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Predicting Physical Therapy Student Clinical Reasoning In Practice Using Aligned Assessments In A Curricular Domain, Joy L. Moulton

Doctor of Education (Ed.D)

Clinical reasoning (CR) is a difficult concept to assess and is a leading cause of failure for outpatient clinical experiences for physical therapy (PT) students (Silberman et al., 2018). The purpose of this study was to determine to what degree didactic assessments of CR could predict CR in clinical practice utilizing Miller’s (1990) pyramid as a conceptual framework. Using a retrospective quantitative exploratory observational design, archived data were collected for graduates in the classes of 2022 and 2023 (N = 84) from a hybrid Doctor of Physical Therapy program. Each assessment pertained to the musculoskeletal domain of PT practice and …

Occupational Therapy Students’ Experiences Of Team-Based Learning: A Multi-Year Study, Bhing-Leet Tan, I-Ling Yeh, Phyllis Liang

Journal of Occupational Therapy Education

Many health sciences disciplines have adopted team-based learning (TBL) as part of their education pedagogy, with studies showing increased classroom participation and learner satisfaction. However, it will be beneficial to explore the learning experiences of occupational therapy students in TBL using a mixed methods approach. In an undergraduate occupational therapy program, students undertook three clinical modules using TBL in years two and three. This study explored their perceptions and experiences of TBL. This was a mixed methods prospective cohort study, during which two cohorts of students from Academic Year (AY) 2016 and AY2017 completed the Team-Based Learning Student Assessment Instrument …

Use Of Case Studies To Promote Critical Thinking In Occupational Therapy Students, Denise D. Allen, Susan Toth-Cohen

Journal of Occupational Therapy Education

Critical thinking is a necessary component of clinical reasoning that should be addressed as part of the graduate curriculum for occupational therapists. For students to apply critical thinking in practice they must also have confidence and minimal anxiety about their abilities. Case-based learning was chosen to address critical thinking skill development, increase confidence, and decrease anxiety. The purpose of this mixed methods pilot study was to evaluate progressively independent engagement with case-based learning on student performance, confidence, and anxiety in applying critical thinking skills in the clinical setting. Critical thinking was measured using a rubric to assess students’ performance in …

Self-Explanation As A Strategy For Supporting The Development Of Diagnostic Reasoning In Medical Students: An Exploratory Study On Knowledge Development, Christian Muhoza-Butoke, Christina St-Onge, Martine Chamberland

Health Professions Education

Purpose: Self-explanation (SE) has been shown to support the development of diagnostic reasoning in medical students. However, no study has documented how SE influences the development of the knowledge that underpins this reasoning. This study was a first step to explore this. More specifically the aim was to compare the use of biomedical and clinical knowledge by medical students who use SE while solving the same clinical cases one week apart. Methods: Fifty-three medical clerks previously took part in a study to determine the impact of combining SE with listening to examples of SE on solving clinical cases one week …

Education In Clinical Reasoning: An Experimental Study On Strategies To Foster Novice Medical Students’ Engagement In Learning Activities, Alexander Linsen, Gijs Elshout, David Pols, Laura Zwaan, Sílvia Mamede

Health Professions Education

Purpose: Clinical reasoning forms the interface between medical knowledge and medical practice. However, it is not clear how to organize education to foster the development of clinical reasoning. This study compared two strategies to teach clinical reasoning. Method: As part of a regular clinical reasoning course 333 students participated in a two-phase experiment. In the learning phase, participants were randomly assigned to either the conventional strategy (CS) or the new strategy (NS). Participants in the CS solved a clinical case using a written description of a patient encounter and individual study. Participants assigned to the NS solved the same case …

The Influence Of Time Pressure And Case Complexity On Physicians' Diagnostic Performance, Dalal A. Alqahtani, Jerome I. Rotgans, Nasr Eldin Ahmed, Ibrahim A. Alalwan, Mohi Eldin M. Magzoub

Health Professions Education

Purpose: Practicing medicine is a cognitively demanding task that consists of the ability to assess the patient, judge the nature of his or her complaints, and make an appropriate diagnosis. A number of factors have the potential to affect the physician's diagnostic performance negatively. Two of these factors are time pressure and case complexity. However, the empirical evidence that supports this negative influence is scant. This study experimentally investigated the effect of time pressure and the complexity of clinical cases on diagnostic accuracy. Method: Thirty-seven senior internal medicine residents participated in this study. These residents were randomly allocated to two …

Self-Explanation, An Instructional Strategy To Foster Clinical Reasoning In Medical Students, Martine Chamberland, Sílvia Mamede

Health Professions Education

Clinical reasoning is a critical and complex skill that medical students have to develop in the course of their training. Although research on medical expertise has successfully examined the different components of that skill, designing educational interventions that support the development of clinical reasoning in students remains a challenge for medical educators. The theory of medical expertise describes how students' medical knowledge develops and is progressively restructured during their training and in particular through clinical exposure to patient problems. Instructional strategies to foster students’ learning from practice with clinical cases are scarce. This article describes the use of self-explanation as …

Clinical Reasoning In First- And Third-Year Physical Therapist Students, Sarah Gilliland

Physical Therapy Faculty Articles and Research

Background and Purpose. The development of clinical reasoning skills is a crucial component of professional physical therapist education. Prior research has described reasoning patterns in novice and expert practitioners, yet little is known about how professional physical therapist (PT) students develop clinical reasoning skills. The purpose of this study was to explore how first-year PT students perform clinical reasoning in comparison to third year PT students in their final semester.

Subjects. A simple random sample of 6 first-year (mean age 23.1 years) and 6 third-year (mean age 27 years) Doctor of Physical Therapy students were recruited.

Methods. …