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Gail M. Jensen - One of the best experts on this subject based on the ideXlab platform.
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Systematic Clinical Reasoning in Physical Therapy (SCRIPT): Tool for the Purposeful Practice of Clinical Reasoning in Orthopedic Manual Physical Therapy
Physical therapy, 2017Co-Authors: Sarah E. Baker, Elizabeth E. Painter, Brandon C. Morgan, Anna L. Kaus, Evan J. Petersen, Christopher Allen, Gail D. Deyle, Gail M. JensenAbstract:Background and Purpose Clinical Reasoning is essential to physical therapist practice. Solid Clinical Reasoning processes may lead to greater understanding of the patient condition, early diagnostic hypothesis development, and well-tolerated examination and intervention strategies, as well as mitigate the risk of diagnostic error. However, the complex and often subconscious nature of Clinical Reasoning can impede the development of this skill. Protracted tools have been published to help guide self-reflection on Clinical Reasoning but might not be feasible in typical Clinical settings. Case Description This case illustrates how the Systematic Clinical Reasoning in Physical Therapy (SCRIPT) tool can be used to guide the Clinical Reasoning process and prompt a physical therapist to search the literature to answer a Clinical question and facilitate formal mentorship sessions in postprofessional physical therapist training programs. Outcomes The SCRIPT tool enabled the mentee to generate appropriate hypotheses, plan the examination, query the literature to answer a Clinical question, establish a physical therapist diagnosis, and design an effective treatment plan. The SCRIPT tool also facilitated the mentee's Clinical Reasoning and provided the mentor insight into the mentee's Clinical Reasoning. The reliability and validity of the SCRIPT tool have not been formally studied. Discussion Clinical mentorship is a cornerstone of postprofessional training programs and intended to develop advanced Clinical Reasoning skills. However, Clinical Reasoning is often subconscious and, therefore, a challenging skill to develop. The use of a tool such as the SCRIPT may facilitate developing Clinical Reasoning skills by providing a systematic approach to data gathering and making Clinical judgments to bring Clinical Reasoning to the conscious level, facilitate self-reflection, and make a mentored physical therapist's thought processes explicit to his or her Clinical mentor.
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Clinical Reasoning strategies in physical therapy
Physical therapy, 2004Co-Authors: Ian Edwards, Mark Jones, Judi Carr, Annette J Braunack-mayer, Gail M. JensenAbstract:Background and Purpose. Clinical Reasoning remains a relatively under-researched subject in physical therapy. The purpose of this qualitative study was to examine the Clinical Reasoning of expert physical therapists in 3 different fields of physical therapy: orthopedic (manual) physical therapy, neurological physical therapy, and domiciliary care (home health) physical therapy. Subjects. The subjects were 6 peer-designated expert physical therapists (2 from each field) nominated by leaders within the Australian Physiotherapy Association and 6 other interviewed experts representing each of the same 3 fields. Methods. Guided by a grounded theory method, a multiple case study approach was used to study the Clinical practice of the 6 physical therapists in the 3 fields. Results. A model of Clinical Reasoning in physical therapy characterized by the notion of “Clinical Reasoning strategies” is proposed by the authors. Within these Clinical Reasoning strategies, the application of different paradigms of knowledge and their interplay within Reasoning is termed “dialectical Reasoning.” Discussion and Conclusion. The findings of this study provide a potential Clinical Reasoning framework for the adoption of emerging models of impairment and disability in physical therapy.
Mark Jones - One of the best experts on this subject based on the ideXlab platform.
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Clinical Reasoning strategies in physical therapy
Physical therapy, 2004Co-Authors: Ian Edwards, Mark Jones, Judi Carr, Annette J Braunack-mayer, Gail M. JensenAbstract:Background and Purpose. Clinical Reasoning remains a relatively under-researched subject in physical therapy. The purpose of this qualitative study was to examine the Clinical Reasoning of expert physical therapists in 3 different fields of physical therapy: orthopedic (manual) physical therapy, neurological physical therapy, and domiciliary care (home health) physical therapy. Subjects. The subjects were 6 peer-designated expert physical therapists (2 from each field) nominated by leaders within the Australian Physiotherapy Association and 6 other interviewed experts representing each of the same 3 fields. Methods. Guided by a grounded theory method, a multiple case study approach was used to study the Clinical practice of the 6 physical therapists in the 3 fields. Results. A model of Clinical Reasoning in physical therapy characterized by the notion of “Clinical Reasoning strategies” is proposed by the authors. Within these Clinical Reasoning strategies, the application of different paradigms of knowledge and their interplay within Reasoning is termed “dialectical Reasoning.” Discussion and Conclusion. The findings of this study provide a potential Clinical Reasoning framework for the adoption of emerging models of impairment and disability in physical therapy.
