Student physical therapist clinical practice, decision making and utilization of thrust joint manipulation during clinical education experiences

2016 ◽  
Vol 25 ◽  
pp. e163
Author(s):  
M. Corkery ◽  
K. Hazel ◽  
C. Cesario
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Clinical Education ◽  
Physical Therapist ◽  
Thrust Joint Manipulation

scholarly journals Role of Physical Therapists in the Management of Individuals at Risk for or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline

2016 ◽  
Vol 96 (2) ◽  
pp. 143-166 ◽  
Author(s):  
Ellen Hillegass ◽  
Michael Puthoff ◽  
Ethel M. Frese ◽  
Mary Thigpen ◽  
Dennis C. Sobush ◽  
...  
Keyword(s):  
Decision Making ◽  
At Risk ◽  
Clinical Practice ◽  
Venous Thromboembolism ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Clinical Decision Making ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Patients At Risk

The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular & Pulmonary and Acute Care sections of APTA, have developed this clinical practice guideline to assist physical therapists in their decision-making process when treating patients at risk for venous thromboembolism (VTE) or diagnosed with a lower extremity deep vein thrombosis (LE DVT). No matter the practice setting, physical therapists work with patients who are at risk for or have a history of VTE. This document will guide physical therapist practice in the prevention of, screening for, and treatment of patients at risk for or diagnosed with LE DVT. Through a systematic review of published studies and a structured appraisal process, key action statements were written to guide the physical therapist. The evidence supporting each action was rated, and the strength of statement was determined. Clinical practice algorithms, based on the key action statements, were developed that can assist with clinical decision making. Physical therapists, along with other members of the health care team, should work to implement these key action statements to decrease the incidence of VTE, improve the diagnosis and acute management of LE DVT, and reduce the long-term complications of LE DVT.

scholarly journals Students’ Retention of Biophysical Agents Curriculum from First to Third Year of Study

2021 ◽  
Author(s):  
Jamie Greco ◽  
Eric Lamberg
Keyword(s):  
Clinical Practice ◽  
Clinical Education ◽  
Test Scores ◽  
Physical Therapist ◽  
Knowledge Retention ◽  
Significant Loss ◽  
T Test ◽  
Future Research ◽  
First Year ◽  
Significant Difference

Purpose: Biophysical agents (BPA) are widely used in physical therapy clinical practice and is a content area included in entry level physical therapist education programs. Retention of this content is critical for clinical practice. The purpose of this study was to measure to what extent 3rd year physical therapist students (PTS) were able to recall knowledge of BPA content after a 2 -year gap by repeating an examination that was given during the first year. Specifically, 1) Is there a significant difference in retention of BPA content/material between the 1st and 3rd year of curriculum, and 2) Does exposure/use of BPA during a clinical education experience (CEE) affect retention of material? Methods: A sample of convenience of 22 current 3rd year PTS who completed a BPA course during their 1st year participated. The comprehensive written examination for the BPA course served as the test instrument to determine knowledge retention. The PTS re-took this exam in their 3rd year of study, after completing their 2nd CEE. The PTS also completed a questionnaire soliciting information about demographics and degree of exposure to BPA during their CEE. A paired t-test was used to compare 1st year and 3rd year total test scores. The PTS were divided based on BPA exposure during their CEE, and test scores were compared using an independent samples t-test. Results: There was a significant decrease in test score from 1st to 3rd year (first year was 89.5% (range: 97.0% - 80.0%) while the 3rd year was 52.1% (range: 39.0% – 67.0%). There was no significant difference (p=0.561) in mean test scores on the 3rd year test for PTS with BPA exposure during CEEs (52.6%) vs those that did not (50.4%). Conclusions: Like other health professions, there was a decrement in knowledge retention. Results indicate a significant loss of retention of BPA knowledge when provided a 2-year gap, which was unaffected by exposure to BPA during CEEs. Exploring methods to improve knowledge retention in BPA curriculum may be needed. Future research should investigate retention with other methods of instruction including those that incorporate more active learning methods.

scholarly journals Examining Diagnostic Tests: An Evidence-Based Perspective

2001 ◽  
Vol 81 (9) ◽  
pp. 1546-1564 ◽  
Author(s):  
Julie M Fritz ◽  
Robert S Wainner
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Diagnostic Tests ◽  
Patient Management ◽  
Physical Therapist ◽  
Clinical Skills ◽  
Diagnostic Process ◽  
Accurate Information ◽  
Evidence Based

Abstract Diagnosis is an important aspect of physical therapist practice. Selecting tests that will provide the most accurate information and evaluating the results appropriately are important clinical skills. Most of the discussion in physical therapy to date has centered on defining diagnosis, with considerably less attention paid to elucidating the diagnostic process. Determining the best diagnostic tests for use in clinical situations requires an ability to appraise evidence in the literature that describes the accuracy and interpretation of the results of testing. Important issues for judging studies of diagnostic tests are not widely disseminated or adhered to in the literature. Lack of awareness of these issues may lead to misinterpretation of the results. The application of evidence to clinical practice also requires an understanding of evidence and its use in decision making. The purpose of this article is to present an evidence-based perspective on the diagnostic process in physical therapy. Issues relevant to the appraisal of evidence regarding diagnostic tests and integration of the evidence into patient management are presented.

