Development and Validation of a Self-Efficacy Scale for Clinical Reasoning in Physical Therapists
| Autor: | Jason A. Craig, Diana G. Venskus |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Persuasion
medicine.medical_specialty Mindfulness 020205 medical informatics business.industry media_common.quotation_subject Cognition 02 engineering and technology Academic achievement Verbal reasoning 03 medical and health sciences 0302 clinical medicine Critical thinking 0202 electrical engineering electronic engineering information engineering Physical therapy Medicine 030212 general & internal medicine Situational ethics business Competence (human resources) media_common |
| Zdroj: | Journal of Physical Therapy Education. 31:14-20 |
| ISSN: | 0899-1855 |
| DOI: | 10.1097/00001416-201731010-00005 |
| Popis: | BACKGROUND AND PURPOSEContemporary physical therapist (PT) practice assigns greater responsibility, accountability, and autonomy to the PT than ever before. State legislation in support of direct access-that is, patient self-referral to PT services without a prescription or referral from a physician-now exists in some form in all jurisdictions across the United States.1 Accuracy in clinical reasoning is essential in this open practice environment and is arguably more complex.Clinical reasoning is a critical skill2 required of PTs, but little is known contextually or developmentally about this skill. Clinical reasoning requires higher-order cognitive processing and mindfulness in context and about the process of thinking.3 Clinical reasoning is the "application of knowledge and clinical experience towards a clinical presentation to derive a solution."41?411 It is the "sum of critical thinking and decision-making processes associated with clinical practice."21?41 Success in reasoning requires scientific and research bases and reflective perspicacity in their application and outcomes for managing specific patient problems.5 Clinical reasoning is developmental; it is dependent on accumulated experiences, an ability to make inferences, and intuition.4,6,7 Reflection on reasoning in practice to derive additional knowledge and practice wisdom is an essential meta-skill for advancing clinical reasoning among novice and expert practitioners.2Competency in clinical reasoning is dependent on more than knowledge of practice and skill development. The capacity of an individual to initiate and regulate a clinical decision is dependent on that person's beliefs or perception of how well he or she can execute courses of action required to deal with prospective situations-that is, personal efficacy.8,9Personal efficacy-or self-efficacy-is an affective, self-referent quality that is inherent within an individual and that mediates interactive reasoning processes. Self-efficacy determines the activities in which a person chooses to engage, the amount of effort expended in a given situation, and the limits of participation on encountering adversity.10 Self-efficacy was initially presented by Bandura as a situation-specific theory.11 More recent research has differentiated general self-efficacy (GSE) and specific self-efficacy (SSE). General self-efficacy is a traitlike competence belief that is situation independent.12 It is "individuals' perception of their ability to perform across a variety of different situations"131?1701 or judgment of their capacity to handle events in their lives and deal with life's challenges.13 General self-efficacy is a stable construct reflective of cognition and other personality characteristics not associated with a specific task. It is conceived by some as an internal averaging of successes and failures attributed to the self.14 In contrast, SSE is a malleable, state-like motivational construct associated with goals, motivation, and situational anxiety.15 Belief in one's capacity as a PT to accurately reason about a patient's clinical presentation is a demonstration of SSE.The development of self-efficacy is reliant on varied experiences and, in particular, on performance accomplishments as well as verbal persuasion, vicarious experiences, and physiological state (eg, level of emotional arousal).11 Reflection on experiences is required for the development of self-efficacy. Given requisite skills and motivation, self-ef ficacy is known to directly influence academic achievement and effectiveness in clinical reasoning.9,11,16,17 Increases in self-efficacy are associated with higher levels of performance. In contrast, people with lower levels of self-efficacy experience greater struggles in task performance.17Specific self-efficacy is a more powerful predictor of behavior and performance and is more strongly linked to achievement than either outcome expectancies or past experiences. … |
| Databáze: | OpenAIRE |
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