| Store Copy of Decision making and the bedside assessment: the speech-language therapist’s thinking when making a diagnosis at the bed |
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Objective: To explore how value needs to be placed on the decision-making abilities of the speech-language therapist (SLT) rather than on the assessment measure itself. Method: A mixed methodology concurrent triangulation design was utilised in two phases. Firstly, seven SLTs were observed conducting assessments using a standardised bedside measure together with pulse oximetry and cervical auscultation. Secondly, a focus group discussion was held, based on the findings from the first phase. Results: The following factors were found to influence the decision-making process at bedside: bedside assessment data sets, patient, multidisciplinary team, context and then SLT. The availability of more data sets improved the confidence of the SLT in making clinical decisions. Clinical instincts are developed through experience. Conclusion: A bedside assessment can provide valuable information that will allow for diagnostic decisions to be made at bedside. This study highlighted the importance of critical thinking using clinical instincts, and that these factors need to be valued and emphasised rather than the assessment measures themselves.
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