important.
So thank you for speaking to that.
I want to I do want to kind
of go back and call out
something you said,
which is really powerful.
You said address the
psychosocial to address the psychomotor.
And I think that's a
powerful foundation for motor learning.
And maybe we can even call
it contemporary motor learning, you know,
because I agree with you motor learning.
I, you know,
I completed fellowship
training not as long ago.
Right.
It was twenty seventeen.
But even, you know,
a couple of years later, seven,
eight years later.
teaching and learning and
the science and the art of that,
I can see it changing,
especially now that I'm in academia.
So I have a deep
appreciation for what you just said there,
which is you cannot
separate the psychosocial
from the psychomotor.
That is pivotal for what
we're trying to do.
And, you know,
it's just it's clear that
when we shift how we teach,
even with our patients,
we haven't talked about patients yet.
And patient education,
that's probably another podcast.
But we shift how we teach,
and we shift how students
show up to learn.
And cultivating that
environment is so important.
I love leaning into your expertise here.
In this area, I wanted to ask you,
and I guess this is sort of a shift,
a parallel shift in what
we're talking about.
I want to talk a little bit
about curriculum.
So I know that you are in
this space right now.
You have led efforts to
integrate content and
create themes and threads, you know,
like we spoke about Dr.
Sarman's movement impairment systems,
evidence informed practice,
professional identity formation.
What is your approach to
designing learning
experiences that stick?
And this question comes from
the fact that I think we
all know that when learning is meaningful,
it sticks.
But let's say you have a
cohort of a hundred
how do you make learning
stick for all hundred?
I'm selfishly asking for myself, right?
But I want to bridge the gap
again between like evidence, curriculum,
didactic, clinical practice and impact.
I feel like you have this
broad experience.
You do have this broad
experience across the spectrum.
And I want to know what is
your approach to designing
these types of learning experiences?
So one,
put it on the table, it is hard.
So I'm not saying I have the answer,
but I can share with you
our thoughts and techniques, as well as,
like you say,
what some of the evidence is saying.
So one of the things,
since we were talking about
psychosocial a little bit,
I do teach that course.
In the past,
it's been the very first
course in the term.
And I do,
I have students to develop
mission statements.
And so a couple page paper
on that in regard to what their why is.
And not just why for PT school,
but why for your life.
What are your short-term
goals and your long-term
goals for your life?
Because that is what's going to help
bring you through as you're
going through challenges
and difficulties.
So when we talk about making
learning stick,
having that intrinsic
motivation is extremely important.
So they need more than you
learn this because I told
you to learn it or just
take my word for it.
So how does this apply to
their personal goals as
well as professional goals?
How can they see a real life
application with that?
Of course,
there's repetition and overlay
and sequencing that of
course needs to occur.
So just because they learned
about a principle in one
course doesn't mean that
you don't teach it in other courses.
So they need to hear it.
multiple times in different
perspectives in different
contexts so you know some
curriculums are very
purposeful in integrating
content so it's not so
siloed which can be very
extremely helpful and
students definitely love
cases and scenarios and
authentic so those who have
the opportunity to be able
to do simulations
that can be very helpful for
helping to make things stick.
You know that the APTA and
ACAP and the Education
Academy for APTA are
working on competency-based education,
which allows that continuum
of learning where people
can kind of learn at their own pace.
and more individualized,
but every student has to
show competency for every
task or entrustable
professional activity.
And so I do think,
I think that's challenging,
but I do think those are
things that are extremely helpful for
developing skills for competency,
in the case of DPT education,
and then mastery for
resident and fellowship education.
So really attaching it to their why.
Positive expectations.
So the first day in my spine class,
I make it very clear,
I do not care if you're
going into pediatrics or aquatics,
or nephrology everyone in
here will be demonstrating
thrust and non-thrust
techniques you will do it
um but I also believe
everyone in here has the
tools to be able to do that
I'm going to teach you I'm
going to allow enough
practice time you will be
able to do that so while
the students are like
you can also see that wheel
turning in regards to, okay,
how do I need to align
myself in order to make it happen?
So being very clear with our expectations,
allowing that practice time
can be very helpful for
skill mastery and making it stick.
I love that so much.
You said you didn't have the answer,
Dr. Meekins,
but I think you just gave me an answer,
which is when you have a
room of a hundred learners
and you want to
Set everyone up to be successful.
How do you do that with a
hundred different ways of
learning is clear expectations.
This is not different from
what we see in the clinic.
It's level setting and saying,
these are the things that
you need to be able to do by this point.
And this is how I'm going to
get you there.
And I love that.