scholarly journals The Hypothesis-Oriented Algorithm for Clinicians II (HOAC II): A Guide for Patient Management

2003 ◽  
Vol 83 (5) ◽  
pp. 455-470 ◽  
Author(s):  
Jules M Rothstein ◽  
John L Echternach ◽  
Daniel L Riddle
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Patient Management ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Functional Deficits ◽  
Original Algorithm ◽  
Contemporary Practice

Abstract In this era of health care accountability, a need exists for a new decision-making and documentation guide in physical therapy. The original Hypothesis-Oriented Algorithm for Clinicians (HOAC) provided clinicians and students with a framework for science-based clinical practice and focused on the remediation of functional deficits and how changes in impairments related to these deficits. The HOAC II was designed to address shortcomings in the original HOAC and be more compatible with contemporary practice, including the Guide to Physical Therapist Practice. Disablement terminology is used in the HOAC II to guide clinicians and students when documenting patient care and incorporating evidence into practice. The HOAC II, like the HOAC, can be applied to a patient regardless of age or disorder and allows for identification of problems by physical therapists when patients are not able to communicate their problems. A feature of the HOAC II that was lacking in the original algorithm is the concept of prevention and how to justify and document interventions directed at prevention.

scholarly journals Physical Therapist Clinical Practice Guideline for the Management of Individuals With Heart Failure

2020 ◽  
Vol 100 (1) ◽  
pp. 14-43
Author(s):  
Michael J Shoemaker ◽  
Konrad J Dias ◽  
Kristin M Lefebvre ◽  
John D Heick ◽  
Sean M Collins
Keyword(s):  
Heart Failure ◽  
Decision Making ◽  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Clinical Decision Making ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Clinical Decision

Abstract The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular and Pulmonary Section of APTA, have commissioned the development of this clinical practice guideline to assist physical therapists in their clinical decision making when managing patients with heart failure. Physical therapists treat patients with varying degrees of impairments and limitations in activity and participation associated with heart failure pathology across the continuum of care. This document will guide physical therapist practice in the examination and treatment of patients with a known diagnosis of heart failure. The development of this clinical practice guideline followed a structured process and resulted in 9 key action statements to guide physical therapist practice. The level and quality of available evidence were graded based on specific criteria to determine the strength of each action statement. Clinical algorithms were developed to guide the physical therapist in appropriate clinical decision making. Physical therapists are encouraged to work collaboratively with other members of the health care team in implementing these action statements to improve the activity, participation, and quality of life in individuals with heart failure and reduce the incidence of heart failure-related re-admissions.

scholarly journals Examining Initial Perceptions of Transition to Clinical Practice from the Perspective of Professional Master's Students

2019 ◽  
Vol 14 (3) ◽  
pp. 167-173
Author(s):  
Thomas G. Bowman ◽  
Stephanie Mazerolle Singe ◽  
Brianne F. Kilbourne ◽  
Jessica L. Barrett
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Athletic Training ◽  
Clinical Education ◽  
Role Models ◽  
Independent Practice ◽  
Semistructured Interview ◽  
Master's Students ◽  
Master's Programs ◽  
Program Administrators

Context Newly credentialed athletic trainers are expected to be independent practitioners capable of making their own clinical decisions. Transition to practice can be stressful and present challenges for graduates who are not accustomed to practicing independently. Objective Explore the perceptions of professional master's students as they prepare to experience role transition from students to autonomous clinical practitioners. Design Qualitative study. Setting Nine higher education institutions. Patients or Other Participants Fourteen athletic training students (7 male, 7 female, age = 25.6 ± 3.7 years) participated. Main Outcome Measure(s) Participants completed a semistructured interview over the phone which focused on the perception of preparedness to enter clinical practice. All transcribed interviews were analyzed using a general inductive approach. Multiple-analyst triangulation and peer review were used to ensure trustworthiness. Results We found themes for facilitators and challenges to transition to autonomous clinical practice. Students felt prepared for independent practice due to (1) mentoring networks they had developed, (2) exposure to the breadth of clinical practice, and (3) autonomy allotted during clinical education. Potential challenges included (1) apprehension with decision making and (2) a lack of confidence. Conclusions Our findings suggest graduates from professional master's programs, although ready for clinical practice, may require more time and exposure to autonomous practice to build confidence. Professional master's program administrators should work to provide clinical education experiences that expose students to a wide variety of clinical situations (patients, settings, preceptors) with appropriate professional role models while providing decision making autonomy within accreditation standards.

scholarly journals Self-Reported Measurement of Heart Rate and Blood Pressure in Patients by Physical Therapy Clinical Instructors

