Developing a framework for teaching clinical reasoning skills to undergraduate physiotherapy students: A Delphi study

Abstract

Students may find it confusing when methods and principles of clinical reasoning vary in different parts of a curriculum. A consistent framework between laboratory and clinical practice, and across the curriculum should be designed to facilitate student learning. The aim of this study was to identify key elements that academic and teaching staff consider to be important for teaching clinical reasoning to undergraduate physiotherapy students at the University of Otago, New Zealand. Educators (n = 41) involved in Year 2 to 4 teaching for at least one academic year across the School of Physiotherapy’s centres and hubs were invited to participate. A Delphi study was used to reach consensus about principles of clinical reasoning. There was consensus that clinical reasoning is an ongoing, complex and systematic process that is both collaborative and interactive. The World Health Organization International Classification of Function was the model considered most relevant for students to both gather and interpret information from the patient, and to plan and apply management. While students are expected to rely mainly on hypothetico-deductive reasoning systems, pattern recognition may develop with integration of theoretical knowledge and clinical practice. This project enabled physiotherapy educators to share information across their different geographical and contextual areas, and to reach consensus about elements considered important for teaching clinical reasoning to undergraduate students.