I think
you know sometimes we reach
for things that are more
abstract but at the end of
the day it's just about
giving the learner their
tools and saying this is
what's expected of you and
this is how I'm going to
get you there and just
setting that expectation I
love that and you know even
in you saying that tying it
back to your why this this
this comes back so much um
and I it always makes me a
little bit maybe sad is the
word is because as we're
educating you know semester
one dpt students
And we, we hammer on your why, you know,
remember your, so I'm in admissions.
I read a lot of like,
why do you want to be a PT
statements and reminding
students about their why they, you know,
sometimes they don't
connect that to learning.
So I love that you're very
intentional about that.
And, um,
I want to say,
because that was a focus on the student,
but us as teachers and instructors or CIs,
we need to be flexible.
We need to be able to adapt
to the variety of learners
or the diversity that's in
your classroom or in your clinic.
Everyone does not learn the same.
And so sometimes that can be hard.
I learned it this way.
So you should be able to
learn it this way.
Or I'm only going to do
traditional lectures or, you know.
So we are doing a disservice as well.
Instead of we don't want to
just teach content.
we want to teach the learner
that is in front of us.
And so with that,
that does put some onus on
us to be adaptable, to listen,
and as well as being in
touch with our why.
Why are we doing this?
Why are we in front of these students?
If it's the purpose is to
improve the profession and
to that generation.
then sometimes reflecting on that,
like we ask the students to do,
can make it easier for us
to pivot and adjust to the
student that's in front of
us instead of the student
that we would like to have.
Sure.
I love that so much.
And you took the words from me.
I know when we chatted a
little bit before this session,
we talked about how it's
one thing to teach motor
learning and repetition and
those things to students, but
How do we empower educators
then to do what you're saying?
You know, pause and reflect.
Are there moments or
triggers or times where you would say,
hey, take a step back,
think about what you're doing,
how you're doing it?
Like,
what are signs and symptoms for me as
an educator to step back
and get out of my way, you know,
to to teach my students?
I know some of the things we talked about
were practical things like
low stakes assessments for
students just to gauge
where they are with the
content we're delivering.
Do you have ideas on other
practical solutions and
resources for entry-level DPT educators,
but also at the level of
the fellow OMPT educators,
what can we do to be better?
How do we become more
reflective educators
thinking about all of these
principles and bridging
that gap between the learner and us,
the instructor?
What can you help us, Dr. Meekins?
Again,
I'm laughing because if my students
were watching this, they would be like,
maybe you should be listening.
We're all guilty and trying to get better,
right?
Right.
Like I said, it's a journey.
And as well as once you
think that you think you've got it,
then that's a problem
because you can't learn anything else.
So with that,
what I started with is listening.
So us as educators being
open to being able to hear that feedback.
So sometimes we're like,
especially those that are
in entry-level education,
sometimes those course
evals can be a little spicy,
but you have to learn how
to eat the meat and throw away the bones,
as my mom would say.
So one being open to feedback.
Don't wait to the end.
So give that feedback and
that response as you are
going throughout the semester,
as you are going throughout
that clinical experience,
as you are going throughout that.
period of fellowship training.
So the minimum you may have set up,
or let's say in a
fellowship training for midterm and final,
but there's nothing
stopping you from getting
additional feedback each
week or as students are learning.
um during um that time
because it gives you time
and room to be able to
pivot so um I do like to
use polling software
because early in my
education you know students
wouldn't say anything so
I'm teaching teaching
nobody's asking this is
great and then I would get
the exam I'm like this is
not great yeah so now you
know I know to pause and go
how do you feel about this
Really?
All right.
I'm going to throw up a
couple of questions.
Let's see.
So I'm forcing them to engage and go,
okay.
They don't.
And usually giving them a
little space and room,
as well as we talked a
little bit earlier about
that environment.
for them to ask the question
without feeling it being punitive.
Us making sure that the
other students are
supporting that learner as they go.
So then that way those
robust discussions can have,
because we don't know
what's wrong unless we
have a space where students
feel free to be able to tell us,
even if the answer is, oh,
I really didn't read that,
or I focused on that wrong.
So we have to be able to hear it.
We have to be able to ask
frequently with that.
And then we have to be open to change.
So for myself,
I had a colleague to help me
when I first started teaching.
I'm someone that I get the
main points during the lecture.
And then I go home and then
I read through it.
I read my book.
And then if I have other questions,
I would ask the next class session.
But my colleague, she would say, no, Meyer,
I try to learn it as much
detail as I can while I'm in class.
I don't have to study as much afterwards.
And so that was a paradigm
shift for me because I was teaching.
I was hitting high points, but
um I was not going in as
much detail because I was
assuming that students were
learning the way I learned
once I started um
recognizing there's various
ways then I changed the way
that I was um relaying the
content and then I would
check in is this enough do
you all need more um so
to get back to your original question,
how do we help these
students to be able to
retain the content?
It's staying close to the materials,
staying close to the students,
regular formative as well
as summative assessment.
