Question

1. Recognize current research-derived models of clinical reasoning in the physical therapy literature and how this knowledge enhances the teaching and the learning of clinical reasoning in practice.

2. Recognize characteristics of the clinical reasoning expert physical therapists and how these can be used to guide students’ learning of clinical reasoning.

3. Discuss the interdependence of deductive and inductive reasoning in adopting a biopsychosocial approach to patient care.

Answer 1

1. Recognize current research-derived models of clinical reasoning in the physical therapy literature and how this knowledge enhances the teaching and the learning of clinical reasoning in practice.

• Clinical Reasoning is the process by which a therapist interacts with a patient, collecting information, generating and testing hypotheses, and determining optimal diagnosis and treatment based on the information obtained.
• Clinical reasoning is “the sum of the thinking and decision-making processes associated with clinical practice.
• Clinical Reasoning is integral to physiotherapy practice.
• As a concept, clinical reasoning is quite a simple one however in practice, it is difficult and fraught with errors.
• The aim of clinical reasoning is to prevent misdirection.
• The most common form of clinical reasoning within the physiotherapy profession is hypothetico-deductive reasoning. Within hypothetico-deductive reasoning, the clinician gains initial clues in regards to the patients problem (from the subjective assessment) which forms initial hypotheses in the therapists mind.
• Continual hypothesis generation may occur during management and reassessment.
• clinical reasoning includes an ability to integrate and apply different types of knowledge, to weigh evidence, critically think about arguments and to reflect upon the process used to arrive at a diagnosis.
• The result of the clinical reasoning will guide the decision making, which may be diagnostic or therapeutic.It helps for new learning.

2. Recognize characteristics of the clinical reasoning expert physical therapists and how these can be used to guide students’ learning of clinical reasoning.

The characteristics include

• Clinical reasoning, clinical judgment and critical thinking are terms that are used interchangeably in literature to represent a cognitive process which underpins safe and effective care delivery.
• Identification of the clinical information that is relevant to diagnosis; interpretation of its meaning
• Generation of hypotheses which provide a coherent explanation of the patient's problem
• Testing and refining of those hypotheses through further data collection

Clinical reasoning is an essential part of medical practice and therefore clinical reasoning helps the teachers to guide the students in an interesting manner. It helps the clinical teachers with the teaching of clinical skills.

3. Discuss the interdependence of deductive and inductive reasoning in adopting a biopsychosocial approach to patient care.

Inductive reasoning aims at developing a theory while deductive reasoning aims at testing an existing theory. Inductive reasoning moves from specific observations to broad generalizations, and deductive reasoning the other way around.

The inductive approach begins with a set of empirical observations, seeking patterns in those observations, and then theorizing about those patterns. The deductive approach begins with a theory, developing hypotheses from that theory, and then collecting and analyzing data to test those hypotheses.

Inductive reasoning in ethics provides the means through which the patient’s, the caregiver’s, and the therapist’s voices counterbalance the deductive reasoning process. Just as with clinical reasoning, expert physical therapists engage in a fluid back-and-forth between deductive and inductive when considering the ethical dimensions of their work with patients and caregivers.