Brown D1
1Medical University of South Carolina, Department of Health Professions, Charleston, United States
Background: Clinical reasoning is a continuum of learning that occurs throughout the didactic and clinical educational components of the physical therapy (PT) curriculum and is critical to the practice of PT. Clinical reasoning can be defined as the decision-making process used to determine the appropriate examination and treatment interventions.
Purpose: While educators and clinicians will agree that it is important to foster these skills in PT students, there is limited evidence on the best practice, but many authors agree that hands on time with patients is essential. Additionally, the practice of clinical reflection is also an essential component of the clinical reasoning process and can contribute to the development of effective decision making in new therapists.
Methods: The musculoskeletal series is completed during the first four semesters of the doctor of physical therapy program at the Medical University of South Carolina. During the 5th semester, the PT students participate in Clinical Practicum (CP) 1. The faculty identified a specific need to improve student clinical reasoning skills prior to CP1. Faculty developed class assignments that are embedded throughout the series to foster clinical reasoning skills. These assignments consist of classroom case presentations with audience response systems; use of educational technology to deliver patient cases; and assignments with patients at the MUSC student run free clinic. While the students are on CP1, two assignments, 'planning the objective' and a 'retrospective case study', are completed to further develop clinical reasoning skills in the clinic. (Examples of these assignments will be available.) Finally, upon return to campus, students present their patient cases assignments to their peers, underclassman and faculty.
Results: In one study related to the online lesson we found on the Self-Assessment of Clinical Reasoning and Reflection (SACRR) the students demonstrated a statistically significant change in 15 of the 26 items on the students' clinical reasoning. On an instructor developed survey, we found that 72% of the students found the assignment enhanced their confidence in the examination and treatment of a patient. In another study, we found that students who participated in the student run free clinic and participated in a related class activities had statistically significant changes in the SACRR. Finally, the case presentations on the clinical reasoning assignments from CP1 demonstrate the students evolution in the clinical reasoning process.
Conclusion(s): The development of clinical reasoning is a process that begins early in the curriculum at MUSC and is embedded throughout the musculoskeletal series and the first clinical practicum. The use of various assignments, educational technology and patient cases can foster orthopedic clinical reasoning skills in the physical therapist student.
Implications: Students during their first fulltime practicum were able to enhance their competence and confidence in the examination and treatment of an orthopedic patient due to participating in this assignment.
Keywords: Clinical reasoning
Funding acknowledgements: There was no external source of funding for this project.
Purpose: While educators and clinicians will agree that it is important to foster these skills in PT students, there is limited evidence on the best practice, but many authors agree that hands on time with patients is essential. Additionally, the practice of clinical reflection is also an essential component of the clinical reasoning process and can contribute to the development of effective decision making in new therapists.
Methods: The musculoskeletal series is completed during the first four semesters of the doctor of physical therapy program at the Medical University of South Carolina. During the 5th semester, the PT students participate in Clinical Practicum (CP) 1. The faculty identified a specific need to improve student clinical reasoning skills prior to CP1. Faculty developed class assignments that are embedded throughout the series to foster clinical reasoning skills. These assignments consist of classroom case presentations with audience response systems; use of educational technology to deliver patient cases; and assignments with patients at the MUSC student run free clinic. While the students are on CP1, two assignments, 'planning the objective' and a 'retrospective case study', are completed to further develop clinical reasoning skills in the clinic. (Examples of these assignments will be available.) Finally, upon return to campus, students present their patient cases assignments to their peers, underclassman and faculty.
Results: In one study related to the online lesson we found on the Self-Assessment of Clinical Reasoning and Reflection (SACRR) the students demonstrated a statistically significant change in 15 of the 26 items on the students' clinical reasoning. On an instructor developed survey, we found that 72% of the students found the assignment enhanced their confidence in the examination and treatment of a patient. In another study, we found that students who participated in the student run free clinic and participated in a related class activities had statistically significant changes in the SACRR. Finally, the case presentations on the clinical reasoning assignments from CP1 demonstrate the students evolution in the clinical reasoning process.
Conclusion(s): The development of clinical reasoning is a process that begins early in the curriculum at MUSC and is embedded throughout the musculoskeletal series and the first clinical practicum. The use of various assignments, educational technology and patient cases can foster orthopedic clinical reasoning skills in the physical therapist student.
Implications: Students during their first fulltime practicum were able to enhance their competence and confidence in the examination and treatment of an orthopedic patient due to participating in this assignment.
Keywords: Clinical reasoning
Funding acknowledgements: There was no external source of funding for this project.
Topic: Education: clinical; Musculoskeletal
Ethics approval required: No
Institution: Medical University of South Carolina
Ethics committee: N/A
Reason not required: This project describes an innovative way in which established methods have been adapted to meet the changing needs of practice and education
All authors, affiliations and abstracts have been published as submitted.
