Novice and Experienced Physical Therapist Clinicians: A Comparison of How Reflection Is Used to Inform the Clinical Decision-Making Process

Wainwright, Susan; Shepard, Katherine F; Harman, Laurinda B.; Stephens, James H.

doi:10.2522/ptj.20090077

Cited by 134 publications

(88 citation statements)

References 29 publications

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“…16 It has also been suggested that physiotherapists' choice of treatment techniques is usually based on the initial academic and clinical training they received and their prior experience with patients, not on the literature. 20,27 However, our results are not directly comparable to those of Wainwright and colleagues (2011), 19 as we did not use the same classification system for clinical decisionmaking factors.…”

Section: Discussioncontrasting

confidence: 56%

“…[16][17][18][19][20][21][22] Physiotherapists with more experience have been shown to have advanced cognitive strategies and problem solving skills supporting their clinical rationale for treatment application. 16 Furthermore, experienced physiotherapists are more readily able to adapt to varying clinical circumstances and develop their own criteria for standards of practice and treatment selection.…”

mentioning

confidence: 99%

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Practice Patterns of Canadian Physiotherapists Mobilizing Patients with External Ventricular Drains

Hale

Wong

Pennings

et al. 2013

Physiotherapy Canada

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Purpose: To describe current mobilization practices of Canadian physiotherapists when treating patients with external ventricular drains (EVDs). Methods: A quantitative, descriptive, cross-sectional study design using an online questionnaire via SurveyMonkey. An email invitation and questionnaire link was distributed in March 2010 to physiotherapists currently working with this patient population in Neurosurgical Centres across Canada. Results: Respondents were 25 physiotherapists (21 full-time, 2 part-time, and 2 who did not disclose work status) working in 5 different provinces who treated b1 patient/ month with an EVD (n ¼ 9). Slightly more than half of respondents had a10 years' clinical physiotherapy experience (n ¼ 14); the remainder had >10 years' experience (n ¼ 11). The majority of respondents indicated that they felt comfortable mobilizing patients with EVDs (n ¼ 19) and that it was safe to do so (n ¼ 20). Clinical experience (n ¼ 23) and safety concerns (n ¼ 25) were most commonly cited as guiding practice. More experienced physiotherapists were more likely to use out-of-bed mobilization practices. Regardless of experience, the majority of physiotherapists (20/25) ranked intracranial pressure (ICP) as the most important factor and saturation of oxygen (Spo 2 ) as the least important factor to consider before mobilization. Conclusions: Canadian physiotherapists are mobilizing patients with EVDs, and the intensity level of their mobilization practices appears to be related to their experience level. Data from the current study may be used in developing future best-practice guidelines for the mobilization of patients with EVDs.Key Words: clinical experience; clinical reasoning; external ventricular drain; mobilization. RÉ SUMÉObjectif : Dé crire les mé thodes actuelles de mobilisation pratiqué es par les physiothé rapeutes canadiens qui traitent des patients avec des drains ventriculaires externes (DVE). Mé thodes : É tude transversale descriptive quantitative basé e sur un questionnaire en ligne administré via SurveyMonkey. Une invitation é lectronique comportant un lien vers le questionnaire a é té distribué e en mars 2010 aux physiothé rapeutes qui travaillent actuellement avec cette population dans les centres de neurochirurgie du Canada. Ré sultats : Les ré pondants é taient 25 physiothé rapeutes travaillant (21 à temps plein, 2 à temps partiel, 2 qui n'ont pas ré vé lé leur statut) dans cinq provinces diffé rentes qui ont traité b1 patient/mois au moyen de DVE (n ¼ 9). Un peu plus de la moitié des ré pondants comptaient a10 ans d'expé rience de la physiothé rapie clinique (n ¼ 14); les autres en comptaient >10 (n ¼ 11). La majorité des ré pondants ont indiqué se sentir à l'aise de mobiliser cette population (n ¼ 19) et qu'il é tait sé curitaire de le faire (n ¼ 20). L'expé rience clinique (n ¼ 23) et les pré occupations en matiè re de sé curité (n ¼ 25) ont é té les facteurs mentionné s le plus souvent comme guide de pratique. La plupart des physiothé rapeutes chevronné s é taient plus susc...

