Jan Gwyer - Academia.edu (original) (raw)

Papers by Jan Gwyer

Journal of Physical Therapy Education, Oct 1, 2012

Physical Therapy, Jun 1, 1982

Journal of Physical Therapy Education, Apr 1, 2012

ABSTRACT Critical care nutrition guidelines have been developed to help busy practitioners decide... more ABSTRACT Critical care nutrition guidelines have been developed to help busy practitioners decide how to feed their critically ill patients. However, despite the publication of guidelines and efforts to disseminate and implement them, there are large gaps between what the recommendations say and what is happening at the bedside. Consequently, the nutrition therapy received by many patients remains suboptimal. Knowledge translation is a term increasingly used in healthcare to describe the process of moving evidence learned from clinical research and summarized in clinical practice guidelines to incorporation into clinical and policy decision making. In this article, knowledge about the implementation of critical care nutrition guidelines is applied to Graham et al's knowledge-to-action model to illuminate the issues pertinent to knowledge translation in critical care nutrition. This model has 2 components: knowledge creation and action. The action component consists of 8 phases of the action cycle that represent activities needed to move knowledge into practice and are derived from planned-action theory. Components of this model are illustrated via empirically derived research, commentaries, and published studies from the field of critical care nutrition. It is hoped that this article and related articles in this issue of JPEN will help critical care nutrition practitioners to better understand the often complex and convoluted road of translating knowledge into practice so that as a community we are no longer "lost" but have direction that can bring about positive changes in nutrition practice.

Journal of Physical Therapy Education, Oct 1, 2011

Physical Therapy, Feb 1, 1993

Physical therapy, 2000

The purpose of this qualitative study was to identify the dimensions of clinical expertise in phy... more The purpose of this qualitative study was to identify the dimensions of clinical expertise in physical therapy practice across 4 clinical specialty areas: geriatrics, neurology, orthopedics, and pediatrics. Subjects were 12 peer-designated expert physical therapists nominated by the leaders of the American Physical Therapy Association sections for geriatrics, neurology, orthopedics, and pediatrics. Guided by a grounded theory approach, a multiple case study research design was used with each of the 4 investigators studying 3 therapists working in one clinical area. Data were obtained through nonparticipant observation, interviews, review of documents, and analysis of structured tasks. Videotapes made during selected therapist-patient treatment sessions were used as a stimulus for the expert therapist interviews. Data were transcribed, coded, and analyzed through the development of 12 case reports and 4 composite case studies, one for each specialty area. A theoretical model of exper...

Qualitative Research in Evidence-Based Rehabilitation, 2004

The putpose of this qualitative case study was to further investigate the work of muster and noui... more The putpose of this qualitative case study was to further investigate the work of muster and nouice clinicians within the practice setting. The sample consisted of three master clinicians and three novice clinicians practicing in orthopedic outpa- tient physical therapy settings in three dz&-ent regions of the United States. Data collection by three researchers included observation of each clinician treating at least three patients, audiotaping of all treatment sessions, intmews with clini- cians and patients, and a review of patient records. Analysis of the data within and across cases revealedjve attribute dimensions that dktingulshed the master clinician from the novice clinician. One attribute dimmon (ie, confidence in predicting patient outcomes) related to knowledge, and four attribute dimensions (ie, ability to control the environment, evaluation and use of patient illness and disease data, focus of verbal and nonverbal communication with patients, and importance of teaching ...

Qualitative Health Research, 1999

In this article, the authors demonstrate how grounded theory may be used to develop models for un... more In this article, the authors demonstrate how grounded theory may be used to develop models for understanding clinical practice. Through a series of research studies involving novice, experienced, and expert physical therapy practitioners, conceptual frameworks were continually revised based on data obtained from returning to the field and relevant literature available at the time. As concepts and relationships moved to larger themes, a theoretical framework for expertise in clinical practice was proposed. Current work on verifying the theoretical framework continues. Grounded theory is an excellent research approach to bound and help guide a multistage research program involving multiple researchers working in multiple settings.

Journal of Physical Therapy Education, 2003