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D. Hess1
1University of the Western Cape, Physiotherapy, Cape Town, South Africa
Background: Clinical reasoning in physiotherapy is characterized as the ability to think and make decisions in a context- dependent manner in order to guide practice actions. This involves the process of making a diagnosis, making decisions on issues related to management, as well as patient interaction as a collaborative effort. Clinical reasoning allows the clinician, and the patient, to develop a more informed understanding of the clinical problem and establish a working relationship, thus allowing the patient’s experience to be integrated into decisions related to the health care provided. Having a good clinical reasoning process allows for more informed decisions and work more efficiently in the work environment. Having a poor clinical reasoning process often leads to mistakes and important pockets of information being overlooked, and therefore having an incorrect diagnosis or management plan for the patient. Therefore, understanding and making connections is key.
Purpose: This data is part representative of a broader PhD study to develop design principles that could guide a physiotherapy curriculum to enhance clinical reasoning in graduating physiotherapists. One of the objectives focused on the exploration and description of the development and process of clinical reasoning in expert physiotherapists. The purpose is therefore to explore the development of clinical reasoning and the clinical reasoning processes used by expert physiotherapists in South Africa with regards to diagnosing and managing patients within the clinical setting.
Methods: Qualitative research methods were employed, data was collected via interviews and the sample population included identified experts in physiotherapy. 8 interviews were conducted. Thematic analysis was employed to analyse the data and trustworthiness improved by using Guba (1981) four constructs of trustworthiness; credibility, transferability, dependability and confirmability.
Results: Eight themes emerged from the data. The development of reasoning and their processes included; being open-minded and always willing to improve, having naturally curious personality, using problem list as a tool, being a lifelong learner, cultivating a practice of reflection, having a sound basic knowledge and foundation, having excellent communication and mentorship within the profession is often overlooked.
Conclusion(s): The themes that have emerged such as cultivating a practice of reflection, using the problem list as a tool, having a sound basic knowledge and foundation as well as mentorship are concepts that can be enhanced in the undergraduate curriculum to attempt to develop clinical reasoning in undergraduate physiotherapy students.
Implications: By understanding the reasoning processes in experts we can assess what strategies are needed to implement at an undergraduate level to develop clinical reasoning. The identified expert strategies could be implemented in educational practices in the undergraduate curriculum.
Funding, acknowledgements: National Research Foundation (NRF)
Keywords: Clinical reasoning, Physiotherapy, Experts
Topic: Education
Did this work require ethics approval? Yes
Institution: University of the Western Cape
Committee: HSSREC
Ethics number: HS17/5/18
All authors, affiliations and abstracts have been published as submitted.
