title: A qualitative grounded theory study of the conceptions of clinical practice in osteopathy - a continuum from technical rationality to professional artistry.
abstract: How practitioners conceive clinical practice influences many aspects of their clinical work including how they view knowledge, clinical decision-making, and their actions. Osteopaths have relied upon the philosophical and theoretical foundations upon which the profession was built to guide clinical practice. However, it is currently unknown how osteopaths conceive clinical practice, and how these conceptions develop and influence their clinical work. This paper reports the conceptions of practice of experienced osteopaths in the UK. A constructivist grounded theory approach was taken in this study. The constant comparative method of analysis was used to code and analyse data. Purposive sampling was employed to initially select participants. Subsequent theoretical sampling, informed by data analysis, allowed specific participants to be sampled. Data collection methods involved semi-structured interviews and non-participant observation of practitioners during a patient appointment, which was video-recorded and followed by a video-prompted reflective interview. Participants' conception of practice lay on a continuum, from technical rationality to professional artistry and the development of which was influenced by their educational experience, view of health and disease, epistemology of practice knowledge, theory-practice relationship and their perceived therapeutic role. The findings from this study provide the first theoretical insight of osteopaths' conceptions of clinical practice and the factors which influence such conceptions.
authors.affiliation: Clinical Research Centre for Health Professions, School of Health Professions, University of Brighton, Darley Road, Eastbourne, UK; Research Department, The British College of Osteopathic Medicine, Lief House, Finchley Road, London, UK; Research Centre, The British School of Osteopathy, 275 Borough High Street, London, UK. Electronic address: o.thomson@bso.ac.uk.
authors.forename: Oliver P
authors.initials: OP
authors.lastname: Thomson
authors.affiliation: Clinical Research Centre for Health Professions, School of Health Professions, University of Brighton, Darley Road, Eastbourne, UK.
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Petty
authors.affiliation: Clinical Research Centre for Health Professions, School of Health Professions, University of Brighton, Darley Road, Eastbourne, UK.
authors.forename: Ann P
authors.initials: AP
authors.lastname: Moore
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003657:Decision Making; D005260:Female; D066296:Grounded Theory; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D026301:Manipulation, Osteopathic / Q000592:standards* / Q000639:trends; D010021:Osteopathic Medicine / Q000592:standards / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D024382:Professional Role; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Clinical reasoning; Osteopathy; Professional artistry; Professional knowledge