The story models of physiotherapy students ' professional development. Narrative research

Abstract The aim of this article is to investigate students’ narratives about their professional development process. This research brings new kind of knowledge to continuing learning, developing education and planning the curriculum in physiotherapy education. The European Qualification Framework (EQF) defines learning competences in education; qualitative research has a narrative approach. The material consists of eight voluntarily participating physiotherapy students’ portfolios written during their whole study time. The longitudinal data describes them as learners and their development process. The major findings are four main episodes in professional development: the previous studies, a new way of learning, understanding the physiotherapy and becoming professional in physiotherapy. Three story models were found: the story of the development of an autonomous learner, the story of the development in becoming a member of the physiotherapy community and the story of the development of a critical developer. In conclusion, four steps in the physiotherapy students’ professional development were formed. The model helps understand the students’ concepts about their professional development. Students need theoretical knowledge and practical skills to build their professional development. Reflecting learning and instructed practice are important for professional development in healthcare. Learning is connected to action, context and culture where information is collected and used.


Introduction
Professional development during education occurs when knowledge, skills and experience increase. Learning and expertise always develop through cooperation between school and working life in education in the health sector (1). Refl ections of learning (2) and instructed practical training (3,4) are important in professional development in physiotherapy.
Development from a novice to an expert can be seen in the development of thinking and the ability to act, utilization of self-refl ection and the development of personality. Expert knowledge can be informal competence, silent practical knowledge or use of common sense. It often includes emotional and social skills to which controlling one ' s own competence, problem solving, communication and cultural interpretation are connected (5,6). Expertise in physiotherapy is based on knowledge of the presumptions of health, human movements and daily activities meaningful turning points and learning experiences of physiotherapy students during their education? (iii) What are the narratives of physiotherapy students ' professional development?

Methods
The research method is qualitative narrative approach to describe and understand the physiotherapy students ' stories as narratives. Narrative is structuring experiences and the world, constructing and a way to use language. Language is an instrument of communication and narrative an instrument of mind to construct meanings (21,22).
In narrative research, the focus is on people ' s authentic stories and the way individuals give meaning to experiences via their stories. When thinking like this, the students ' own voice is better heard with the help of their own stories, when they have done the fi rst interpretation themselves. They tell what they experience as necessary to say. With the help of a narrative approach, students can build their professional development. Narrative research enables a new kind of perspective, in which it is possible to combine students ' life stories to their professional development. The research of the narratives ' turning points allows the identifi cation of transitions during studies (21 -23).

Study design
This study is part of a wider research project that concentrates on healthcare teacher ' s education. This article focuses on the students ' view in learning.
The data was collected in 2008 and 2012 from two different universities of applied sciences from different parts of Finland with a different curriculum, graduating time and age groups. In the fi rst data collection, only six students out of 18 voluntary students completed their portfolios completely. In the second data collection, we wanted to saturate the fi rst data with two different types of students out of the 11 voluntary students (criteria: different ages, different earlier education and working experience) ( Figure 1).

Participants
Participants were eight 22 -37-year-old female students (mean age 27.5 years) who fi nished their studies in 2008 and 2012. Six students did not have earlier experience of higher education. Two had studied in university. Four had graduated from vocational upper secondary education, three as practical nurses and one from the catering branch. One was a Higher education in Finland is offered by universities and universities of applied sciences (dual model). Universities emphasize more scientifi c research and instruction. Universities of applied sciences also give practical professional skills. The extent of a degree in a university of applied sciences is generally 210 -240 ECTS points and requires 3 -4 years of full-time study (13). The National Qualification Framework (NQF), set by the Finnish Board of Education, is an instrument for the classifi cation of qualifi cations according to a set of criteria for specifi ed levels of learning achieved. Finnish Bachelor degrees are placed on level six of the eight levels of the EQF. This is central in physiotherapy education now. NQF and competences came into use in the beginning of 2013 (14).
The theory of development for expertise according to Dreyfus & Dreyfus (10) is a traditional way of describing transition from a novice to an expert and is used in this article. Transformative learning theory has a central place in the adult education literature. According to Mezirow (15), transformative learning occurs when people critically examine their habitual expectations, revise them and act on the revised point of view. Transformative learning is a process of progress in a learner ' s life. It occurs in relation to a variety of kinds of habits of minds. Transformative learning takes place in a multiplicity of contexts and it is stimulated by different types of events. Transformative learning from the learner ' s point of view includes as many different transformative learning stories as there are people who experience transformation (16).
Physiotherapy students ' professional development throughout their studies, how the students describe their professional development, has not previously been studied. A systematic search from scientifi c databases (ERIC, MEDLINE, CINAHL and Academic Search Elite) was done (18 February 2014) using the keywords " physiotherapy students " AND " professional development " AND " narrative research " . Four articles were found and they concentrated in cultural and work cultural issues (17,18), and professional knowledge and skill (19,20).
The aim of this study is to investigate students ' narratives about their professional development for planning their personal curricula in physiotherapy. Both Finnish physiotherapy curricula and EQF competences concentrate on the learning outcomes in physiotherapy but do not cover the ways to achieve those outcomes. Results of this research will help when planning education and courses in physiotherapy.
The research questions are: (i) How do physiotherapy students describe their professional development during their study time? (ii) What are the masseur in a previous profession. Six students had taken a matriculation examination. All students had work experience from both childcare and elderly care during their studies (Table I).

