Clinical Reasoning - Physiotherapy

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CLINICAL REASONING: DECISION MAKING IN PHYSICALTHERAPY PRACTICE. Background and Purpose: This study was designed to describe the clinical reasoning process behind the diagnosis and management process employed by a physiotherapist working in musculoskeletal out patients department. The therapist was video taped while he was describing about a patient who suffered from lumbar spondylosis, which he came across during his musculoskeletal rotations. In the findings and analysis of this study the therapist was trying to reflect on his practice describing the thoughts and consideration on the condition which he had diagnosed as lumbar spondylosis. The model of hypothetico deductive reasoning proposed by Elstein et al., (1978) served as the main frame work for the analysis. The major out come of the study was that although hypothetico deductive method of clinical reasoning appeared to be predominant in diagnostic procedure the collaboration between the therapist and patient occurred at various stages. Also it describes how therapist used collaborative information in patient’s management. This paper explores these findings and relating them to the research in the field of reasoning. This paper also includes discussion of findings, and employment of above mentioned models in physical therapy practise and how it is use full while teaching students in health profession. KEY WORDS: Clinical reasoning, Diagnostic reasoning, collaborative reasoning. PT, is Msc Student, Physiotherapy (Musculoskeletal), School of Health and Biosciences, University of East London, Romford road, Stratford, London E15 4LZ. Clinical reasoning can be defined as “the ability to select and use information effectively in solving problems…a teachable cognitive skill independent of specific clinical knowledge.” (Elstein et al, 1978). Barker-Schwartz,
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