Osteopaths' clinical reasoning during consultation with patients experiencing acute low back pain: A qualitative case study approach

Roots, Simon A.; Niven, Elizabeth; Moran, Robert

doi:10.1016/j.ijosm.2015.06.003

Cited by 10 publications

(12 citation statements)

References 43 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Osteopathy highlighted the role of movement and "doing" such as performing special tests to inform judgments. 61,81,84 In the more recent medical literature, there was an increasing emphasis on the role of context and patient preferences as part of the reasoning process. 33,44,64,[85][86][87] In the nursing literature, related terms were critical thinking [88][89][90][91][92][93][94][95][96] and clinical reasoning.…”

Section: [Hd2]synopses Of Clinical Reasoning By Disciplinementioning

confidence: 99%

“…The osteopathic literature highlighted the act of "doing" and how physical skills are used to evaluate hypothesis and gather information that informs the practitioners thinking. 84 Physical therapy literature included the role of movement as a source of integrated knowledge and a characteristic of expert practice. 11,164,172 Specifically within the literature reviewed, occupational therapy and physical therapy literature considered the importance of static and dynamic observation of the patient as an antecedent to clinical reasoning.…”

Section: [Hd3]cognitivementioning

confidence: 99%

See 1 more Smart Citation

Clinical Reasoning in Physical Therapy: A Concept Analysis

et al. 2018

View full text Add to dashboard Cite

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.

show abstract

Section: [Hd2]synopses Of Clinical Reasoning By Disciplinementioning

confidence: 99%

Section: [Hd3]cognitivementioning

confidence: 99%

Clinical Reasoning in Physical Therapy: A Concept Analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The majority of literature on clinical decision processes relates to a simpler process of what Wainwright et al (2010), refer to as "reasoning that results in action." In particular, these decision processes relate to cognitively determining a pathological or clinical diagnosis in order to select an initial treatment plan (Roots, Niven, and Moran, 2016). The decision processes within physiotherapy, however, include additional and more complex processes.…”

Section: Introductionmentioning

confidence: 99%

“…They exhibit a kind of knowing in practice, most of which is tacit." (Schon, 1983) The process of reflection in action is generally considered to be characteristic of more experienced clinicians Roots, Niven, and Moran, 2016;Wainwright, Shepard, Harman and Stephens, 2010). Anecdotally, however, even many novice physiotherapists demonstrate reflection in action by being able to recall occasions during patient interactions when, based on a perceived change during the treatment application, they 'knew' or sensed with confidence a patient was improving during treatment even prior to objectively reassessing their impairments i .…”

Section: Introductionmentioning

confidence: 99%

An empirical, pragmatic approach applying reflection in interaction approach to manual therapy treatments

Tuttle

Hazle

2019

Physiotherapy Theory and Practice

View full text Add to dashboard Cite

The majority of literature on decision processes within physiotherapy relates to what can be referred to as "reasoning that results in action"-cognitive processes that determine initial treatment and its modification after reassessment. Particularly expert clinicians also use "reasoning in interaction" including ongoing, interactive processes that occur during the application of treatments. The theory behind the approach discussed in this article can be stated as: If the extent of a deficit (pain or limitation of passive movement) is related to the extent of a patient's limitations (impairments or functional limitations), then 1) a change in the deficit would be expected to be accompanied by a change in the patient's limitations and 2) the relative magnitude of a change in the deficit would be expected to correspond with the relative magnitude of change in the patient's limitations. When applied to manual therapy interventions, the theory suggests that rather than all parameters of a treatment technique being predetermined , therapists continually adjust their treatment in real time. Adjustments are made in real-time to maximise improvement and are informed by patient response (typically changes in pain or range or stiffness of (passive) movement). Implications for other areas of practice and teaching are discussed.

show abstract

“…20 Some studies have shown that experienced osteopaths mainly adopt both hypotheticodeductive and pattern recognition approaches as part of their diagnostic reasoning, depending on the "perceived level of complexity and degree of familiarity of the patient presentation." 21,22 However, Esteves 23 reported that in experimental studies, osteopaths' diagnostic judgments are influenced mainly by intuitive processing, whereas osteopathy students primarily rely on analytical processing using vision and haptics. Furthermore, osteopathy students reaching the end of their professional training generally demonstrated more analytical decision making than students at the start of their professional training, without differences in reflective thinking.…”

mentioning

confidence: 99%

Intuitive Judgement in the Context of Osteopathic Clinical Reasoning

Liem¹

2017

Journal of Osteopathic Medicine

View full text Add to dashboard Cite

Previous research into osteopathic clinical and diagnostic decision making suggests that reasoning is commonly based on highly analytical as well as intuitive processes. According to the dual-process theory, the intuitive and analytical processing that leads to decision making is equally important in diagnostic reasoning. This article aims to explore the underlying and influencing factors that may lead to the development and reliability of intuition in clinical decision making generally and in osteopathic clinical reasoning specifically. Practical suggestions are given on how to encourage the development of intuition within the context of osteopathic teaching and practice.

show abstract

Osteopaths' clinical reasoning during consultation with patients experiencing acute low back pain: A qualitative case study approach

Cited by 10 publications

References 43 publications

Clinical Reasoning in Physical Therapy: A Concept Analysis

Clinical Reasoning in Physical Therapy: A Concept Analysis

An empirical, pragmatic approach applying reflection in interaction approach to manual therapy treatments

Intuitive Judgement in the Context of Osteopathic Clinical Reasoning

Contact Info

Product

Resources

About