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Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
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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