临床医师对Farrell等人的评论(1)。

A. Agur
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引用次数: 0

摘要

临床解剖学是肌肉骨骼(MSK)物理治疗师的基础科学。最佳实践是基于知情的治疗策略,严重依赖于广泛和最新的MSK解剖学知识。Farrell及其同事的这项新研究1调查了门诊物理治疗师对临床解剖学资源的使用情况,其结果对于确定毕业后在这一领域进行的自主学习的程度非常重要。经验丰富的物理治疗师使用资源的频率明显低于经验不足的同事,这一发现可以从很多方面加以解释。也许更有经验的物理治疗师认为不需要进一步的临床解剖学教育,他们认为解剖学是一门“教科书科学”,应该从教科书中学习,而不是从研究文献中学习。在光谱的另一端,可能是目前的临床文献,包括相关的基础科学研究,由于高订阅率而相对难以获得。开放获取的论文很容易获得,但要想从许多专门的期刊上获得文章,需要进入订阅这些期刊的图书馆,或者从出版商那里购买或租用文章。这可能代价高昂,因为学生的图书馆特权在毕业时就被终止了。与澳大利亚(法雷尔和他的同事在那里执业)不同,加拿大没有“全州卫生部门在线资源门户”,这可能进一步限制了能够访问在线图书馆资源的物理治疗师的数量。鼓励学生成为终身学习者是专业课程的重要目标。Farrell和他的同事们指出,“临床推理需要对适当的临床主题有透彻的理解”,但他们的研究结果表明,对病理特异性MSK解剖结构有更深入的了解,对一些从业者来说可能不是优先考虑的事情。临床解剖学是一门活生生的、不断发展的科学,因此,所有的从业者都应该努力跟上当前文献的步伐,以便将研究结果整合到他们的临床实践中。教科书是有用的参考,但研究文献是推进循证实践的关键。我祝贺作者们出色地研究了物理治疗师对临床解剖学的行为和态度。他们的研究结果支持开发更好的资源,使物理治疗社区更容易获得,从而实现终身学习,并将研究成果整合到临床实践中。
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Clinician's Commentary on Farrell et al.(1).
Clinically based anatomy is a foundational science for musculoskeletal (MSK) physiotherapists. Best practices are based on informed treatment strategies that rely heavily on an extensive and up-to-date knowledge of MSK anatomy. The results of this novel study by Farrell and colleagues,1 which investigated the use of clinical anatomy resources by outpatient physiotherapists, are important in identifying the extent of self-directed learning that is taking place in this area after graduation. The finding that more experienced physiotherapists used resources significantly less frequently than their less experienced colleagues can be interpreted in many ways. Perhaps more experienced physiotherapists do not see a need for further clinical anatomy education and view anatomy as a “textbook science,” to be studied from textbooks rather than from the research literature. On the opposite end of the spectrum, it may be that current clinical literature, including relevant basic science studies, is relatively inaccessible as a result of high subscription rates. Open-access papers are readily available, but obtaining articles from many specialty-specific journals requires access to a library that subscribes to these journals or purchasing or renting articles from the publisher. This can be costly, as students' library privileges are terminated on graduation. Canada, unlike Australia (where Farrell and colleagues practise), does not have a “statewide health department online resource portal,” which may further limit the number of physiotherapists who can access online library resources. Encouraging students to become lifelong learners is an important goal of professional programmes. Farrell and colleagues state that “clinical reasoning demands a thorough understanding of the appropriate clinical subject matter,” but the results of their study suggest that gaining deeper insight into pathology-specific MSK anatomy may not be a high priority for some practitioners. Clinical anatomy is a living and evolving science, and all practitioners should therefore strive to keep abreast of the current literature, with a view to integrating the findings into their clinical practice. Textbooks are useful references, but the research literature provides the key to advance evidence-based practice. I congratulate the authors on their excellent study exploring physiotherapists' behaviour and attitudes toward clinical anatomy. Their findings support the development of better resources with greater accessibility to the physical therapy community, enabling lifelong learning and the integration of research findings into clinical practice.
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