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https://www.readbyqxmd.com/read/28434131/knowing-how-and-knowing-why-testing-the-effect-of-instruction-designed-for-cognitive-integration-on-procedural-skills-transfer
#1
Jeffrey J H Cheung, Kulamakan M Kulasegaram, Nicole N Woods, Carol-Anne Moulton, Charlotte V Ringsted, Ryan Brydges
Transfer is a desired outcome of simulation-based training, yet evidence for how instructional design features promote transfer is lacking. In clinical reasoning, transfer is improved when trainees experience instruction integrating basic science explanations with clinical signs and symptoms. To test whether integrated instruction has similar effects in procedural skills (i.e., psychomotor skills) training, we studied the impact of instruction that integrates conceptual (why) and procedural (how) knowledge on the retention and transfer of simulation-based lumbar puncture (LP) skill...
April 22, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28425221/conceptualizing-movement-by-expert-bobath-instructors-in-neurological-rehabilitation
#2
Julie Vaughan-Graham, Kara Patterson, Karl Zabjek, Cheryl A Cott
RATIONALE, AIMS, AND OBJECTIVES: Movement, a core aspect of physiotherapy practice, and integral to the clinical reasoning process has undergone limited theoretical development. Instead, research has focused on intervention effectiveness embedded within the positivist paradigm. The purpose of this study was to explore how expert neurorehabilitation therapists conceptualize movement as part of their clinical reasoning. METHOD: A qualitative interpretive descriptive approach consisting of stimulated recall using video-recorded treatment sessions and in-depth interviews was used...
April 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28425112/beyond-guidelines-discretionary-practice-in-face-to-face-triage-nursing
#3
Lars E F Johannessen
This article draws on ethnographic data from a Norwegian emergency primary care clinic (EPCC) to explore nurses' discretionary application of guidelines. Specifically, it analyses nurses' discretionary use of the Manchester Triage System (MTS) when performing face-to-face triage, that is, assessing the urgency of patients' complaints. The analysis shows how nurses assessed patients at odds with MTS prescriptions by collecting supplementary data, engaging in differential diagnostic and holistic reasoning, relying on emotion and intuition, and allowing colleagues and patients to influence their reasoning...
April 20, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28421952/implementing-spiritual-care-interventions
#4
S Ílvia Caldeira, Fiona Timmins
This article, the third and final in a series of three, discusses the implementation of spiritual care interventions by nurses. It describes how nurses can use clinical reasoning and the nursing process to implement appropriate spiritual care for patients, and outlines the competencies necessary to identify spiritual distress and meet the spiritual needs of patients. Spiritual care interventions are discussed as part of a multidisciplinary team approach to the provision of holistic care.
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28421651/self-management-of-first-trimester-medical-termination-of-pregnancy-a-qualitative-study-of-women-s-experiences
#5
Carrie Purcell, Sharon Cameron, Julia Lawton, Anna Glasier, Jeni Harden
OBJECTIVE: To explore the experiences of women in Scotland who return home to complete medical termination of pregnancy (TOP) ≤63 days of gestation, after being administered with mifepristone and misoprostol at an NHS TOP clinic. DESIGN: Qualitative interview study. SETTING: One National Health Service health board (administrative) area in Scotland. POPULATION OR SAMPLE: Women in Scotland who had undergone medical TOP ≤63 days, and self-managed passing the pregnancy at home; recruited from three clinics in on NHS health board area between January and July 2014...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28419307/truth-or-spin-disease-definition-in-cancer-screening
#6
Lynette Reid
Are the small and indolent cancers found in abundance in cancer screening normal variations, risk factors, or disease? Naturalists in philosophy of medicine turn to pathophysiological findings to decide such questions objectively. To understand the role of pathophysiological findings in disease definition, we must understand how they mislead in diagnostic reasoning. Participants on all sides of the definition of disease debate attempt to secure objectivity via reductionism. These reductivist routes to objectivity are inconsistent with the Bayesian nature of clinical reasoning; when they appeal to the sciences, they are inconsistent with what philosophy of biology tells us about its natural kinds...
