INTRODUCTION TO CLINICAL REASONING  The problem-solving process used by doctors is

Alsol generally referred to as the clinical reasoning

process. (Barrows et al. 1987)

WHAT IS THE ROLE OF A PHYSICAL THERAPIST?  Refers to the thinking and decision-making
processes that are used in clinical practice.
 According to the WCPT, Physical therapists are (Edwards et al. 2004)
independent professionals concerned with
movement and functions. They provide services
that develop, retain and restore movement and Notes:
functional ability to individuals and groups
 Generally, it is not just use by physicians but
throughout the lifespan
also all medical health workers.
 PTs in general, includes different procedures
 It is an effective and efficient way to determine
such as your examination, evaluation, diagnosis,
how well the doctors medical knowledge, no
prognosis, interventions and outcomes
matter how expensive the condition is, it is still
assessment
translated to patient care
 Clinical practice – you would apply

WHAT IS CLINICAL REASONING?

WHY IS CLINICAL REASONING IMPORTANT?

 It is an important process of patient/client

management process.
 In order for us to achieve an efficient and
effective client care. This is also to better
understand the patient’s case, give PT diagnosis
and plan a proper management
 A therapist should go through a CRP process to
be able to give PT diagnosis

TYPES OF CLINICAL REASONING STRATEGIES

1. DIAGNOSIS

a. Diagnostic reasoning is the formation of a

diagnosis related to physical disability and
impairment with consideration of associated pain
mechanisms, tissue pathology, and the broad scope
of potential contributing factors.

b. Narrative reasoning involves the apprehension

and understanding of patients' "stories," illness
experiences, meaning perspectives, contexts, beliefs,
and cultures.

2. MANAGEMENT

a. Reasoning about procedure is the decision making

behind the determination and carrying out of
treatment procedures.

b. Interactive reasoning is the purposeful

establishment and ongoing management of therapist-
patient rapport.
c. Collaborative reasoning is the nurturing of a
consensual approach toward the interpretation of
examination findings, the setting of goals and
priorities, and the implementation and progression of
intervention.

d. Reasoning about teaching is thinking directed to

the content, method, and amount of teaching in
clinical practice, which is then assessed as to whether
it has been effectively understood.

e. Predictive reasoning is the active envisioning of

future scenarios with patients, including the
exploration of their choices and the implications of
those choices.

f. Ethical reasoning includes the apprehension of

ethical and practical dilemmas that impinge on both
the conduct of intervention and its desired goals, and
the resultant action toward their resolution.

How do they arrive to CRP?

1. 1st meeting with the patient

2. Generation of multiple hypothesis
3. Hypothesis oriented questions leading to review of
systems (menu driven inquiry)
4. Problem synthesis as internal representation
5. Diagnostic decision
6. Laboratory tests and management
7. Role of pattern recognition
8. Nature of expert's reasoning process novice versus
expert

PROCESS OF CLINICAL REASONING