CLINICAL DECISION-MAKING BY EXPERIENCED AND INEXPERIENCED PEDIATRIC PHYSICAL-THERAPISTS FOR CHILDREN WITH DIPLEGIC CEREBRAL-PALSY

Background and Purpose. This qualitative study was designed to explore , identify, and describe clinical decision-making processes used by pe diatric physical therapists. Subjects. Clinical decision-making proces ses of three experienced therapists and three inexperienced therapists were assessed as they worked with Is children with diplegia. Methods. Retrospective think-aloud procedures were used to elicit verbalizatio ns, which were transcribed, coded, and analyzed. Results. Four charact eristics of clinical decision making were identified: (1) Movement scr ipts provided insights into the clinical application of cognitive sche mata based experiences, (2) procedural changes occurred rapidly, durin g within session decision making, (3) psychosocial sensitivity was imp ortant for positive interaction during therapy, and (4) self-monitorin g appeared to be pivotal in making clinical decisions as therapists se lf-assessed their practice. Contrasting data illustrated similarities and differences of experienced and inexperienced clinicians. Conclusio n and Discussion. Findings are generally consistent with existing clin ical decision-making literature and provide important information for physical therapy practice, research, and education.