Integrating knowledge and improving clinical reasoning

This is an older, but still very relevant, posting about how to best integrate new knowledge within the broad field of manual therapy. With so many diverse streams of information, and instructors sometimes teaching with extreme bias to their techniques, how do we best integrate and synthesize this information?

http://download.journals.elsevierhealth.com/pdfs/journals/1356-689X/PIIS1356689X99901959.pdf

A few quotes...

"participants need to maintain their vigilance, and critically evaluate and question the material presented"...

"should demand evidence of speakers and objectively examine their arguments in the light of current scientific understanding, whilst keeping an open mind to new ideas, even if they seem to contradict previously accepted notions."

"the successful management of many clinical problems requires well-developed clinical reasoning, often drawing on a number of manual therapy approaches."

Early NOIJAM Blog post: Straining Scientist - Clinician Relationships

For those of you that already subscribe to the Neuro Orthopedic Institute (NOI) Group newsletter, you will have already been informed in the last few days about their new blog: NOIJAM (www.noijam.com).  It sounds as though David Butler is taking the lead on this blog and facilitating good discussion through it.  Very exciting!  Make sure to bookmark this one.

In their words:
"This blog is for clinicians in the world of science.
NOI jam is about:
• providing an open liberal discussion forum led by experienced clinicians, focusing on the treatment of ongoing pain states via nervous system changing therapies based on movement and education
• facilitating findings from science into clinical decision making,
• enhancing links between clinicians and researcher,
• bringing researchable ideas from the clinic to the fore."

The posting on Feb 1st titled "Straining Scientist - Clinician Relationships" (http://noijam.com/2013/02/01/straining-scientist-clinician-relationships/) has been particularly interesting so far.  David Butler has lead off with some things that scientists should be looking for from their relationships with clinicians, and some of the responses so far have pitched the ball right back at clinicians and the level of evidence-based scrutiny we require when treating patients.  Very great points and excellent food for thought as we continue to become better clinicians and researchers.

Contextually, at GF Strong we really are fortunate to have relatively easy access to researchers.  We have ample opportunities to create momentum towards having our research questions explored, and to get involved with research that is already underway in areas of our interest.  

Additionally, there is currently hot debate on the value of core activities like stretching to improve range of motion or reduce contracture.  Clinicians are attempting to decipher a Cochrane review with generally limited experience in doing so. Clearly, as our profession moves forward, clinicians are going to have to become adept at understanding research, sifting through research recommendations, and integrating them into our clinical decision making.  

Every clinician is capable of single subject research design, and I can't help but think that this might be part of the middle ground.  The practice of developing ideas about what we expect from our treatments, collecting key information about them, and presenting it, is part of the work of being a clinician.  Anyone have any ideas about how to be more organized about it?  How to find the time? Perhaps a separate posting about it (single subject research design) in the near future is warranted.