Search results for "clinical reasoning"
showing 7 items of 7 documents
Premature diagnostic closure: An avoidable type of error
2013
A well-developed clinical interview makes it possible to adequately focus the diagnosis. However, cognitive psychology shows that mistakes are made when the persons face complex problems, such as those faced when making a diagnosis, especially if time or resources are limited. The main cause of failures in clinical reasoning is using "cognitive shortcuts". Among them, premature closure is a key factor triggering a diagnostic error. Cognitive errors are predictable and thus, it is possible to learn strategies to reduce or avoid them. Knowing the main features of cognitive shortcuts and identifying those automatically used is the first step towards preventing errors or minimizing their conseq…
Rethinking clinical decision-making to improve clinical reasoning
2022
Improving clinical reasoning techniques is the right way to facilitate decision-making from prognostic, diagnostic, and therapeutic points of view. However, the process to do that is to fill knowledge gaps by studying and growing experience and knowing some cognitive aspects to raise the awareness of thinking mechanisms to avoid cognitive errors through correct educational training. This article examines clinical approaches and educational gaps in training medical students and young doctors. The authors explore the core elements of clinical reasoning, including metacognition, reasoning errors and cognitive biases, reasoning strategies, and ways to improve decision-making. The article addres…
Physiotherapists' lived experiences of decision making in therapeutic encounters with persons suffering from whiplash-associated disorder: A hermeneu…
2020
Conceptual discussions related to clinical reasoning and decision making have evolved over the years from biomedical to incorporating more holistic approach to reasoning. Empirical studies exploring clinical reasoning and decision making in physiotherapy practice have mostly focused on aspects of managing persons with low back pain, such as exercise prescription, education and communicating diagnosis. There is a paucity of studies exploring decision making in whiplash‐associated disorder (WAD); thus, the aim of this study was to explore the physiotherapists' lived experiences of decision making related to treating persons with WAD. A qualitative research design based on hermeneutic phenomen…
What effect can manual therapy have on a patient's pain experience?
2015
Manual therapy (MT) is a passive, skilled movement applied by clinicians that directly or indirectly targets a variety of anatomical structures or systems, which is utilized with the intent to create beneficial changes in some aspect of the patient pain experience. Collectively, the process of MT is grounded on clinical reasoning to enhance patient management for musculoskeletal pain by influencing factors from a multidimensional perspective that have potential to positively impact clinical outcomes. The influence of biomechanical, neurophysiological, psychological and nonspecific patient factors as treatment mediators and/or moderators provides additional information related to the proces…
Knowledge translation from continuing education to physiotherapy practice in classifying patients with low back pain
2015
Physical therapists have used continuing education as a method of improving their skills in conducting clinical examination of patients with low back pain (LBP). The purpose of this study was to evaluate how well the pathoanatomical classification of patients in acute or subacute LBP can be learned and applied through a continuing education format. The patients were seen in a direct access setting.The study was carried out in a large health-care center in Finland. The analysis included a total of 57 patient evaluations generated by six physical therapists on patients with LBP. We analyzed the consistency and level of agreement of the six physiotherapists' (PTs) diagnostic decisions, who par…
Clinical reasoning and critical reflection in physiotherapists’ examinations of patients with low back pain in its early phase : a qualitative study …
2017
Aim: The aim of this study was to deepen the current understanding of physiotherapists’ decision-making process and more specifically, to investigate their reflections on their clinical reasoning when examining low back pain patients. Method: Data were collected in interviews with six physiotherapists, were the stimulated recall method was used. Interviews were audio-recorded and transcribed and then analysed by content analysis. Results: Physiotherapists critically analysed and reflected their choices and decisions in clinical reasoning with patient’s symptoms, onset of pain, clinical test choices and results. They stopped to consider the adequacy of tests for drawing conclusions and their…
The challenge of using the rheumatoid arthritis diagnostic criteria in clinical practice.
2015
The new 2010 ACR/EULAR (American College of Rheumatology/European League Against Rheumatism) criteria of Rheumatoid Arthritis recently published, have been released to classify and identify patients with early RA who could benefit from early therapy. They recommend anti-citrullinated protein antibody (ACPA) testing as an alternative criterion to Rheumatoid Factor (RF) and ACPA that were introduced together with the other classic criteria in a scoring system. We previously criticized these new criteria because of unavailable specificity and sensibility in the first paper, and the use of ACPA as dichotomous criterion (presence/absent) and alternatives to rheumatoid factor. Our previous work p…