Student Perception of Integrating the Systematic Clinical Reasoning in Physical Therapy Tool within Problem-Based Learning
Purpose/Hypothesis: Problem-based learning (PBL) is suggested to enhance clinical reasoning among health care trainees. Similarly, the systematic clinical reasoning in physical therapy (SCRIPT) tool is proposed to improve critical thinking skills during orthopedic physical therapy (PT) residency education. Unfortunately, few studies have investigated entry level PT students’ perception of clinical decision-making frameworks such as SCRIPT within PBL, thus neglecting the views of trainees during the promotion of key educational domains. Consequently, the purpose of this study was to (1) determine if entry level PT students perceived SCRIPT integration within PBL to positively influence critical thinking and clinical reasoning development and (2) explore positive perceptions and ways to improve SCRIPT integration in PBL. We hypothesize entry-level PT students will positively perceive integration of SCRIPT into PBL.
Number of Subjects: n=25
Materials and Methods: With IRB approval, 25 second year PT students voluntarily completed a survey design study following a 16-week orthopedic course. The course included PBL groups of six students completing five different orthopedic cases using SCRIPT. The post-course survey entailed four questions on a 5-point Likert scale (strongly disagree=1 to strongly agree=5) and two open ended questions on positive aspects and suggestions to improve the activity. Likert scale questions asked if students perceived SCRIPT within PBL to help (Q1) improve critical thinking skills, (Q2) determine significance of objective findings, (Q3) link objective findings to selected interventions, and (Q4) consider how severity, irritability, nature, stage, and stability of the presentation impacted treatment decisions. Descriptive statistics were utilized for Likert scale questions. Short answer qualitative analysis used an interpretative lens with responses being coded for theme analysis, as well as a repeated process employed until codes collapsed and themes emerged. A peer-check was completed to finalize themes.
Results: Mean scores indicated a positive perception of all Likert scale items (Q1=4.2±0.6, Q2=4.0±0.7, Q3=4.3±0.6, Q4=3.8±0.7), with three of four items between “agree” and “strongly agree”. Two positive themes emerged: ‘an additional opportunity to practice critical thinking skills’ and ‘helped link objective findings to intervention strategies’. One theme emerged regarding a suggestion for improvement: ‘smaller groups when completing the activity’.
Conclusions: SCRIPT’s use within PBL among entry-level PT students shows promise as a positively perceived framework to foster improved clinical decision-making, with trainees citing the value of considering group size upon implementation.
Clinical Relevance: While SCRIPT usage is proposed to enhance clinical reasoning and critical thinking during residency training, this study notes positive student perception within entry-level PT education. Moreover, when paired with PBL, SCRIPT offered a positively perceived framework for the development of critical thinking and clinical reasoning.