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Clinical Reasoning for manual therapists
2003Co-Authors: Mark Jones, Mark Jones Bsc Pt Graddipmanipther A Mappsc, Darren A Rivett, Darren Rivett A BappscAbstract:Introduction Section 1: Principles of Clinical Reasoning in manual therapy 1. Introduction to Clinical Reasoning Section 2: Clinical Reasoning in action: case studies from expert manual therapists 2. Back and bilateral leg pain in a 63 year old woman 3. Ongoing low back, leg and thorax troubles, with tennis elbow and headache 4. Chronic low back pain over 13 years 5. Unnecessary fear aviodance and physical incapacity in a 55 year old housewife 6. A chronic case of mechanic's elbow 7. Chronic low back and coccygeal pain 8. Ankle sprain in a 14 year old girl 9. Headache in a mature athlete 10. Thoracic pain limiting a patient's secretarial work and sport 11. Bilateral shoulder pain in a 16 year old long-distance swimmer 12. Medial collateral ligament repair in a professional ice hocket player 13. Patellofemoral pain in a professional tennis player 14. Self-management guided by directional preference and centralization in a patient with low back and leg pain 15. Craniovertebral dysfunction following a motor vehicle accident 16.A judge's fractured redius with metal fixation following an accident 17. A university student with chronic facial pain 18. Adolescent hip pain 19. A software programmer and sportsman with low back pain and sciatica 20.An elderl woman 'trapped within her own home' by groin pain 21. Chronic peripartum pelvic pain 22. Acute on chronic low back pain 23. A non-musculoskeletal disorder masquerading as a musculoskeletal disorder 24. Forearm pain preventing leisure activities Section 3: Theroy and development 25. Educational theory and principles related to learning Clinical Reasoning 26. Improving Clinical Reasoning in manual therapy Appendix 1: Reflective diary Appendix 2: Self-reflection worksheet Index
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Clinical Reasoning in the Health Professions
2000Co-Authors: Joy Higgs, Mark JonesAbstract:SECTION ONE: Clinical Reasoning: Clinical Reasoning in the health professions The development of Clinical Reasoning expertise Knowledge and Reasoning Clinical Reasoning and biomedical knowledge: Implications for teaching Parallels between Clinical Reasoning and categorization Action and narrative: Two dynamics of Clinical Reasoning Clinical Reasoning and generic thinking skills Clinical Reasoning and patient-centred care Methods in the study of Clinical Reasoning SECTION TWO: Clinical Reasoning in the health professions: Clinical Reasoning in medicine Clinical Reasoning in nursing Clinical Reasoning in physiotherapy Clinical Reasoning in occupational therapy SECTION THREE: Teaching Clinical Reasoning: Teaching Clinical Reasoning The Internet and Clinical Reasoning Assessing Clinical Reasoning Self-monitoring of Clinical Reasoning The case study as an instructional method to teach Clinical Reasoning Teaching Clinical Reasoning to medical students Teaching Clinical Reasoning to occupational therapists Learning Reasoning in physiotherapy programs Speech-language pathology students: Learning Clinical Reasoning Using mind mapping to improve students' metacognition Facilitating the acquisition of knowledge for Reasoning Teaching Clinical Reasoning to speech and hearing students Teaching Clinical decision analysis in physiotherapy Facilitating the Clinical Reasoning of occupational therapy students on fieldwork placement Teaching Clinical Reasoning in nursing education Teaching Clinical Reasoning across cultures Using simulated patients to teach Clinical Reasoning Teaching Clinical Reasoning in Clinical education: Orthoptics Teaching Clinical Reasoning to nurses during Clinical education Peer coaching to generate Clinical-Reasoning skills Teaching Clinical Reasoning: A case-based approach Fostering Clinical decision making in critical care nursing SECTION FOUR: Directions for the future: Will evidence-based practice take the Reasoning out of practice? Index
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Clinical Reasoning in manual therapy.
Physical therapy, 1992Co-Authors: Mark JonesAbstract:Clinical Reasoning refers to the cognitive process or thinking used in the evaluation and management of a patient. In this article, Clinical Reasoning research and expert-novice studies are examined to provide insight into the growing understanding of Clinical Reasoning and the nature of expertise. Although hypothetico-deductive methods of Reasoning are used by clinicians at all levels of experience, experts appear to possess a superior organization of knowledge. Experts often reach a diagnosis based on pure pattern recognition of Clinical patterns. With an atypical problem, however, the expert, like the novice, appears to rely more on hypothetico-deductive Clinical Reasoning. Five categories of hypotheses are proposed for physical therapists using a hypothetico-deductive method of Clinical Reasoning. A model of the Clinical Reasoning process for physical therapists is presented to bring attention to the hypothesis generation, testing, and modification that I feel should take place through all aspects of the patient encounter. Examples of common errors in Clinical Reasoning are highlighted, and suggestions for facilitating Clinical Reasoning in our students are made.
