Clinical Applications of Self-Monitoring by Experienced and Novice Pédiatrie Physical Therapists

Abstract

Scholars in a variety of disciplines propose that self-monitoring is a key characteristic of sound decision making. In this study we explore and illustrate how three experienced and three novice pédiatrie physical therapists monitor their practice. These clinicians were videotaped during 48 hourly sessions with 18 children who were diagnosed with diplegic cerebral palsy. Then, videotapes were used to elicit retrospective think-aloud dialogues that were transcribed, coded, and analyzed to: 1 ) assess the frequency and clinical characteristics of self-monitoring, 2) calculate the percentage of positive verbalizations, and 3) determine if therapists verbalize an advanced form of self-monitoring called dialectical processing. Treatment videotapes of the experienced clinicians were analyzed further to highlight and illustrate how they monitor themselves during treatment. Findings revealed that experienced and novice clinicians verbalize self-monitoring about every three minutes. Experienced clinicians were positive in verbalizing self-monitoring 81% of the time, whereas, novices were positive 36% of the time. Self-monitoring was verbalized in conjunction with other characteristics of decision making by experienced clinicians a mean of 84% of the time and by novices 57% of the time. Examples of transcribed data suggest some clinicians used dialectical processing. Findings suggest self-monitoring is an important and pivotal characteristic of clinical decision making and appears to be used by clinicians to develop, enhance, and refine their repertoires of treatment procedures.