Data collection
Longitudinal data was collected over 3.5 years from two different universities of applied sciences in different parts of Finland. The data consists of 283 typewritten A4 pages of learning experiences of the students. Students wrote their portfolios every 6 months, in which they described their learning experiences and feelings. Students were given guidance in making a portfolio. They were instructed to themewrite about the subjects what kind of a learner am I at the beginning of their studies and my professional development in every 6 months. The lengths of the stories varied from 12 to 47 pages; on average they wrote 35 pages. The writing was free narration from the students. In some of the stories, the students used literary sources as a back-up to their thinking. Finally, the portfolio consisted of a single report of their study time.

Data analysis
The analysis in a narrative research is often in a free form, but also accurate methods for analysis have been developed. Narrative data always needs interpretation; results cannot be explained in a simple way, numbers or categories (21,22). It was a process to analyse the data, and it had to be read several times. Different ways of reading are used in narrative analysis depending on the question answered. We tried to discover such issues in the material that would help to understand professional development.
Three-stage analysis of narration has been used as a basis for the analysis of the students ' longitudinal narration. First, a general view and descriptions of the stories are made, and thereafter the turning points of the stories and story models can be recognized (24). Taxonomies and categories out of the common elements across the database are used in this study to build up explanatory stories (25). Story models of professional development were constructed from the students ' learning stories. The analysis in this study had three phases ( Figure 2): In this phase of the analysis, a general view (1) of the students ' stories was made. A chronological plot was formed from the stories. The plot is an integrating and interpreting process, in which pieces of a story are connected to make an entire story. Summarized individual narratives were formed of the students ' stories (21,24). The recognizable features of a story were clearly shaped from the stories -the beginning, midpoint, ending and a chronological plot. Components defi ned by Labov (26) were recognizable in the students ' stories. In particular, the evaluation the students wrote about professional development was considered. These individual descriptions were used in the following phases of the analysis. Purposive sample of (8 portfolios) n=8 The second data was collected to saturate the first data Analysis was sharpened to cover details of the (2) ongoing plot. In this phase, the main episodes and turning points, in which the students most used the dense lingual descriptions, were formed. The dense parts and the evaluations in the students ' stories exposed the turning points in the study time (21,26). Three different story models of the students ' (3) stories were formed according to the turning points of professional development. The direction, genre of the story, which is graphically presented after the description, was formed from the plot, main episodes and critical turning points of the story. The story models have been given names according to their recognizable characteristics (25). The students ' ongoing professional development has been described yearly because the students themselves had used the years of studying as the " boundary marks " . After analysing the data, it was possible to connect the results and the story models to theoretical reference frames.

Results
Stories from eight physiotherapy students ' professional development from the level of novice student to the level of skilled student had different turning points on their study time. During their studies, physiotherapy students formed their professional identity. When fi nishing their education, the students should have a capability for lifelong learning. It is important to pay attention to different types of learners when planning the curricula.