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Section: Discussioncontrasting

confidence: 56%

mentioning

confidence: 99%

Practice Patterns of Canadian Physiotherapists Mobilizing Patients with External Ventricular Drains

Hale

Wong

Pennings

et al. 2013

Physiotherapy Canada

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“…In a study comparing clinical decision making of novice and experienced clinicians, researchers found that each engaged in similar but different types of reflection during the clinical decision-making process. 28 Relevant findings from this research include the importance of novices having time to reflect on clinical decision making, having the opportunity to discuss reflections with a mentor, and gaining insight into how seasoned clinicians use reflection. The authors suggest that the development of reflection and metacognition skills are essential in assisting the students in the transition from classroom knowledge to real-world application and subsequent growth as a practitioner in the field.…”

Section: Positive Experiencementioning

confidence: 99%

The Impact of Clinical Experiences from Athletic Training Student and Preceptor Perspectives

Benes

Mazerolle

Bowman

2014

Athletic Training Education Journal

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Context: Clinical education is an integral part of athletic training programs. This is where students should develop their professional identities and become socialized into the profession. Understanding the student and preceptor perspectives of the impact that clinical experiences have on students can provide valuable insight into this aspect of athletic training education.Objective: To evaluate the impact of clinical education on the professional development of athletic training students from the student and preceptor perspective.Design: Qualitative study.Setting: Commission on Accreditation of Athletic Training Education-accredited undergraduate programs.Patients or Other Participants: A total of 15 participants (7 athletic training students and 8 preceptors) from four schools enrolled in our study.Data Collection and Analysis: One researcher conducted semistructured interviews over the phone or in person. Data analysis used a general inductive approach to reveal the dominant themes that related to our purpose. We achieved data credibility through multiple analyst triangulation, peer review, and member checks.Results: Athletic training students and preceptors agree that clinical education is integral to the professional development process. Realistic and positive experiences and diversity in experiences were identified as factors affecting professional growth during clinical education experiences.Conclusions: Athletic training students and preceptors have similar views on the importance of clinical placements on professional development. Clinical experiences provide students with the opportunity to learn more about the profession, affirm their career choice, practice knowledge and skills, and learn about themselves personally and professionally. The student and the fit/match of the placement directly impact the students' clinical experiences.

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“…The type of reflection that is commonly used as an exercise in decision making processes for students in the various healthcare professions is reflection on action (Conte, 2015;Wainwright, Shepard, Harman & Stephens, 2010).…”

Section: Reflection and Critical Thinkingmentioning

confidence: 99%

Upgrading Learning In Nursing Preceptorship Using A Reflection Tool

Goldman¹

2018

The European Proceedings of Social and Behavioural Sciences

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Nursing, as a progressive and developing profession, requires those who engage in it to demonstrate well developed critical thinking, as early as their undergraduate training. Reflection skills are a mechanism for developing critical thinking and they form part of the core of the nursing training programme. Preceptors have a major role in helping students perform reflection, through guided reflection that facilitates the development of critical thinking. Nonetheless, it is hard to instil productive reflective thinking in students and to sufficiently develop their critical thinking. An academic nursing school in central Israel developed a tool called Reflective Nursing Debriefing (RND), based on well-established principles of reflection, which constitutes an initiated, systematic and structured reflective learning tool for the development of critical thinking. This tool is used by students to perform reflection and by preceptors for the purpose of monitored involvement in guided reflection. In practice, preceptors do not achieve full utilization of the tool, and thus students are not exposed to its potential contribution to developing their critical thinking. The case study presented in this paper portrays the issue by analysing three cases that utilized this tool, with the preceptor employing guided reflection, and it suggests important recommendations for preceptors.Additionally, it offers professional nursing education recommendations with regard to the system's responsibility for achieving professionalization of preceptors. This will help preceptors use the tool properly and develop a prominent skill necessary for guided reflection and in general, develop better critical thinking among students.

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Novice and Experienced Physical Therapist Clinicians: A Comparison of How Reflection Is Used to Inform the Clinical Decision-Making Process

Abstract: 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.

Cited by 134 publications

References 29 publications

Practice Patterns of Canadian Physiotherapists Mobilizing Patients with External Ventricular Drains

Practice Patterns of Canadian Physiotherapists Mobilizing Patients with External Ventricular Drains

The Impact of Clinical Experiences from Athletic Training Student and Preceptor Perspectives

Upgrading Learning In Nursing Preceptorship Using A Reflection Tool

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