An Exploration of Clinical Reasoning Curriculum and Assessment in Physical Therapist Education
Purpose/Hypothesis : Clinical reasoning is a highly complex skill that involves cognition, perception, intuition and reflection. Development of clinical reasoning abilities has long been recognized as a critical learning outcome of professional education of physical therapists. To date, a Ògold standardÓ has not been established to guide curriculum design or assessment of clinical reasoning skills. The purpose of this research was to explore how clinical reasoning is currently defined, taught and assessed in the professional education of physical therapists, and provides insight to the current state of affairs in order to focus future work aimed at developing consistent clinical reasoning curriculum guidelines and outcomes measurement methods.Number of Subjects : 80 respondents to dateMaterials/Methods : A 24 question survey was created by the Clinical Reasoning Curricula and Assessment Consortium and distributed electronically to Program Directors of the 207 CAPTE Accredited Physical Therapy programs across the United States and Puerto Rico. Preliminary results from a small (38%) but representative sample of respondents have been analyzed to date. The survey included four key areas of questions: 1) Clinical Reasoning Defined; 2) Curricular Design; 3) Assessment of Self Reflection Skills; and 4) Assessment of Clinical Reasoning Skills.Results : Definition of Clinical Reasoning: All respondents reported incorporating clinical reasoning into their curricula however only 24% of respondents reported they had a common definition of clinical reasoning, and 76% reported that the definition was not consistent within their own curriculum. Curricular Integration of Clinical Reasoning Skills: All respondents reported that their programs integrate clinical reasoning into their curricula and most (87%) reported they make it explicit in their curriculum. 27.5% had a separate course on clinical reasoning and 96% reported they use multiple methods to achieve this integration. Instructor-designed materials are the most commonly employed tools (82%), followed by required (61%) or suggested (55%) articles, and required (12%) or suggested (20%) clinical reasoning texts. Assessment of Clinical Reasoning Skills: Clinical reasoning was assessed using a variety of methods including practical exams (97%), clinical coursework (93%), written examinations (86%), and written assignments (81%).Conclusions : While clinical reasoning is explicitly integrated into the vast majority of programs, clinical reasoning is not consistently defined, taught, or assessed within or between physical therapist education programs.Clinical Relevance : Understanding the variability characterizing the teaching and assessment of clinical reasoning in physical therapist education programs is the first step in directing future work aimed at developing best educational practice guidelines for clinical reasoning curriculum development and assessment methods.