Clinical Reasoning

Question 1

Clinical reasoning

Answer 1

Thinking and decision-making process associated with practice

Question 2

Wise action

Answer 2

Making the best decision with in a specific context

Question 3

Three components of the physical therapy context

Answer 3

therapist perspectives patient’s perspective external environment

Question 4

Hypothetico-deductive inquiry

Answer 4

Process where clinician initially farms multiple generalized hypotheses that guide subsequent questioning and examination

Question 5

Pattern recognition

Answer 5

Compare patient problem with expected patterns of diagnosis familiar to clinician

Question 6

Components of clinical patterns

Answer 6

Symptom distribution, potential sources of symptoms, behavior of symptoms, responses to particular types of treatment, predisposing and contributing factors, prognosis, and other related information

Question 7

Australian approach

Answer 7

Provides a template for organization of patient information with an emphasis on signs and symptoms that helps develop critical patterns that are clinically relevant and therefore more accessible for future encounters.
Hypotheses categories.

Question 8

Steps of clinical reasoning model

Answer 8

Initial impressions, multiple generalized hypotheses, collect data based on individual patient presentation, interpret data/make measures fit, dx and management decision, asses, intervention, reasses

Question 9

Make features fit

Answer 9

Incorporate previously unrecognized variations into existing clinical patterns

Question 10

Maitland concept

Answer 10

PATIENT CENTERED: Focused on patient’s perspectives,Body’s ability to inform, Good communication skills, effective inquiry. Superior manual skills, pt specific physical exam,

Question 11

Analytical assessment

Answer 11

Clinical reasoning (most important in promoting effective management of patients and counters)

Question 12

Patient centered communication

Answer 12

Understanding the patient’s perspective including psychosocial issues

Question 13

Factors influencing clinical reasoning

Answer 13

Knowledge cognition and self-monitoring,

Question 14

Knowledge types

Answer 14

Facts, procedures(exam/tx), concepts(severity,stability,irritability), principles(rationale), and clinical pattern presentations(knowledge)

Question 15

Participation restrictionsHypotheses

Answer 15

Inability to perform or a limitation in the performance of actions, tasks, and activities

Question 16

Activity limitations Hypotheses

Answer 16

Restriction of the ability to perform a physical action task or activity in an efficient, typically expected, competent manner

Question 17

Impairment hypotheses

Answer 17

Any Loss or abnormality of anatomical, physiological, mental, or psychological structure

Question 18

Contributing/predisposing factors hypotheses

Answer 18

Any factors involved in the development or maintenance of the patient’s problem including environmental, emotional, physical and or biomechanical factors

Question 19

Precautions and contraindications hypotheses

Answer 19

Determine the extent of physical examination that may be perform safely

Question 20

Management and treatment hypotheses

Answer 20

Facilitated by clues gained in analysis of patients main problem, site of symptoms, behaviors symptoms, precautionary questions, On set and progression, mechanism of injury, past treatment and effect, pain threshold, personality, physical exam and ongoing management

Question 21

Prognosis hypotheses

Answer 21

Whether or not the patients presentation will respond to physical therapy and an estimate of time frame within recovery can be expected

Question 22

Unfavorable vs favorable findings

Answer 22

Mechanical versus inflammatory presentation, irritability, ability to centralize symptoms with repeated movement, degree of potential damage/injury to tissue, Length of history and progression, pre-existing disorders, patients personality and lifestyle

Question 23

Metacognition

Answer 23

Self-monitoring. Clinicians awareness and ability to think about her thinking

Question 24

Cognition

Answer 24

Thinking processes such as data analysis, inquiry strategies and hypothesis testing

Question 25

Diagnostic reasoning

Answer 25

Formation of diagnosis. Mechanisms of symptom production

Question 26

Narrative Reasoning

Answer 26

Understanding of patient/client and their context

Question 27

Reasoning about procedure

Answer 27

The determination/execution of treatment procedures

Question 28

Interactive reasoning

Answer 28

Establishing therapist patient rapport

Question 29

Collaborative reasoning

Answer 29

Nurturing a collaborative approach towards the siding and implementing goals of treatment

Question 30

Reasoning about teaching

Answer 30

Engaging an individualized/context sensitive Teaching

Question 31

Predictive reasoning

Answer 31

Envisioning future scenarios with clients and exploring their choices and their implications

Question 32

Ethical reasoning

Answer 32

Apprehension and resolution of ethical and pragmatic dilemmas

Question 33

Web of determinants

Answer 33

Biological, psychological, and social factors that interact to produce the patients unique pain experience (emergent) . Feedback loop. INTERVIEW/PHYSICAL EXAM/REASSESSMENT to discover

Question 34

Biological factors

Answer 34

Disease severity, nociception, inflammation, and brain function

Question 35

Psychological factors

Answer 35

Mood/affect, catastrophizeIng, stress, coping

Question 36

Social factors

Answer 36

Cultural factors, social environment, economic factors, social support