Limited clinical reasoning skills used by novice physiotherapists when involved in the assessment and management of patients with shoulder problems: a qualitative study.

MAY, Stephen, WITHERS, S, REEVE, S and GREASLEY, A (2010). Limited clinical reasoning skills used by novice physiotherapists when involved in the assessment and management of patients with shoulder problems: a qualitative study. Journal of Manual and Manipulative Therapy, 18 (2), 84-88.

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Link to published version:: 10.1179/106698110X12640740712770

Abstract

The aim of this study was to explore the clinical reasoning process used by novice physical therapists in specific patient problems. Nine physical therapists in the UK with limited experience of managing musculoskeletal problems were included. Semi-structured interviews were conducted on how novice physical therapists would assess and manage a patient with a shoulder problem; interviews were transcribed and analyzed using framework analysis. To be included as a final theme at least 50% of participants had to mention that theme. A large number of items (n593) were excluded as fewer than 50% of participants referred to each item. Included items related to seven main themes: history (16), physical exam (13), investigations (1), diagnostic reasoning (1), clinical reasoning process (diagnostic pathway) (3), clinical reasoning process (management pathway) (5) and treatment options (1). Items mostly related to information gathering, although there was some use of hypothetico-deductive clinical reasoning there appeared to be limited understanding of the clinical implications of data gathered, and clinical reasoning through use of pattern recognition was minimal. Major weaknesses were apparent in the clinical reasoning skills of these novice therapists compared to previous reports of expert clinical reasoning, indicating areas for development in the education of student and junior physical therapists.

Item Type: Article
Research Institute, Centre or Group: Centre for Health and Social Care Research
Identification Number: 10.1179/106698110X12640740712770
Depositing User: Rebecca Jones
Date Deposited: 08 Mar 2012 09:39
Last Modified: 08 Mar 2012 09:39
URI: http://shura.shu.ac.uk/id/eprint/4485

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