Clinical reasoning and bio-psychosocial models

Duration

16h Th

Number of credits

Lecturer

Christophe Demoulin, Sébastien Wolfs

Language(s) of instruction

French language

Organisation and examination

Teaching in the first semester, review in January

Schedule

Schedule online

Units courses prerequisite and corequisite

Prerequisite or corequisite units are presented within each program

Learning unit contents

Course Content Current recommendations for the management of musculoskeletal disorders advocate a comprehensive, patient-centred approach, particularly one based on the biopsychosocial model. This course will address the different components of this model and their integration into the physiotherapist's clinical reasoning when assessing and managing patients with musculoskeletal disorders or pain.

The course aims to develop a structured and scientific clinical reasoning process, enabling students to progress from the collection of clinical information to therapeutic decision-making and patient reassessment.

The course will address the following topics:

• Patient history taking and the collection of relevant clinical data, as well as their analysis and interpretation, in order to formulate and test different clinical hypotheses;
  
  
• the principles of triage in physiotherapy, including the identification of situations requiring referral to, or additional management by, another healthcare professional;
  
  
• the formulation and justification of a physiotherapy diagnosis, based on information obtained from the patient history, clinical examination, and clinical reasoning process;
  
  
• the use of the International Classification of Functioning, Disability and Health (ICF) as a framework for conceptualising the patient's situation as a whole and integrating the different dimensions of the biopsychosocial model;
  
  
• the conceptualisation of the clinical situation, allowing the information collected to be organised and integrated in order to develop a coherent representation of the patient's condition and guide clinical decision-making;
  
  
• the development of an individualised therapeutic plan based on the physiotherapy diagnosis, including the definition and prioritisation of therapeutic goals and the selection of appropriate intervention strategies;
  
  
• the selection and implementation of a physiotherapy intervention consistent with the therapeutic goals, the patient's characteristics and preferences, and the available scientific evidence;
  
  
• the reassessment of the patient and the effects of the intervention in order to confirm or challenge clinical hypotheses and adapt the diagnosis, goals, and therapeutic plan accordingly;
  
  
• the integration of Evidence-Based Practice (EBP) principles into clinical reasoning and decision-making by combining the best available scientific evidence, clinical expertise, and the patient's characteristics, values, and preferences;
  
  
• the development of scientific reasoning, particularly through the critical analysis of available information, the formulation and testing of hypotheses, and the continuous updating of knowledge required for evidence-based practice;
  
  
• the use of shared and structured professional terminology, particularly through the ICF, to facilitate the conceptualisation, justification, and communication of clinical reasoning among healthcare professionals.
  
  

Learning outcomes of the learning unit

Learning Objectives By the end of the course, students will be able to:

• Understand and apply the biopsychosocial model to the assessment and management of patients with musculoskeletal disorders, taking into account the interactions between biological, psychological, and social factors.
  
  
• Identify and consider psychosocial factors that may influence pain, functional limitations, recovery, and response to treatment.
  
  
• Develop a structured clinical reasoning process for the assessment and management of musculoskeletal disorders and pain, particularly based on the Mitchell model.
  
  
• Collect, analyse, and interpret relevant clinical information obtained from the patient history, clinical examination, and other available sources in order to formulate and test clinical hypotheses.
  
  
• Perform and adapt a relevant functional assessment according to the information collected, the patient's progress, and the hypotheses generated through the clinical reasoning process.
  
  
• Formulate and justify a physiotherapy diagnosis, integrating clinical, functional, and contextual information, as well as the patient's expectations and goals.
  
  
• Apply the International Classification of Functioning, Disability and Health (ICF) to develop a comprehensive understanding of the patient's situation, including body functions and structures, activities, participation, as well as personal and environmental factors.
  
  
• Develop an individualised and coherent treatment plan based on the physiotherapy diagnosis, defining and prioritising relevant therapeutic goals.
  
  
• Select and implement appropriate therapeutic interventions consistent with the physiotherapy diagnosis, the defined goals, the patient's individual characteristics, and the available scientific evidence.
  
  
• Reassess the patient's progress and the effectiveness of the intervention, and subsequently adapt the assessment, clinical hypotheses, therapeutic goals, and treatment plan according to the outcomes.
  
  
• Adopt an Evidence-Based Practice (EBP) approach, integrating current and relevant scientific evidence, clinical expertise, and the patient's characteristics, values, and preferences into the clinical reasoning and decision-making process.
  
  
• Use precise and shared professional terminology to describe, justify, and communicate clinical reasoning, the physiotherapy diagnosis, therapeutic goals, and treatment decisions.
  
  

Prerequisite knowledge and skills

Basics of anatomy, biomechanics, physiology and physiopathology

Planned learning activities and teaching methods

• Courses ex cathedra
• Discussions
• Questions and answers.
• Videos
• Demonstrations
• Clinical cases
• Activities in small groups

Mode of delivery (face to face, distance learning, hybrid learning)

Face-to-face course

Course materials and recommended or required readings

Various reference books can be recommended such as :
-  "Clinical Reasoning in musculoskeletal practice" by Mark A Jones and Darren A Rivett
- "Explain Pain Supercharged" by L. Moseley and D. Butler
"Evidence based practice en rééducation: Démarche pour une pratique raisonnée" by Adrien Pallot

Exam(s) in session

Any session

- In-person

written exam ( multiple-choice questionnaire, open-ended questions )


Further information:

Exam(s) in session

Any session

- In-person

written exam (T-F, open-ended questions )


Additional information:

This course is subject to a written exam. The questions may cover the entire subject.

Work placement(s)

None.

Organisational remarks and main changes to the course

See timetable at the beginning of the semester.

Contacts

Prof DEMOULIN C. - ISEPK - Bât. B21
Tél : 04/366.38.95 - email : Christophe.Demoulin@uliege.be
WOLFS S. - ISEPK - Bât. B21 
email : sebastien.wolfs@uliege.be
 
Secretary :  Annette HANSSEN or Steve JASPAR (04/366.38.97) or Annie DEFAIFVE (04/366.38.90)
Pedagogic coordinator : sebastien.wolfs@uliege.be

Association of one or more MOOCs