resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.