The four episodes of professional development
The students ' stories were constructed as chronological narratives. One of the main results of the research was so that a four-level transition step of the physiotherapy students ' professional development could be formed. Four different main episodes of professional development were constructed: (i) the previous studies, (ii) a new way of learning, (iii) understand the physiotherapy and (iv) turning professional in physiotherapy.
(i) The previous studies: the students described their previous learning experiences and earlier achievement in studies. (ii) A new way of learning: the students described their needs in learning, their problems in a new learning environment and things they experienced as benefi cial. (iii) Understand the physiotherapy: after the changes of the beginning, the students described their professional development, constructing knowledge and learning practical skills. Practical training periods had a big role in the professional development process in the stories. (iv) Turning professional in physiotherapy: In the fi nal stage of studying, the students described their specialization area and the process of doing their fi nal thesis. Transferring to working life and learning at work were in the thoughts of students near graduation. When going up in the professional development steps, the feelings of the students changed from feelings of insecurity and fear to experiences and assurance, fi nally fi nding their own developmental needs and gradually perceiving the whole nature of physiotherapy.
Understanding the whole nature of physiotherapy increased their trust, and their own skills also grew.

The story models of physiotherapy students ' professional development
Three story models were formed from the students ' narratives: the story of an autonomous learner , the story of becoming a physiotherapy community member and the story of a critical developer . It could be seen that during the students ' study time, they had turning points that describe their professional development. They took place in different times in their studies depending on the story model. The ongoing plot and turning points, which describe dense points in study time, can be seen in the Figures 1 -3, as the students tell in their stories. Even though the turning points are different in the story models, every narrative ends up in a Bachelor ' s degree in physiotherapy.

The story of an autonomous learner
The main turning points of the autonomous learners ' stories were at the beginning of their studies when they found appropriate study places and professions for themselves (Figure 3). In particular, Anna, Liisa writing descriptions about whole stories (Ricour,24,Hyvärinen,21) recognizing the turning points of the stories (Labov,26,Hyvärinen,21) analysing and categorizing the stories (Polkinghorne,25) step 1 step 2 step 3 Figure 2. Data analysis.
and Sonja described their own growth as human beings in their stories. These students had previous studies behind them, but not until this stage in their life they had found the right branch and study place they had been seeking. They described the beginning of their studies and the new study place as a positive change in their lives, like a new start for their own growth. Anna fi nds the university of applied sciences a learning environment, which seems to fi t just for her. As she writes: I studied three years in university of technology before entering to university of applied sciences. In the university of technology, studying consisted mainly of sitting in a large auditorium with about two hundred other students. Such an environment was not for me and I felt it was wiser to apply to the university of applied sciences, where teaching is more personal, and the school community is smaller. (A3) She felt that she needed a concise study environment in order to keep up with other students. I am very lazy by nature and I only do what I am pressured to do. That ' s why I need a concise learning environment, where I cannot be a slacker but have to keep up with the others constantly. (A4) Also, Sonja found studying at a university of applied sciences different from studying in the university. She felt she belonged to a group now. As she writes: Clear advantages compared to the university: I see education and training programs have had a strong desire to get started grouping right away. I was just wandering more or less by myself in the university -because social contacts were not forcibly created, I did not create them. Even though there is a large age difference between me and many others in the class, I ' m actually amazed that everything has worked out so nicely. I have a real team, where I really belong now! (H13) A Finnish reform established universities of applied sciences, aimed at more student focused and workoriented higher education. This seemed more appropriate to Anna than the traditional university environment. In the university of applied sciences, she felt she belonged to a more concise student group and obtained more personalized guidance.
Also a turning point in the story of Liisa was in the beginning of her studies when she found a suitable study place. She had studied many branches, but she had not found the right profession for herself before studying physiotherapy. She says previous studies were a search for the right profession. As she writes: My fi rst studies were just searching. I had to look around and see what there was on offer. It was really diffi cult to decide what to do with the rest of my life. My previous degrees have benefi ted and will only benefi t me. Studying is never a waste of time. In working life, I have noticed that the more you have competence, knowledge and skills in various areas, the more opportunities open up. At least I have experienced it as richness. (C4) Sonja felt she was wasting her life in her previous profession. She wanted more meaning for her work and life. Starting to study physiotherapy was a big change in her life, and she was happy about it. As she writes: I had experienced very strongly that I wasted my life as a human being in the previous work. I felt that I was not able to give enough for others, I could give more. I wanted my work to have more relevance and meaning. Physiotherapy crystallized things that I was searching for and which were meaningful and relevant to me. Human movements, body and mind, and how they work together, interested me very much.
Starting to study physiotherapy was signifi cant to Anna, Liisa and Sonja. They already had more life experience than many of their fellow students, which they experienced as only positive in studies. Now they knew what they wanted to do, and they were willing to invest in it.

