Clinical Decision Making and Differential Diagnosis (402-A)

As physical therapy seeks to clarify its professional responsibilities by providing education at the clinical doctoral level, emphasizing diagnostic skills, and providing direct access care, a necessary component is accuracy in communicating these responsibilities. The course will cover the principles and methods of clinical screening in physical therapy practice. A basic format for musculoskeletal, neuromuscular, Integumentary, and cardiopulmonary screening in physical therapy will be presented, with a focus on differential diagnosis within the scope of physical therapy practice, and incorporation of the role of the physical therapist as it interfaces with the role of the physician. A clarification of red-flags that differentiate a systemic condition from a neuro-musculoskeletal condition will be a continuing theme throughout the course. Decision-making skills related to physical therapy will be emphasized through the use of patient case scenarios with a focus on when to treat, and when to refer. Strategies to effectively and appropriately communicate with health care colleagues and patients regarding medical diagnostic information and medical status will be introduced.

See Course Outline for more details.

Learning Outcome:

By the time the students finish the course, they will be able to

Demonstrate the ability to analyze and interpret the principles and methods of clinical screening in physical therapy practice.
Demonstrate the ability to understand the differential diagnosis of musculoskeletal, neuromuscular, Integumentary, and cardiopulmonary disorders with a focus on the scope of physical therapy practice, the role of the physician, and referral.
Demonstrate the ability to learn advanced decision-making skills related to physical therapy with a focus on when to treat, and/or when to refer.
Demonstrates superior ability to obtain and organize all parts of a clinical history
Demonstrates superior ability to summarize the clinical history and present to the attending and the patient in an appropriately organized way.
Consistently demonstrates the ability to listen carefully by accurately communicating information presented
Demonstrate the ability to form an excellent doctor-patient relationship with patients from different cultural, racial, and ethnic, gender, and sexual orientation consistently
Communicates effectively and compassionately with patients and family in all three modalities (nonverbal, verbal, and written)
Demonstrates ability to perform a full or focused physical examination on any patient in a logical sequence appropriate for the clinical problem directed from the clinical history and visit type/time
Demonstrates the ability to utilize clinical findings to prioritize additional anatomical and physiological testing in a systematic and logical way.
Demonstrates the ability to complete a written H&P or SOAP note with a good problem list and careful differential diagnoses.
Demonstrates the ability to describe a well-designed plan of management in any patient with acute or chronic illness
Demonstrates the ability to correlate the findings of a patient at clinical presentation
Demonstrates the ability to recognize and explain both typical and atypical presentations for commonly seen clinical conditions
Demonstrates the ability to order appropriate diagnostic tests needed to facilitate both diagnosis and evaluative response to therapy in a cost- and time-effective manner.
Demonstrates the ability to analyze the interpretation of diagnostic tests.

Reading/Reference Books:

Goodman CC, Snyder TEK. Differential Diagnostics for Physical Therapists: Screening for Referral. Saint Louis, MO: Saunders: Elsevier; 2006. ISBN: 978-0-7216-0619-4 (Click to Download)
APTA. Guide to Physical Therapy Practice: Revised second edition. Alexandria, VA: American Physical Therapy Association; 2003. ISBN: 978-1-887759-85.