Clinical decision making by experienced and inexperienced pediatric physical therapists for children with diplegic cerebral palsy.
OBJECTIVE
This qualitative study was designed to explore, identify, and describe clinical decision-making processes used by pediatric physical therapists.


METHODS
Clinical decision-making processes of three experienced therapists and three inexperienced therapists were assessed as they worked with 18 children with diplegia.


METHODS
Retrospective think-aloud procedures were used to elicit verbalizations, which were transcribed, coded, and analyzed.


RESULTS
Four characteristics of clinical decision making were identified: (1) Movement scripts provided insights into the clinical application of cognitive schemata based on previous experiences, (2) procedural changes occurred rapidly during within-session decision making, (3) psychosocial sensitivity was important for positive interaction during therapy, and (4) self-monitoring appeared to be pivotal in making clinical decisions as therapists self-assessed their practice. Contrasting data illustrated similarities and differences of experienced and inexperienced clinicians.


CONCLUSIONS
Findings are generally consistent with existing clinical decision-making literature and provide important information for physical therapy practice, research, and education.
Children's Therapy Unit, Good Samaritan Hospital, Puyallup, WA 98371, USA.
D G
DG
Embrey
M R
MR
Guthrie
O R
OR
White
J
J
Dietz
D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009068:Movement / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology; D026741:Physical Therapy Modalities / Q000379:methods*; D011187:Posture / Q000502:physiology; D012189:Retrospective Studies; D012647:Self-Assessment; D012944:Social Support; D014743:Videotape Recording