| Summary: | The design of a profession’s standard frame of reference, for training or management purposes, has an effect on the activity of the persons involved in the process. Once completed, however, it becomes a standardizing document, a document which impedes the dynamics of the activity. With a group of physiotherapists, we conducted a clinical intervention that aimed to identify issues in their profession which are unresolved and which we consider as offering a possible access to the “real of the activity”. Some of these unresolved issues are permanent and are particularly characteristic of the profession: these are the dilemmas that present professionals, when practicing, with impossible choices between two or more unsatisfactory solutions. Faced with these unsolvable obstacles, yet nevertheless obliged to act, these operators develop and capitalize on their experience. On this basis, our clinical intervention with physiotherapists allowed us to design a standard frame of reference which supports dilemma and acquired knowledge, which, through use, encourages renewed dialogue between professionals. Its clinical efficacy would seem to be explained by the presence of a "proto-referential", a generic instrument of pre-organization implicit in the situations encountered, which the “referentialization” process enables us to rediscover and rediscuss. The artificial setting of clinical intervention thus allows us to reconsider the ecological framework underlying the profession.
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