Title: Promoting Clinical Reasoning in Undergraduate Physical Therapy Education: A
Review of Strategies and Approaches
Juneja H1, Brekke A F2
1,2
Physical Therapy Education, University College Zealand, Denmark
Background: Clinical reasoning (CR) also referred to as “critical thinking” or “decision
making” is being recognized as a core competency of the physical therapy professional at
various levels of practice. However, it is difficult to teach in view of its invisible and tacit
nature. Phenomenal changes in the profession, including the role as a diagnostician have
witnessed aggressive thinking in this area. This has resulted in diverse methods and
strategies to transfer reasoning skills effectively to students. Awareness about
recommended pedagogical techniques to enhance clinical reasoning skills can significantly
influence the educator’s choice of methods within and beyond the classroom teaching. It is
imperative that physical therapy educators utilize innovative pedagogical methods to
facilitate learning of reasoning skills in students.
Purpose: The review is an attempt to highlight and discuss selected pedagogical
strategies and approaches to enhance clinical reasoning skills in undergraduate physical
therapy education. It also emphasizes the approaches utilized by clinical instructors and
students themselves to facilitate the reasoning process.
Methods: A literature search was conducted using the key words “clinical reasoning”,
“critical thinking“, “decision making“, “teaching clinical reasoning”, “promoting clinical
reasoning” and “reflective practice”. The databases PUBMED, CINAHL, PEDro, ERIC
were used and direct search through google scholar was also performed for popular
literature on the subject. English literature relevant to the teaching and promotion of clinical
reasoning in education programs was shortlisted for the review. References of pertinent
literature were scanned to identify further relevant citations.
Results: The review provides a detailed insight into the interwoven nature of pedagogical
techniques to promote clinical reasoning being used by different physical therapy curricula.
Under the broad paradigm of Problem Based Learning (PBL), which is being viewed as the
key shift in educations in the last few years, many other models have been proposed.
Strategies such as case based teaching, blended learning, co-operative learning,
interactive learning, blogging and clinical practise with guided thinking are some of the
important recommended pedagogical methods to enhance reasoning skills. The review
also suggests that there is a huge scope of customization of these techniques to match
different curricula and contexts.
Conclusion(s): To enhance hypothetico-deduction and the pattern recognition skills in
physical therapy students, focused teaching methods and strategies need to be
emphasized and adopted by academicians, clinical educators and of course students. It
is also of utmost importance that evaluation systems of physical therapy programs are
introspected for inclusion of clinical reasoning skills.
Implications: Within the existing curricula frameworks of Physical Therapy programs,
there is a tremendous scope of including innovative pedagogical strategies to augment
clinical reasoning skills in students. It is expected that this review will help to promote the
use of certain facilitatory techniques which have been recommended to improve clinical
reasoning skills amongst students.
Keywords: 1.Clinical reasoning (CR) 2. Problem based learning (PBL) 3.Pedagogical
techniques
Funding acknowledgements: The work did not require funding from internal or external
sources.
Ethics Approval: Ethical approval was not required due to the nature of the work.