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Clinical Reasoning of Expert and Novice Physiotherapists in an Outpatient Orthopaedic Setting

  • Author Footnotes
    1 Catherine Doody MSc Cert Ed DipPhysio is a lecturer at University College Dublin School of Physiotherapy and is currently carrying out a PhD study on the clinical reasoning of expert and novice physiotherapists.
    Catherine Doody
    Correspondence
    Address for Correspondence Catherine Doody, University College Dublin, School of Physiotherapy, Mater Hospital, Eccles Street, Dublin 7, Ireland
    Footnotes
    1 Catherine Doody MSc Cert Ed DipPhysio is a lecturer at University College Dublin School of Physiotherapy and is currently carrying out a PhD study on the clinical reasoning of expert and novice physiotherapists.
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  • Author Footnotes
    2 Mary McAteer PhD MEd DipPhysio is a senior lecturer at University College Dublin School of Physiotherapy.
    Mary McAteer
    Footnotes
    2 Mary McAteer PhD MEd DipPhysio is a senior lecturer at University College Dublin School of Physiotherapy.
    Search for articles by this author
  • Author Footnotes
    1 Catherine Doody MSc Cert Ed DipPhysio is a lecturer at University College Dublin School of Physiotherapy and is currently carrying out a PhD study on the clinical reasoning of expert and novice physiotherapists.
    2 Mary McAteer PhD MEd DipPhysio is a senior lecturer at University College Dublin School of Physiotherapy.

      Summary

      The purpose of this qualitative study was to investigate the clinical reasoning of expert and novice physiotherapists in an outpatient orthopaedic setting. Ten experienced clinicians and ten students were observed and audiotaped as they examined and treated a real, previously unseen, patient. The audiotape was reviewed immediately afterwards with the therapists by means of a semi-structured interview. The subsequent analysis showed that all used a hypothetico-deductive reasoning process. However, the experts and novices went beyond this essentially diagnostic process to include reasoning focused on treatment. In particular, manual therapy treatment was used as a method of further hypothesis testing.
      In addition to hypothetico-deductive reasoning the experts also made use of pattern recognition. The clinical reasoning of the physiotherapists in this study was found to be a dynamic, cyclical process. The results of the study support the model of clinical reasoning proposed by
      • Jones MA
      ‘Clinical reasoning in manual therapy’.
      .

      Key Words

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