Clinical reasoning in osteopathy: experiences of novice and experienced practitioners

Background A number of clinical reasoning models, including hypothetico-deductive, pattern recognition and narrative reasoning have been identified in both novice and experienced medical, nursing and allied health professionals. The aim of this project was to explore clinical reasoning in osteopathy from the perspectives of both experienced practitioners and novice practitioners. Methods Data were collected via semi-structured interviews that encouraged practitioners to reflect on the clinical reasoning processes they used in response to two case studies. Interviews were transcribed and analysed to identify key themes. Results Two themes emerged: (1) that experienced and novice osteopaths demonstrated different approaches to clinical reasoning, and (2) that experiential findings (e.g. from observation and palpatory findings derived from having direct contact with the patient) were integral to clinical reasoning in osteopathy. Conclusion The results of this study suggest that clinical reasoning in osteopathy is similar to that of other health professions in that deep understanding of clinical applications and clinical experience were key factors in developing sophisticated clinical reasoning processes. However, clinical reasoning in osteopathy, unlike many other health professions, relies on experiential findings resulting from direct observation and palpatory contact with the patient. Clinical reasoning that relies on subjective experiential findings requires further investigation