Leading the Way: Physical Therapist Clinical Reasoning (CR)
Theory/Body: Clinical Reasoning (CR) is an essential non-negotiable element for all health professionals. CR cannot be seen merely as a generic skill or trait, but it is complex and tightly connected to the development of clinical knowledge as practitioners interact with patients in the context of care. The ability to demonstrate professional competence, compassion, and accountability depend on a foundation of sound CR. The commitment for educators is to promote healthcare providers who serve as leaders in their CR capacities. The CR process needs to bring together knowledge, experience, and understanding of people, the environment, and organizations along with a strong moral compass in making sound decisions and taking necessary actions.CR is coupled directly with clinical decision-making (CDM) and clinical problem-solving (CPS) for patient/client management in health care and we find these inextricably linked with each other, as foundational elements of physical therapist practice and key within the work of the PT-PTA team. Within the affective domain, physical therapy professionals go beyond the theory, internalizing the core values of the profession and incorporating the movement system concepts to resolve competing conflicts and collaborating with the patient/client and their families/caregivers. We work to understand the lived experience of our patients and incorporate the values and beliefs of the person-centered care, while working to evolve the health and wellness of the patient/client. This complex collaboration is accomplished through creative, self-actualizing change processes within the patient/client. The lifelong professional in physical therapy continues to challenge her or his own perspectives and beliefs and integrates their past experiences with the current situation. Real-world problems in practice are messy “indeterminate situations” and physical therapy professionals must constantly think, reflect and react in the act of practice with our hands, bodies, and minds to progress a patient safely through a plan of care and determine the best working clinical diagnosis relative to movement. While algorithms and hypothetico-deductive approaches are systematically organized and guiding for many problems, some problems need to be seen from multiple perspectives by turning them upside down and sidewise in order to see what is hidden for the true dissection of CDM-CPS-CR.There is a critical need to have a broader, in-depth look at how educators across academic and clinical settings intentionally facilitate the development of CR skills across one’s career. CR is an important component for all health professions, yet many would comment that despite many years of research across disciplines, it is poorly understood. CR cannot be seen merely as a generic skill or trait, but it is complex and tightly connected to the development of clinical knowledge as practitioners interact with patients in the context of care. The focus of this presentation examines the various CR frameworks within the health professions and common bias errors, along with leading to avoid bias.