Practice decision-making is at the heart of all clinical practice, and part of this consists of being able to demonstrate appropriate professional autonomy and accountability within a clinical setting (1,2). Prior experiences as a physiotherapy assistant did not allow me to make any substantial decisions on patient care, and I often was delegated work from qualified physiotherapists, therefore, my previous experience before the commencement of university did not allow me to adequately experience making decisions in practice (1). However, this soon changed when starting the course where I was introduced to being an autonomous practitioner, setting us up for a future career in healthcare.

To be an effective decision-maker, I had to learn how to effectively collect information from a variety of sources relevant to decision-making situations (1). I first had the opportunity to hone these skills during a written task (evidenced – Task 3) where I was collecting information from literature searches online on a topic regarding strength training parameters for stroke patients with gait deficits. From this, I was able to process and analyse the information I collected through critical analysis of each paper (evidenced – Task 3), and this allowed me to draw reasoned conclusions, and make informed judgements on the practical application of my findings, helping me to address and resolve my own issues on this topic for future clinical practice, assisting me to make informed decisions (1,2).

More practical methods of collecting information from a variety of sources presented themselves during placement experiences where I was collecting information from patients during subjective and objectives assessments, which is pertinent for the hypotheticodeductive reasoning process to guide decision making (1,3). Techniques during a subjective assessment such as active listening and open questioning (evidenced – Skills Journal: Collecting/Analysing Data) allowed me to obtain valuable information subjectively, and assisted me to informed my objective assessments using objective testing (evidenced – Skills Journal: Collecting/Analysing Data) which would also help inform my assessment further to guide treatment, demonstrating collecting information from a variety of sources relevant to the decision making process (1). Supplementary to this, the skills obtained within my Skills Journal: Collecting/Analysing Data aided me to develop my clinical reasoning skills, where I was able to use hypotheticodeductive reasoning to develop and test my hypothesis during an objective assessment (3). Evidence of being able to process and analyse the information and draw reasoned conclusions, and make informed judgements to address patient issues and resolve problems in practice have been demonstrated within my clinical reasoning forms (evidenced – Respiratory Clinical Reasoning Form, Neuro Clinical Reasoning Form, MSK clinical Reasoning Form), where I establish an ability to talk through different scenarios of clinical practice with different pathological conditions clearly and effectively through the information I collected subjectively and objectively, analysing the information to draw reasoned conclusions and utilising my clinical reasoning to make informed decisions on patient care to resolve their issues, highlighting an ability to practice as an autonomous professional, exercising my own professional judgement  (1,2,4,5).

To critically evaluate the decision making process is to reflect on events that have passed in order to understand what went well, what didn’t and what can be done different in future to improve and grow as a clinician (1,6). I had the opportunity to develop a service improvement project (evidenced – Service Improvement Poster) where I had to highlight an area of a service that could be improved in one way, shape or form. This was an interesting task as this was in a real clinical setting that I saw as a good learning opportunity, as I had the chance to see how services run and how the implementation of something new can be hindered/influenced by a wide array of variables in real-world practice. Following the completion of this task, I completed a reflection of the task and the means and methods of my decision-making processes where (evidenced – Reflection: Service Improvement). This allowed me to critically evaluate the process and the decisions I made throughout the process, which allowed me to grow and develop for future practice to help develop physiotherapy (1,2,6).

Reference List

1. Physiotherapy CS of. Chartered Society of Physiotherapy Framework [Internet]. 2013 [cited 2020 Mar 23]. Available from: http://www.csp.org.uk/professional-union/careers-development/cpd/csp-eportfolio/my-eportfolio/cpd-
2. Charted Society of Physiotherapy. Chartered Society of Physiotherapy xx Professional Values of Members’ Code and Behaviour 2 Code of Members’ Professional Values and Behaviours [Internet]. 2019 [cited 2019 Apr 9]. Available from: https://www.csp.org.uk/system/files/csp_code_of_professional_values_behaviour_full.pdf
3. May S, Withers S, Reeve S, Greasley A. Limited clinical reasoning skills used by novice physiotherapists when involved in the assessment and management of patients with shoulder problems: A qualitative study. J Man Manip Ther. 2010 Jun 1;18(2):84–8.
4. Council H and CP. Physiotherapists | The Standards of Proficiency For Physiotherapists [Internet]. 2013 [cited 2020 Mar 24]. Available from: https://www.hcpc-uk.org/standards/standards-of-proficiency/physiotherapists/
5. Doody C, McAteer M. Clinical reasoning of expert and novice physiotherapists in an outpatient orthopaedic setting. Physiotherapy. 2002;88(5):258–68.
6. Knowles Z, Tyler G, Gilbourne D, Eubank M, Ltd F. Reflecting on reflection: exploring the practice of sports coaching graduates. 2006;7(2):163–79.