Biomedical subjects

J Gwyer

Publications and source records attributed to J Gwyer.

7 recordsLinked to original sources

PubMed2000

Expert practice in physical therapy.

BACKGROUND AND PURPOSE: The purpose of this qualitative study was to identify the dimensions of clinical expertise in physical therapy practice across 4 clinical specialty areas: geriatrics, neurology, orthopedics, and pediatrics. SUBJECTS: Subjects were 12 peer-designated expert physical therapists nominated by the leaders of the American Physical Therapy Association sections for geriatrics, neurology, orthopedics, and pediatrics. METHODS: Guided by a grounded theory approach, a multiple case study research design was used with each of the 4 investigators studying 3 therapists working in one clinical area. Data were obtained through nonparticipant observation, interviews, review of documents, and analysis of structured tasks. Videotapes made during selected therapist-patient treatment sessions were used as a stimulus for the expert therapist interviews. Data were transcribed, coded, and analyzed through the development of 12 case reports and 4 composite case studies, one for each specialty area. RESULTS: A theoretical model of expert practice in physical therapy was developed that included 4 dimensions: (1) a dynamic, multidimensional knowledge base that is patient-centered and evolves through therapist reflection, (2) a clinical reasoning process that is embedded in a collaborative, problem-solving venture with the patient, (3) a central focus on movement assessment linked to patient function, and (4) consistent virtues seen in caring and commitment to patients. CONCLUSION AND DISCUSSION: These findings build on previous research in physical therapy on expertise. The dimensions of expert practice in physical therapy have implications for physical therapy practice, education, and continued research.

Clinical Competence↗

PubMed1999

Describing expert practice in physical therapy.

In this article, the authors demonstrate how grounded theory may be used to develop models for understanding clinical practice. Through a series of research studies involving novice, experienced, and expert physical therapy practitioners, conceptual frameworks were continually revised based on data obtained from returning to the field and relevant literature available at the time. As concepts and relationships moved to larger themes, a theoretical framework for expertise in clinical practice was proposed. Current work on verifying the theoretical framework continues. Grounded theory is an excellent research approach to bound and help guide a multistage research program involving multiple researchers working in multiple settings.

Humans↗

PubMed1995

Personnel resources in physical therapy: an analysis of supply, career patterns, and methods to enhance availability.

Describing the ever-changing supply and demand for physical therapy personnel in the United States is an intricate, complex, and profoundly significant task for the profession. In this article, a review of data relating to the supply of physical therapy personnel in the work force and their typical career patterns is presented. The estimates of the numbers of physical therapists and physical therapist assistants are discussed, as are problems associated with such estimates. Studies of career patterns of physical therapists are compared. Changes in the participation rates of women in the physical therapy work force over the last three decades are described. Career expectations, defined as both length and pattern of work-force participation, of entering physical therapy professionals are presented. Strategies to adjust the work-force participation of personnel through changes in the educational process, career patterns, and practice patterns are discussed.

Career Mobility↗

PubMed1993

Alternative approaches to research in physical therapy: positivism and phenomenology.

This article presents philosophical approaches to research in physical therapy. A comparison is made to demonstrate how the research purpose, research design, research methods, and research data differ when one approaches research from the philosophical perspective of positivism (predominantly quantitative) as compared with the philosophical perspective of phenomenology (predominantly qualitative). Differences between the two approaches are highlighted by examples from research articles published in Physical Therapy. The authors urge physical therapy researchers to become familiar with the tenets, rigor, and knowledge gained from the use of both approaches in order to increase their options in conducting research relevant to the practice of physical therapy.

Forecasting↗

PubMed1992

Attribute dimensions that distinguish master and novice physical therapy clinicians in orthopedic settings.

The purpose of this qualitative case study was to further investigate the work of master and novice clinicians within the practice setting. The sample consisted of three master clinicians and three novice clinicians practicing in orthopedic outpatient physical therapy settings in three different regions of the United States. Data collection by three researchers included observation of each clinician treating at least three patients, audiotaping of all treatment sessions, interviews with clinicians and patients, and a review of patient records. Analysis of the data within and across cases revealed five attribute dimensions that distinguished the master clinician from the novice clinician. One attribute dimension (ie, confidence in predicting patient outcomes) related to knowledge, and four attribute dimensions (ie, ability to control the environment, evaluation and use of patient illness and disease data, focus of verbal and nonverbal communication with patients, and importance of teaching to hands-on care) related to improvisational performance. Further investigations are needed to confirm these findings and add to the body of knowledge concerning the parameters of physical therapy that may affect the efficacy and quality of patient care.

Communication↗

PubMed1982

Evaluation of clinical education centers in physical therapy.

The purpose of this research was to test a set of 20 physical therapy clinical education standards and three related evaluation forms that were published in 1976 by Moore and Perry. Mail questionnaires and telephone interviews with 134 Academic Coordinators of Clinical Education, 708 Center Coordinators of Clinical Education, 15 Clinical Instructors, and 52 students were used to collect data reported here. The resulting standards and evaluation forms were found to be practical, reliable, and valid for use by personnel of physical therapy and physical therapist assistant educational programs responsible for selecting clinical education centers for part-time and full-time students. We recommend that the standards and evaluation forms be used by personnel of physical therapy educational programs, clinical education centers, and selected committees of the American Physical Therapy Association because the standards and forms incorporate aspects of clinical education currently believed important to providing high-quality learning experiences in physical therapy practice.

Clinical Competence↗

PubMed1982

Selection of clinical education centers in physical therapy.

With the growing importance placed on the clinical portion of the educational preparation of health care professionals, standards with which to evaluate potential clinical education centers are needed. The primary purpose of the two-year Project on Selection of Clinical Education Sites was to provide the physical therapy profession with a set of standards and relevant evaluation forms that are clear, practical, reliable, and valid. The standards and forms can be used in all types of centers and during all phases of clinical education. This article presents the results of the project: a set of 20 standards that have been tested in a nationwide multiphase study and three evaluation forms that can be used with the standards to evaluate a clinical education program. The evaluation process based on the use of these materials has been demonstrated to be reliable and valid. The standards and evaluation forms have applicability for other allied health disciplines that use a pattern of clinical education similar to that in physical therapy education.

Clinical Clerkship↗