Clinical reasoning in musculoskeletal practice: students' conceptualizations.

BACKGROUND: Qualitative research on physical therapist students' conceptualizations of clinical reasoning (CR) is sparse. OBJECTIVES: The purpose of this study was to explore CR from students' perspectives. DESIGN: For this study, a qualitative, cross-sectional design was used. METHODS: Thirty-one s...

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Publicado en:Physical Therapy Vol. 89; no. 5; pp. 430 - 443
Autores principales: Hendrick P, Bond C, Duncan E, Hale L
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA May2009
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2009
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      pub: Oxford University Press / USA
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        atl: Clinical reasoning in musculoskeletal practice: students' conceptualizations.
      aug:
        au:
          Hendrick P
          Bond C
          Duncan E
          Hale L
        affil: Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, PO Box 56, Dunedin, New Zealand. paul.hendrick@otago.ac.nz
      sug:
        subj:
          Critical Thinking
          Education, Competency-Based
          Knowledge
          Students, Physical Therapy
          Clinical Competence
          Cross Sectional Studies
          Curriculum
          Education, Physical Therapy New Zealand
          Funding Source
          Interview Guides
          New Zealand
          Problem-Based Learning
          Qualitative Studies
          Questionnaires
          Random Sample
          Human
      ab: BACKGROUND: Qualitative research on physical therapist students' conceptualizations of clinical reasoning (CR) is sparse. OBJECTIVES: The purpose of this study was to explore CR from students' perspectives. DESIGN: For this study, a qualitative, cross-sectional design was used. METHODS: Thirty-one students were randomly selected from years 2, 3, and 4 of an undergraduate physical therapist program in New Zealand. Students were interviewed about their understanding of CR and how they used it in practice in a recent musculoskeletal placement. Interviews were recorded and transcribed verbatim. A 3-stage analysis included the categorization of students' conceptualizations on the basis of the meaning and the structure of each experience and the identification of cross-category themes. RESULTS: Five qualitatively different categories were identified: A--applying knowledge and experience to the problem, patient, or situation; B--analyzing and reanalyzing to deduce the problem and treatment; C--rationalizing or justifying what and why; D-combining knowledge to reach a conclusion; and E--problem solving and pattern building. Cross-category analysis revealed 5 general themes: forms of CR, spatiotemporal aspects, the degree of focus on the patient, attributions of confidence, and the role of clinical experience. CONCLUSIONS: Categories formed a continuum of CR from less to more sophistication and complexity. Students were distributed evenly across categories, except for category E, which included only students from years 3 and 4. Each category comprised a logical, coherent experiential field. The general themes as critical dimensions suggest a new way of exploring CR and suggest a possible pathway of development, but further research is required. These findings have implications for teaching and the development of physical therapy curricula.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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