Although PTs and PTAs are recognized to be knowledgeable in prevention and treatment of musculoskeletal injuries, they are susceptible to sustaining occupational musculoskeletal injuries because of performing labor-intensive tasks.
The results of this study may be used by educators and employers to develop and structure learning experiences and mentoring opportunities for students and novice learners with the aim of facilitating the development of skills and abilities consistent with expert clinical decision making.
Background and Purpose. The purpose of this qualitative study was to identify the dimensions of clinical expertise in physical therapy practice across 4 clinical specialty areas: geriatrics, neurology, orthopedics, and pediatrics. Subjects. Subjects were 12 peer-designated expert physical therapists nominated by the leaders of the American Physical Therapy Association sections for geriatrics, neurology, orthopedics, and pediatrics. Methods. Guided by a grounded theory approach, a multiple case study research design was used, with each of the 4 investigators studying 3 therapists working in one clinical area. Data were obtained through nonparticipant observation, interviews, review of documents, and analysis of structured tasks. Videotapes made during selected therapist-patient treatment sessions were used as a stimulus for the expert therapist interviews. Data were transcribed, coded, and analyzed through the development of 12 case reports and 4 composite case studies, one for each specialty area. Results. A theoretical model of expert practice in physical therapy was developed that included 4 dimensions: (1) a dynamic, multidimensional knowledge base that is patient-centered and evolves through therapist reflection, (2) a clinical reasoning process that is embedded in a collaborative, problem-solving venture with the patient, (3) a central focus on movement assessment linked to patient function, and (4) consistent virtues seen in caring and commitment to patients. Conclusion and Discussion. These findings build on previous research in physical therapy on expertise. The dimensions of expert practice in physical therapy have implications for physical therapy practice, education, and continued research.
The results of this study may be used by educators and employers to develop and structure learning experiences and mentoring opportunities to facilitate clinical decision-making abilities and the development of the skills necessary for reflection in students and novice practitioners.
The purpose of this study was to develop a conceptual framework and a data-collection tool to begin a systematic analysis of the work of the physical therapist. The primary method of data collection was nonparticipant observation of physical therapist-patient treatment sessions. A team of two researchers performed each of the observations. Eight physical therapists, representing three levels of experience, were observed in four different adult outpatient orthopedic settings. Field notes constructed from the observations and transcribed data were used to develop coding categories. These categories were the basis for the development of five themes that describe some aspects of the therapeutic intervention: 1) how treatment time is allocated, 2) the types and uses of information gathered from the patient, 3) the impact of the therapeutic environment, 4) the degree of responsive therapeutic interaction, and 5) the therapist integration of nontherapeutic interaction with therapeutic interaction. These findings are a beginning for understanding the practice of physical therapy.
The purpose of this qualitative case study was to further investigate the work of master and novice clinicians within the practice setting. The sample consisted of three master clinicians and three novice clinicians practicing in orthopedic outpatient physical therapy settings in three different regions of the United States. Data collection by three researchers included observation of each clinician treating at least three patients, audiotaping of all treatment sessions, interviews with clinicians and patients, and a review of patient records. Analysis of the data within and across cases revealed five attribute dimensions that distinguished the master clinician from the novice clinician. One attribute dimension (ie, confidence in predicting patient outcomes) related to knowledge, and four attribute dimensions (ie, ability to control the environment, evaluation and use of patient illness and disease data, focus of verbal and nonverbal communication with patients, and importance of teaching to hands-on care) related to improvisational performance. Further investigations are needed to confirm these findings and add to the body of knowledge concerning the parameters of physical therapy that may affect the efficacy and quality of patient care.
This experimental field study examined the potential usefulness of mental practice for improving physical performance in health care. Ideokinetic facilitation, which involves the use of idealized visual and kinesthetic mental images, was used as mental practice. Thirty-six women over the age of 70 were assigned to one of three intervention groups: Group A, nonsense; Group B, relaxation; or Group C, ideokinetic facilitation. Baseline and final measures of one-legged balance time were compared after a three-day intervention period. Results showed significant improvement between baseline and final measures within Group C only (t = 2.64, p less than or equal to .05). The improvement in Group C, however, was not significantly more than the improvement in Groups A and B. This study suggests that mental practice of a physical task can improve performance and may be of use to the physical therapy clinician.
Inpatient physiotherapists clearly perform in a 'high touch' arena. Clinical experience was reported as the strongest factor in developing the physiotherapists' sensitivity to patient needs and their skill in using specific types of touch. Further research is needed concerning the way patients perceive and respond to the presence or absence of these various forms of practitioner touch.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.