How do orthopaedic manual physical therapy fellows experience clinical reasoning? A phenomenological study

Area of Science:

• Orthopaedic Physical Therapy
• Clinical Reasoning Research
• Phenomenological Studies

Background:

• Clinical reasoning in orthopaedic physical therapy is a complex integration of cognitive and psychomotor skills.
• Orthopaedic manual physical therapy fellows are recognized as experts in clinical reasoning.

Purpose of the Study:

• To explore the lived experiences of orthopaedic manual physical therapy fellows regarding clinical reasoning.
• To identify the core components and essential structure of advanced clinical reasoning in this population.

Main Methods:

• A qualitative phenomenological approach was employed.
• Semi-structured interviews were conducted with eight fellows from the American Academy of Orthopaedic Manual Physical Therapists.
• Interview transcripts were analyzed using Amedeo Giorgi's descriptive phenomenological method.

Main Results:

• Four key themes emerged: Receptive-Reflective Mind, Patient Presence, Empirical and Iterative Process, and Synthesis.
• The Receptive-Reflective Mind involves unbiased, real-time observation and reflection.
• Patient Presence ensures the patient remains central, with decisions guided by empirical data and patient response.

Conclusions:

• The essential structure of clinical reasoning for these fellows is a receptive, reflective mindset attuned to the patient.
• This mindset, characterized by unbiased awareness and real-time reflection, is crucial for advanced clinical reasoning.
• Further research is recommended to explore the Receptive-Reflective Mind concept in greater depth.