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The Integration of Clinical Reasoning in Osteopathy

Journal: Unpublished MSc thesis Wiener Schule für Osteopathie, Date: 2008/02, Pages: 102, type of study: review

Free full text   (https://www.osteopathicresearch.org/s/orw/item/3010)

Keywords:

clinical reasoning [56]
osteopathic manipulative treatment [2973]
OMT [2951]
msc thesis [22]
review [496]
WSO [433]

Abstract:

Clinical reasoning is the thinking process behind the clinical process of decision finding of manual therapists and physicians and represents the basis of each therapeutic action. The patient whose problem is to be solved is in the center of attention of clinical reasoning. By integration of the patient's impressions and wishes (cf. the patient-centered model of clinical reasoning, chapter 3.2.1), the person behind the medical condition is not neglected. Already in the Andrew Taylor Still's osteopathic approach, we can detect aspects of clinical reasoning as known from manual therapy and medicine. By categorizing the body into certain regions Still structures the treatment; the characterization of typical features enables the fast and efficient establishment of diagnoses; and by drawing prudent conclusions, the patient can be provided with an individual and adequate treatment. Furthermore, Still demands to abandon unprovable theories and oppose them to actions, thus giving the impetus for scientific work. A helpful consequence of this claim is the provision of a communication platform among colleagues and other health care professionals. Constant reflection of treatment enables the osteopath to evaluate his therapy method. However, Still does not only integrate the clearly structured patient-related procedure with the help of the clinical reasoning process, but also intuition plays an essential role. It is important to note that the application of clinical reasoning does not protect against cognitive errors since it contains possible errors sources the therapist has to be aware of in order to avoid them. Meanwhile, clinical reasoning has been integrated into osteopathic education and training with the help of different practice-relevant teaching methods; the application of this thinking process is considered the basis of osteopathic treatment. Osteopaths, therapists, and physicians must always be aware that errors may occur despite all efforts of reflection and assessment of the treatment. Furthermore it is noticeable that besides this thinking, structuring, reflecting and assessing, the person must not be overlooked and the individual is to be respected with all his feelings, worries, and wishes.


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