Flashcards in Week 1 Deck (26)
What is clinical reasoning?
A multidimensional, non-linear cognitive process that involves synthesis of information and collaboration with the patient, caregivers, and health care team” –O’Sullivan
What is a clinical decision?
The outcome of the clinical reasoning process.
What forms the basis for patient management?
What are the factors that influence clinical reasoning for the clinician?
• Setting of PT Practice
• Psycho-Social Skills
• Problem Solving Strategies
• Procedural Skills
• Knowledge & Expertise
What are the patient characteristics that influence clinical reasoning?
• Psycho- Social
• Time &/or Resources
• Goals, Values, Beliefs
What are some of the biases that can affect clinical reasoning?
1. Having prior information about the patient’s diagnosis
2. Confirmation bias: structuring the exam to confirm what you already suspect is true
3. Memory bias: influenced by a past patient episode of care
4. Conservatism: continue to maintain initial hypothesis despite gathering information that does NOT support it
What is logical thinking?
Making justified deductions based on what is obviously relevant
What is lateral thinking?
Taking information that may not have a clear connection to the health condition and considers possibility that there is a cause-effect relationship
What does lateral thinking include?
The development of a hypothesis and pursuit of information to support or eliminate that hypothesis
What is inductive reasoning?
Pattern recognition, whihc generally involves experience to identify a clinical pattern and treatments may follow a protocol. And clinical reasoning is considerably fast
What is deductive reasoning?
Form hypothesis on the basis of information gathered from examination, using the results of PMHx, patient interview and clinical exam which are evaluated to develop a hypothesis and includes multiple variables to determine Dx or treatment plan
The ___ model is a form of deductive reasoning
The *ICF* model is a form of deductive reasoning
What is the ICF model?
A classification system developed by the WHO that is used to describe the health of a person at a particular point in time
What does the ICF model place emphasis on?
Emphasis of this system is on the function of the patient, not on the health condition (diagnosis)
What does the ICF model take into consideration?
Takes into consideration influences that may impact the patient and health condition
What are the main components of the ICF model?
• Functioning and Disability
• Contextual Factors
What are the components included in the functioning and disability category of the ICF model?
- Body functions and structures. EX: physical impairments
- Activities: capabilities and restrictions in function
- Participation: capabilities and restrictions
What are the components included in the contextual factors category of the ICF model?
- Environmental factors
- Personal factors
What are the environmental factors that are in the contextual factors category of the ICF model?
Factors that are not within the person's control like government agencies, laws, religious & cultural beliefs. Also includes family and work
What is the purpose of the Exercise is Medicine Initiative?
To encourage physicians and health care providers to include exercise in the management plan for patients
Why is Exercise Considered Medicine?
• Physical activity and physical fitness are immensely powerful in their ability to both prolong and enhance the quality of life.
• Every tissue in the body benefits from regular physical
• Exercise can prolong health and reduce the risk of
developing chronic diseases
How can exercise benefit people with chronic conditions?
• Reducing the severity of the chronic condition
• Improve co-morbidities related to chronic conditions
• Improve the quality of life
What are the health benefits of regular physical activity at a moderate level of intensity?
• 22% reduced mortality in highly active vs low active men
• Men over age 65, mortality reduces by:
- 33% for moderate activity
- 45% for vigorous activity
• Men < 65 have a 19% drop in mortality with physical
What are the effects of resistance training on mortality?
• Higher levels of strength are associated with lower levels of all-cause mortality in middle aged and older populations
• Resistance training of 30 min or more per week is associated with a 23% lower risk of coronary heart disease
What is the primary reason to emphasize a physically active
To avoid the “disease syndrome” also known as the “downward spiral of chronic disease” which includes:
• Low functional capacity
• Reduced gait speed
• Loss of independence
• Increased weight gain
• Insulin resistance
• Gradual deterioration toward disability
• Higher all-cause mortality rates