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Transcending parts to see a whole – Humpty Dumpty represents us all
Published in Johanna Lynch, A Whole Person Approach to Wellbeing, 2020
In a clinical encounter, the practitioner needs to keep track of Humpty’s needs as well as their own needs for pattern recognition (Launer 1999). This process requires a means to manage attention in the face of complexity. Those who study the clinical method highlight this challenge: In the course of the clinical encounter, the clinician attends to some things and ignores others. The clinician’s attention is selective and the object of attention is thematic for that moment.(Sadler and Hulgus 1992, 1316)
Education and Training
Published in John Fry, Nat Yuen, Principles and Practice of Primary Care and Family Medicine: Asia-Pacific Perspectives, 2018
Wesley Fabb, Goh Lee Gan, Nat Yuen
Clinical disciplines evolved as consensus was reached amongst members of the discipline about the main medical problems that those disciplines could address, and the knowledge needed to deal with them. For general practitioners, the main clinical problems reside in the community and encompass not only curative care but rehabilitation and preventive care as well. There is a defined clinical method, and established areas for research. There are research questions which can be addressed only from within the discipline of family medicine.
Facing an Incurable Condition
Published in Brown Judith Belle, Challenges and Solutions: Narratives of Patient-Centered Care, 2017
This case also illustrates the process by which a primary care physician uses a clinical method to assess and investigate undifferentiated presenting symptoms. At first, common hypotheses are formed and verified. If these do not fit, it is often follow-up over a period of time, coupled with keen observation and attentiveness, that will lead to a clearer understanding and definition of the patient’s problems. These include not only a physical disease process, which in this case happened to be irreversible, but also the impact of that disease on the patient’s function, person and family.
CPE for leaders: Adapting Clinical Pastoral Education’s learning methodology for healthcare managers and directors
Published in Journal of Health Care Chaplaincy, 2022
Jo Hirschmann, David W. Fleenor, Rachel Van Thyn, Vansh Sharma
CPE is typically designed to teach pastoral care skills to seminarians, religious professionals, and those seeking to become professional chaplains. In CPE for Leaders, our goal wasn’t to teach pastoral care skills but, rather, to use CPE’s learning methodology to help students deepen their capacity for attunement to self and others in their roles as healthcare leaders. In CPE circles, this learning methodology is frequently referred to as the clinical method of learning. We are not aware of any references to this learning methodology in the research literature. However, we understand it to be similar to the experiential learning cycle, a pedagogical method developed by David Kolb, which takes learners through a continual four-step process of experiencing, reflecting, thinking, and acting (Kolb & Kolb, 2017). As Table 1 illustrates, we modified the ACPE’s Level I Learning Outcomes to reflect participants’ professional practice as healthcare leaders.
Extraocular Muscle Transplantation for Primary Treatment of Large-Angle Exotropia
Published in Journal of Binocular Vision and Ocular Motility, 2021
Shailja Tibrewal, Rajat Kapoor, Soveeta Souravee Rath, Virender Sachdeva, Ramesh Kekunnaya
The results of our study must be interpreted considering its limitations. We have a small sample size; however, we tried to homogenize it by excluding those patients with bilateral surgery and including only those with physiological amounts of lateral rectus muscle recession and medial rectus muscle resection. Multiple surgeons were involved in the study, which may have led to the variability in the technique and thus results. However, we considered the length of elongation obtained after anastomosis of the graft with the lateral rectus muscle considering any loss of tissue due to surgical technique or shrinkage. This reduced the error in the calculation of the correction/mm of surgery performed. The grading of extraocular motility limitation was performed using a subjective clinical method, which could have led to some variability in measurements. Finally, we cannot make a direct comparison between primary muscle transplantation and other surgical options for large angle exotropia, and future studies are warranted for the same.
Clinician–patient relationships after two decades of a paradigm of patient-centered care
Published in International Journal of Healthcare Management, 2021
Riaz Akseer, Maureen Connolly, Jarold Cosby, Gail Frost, Rajwin Raja Kanagarajah, Swee-Hua Erin Lim
The patient-centered clinical method allows physicians to listen to a patient’s stories and explore a patient’s experience of illness. Physicians enter the patient’s world and grasp the uniqueness of the patient’s experience of illness, and understanding of what illness means for them (i.e. emotions, feelings, beliefs, expectations, goals and barriers) in order to effectively provide diagnosis and treatment, leading to better clinical outcomes [6,24,25]. Patient-centeredness as an approach strongly supports individualistically oriented Western cultural views where patients actively participate in a diagnostic interview, establish a mutually respectful working relationship with their physician and participate in joint decision-making, all of which can be adopted if the interactions are indeed reciprocal and mutual. This approach does not seem to be equally effective in communicating with patients from non-Western cultures. Studies such as the one by Kim, Smith and Yueguo [26] support a decision-making process based on a patient’s preference as a preferred method for physician interaction with patients from non-Western cultures.