Please review any material related to the questions that you missed before you move onto the case example applications below.
Case Example Applications
For each of the case studies below try to identify the student's current level of expertise and type of clinical reasoning strategy that they are using to problem solve. Then, if applicable, list some examples of deliberate practice activities that you might utilize as the student's clinical preceptor in order to improve that student's clinical performance.
Case Example #1:
Johnny Appleseed is performing his second knee evaluation since entering the athletic training program at your institution. During the evaluation you notice Johnny making a mental note of all the special tests that he has performed and those that he has not. While he asks good history questions, he seems to be lacking a connection of that information to the results of his physical evaluation. At the end of his evaluation, Johnny has difficultly coming to a single diagnostic conclusion. He finally says to you, "Well... it could be a possible MCL sprain... but it also... well the clicking and locking with McMurray's test could mean he has torn his medial meniscus. But the athlete's mechanism of injury does not indicate a meniscal tear, though."
What is Johnny's current level of expertise? What type of clinical reasoning strategy is Johnny using to make his decision? If applicable, what are some deliberate practice activities that you could use to improve Johnny's clinical performance?
Case Example #2:
Mary Poppins has just completed an evaluation of a baseball pitcher's elbow and has concluded that the athlete has a partially torn UCL. She also knows that the treatment for a partially torn UCL it that could be managed conservatively or surgically. Mary's rich knowledge about baseball injuries guides her explanation to the athlete that while it is generally true that conservative treatment would have a shorter recovery period (6-8 weeks), the athlete will most likely never return to their previous level of throwing without pain. She also knows that even with surgical intervention and a much longer recovery period (6-9 months), there is still a small percentage of failure that occurs with the reconstructed UCL once the athlete has returned to full participation. The athlete expressed an interest in going pro after the completion of this year, which ends in less than two months. Given the circumstances of the situation, Mary seeks out advice from her supervisor before recommending a plan to the athlete.
What is Mary's current level of expertise? What type of clinical reasoning strategy is Mary using to make her decision? If applicable, what are some deliberate practice activities that you could use to improve Mary's clinical performance?
Case Example #1:
Johnny Appleseed is performing his second knee evaluation since entering the athletic training program at your institution. During the evaluation you notice Johnny making a mental note of all the special tests that he has performed and those that he has not. While he asks good history questions, he seems to be lacking a connection of that information to the results of his physical evaluation. At the end of his evaluation, Johnny has difficultly coming to a single diagnostic conclusion. He finally says to you, "Well... it could be a possible MCL sprain... but it also... well the clicking and locking with McMurray's test could mean he has torn his medial meniscus. But the athlete's mechanism of injury does not indicate a meniscal tear, though."
What is Johnny's current level of expertise? What type of clinical reasoning strategy is Johnny using to make his decision? If applicable, what are some deliberate practice activities that you could use to improve Johnny's clinical performance?
Case Example #2:
Mary Poppins has just completed an evaluation of a baseball pitcher's elbow and has concluded that the athlete has a partially torn UCL. She also knows that the treatment for a partially torn UCL it that could be managed conservatively or surgically. Mary's rich knowledge about baseball injuries guides her explanation to the athlete that while it is generally true that conservative treatment would have a shorter recovery period (6-8 weeks), the athlete will most likely never return to their previous level of throwing without pain. She also knows that even with surgical intervention and a much longer recovery period (6-9 months), there is still a small percentage of failure that occurs with the reconstructed UCL once the athlete has returned to full participation. The athlete expressed an interest in going pro after the completion of this year, which ends in less than two months. Given the circumstances of the situation, Mary seeks out advice from her supervisor before recommending a plan to the athlete.
What is Mary's current level of expertise? What type of clinical reasoning strategy is Mary using to make her decision? If applicable, what are some deliberate practice activities that you could use to improve Mary's clinical performance?