April 17, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28419010/extending-short-peripheral-catheter-dwell-time-a-best-practice-discussion
#7
Brenda Ansel, Michelle Boyce, Jennifer L Embree
Complications involving short peripheral catheters (SPCs) can significantly affect health care costs, patient quality of life, morbidity, mortality, and treatment expense, especially when the hospital stay is lengthened. This article examines the relationship between SPC dwell time and the incidence of phlebitis and potential bacteremia. The literature is replete with most studies supporting SPCs remaining in situ until a clinical reason warrants catheter removal. Removing and not routinely restarting unneccessary intravenous catheters can help prevent catheter-related infections and other vascular complications and reduce cost...
May 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28416622/clinical-reasoning-a-child-with-delayed-motor-milestones-and-ptosis
#8
Partha S Ghosh
No abstract text is available yet for this article.
April 18, 2017: Neurology
https://www.readbyqxmd.com/read/28407718/perspectives-on-tactile-intervention-for-children-with-cerebral-palsy-a-framework-to-guide-clinical-reasoning-and-future-research
#9
Megan L Auld, Leanne M Johnston
PURPOSE: Many children with cerebral palsy (CP) are known to experience tactile impairments. Research evaluating specific interventions to manage this is, however, minimal. This paper seeks to consolidate current literature and provide a framework to help clinicians and researchers think strategically about tactile treatment selection and future research planning. METHOD: The framework is described via a novel analogy - "The Apartment Block Theory". The theory describes the relative effectiveness of three intervention strategies aimed at overcoming a poorly responsive tactile system: (1) Pressing the buzzer - providing repeated passive tactile stimulation at the periphery; (2) Sneaking in the door - providing active tactile-enhanced motor training that capitalises on the opportunity to provide high-dose tactile input during motor interventions; and (3) Connecting another way - providing visually enhanced touch strategies with the aim of enhancing tactile function, which can be compared to phoning the apartment as an alternative to using the buzzer...
April 14, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28396457/clinical-reasoning-reversible-gait-ataxia-from-wheelchair-to-independent-mobility
#10
Tarig Mohammed Abkur, Peter Bede
No abstract text is available yet for this article.
April 11, 2017: Neurology
https://www.readbyqxmd.com/read/28394819/background-noise-lowers-the-performance-of-anaesthesiology-residents-clinical-reasoning-when-measured-by-script-concordance-a-prospective-randomised-crossover-volunteer-study
#11
Maya Enser, Jérôme Moriceau, Julien Abily, Cédric Damm, Emilie Occhiali, Emmanuel Besnier, Thomas Clavier, Antoine Lefevre-Scelles, Bertrand Dureuil, Vincent Compère
BACKGROUND: Noise, which is omnipresent in operating rooms and ICUs, may have a negative impact not only patients but also on the concentration of and communication between clinical staff. OBJECTIVE: The present study attempted to evaluate the impact of noise on the performance of anaesthesiology residents' clinical reasoning. Changes in clinical reasoning were measured by script concordance tests (SCTs). DESIGN: This was a prospective, randomised and crossover study...
April 10, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28392248/creating-authentic-video-scenarios-for-use-in-prehospital-research
#12
Christopher Preston, Bernie Carter, Barbara Jack, Lucy Bray
Video scenarios have been used to explore clinical reasoning during interviews in Think Aloud studies. This study used nominal group technique with experts to create video scenarios to explore the ways paramedics think and reason when caring for children who are sick or injured. At present there is little research regarding paramedics' clinical reasoning with respect to performing non-urgent procedures on children. A core expert panel identified the central structure of a prehospital clinical interaction and the range of contextual factors that may influence a paramedic's clinical reasoning [the way in which information is gathered, interpreted and analysed by clinicians]...
April 6, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28387489/-orthopaedic-manual-therapy-definition-characteristics-and-update-on-the-situation-in-belgium
#13
REVIEW
C Demoulin, Y Depas, M Vanderthommen, Y Henrotin, S Wolfs, B Cagnie, B Hidalgo
Although orthopaedic manual therapy (OMT) has existed for decades, and although a recent Belgian Royal Decree, published in 2014, recognized it as a particular professional qualification in physiotherapy for the treatment of neuromusculoskeletal dysfunctions, OMT remains little known by patients, but also by healthcare professionals. Yet, this professional qualification, based on clinical reasoning, using highly specific treatments, guided by the best available scientific and clinical evidence and the specific biopsychosocial characteristics of each patient, is the subject of a growing number of scientific studies pointing out its effectiveness...