2002 ◽  
Vol 82 (12) ◽  
pp. 1192-1200 ◽  
Author(s):  
Ethel M Frese ◽  
Randy R Richter ◽  
Tamara V Burlis
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Clinical Education ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Practice Setting ◽  
Clinical Instructors ◽  
Strongly Agree

Abstract Background and Purpose. The Guide to Physical Therapist Practice (Guide) recommends that heart rate (HR) and blood pressure (BP) measurement be included in the examination of new patients. The purpose of this study was to survey physical therapy clinical instructors to determine the frequency of HR and BP measurement in new patients and in patients already on the physical therapists' caseload. The use of information obtained from HR and BP measures in decision making for patient care and the effects of practice setting and academic preparation on the measurement and use of HR and BP also were examined. Subjects and Methods. A sample of 597 subjects was selected from a list of 2,663 clinical instructors at the clinical education sites of the 2 participating universities. Clinical instructors from a variety of practice settings were surveyed. A 26-item survey questionnaire was mailed to the clinical instructors. Results. Usable survey questionnaires were received from 387 respondents (64.8%); 43.4% reported working in an outpatient facility. The majority of the respondents strongly agreed or agreed (59.5%) that measurement of HR and BP should be included in physical therapy screening. When asked if routinely measuring HR and BP during clinical practice is essential, opinions were nearly split (strongly agree or agree=45.0%, strongly disagree or disagree=43.7%, no opinion=11.3%). More than one third (38.0%) of the respondents reported never measuring HR in the week before the survey as part of their examination of new patients. A slightly larger percentage (43.0%) reported never measuring BP of new patients in the week before the survey. Conversely, 6.0% and 4.4% of the respondents reported always measuring HR and BP, respectively, of new patients in the week before the survey. When given a list of reasons why HR and BP were not routinely measured in their clinical practice, respondents most frequently chose “not important for my patient population” (52.3%). Relationships were found between practice setting and frequency of HR and BP measurement in new patients. Discussion and Conclusion. Practices related to HR and BP measurement reported by this sample of clinical instructors do not meet the recommendations for physical therapy care described in the Guide.

An introduction to advance care planning: practice at the frontline

2018 ◽  
Author(s):  
Anjali Mullick ◽  
Jonathan Martin
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Communication Skills ◽  
Advance Care Planning ◽  
Use Case ◽  
Care Planning ◽  
Practical Advice ◽  
Future Care ◽  
Case Vignettes ◽  
Advance Care

Advance care planning (ACP) is a process of formal decision-making that aims to help patients establish decisions about future care that take effect when they lose capacity. In our experience, guidance for clinicians rarely provides detailed practical advice on how it can be successfully carried out in a clinical setting. This may create a barrier to ACP discussions which might otherwise benefit patients, families and professionals. The focus of this paper is on sharing our experience of ACP as clinicians and offering practical tips on elements of ACP, such as triggers for conversations, communication skills, and highlighting the formal aspects that are potentially involved. We use case vignettes to better illustrate the application of ACP in clinical practice.

scholarly journals Text Classification in Clinical Practice Guidelines Using Machine-Learning Assisted Pattern-Based Approach

2021 ◽  
Vol 11 (8) ◽  
pp. 3296
Author(s):  
Musarrat Hussain ◽  
Jamil Hussain ◽  
Taqdir Ali ◽  
Syed Imran Ali ◽  
Hafiz Syed Muhammad Bilal ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Machine Learning Algorithms ◽  
Nominal Group ◽  
Specific Information ◽  
Matching Techniques ◽  
Disease Specific

Clinical Practice Guidelines (CPGs) aim to optimize patient care by assisting physicians during the decision-making process. However, guideline adherence is highly affected by its unstructured format and aggregation of background information with disease-specific information. The objective of our study is to extract disease-specific information from CPG for enhancing its adherence ratio. In this research, we propose a semi-automatic mechanism for extracting disease-specific information from CPGs using pattern-matching techniques. We apply supervised and unsupervised machine-learning algorithms on CPG to extract a list of salient terms contributing to distinguishing recommendation sentences (RS) from non-recommendation sentences (NRS). Simultaneously, a group of experts also analyzes the same CPG and extract the initial patterns “Heuristic Patterns” using a group decision-making method, nominal group technique (NGT). We provide the list of salient terms to the experts and ask them to refine their extracted patterns. The experts refine patterns considering the provided salient terms. The extracted heuristic patterns depend on specific terms and suffer from the specialization problem due to synonymy and polysemy. Therefore, we generalize the heuristic patterns to part-of-speech (POS) patterns and unified medical language system (UMLS) patterns, which make the proposed method generalize for all types of CPGs. We evaluated the initial extracted patterns on asthma, rhinosinusitis, and hypertension guidelines with the accuracy of 76.92%, 84.63%, and 89.16%, respectively. The accuracy increased to 78.89%, 85.32%, and 92.07% with refined machine-learning assistive patterns, respectively. Our system assists physicians by locating disease-specific information in the CPGs, which enhances the physicians’ performance and reduces CPG processing time. Additionally, it is beneficial in CPGs content annotation.

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