Clinical reasoning in osteopathy : a comparative study of experienced and advanced beginner practitioners

Item

Title
Clinical reasoning in osteopathy : a comparative study of experienced and advanced beginner practitioners
Author(s)
Jorge Esteves
Abstract
Background: In analogy to other autonomous health care professions, clinical reasoning is a core element of osteopathic professional practice. However, in contrast to other disciplines where clinical reasoning has been extensively researched, models of clinical reasoning in osteopathy remain largely theoretical.
Purpose: To investigate the clinical reasoning of experienced and advanced beginner osteopaths in an osteopathic clinical setting, using a qualitative case study approach.

Methods: Three experienced osteopaths and three fifth year students at OBU were observed in clinic whilst evaluating and treating a different, previously unseen patient. Each encounter was audiotaped and field notes were recorded. Following the observed encounter both participant and researcher reviewed the audiotape. Subjects were asked to think aloud retrospectively after the completion of their task. A semi-structured interview was conducted at stages where either the participant or researcher stopped the tape.

Results: Analysis of data revealed that all used a hypothetico-deductive reasoning framework with instances where they all made use of pattern recognition. Participants went beyond the diagnostic reasoning process to include reasoning focused on treatment strategies. In particular their treatment was used as a method of hypothesis evaluation.

Conclusions: Results indicate that clinical reasoning in osteopathy goes beyond top-down or bottom-up processing involved in hypotheses generation and evaluation to integrate the concepts of knowledge representation and metacognition. Results further indicate that experienced osteopaths use mental scripts as a clinical reasoning strategy, thus providing a possible framework for understanding the development of expertise in osteopathy. Considering the exploratory nature of the study it was beyond its scope to generalise findings. Results highlight that a better understanding of the phenomenon of knowledge encapsulation in osteopathy should be attempted by means of experimental research.
Date Accepted
2004
Date Submitted
20.4.2005 00:00:00
Type
osteo_thesis
Language
English
Submitted by:
62
Pub-Identifier
13203
Inst-Identifier
1230
Keywords
Clinical Competence,Knowledge
Recommended
0
Item sets
Thesis

Jorge Esteves, “Clinical reasoning in osteopathy : a comparative study of experienced and advanced beginner practitioners”, Osteopathic Research Web, accessed November 1, 2024, https://www.osteopathicresearch.org/s/orw/item/256