And then going along with
this competency-based education trend,
making sure these assessments are valid.
So are the assessments I'm
doing actually reflective
of their actual performance?
So that way we have truthful
information that we can
make better decisions.
There's everything you're
saying is so rich.
There's so much there.
And I'm kind of
internalizing this as I'm
listening because teaching
in a hybrid program that
offers maybe some unique
challenges when we talk
about psychomotor skills,
where we encourage students
to practice immediately,
staying close to the material,
like you said,
even though we're not
physically in person until
at midpoint in the semester
where they've got a ton of
information to filter through.
But I love what you're saying there,
because if we fall into the
trap of maybe teaching the way we learn,
then we're doing a
disservice to our students.
And I think that's something that,
that in itself,
if you reflect on that alone,
seems to be the answer to
all our problems, right?
Like staying close, getting the feedback.
And this is,
I love the parallel between
the educator side and the clinical side.
because a lot of what you
say is in parallel with
what we say to students
when they're in the clinic
or fellows when they're
training which is you've
got to be adaptable you use
that word a couple minutes
ago you have to pivot in
the moment and this is
sometimes I think the
educator does think this
doesn't necessarily apply
to them um because I've
already course planned
through the semester this
is what I'm doing this is
how I'm doing it you got to
pivot in the moment um
and failing safely.
You have to create an
environment where students
and fellows can fail safely.
I think that's a lot of what
you seem to have just spoken about.
And that's a place where I love.
It connects the psychomotor
and the psychosocial so
beautifully and so
seamlessly that I love that
we've come full circle on
separating all of these
components and trying to
bring them together.
So thank you so much for that.
I know that you, like I said,
wear many hats.
And just before we close, I was wondering,
in addition to all the
insights and your passion
and your interests and your
work that you've shared with us,
what are you excited about
next what's what's next for
you what are you up to
before we wrap up any uh
projects you're excited
about working on or any
upcoming interests I guess
life interests even outside
of ompt here with us well
that's a little busy right
now so like I mentioned I
um am part of a new
a developing doctor of
physical therapy program at
the University of Memphis.
So I am the director of curriculum.
So currently working on coordinates.
So really exciting about, you know,
like I said,
I've been blessed to have so
many opportunities along my
career and that knowledge.
And so to be able to take
that and be able to share
that with students
as well as the community is
something I'm very passionate about.
And so with that, you know,
threading those things such
as evidence informed
practice throughout the curriculum,
professional formation.
So you may if you've been
attending the conferences
You know,
really helping to be intentional
with building the student
in regards to not just
ethics and regulatory issues,
but leadership and what
does their professional life look like?
Again,
where do we or they visualize
themselves as they graduate?
For us,
we do have a thread of rural health care.
because our program will be
actually on a satellite campus in Jackson,
Tennessee.
So with that,
we have a strong emphasis on
that autonomy and being
able to be that person in
the community to be a
support going for that.
And then, of course, movement.
So I can't go past that.
So my training with MTI,
my training at Wash U School of Medicine,
uh in movement system
impairments and so really
using movement to guide our
interventions our
assessments our plans and
making that the forefront
versus a focus just on
using tools is very
important and then of
course education and
learning so you know at the
heart of it as physical
therapists we teach every
day um and so really giving
them the skill set to do that um and
um sorry learning uh for
their professional life but
also helping patients in
how they're learning those
techniques as well so very
excited about that I've
been fortunate I'm a co um
I guess it's
co-investigator on a uh one
point six million dollar
grant that we just received in april
where we are developing
simulation and physical
therapy education courses
in area high schools.
So they graduate with their
PT technician certificate
that they can use in area clinics,
which in turn can help them
get hours for physical
therapy if they should
choose to do that as a career.
So that's exciting.
And...
I think that's pretty, oh,
I plan next month to,
one of my bucket lists were
to visit the Redwood Forest.
When I was a child, I wanted to do that.
So I plan on doing that in
the next couple of months.
So that's exciting.
That is exciting.
You'll have to share photos
once you come back from your adventure.
Dr. Meekins,
thank you so much for sharing
your insights with us today
and your passions along this work.
I think it is a really
powerful reminder that
learning is not just about
doing and repeating um it's
truly about like feeling
and evolving and thinking
and growing um and also
adapting and stretching no
no pun no cheesy pun
intended but kind of
stretching ourselves to
maybe spaces where we're a
little bit um uncomfortable
as educators and lifelong learners so
To the listeners,
if you're inspired to kind
of rethink how you're
practicing and teaching,
this conversation is a call
to action to look into some
of the tools that exist in
this space and dig into Dr.
Meekins' work.
But until next time, keep learning,
keep growing,
keep your hands on and your
minds engaged.
Thanks again, Dr. Meekins.
It was a pleasure.