Weighing the Evidence: Clinical Decision Making in Neurological Physical Therapy

Abstract

Purpose: The purpose of this study was to explore (1) the processes that neurological physical therapists go through in making dayto-day clinical decisions and (2) the sources of information or evidence that therapists use in their day-to-day practice. Method: A qualitative, grounded theory method was used consisting of semistructured, face-to-face in-depth interviews with 12 neurological physical therapists practising in a variety of settings in the Greater Toronto Area. Data were analyzed using a constant comparative approach. Results: Therapists weigh a variety of informal and formal sources of evidence as they go about their day-to-day practice. Our results fall into three main categories: (1) sources of evidence weighed, (2) when and why therapists weigh the evidence, and (3) factors that influence the process of weighing the evidence. Conclusions: The results of this study indicate that implementing evidence-based practice will be a challenge to the physical therapy profession unless we broaden our definition of evidence to include informal sources of evidence that are highly valued by clinicians.