Seeing the Forest and the Trees: Increasing Nurse Practitioner Students ‘Observational and Mindfulness Skills

Grossman, Sebastian P.; Deupi, Jill; Leitao, Kathleen

doi:10.1891/1078-4535.20.1.67

Cited by 13 publications

(9 citation statements)

References 12 publications

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“…108,109 Nursing literature is replete with information on educational strategies to facilitate reasoning in nursing students. 89,108,[110][111][112] Downloaded from https://academic.oup.com/ptj/advance-article-abstract/doi/10.1093/ptj/pzy148/5212793 by Chapman University Library user on 04 December 2018…”

Section: [Hd2]synopses Of Clinical Reasoning By Disciplinementioning

confidence: 99%

Clinical Reasoning in Physical Therapy: A Concept Analysis

et al. 2018

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Background Physical therapy, along with most health professions, struggles to describe clinical reasoning, despite it being a vital skill in effective patient care. This lack of a unified conceptualization of clinical reasoning leads to variable and inconsistent teaching, assessment, and research. Objective The objective was to conceptualize a broad description of physical therapists’ clinical reasoning grounded in the published literature and to unify understanding for future work related to teaching, assessment, and research. Design/Methods The design included a systematic concept analysis using Rodgers’ evolutionary methodology. A concept analysis is a research methodology in which a concept's characteristics and the relation between features of the concept are clarified. Results Based on findings in the literature, clinical reasoning in physical therapy was conceptualized as integrating cognitive, psychomotor, and affective skills. It is contextual in nature and involves both therapist and client perspectives. It is adaptive, iterative, and collaborative with the intended outcome being a biopsychosocial approach to patient/client management. Limitations Although a comprehensive approach was intended, it is possible that the search methods or reduction of the literature were incomplete or key sources were mistakenly excluded. Conclusions A description of clinical reasoning in physical therapy was conceptualized, as it currently exists in representative literature. The intent is for it to contribute to the unification of an understanding of how clinical reasoning has been conceptualized to date by practitioners, academicians, and clinical educators. Substantial work remains to further develop the concept of clinical reasoning for physical therapy, including the role of movement in our reasoning in practice.

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Section: [Hd2]synopses Of Clinical Reasoning By Disciplinementioning

confidence: 99%

Clinical Reasoning in Physical Therapy: A Concept Analysis

et al. 2018

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“…A total of around 300 articles were reviewed in detail. After applying the aforementioned inclusion and exclusion criteria, the literature search yielded 12 studies, [26][27][28][29][30][31][32][33][34][35][36][37] as listed in Table 1. Thereafter, 3 of these 12 studies 28,31,37 were found by manual search and missed by search results of the aforementioned review studies.…”

Section: Resultsmentioning

confidence: 99%

Appreciating visual arts may not foster medical diagnosis skills

Matsumoto

2023

F1000Res

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Background: This article examined intervention studies that used appreciation of visual arts to foster observation skills and discussed their effectiveness in making accurate diagnoses in terms of expertization. Methods: In order to collect journal articles and academic books (written in English) on empirical intervention studies that examined the use of visual arts for cultivating observation skills in health professionals’ education and training, the author first targeted articles that had been included in previous systematic reviews. In addition, they conducted a manual search. From this body of literature, the author selected studies that objectively measured observation skills only through the appreciation of visual art. They collected and read around 300 articles and selected 12 studies after applying the inclusion and exclusion criteria. Results: This article revealed no concrete evidence on whether appreciating visual art contributes toward an accurate diagnosis. Extant studies determined that such appreciation facilitates the observation of more visual features and a detailed view over time. However, they did not confirm the positive effects of appreciating visual arts on an accurate diagnosis. This article also confirmed that such appreciation does not reduce misdiagnoses or develop tolerance toward ambiguity that prevents premature closure. Moreover, the transfer of observation skills from one context to another is unlikely to be as successful as the intervention studies had intended. Conclusions: For fostering diagnostic skills, providing students with many instances of medical cases and appropriate knowledge to evoke implicit learning for extracting subtle differences in the cases, should be prioritized over visual art appreciation. On the other hand, such appreciation may foster verbalization skills and understanding or extraction of the patient’s background and context. These competencies may cultivate teamwork and perspective-taking, indirectly leading to an accurate diagnosis.

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“…The identified training approaches are: visual thinking strategy, [29,34] visual reinforcement, [30] visual literacy, [31] Looking Is Not Seeing pedagogy [32,33] and training the clinical eye. [35] The training approaches follow two main types of training principles: training the eye for deep seeing and guiding the eye.…”

Section: Resultsmentioning

confidence: 99%

“…Out of the seven studies, six used a static display of patient images [29,[31][32][33][34][35] and improvements were then reported when there was an increase in the number of details provided by the participant, the number of words used by the student to describe the image, and the number of accurate observations made. [29,[31][32][33][34][35] Jarodzka et al [30] reported improvement in students' ability to visually search for clues and interpret the findings (see Table 1). It appeared that the evaluation was conducted immediately after finishing the training sessions and there was no follow up to evaluate if these improvements were consistently transferred to the authentic practice.…”

Section: Resultsmentioning

confidence: 99%

“…In the selected visual training approaches evaluating the impact of training on clinical observation, students were asked to search for any observations over a specific period of time, usually using a static patient's image. [29,[31][32][33][34][35] The visual attention paid by students during the observation is more focused than the actual visual attention clinicians usually pay in a real clinical area. Using focussed attention on a static image allows localizing and concentrating on visual transients in a particular scene, making cues easily detectable with minimum perceptual efforts.…”

Section: Visual Attentionmentioning

confidence: 99%

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Training paradigms to enhance clinical observational skills in clinical practice: A scoping review

Al‐Moteri

Plummer

Cooper

et al. 2015

JNEP

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A number of training approaches to improve the clinical observation skills of undergraduate students have been identified in the literature. Immediate improvement from such approaches on students' clinical observational skills have been documented. However, this review identified that observational skill improvements did not occur in real and complex clinical conditions where the incidence of perception failure may increase. In six out of seven approaches examined, (i) the visual attention paid by students during observation is more focused than the actual visual attention clinicians usually pay in the real clinical area; (ii) the observations were made on images of clinical cases with visible signs which allowed findings to be noticed easily and with minimal searching efforts; (iii) the improvement in observation skills was based on what was noticed rather than what was missed, hence, perceptual failure was concealed; and (iv) in evaluations, students were asked to describe "what they see", the process of describing has the possibility to increase the tendency to conflate observations with inferences, and as a result, students may have stopped searching after being satisfied with their findings. To conclude, this review showed that perception paradigms have not been acknowledged in clinical observation training approaches with a need for further research relating to visual perception in clinical settings.

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Seeing the Forest and the Trees: Increasing Nurse Practitioner Students ‘Observational and Mindfulness Skills

Cited by 13 publications

References 12 publications

Clinical Reasoning in Physical Therapy: A Concept Analysis

Clinical Reasoning in Physical Therapy: A Concept Analysis

Appreciating visual arts may not foster medical diagnosis skills

Training paradigms to enhance clinical observational skills in clinical practice: A scoping review

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