The story of becoming a physiotherapy community member
The turning points of becoming physiotherapy community members were during the second year of their studies (Figure 4). In particular, Eeva, Tiina and Maria described their professional development and the ability to step into working life. They refl ected how ready they were to face the challenges of the " real work " . In chronological plot descriptions, their professional development started to increase during the second year of studying when the problems at the beginning of studying and changes in study techniques were mostly over (Figure 4). Courses of their own branch and practical training made the picture of physiotherapy clearer and brought new enthusiasm to studying. Practical experiences helped the students ' professional development.
Tiina ' s turning point in professional development was at the start of the second year of her studies, when she had a new kind of enthusiasm for learning. Courses in her own fi eld and practical training increased her understanding of physiotherapy. As she writes: During the second year there was more workbased learning, and courses in my own fi eld. I got a whole new kind of enthusiasm for the sector. (F13) Tiina felt that she had learnt most of physiotherapy when she was on practical training, but she gained important knowledge to survive in practice from school as well. As she writes: I think I have learnt most physiotherapy in practice; however, the school has given me tools for success there. On some subjects, I have learnt a little bit more at school than in some other subjects. (F14) Also Maria felt that getting to work with real patients was important experience for her. After her fi rst practical training, she was eagerly waiting for the next one. As she writes: Practical training was a highlight of the autumn. It was nice to get to work with real customers. Practical training was a rich experience, and taught me a lot. I look forward to the next practice. (G7) The turning point of Eeva ' s story of professional development was also during the second year of her studies, when the diffi culties of the beginning of studies and changes in study techniques were over. Eeva described the training periods that extended her understanding of how wide the physiotherapy sector was. Eeva felt that practical experience and practical work helped her professional development, as well as giving her a valuable experience to meet clients.
Practical training periods were important learning environments to Eeva, Tiina and Maria. They felt their professional identity and expertise were mostly built in real work situations. In practical training, they found the meanings for what they had learnt at school.

The story of a critical developer
The turning points of critical developers were described in the third year of their studies. In particular, Kaija and Minna are critical towards their own skills, information and sources ( Figure 5). It is important to question everything one has learnt, because that is the way one remains interested in knowledge and even the development of one ' s own profession.   The turning point of Kaija ' s professional development was in the fi nal phase of her studies, the third year, when she gained a clearer picture of the physiotherapy sector and at the same time her selfconfi dence increased. As she writes: A challenging and interesting time for school work slowly begins to take shape in front and back of the head; what is at stake and the study group is also welded together nicely → a great resource! (E15) At the same time the criticality towards her own skills increased. As she writes: After the practical period in spring, the feeling was unusual: I was partly surer about myself than earlier, but awareness of the fact that school is fi nishing soon made me feel quite critical about myself and my skills. (E16) When assertiveness and understanding of physiotherapy increased, Kaija was able to refl ect on her skills critically. She started to question what she knew and could do before going to real working life.
The turning point of Minna ' s professional development is also located in the end of the studies, when she started to estimate skills and knowledge she had learnt critically. Through education, she had learnt how to be critical towards information. In addition to developing herself, Minna also became interested in the development of the physiotherapy sector. School projects inspired her to develop a new type of activity. As she writes: Through it, developing of one ' s own action has been renewed. In addition to developing my own skills there has also been talk about developing the physiotherapy sector. When there has been development in all kinds of [welfare TV, etc.] things in school, the amount of enthusiasm increases. (D12) Minna became critical towards information as well as her own knowledge and skills. She was able critically to refl ect her learning. She also experienced development projects at school as benefi cial. They made it possible to innovate in the physiotherapy branch.

