Attribute Dimensions that Distinguish Master and Novice Physical Therapy Clinicians in Orthopedic Settings

Abstract

The purpose of this qualitative case study was to further investigate the work of master and novice clinicians within the practice setting. The sample consisted of three master clinicians and three novice clinicians practicing in orthopedic outpatient physical therapy settings in three different regions of the United States. Data collection by three researchers included observation of each clinician treating at least three patients, audiotaping of all treatment sessions, interviews with clinicians and patients, and a review of patient records. Analysis of the data within and across cases revealed five attribute dimensions that distinguished the master clinician from the novice clinician. One attribute dimension (ie, confidence in predicting patient outcomes) related to knowledge, and four attribute dimensions (ie, ability to control the environment, evaluation and use of patient illness and disease data, focus of verbal and nonverbal communication with patients, and importance of teaching to hands-on care) related to improvisational performance. Further investigations are needed to confirm these findings and add to the body of knowledge concerning the parameters of physical therapy that may affect the efficacy and quality of patient care.

A qualitative grounded theory study of the conceptions of clinical practice in osteopathy – A continuum from technical rationality to professional artistry

“…This finding is consistent with findings from research investigating the clinical reasoning of musculoskeletal physiotherapists (Noll et al, 2001;Thornquist, 2006;Cruz et al, 2012). Practice akin to technical rationality has been considered an attribute of novice healthcare practitioners (Jensen et al, 1990(Jensen et al, , 1992Unsworth, 2001;Smith et al, 2008, Smith et al, 2010, where practice is characterised as being practitioner-centred, emphasising the application of specific factual knowledge and technical skills in a routine predictable manner. In this current study, no relationship between participants' years of clinical experience and their conception of practice was found.…”

Efficacy of suit therapy on functioning in children and adolescents with cerebral palsy: a systematic review and meta‐analysis

“…All other studies 41,45,47 did not report on the previous experience and skills of therapists. Jensen et al 70 reported that experienced clinicians' knowledge was more extensive in comparison to novice clinicians and that they were more comfortable with their knowledge level. Studies show that physical therapists with higher self-awareness and confidence in their clinical judgement, problem solving skills, and the ability to communicate this to each patient (i.e.…”

The role of clinician emotion in clinical reasoning: Balancing the analytical process

“…Expert practice in physiotherapy has been proposed to involve a combination of knowledge, clinical reasoning, movement and virtues (Jensen et al 2000), whilst "master" or expert practice when compared to novice has been shown to be separated by the ability to use time, develop frameworks, communicate, teach, and predict clinical outcomes (Jensen et al 1992). The musculoskeletal physiotherapy literature surrounding therapists and reasoning suggests that clinicians commonly may generate initial hypotheses and subsequently test them via questioning or physical examination procedures (hypotheticodeductive) in a deductive way from a general presentation resulting to one that is more specific (Jones 1995;Loftus and Smith 2008).…”