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REVIEW PAPER
What methods are being used to teach clinical reasoning in physical therapy
education and are they effective? A systematic review of literature
1
Physical Therapy Department, Misericordia University, Dallas, PA, USA
2
Physical Therapy Department, University of Scranton, Scranton, PA, USA
Submission date: 2022-10-06
Acceptance date: 2023-02-03
Publication date: 2023-08-30
Physiother Quart. 2023;31(3):20-29
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Development of clinical reasoning (CR) is a critical skill for physical therapy (PT) students. A consensus of the most effective way to teach CR is lacking. The purpose of this study was to identify educational methods that PT education programs in the United States and abroad are utilising to develop CR skills and compare the effectiveness of those methods.
Methods:
Preferred Reporting Items for Systematic Review (PRISMA) guidelines were followed. A literature search was conducted in September 2021 and March 2022 in the following databases: PubMed, CINAHL, Health Source: Nursing/Academic Edition, and Academic Search Ultimate (EBSCO). Articles that investigated instructional methods used to teach and measure CR in PT students were included. Data extracted included instructional method details and results of outcome measures used to assess CR.
Results:
Of 324 articles, 12 met eligibility. Instructional methods included simulated patients (n = 3), case activities (n = 6), patient care activities (n = 2), and curriculum design considerations (n = 2). Results suggested that CR performance improved with all but was better when students worked in dyads or groups (n = 3). A variety of outcome measures were used to assess CR, the majority relying on student self-assessment of CR skills.
Conclusions:
This systematic review illustrates great variety in the methods used to teach and measure CR in PT education, all of which resulted in improved CR. Further research comparing the effectiveness of teaching methods and the reliability and validity of outcome measures of CR is needed.
Development of clinical reasoning (CR) is a critical skill for physical therapy (PT) students. A consensus of the most effective way to teach CR is lacking. The purpose of this study was to identify educational methods that PT education programs in the United States and abroad are utilising to develop CR skills and compare the effectiveness of those methods.
Methods:
Preferred Reporting Items for Systematic Review (PRISMA) guidelines were followed. A literature search was conducted in September 2021 and March 2022 in the following databases: PubMed, CINAHL, Health Source: Nursing/Academic Edition, and Academic Search Ultimate (EBSCO). Articles that investigated instructional methods used to teach and measure CR in PT students were included. Data extracted included instructional method details and results of outcome measures used to assess CR.
Results:
Of 324 articles, 12 met eligibility. Instructional methods included simulated patients (n = 3), case activities (n = 6), patient care activities (n = 2), and curriculum design considerations (n = 2). Results suggested that CR performance improved with all but was better when students worked in dyads or groups (n = 3). A variety of outcome measures were used to assess CR, the majority relying on student self-assessment of CR skills.
Conclusions:
This systematic review illustrates great variety in the methods used to teach and measure CR in PT education, all of which resulted in improved CR. Further research comparing the effectiveness of teaching methods and the reliability and validity of outcome measures of CR is needed.
REFERENCES (28)
1.
The Clinical Reasoning and Curricula Assessment Consortium. The American Council of Academic Physical Therapy. Available 04.06.2023 from: https://acapt.org/about/consor....
2.
Young M, Thomas A, Gordon D, Gruppen L, Lubarsky S, Rencic J, et al. The terminology of clinical reasoning in health professions education: Implications and considerations. Med Teach. 2019;41(11):1277–1284; doi: 10.1080/0142159X.2019.1635686.
3.
Young M, Thomas A, Lubarsky S, Ballard T, Gordon D, Gruppen LD, et al. Drawing boundaries: the difficulty in defining clinical reasoning. Acad Med. 2018;93(7):990–995; doi:10.1097/ACM.0000000000002142.
4.
Clinical Reasoning Fact Sheet. ACAPT Clinical Reasoning Curriculum and Assessment Research Consortia. Available June 4, 2023 from: https://acapt.org/docs/default....
5.
Higgs J. A programme for developing clinical reasoning skills in graduate physiotherapists. Med Teach. 1993;15(2–3):195–205; doi: 10.3109/01421599309006714.
6.
Delany C, Golding C. Teaching clinical reasoning by making thinking visible: an action research project with allied health clinical educators. BMC Med Educ. 2014;14:20; doi: 10.1186/1472-6920-14-20.
7.
Cook DA, Reed DA. Appraising the quality of medical education research methods: the Medical Education Research Study Instrument and the Newcastle-Ottawa-Scale-Education. Academic Medicine. 2015;90(8):1067–1076; doi: 10.1097/ACM.0000000000000786.
8.
Letts L, Wilkes S, Law M, Stewart P, Bosch J, Westmoreland M. Critical Review Forms – Qualitative Studies (version 2.0). McMaster University; 2007. Available 04.06.2023 from: https://www.unisa.edu.au/conte....
