resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
June, 2009, Vol. 09, Issue 06
Thinking in Practice
By Keith Eric Grant, PhD, NCTMB
"Experts see the world differently. They see things the rest of us cannot. Often experts do not realize that the rest of us are unable to detect what seems obvious to them." Gary Klien, author of Sources of Power: How People Make Decisions.
The world of learning has long fascinated me. I've taken the opportunity to walk it from a number of different perspectives: a physics graduate student; a research scientist; a massage student, practitioner and instructor; a martial arts student and teacher; a music student; and a folk dancer. My experience has thus spanned both the academic and experiential realms; both the conceptual and the kinesthetic. And out of all these experiences, one lesson has become clear (and applied in multiple realms): You cannot just pour information into a student and expect it to become magically useful.
Creating useful skills requires skill practice in context, and requires changing the manner in which the student uses their mind and senses to perceive the world. Without this context, information lies dormant, unconnected and unusable outside of the academic realm. I've had the opportunity to verify in my own experience that "experts see the world differently,"1 just as Gary Klein, senior scientist at Applied Research Assoicates, concluded from his field research. This change in perception is not a result of classroom lectures, but a result of guided participation. If we want to create skilled massage practitioners, we cannot just talk at students or be satisfied when they have memorized definitions and phrases from books. We must encourage and guide them in gaining patterns of tactile memory coupled with active awareness of what they are encountering.
From his research, Klein summarizes what differentiates the novice from the expert into three aspects: a history of experienced patterns; the ability to project the effects of an intervention; and a tuning of sensory discrimination. "These aspects of learning can be tied to the two primary sources of power we have been examining: pattern matching and mental simulation. Pattern matching (intuition) refers to the ability of the expert to detect typicality and to notice events that did not happen and other anomalies that violate the pattern. Mental simulation covers the ability to see events that happened previously and events that are likely to happen in the future. We also encounter some additional sources of power. The ability to make fine discriminations must involve some sort of perceptual learning."1
In a recent book, Think Again,2 authors Sidney Finkelstein, Jo Whitehead, and Andrew Campbell drew on Klein's research and other sources of neurological and cognitive research to better understand failures of decision. One of the things they noted is that experts rarely compare alternative actions. Instead, an expert will move directly to what experience indicates to be a viable solution. This can be both a strength and a weakness: a strength in that it generally produces a correct action quickly, and a weakness because it can also be the cause of occasionally missing alternatives or misidentifying a situation. One interesting aspect of this process is that most of the cognition happens at an unconscious level, as in the following quote taken from Think Again:
"Klein discovered that people with experience do most of their decision making unconsciously. They assess the situation by drawing on similar experiences from their memory, but much of this assessment process happens unconsciously. They then select a course of action from their memories of past actions. Finally, they test the practicality of this course of action by imagining what will happen if the action is taken. The imagining activity is the main conscious work that happens during a decision. What Klein had discovered is that we mostly make decisions unconsciously using experience, intuition, and imagination. We do not normally do much conscious analysis, such as identifying and comparing options or challenging assumptions and initial assessments."2
The conscious level of processing is primarily used only in unfamiliar situations and, for decisions where there is time, for consciously cross-checking the faster, unconscious process. It's fair to ask if this really is the case in health care. The answer provided for nursing, from over a decade of study by Patricia Benner and colleagues is a definite yes. The following is an excerpt from a book written by Benner, et al Expertise in Nursing Practice3:
"As a process, the diagnosis-treatment model was simply not apparent in the narrative accounts provided by nurses at any level, but clearly not in those by nurses practicing at the expert level. The judgments were rather characterized by immediate apprehension of the clinical situation, progressive understanding of the patient's story through his narrative accounts, and the capacity to notice qualitative changes by knowing the patient's pattern of responses; nursing actions were typically response-based, relying on whole intuitions of what had worked in past similar situations, and modified in accordance with this particular patient's responses to it. In this kind of fluid, skillful response, there was virtually no evidence of 'treatment' based on explicit nursing diagnoses."3
The above in no way diminishes the usefulness of anatomical information and abstract knowledge of techniques. What it does indicate is that, like pouring the molten bronze for a cast statue, the usefulness and integrity of the end result is only as good as the containing mold created by practice and experience. Without such a mold, all that is obtained for either statue or learning is a puddle of slag.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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