An exploration of the clinical reasoning used by registered osteopaths in their choice of therapeutic approach

Abstract

Objectives: Osteopathic healthcare has been shown to include a broad range of therapeutic interventions, however little is known about the clinical reasoning used by practitioners in their selection of these modalities. The aim of this research is to address this gap in the literature and explore what influences a practitioner's choice of therapeutic approach. Methods: A sequential mixed methods design was used to explore the question. Quantitative data was obtained by an exploratory national survey and qualitative data was obtained by a practitioner focus group. Survey data was analysed by SPSS while the qualitative data was analysed using a thematic analysis. The results were then synthesised via triangulation. Results: Findings showed that there are numerous variables involved in clinical reasoning. Quantitative data showed that practitioners look to include patient and practitioner-based factors as well as external influences. Four main themes emerged from the qualitative phase: (1) Patient/person Centred Care, (2) Practitioner Wellbeing, (3) Experiential Learning and (4) Integrating Evidence. Synthesised results revealed the complex nature of CR and how the numerous factors from both sets of data overlap. Conclusion: This study revealed a diversity of factors influencing clinical reasoning in osteopathic practice in the choice of therapeutic approach.