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Clinical decision making by experienced and inexperienced pediatric physical therapists for children with diplegic
D G Embrey1, M R Guthrie, O R White
1Children's Therapy Unit, Good Samaritan Hospital, Puyallup, WA 98371, USA.
Background And Purpose:
This qualitative study was designed to explore, identify, and describe clinical decision-making processes used by pediatric physical therapists.
Subjects:
Clinical decision-making processes of three experienced therapists and three inexperienced therapists were assessed as they worked with 18 children with diplegia.
Methods:
Retrospective think-aloud procedures were used to elicit verbalizations, which were transcribed, coded, and analyzed.
Results:
Four characteristics of clinical decision making were identified: (1) Movement scripts provided insights into the clinical application of cognitive schemata based on previous experiences, (2) procedural changes occurred rapidly during within-session decision making, (3) psychosocial sensitivity was important for positive interaction during therapy, and (4) self-monitoring appeared to be pivotal in making clinical decisions as therapists self-assessed their practice. Contrasting data illustrated similarities and differences of experienced and inexperienced clinicians.
Conclusion And Discussion:
Findings are generally consistent with existing clinical decision-making literature and provide important information for physical therapy practice, research, and education.