About The Hypothesis oriented Algorithm for Clinicians II Part 1
The Hypothesis Oriented Algorithm for Clinicians II Part 1 was designed to give physical therapist clinicians a way to organize their thought processes when performing a patient examination (collecting patient data) and evaluation (formulating a diagnosis). The HOAC II was initially developed to facilitate better clinical reasoning by emphasizing the use of data in formulating hypothesis driven or pattern recognition strategies, which are commonly used by expert practitioners, with the goal of improving the diagnostic process and decreasing errors (Rothstein, et al., 2003). Studies have shown that the use of external frameworks such as the HOAC II that emphasize hypothetical deductive reasoning are able to provide scaffolding that allowed development of more sophisticated reasoning strategies (Gilliland, 2014).
Within the HOAC II algorithmic framework, Parts I and II, data collected from the patient and other sources of information are used to assist in developing hypotheses that guide the evaluative, diagnostic, and treatment processes associated with patient care. Part I of the HOAC II (HOAC II-1) framework is centered on the steps in the evaluative framework as presented in the Guide to Physical Therapist practice (American Physical Therapy Association, 1999). These steps consist of: examination, defined as the scientific collection of from the patient through evaluative tests and measures; evaluation, which includes disconfirming or confirming hypotheses generated from outside consultation and the examination process; integrating and synthesizing information from examination and evaluation to generate a series of diagnostic hypotheses, selecting the most appropriate hypothesis by synthesizing information from examination and evaluation, and finally, formulation of a prognosis that includes the plan of care. The plan of care within this framework includes considering: anticipated (future) patient problems that exist as a result of present problems, preventative measures to impact future impairments or disability, current problems related to impairments or functional disability that require immediate intervention, and documentation of expected improvements from the plan of care (American Physical Therapy Association, 1999, S35; Rothstein, et. al., 2003). Further, there is an emphasis on seeking referral if needed.
The HOAC II framework steps are utilized in the mobile application to support the process of hypothesis generation and are depicted by the buttons found in the mobile application. As a student works through the mobile application, they are directly following the sequence of reasoning suggested by the HOAC II-1.
References:
American Physical Therapy Association ( (Ed.). (1999). Guide to physical therapist practice (Vol. 77). American Physical Therapy Association.
Gilliland, S. (2014). Clinical reasoning in first- and third-year physical therapist students. Journal of Physical Therapy Education, 28(3). 64-77.
Rothstein, J. M., Echternach, J. L., & Riddle, D. L. (2003). The Hypothesis-Oriented Algorithm for Clinicians II (HOAC II): a guide for patient management. Physical Therapy, 83(5), 455-470.
Within the HOAC II algorithmic framework, Parts I and II, data collected from the patient and other sources of information are used to assist in developing hypotheses that guide the evaluative, diagnostic, and treatment processes associated with patient care. Part I of the HOAC II (HOAC II-1) framework is centered on the steps in the evaluative framework as presented in the Guide to Physical Therapist practice (American Physical Therapy Association, 1999). These steps consist of: examination, defined as the scientific collection of from the patient through evaluative tests and measures; evaluation, which includes disconfirming or confirming hypotheses generated from outside consultation and the examination process; integrating and synthesizing information from examination and evaluation to generate a series of diagnostic hypotheses, selecting the most appropriate hypothesis by synthesizing information from examination and evaluation, and finally, formulation of a prognosis that includes the plan of care. The plan of care within this framework includes considering: anticipated (future) patient problems that exist as a result of present problems, preventative measures to impact future impairments or disability, current problems related to impairments or functional disability that require immediate intervention, and documentation of expected improvements from the plan of care (American Physical Therapy Association, 1999, S35; Rothstein, et. al., 2003). Further, there is an emphasis on seeking referral if needed.
The HOAC II framework steps are utilized in the mobile application to support the process of hypothesis generation and are depicted by the buttons found in the mobile application. As a student works through the mobile application, they are directly following the sequence of reasoning suggested by the HOAC II-1.
References:
American Physical Therapy Association ( (Ed.). (1999). Guide to physical therapist practice (Vol. 77). American Physical Therapy Association.
Gilliland, S. (2014). Clinical reasoning in first- and third-year physical therapist students. Journal of Physical Therapy Education, 28(3). 64-77.
Rothstein, J. M., Echternach, J. L., & Riddle, D. L. (2003). The Hypothesis-Oriented Algorithm for Clinicians II (HOAC II): a guide for patient management. Physical Therapy, 83(5), 455-470.
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