CCR theory

Question 1

Clinical Reasoning

Answer 1

The thinking and/or decision-making processes that are used in clinical practice
- The ability to select and use information effectively in solving problems, a teachable,
cognitive skill that is independent of specific clinical knowledge.

Question 2

HOAC II

Answer 2

Hypothesis Oriented Algorithm for Clinicians

Question 3

ICF

Answer 3

International Classification of Functioning Disability and Health

Question 4

RPS

Answer 4

Rehabilitation Problem Solving form

Question 5

Hypotheses

Answer 5

Proposed, testable explanations (cause + effect) of the complaints of the patients = Target problem + target mediator

Question 6

Primary Prevention

Answer 6

Preventing anticipated / future problems

Question 7

Secondary Prevention

Answer 7

Preventing existing / current problems

Question 8

Tertiary Prevention

Answer 8

Preventing longer term, lasting effects i.e) linked to the problem - depression

Question 9

PIPS

Answer 9

Patient Identified Problems

Question 10

NPIPS

Answer 10

Non-patient Identified Problems

Question 11

Body Functions

Answer 11

Physiological functions of body systems

Question 12

Body Structures

Answer 12

Anatomical parts of the body i.e.) organs, limbs

Question 13

Impairments

Answer 13

Problems in body function or structure

Question 14

Participation

Answer 14

Involvement in a life situation

Question 15

Activity Limitations

Answer 15

Difficulty an individual may have in executing activities

Question 16

Participation Restrictions

Answer 16

Problems an individual has in involvement in life situations

Question 17

Environmental Factors

Answer 17

External to the patient. Make up the physical, social and attitudinal environment in which people live and conduct.

Question 18

Personal Factors

Answer 18

Internal to the patient. Influence how disability is experienced by the individual.

Question 19

Target Problem

Answer 19

“Effect”
Difficulties the patient has
Identified in activities and participation section of RPS

Question 20

Target Mediator

Answer 20

“Cause”
Supposed to have the highest potential to solve the target problem Identified in the body functions section of RPS

Question 21

Existing problem

Answer 21

A current problem (secondary-tertiary prevention)

Question 22

Anticipated problem

Answer 22

Nearby future (primary prevention)

Question 23

Observed Pain Behaviour

Answer 23

Guarding, bracing, rubbing, grimacing and sighing

Question 24

Clinical Outcomes

Answer 24

Strength, swelling, range of motion, pain, proprioception, psychological overlay and endurance (muscular)

Question 25

Functional Outcomes

Answer 25

Power, speed, agility, activity specific, kinesthetic awareness, pain, endurance (muscular and cardiovascular), skill level required for activity, psychological preparedness and daily living skills

Question 26

Screening process

Answer 26

Early identification of a health problem, not yet diagnosed, through a process that can be quickly executed.

Question 27

Medical Diagnosis

Answer 27

A process in which elements that have been observed will be classified under the name of a pathology.

Question 28

Physiotherapeutic Diagnosis

Answer 28

An inventory and analysis of limiting and facilitating factors for biological and behavioural recovery and adaptation processes within the boundaries of physical therapy.

Question 29

“Gut Feeling”

Answer 29

The instinctive feeling that there’s something wrong, though concrete evidence is missing

Question 30

Signs

Answer 30

Clinical information which is taken as objective proof from the PT

Question 31

Symptoms

Answer 31

Information that the patient gives but it is not taken by the PT as objective.

Question 32

Pattern Recognition

Answer 32

“Screening”

Question 33

Patient Profile

Answer 33

“Patient History” Personal story of the patient about perceived health problems, in their own language, in its own context, with its own history and with its own dynamics.

Question 34

Red Flags

Answer 34

The problem is not a musculoskeletal one. Biomedical risk factors (Serious pathology - Cancer, infection, fracture, etc.) Red flag findings in patient history indicate a need for referral to physician.

Question 35

Orange

Answer 35

Psychological risk factors (Psychiatric issues - Major depression, schizophrenia, etc.)

Question 36

Yellow Flags

Answer 36

Signs and symptoms that denote problems may be more severe or may involve more than one area requiring a more extensive examination, or they may relate to cautions and contradictions to treatment that the examiner have to consider (ex. Abnormal signs/symptoms, bilateral symptoms, drop attacks, vertigo, abnormal sensation patterns etc.) Or overlying psychosocial or cognitive risk factors (Distress, anxiety, etc.) Yellow flag findings indicate a more extensive examination may be required.

Question 37

Blue Flags

Answer 37

Social and economical (work related) risk factors (Job dissatisfaction, lack of support, etc.)

Question 38

Black Flags

Answer 38

Societal and insurance related factors (Limitations imposed by legislation, conflict with the insurer or workplace)

Question 39

SMART Goals

Answer 39

Specific, Measurable, Attainable, Relevant, Time

Question 40

Long-term goals

Answer 40

Related to patients target problem

Question 41

Short-term goals

Answer 41

Steps taken to meet the long term goal

Question 42

Strategies in Clinical Reasoning

Answer 42

1. Trial and Error 2. Following Protocol 3. Rule-in/Rule-out (diseases) 4. Hypothetico-deductive reasoning (research) 5. Pattern recognition (experienced practitioners)

Question 43

7 Steps of HOAC

Answer 43

1. Contextualisation of patient 2. Interview (patient history) + problem list+ hypotheses 3. Examination Strategy 4. Examination Findings = accept/reject hypothesis 5. Goals/Actions to take 6. Intervention Strategy 7. Reassessment

Question 44

ICD10 vs ICF

Answer 44

ICD10 = deals with disease and limitation giving a medical diagnosis, objective ICF = deals with overall functioning ability and perspective of the patient, subjective

Question 45

Clinical Reasoning Systems

Answer 45

System 1 = subconscious CR of pattern recognition, quick, narrow view (Exp. Health prof) System 2 = conscious CR which is analytical, slow, systematic, reflective, broad view (Student)