Osteopathic clinical reasoning: An ethnographic study of perceptual diagnostic judgments, and metacognition
Osteopathic clinical reasoning: An ethnographic study of perceptual diagnostic judgments, and metacognition
Background: Clinical reasoning has been widely researched in the health sciences; however, in osteopathy it is still in its relative infancy. Objective: To explore the moment by moment clinical reasoning processes of an osteopath whilst with patients, to understand the role of perceptual diagnostic judgments, and metacognitive processes. Method: A qualitative interpretive study with a novel narrative method as an organising structure: the moment by moment thought processes of a single osteopath were recorded and transformed into descriptions of the interactions with patients. The descriptive texts were expanded into narratives using autoethnography and reflective practice. Narratives were then analysed using methods originating from grounded theory. Results: Our interpretations indicate that osteopaths establish a multisensory construct during clinical reasoning which enables both analytic and intuitive decision-making strategies. Clinical reasoning was monitored by a variety of metacognitive processes, including intuitive discernments such as feeling that a decision is correct, and the judgment that there is sufficient information to make that decision. Conclusions: This is the first study to explore the subjective moment by moment clinical reasoning and decision-making strategies of an osteopath whilst with patients. It suggests that perceptual diagnostic judgments are multisensory and include mental and visual imagery, and embodied senses. These enable analytic and intuitive diagnostic strategies that are accompanied by persistent metacognitive processes during the consultation, which guide the practitioner's decision strategies.
McIntyre, Cindy
74c5df90-6007-4162-abb3-f5676423265a
Lathlean, Judith
98a74375-c265-47d2-b75b-5f0f3e14c1a9
Esteves, Jorge E.
b42185bc-160e-4c4d-ad79-aeb6a78a1851
McIntyre, Cindy
74c5df90-6007-4162-abb3-f5676423265a
Lathlean, Judith
98a74375-c265-47d2-b75b-5f0f3e14c1a9
Esteves, Jorge E.
b42185bc-160e-4c4d-ad79-aeb6a78a1851
McIntyre, Cindy, Lathlean, Judith and Esteves, Jorge E.
(2018)
Osteopathic clinical reasoning: An ethnographic study of perceptual diagnostic judgments, and metacognition.
International Journal of Osteopathic Medicine.
(doi:10.1016/j.ijosm.2018.03.005).
Abstract
Background: Clinical reasoning has been widely researched in the health sciences; however, in osteopathy it is still in its relative infancy. Objective: To explore the moment by moment clinical reasoning processes of an osteopath whilst with patients, to understand the role of perceptual diagnostic judgments, and metacognitive processes. Method: A qualitative interpretive study with a novel narrative method as an organising structure: the moment by moment thought processes of a single osteopath were recorded and transformed into descriptions of the interactions with patients. The descriptive texts were expanded into narratives using autoethnography and reflective practice. Narratives were then analysed using methods originating from grounded theory. Results: Our interpretations indicate that osteopaths establish a multisensory construct during clinical reasoning which enables both analytic and intuitive decision-making strategies. Clinical reasoning was monitored by a variety of metacognitive processes, including intuitive discernments such as feeling that a decision is correct, and the judgment that there is sufficient information to make that decision. Conclusions: This is the first study to explore the subjective moment by moment clinical reasoning and decision-making strategies of an osteopath whilst with patients. It suggests that perceptual diagnostic judgments are multisensory and include mental and visual imagery, and embodied senses. These enable analytic and intuitive diagnostic strategies that are accompanied by persistent metacognitive processes during the consultation, which guide the practitioner's decision strategies.
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Osteopathic clinical reasoning - An ethnographic study of perceptual diagnostic
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Accepted/In Press date: 29 March 2018
e-pub ahead of print date: 30 March 2018
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Local EPrints ID: 421584
URI: http://eprints.soton.ac.uk/id/eprint/421584
ISSN: 1746-0689
PURE UUID: c2f88d69-13e6-48bf-80de-e9a3499a3ad7
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Date deposited: 15 Jun 2018 16:30
Last modified: 15 Mar 2024 20:06
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Author:
Cindy McIntyre
Author:
Judith Lathlean
Author:
Jorge E. Esteves
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