S. Ramakrishnan1,2, A. Abukari3
1Coventry University, Coventry, United Kingdom, 2Fatima College of Health Sciences, Physiotherapy, Al Ain, United Arab Emirates, 3The British University in Dubai, Faculty of Education, Dubai, United Arab Emirates
Background: Evidence indicates that clinical reasoning skills determine the quality of patient care however, the process by which physiotherapists achieve expertise in clinical reasoning is yet to be clearly established due to limited knowledge of the factors influencing the development of clinical reasoning skills among physiotherapy students. In the absence of concrete evidence related to clinical reasoning, there is often weak and inconsistent therapeutic goal setting and communication based on clinical diagnosis. Research shows that clinical reasoning constitutes an important foundation for independent and effective health professional practice, however, helping students to develop clinical reasoning skills is found to be challenging to both educators and students.
Purpose: The primary objective of the study was to empirically investigate the factors that affect the development of clinical reasoning skills among physiotherapy students in practice placements. It was assumed that there are several factors may influence the development of clinical reasoning skills for physiotherapy students in practice placements. Some of these factors may act as facilitators and ease the process of clinical reasoning development. Conversely, the other factors may act as barriers and make it difficult for the students to acquire clinical reasoning skills in practice placements. Therefore, the aim of the study was to explore participants lived experience in practice placements to identify the factors in practice placements that either enhances or hinders the development of clinical reasoning skills for physiotherapy students.
Methods: This research study used mixed-methods design. Quantitative study used survey research to collect data from students before and after the 12 weeks of clinical placements. The questionnaire consisted of two parts: the first is the demographic part which was developed by the researchers and the second is the Self-Assessment of Clinical Reasoning and Reflection (SACRR) questionnaire adopted from (Royeen, Mu, Barrett, & Luebben, 2001). The qualitative study collected data through individual interviews from both clinical educators and students. Purposive sampling was used to recruit the participants conveniently. This study selected all students (n=34) attending the full time clinical placements and their clinical educators (n=26). All the students were females and the clinical educators represented both sexes. First language of participants varied, and all students were Arabic speakers, but clinical educators had mixed linguistic background depending on their nationality.
Results: Findings from quantitative and qualitative data show that the main factors that affect the development of clinical reasoning skills of physiotherapy students in practice placements are related to students’ knowledge, skills and experience such as theory-practice gap, open-mindedness, withstanding uncertainties, problem-solving, decision-making and reflective practice.
Conclusion(s): The main factors that affect the development of clinical reasoning skills of physiotherapy students in practice placements are related to students’ knowledge, skills and experience such as theory-practice gap, open-mindedness, withstanding uncertainties, problem-solving, decision-making and reflective practice.
Implications: The findings of this study can inform education practitioners and providers, particularly in the health sector, in their drive to develop clinical reasoning skills in trainees and practitioners. Further research is needed to develop context specific clinical education strategies to strengthen the physiotherapy clinical education.
Funding, acknowledgements: No funding received for this study. This study was conducted as a part of PhD Thesis which was fully self-funded.
Keywords: Clinical reasoning skills, Practice placement, Physiotherapy
Topic: Education: clinical
Did this work require ethics approval? Yes
Institution: Fatima College of Health Sciences
Committee: Research Ethics Committee
Ethics number: FCHS/RECA/003/2016-17
All authors, affiliations and abstracts have been published as submitted.
