“Should I Stay, or Should I Go?” Making Sense of Physiotherapists’ Turning Point Experiences in Elite Sport.

This programme of research critically examined the experiences of elite sport physiotherapists throughout an Olympic and Paralympic cycle. Specifically, the purpose of this thesis was threefold. First, I provide an honest account of conducting longitudinal qualitative research within elite sport environments. I utilised the genre of the confessional tale to reflect on the challenges that I encountered, which although unplanned became an important contribution to this thesis. Data was collected through a reflexive journal and analysed using reflexive thematic analysis. Five tales are discussed: entering the world of elite sport, breaking the cycle of performative actions, vulnerable elites, breaking the code of silence in elite sport, and negotiating with elites. Throughout the tales, I also provide recommendations and guidance for novice researchers and students who are currently or thinking about conducting qualitative research in elite sport environments. Second, this thesis aimed to extend theoretical understanding of turnover and retention practices by explaining how elite sport physiotherapists make sense of their turning point experiences and examining the processes that led to turnover and retention outcomes throughout an Olympic and Paralympic cycle. A qualitative, longitudinal, and rigorous methodological grounded theory approach was used to understand turnover and retention experiences in an elite sport organisation. Data was collected through semi-structured interviews, electronic application entries, timelining, and a reflexive journal and analysed using grounded theory analysis. Four core categories were identified: socio-cultural context, experiencing turning points, sense-making, and sense-made and lessons learned. These four categories helped me to build, develop, and produce a substantive theory (i.e., Theory of Turnover and Retention in Elite Sport). Third, this thesis aimed to bridge the theory-practice gap, by identifying how organisations can better support elite sport physiotherapists by developing a duty of care to inform practice, policies, and codes of conduct. Data was collected through semi-structured interviews and analysed using reflexive thematic analysis. Five themes were identified and discussed: person first, physio second; stronger together; aligning policy with practice; sustainability; and more collaboration and communication. Throughout the themes, the recommendations are supported by physiotherapists’ voices and contemporary empirical literature. Finally, the findings from all three empirical chapters were considered together and implications across empirical, theoretical, methodological, and practical perspectives were discussed. The thesis closes with future research avenues comprised of worthy topic areas that warrant further attention and my concluding thoughts.