Promoting clinical reasoning in general practice trainees: role of the clinical teacher

Atkinson, Kaye; Ajjawi, Rola; Cooling, Nick

doi:10.1111/j.1743-498x.2011.00447.x

Cited by 28 publications

(23 citation statements)

References 16 publications

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“…Their study also proposed themes of time restrictions and “knowing” patients. In the present study, People and communication skills , Speed of thought in an uncertain environment and applying Common sense/simplify were similar skills and attributes to the study from Atkinson et al (), and this would have been expected as MSK first‐contact physiotherapy involves working in a similar way to a GP in determining the appropriate management plans for patients within primary care.…”

Section: Discussionsupporting

confidence: 77%

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The skills, knowledge and attributes needed as a first‐contact physiotherapist in musculoskeletal healthcare

Langridge

2019

Musculoskeletal Care

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Objectives The provision of musculoskeletal assessment and pathway management by physiotherapists in primary care is an expanding innovation within the UK National Health Service. This new model of care is challenging physiotherapists to work in new ways, and so an understanding of these roles is timely and wil contribute to the growing knowledge regarding these practitioners and their impact. Methods This qualitative study aimed to improve the understanding of the clinical practice of first‐contact clinicians in musculoskeletal healthcare. The study used a think‐aloud method to explore eight clinicians’ views via a stage 1 semi‐structured interview process. This was followed by a stage 2 focus group involving physiotherapists and a general practitioner trainer. A thematic analysis then followed, which involved the researcher and a research colleague coding the data and subsequently developing themes. Results The themes identified were: medical assessment and systems knowledge; speed of thought in an uncertain environment; breadth of knowledge; people and communication skills; common sense/simplify; and responsibility and experience. Conclusions The identified themes should help to underpin the competence, capability and training requirements for these new roles, and should be considered when developing new services utilizing first‐contact primary care physiotherapy practice.

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Section: Discussionsupporting

confidence: 77%

“…Atkinson, Ajjawi, and Cooling () proposed that GP training develops certain attributes to support their practice. The ability to deal with uncertainty was clearly identified in their research, and this was replicated in the current study.…”

Section: Discussionmentioning

confidence: 99%

The skills, knowledge and attributes needed as a first‐contact physiotherapist in musculoskeletal healthcare

Langridge

2019

Musculoskeletal Care

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“…The specific focus on creating thinking routines seemed to be useful for teaching clinical reasoning because it directed the clinicians to develop an understanding of their own clinical reasoning, which is a necessary precondition for teaching clinical reasoning [17,64]. It provided a method of working towards the pedagogical goal of aligning the learning outcome of developing expert clinical reasoning skills with specific teaching methods - in this case - the thinking steps used by expert clinicians [65,66].…”

Section: Discussionmentioning

confidence: 99%

Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators

2014

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BackgroundClinical reasoning is fundamental to all forms of professional health practice, however it is also difficult to teach and learn because it is complex, tacit, and effectively invisible for students. In this paper we present an approach for teaching clinical reasoning based on making expert thinking visible and accessible to students.MethodsTwenty-one experienced allied health clinical educators from three tertiary Australian hospitals attended up to seven action research discussion sessions, where they developed a tentative heuristic of their own clinical reasoning, trialled it with students, evaluated if it helped their students to reason clinically, and then refined it so the heuristic was targeted to developing each student’s reasoning skills. Data included participants’ written descriptions of the thinking routines they developed and trialed with their students and the transcribed action research discussion sessions. Content analysis was used to summarise this data and categorise themes about teaching and learning clinical reasoning.ResultsTwo overriding themes emerged from participants’ reports about using the ‘making thinking visible approach’. The first was a specific focus by participating educators on students’ understanding of the reasoning process and the second was heightened awareness of personal teaching styles and approaches to teaching clinical reasoning.ConclusionsWe suggest that the making thinking visible approach has potential to assist educators to become more reflective about their clinical reasoning teaching and acts as a scaffold to assist them to articulate their own expert reasoning and for students to access and use.

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“…35 Decision-making is context dependent and intuitive, 36 requiring practice-specific skills. 37,38 GPRs eventually have to be able to manage chronic complex problems, to think intuitively and work independently. In other words, be able to function in the complex domain.…”

Section: Recommendations For Managing High-performing and Gifted Gprsmentioning

confidence: 99%

High-performing general practice registrars, the gifted and the talented: Helping them to reach their potential

Zaharias¹

2018

MedEdPublish

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The under-performing medical student or trainee in difficulty, is the subject of extensive discussion in the medical education literature. In contrast, literature on the high-performing medical student or trainee is limited, possibly because high-performers are considered the 'quiet achievers' requiring little assistance. High-performers however are diverse and they may also have difficulties with their learning and face particular impediments. Whether quiet achievers or otherwise, high-performers provide challenges to the educator and educational institution alike. This is a discussion paper based largely on the author's broad experiences in General Practice (GP) training. It references educational theories of giftedness and knowledge management theory in order to provide an understanding of highperforming GP Registrars (GPRs) and the gifted, their attributes, particular challenges and needs. It argues that high-performing GPRs, those having talent or showing potential, should be supported and encouraged to excel. This requires striking the right balance between challenge and support as well as the optimization of: learning, experience, self-reflection and self-actualization. In addition, impediments to learning should be addressed, psychosocial needs met and assistance provided to surmount any disabilities. This is important, not only that high-performing GPRs will aim higher and attain their ultimate potential but also to give impetus to the gifted amongst them, who have special abilities and the potential to make new discoveries, challenge extant ideas and create new paradigms.

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Promoting clinical reasoning in general practice trainees: role of the clinical teacher

Cited by 28 publications

References 16 publications

The skills, knowledge and attributes needed as a first‐contact physiotherapist in musculoskeletal healthcare

The skills, knowledge and attributes needed as a first‐contact physiotherapist in musculoskeletal healthcare

Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators

High-performing general practice registrars, the gifted and the talented: Helping them to reach their potential

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