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Understanding clinical reasoning in osteopathy: a qualitative research approach

BACKGROUND: Clinical reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the clinical reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypoth...

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Autores principales: Grace, Sandra, Orrock, Paul, Vaughan, Brett, Blaich, Raymond, Coutts, Rosanne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782380/
https://www.ncbi.nlm.nih.gov/pubmed/26958339
http://dx.doi.org/10.1186/s12998-016-0087-x
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author Grace, Sandra
Orrock, Paul
Vaughan, Brett
Blaich, Raymond
Coutts, Rosanne
author_facet Grace, Sandra
Orrock, Paul
Vaughan, Brett
Blaich, Raymond
Coutts, Rosanne
author_sort Grace, Sandra
collection PubMed
description BACKGROUND: Clinical reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the clinical reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand clinical reasoning in osteopathy from the perspective of osteopathic clinical educators and the extent to which it was similar or different from clinical reasoning in other health professions. METHODS: This study was informed by constructivist grounded theory. Participants were clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. RESULTS: According to participants, clinical reasoning in osteopathy is different from clinical reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic reasoning models that are based on the relationship between structure and function in the human body. Clinical reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. CONCLUSIONS: The use of diagnostic reasoning models that are based on the relationship between structure and function in the human body differentiated clinical reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that clinical reasoning in osteopathy is distinct from clinical reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary decision-making and potentially enhance the quality of patient care. Where commonalities exist in the clinical reasoning processes of osteopathy and other health professions, shared learning opportunities may be available, including the exchange of scaffolded clinical reasoning exercises and assessment practices among health disciplines.
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spelling pubmed-47823802016-03-09 Understanding clinical reasoning in osteopathy: a qualitative research approach Grace, Sandra Orrock, Paul Vaughan, Brett Blaich, Raymond Coutts, Rosanne Chiropr Man Therap Research BACKGROUND: Clinical reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the clinical reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand clinical reasoning in osteopathy from the perspective of osteopathic clinical educators and the extent to which it was similar or different from clinical reasoning in other health professions. METHODS: This study was informed by constructivist grounded theory. Participants were clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. RESULTS: According to participants, clinical reasoning in osteopathy is different from clinical reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic reasoning models that are based on the relationship between structure and function in the human body. Clinical reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. CONCLUSIONS: The use of diagnostic reasoning models that are based on the relationship between structure and function in the human body differentiated clinical reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that clinical reasoning in osteopathy is distinct from clinical reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary decision-making and potentially enhance the quality of patient care. Where commonalities exist in the clinical reasoning processes of osteopathy and other health professions, shared learning opportunities may be available, including the exchange of scaffolded clinical reasoning exercises and assessment practices among health disciplines. BioMed Central 2016-03-08 /pmc/articles/PMC4782380/ /pubmed/26958339 http://dx.doi.org/10.1186/s12998-016-0087-x Text en © Grace et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Grace, Sandra
Orrock, Paul
Vaughan, Brett
Blaich, Raymond
Coutts, Rosanne
Understanding clinical reasoning in osteopathy: a qualitative research approach
title Understanding clinical reasoning in osteopathy: a qualitative research approach
title_full Understanding clinical reasoning in osteopathy: a qualitative research approach
title_fullStr Understanding clinical reasoning in osteopathy: a qualitative research approach
title_full_unstemmed Understanding clinical reasoning in osteopathy: a qualitative research approach
title_short Understanding clinical reasoning in osteopathy: a qualitative research approach
title_sort understanding clinical reasoning in osteopathy: a qualitative research approach
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782380/
https://www.ncbi.nlm.nih.gov/pubmed/26958339
http://dx.doi.org/10.1186/s12998-016-0087-x
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