9.
Seif G, Coker-Bolt P, Kraft S, Gonsalves W, Simpson K, Johnson E. The development of clinical reasoning and interprofessional behaviors: service-learning at a student-run free clinic. J Interprof Care. 2014;28(6):559–564; doi: 10.3109/13561820.2014.921899.
10.
Gillardon P, Zipp GP. A proposed strategy to facilitate clinical decision making in physical therapist students. J Phys Ther Educ. 2002;16(2):57–63; doi:10.1097/00001416-200207000-00009.
11.
Ladyshewsky RK. A quasi-experimental study of the differences in performance and clinical reasoning using individual learning versus reciprocal peer coaching. Physiother Theory Pract. 2002;18(1):17–31; doi: 10.1080/095939802753570666.
12.
Seif GA, Brown D, Annan-Coultas D. Fostering clinical-reasoning skills in physical therapist students through an interactive learning module designed in the moodle learning management system. J Phys Ther Educ. 2013;27(3):32–40; doi:10.1097/00001416-201307000-00006.
13.
O’Dell B, Mai J, Thiele A, Priest A, Salamon K. The hot seat: challenging critical thinking and problem-solving skills in physical therapist students. Internet J Allied Health Sci Pract. 2009;7(1):1–10; doi: 10.46743/1540-580X/2009.1230.
14.
Willis BW, Campbell AS, Sayers SP, Gibson K. Integrated clinical experience with concurrent problem-based learning is associated with increased clinical reasoning of physical therapy students in the United States. J Educ Eval Health Prof. 2018;15:30; doi: 10.3352/jeehp.2018.15.30.
15.
Elvén M, Dean E, Söderlund A. Augmented behavioral medicine competencies in physical therapy students’ clinical reasoning with a targeted curriculum: a final-semester cohort-comparison study. Physiother Theory Pract. 38(12):2007–2018; doi: 10.1080/09593985.2021.1895387.
16.
Montpetit-Tourangeau K, Dyer J-O, Hudon A, Windsor M, Charlin B, Mamede S, et al. Fostering clinical reasoning in physiotherapy: comparing the effects of concept map study and concept map completion after example study in novice and advanced learners. BMC Med Educ. 2017;17(1):238; doi: 10.1186/s12909-017-1076-z.
17.
Roitsch J, Walker ML, Raymer AM. Executive functions and student success during physical therapist education: an exploratory study. J Allied Health. 2021;50(4):107–114.
18.
Trommelen RD, Karpinski A, Chauvin, S. Impact of case-based learning and reflection on clinical reasoning and reflection abilities in physical therapist students. J Phys Ther Educ. 2017;31(1):21–30; doi: 10.1097/00001416-201731010-00006.
19.
Ladyshewsky RK, Richardson J. Impact of peer-coaching on the clinical reasoning of the novice practitioner. Physiother Can. 2004;56(1):15–26; doi: 10.2310/6640.2004.15341.
20.
LaRosa N, Dinsmore DL. The effect of case presentation on student physical therapists’ clinical reasoning hypotheses. Internet J Allied Health Sci Pract. 2021;19(1):1–7.
21.
Yaqoob MF, Khalid Z, Azim ME, Ahsan S, Hassan MF, Naeem A. Perceptions regarding team-based learning among undergraduate physical therapy students. J Pak Med Assoc. 2020;71(1B):1–10; doi: 10.47391/JPMA.1172.
22.
Reed DA, Cook DA, Beckman TJ, Levine RB, Kern DE, Wright SM. Association between funding and quality of published medical education research. J Am M Assoc. 2007;298:1002–1009.
23.
Huhn K, Black L, Jensen GM, Deutsch JE. Tracking change in critical-thinking skills. J Phys Ther Educ. 2013;27(3):26–31; doi: 10.1097/00001416-201307000-00005.
24.
Jessee, M. Pursuing improvement in clinical reasoning: the integrated clinical education theory. J Nurs Educ. 2018;57(1):7–13; doi: 10.3928/01484834-20180102-03.
25.
Definition of integrated clinical education (ICE). American Council of Academic Physical Therapy website. Available 13.10.2017 from: https://acapt.org/docs/default....
26.
Coker, P. Effects of an experiential learning program on the clinical reasoning and critical thinking skills of occupational therapy students. J Allied Health. 2010;39(4):280–286.
27.
Gordon D, Rencic JJ, Lang VJ, Thomas A, Young M, Durning SJ. Advancing the assessment of clinical reasoning across the health professions: definitional and methodologic recommendations. Perspect Med Educ. 2022;11(2):108–114; doi: 10.1007/s40037-022-00701-3.
28.
Cencetti, M. Clinical reasoning in PTA students: a survey of PTA program directors. Internet J Allied Health Sci Pract. 2022;20(2) doi: 10.46743/1540-580X/2022.2172.
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