Attributes of Expert and Novice Clinicians: A Brief Review and Investigation of the Differences in Peripheral Sympathetic Nervous System Activity Elicited During Thoracic Mobilization
The clinical attributes that distinguish expert from novice clinicians have become a topic of great interest. To date, the majority of the literature has investigated the differences that exist in the clinical reasoning process. Despite the reported importance of joint mobilization techniques in ort...
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| Published in: | Physical therapy reviews Vol. 9; no. 1; pp. 31 - 38 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Taylor & Francis
01-03-2004
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | The clinical attributes that distinguish expert from novice clinicians have become a topic of great interest. To date, the majority of the literature has investigated the differences that exist in the clinical reasoning process. Despite the reported importance of joint mobilization techniques in orthopaedic practice, many of these studies have admittedly omitted the movement component (manual skills) of clinical practice from their analysis. The purpose of this study was to investigate the differences, in peripheral sympathetic nervous system activity elicited with thoracic mobilizations, between an expert and novice clinician. The expert and a novice clinician performed central grade III mobilizations to T12 on a convenience sample of 15 asymptomatic subjects utilising a crossover design. Skin conductivity was utilised as a measure of peripheral sympathetic nervous system activity. A paired samples t-test was used to compare the mean change in skin conductivity between groups. Results demonstrated that the expert clinician elicited a statistically significant (P < 0.025) greater increase in skin conductivity when compared to the novice. Although it cannot be stated with absolute certainty that expert clinicians produce a greater sympathetic nervous system response when performing spinal manipulative therapy, we speculate that differences exist between therapists, which may have clinically significant implications. |
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| ISSN: | 1083-3196 1743-288X |
| DOI: | 10.1179/108331904225003964 |