Factors that influence the clinical decision making of novice and experienced physical therapists.
BACKGROUND
The depth and breadth of prior experience informs clinical decision making in novice and experienced physical therapist clinicians.


OBJECTIVE
The aims of this research were to identify differences in clinical decision-making abilities and processes between novice and experienced physical therapist clinicians and to develop a model of the factors that influence clinical decision making.


METHODS
Qualitative research methods and grounded theory were used to gain insight into the factors and experiences that inform clinical decision making.


METHODS
Three participant pairs (each pair consisted of 1 novice physical therapist and 1 experienced physical therapist) were purposively selected from 3 inpatient rehabilitation settings. Case summaries from each participant provided the basis for within- and across-case analyses. The credibility of the results was established through checking of the case summaries by the participants, presentation of low-inference data, and triangulation across multiple data sources and within and across participant groups.


RESULTS
The factors that influenced clinical decision making were categorized as informative or directive. Novice participants relied more on informative factors, whereas experienced participants were more likely to rely on directive factors. An intermediate effect beyond novice practice was observed.


CONCLUSIONS
The results of this study may be used by educators and employers to develop and structure learning experiences and mentoring opportunities for students and novice learners with the aim of facilitating the development of skills and abilities consistent with expert clinical decision making.
Department of Physical Therapy, University of the Sciences in Philadelphia, 600 S 43rd St, Philadelphia, PA 19104, USA. s.wainwr@usp.edu
Susan Flannery
SF
Wainwright
Katherine F
KF
Shepard
Laurinda B
LB
Harman
James
J
Stephens
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D026761:Physical Therapy Specialty; D024382:Professional Role; D020377:Self Efficacy