Discussion
Previous studies are the starting point for professional development. Autonomous learners are enthusiastic students at the beginning of their studies; they have found their own fi eld. A university of applied sciences, an alternative to the traditional university education, is a suitable learning environment for them. The dual model of tertiary education in Finland tried to unite the traditions of further education and university. Positive sides of further education institutions below university were their practical orientation, access to employment, good pedagogy and principles of taking care of the students (13). Autonomous learners search for their identities when seeking appropriate study and work places. They aim to answer the questions of who or what they are. Identity refers to the different meanings people fi nd for themselves and each other, as well as the way they perceive themselves as part of a social network (27). Starting to study physiotherapy was signifi cant to them. They were active and analysed their studies in many ways.
Autonomous learners are self-guided and independent learners. Well-planned and given feedback supports their learning. They also have the ability to co-operate with others and consider the problems to be solved (28). Competence is described in terms of responsibility and autonomy in the context of EQF, which suits an autonomous learner in physiotherapy well. They are responsive and certain that they have chosen a suitable profession. Autonomous learners have a good attitude to their studies, which is one of the key competences for lifelong learning (11). Autonomous learners have motivation to learn important knowledge and the skills needed to become physiotherapists. The challenge of physiotherapy education is to maintain their motivation at all times until the end of their studies. They need support and guidance, especially after the fi rst year of their studies.
Learning in work is essential, especially for becoming physiotherapy community members. Practical training periods have been found to be important learning environments for physiotherapy students (1,3,4). Students ' professional identity and expertise are built in real work situations. In practical training, students can fi nd meanings for what they have learnt at school (3). In the work community, learning and professional development grows in the participation process. Students ' professional development grows within interaction with the work place ' s material, cultural and social environment. Gradually deepening participation at work offers the beginner a limited opportunity to take part in expert practices. Learners get to know the tacit knowledge of experts and working culture (29). It is important for novice physiotherapy community members to learn the advanced skills needed in physiotherapy at practise. Skills, social and civic competences are important for them (11,30). During education, they need support especially at the beginning of their studies, before they get to the actual fi eld of practice. Their motivation decreased right after the beginning, because there was not much physiotherapy studied. They also had to learn a new way of learning.
An investigative approach to work and critical community development can be seen in the critical developers ' narratives. They refl ected their knowledge and skills critically when they understood physiotherapy better. Through education, they had also learnt how to be critical towards information. Refl ection is always a critical element, but according to Mezirow (15), the concept of critical refl ection refers to the earlier learning presuppositions ' validity of questioning. Critical refl ection and re-evaluation of problems, attitudes, perception, knowing, believing and acting are always significant adult learning experiences. Giving a meaning is to understand what experience is, and to make an interpretation about it. Using this interpretation as a help for decision making and activities transforms a meaning to learning (15). Also, Sch ö n (31) calls for a refl ective expert, whose action is continuously based on self-examination, questioning and the developing of oneself.
Development projects at school appeared to be benefi cial for critical developers. They became interested in the development of the physiotherapy sector. On the level of critical refl ection, students are able to innovate and develop new cooperation with working life. In the university of applied science ' s curriculum, students have the opportunity to be involved in development projects and learn by doing and experiencing the projects involved. Experiences of various projects have been positive and encouraging (32). Physiotherapists must remain in the rapid development of healthcare, which requires innovative physical therapy services. Also, critical evaluation skills are needed to assess the increasing research information. Another challenge is to create new knowledge and the development of the work. Active innovators develop their own work processes and create new ways to work for organizations. They innovate alternative ways of thinking in decisionmaking, even at a societal level (32). All the EQF key competences require critical thinking, creativity, problem solving and decision making (12). To gain general competence on a Bachelor ' s level, the candidate should manage complex technical or professional activities or projects. They should refl ect also their need of further knowledge and take responsibility for developing knowledge (30). This especially suits critical developers at the end of their studies. Critical developers need support throughout their studies, until they feel they understand enough physiotherapy. After that, they fi nd their own way of thinking and expressing themselves. In conclusion a four-level step of the physiotherapy students ' professional development was formed. " Thresholds " of the steps are the main episodes constructed from the students ' stories. The model helps to understand students ' conceptions about the steps of professional development in universities of applied sciences. The terms of the theory of development for experts by Dreyfus & Dreyfus (10) were used in this article. The fi ndings of this research fi t well to this theory and help to understand the different stages needed when building the students ' professional development ( Figure 6). This data showed also that transformation (15,16) in the turning points of student ' s narratives are also important in professional development.
This data has seen three interesting students ' story models, to which individual learning ways should be made possible . Every student type is important for real working life and for creating new knowledge and development of the work. All the students have their own ways of learning and the challenge for the planners of curricula is to open up possibilities for different kinds of learners. Professional development is a continuous creative process that takes place within real life situations. Belonging to a group is meaningful: in that context, students fi nally become professionals and fi nd themselves (33). The European Union ' s competences for lifelong learning must be noted in teaching. Key competences are major factors in innovation, productivity and competitiveness (21). The recommendations in physiotherapy education have been followed in Finland since the beginning of 2013 (14). Competences should not become barriers to studying. They should rather open possibilities to different stories of learning.

