Novice and Experienced Physical Therapist Clinicians: A Comparison of How Reflection Is Used to Inform the Clinical Decision-Making Process
Open Access
- 1 January 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in PTJ: Physical Therapy & Rehabilitation Journal
- Vol. 90 (1), 75-88
- https://doi.org/10.2522/ptj.20090077
Abstract
Background Prior experience informs clinical decision making and shapes how reflection is used by novice and experienced physical therapist clinicians. Objectives The aims of this research were: (1) to determine the types and extent of reflection that informs the clinical decision-making process and (2) to compare the use of reflection to direct and assess clinical decisions made by novice and experienced physical therapists. Design Qualitative research methods using grounded theory were used to gain insight into how physical therapists use reflection to inform clinical decision making. Methods Three participant pairs (each pair consisting of one novice and one experienced physical therapist) were purposively selected from 3 inpatient rehabilitation settings. Case summaries of each participant provided the basis for within- and across-case analysis. Credibility of these results was established through member check of the case summaries, presentation of low-inference data, and triangulation across multiple data sources and within and across the participant groups. Results Although all participants engaged in reflection-on-action, the experienced participants did so with greater frequency. The experienced participants were distinguished by their use of reflection-in-action and self-assessment during therapist-patient interactions. An intermediate effect beyond novice practice was observed. Conclusions The results of this study may be used by educators and employers to develop and structure learning experiences and mentoring opportunities to facilitate clinical decision-making abilities and the development of the skills necessary for reflection in students and novice practitioners.Keywords
This publication has 26 references indexed in Scilit:
- Valuing both critical and creative thinking in clinical practice: narrowing the research–practice gap?Journal of Advanced Nursing, 2003
- Clinical decision-making: coping with uncertaintyHeart, 2002
- Research information in nurses’ clinical decision‐making: what is useful?Journal of Advanced Nursing, 2001
- Clinical Decision Making by Experienced and Inexperienced Pediatric Physical Therapists for Children With Diplegic Cerebral PalsyPTJ: Physical Therapy & Rehabilitation Journal, 1996
- Nurse educators’ perceptions of reflection and reflective practice: a report of a descriptive studyJournal of Advanced Nursing, 1995
- Reflection: a review of the literatureJournal of Advanced Nursing, 1993
- On the Role of Biomedical Knowledge in Clinical Reasoning by Experts, Intermediates and NovicesCognitive Science, 1992
- The Novice Versus the Experienced Clinician: Insights into the Work of the Physical TherapistPTJ: Physical Therapy & Rehabilitation Journal, 1990
- Medical Problem SolvingEvaluation & the Health Professions, 1990
- The reflective practitioner in nursingJournal of Advanced Nursing, 1989