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Exploring the teaching and learning of clinical reasoning, risks, and benefits of cervical spine manipulation

The aim of this study was to examine how risks and benefits of cervical spine
manipulation (CSM) were framed and discussed in the context of mentorship and
their impact on the perception of safe practice of CSM in clinical physiotherapy
settings. A multi-method qualitative approach was employed, including a document
analysis of established educational guidelines, observations of mentoring
sessions, and individual face-to-face interviews with five mentees in the process
of learning CSM, and four mentors with Orthopedic Manual Physical Therapy (OMPT)
certification. Results demonstrated that participants' clinical decision-making
processes to perform CSM were primarily oriented to the mitigation of risk.
Achieving proficiency in the "science" of clinical reasoning and the "art" of
"feel" related to mastering technical skills were viewed as means to mitigating
risk and enhancing confidence to use CSM safely in clinical practice. While the
"art" of technical skill mastery was of high importance to mentees and considered
important to developing competency in performing CSM, it was discussed as
distinct from their clinical reasoning processes. Thus, promoting a more balanced
and integrated use of the "art" and "science" of safe practice for CSM in OMPT
training may result in greater confidence and judicious use of CSM by
physiotherapists.

Langue : ANGLAIS

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