Trustworthiness of the results
The qualitative, narrative approach was a good way of recognizing the students ' way of learning. The portfolio process and getting to know one ' s own story of learning are ways to become aware of one ' s own learning process and develop it. The disadvantages in narrative research are that there is no one exact way to analyse the data, and the researcher has to create a suitable way to answer the research questions. When using different ways of reading, new information always appeared from the data, however, which supported earlier fi ndings. An advantage in narrative analysis is, however, that as a result of the analysis, the unique meanings from the stories of the participants in the study are fi gured out (21,25).
When narrativeness is attached to constructive thinking, like in this research, then the validity of this study concerns its trustworthiness, verisimilitude, adequate observation of phenomena, justifying their theoretical choices and presenting the results in a summarized way (34,35). The researchers have taken care of having enough observations about the studied phenomenon. The ongoing analytical process has described the way that it is possible to follow from where and how the researchers have obtained the results and it is transferable. Several ways of reading were used in the analysis and the results include direct citations of the research material (34).
In this study, the researchers justifi ed their theoretical choices in a reference frame and looked at the results of their study in relation to earlier research results and theories (34). The theoretical model used for professional development was Dreyfus & Dreyfus (10), from a novice to an expert classifi cation, which was originally used in pilot education and that Benner (36) has applied to the development of experts in healthcare employees. The results of the study were looked at in relation to this model of the students ' professional development, in which the main episodes of the students ' stories fi t well. It was thought, however, that professional development is not only linearly ongoing, but that it increases in different dimensions and in different ways. Transformative learning by Mezirow (15) is a process of progress in learners ' lives and takes place especially in the turning points of professional development. This study brings new information about the physiotherapy students ' development process. Each student narrative has its own turning point on a different step.
The results were summarized in a way that is logical and suitable for the approach. The plot of the students ' stories had to be arranged in chronological order in a compact format. In the stories ' headlines, the most important message was summarized (34).
In the end, the results were summarized in graphical pictures, story models and steps of the professional development of physiotherapy students.
The relevance of this study is also a question of utility of narrative truth. It is good to ask the following questions. Is this study useful? Is it relevant for use by members of the research community or by members of the teaching community? (34) This is what Riessman (37) considers the " ultimate test " : " Does a piece of narrative research become a basis for others ' work " ? This research brings new kind of knowledge to continual learning, and can be utilized in developing education and planning the curricula in physiotherapy.
Limitations of the study are that the material focuses culturally on Finland and only in two out of 15 universities of applied sciences, so it is not necessarily comparable elsewhere. The material also focuses on students at a Bachelor ' s level. The amount of material is also small, but it includes a long period -the whole study time.
The results of this study describe the experiences of the professional development of the students in this study and cannot be generalized. They bring new knowledge of physiotherapy students ' professional development.

Ethical issues
Participation was voluntary and permission for the study was requested from both educational institutions as well as the students themselves. It is important to make sure that the anonymity of the participants is maintained during the whole process because the number of participants of narrative research is often small. That is why the student ' s real names were not used in this study. The researcher met students personally and told them both orally and in writing the aims and meaning of the research. None of the authors was teaching in these universities of applied sciences while this study was done. Good ethical principles are used in the study, which is a part of a wider research project that has research permission from Jyv ä skyl ä University.

Conclusion
The aim of this study was to investigate students ' narratives about their professional development for planning their personal curricula in physiotherapy. Individual stories strengthened the conception that everyone constructs knowledge, skills and conception from their previous understanding and build one ' s own story of learning in an individual schedule.
The results of the study help to understand the entirety of professional development and professional ability in physiotherapy. The critical stages of learning become clear in the four-level transition steps of the physiotherapy students ' professional development ( Figure 6). Four different main episodes of professional development are: the previous studies, a new way of learning, understand the physiotherapy and turning professional in physiotherapy. In particular, seeing the turning points of three different story models -the story of an autonomous learner, the story of becoming a physiotherapy community member and the story of a critical developer -help to recognize when the different kinds of learners need guidance the most. This directs the planning of the physiotherapy curricula and improves the teachers ' and instructors ' own work.