King Gillian, Currie Melissa, Bartlett Doreen J, Gilpin Michelle, Willoughby Colleen, Tucker Mary Ann, Strachan Deborah, Baxter Donna
Thames Valley Children's Centre, London, Ontario, Canada.
Dev Neurorehabil. 2007 Jul-Sep;10(3):223-40. doi: 10.1080/17518420701302670.
To examine the clinical decision making of novice, intermediate, and expert pediatric rehabilitation therapists from various disciplines.
Two qualitative studies were conducted. Thirteen therapists took part in a study using the critical incident interview technique and 11 therapists took part in a study using the 'think aloud' technique. Therapists were classified as novice, intermediate, or expert in developmental level based on a cluster analysis of data collected using a multifaceted battery of assessment tools. Data were analyzed using a grounded theory approach.
Expert and intermediate therapists differed from novices with respect to content, self-, and procedural knowledge.
With increasing expertise, therapists use a supportive, educational, holistic, functional, and strengths-based approach; have heightened humility yet increased self-confidence; and understand how to facilitate and support client change and adaptation by using principles of engagement, coherence, and manageability. Expert therapists use enabling and customizing strategies to ensure a successful therapeutic session, optimize the child's functioning in the mid-term, and ensure child and family adaptation and accommodation over the longer-term.
考察来自不同学科的新手、中级水平和专家级儿科康复治疗师的临床决策过程。
进行了两项定性研究。13名治疗师参与了一项采用关键事件访谈技术的研究，11名治疗师参与了一项采用“大声思考”技术的研究。根据使用多方面评估工具收集的数据进行聚类分析，将治疗师按发展水平分为新手、中级或专家。采用扎根理论方法对数据进行分析。
专家级和中级治疗师在内容、自我和程序知识方面与新手不同。
随着专业知识的增加，治疗师采用支持性、教育性、整体性、功能性和基于优势的方法；谦逊感增强但自信心提高；并且懂得如何通过运用参与、连贯和可管理性原则来促进和支持服务对象的改变与适应。专家级治疗师采用赋能和定制策略，以确保治疗过程顺利，在中期优化儿童的功能，并确保儿童及其家庭在长期内实现适应和调整。