Sandra Grace - One of the best experts on this subject based on the ideXlab platform.
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Clinical Reasoning in osteopathy: Experiences of novice and experienced practitioners
International Journal of Osteopathic Medicine, 2018Co-Authors: Lachlan King, Paul J Orrock, Suenje Kremser, Phil Deam, Joe Henry, Dane Reid, Sandra GraceAbstract:Abstract Background A number of Clinical Reasoning models, including hypothetico-deductive, pattern recognition and narrative Reasoning have been identified in both novice and experienced medical, nursing and allied health professionals. The aim of this project was to explore Clinical Reasoning in osteopathy from the perspectives of both experienced practitioners and novice practitioners. Methods Data were collected via semi-structured interviews that encouraged practitioners to reflect on the Clinical Reasoning processes they used in response to two case studies. Interviews were transcribed and analysed to identify key themes. Results Two themes emerged: (1) that experienced and novice osteopaths demonstrated different approaches to Clinical Reasoning, and (2) that experiential findings (e.g. from observation and palpatory findings derived from having direct contact with the patient) were integral to Clinical Reasoning in osteopathy. Conclusion The results of this study suggest that Clinical Reasoning in osteopathy is similar to that of other health professions in that deep understanding of Clinical applications and Clinical experience were key factors in developing sophisticated Clinical Reasoning processes. However, Clinical Reasoning in osteopathy, unlike many other health professions, relies on experiential findings resulting from direct observation and palpatory contact with the patient. Clinical Reasoning that relies on subjective experiential findings requires further investigation.
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Understanding Clinical Reasoning in osteopathy: a qualitative research approach
Chiropractic & Manual Therapies, 2016Co-Authors: Sandra Grace, Paul J Orrock, Raymond Blaich, Brett Vaughan, Rosanne CouttsAbstract:Background Clinical Reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the Clinical Reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand Clinical Reasoning in osteopathy from the perspective of osteopathic Clinical educators and the extent to which it was similar or different from Clinical Reasoning in other health professions. Methods This study was informed by constructivist grounded theory. Participants were Clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. Results According to participants, Clinical Reasoning in osteopathy is different from Clinical Reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic Reasoning models that are based on the relationship between structure and function in the human body. Clinical Reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. Conclusions The use of diagnostic Reasoning models that are based on the relationship between structure and function in the human body differentiated Clinical Reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that Clinical Reasoning in osteopathy is distinct from Clinical Reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary decision-making and potentially enhance the quality of patient care. Where commonalities exist in the Clinical Reasoning processes of osteopathy and other health professions, shared learning opportunities may be available, including the exchange of scaffolded Clinical Reasoning exercises and assessment practices among health disciplines.
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understanding Clinical Reasoning in osteopathy a qualitative research approach
Chiropractic & Manual Therapies, 2016Co-Authors: Sandra Grace, Paul J Orrock, Raymond Blaich, Brett Vaughan, Rosanne A CouttsAbstract:Clinical Reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the Clinical Reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand Clinical Reasoning in osteopathy from the perspective of osteopathic Clinical educators and the extent to which it was similar or different from Clinical Reasoning in other health professions. This study was informed by constructivist grounded theory. Participants were Clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. According to participants, Clinical Reasoning in osteopathy is different from Clinical Reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic Reasoning models that are based on the relationship between structure and function in the human body. Clinical Reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. The use of diagnostic Reasoning models that are based on the relationship between structure and function in the human body differentiated Clinical Reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that Clinical Reasoning in osteopathy is distinct from Clinical Reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary decision-making and potentially enhance the quality of patient care. Where commonalities exist in the Clinical Reasoning processes of osteopathy and other health professions, shared learning opportunities may be available, including the exchange of scaffolded Clinical Reasoning exercises and assessment practices among health disciplines.
Nicole Christensen - One of the best experts on this subject based on the ideXlab platform.
