Clinical Reasoning: Concept Analysis
Purpose
The complex nature of clinical reasoning and the fact that our understanding of it is still evolving makes it difficult to reach a consensus on how to define or describe clinical reasoning in professional physical therapist education. Survey results of both academic and clinical educators were indicated there is a general lack of agreement not only on how to define or describe clinical reasoning but also about how we teach and assess it (Christensen, Black et al. 2016, Huhn, Black et al. 2016). In order to move forward with research focused on establishing best methods for teaching and assessing clinical reasoning we must have a unified understanding of what clinical reasoning in physical therapy is. Concept analysis can be defined as an activity where concepts, their characteristics and relations to other concepts are clarified (Simmons 2010). Creation of clarity around the concept of clinical reasoning will enable physical therapy educators to move forward in developing competencies and best practices for teaching and assessing clinical reasoning skills.
Methods/Description
This presentation will describe the process of and preliminary findings of a concept analysis of clinical reasoning in physical therapy. Concepts are cognitive in nature and comprised of attributes and expressed in some form and utilized for a common purpose. Concept analysis is similar to a literature review. However a concept analysis is designed to identify, clarify or refine a concept whereas a literature review is designed to synthesize knowledge (Rodgers and Knafl). The approach is inductive in nature as we are seeking to identify what is common across the description of clinical reasoning from the fields of medicine, nursing, dentistry, psychology, pharmacology, veterinary medicine and occupational therapy. The results can be applied and tested and provide groundwork for further investigation.
Results/Outcomes
Scopus was the search engine used for this concept analysis. Initial search terms included: clinical reasoning, critical reasoning, critical thinking, diagnostic reasoning, clinical problem solving, practical reasoning. The search identified top authors and was limited to English and the 1970’s. We included: medicine, nursing, veterinary medicine, dentistry, pharmacology, psychology and health professions. The results represent 20% of the literature related to clinical reasoning in each discipline and include the most frequently cited authors in each field.
Conclusions/Relevance to the conference theme: The Pursuit of Excellence in Physical Therapy Education
Clinical reasoning is a crucial component of entry-level physical therapists education. Gaining clarity and agreement regarding how clinical reasoning is conceptualized is the first step towards developing evidence based teaching practices to support students’ development of clinical reasoning skills. Additionally, it sets the foundation for future focused study on clinical reasoning in physical therapy. I
References
Christensen, N., B. Black, J. Furze, K. Huhn, A. Vendrely and S. F. Wainwright (2016). "Clinical Reasoning: Survey of Teaching Methods, Integration and Assessment In Entry Level Physical Therapist Academic Education." Physical Therapy In review.
Huhn, K., L. Black, N. Christensen, J. Furze, A. Vendrely and S. F. Wainwright (2016). "Clinical Reasoning: Survey of Teaching Methods and Assessment in Entry-Level Physical Therapist Education." Physiotherapy Theory and Practice in review.
Rodgers, B. and K. Knafl Concept Development in Nursing Foundations, Techniques and Applications, Elsevier.
Simmons, B. (2010). Clinical reasoning: Concept analysis. 66.
Higgs J, Jones M, (eds). Clinical Reasoning in the Health Professions. 3rd edition, Elsevier Pub, 2008
Huang G, Newman L, Schwartzstein R. Critical thinking in health professions education: summary and consensus statements of the millennium conference 2011. Teaching and Learning and Medicine. 2014; 26:95-102.
Trowbridge R, Rencic J, Durning S (eds). Teaching Clinical Reasoning. Philadelphia, PA; American College of Physicians. 2015