Section 2: Clinical reasoning as a framework

Clinical reasoning is employed to underpin the framework detailed in this document. The cognitive and metacognitive processes of reasoning, using evidence-informed knowledge within OMT are the central components to expertise of practice in OMT (Rushton and Lindsay, 2010).

IFOMPT Standards

The IFOMPT Standards Document (IFOMPT, 2008) states that:

“Advanced clinical reasoning skills are central to the practice of OMT Physical Therapists, ultimately leading to decisions formulated to provide the best patient care. Clinical decisions are established following consideration of the patient’s clinical and physical circumstances to establish a clinical physical diagnosis and treatment options. The decisions are informed by research evidence concerning the efficacy, risks, effectiveness, and efficiency of the options (Haynes, 2002). Given the likely consequences associated with each option, decisions are made using a model that views the patient’s role within decision making as central to practice (Higgs and Jones, 2000), thus describing a patient centred model of practice”.

“The application of OMT is based on a comprehensive assessment of the patient’s neuromusculoskeletal system and of the patient’s functional abilities. This examination serves to define the presenting dysfunction(s) in the articular, muscular, nervous and other relevant systems; and how these relate to any disability or functional limitation as described by the World Health Organisation’s International Classification of Functioning, Disability and Health (World Health Organisation, 2001). Equally, the examination aims to distinguish those conditions that are indications or contraindications to OMT Physical Therapy and / or demand special precautions, as well as those where anatomical anomalies or pathological processes limit or direct the use of OMT procedures”.

IFOMPT competencies relating to clinical reasoning

Dimension 6 of the detailed competencies relates to clinical reasoning in postgraduate physical therapy practice in OMT, as follows:

Dimension 6: Demonstration of critical and an advanced level of clinical reasoning skills enabling effective assessment and management of patients with neuromusculoskeletal dysfunctions

Competencies Relating to Knowledge

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