The Development of Pattern Recognition via Clinical Experience: A Preliminary Study

Introduction: Pattern recognition is a process whereby illness scripts are rapidly retrieved in response to attempting to recognize a clinical problem at hand. Although adeptness in clinical reasoning is not strictly related to years of clinical experience, pattern recognition as a part of such reasoning does require prior clinical experience if a repertoire of illness scripts is to be built up. Clinical experience provides the clinician with opportunities to link subjective description to objective findings and thus to appreciate the significance of changes in subjective findings. Objective: To investigate how pattern recognition develops through clinical experience. Method: 31 participants (10 undergraduate students and 21 clinicians) were surveyed via three rounds of questionnaires designed according to the Delphi technique to elucidate treatments for osteoarthritis of the knee and for Colles fracture after surgery. Consensus was considered achieved if 75% of the responses agreed. Result: For treatment of osteoarthritis of the knee, 72 items proposed by the students converged to 20 items, and 129 items proposed by the clinicians converged to 41. For postoperative care of Colles fracture, 41 items proposed by the students were reduced to 19 items while the clinicians honed 88 items down to 35 through three rounds of survey. Conclusion: The quasi-Delphi did enable both students and clinicians to achieve consensus. Whereas the students came up with relatively vague items, the clinicians described concrete problems that patients encounter. Such differences suggest instances of narrative and diagnostic reasoning that might be incorporated into physical therapy education.