March 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28379080/interprofessional-collaborative-reasoning-by-residents-and-nurses-in-internal-medicine-evidence-from-a-simulation-study
#14
K S Blondon, F Maître, V Muller-Juge, N Bochatay, S Cullati, P Hudelson, N V Vu, G L Savoldelli, M R Nendaz
Clinical reasoning has been studied in residents or nurses, using interviews or patient-provider encounters. Despite a growing interest in interprofessional collaboration, the notion of collaborative reasoning has not been well studied in clinical settings. Our study aims at exploring resident-nurse collaborative reasoning in a simulation setting. We enrolled 14 resident-nurse teams from a general internal medicine division in a mixed methods study. Teams each managed one of four acute case scenarios, followed by a stimulated-recall session...
April 2017: Medical Teacher
https://www.readbyqxmd.com/read/28377916/empowering-the-physiotherapy-profession-in-ethiopia-through-leadership-development-within-the-doctoring-process
#15
Cheryl Burditt Footer, Hailu Seifu Tsegaye, Tesfaye Asnake Yitnagashaw, Wintana Mekonnen, Tizita Destaw Shiferaw, Endashaw Abera, Alice Davis
Ethiopia recently introduced the Doctor of Physiotherapy (DPT) degree at Addis Ababa University as a mechanism to increase the work force capacity of primary care providers in the health sector. The DPT program was supported by an international academic partnership and was designed to empower physiotherapists as leaders to move the profession forward. The curriculum was framed by core pedagogical principles and strategies and was phased into two programs. First, the 4-year Advanced Standing DPT program focused on developing registered Ethiopian physiotherapists with Bachelor of Science degrees as academic faculty...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28373971/the-influence-of-an-orthopedic-manual-therapy-residency-program-on-improved-knowledge-psychomotor-skills-and-clinical-reasoning-in-nairobi-kenya
#16
Shala Cunningham, Joni McFelea
INTRODUCTION: The purpose of this study was to describe the influence of a post-graduate orthopedic manual therapy residency program in Kenya on the development of physical therapists' (PTs) knowledge and clinical reasoning related to the performance of a musculoskeletal examination and evaluation as compared to an experience-matched control group of PTs waiting to enter the program. METHODS: A cross-sectional design was utilized in which 12 graduating residents and 10 PTs entering the residency program completed a live-patient practical examination to assess the knowledge, clinical reasoning, and psychomotor skills related to the examination and evaluation of musculoskeletal conditions...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28373375/clinical-reasoning-corpus-callosum-lesion-with-multiple-strokes
#17
Zubeda Sheikh, Nidhiben Anadani, Bhrugav Raval, Leroy Sharer, Machteld Hillen
No abstract text is available yet for this article.
April 4, 2017: Neurology
https://www.readbyqxmd.com/read/28373374/clinical-reasoning-a-young-woman-with-progressive-headache-and-pancytopenia
#18
Erin C Conrad, James E Siegler, Joanna Mattis, Nilan Schnure, Steven R Messé
No abstract text is available yet for this article.
April 4, 2017: Neurology
https://www.readbyqxmd.com/read/28371873/patterns-of-clinical-reasoning-in-physical-therapist-students
#19
Sarah Gilliland, Susan Flannery Wainwright
Background and Purpose.: Clinical reasoning is a complex, non-linear problem solving process that is influenced by models of practice. The development of physical therapists' clinical reasoning abilities is a crucial yet under-researched aspect of entry-level physical therapist education. Objectives.: The purpose of this qualitative study was to examine the types of clinical reasoning strategies physical therapist students engage in during a patient encounter. Methods...
March 24, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28363384/dedicated-educational-nursing-unit-clinical-instructors-role-perceptions-and-learning-needs
#20
Donna M Glynn, Cecilia McVey, Judith Wendt, Bonnie Russell
Over the past decade, health care leaders have called for a radical transformation in health care and nursing education. Patient care has become complex, demanding succinct interprofessional communication and collaboration to optimize the care of the patient, and the nurse at the bedside is the optimal leader at the point of care. Assistance with the clinical reasoning and critical thinking with nursing students is pivotal for successful patient outcomes. The expert clinical nurse at the bedside is the premier faculty to guide the young practitioner in the care of the patient...
March 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
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