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Clinical Reasoning in Physical Therapy: A Concept Analysis
Physical therapy, 2018Co-Authors: Karen Huhn, Susan Wainwright, Sarah Gilliland, Lisa Black, Nicole ChristensenAbstract:Background Physical therapy, along with most health professions, struggles to describe Clinical Reasoning, despite it being a vital skill in effective patient care. This lack of a unified conceptualization of Clinical Reasoning leads to variable and inconsistent teaching, assessment, and research. Objective The objective was to conceptualize a broad description of physical therapists' Clinical Reasoning grounded in the published literature and to unify understanding for future work related to teaching, assessment, and research. Design/methods The design included a systematic concept analysis using Rodgers' evolutionary methodology. A concept analysis is a research methodology in which a concept's characteristics and the relation between features of the concept are clarified. Results Based on findings in the literature, Clinical Reasoning in physical therapy was conceptualized as integrating cognitive, psychomotor, and affective skills. It is contextual in nature and involves both therapist and client perspectives. It is adaptive, iterative, and collaborative with the intended outcome being a biopsychosocial approach to patient/client management. Limitations Although a comprehensive approach was intended, it is possible that the search methods or reduction of the literature were incomplete or key sources were mistakenly excluded. Conclusions A description of Clinical Reasoning in physical therapy was conceptualized, as it currently exists in representative literature. The intent is for it to contribute to the unification of an understanding of how Clinical Reasoning has been conceptualized to date by practitioners, academicians, and Clinical educators. Substantial work remains to further develop the concept of Clinical Reasoning for physical therapy, including the role of movement in our Reasoning in practice.
Paul J Orrock - One of the best experts on this subject based on the ideXlab platform.
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Clinical Reasoning in osteopathy: Experiences of novice and experienced practitioners
International Journal of Osteopathic Medicine, 2018Co-Authors: Lachlan King, Paul J Orrock, Suenje Kremser, Phil Deam, Joe Henry, Dane Reid, Sandra GraceAbstract:Abstract Background A number of Clinical Reasoning models, including hypothetico-deductive, pattern recognition and narrative Reasoning have been identified in both novice and experienced medical, nursing and allied health professionals. The aim of this project was to explore Clinical Reasoning in osteopathy from the perspectives of both experienced practitioners and novice practitioners. Methods Data were collected via semi-structured interviews that encouraged practitioners to reflect on the Clinical Reasoning processes they used in response to two case studies. Interviews were transcribed and analysed to identify key themes. Results Two themes emerged: (1) that experienced and novice osteopaths demonstrated different approaches to Clinical Reasoning, and (2) that experiential findings (e.g. from observation and palpatory findings derived from having direct contact with the patient) were integral to Clinical Reasoning in osteopathy. Conclusion The results of this study suggest that Clinical Reasoning in osteopathy is similar to that of other health professions in that deep understanding of Clinical applications and Clinical experience were key factors in developing sophisticated Clinical Reasoning processes. However, Clinical Reasoning in osteopathy, unlike many other health professions, relies on experiential findings resulting from direct observation and palpatory contact with the patient. Clinical Reasoning that relies on subjective experiential findings requires further investigation.
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Understanding Clinical Reasoning in osteopathy: a qualitative research approach
Chiropractic & Manual Therapies, 2016Co-Authors: Sandra Grace, Paul J Orrock, Raymond Blaich, Brett Vaughan, Rosanne CouttsAbstract:Background Clinical Reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the Clinical Reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand Clinical Reasoning in osteopathy from the perspective of osteopathic Clinical educators and the extent to which it was similar or different from Clinical Reasoning in other health professions. Methods This study was informed by constructivist grounded theory. Participants were Clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. Results According to participants, Clinical Reasoning in osteopathy is different from Clinical Reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic Reasoning models that are based on the relationship between structure and function in the human body. Clinical Reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. Conclusions The use of diagnostic Reasoning models that are based on the relationship between structure and function in the human body differentiated Clinical Reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that Clinical Reasoning in osteopathy is distinct from Clinical Reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary decision-making and potentially enhance the quality of patient care. Where commonalities exist in the Clinical Reasoning processes of osteopathy and other health professions, shared learning opportunities may be available, including the exchange of scaffolded Clinical Reasoning exercises and assessment practices among health disciplines.
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understanding Clinical Reasoning in osteopathy a qualitative research approach
Chiropractic & Manual Therapies, 2016Co-Authors: Sandra Grace, Paul J Orrock, Raymond Blaich, Brett Vaughan, Rosanne A CouttsAbstract:Clinical Reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the Clinical Reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand Clinical Reasoning in osteopathy from the perspective of osteopathic Clinical educators and the extent to which it was similar or different from Clinical Reasoning in other health professions. This study was informed by constructivist grounded theory. Participants were Clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. According to participants, Clinical Reasoning in osteopathy is different from Clinical Reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic Reasoning models that are based on the relationship between structure and function in the human body. Clinical Reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. The use of diagnostic Reasoning models that are based on the relationship between structure and function in the human body differentiated Clinical Reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that Clinical Reasoning in osteopathy is distinct from Clinical Reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary decision-making and potentially enhance the quality of patient care. Where commonalities exist in the Clinical Reasoning processes of osteopathy and other health professions, shared learning opportunities may be available, including the exchange of scaffolded Clinical Reasoning exercises and assessment practices among health disciplines.