Answers
You may now check the case example answers by downloading and opening the document below.
case_example_answers.docx | |
File Size: | 180 kb |
File Type: | docx |
Resources
Listed below are all of the documents that you should print for your clinical preceptor toolbox.
five_levels_of_proficiency.pdf | |
File Size: | 60 kb |
File Type: |
dreyfus_model_of_skill_acquisition.pdf | |
File Size: | 86 kb |
File Type: |
preceptor_novice_to_expert_chart.pdf | |
File Size: | 712 kb |
File Type: |
geisler_annd_lazenby_-_differential_diagnosis_schematic_exercise.pdf | |
File Size: | 55 kb |
File Type: |
References
Benner, P. (1982). From novice to expert. The American Journal of Nursing, 82(3), 402-407.
Benner, P. (2004). Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bulletin of Science, Technology & Society, 24(3), 188-199.
Bruning, R.H., Schraw G.J., Norby, M.M. (2011). Cognitive psychology and instruction (5th ed.). Boston, MA: Pearson Education.
Burns, C., Beauchesne, M., Ryan-Krause, P., & Sawin, K. (2006). Mastering the preceptor role: challenges of clinical teaching. Journal of Pediatric Health Care, 20(3), 172-183.
Cash, K. (1995). Benner and expertise in nursing: a critique. International Journal of Nursing Studies, 32(6), 527-534.
Daley, B. J. (1999). Novice to expert: An exploration of how professionals learn. Adult Education Quarterly, 49(4), 133-147.
Darbyshire, P. (1994). Skilled expert practice: is it ‘all in the mind’? A response to English's critique of Benner's novice to expert model. Journal of Advanced Nursing, 19(4), 755-761.
Dreyfus, S. E., & Dreyfus, H. L. (1980). A five-stage model of the mental activities involved in directed skill acquisition (No. ORC-80-2). California Univ Berkeley Operations Research Center.
English, I. (1993). Intuition as a function of the expert nurse: a critique of Benner's novice to expert model. Journal of Advanced Nursing, 18(3), 387-393.
Ericsson, K. A., Krampe, R. T., & Tesch-Römer, C. (1993). The role of deliberate practice in the acquisition of expert performance. Psychological Review, 100(3), 363-406.
Geisler, P. R., & Lazenby, T. W. (2009). Clinical reasoning in athletic training education: modeling expert thinking. Athletic Training Education Journal, 4(2), 52-65.
Gobet, F., & Chassy, P. (2008). Towards an alternative to Benner's theory of expert intuition in nursing: a discussion paper. International Journal of Nursing Studies, 45(1), 129-139.
Benner, P. (2004). Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bulletin of Science, Technology & Society, 24(3), 188-199.
Bruning, R.H., Schraw G.J., Norby, M.M. (2011). Cognitive psychology and instruction (5th ed.). Boston, MA: Pearson Education.
Burns, C., Beauchesne, M., Ryan-Krause, P., & Sawin, K. (2006). Mastering the preceptor role: challenges of clinical teaching. Journal of Pediatric Health Care, 20(3), 172-183.
Cash, K. (1995). Benner and expertise in nursing: a critique. International Journal of Nursing Studies, 32(6), 527-534.
Daley, B. J. (1999). Novice to expert: An exploration of how professionals learn. Adult Education Quarterly, 49(4), 133-147.
Darbyshire, P. (1994). Skilled expert practice: is it ‘all in the mind’? A response to English's critique of Benner's novice to expert model. Journal of Advanced Nursing, 19(4), 755-761.
Dreyfus, S. E., & Dreyfus, H. L. (1980). A five-stage model of the mental activities involved in directed skill acquisition (No. ORC-80-2). California Univ Berkeley Operations Research Center.
English, I. (1993). Intuition as a function of the expert nurse: a critique of Benner's novice to expert model. Journal of Advanced Nursing, 18(3), 387-393.
Ericsson, K. A., Krampe, R. T., & Tesch-Römer, C. (1993). The role of deliberate practice in the acquisition of expert performance. Psychological Review, 100(3), 363-406.
Geisler, P. R., & Lazenby, T. W. (2009). Clinical reasoning in athletic training education: modeling expert thinking. Athletic Training Education Journal, 4(2), 52-65.
Gobet, F., & Chassy, P. (2008). Towards an alternative to Benner's theory of expert intuition in nursing: a discussion paper. International Journal of Nursing Studies, 45(1), 129-139.