[Physio Explained] Perfecting your clinical reasoning with Mark Jones
Aug 21, 2024
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Join Mark Jones, an Adjunct Senior Lecturer at the University of South Australia with 35 years in physiotherapy education, as he dives into the art of clinical reasoning. He discusses common principles and how physios can sharpen their skills. Mark emphasizes the integration of psychosocial factors, the significance of hypothesis formulation, and the need for minimizing biases. He advocates for a holistic approach in evaluating patients while encouraging self-critique to enhance decision-making in treatment.
Clinical reasoning should be treated as a dynamic hypothesis-testing process, emphasizing ongoing evaluation and openness to new evidence.
Incorporating the biopsychosocial model is essential for physiotherapists to effectively assess and address all dimensions of patient health.
Deep dives
The Hypothetical-Deductive Process in Clinical Reasoning
Clinical reasoning is fundamentally a process of human judgment that involves forming hypotheses based on patient information. This process relies heavily on continuous evaluation where clinicians assess their initial hypotheses against ongoing clinical findings, subject assessments, and treatment re-evaluations. It’s crucial for clinicians to approach their judgments as tentative hypotheses rather than established facts, enabling them to remain open to new evidence that may support or contradict their initial thinking. This approach minimizes biases and encourages a thorough exploration of potential differential diagnoses, allowing for a more comprehensive understanding of the patient's condition.
Improving Clinical Reasoning Skills
Enhancing clinical reasoning skills requires a solid understanding of the reasoning process itself, along with a reflective assessment of one’s own practices. Clinicians should familiarize themselves with contemporary theories of clinical reasoning, which extend beyond merely diagnosing a condition to encompass various patient dimensions, including psychosocial factors. Those in the field must actively incorporate the biopsychosocial model into their assessments, ensuring a balanced consideration of all aspects affecting patient health. By recognizing blind spots in their reasoning, clinicians can refine their judgment strategies, particularly regarding the relevance of psychosocial elements in patient care.
The Role of Comprehensive Patient Assessment
Conducting an in-depth assessment of patient behavior and symptoms is essential in forming accurate clinical judgments. Recognizing the importance of analyzing aggravating and easing factors during subjective assessments allows clinicians to build a richer picture of the patient's condition and potential pain mechanisms. By categorizing these observations, physiotherapists can differentiate between various classifications of problems, improving their overall diagnosis and treatment strategies. This approach encourages not just rote memorization of questions, but also critical thinking on how patient information correlates with clinical reasoning, ultimately leading to better patient outcomes.
What Physios can do to improve their clinical reasoning skills
Psychosocial factors in clinical reasoning
Categories of clinical reasoning/hypothesis categories
Analysis of clinical reasoning and using this in your treatment
Mark Jones is an Adjunct Senior Lecturer at the University of South Australia with 35 years’ experience teaching undergraduate and postgraduate physiotherapy. He has over 90 publications including three editions of the text “Clinical Reasoning in the Health Professions” and two editions of the text “Clinical Reasoning in Musculoskeletal Practice”.
Want to learn more about Clinical Reasoning? Mark recently did a brilliant Masterclass with us, called, “Enhancing Clinical Reasoning: Effective Strategies for Clinicians” where he goes into further depth on this topic.