The impact of a musculoskeletal masters course: Developing clinical expertise

Abstract

a b s t r a c t A common aim of Masters (MSc) courses in the UK, accredited by the Manipulation Association of Chartered Physiotherapists (MACP), is to promote the clinical expertise of practitioners. Few studies have explored the extent to which this is achieved and understanding is further hampered by the contested nature of expertise. This paper reports on the impact of an MACP approved MSc on practitioners and offers a conceptual model of their development towards clinical expertise.A qualitative theory-seeking case study was used, drawing on the procedures and processes of grounded theory. Twenty-six semi-structured interviews were conducted with eleven alumni from one MACP approved MSc programme. Dimensional analysis and the constant comparative method of data analysis, was used to build the conceptual model.Prior to enrolment, practitioners uncritically accepted knowledge from others and followed habitual routines with their patients. Their diet of informal CPD appeared ineffective in developing these attri-butes. The impact of the MACP approved MSc involved three developmental aspects of clinical expertise: critical understanding of practice knowledge, patient centred practice and capability to learn in, and from, clinical practice. These inter-related aspects of knowledge, practice and learning offer a conceptual model of the development towards clinical expertise. The most powerful experience to trigger change was direct observation and feedback of their clinical practice by an MACP educator; this highlights the value of clinical mentors facilitating less experienced colleagues. The implementation of such mentorship within departments may offer a cost effective and manageable way to support CPD within the workforce.

A qualitative grounded theory study of the conceptions of clinical practice in osteopathy – A continuum from technical rationality to professional artistry

“…In this current study, no relationship between participants' years of clinical experience and their conception of practice was found. This finding is consistent with existing research (Resnik and Hart, 2003;Resnik and Jensen, 2003;Petty et al, 2011a), and theories of expertise (Schön, 1987;Eraut, 1994), thereby supporting the notion that the development of clinical expertise and artistry, is not related to years of experience (Richardson, 1999).…”

Diagnostic reasoning in osteopathy – A qualitative study

“…24 Later, in the 1980s, medical researchers began focusing on the different ways in which expert physicians organised and structured their knowledge in relation to their diagnostic reasoning. Groen and Patel 25 identified that during non-problematic situations, experts did not rely solely on hypotheticod The concept of the 'expert' is problematic, and researchers currently have a limited understanding of the nature of expertise in healthcare (for example see, Mylopoulos et al, 20 Jensen et al 21,22 and Petty et al 23 ).…”

Grounding osteopathic research – Introducing grounded theory

“…Furthermore, in taking a grounded theory approach, this research followed in the footsteps of researchers in the physiotherapy profession who used grounded theory to help understand clinical expertise and decision-making. 57e59, 72,73 The main methodological processes used in grounded theory (Fig. 1) are now discussed with reference to the case example.…”